Summer 2018

with

Open arms

9th Annual Golf Tournament Trust and Support The Value of Advocacy

Summer 2018

NOR C A L

G R O U P

O F

CO M PA N IES

MEDICAL PROFESSIONAL LIABILITY INSURANCE

PHYSICIANS DESERVE Offering top-tier educational resources essential to reducing risk, providing versatile coverage solutions to safeguard your practice and serving as a staunch advocate on behalf of the medical community.

2

SAN JOAQUIN PHYSICIAN

Talk to an agent/broker about NORCAL Mutual today.

SUMMER 2018

VOLUME 66, NUMBER 2 • JUNE 2018

16 20 27 32 40 44 SUMMER 2018

{FEATURES}

{DEPARTMENTS}

9TH ANNUAL GOLF TOURNAMENT

48 IN THE NEWS

TRUST AND SUPPORT

Young Physician Award Recipient, Dr. Cyrus Buhari

THE VALUE OF ADVOCACY WITH OPEN ARMS

Lifetime Achievement Award Recipient, Dr. Jerold Yecies

New faces and Announcements

54 PRACTICE MANAGEMENT:

Committed to Improving Quality Health Care

56 PUBLIC HEALTH

Shutoff Protection for Life-Saving Equipment

58 NEW MEMBERS 60 IN MEMORIAM

TOP 10 REASONS TO BE A MEMBER NO ON AB 3087

SAN JOAQUIN PHYSICIAN

3

PRESIDENT R. Grant Mellor, MD PAST-PRESIDENT Kwabena Adubofour, MD SECRETARY-TREASURER Dan Vongtama, MD BOARD MEMBERS Kismet Baldwin, MD, Hyma Jasti, MD, Mohsen Saadat, DO, Clyde Wong, MD, Peter Garbeff, MD, Sanjay Marwaha, MD, Ramin Manshadi, MD, Benjamin Morrison, MD, Richelle Marasigan, DO, Aliya Gessling, MD

MEDICAL SOCIETY STAFF EXECUTIVE DIRECTOR Lisa Richmond MEMBERSHIP COORDINATOR Jessica Peluso

SAN JOAQUIN PHYSICIAN MAGAZINE EDITOR Lisa Richmond EDITORIAL COMMITTEE Grant Mellor MD, Lisa Richmond MANAGING EDITOR Lisa Richmond

COMMITTEE CHAIRPERSONS DECISION MEDICINE Kwabena Adubofour, MD CMA AFFAIRS COMMITTEE Larry Frank, MD

CREATIVE DIRECTOR Sherry Lavone Design CONTRIBUTING WRITERS R. Grant Mellor, MD, James Noonan, Kismet Baldwin, MD, Justine Marcus

PUBLIC HEALTH TBD SCHOLARSHIP LOAN FUND Matthew Wetstein, PhD

THE SAN JOAQUIN PHYSICIAN MAGAZINE is produced by the San Joaquin Medical Society

CMA HOUSE OF DELEGATES REPRESENTATIVES Robin Wong, MD, Lawrence R. Frank, MD, James R. Halderman, MD, Grant Mellor, MD,

SUGGESTIONS, story ideas are welcome and will be reviewed by the Editorial Committee.

Kwabena Adubofour, MD, Raissa Hill, DO, Ramin Manshadi, MD

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 E-mail Address: lisa@sjcms.org MEDICAL SOCIETY OFFICE HOURS: Monday through Friday 9:00am to 5:00pm Closed for Lunch between 12pm-1pm

4

SAN JOAQUIN PHYSICIAN

SUMMER 2018

Anterior Hip Replacement

Move at the Speed of Life.

ALIGN WITH THE BEST

Our premier anterior hip specialist is board-certified orthopedic surgeon Dr. Thomas McKenzie, who converted to the anterior total hip replacement approach in 2013.

Dr. McKenzie is a Lodi local, offering our community comprehensive orthopedic surgical and sports medicine solutions.

SUMMER 2018

If your patients are in need of hip replacement, then the anterior method may be the best answer. This minimally invasive surgery utilizes advanced technology and a non-traditional approach, enabling the surgeon to access the hip joint from the front rather than from the side or back, without cutting major muscles.

Patients who have this procedure enjoy a shorter hospital stay, better range of motion and find that in the recovery process, the hip precautions outlined for traditional hip replacement are unnecessary.

To refer a patient candidate for anterior hip surgery, please call our nurse navigator at 209-210-4229 today.

SAN JOAQUIN PHYSICIAN

5

6

SAN JOAQUIN PHYSICIAN

SUMMER 2018

SUMMER 2018

SAN JOAQUIN PHYSICIAN

7

EXECUTIVE DIRECTOR’S REPORT

STRONGER TOGETHER Good news! As a follow-up to my last article regarding the Sheriff-Coroner’s office and resignations of two SJMS members, the County Administrator Monica Nino hired expert Forensic Pathologist, Dr. Roger Mitchell to conduct an audit of the current Coroners Department and provide a recommendation. The comprehensive report cited outdated equipment and technology, lack of training and supervision and no health and safety program for the Morgue and Medical Technician staff. Additionally, Coroner and Patrol Deputies also had limited training and lack of continuing education. The office had never been accredited by an outside agency.

LISA RICHMOND

In his report and in person at the April 24, 2018 Board of Supervisors meeting, Dr. Mitchell recommended that the “San Joaquin County Coroner’s Office must adopt a new structure to properly serve the citizens of San Joaquin County. The organizational structure must ensure that the individuals with the most knowledge and experience in conducting medicolegal death investigations provide the ultimate management and leadership for the office. The office must be and appear to be independent of law enforcement, particularly when investigating deaths in the custody of law enforcement or while in jail/prison. This requires a complete shift towards a Medical Examiner’s System.”

The Board ultimately voted 5-0 to separate the offices. Kudos to our physician leadership for understanding the importance of protecting physician independence and the potential consequences of keeping the current system on physician recruitment to our community. A HUGE thank you to the physicians, alliance members and community partners who sent letters, emails and attended the meetings to speak to the issue. I strongly believe that the without the engagement of SJMS and CMA, the outcome would have been much different.

This is a big win for organized medicine! The creation of the Medical Examiner’s office, with physician leaders at the helm, will bring many exciting opportunities for physician training and research to our community that were impossible under the antiquated Sheriff-Coroner System.

While we were busy working on this issue locally, the California Medical Association has been fighting to defeat AB3087, which is dangerous and irresponsible price-fixing legislation that would increase patient out-of-pocket costs, create state-sanctioned rationing of health care for all Californians and force physicians out of state or into early retirement. As of the writing of this article, the Bill has passed the Assembly Health Committee and is currently in the Appropriations Committee awaiting a hearing date. Please visit actnow.io/pricefixing to learn more and to take action!

Finally, we hope that you will join us as we honor this year’s Young Physician and Lifetime Achievement Award recipients, Cyrus Buhari, DO and Jerold Yecies, MD on Sunday, June 10 at Stockton Golf & Country Club. We know you will enjoy reading the enclosed features on each of these wonderful physicians!

Best Wishes,

Lisa Richmond

8

SAN JOAQUIN PHYSICIAN

SUMMER 2018

SUMMER 2018

SAN JOAQUIN PHYSICIAN

9

WORLD-CL ASS CARDIAC CARE IN THE HEART OF THE CENTR AL VALLEY

The Stanford Cardiac Surgery Program at Dameron Hospital has partnered with Stanford Health Care and the Stanford School of Medicine to establish a joint cardiothoracic surgery program to enhance its quality of care and the overall patient care experience. Led by Dr. Eric Keyser, an experienced cardiothoracic surgeon and faculty member of Stanford’s Cardiothoracic Surger y Department, this program offers an opportunity for patients with heart and lung disease to receive the highest quality of care available in our community.

DR. ERIC KEYSER, MD

“It makes perfect sense to create a presence in the Central Valley with Dameron. It’s an outstanding hospital with a dedicated staff and a great practice environment for our cardiothoracic surgery program. This new program will enhance the standard of surgical care available in the community and leverages the best of what Stanford Health Care and Dameron bring to the table.”

– Dr. Joseph Woo, MD Cardiothoracic Surgeon and Chairman of Stanford University School of Medicine’s Cardiothoracic Surgery Department

A N E X T R AO R D I N A RY PA RT N ER S H I P 525 West Acacia Street, Stockton, CA 95203 209-944-5550 DameronHospital.org 10

SAN JOAQUIN PHYSICIAN

SUMMER 2018

A message from our President > R. Grant Mellor, MD

Special Days

ABOUT THE AUTHOR ­ R. Grant Mellor, MD- Pediatrician and Chief of Professional Development, Central Valley Service Area, The Permanente Medical Group and current President of the San Joaquin Medical Society

SUMMER 2018

There are the special days in one’s life: the day you graduate, the day you get married, or the day your child is born. One of the best days is the day your child gets accepted to medical school! My daughter Xochitl was fortunate enough to get accepted to Case Western Reserve University School of Medicine in Cleveland, where she will start in July. She follows her older brother Joshua (Albany Medical College, class of 2017), who is finishing his first year of pediatric residency, and of course her father (MCP/Hahnemann class of 2000).

Each of us took a different path to med school. In my case, I discovered I wanted to be a doctor when I was 33 years old, after having taught in public schools for nearly a decade. I was fortunate to learn about Bryn Mawr College’s post-baccalaureate program, which offered me preadmission to med school pending successful completion of course work and good MCAT scores.

Thus, my wife Sara and I set off for Philadelphia from Coalinga, California with a 4-year-old (Josh), a 2-year-old (Xochitl), and a 2-month-old (Matthew).

Josh grew up watching his dad go to med school, through residency, and start his first practice in Iowa. By his sophomore year of high school, he knew wanted to pursue medicine, so he applied to BS/MD programs as a high school senior. He was accepted into the Sienna College/Albany Medical College eight-year program. After doing well in Sienna, he was automatically admitted to med school. He had no application, no interview, and no MCAT! Xochitl chose to take the harder road. She studied mechanical engineering, and seemed set on engineering as a career, until she took a medical devices design class which piqued her interest in medicine. By the time she graduated,

SAN JOAQUIN PHYSICIAN

11

A message from our President > R. Grant Mellor, MD

she knew she wanted to be a doctor. But what to do? She had taken none of the pre-med requisites (except math and physics). Once again, Bryn Mawr’s post-bac program offered a solution. Unlike me, however, she chose not to apply to a linkage program. Thus, she became the first Mellor to slog through the traditional application process.

As my daughter can attest, this “front door” approach to medical school is laborious, time consuming, and expensive. The initial AMCAS application process is lengthy and must be completed with great care. It is common for a student to apply to 20 to 30 schools now. If a student is fortunate, the secondary applications arrive (at $100 apiece) and the real application work begins, as each school requires its own essays. Some students plan to take a month off just to complete the secondary applications, as it’s crucial to submit them as soon as possible. The first students to return their secondary applications are first in line for interviews, which is especially important as many

12

SAN JOAQUIN PHYSICIAN

schools have a rolling admission policy. If all goes well, the student is invited to interview. This requires a heavy investment in travel, time, and preparation. Applicants must prepare for the “Multiple Mini Interview” format, as well as the traditional one-on-one meeting. When the letter of acceptance finally comes, the student will typically have spent countless hours and more than $10,000 on the application process.

As you know, we’re starting a new group within the SJMS called “Bridge to Medicine.” The purpose is to help guide local students through the complex preparation and application process. Now that you know my family’s medical school stories, you can understand why I’m a proponent of the “side-door” admissions: BS/MD programs and post-bac linkage programs. Whatever route they take, we aim to help students through the process, and watch them return home to the Central Valley to live and practice.

SUMMER 2018

Strong community partnerships lead to happier, healthier people

Celebrate Health Partnering today for a healthier tomorrow

With nearly 350,000 members and growing, Health Plan of San Joaquin continues to build relationships with health care providers, resource agencies, and local businesses to deliver on our mission to improve wellness throughout the communities we serve.

SUMMER 2018

SAN JOAQUIN PHYSICIAN

13

MANTECA SURGERY CENTER

SURGICAL PROCEDURES DENTAL PROCEDURES • INFUSION THERAPY • PAIN PROCEDURES • •

adio frequency ablations

• PLASTIC SURGERY • • • • • • EYE SURGERY • • • • •

lepharoplasty row lifts

co

1134 Norman Dr. Manteca, CA 95336 |

surgery

-

-

DoctorsManteca.com 14

SAN JOAQUIN PHYSICIAN

SUMMER 2018

SUMMER 2018

SAN JOAQUIN PHYSICIAN

15

The

9TH ANNUAL GOLF TOURNAMENT

BY GEORGE KHOURY, MD

The 9th annual SJMS Golf Tournament benefitting The First Tee of San Joaquin and SJMS’s Decision Medicine program was held on Sunday, April 29 at the beautiful Brookside Country Club. This annual event is 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 day started with a pregame barbeque lunch and Putting Contest. Despite the wind, golfers enjoyed playing on the perfectly manicured greens using a simple scramble format and ended with a delicious dinner and many happy raffle prize winners!

Our energetic, fully engaged committee worked hard to bring in 86 golfers, plentiful raffle baskets, as well as a grand door prize of $1000 gift certificate donated by 209 Furniture! A special shout out to our Raffle Queen extraordinaire, Karin Heath for all her hard work gathering so many prizes! We would like to thank everyone who participated in and sponsored this event and are excited to announce that we raised $4700 to benefit The First Tee and $6000 for Decision Medicine.

18

SAN JOAQUIN PHYSICIAN

SUMMER 2018

WINNERS FIRST PLACE: Jim Nesbit Justin Holcomb Alan Corey Ryan Winther

MOST HONEST: Jeanne Hoffman Monica Harmon Laura Maupin Kohana Martz

SPONSORS 209 Furniture Dameron Hospital RadNet, Inc Alpine Orthopaedic Medical Group American Hearing Aids BAC Community Bank Darren Primack, MD Dignity Health Medical Group Lawrence Frank, MD Oak Valley Community Bank

CLOSET TO THE PIN: Rich Howarth Jeanne Hoffman

LONGEST DRIVE: Seren Moreno Karin Heath

PUTTING CONTEST WINNER: Kwabena Adubofour, MD

SUMMER 2018

GOLF TOURNAMENT COMMITTEE: George Khoury, MD Kwabena Adubofour, MD George Herron, MD Prasad Dighe, MD Karin Heath Karen Amestoy Cathy Ghan Lisa Richmond Donald Miller

SAN JOAQUIN PHYSICIAN

19

20

SAN JOAQUIN PHYSICIAN

SUMMER 2018

Trust& Support BY: JAMES NOONAN

“TO BE ANYONE’S

DOCTOR IS A

PRECIOUS THING, BUT

TO BE SOMEONE’S

HEART DOCTOR IS AN

INCREDIBLY INTIMATE RELATIONSHIP. THE

TRUST NEEDS TO BE

THERE COMPLETELY.”

In the eyes of Dr. Cyrus Buhari, the successful practice of medicine is a complex formula, one that requires its practitioners to find a delicate balance of the seemingly infinite number of factors that go into the day-to-day delivery of care.

Amidst all of these, however, are two key elements – trust and support – things that, as one of the region’s leading cardiologists, Buhari has become intimately familiar with over the course of his young career. By embracing these elements, and using them to help elevate Stockton’s cardiac care to what he describes as “state of the art,” Buhari’s promising career has landed him the honor of the San Joaquin Medical Society’s “Young Physician” award in 2018.

When explaining the role of these two elements, and the need for their presence when delivering care, “trust” may seem obvious.

“To be anyone’s doctor is a precious thing,” Buhari said,” but to be someone’s heart doctor is an incredibly intimate relationship. The trust needs to be there completely.” >>

SUMMER 2018

SAN JOAQUIN PHYSICIAN

21

22

SAN JOAQUIN PHYSICIAN

SUMMER 2018

“THERE WAS THIS

SENSE OF AN

IMMEDIATE, AND

DIRECT, RESULT. YOU

FIX SOMETHING, AND THE PATIENT’S PAIN

IS BETTER. YOU FIX SOMETHING, AND

THE PATIENT’S LIFE IS

SAVED.”

SUMMER 2018

That same sense of gravity that characterizes virtually every medical decision surrounding matters of the heart, one that so often translates a direct result in the patient’s life when care is delivered successfully, is of the things that drew Buhari to medicine, and cardiology, in the first place. As a child, Buhari watched his father, and fellow cardiologist, Dr. Fram Buhari, have a tremendous impact on the lives of his patients. At the same time, this experience allowed him to be gradually introduced to a field in which technological advancements seem to move at light-speed, allowing one generation to be treated with methods and advancements that would have seemed unthinkable only years earlier.

“There was this sense of an immediate, and direct, result. You fix something, and the patient’s pain is better. You fix something, and the patient’s life is saved,” Buhari said.

“At the same time, the advances in technology are seemingly exponential, and there’s so much more to come.”

One such advancement has allowed Buhari to place his personal stamp on the field of interventional cardiology in northern California and the Central Valley at an early age.

Since returning to Stockton after his postgraduate training in 2013, Buhari has been at the leading edge of technological advancements, particularly those geared toward patients who would be considered high-risk for more traditional treatments.

In 2016, together with a team that included Dr. James Morrissey, Dr. Richard Waters and Dr. Amod Tendulkar, Buhari performed the first transcatheter aortic valve replacement in Stockton’s history. A year later, he, along with his father, placed the first “leadless” pacemaker, a device no larger than a paperclip that is inserted into the heart through the femoral artery and allows patients to bypass the lengthy recovery times and bulky aftermath of a traditional pacemaker.

SAN JOAQUIN PHYSICIAN

23

Since the first installation, Buhari has gone on to be recognized as an expert implanter of the device, and now regularly trains cardiologist from around the country in the procedure.

“This is a tried and true procedure. At the end, the patient has almost nothing in the way of scarring. You would never know it’s there,” Buhari said. “There’s almost no recovery time at all.”

While these advancements, and the ability to transform patients lives that they provide, illustrate why patients are willing to place their trust in the hands of physicians, Buhari notes that there is also an obligation for physicians practice in such a way that merits said trust.

“In the physician-patient relationship, the physician has all of the power,” he said, noting that, in order to protect the patient, and preserve that all-important trust, there needs to be a level of oversite placed upon medical care in our society.

“WHEN I FIRST HEARD ABOUT THIS AWARD, I IMMEDIATELY THOUGHT OF TEN PEOPLE WHO WERE MORE DESERVING. WE ALL OPERATE IN A

MEDICAL COMMUNITY, AND NONE OF WHAT I DO IS DONE IN VACUUM. AS A CARDIOLOGIST, WE RELY ON THIS COMMUNITY. WITHOUT A PATIENT’S

PRIMARY CARE PROVIDER, OR NURSES, NONE OF THIS CAN BE ACHIEVED. IT’S THIS COMMUNITY THAT HAS ALLOWED ME TO DO WHAT I DO, AND IT’S THESE INTERACTIONS THAT HELP OUR PATIENT’S OUTCOMES.”

There feelings are what motivated Buhari to apply for an appointment from Gov. Jerry Brown to the Osteopathic Medical Board of California, the entity which is responsible for licensing osteopathic physicians and surgeons, as well as investigating and reviewing consumer complaints that may arise.

“The purpose of the board is really to protect the public,” he said. “It’s been an eye-opening experience, but it comes with a heavy burden, knowing that your decisions could impact someone’s ability to practice medicine.”

For as much as trust factors into how he practices medicine, that second element – support – plays an equally important role in Buhari’s success. From the onset of his career, it was the support and urging of his father that helped him launch his career as a physician.

“My initial run at medical school, I didn’t get in,” he said, noting that it was only after he pursued a master’s in engineering that he was eventually nudged back toward the field. “My father pushed me back a little bit, and that ultimately saw me being accepted to an osteopathic medical school in southern California.”

Today, that support frames virtually every accomplishment that has come in Buhari’s young, but decorated career.

“When I first heard about this award, I immediately thought of ten people who were more deserving. We all operate in a medical community, and none of what I do is done in vacuum,” he said. “As a cardiologist, we rely on this community. Without a patient’s primary care provider, or nurses, none of this can be achieved. It’s this community that has allowed me to do what I do, and it’s these interactions that help our patient’s outcomes.”

24

SAN JOAQUIN PHYSICIAN

SUMMER 2018

SUMMER 2018

SAN JOAQUIN PHYSICIAN

25

26

SAN JOAQUIN PHYSICIAN

SUMMER 2018

The Value

of

ADVOCACY Dear Health Care Professional, This report details the California Medical Association’s (CMA) efforts, on your behalf, to increase practice profitability and save physician practices from bad bills. This year CMA has successfully:

PREVENTED RAISES IN YOUR OPERATIONAL COSTS DECREASED YOUR PROFESSIONAL LIABILITY BLOCKED ATTEMPTS TO SADDLE YOU WITH MORE ADMINISTRATIVE BURDENS INCREASED ACCESS TO CARE FOR YOUR PATIENTS

CMA is one of the most influential stakeholders in the development and implementation of health policy. Our past, present and future success is rooted in one principle: California’s physicians are stronger when we stand together.

With over 80 years of combined experience in Sacramento politics, our team is constantly monitoring legislative threats to the practice of medicine, and working to ensure that bad bills don’t become bad medicine.

The bills in this report were introduced last year, the first of a two-year legislative session. This means they could possibly move forward or get re-introduced this year. CMA will continue to keep you engaged and informed on these important matters that could have a profound impact on your practice.

SUMMER 2018

To join this fight and stay informed on issues critical to the practice of medicine, please contact us at 800.786.4262 You can also receive regular updates by SAN JOAQUIN PHYSICIAN 27 subscribing to our free biweekly Newswire at www.cmanet.org/newsletters.

Prevented Administrative Burdens, Lowered Operational Costs and Increased Profitability Recent studies have suggested that physicians spend twice as much time completing administrative tasks as they do seeing patients. This is unacceptable and negatively affects delivery of care. CMA aims to lessen or streamline the administrative requirements placed on physicians so they can spend more time with patients, which improves health outcomes, increases access and increases practice profitability.

AB 40 (Santiago): CURES database: health information technology system Obtained amendments to remove the Department of Justice’s ability to influence the electronic health record (EHR) vendor market by establishing a narrow vendor list of EHRs allowed to interface with the Controlled Substance Utilization Review and Evaluation System (CURES), and unilaterality dictating the terms of being able to interface.

AB 120 (Ting): Proposition 56 tobacco tax funds Appropriates Proposition 56 funds to the Department of Health Care Services (DHCS) and contains language allocating over $700 million ($325 million plus the federal match) in funding to physicians. Additional provisional language states that provider payments may be adjusted up to $800 million in the 2018-19 fiscal year. The bill was signed by the Governor in June as part of the Budget Act of 2017.

AB 221 (Gray): Workers’ compensation Defeated this workers’ compensation legislation that would have broadly limited payments to physicians for treatment provided to workers suffering from occupational cumulative trauma injuries.

AB 387 (Thurmond): Minimum wage: health professionals: interns For the purposes of paying minimum wage, AB 387 expanded the definition of employer. CMA obtained amendments to mitigate the impact of the bill on physician practices by excluding all practices. The bill was ultimately defeated in the Assembly.

AB 700 (Jones-Sawyer): Public health: alcoholism or drug abuse recovery Stopped this measure that would have required physicians

28

SAN JOAQUIN PHYSICIAN

who provide substance use disorder services to get certified by DHCS, in addition to their medical license, to provide these services in programs authorized by DHCS. AB 715 (Wood): Workgroup review of opioid pain reliever use and abuse Worked with the author to avoid the creation of duplicative opioid prescribing guidelines, which could have created further confusion and complication around prescribing for chronic pain, narrowing the bill to create a guideline focused exclusively on acute prescribing.

AB 1250 (Jones-Sawyer): Counties: contracts for personal services Obtained amendments that exempt physician services from newly proposed stringent requirements for a county and a third party to enter into a contract to provide government services. AB 1250 was defeated in the Senate.

AB 1312 (Gonzalez Fletcher): Sexual assault victims: rights Obtained amendments to remove a requirement that physicians provide sexual assault victims information about the investigation process, evidentiary process and the rights of victims under criminal laws.

AB 1316 (Quirk): Public health: childhood lead poisoning: prevention Obtained amendments to remove mandatory universal lead screening for all young children.

SB 43 (Hill): Antimicrobial-resistant infection: reporting Obtained amendments to remove a proposed new requirement to list antimicrobial-resistant infections as a cause of death on a person’s death certificate.

SUMMER 2018

SB 199 (Hernandez): The California Health Care Cost, Quality and Equity Atlas Defeated this measure that would have created additional administrative reporting requirements on physician practices.

SB 419 (Portantino): Medical practice: pain management Defeated this measure that would have legislated the practice of medicine by preventing physicians’ ability to appropriately prescribe pain relief medications.

Decreased Liability

ADVOCACY

SB 189 (Bradford): Workers’ compensation fix Effective July 1, 2018, all owners of medical corporations will be able to exempt themselves from workers’ compensation coverage, regardless of percentage ownership, as long as they submit a waiver and have health insurance coverage. This will result in thousands of dollars in premium savings for physician practices.

SB 636 (Bradford): Addiction treatment: advertising: payment Stopped this measure that would have created an additional disciplinary process for physicians providing substance use disorder treatment in DHCS-certified programs.

SB 640 (Hertzberg): Sales tax on services Obtained an exemption for health care services in this proposed services tax legislation.

SB 790 (McGuire): Health care providers: gifts and benefits Defeated this measure that would have unfairly curtailed what expenses a pharmaceutical company could provide a physician, including all those expenses connected to educational seminars, research and events.

Allowing physicians to practice without worrying about the threat of a frivolous lawsuit is one of CMA’s

core tenets. We work to ensure that the trial lawyers’ efforts to increase malpractice liability are beaten

back, and we oppose any effort to increase malpractice premiums. Additionally, we advocate to protect physicians from exposure to new areas of liability.

AB 334 (Cooper): Sexual assault/forensic medical exams Obtained amendments to remove provisions that would have increased physician liability by allowing forensic medical exams on unconscious patients without the patient’s consent.

AB 859 (Eggman): Elders and dependent adults: abuse or neglect Obtained amendments that exempt physicians from a proposed lowering of the standard of review in elder abuse cases from “clear and convincing” to a “preponderance of the evidence” if the court found that a defendant intentionally destroyed evidence. The bill was vetoed by the Governor.

SUMMER 2018

AB 889 (Stone): Secrecy agreements Defeated this measure that would have prevented certain confidentiality agreements from being enforced if keeping the information secret presented a “public health hazard” or “environmental danger.” CMA was concerned about how this law would affect medical malpractice settlement agreements.

AB 1422 (Daly): Workers’ compensation insurance: fraud Obtained amendments to ensure due process protections for workers’ compensation physicians facing certain types of fraud accusations.

SAN JOAQUIN PHYSICIAN

29

MEMBER BENEFITS AND RESOURCES

EMPOWERING PHY SICIANS

CMA gives me the sens e that I am not alone in the fight to protect my patients and ensure that they get the best and highest qu ality of care.

C. Freeman, M.D. Psychiatrist, Member Since 2006

YOUR PRACTICE

YOUR PROFESSION

YOUR VOICE

Access to practice management experts

Valuable tools and resources

Legislative advocacy

Free CME webinars

Legal support

Free reimbursement helpline

News and updates you need to know

Free access to the most comprehensive health law library

WE GET YOU

WE KEEP YOU UP-TO-DATE

WE ARE YOUR VOICE

Direct payor intervention

30

www.cmanet.org/benefits

SAN JOAQUIN PHYSICIAN

SUMMER 2018

ADVOCACY

SB 33 (Dodd): Arbitration agreements Obtained amendments to exempt physician arbitration agreements from a new consumer protection that invalidates arbitration clauses in contracts upon a showing of fraud.

SB 349 (Lara): Chronic dialysis clinics: staffing requirements Obtained amendments to remove liability for medical directors of chronic dialysis clinics related to the proposed staffing requirements.

SB 219 (Wiener): Long-term care facilities: right of residents Obtained amendments to ensure that physician liability would not be increased for those practicing in long-term care facility settings acting in the best medical interests of their patients.

SB 617 (Bradford): Workers’ compensation Stopped workers’ compensation legislation that would have required outreach reports to physicians without sufficient privacy protections.

Access to Care and the Physician-Patient Relationship

CMA defends and advocates to improve physicians’ ability to negotiate fair contracts with payors.

Protecting the economic viability of physician practices ensures that physicians are financially

capable of providing service for patients and protects access to care. Additionally, CMA advocates to protect patient privacy, recognizing that it is an essential component of quality medical care and the patient-physician relationship.

AB 595 (Wood): Health care service plans: mergers and acquisitions Obtained amendments to ensure that the Department of Managed Health Care and the Department of Insurance, for any health care service plan merger, consider the impact on physicians’ ability to secure competitive contracts and patient access to care prior to approving the mergers.

SB 350 (Galgiani): Incarcerated persons: health records Obtained amendments ensuring consistency in medical information privacy laws to limit confusion on when medical information and records can be disclosed. The bill was ultimately defeated in the Senate.

SUMMER 2018

SB 538 (Monning): Hospital contracts Defeated this measure that allowed health plans and health insurers to eliminate the Provider’s Bill of Rights, which helps guard a physician’s ability to negotiate fair and reasonable contracts and break up integrated health care systems.

SAN JOAQUIN PHYSICIAN

31

with

Open arms

Dr. Jerold Yecies and his family were welcomed to Stockton with open arms when they arrived in 1973. Since then, he and Dr. George Bensch have built a practice that has helped tens of thousands of patients from across the Central Valley In California’s Central Valley, sky-high pollen counts, and the seasonal allergies that stem from them, are nothing to sneeze at.

For the hundreds of thousands of people who live here, particularly those with asthma or other respiratory conditions, relief from these seasonal afflictions can be a life-changing event, and the people who deliver such relief can be venerated for generations. It may seem an embellishment, but here in Stockton and its surrounding communities, Dr. Jerold Yecies and his partners have served more than 100,000 patients in the 45-year history of the Allergy, Immunology and Asthma Medical Group. >>

BY JAMES NOONAN

As the first board-certified allergist to practice in San Joaquin County, Yecies arrival in Stockton decades ago has helped make life in allergy country tolerable for thousands, the road that led him here was something of a circuitous one, helping shape his career, and life, in ways that have forever changed the region’s medical community.

“This town has been wonderful to us,” Yecies said, sitting beside his wife Judy in their Stockton home. “From the day we arrived, we were welcomed by this community and it’s been that way ever since.”

Yecies’ journey began in a small steel town in western Pennsylvania, where both he and Judy grew up, fell in love and began their journey through life together.

“We were high school sweethearts,” Judy said.

After graduating high school, Jerry went on to attend Case Western University in Cleveland, Ohio, before heading back to Pennsylvania, where he attended medical school at Philadelphia’s Hahnemann School of Medicine. After completing school, Yecies began a pediatric residency at the Johns Hopkins Hospital in Baltimore, Maryland, starting a typical physician’s post-graduate training that would soon take an unusual turn.

Midway through his post-graduate residency, Yecies was selected for service via the United States military’s doctor draft and was assigned to the U.S. Navy’s Sixth Fleet headquartered in Naples, Italy.

The fleet, by its nature, was active throughout the Mediterranean region, exposing Yecies, a former small-town boy from west Pennsylvania, to a variety of exotic cultures and experiences.

“Everywhere the fleet went, I went,” he said, noting that the he and his wife Judy had one child before leaving for Italy, and would go on to have another two while stationed overseas.

For most budding pediatricians, an assignment on a naval destroyer more than 4,000 miles from home would seem unusual, but when Yecies raised such a question at the beginning of his service, he was met with the sort of blunt, plain-talking response one might expect from the armed forces.

“I told them I was a pediatrician, and they just looked back at me and said, ‘They’re all kids anyway. You’ll be fine,’” he recalls.

In addition to the cultural exposure provided by the Navy, Yecies’ service provided significant opportunities for professional advancement. Working as the Sixth Fleet’s epidemiologist, Yecies was responsible for surveying the water supply at each of the fleet’s

34

SAN JOAQUIN PHYSICIAN

SUMMER 2018

After graduating high school, Jerry went on to attend Case Western University in Cleveland, Ohio, before heading back to Pennsylvania, where he attended medical school at Philadelphia’s Hahnemann School of Medicine

SUMMER 2018

planned stops. During this time, he was also involved in the study and treatment of meningitis, rabies and other communicable diseases, while traveling to port cities in countries such as Turkey, Spain, Greece and Morocco.

“During those years, I developed quite a bit as a physician,” Yecies said. “I also developed a love for travel.”

When his commission in the Navy reached its conclusion, Yecies and his family returned to Johns Hopkins to complete his pediatric residency, an experience he now describes as both grueling and worthwhile. In those days, it was typical for medical residents to work on-call shifts every other night, as well as every other weekend, on top of the already twelve- or thirteen-hour regular scheduled day shifts.

“It was tough, but it was great,” he said, “a wonderful educational opportunity.”

It was after his residency that Yecies career as an allergist began in earnest, when he headed to Denver to complete a fellowship at the nationally-renowned allergy and clinical immunology program

SAN JOAQUIN PHYSICIAN

35

at the National Jewish Hospital. During this time, Yecies worked and trained alongside some of the nation’s top allergists, and met Dr. George Bensch, a North Carolina native, who would go on to be Yecies’ partner for more than four decades.

“We had a wonderful two years in Denver,” he said, noting that staying and practicing in the Rocky Mountain capital would have been difficult, given the incredible resources already available there. “There were so many allergists already set up in Denver, because that program was so good.”

Yecies and Bensch had already decided to go into practice together, and when it came time to plot their next move the pair developed a list of every major city west of Denver with a population of 100,000 or more. Cities like Phoenix, Arizona and Eugene, Oregon made the list, as did Stockton, California.

“When someone first told me to consider Stockton, my response was, Where’s that?” Yecies recalls.

As fate would have it, an advertisement in a major medical journal placed by Stockton’s Dr. Joseph Barkett found its way to the pair while they were hunting for the home of their future practice, listing an array of medical specialties needed in the up-and-coming town of Stockton.

Allergist was among the list.

After viewing Stockton, Yecies determined that the fit was a good one, and Barkett was kind enough to offer help in enlisting new patients for the fledgling practice. In the first week of July of 1973, only a week after finishing his fellowship in Denver, Yecies opened the doors of the Allergy Immunology and Asthma Medical Group and was handed an appointment book filled with three-weeks of appointments by Barkett.

“It just never stopped,” he said of the demand. “It still hasn’t stopped.”

Only a year after those early days, the demand for allergy related care was so high that Yecies and Bensch needed to expand the office to the Georgetown Place location, where the Allergy Immunology and Asthma Medical Group is still located, to this day. While the clinic’s location has remained a constant, virtually everything else about the surrounding area in Stockton has changed considerably.

“Where we were building the new office, there were still

36

SAN JOAQUIN PHYSICIAN

SUMMER 2018

Now, nearly 45 years, and more than 100,000 patients, later, Yecies’ original practice has expanded to eight locations, including Manteca, Modesto, Tracy, Lodi and employs a staff of more than 40 employees. Today, four partners helm the practice, with Dr. Gregory Bensch, son of original partner George, joining nearly two decades ago and Dr. Michael Balduzzi coming aboard three years ago.

SUMMER 2018

cows in a pasture across the street,” he said, noting that, in those days, the stretch of Interstate 5 that runs through town was still unfinished.”

While the town may have changed around them, Yecies never forgot the strong sense of kinship he felt among Stockton’s medical community when he first arrived. Since 1973, he’s been an active member of the San Joaquin Medical Society, having previously let the organization as president, and is a strong advocate for organized medicine and the benefits it provides both to physicians and the community they serve.

Now, nearly 45 years, and more than 100,000 patients, later, Yecies’ original practice has expanded to eight locations, including Manteca, Modesto, Tracy, Lodi and employs a staff of more than 40 employees. Today, four partners helm the practice, with Dr. Gregory Bensch, son of original partner George, joining nearly two decades ago and Dr. Michael Balduzzi coming aboard three years ago.

For the patients the team has treated, the care is often life changing.

“We always hear “I wish I had done this years ago,’” Yecies said. “That’s the best part about medicine, seeing the patients respond.”

Over the course of his career, Yecies has also seen the specialty evolve in ways that previously seemed unimaginable. Decades ago, much of the care related to asthma and other allergy-related respiratory illnesses was often done in a hospital

SAN JOAQUIN PHYSICIAN

37

Please join us for the

Annual Membership Dinner honoring our

2018 Lifetime Achievement Award Recipient

JeRoLd yecIeS, Md young Physician Award Recipient – cyrus Buhari, do

S u n d ay, J u n e 1 0 , 2 0 1 8 cocktail Reception 6:00pm | dinner 7:00pm S to c k to n G o l f & c o u n t ry c lu b 3800 country club Boulevard | Stockton, california Member Physicians and Spouse/Guest – $45 per person non-Members and Invited Guests – $75 per person

If you would like to attend this event, please call in your reservation to the Medical Society: (209) 952-5299 before June 1

PReMIeR LeveL SPonSoRS

38

SAN JOAQUIN PHYSICIAN

SUMMER 2018

“Stockton has been wonderful to us. We try to be very supportive of the community.

They have been so supportive of us."

- Dr. Yecies

SUMMER 2018

setting, while, thanks to advancement in inhaled steroid treatment and immunotherapy, the vast majority is done in a clinic setting, like the one offered by Yecies and his partners.

“The field has advanced so much. There have been advancements in medicine and therapies.

All of this makes life better for our patients,” he said. “It’s why I still do it.”

At 78, Yecies’ passion for medicine and delivering care is as high as its ever been, evidenced by the way he talks about the latest development in treatments, or quality of life that a patient can go on to enjoy despite previously suffering from debilitating allergies and asthma.

“I can’t get him to slow down,” Judy jokes.

Outside of the clinic, Yecies’ passion for travel remains nearly as high as his love for medicine.

Together, Jerry and Judy have visited more than 100 countries, and set foot on all seven continents. As proof of their travels, a map of the world is littered with color-coordinated pins, each one sunk deep in a country where the two have previously visited. The map is blanketed, yet Jerry points out that the most recent trips to places like Borneo and New Guinea have yet to be added.

While gazing over the map, Yecies reflects on the good fortune he’s experienced in his life, remarking that none of his success would have been possible without the support of his wife, their three children, his colleagues and community of Stockton as a whole.

“Stockton has been wonderful to us. We try to be very supportive of the community,” he said.

“They have been so supportive of us.”

SAN JOAQUIN PHYSICIAN

39

MEMBERSHIP

Top 10 Reasons to Be a Member

When you become a member, you hire a powerful professional staff to protect your profession from legal, legislative and regulatory intrusions. But that’s not all. Let’s count down the top 10 reasons to be a member of the California Medical Association (CMA) and your local county medical society.

10. Protect the Profession Your membership affirms your commitment to the medical profession and ensures physicians remain in control of the practice of medicine.

9. Lead by Example

CMA and its county medical societies provide many opportunities to get involved, including opportunities to volunteer; serve on a committee, council or board; and shape the future of the medical profession.

8. Stay in the Know

CMA and its county medical societies produce publications to keep you up-to-date on the latest health care news

40

SAN JOAQUIN PHYSICIAN

and information affecting the practice of medicine in California.

7. Get Paid

Members receive one-onone assistance from CMA’s reimbursement experts who have recouped $15.5 million from payors on behalf of CMA physicians in the past nine years.

6. Protect MICRA

CMA staunchly defends the landmark Medical Injury Compensation Reform Act (MICRA) year after year, saving each California physician an average of $75,000 per year in professional liability insurance premiums.

SUMMER 2018

MEMBERSHIP

Through CMA we give important public health “concerns a strong voice and keep elected representatives in tune with changing practice paradigms. – Brandon Woodward, MD

”

5. Collaborate with Colleagues

4. Promote Public Health

CMA and its county medical societies bring together physicians from all regions, specialties and modes of practice through leadership, collaboration, social and educational events, and community service.

From tobacco use and obesity to prescription drug abuse and vaccinations, your membership dollars support forward-thinking public health advocacy to improve the health of Californians.

Continued on page 9 >>

NEW! Membership is easier than ever with new

monthly payment plan

Membership in the California Medical Association (CMA) and your local county medical society is easy to maintain and hassle-free with automatically recurring monthly payments at an affordable monthly price. If you’re not already a member, enroll today at www.cmanet.org/monthly to start receiving your benefits! If you’re a current member, keep an eye out for your renewal invoices this fall and choose the monthly payment plan.

QUESTIONS? Contact CMA’s Member Resource Center at 800.786.4262 or memberservice@cmanet.org.

SUMMER 2018

SAN JOAQUIN PHYSICIAN

41

The

REMEDY for all your

Financial

NEEDS

As a member of the San Joaquin Medical Association, you’re privy to an exclusive benefit—Financial Center Credit Union membership for you and your staff !

In a time when the safety and soundness of funds is at the forefront of everyone’s minds, Financial Center membership is the perfect prescription for peace-of-mind. Voted Best Of San Joaquin, Financial Center is the most trusted credit union in the Valley. Time and time again, we offer our members the lowest rates on their loans as well as the safest place to save their money.

Follow the doctor’s orders and call us today. And don’t forget to pass this message onto your staff – they (and their wallets!) will thank you.

209-948-6024

•

www.fccuburt.org Federally insured by the NCUA.

42

SAN JOAQUIN PHYSICIAN

SUMMER 2018

MEMBERSHIP

Ask yourself who will have the most impact on the way you practice “medicine–the government, or physicians in organized medicine through CMA? Be involved or be left behind. ” – J. Brennan Cassidy, MD

3. Head Seat at the Policy Table

Through aggressive political and regulatory advocacy, CMA and its county medical societies are positioned among the most influential stakeholders in the development and implementation of health policy.

2. Shape the Future of Medicine

Members receive direct access to our state and national

legislative leaders to influence how medical care is provided today and in the future.

1. Together We Are Stronger

Together, we stand taller and stronger as we fight to protect patients and improve the health of our communities. We are a dominant force in health care – but all the great work we do wouldn’t be possible without the support of members like you.

Join or renew your membership today! www.cmanet.org/join

QUESTIONS? Contact our Member Resource Center at 800.786.4262 or memberservice@cmanet.org.

SPEAK MI CULTURA PHYSICIAN SUPPORT AND QUALITY PATIENT COMMUNICATION SERVICES INTERPRETATION, TRANSLATION AND QUALITY OUTREACH FOR A MULTICULTURAL WORLD

139 Guild Avenue, Lodi, CA 209.405.0951 jriva.com

SUMMER 2018

SAN JOAQUIN PHYSICIAN

43

44

SAN JOAQUIN PHYSICIAN

SUMMER 2018

BY KATHERINE BOROSKI

Danger Ahead Dangerous rate setting proposal threatens to decimate California’s health care delivery system

!

Since passage of the Affordable Care Act (ACA), California has made great strides in expanding access to health care and bringing the state’s uninsured rate to an all-time low of 7.1 percent. Now, some lawmakers in Sacramento are turning their backs on the gains made under the ACA and pushing a reckless proposal to put a new government bureaucracy in charge of health care.

The bill—AB 3087, authored by Ash Kalra (D-San Jose)—would create a commission of unelected political appointees empowered to arbitrarily cap rates for all health care services in all clinics, hospitals and physician practices in California. By unilaterally setting the price for all medical services, the bill would essentially eliminate the commercial health care market in California.

“No state in America has ever attempted such an unproven policy of inflexible, government-managed price caps across every health care service,” said California Medical Association (CMA) President Theodore M. Mazer, M.D. “It threatens to reverse the historic gains for health coverage and access made in California since the passage of the ACA.” >>

SUMMER 2018

SAN JOAQUIN PHYSICIAN

45

!

AB 3087 Moves California in the Wrong Direction This poorly conceived legislation would do nothing to ensure that patient out-ofpocket costs are decreased, nor does it solve the fundamental problems of the health care payment system.

“Simply setting physician rates without addressing the rising cost of providing care will do nothing to address health care spending,” said San Francisco pediatrician Shannon Udovic-Constant, M.D., vice chair of the CMA Board of Trustees. “AB 3087 would drive a lot of physicians out of our state, and it doesn’t address the underlying reasons around rising health care costs.”

This dangerous rate setting proposal would also move California away from value-based care and universal access, backwards to an antiquated fee-for-service model that discourages contracting and stifles innovation. Instead of addressing the underlying issues, this bill would force hospitals to close, push health care providers into early retirement and cause a “brain drain” of talented medical students and residents fleeing California for more ideal working conditions.

Medicare Should Not Be a Benchmark for Costs AB 3087 requires the commission to cap prices for commercial payments for all services to Medicare rates, which is a fundamentally flawed approach that does not address coverage and benefits or the costs to provide care. Medicare was created to reimburse medical services for an agespecific population based on federal budgetary and regulatory constraints.

Medicare rates do not keep up with inflation

46

SAN JOAQUIN PHYSICIAN

or the cost of running a practice. Adjusted for inflation in practice costs, Medicare physician pay has declined 19 percent from 2001 to 2017, or by 1.3 percent per year on average. Medicare rates are not intended to represent the fair market value of health care services. Rather, they fluctuate based on variables unrelated to the services provided, such as the federal budget.

AB 3087 Does Not Address Medi-Cal Rates Medi-Cal is the largest Medicaid program in the nation, with 13.5 million people— about one-third of the state’s population— enrolled in the program. And yet, California still pays among the lowest reimbursement rates of all 50 states, creating a serious access issue for patients.

California’s Medi-Cal rates don’t come close to covering the cost of providing care—meaning that physicians lose money for every Medi-Cal patient they serve. Due to low Medi-Cal rates, physicians must make up revenue through their commercial contracts to keep their doors open. Because the AB 3087 proposal does nothing to address California’s sub-standard Medi-Cal rates, hospitals and health care providers would continue to be underpaid by these governmental programs, putting them in an untenable situation.

“I expect even lower physician participation in Medi-Cal because it’s financially unsustainable already, and it will be even more so if something like this passes,” said Christina Wang, a University of California, San Francisco medical student who came to CMA’s 24th Annual Legislative Advocacy Conference in April to educate lawmakers about this irresponsible legislation.

SUMMER 2018

AB 3087 Would Drive California’s Physicians Out AB 3087 also ignores the recommendations from the University of California, San Francisco’s report—commissioned by the Assembly— on how to achieve universal access to health care, which includes implementing a comprehensive strategy to overcome the physician workforce shortage in the state by removing barriers that prevent physicians and other clinicians from specializing in primary care and practicing in underserved areas.

Currently, six of nine California regions are facing a primary care provider shortage, and 23 of California’s 58 counties fall below the minimum required primary care physician-to-population ratio. The state needs 8,243 additional primary care physicians by 2030—a 32 percent increase.

“AB 3087 would cause an exodus of practicing physicians, which would exacerbate our physician shortage and make California unattractive to new physician recruits,” said Dr. Mazer. “When I look at the economics of my own practice, it’s enough to tell me that I could not survive that environment and continue to see Medi-Cal patients.

And probably at this stage of my career, it would drive me out of practice earlier that I might otherwise.”

The bill also operates on the false premise that the cost of professional services—in other words, what physicians and hospitals charge for their services—is what’s behind the increase in health care spending in California.

Data shows, however, that the price of prescription drugs and increases in health care utilization are what’s driving health care spending growth. Professional services had relatively low impact on spending growth. In fact, nationally, California had lower than average annual growth in per capita spending on physician and clinical services over the past 20 years. The primary driver of spending on doctor visits is increased utilization, not price.

“Physicians want real solutions to these problems too,” said Valencia Walker, M.D., chair of the CMA Council on Legislation. “We remain focused on real solutions that would protect the access and coverage gains made under the ACA, further value-based care, ensure patients can access health care in a timely and affordable manner, and tackle California’s health care workforce shortage.”

California Physicians: Time to Take Action Physicians are urged to visit actnow.io/PriceFixing to ask their legislators to stop this dangerous bill.

California physicians overwhelmingly oppose price fixing bill A recent survey of 398 California physicians conducted by CMA found: 92 PERCENT opposed AB 3087 (6 percent undecided, 2 percent in support).

58 PERCENT believed AB 3087 would force them to leave California and practice elsewhere.

39 PERCENT believed AB 3087 would force them into early retirement.

ONLY 5 PERCENT believed AB 3087 would have little to no effect on their medical practice.

OF THE 79 PERCENT of respondents who currently serve Medi-Cal patients, 64 percent believed AB 3087 would force them to decrease the number of Medi-Cal patients they serve.

Katherine Boroski is Senior Director of Communications for the California Medical Association.

SUMMER 2018

SAN JOAQUIN PHYSICIAN

47

In The News

IN THE

NEWS Doctors Hospital of Manteca Welcomes New CSO Neil Pithadia is no stranger to working alongside physicians and caregivers. After spending the last eight years of his career running large group practices at premier organizations Neil Pithadia like University of Texas Southwestern Medical Center and most recently, the last two years responsible for Northern California (across San Joaquin and Stanislaus counties) physician services for Tenet Healthcare, we now welcome Neil to Doctors Hospital of Manteca as the Chief Strategy Officer. In his new role, Neil will oversee service line growth as well as change management, partnerships and market development.

Neil is a trained scientist in Cell Molecular Biology and Medical informatics. He started his healthcare career in patient registration after leaving the life sciences sector and quickly grew through the ranks. Neil attributes his success to his patient-centered focus. “I used to take my mother for her medical care. I am the first-generation and only child in my family and recall the barriers we faced when we learned my mother had chronic uncontrolled diabetes. We were vulnerable. The care-givers left an impression on me. They were our beam of light in the highly complex medical care system in the United States (and this was 25 years ago). From

48

SAN JOAQUIN PHYSICIAN

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

then on, I knew I wanted to be a part of the equation somehow or some way. While I do not have direct patient care like my care-giver colleagues I make it a point to be ever-aware of the decisions we make and how it will impact the care of our patients.”

Neil currently resides in Ripon with his wife, Kalgi, a CPA at Moss Adams in Stockton. The two enjoy the small-town feel of San Joaquin county and spend their free time cooking and hiking. You might find Neil on the weekends at Cars and Coffee or Eurosunday, an avid car enthusiast since his childhood in Detroit, Michigan.

New HPSJ Speakers Bureau Due to increasing demands from local, regional and national groups for HPSJ’s healthcare professionals and industry experts to participate in conferences, workshops and meetings, we have created a Speakers Bureau to better accommodate each of these requests.

In addition to participation by HPSJ staff who are authorities ranging from medicine to public policy, business systems to the intricacies of Medicaid managed care, we are fortunate to include several members of our governing Health Commission. As you may know, one of our greatest strengths is the Commission’s blend of public servants, community representatives, and local physicians. Together, these HPSJ speakers are helping audiences stay current on the complex healthcare landscape.

Here are some samples from our menu of Speakers Bureau topics: •O pioids Crisis – A rising local collaboration is providing a way forward •T elehealth – How HPSJ is partnering to expand support for local providers & practices

SUMMER 2018

•H ealth Care Workforce – Central Valley Challenges, Innovative Opportunities •G enNext – HPSJ Scholarships and Mentors for Tomorrow’s Doctors, Nurses & Pharmacists •L ike patients, health plans need to know their numbers – How we’re using data to improve care for HPSJ members • P alliative Care Options – A pioneering HPSJ collaboration is helping local medical teams comfort some of their most critically ill patients For more about the HPSJ Speakers Bureau, a complete list of topics – and to learn how to request a speaker for your own community group or professional association – please go to https://www.hpsj.com/speakers.

Baby Partners Program – Health Plan of San Joaquin selected for this initiative of the Advisory Board Health Plan of San Joaquin is one of five plans around the U.S. selected by the nationally recognized Advisory Board to participate in the new Baby Partners Program: How to save $1.5M by identifying high-risk pregnancies early. Goals for this program – due to start in summer 2018 -- include: • E arly Identification of High Risk Pregnancy •D ecreased admissions and ER visits related to pregnancy • Decreased NICU admissions • Decreased postpartum maternal/fetal complications Andrea Brown has joined Health Plan of San Joaquin as Vice President of Provider Networks Health Plan of San Joaquin (HPSJ) has a robust provider network comprised of physicians, hospitals, clinics and other providers serving HPSJ members in Andrea Brown San Joaquin and Stanislaus counties. To support providers as they partner with HPSJ in providing access to quality health care, Andrea Brown has been selected to lead the HPSJ Provider Networks team. She is a healthcare leader with broad experience in all aspects of managed care contracting, network development and health plan operations. For several years, she has provided strategic and operational leadership

SUMMER 2018

in network management for commercial health plans and medical groups in California. Most recently, she has provided managed care consulting services to health care organizations throughout the nation.

Andrea Brown is a familiar presence at HPSJ. For the past few years she has worked with HPSJ as a consultant providing support on various projects supporting the Provider Networks team. She has been able to utilize her extensive industry expertise to provide guidance and operational support on many initiatives impacting health plan contracting, regulatory compliance, and department operations.

San Joaquin County Supervisor Chuck Winn is now a Commissioner for HPSJ’s governing board; two Commissioners have been reappointed The San Joaquin County Board of Supervisors appointed Chuck Winn, a county supervisor representing District 4, as a member of Health Plan of San Joaquin’s governing Health Commission.

Community Representative Michael Kirkpatrick and San Joaquin County District 1 Supervisor Miguel Villapudua have been reappointed to the Health Commission. Commissioner Kirkpatrick previously was appointed in 2015; Commissioner Villapudua was appointed in 2016.

Charlene Giles is Compliance and Privacy Officer with Health Plan of San Joaquin Charlene Giles, CCEP, CHP, of Turlock has extensive senior executive experience in Medicaid, as well as Medicare and commercial health insurance, and is a widely respected leader in establishing internal controls to protect health plan operations and organizational assets.

“Through her experiences and career-long values that perfectly match up with many of our HPSJ values – including accountability, integrity, and stewardship – Charlene is already leading our Compliance team to improve our program of regulatory compliance and improving systems so we can maximize state and federal funds we receive for the health care of our members,” said HPSJ CEO Amy Shin.

SAN JOAQUIN PHYSICIAN

49

In The News

IN THE

NEWS Lodi Memorial and UC Davis Health Announce Partnership Bringing Advanced Specialty Care for Children to the Region Adventist Health Lodi Memorial is continuing to expand the care available to residents of San Joaquin and Sacramento counties with a first-of-its kind partnership bringing the worldclass care of UC Davis Health directly to Lodi.

Adventist Health Lodi Memorial and the UC Davis Medical Center have signed a partnership to greatly expand pediatric and neonatal care services at the Lodi medical center, bringing UC Davis physicians and nurses into the local community, and establishing a 24-hours-a-day, seven-days-a-week instant connection to the UC Davis Medical Center’s dedicated pediatric emergency department. The partnership begins July 1.

The agreement brings a Level II NICU facility to Lodi to treat premature infants who need extra support, and who will receive their care from UC Davis Health specialists. The facility will be equipped with the most current technology and equipment to better serve neonatal cases, and do so without the current need for an ambulance or helicopter trip to Sacramento. The new NICU greatly increases the level of care available to pediatric patients in the region and decreases the need for transfers to UC Davis Health.

In addition to the newborn nursery, the partnership will also offer an expanded array of pediatric inpatient and outpatient services for Adventist Health Lodi Memorial’s labor and delivery, emergency room and general inpatient services. UC Davis Health’s pediatric hospitalists will be on site in Lodi for consultation and care of pediatric patients in the emergency department and to care for patients admitted for inpatient services.

“Adventist Health Lodi Memorial is pleased to partner with UC Davis to provide world-class, comprehensive care

50

SAN JOAQUIN PHYSICIAN

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

for premature infants and children, right here in Lodi,” said Adventist Health Lodi Memorial President Daniel Wolcott.

“This collaboration connects Davis’ and Lodi’s expert teams, allowing families access to advanced and highly specialized care close to home.”

Adventist Health Lodi Memorial delivers nearly 1,100 babies a year and cares for more than 9,000 pediatric patients annually.

Adventist Health Lodi Memorial Enhances Imaging Services Lodi area residents now have expanded access to imaging services at Adventist Health Lodi Memorial. The Advanced Imaging Center, located on the Adventist Health Lodi Memorial Medical Center campus, now provides comprehensive outpatient imaging services in one location.

The hospital acquired Delta Radiology Medical Group in 2017, which allows for further expansion of diagnostic care in the local community, including new 3D digital breast tomosynthesis, which allows for better detection than conventional mammography.

“We are pleased to offer enhanced diagnostics services for our community,” said Tim Karagounis, Imaging Services Director at Adventist Health Lodi Memorial. “We have additional advanced technology that our patients can now seamlessly access as a part of this acquisition.”

In addition to new 3D digital mammography, Imaging services now include MRIs, CT scans, digital radiography (x-ray), vascular and general ultrasound, nuclear medicine, cardiac catheterization lab, interventional radiology, echocardiography and 2D digital mammography.

“I’m excited at the progress we’ve made in our diagnostic imaging services, and I know our patients will benefit greatly,” Karagounis said.

SUMMER 2018

The prior Delta Radiology sites on Ham Lane and Vine Open MRI are now operating out of Advanced Imaging Center. The imaging sites are located at: Advanced Imaging Center Adventist Health Lodi Memorial 1031 S. Fairmont Ave Lodi, Ca 95240 Office: 209-334-8580 Scheduling: 209-339-7505

Adventist Health Lodi Memorial 975 S. Fairmont Ave Lodi, Ca 95240 209-334-3411 Learn more about Advanced Diagnostic Imaging Services at adventisthealth.org/lodimemorial today.

St. Joseph’s Receives Reaccreditation by NAPBC for Breast Center of Excellence The Breast Center of Excellence at St. Joseph’s Medical Center has received re-accreditation by the National Accreditation Program for Breast Centers (NAPBC). Accreditation by the NAPBC is only given to those centers that have committed to provide the highest level of quality breast care and that undergo a rigorous evaluation process and review of their performance. Accreditation also ensures that each patient continues to be treated with the latest standards in mind.

St. Joseph’s Breast Center of Excellence offers those being diagnosed and treated for breast cancer a unique, patient-centered environment for healing. Working with a team of breast care experts, patients have access to comprehensive breast

SUMMER 2018

imaging services, genetic counseling, and advanced medical and radiation oncology. The multidisciplinary panel of doctors focus their efforts on designing individualized treatment plans for each patient, and providing the best possible care, close to home. Additionally, a breast cancer patient navigator is available to guide patients through the entire cancer treatment and recovery process - from diagnosis to survivorship.

This re-accreditation was made possible thanks to the

BORROW OUR

STRENGTH to build a powerful business

Considering a commercial loan?

Choose the right bank to join your team. At Central Valley Community Bank, we’re just the right amount of both big and small – the strong lending power of a big bank together with the values and relationships of a community bank. We’re local too – and know the marketplace and what is right for you and your medical practice.

Whether you want to expand, start a new product line, modernize or hire new employees, sit down with our expert lenders today and find out why so many of our satisfied customers refer us to friends and colleagues.

Get to know the most trusted, safe and secure business partners in the region.

Investing In Business Relationships.

www.cvcb.com • (800) 298-1775 Proudly serving the San Joaquin Valley and Greater Sacramento

SAN JOAQUIN PHYSICIAN

51

In The News

IN THE

NEWS

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

efforts and leadership of St. Joseph’s Breast Center Steering Committee, including the following physicians: Dr. Ajith Puthillath, Dr. Aminder Mehdi, Dr. Prasad Dighe, Dr. Edward Greenleaf, Dr. Kiran Jain, Dr. Nathan Kludt, Dr. Neelesh Bangalore, Dr. DeAndrea Sims, Dr. Gaurav Singh and Dr. Steven Goldberg.

St. Joseph’s Celebrates TAVR Two-Year Transcatheter Aortic Valve Replacement Anniversary St. Joseph’s Medical Center record and a history of ‘firsts’ in advancements.” is celebrating the two-year For nearly fifty years, St. Joseph’s Medical Center has anniversary of its Transcatheter Aortic Valve Replacement been paving the path to heart wellness in San Joaquin (TAVR) Program. Prior to St. Joseph’s opening the area’s County. Recognized as having one of the top 10 programs first and only cardiac hybrid suite and offering TAVR, local in California for heart surgery, St. Joseph’s has continued San Joaquin County residents had to travel out of the area for its tireless efforts to provide premier heart care, right here in this procedure.

Stockton.

With over 75 TAVR procedures completed since the programs launch in 2016, physicians at St. Joseph’s have given new hope to those who can’t safely have traditional valve surgery because of advanced age or poor health. With TAVR, physicians can replace a damaged heart valve without opening the chest. Instead, they access the heart through catheters inserted in the groin.

“St. Joseph’s has a long legacy of excellence in cardiac services,” said Don Wiley, Hospital President and CEO. “Right here at St. Joseph’s, our community has a high volume, high quality cardiac surgery program with a strong track

52

SAN JOAQUIN PHYSICIAN

St. Joseph’s Launches Graduate Medical Education St. Joseph’s Medical Center is proud to welcome its first class of residents to the new Graduate Medical Residency Program. In this inaugural year, the program will host nine residents in Emergency Medicine and six residents in Internal Medicine.

By 2023, St. Joseph’s plans to offer additional residencies

SUMMER 2018

in Obstetrics and Gynecology, Internal Medicine, and other Fellowships, for a total of around 80 residents training.

With a shortage of residency positions in California, medical students from the Central Valley must typically leave the area to obtain a residency, which decreases the likelihood that they will return to the area to practice. St. Joseph’s new GME program will provide high quality training opportunities to medical students from California and beyond.

Available Space to Lease for Medical Office: For Medical office in Weber Ranch Professional park, 1801 East March Lane, Stockton, CA; call today at 209-951-8830 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).

performed at his clinic. The new location will have infusion services soon. Dr. Saharan accepts most insurances including Health Plan of San Joaquin. For appointment, please call 209-462-7246.

Michael R. MoRdaunt PeteR J. Kelly RichaRd J. SoRdello, JR. StePhanie Roundy loRi a. Reihl cuRtiS e. JiMeRSon

Dr. Saharan’s Office Has Moved Dr. Sahdev Saharan’s Rheumatology office moved to the new location in The Fountains, 3031 W. March Lane, Ste 203W in Stockton with easy access from I-5. Dr. Saharan is a board-certified Rheumatologist who has been serving the community for the last 8 years.

He specializes in treatment of autoimmune conditions like Rheumatoid Arthritis, Ankylosing Spondylitis, Lupus and Psoriatic Arthritis. Trigger Point Injection and Intraarticular injections are

SUMMER 2018

JaMil R. GhannaM

our firm devotes its practice to civil litigation with decades of experience representing healthcare professionals in: • MEDICAL MALPRACTICE ACTIONS • Medical BoaRd inveStiGationS • HOSPITAL CREDENTIALING PRoceedinGS • PeRSonal inJuRy litiGation

2509 West March lane, Suite 200 Stockton, california 95207 Phone (209) 473-8732 Fax (209) 957-9165 rmktriallawyers.com

SAN JOAQUIN PHYSICIAN

53

practice manager Free to SJMS/CMA Members!

resources

The Office Manager’s Forum empowers physicians and their medical staff with valuable tools via expert led educational sessions from industry professionals who are committed to delivering quality health care.

For more than 130 years, the San Joaquin Medical Society (SJMS) has been at the forefront of current medicine, providing its physician’s and their staff with assistance and valuable practice resources. SJMS is proud to offer the Office Manager’s Forum, a monthly educational seminar designed to enhance the healthcare environment with professional development opportunities while providing solutions to some of the challenges that come from managing a practice.

Attendees gain knowledge on a broad array of topics related to the field of medical staff services, office management, billing and coding, human resources, accounting and back office support.

The Office Manager’s Forum is held on the second Wednesday of each month from 11:00AM – 1:00PM at Papapavlo’s in Stockton and includes a complimentary lunch. Attendance is always FREE to our members. Non-members are welcome and may attend for one month at no cost to experience one of the quality benefits that comes with Society Membership ($35.00 thereafter). Registration required.

For more information or to be added to the mailing list email Jessica Peluso, SJMS Membership Coordinator, at Jessica@SJCMS.org or call (209) 952-5299.

JUNE 13TH , 2018:

PRACTICE MANAGEMENT 101

11:00AM to 2:00PM

Join us and learn from the expert! CMA’s Physician Advocate Mitzi Young will help you identify opportunities for increased revenue and teach you best practices for implementing effective policies, procedures and processes into your medical office.

Topics Covered: • Three Strategies for Better Financial Outcomes • Common Practice Mistakes Costing You Money • Managing Patient Scheduling • Improving Patient Experience • Monthly Reports Every Practice Should Review • Effectively Processing Denied Claims • Marketing Your Practice for Success • Questions Every Office Should Ask Yearly ~ Mitzi Young is the Physician Advocate, for the CMA, RCMA and SBCMS. Mitzi brings 25 years of experience and expertise in the health care industry. Mitzi started her career working for a third party administrator as a claim and eligibility processor for San Bernardino county hospital’s medically indigent adult program.

She went on to further her education and worked as operations and business manager for a specialty practices and for an ambulatory surgery center. Overseeing all personnel and business operations. She brings with her a vast knowledge of medical billing and collections, contracting, accreditation, and personnel and business management. She understands the needs of physicians and their staff, the challenges that face medical practices, and is very passionate about advocating on behalf of providers on succeeding in the ever-changing challenges of the healthcare landscape.

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

from the is thly bulletin This bulletin is a free mon nomic Services. practice Eco ces (CPR) f improve tice Resour ciation’s Center for r office staf CMA Prac ical Asso ns and thei sicia Med phy nia ifor CMAtool Cal , sign Practice s to help Resources (CPR) is Aetna to require addition and up to date a free monthl tips Californ stay of To y al bulletin . ia accredit full Medical RS: from the ation requireAssociation’sNEW ments SLETTE Econom and viability : in order to be atio ire- surgical paidnfor CMA Center for certain requ efficiency full of tips andANY tools OTH ewsletters.ic Services. This eagues. is toERhelp physicia y services In this issuepatholog t.ornsg/n accredit and their office staffrs and collbulletin efficienc CPR OR viability orke improve practice additional certain surgical www.cmane ire Update 1 SUBSCRIBE TO y and on two ptions at . for Anthem Blue Cross 1 to your cow Aetna to requ r to subscri SUBSCR be paid issues pending IBE TO CPR OR ANY this bulletin with ardOTHER up for free CMA NEWSLE ments in orde ices the Department of Managed Health up for Please forw D:subscrip free 1 serv Meet Your CMA s issues pending Care tions at www.cmanet.org TTERS: To stay up toem ts THE WOR pathology Center for Economic 1 Cros SPREAD SPREAD /newsletters. uir date,ensign Blue req Services em n Care THE WORD: Please Anth : Markaged tio two Advocate LaneHealth forward this redita bulletin seracc Update on of Man to your coworkers 2 artm CMAent andycolleagues.

Advocacy at Work patholog Services additional with the Dep 2 for Economic to require for certain surgical 2 Center Urgent CMA survey response requeste Aetna Aetna tobe requir Meet Your d paide additional accreditatio 2 tices perk Lane 3 to Mar prac Aetna e: er 2, erroneou n1,requir 201 ements orain order to be paid for Advocat in ord k sly terminates providers from 3 Californi ctive August both Clinical Lab certai a network y at Wor n surgic that, effe altopatho be CMA Advocac vices logy ser-the Col3 requested vices physicians Docume be required Document, Docume s from edited with ey respnt,onse ntly notified Aetna idernt a recerecently y testing will certified and accr Urgent surv Aetn 3 3 physicia inates prov patholog United Healthca that,IA) fficenotified effective August 1, forming tsns(CL neously termre announces extension of HIPAA ing in-o in-office with the 2012,con form practice sistent Amendgymen testing will s perAetna erro5010 enforcem t patholo 3 ge isClinical toryImp rovemen Improve (CAP). be required network ent be both ment Amendm ists P as an thetochan 4 tory olog nt Laboraents that CaliforniaWhat’s a COHS? s (CLIA) Path ume ion of CA certified and accredit lege ofAm ericann Pathologists America recognit Aetna claim ument, Doc ed the olog of HIPAA lege of nt, Doc Col-y test physicians, (CAP). Services (CMS) l anatomwith ic path tophysicia DocumeSave In aa lette the Date unces extension 4 4 letterr to icaid pita In Aetna re anno -hos claimsforthat e &ns,Med non Centers for 4 icar the change Act lthca Med Medicar is now to avoid the 2013 consiste tion United Hea for e & nt with the ters implemend Services (CMS) recognit organiza e-prescribing pen-4 Cen nMedicai approve atioorganiza altyrcement d accredit s withas the ioncern ation of CAP accredit 5010 enfo an l certification for non-hospital ed con 45 approved ing. has voicanatomi S? forgydua patholo a COH Updates testAssociation to explain thec need organizaWhat’sPayor n ical ing. atio The Med Californ ia nia Medical Associat Aetna d accredit Health plan provider Califor ibing pen 5 iond has society voiced tation The has aske newslett an appsrove of this policy Save the Date andasked ers escr P asconcern with cy has specialty thea implem 2013 e-pr poliand 55 and enAetna e CA A tion avoid the explain tion. n of this Althoug theifica tatio need may recogniztoCLI h CMS cert for dual mayS recogniz Further- , CM aAct now to 5 ices.certifica e CAPa as an Aapprove ing serv ough CM tion,tion CMS . Alth does not requirerequirea both ation organiza CAP -accredit aalty ology testd accredit CLIA certifica S does not bothin-o accreditation 5 obtain the ffice path tion and accredit a specialty ns to tion, CMto perform CMA ates orm patholo in-office society physicia CAP, the to perf gyof Payor Updresources expressededit testing ng toCMA ations with services. sletters ability concern ordi obtaining Further, new the When youprov of Acc accr the ider a. ess ability see with this icon, that of physicia proc cerns tion prior to the to obtainition th plan osed bynsAetn ally, the there Heal the CAP deadline imp are additional resourc means ressed con accreditaimposed exp line Add by s.

Aetna. dead es tion availAccordi day the processprio ng to CAP, able free to Californ r to ely 90 approxim thes.accredita-is working closepractice ately ia Medical Assotion takes 90mat roxi days. Additio ly for app a seconda ciation (CMA) membe nally, CMA ry accredit takescan the process e, obtainin be very cost rs at the CMA website be very this issuof n can g r state and tion processation edit costly atio To access any of for practice In addition .

Aetna s.on ral othe accr to ry thesesresources, their contact with nda tact with rce A) and seve visitns http://w r conAetna a seco on this ly with the mea resounet.org/ issue,(AM to thei Americaition CMA is working ciation ces., that CMAww.cma icon Associat details. close- Gaul, senior In addn Medicalan ion Asso (AMA) and see this specialty medical Medical s availfurtherother for several societies resource stateTam When you Am.eric Stay tuneds.for andmy tuneddetails. the Stay contact further with additional Medical AssoPractice can ly etie r are . s with e soci question lette site ther al-LegCalifornia s about the letter Medic ut the medical CMA web network manage to ns abocan contact Librar specialty 4. Gaul, seniormlane@cmanet.org Tammy r at Aetna questio5-6604.

-660 able free A)almem bersyat the s, visit at (215)77 with )775 or s 1 tice Contact: CMA Prac (Form a at (215 resource reimbur erly(CM ) 401-591 CMA ciation sement at Aetn these ll) agerhelp line, (888) 401-591 line,1(888 any ofOn-Ca In this ces. or mlane@cmanet.o access ion, you will network manA reimbursement help org/ Topublicat rg references to cmanet.find “medical-legal” ://www. docume h Contact: CM May 2012

May 2012

In this issue:

http

ing wit

nd Update on two Anthe ss issues pe m Blue Blue Cro pendingCa the Department of Mana o AnCross themissues with re tw ged Health Update on ged Health ManaCare

Medical Association’s nts. The California (CMA) online medical library contains over -legal 4,500 pages of medical legal, regulatory, and reimbursement informatMedical-legal docume ion. nts are free to membe and can be found rences to DMHC claims audit in CMA’s online will find refers library, http://www.cma Health ion, you resource California Asl previously reported licat The net.org/ pub Managed with nts. -library. medical-lega resource this , on ume NonmemIn 2012 artment of bers s, e can l-leg al” doc Care (DMHC) ordered Jan. 12,aud purchas it the Departm ent of2Manage e medical the Dep A) onlin dica -legal (CM ments for “me d Health provider claim docu-of medical12, 201 $2 per claimsBlue CrossontoJan. page. ociation’s interest, HCAnthem es reprocess reproces

al Library Medical-Leg A On-Call) CM (Formerly

ent of the Departm

to dating back DMto 2007. reported, s provider Medical Ass s over 4,500 pag nt information. e Cross claims, with The order is As previously Anthem Blu burseme ry contain

s health plan

bers based on 2008 DMHC red reim libra largest HC) orde audits CMA Center free to mem in California. These e (DM latory, and the seven above the threshl, regu Econom its of plans Car to 200of7.the seven largest audits found legafor uments are audhealth ic Servic urce ts

back s of claim8 DMHC reso es ngviolation men 1201 J Street, #200, legal doc old allowed under Californ A’s online 200 payments above claim pay Sacramento, Medicalofthe interest,iadati -library. d on in CM95814 law at economicservices@cman seven r isallbase health plans. be found CA net.

As a result, DMHCThe orde d violations healthreshorg/resource l docuth plans. and can et.org • 916/551 cma -2061 assessed adminis audits foun lega n ww. ://w medicallibrary, http purchase bers can e.

Nonmem $2 per pag ments for

s to pay

plan seve providers the money Thesetrative fines,law at allthe required required the onstrate ifornia. plans Calwere pays, ifornia ivetofine inthey owed and trat mandat ed ssed plans dem that plans under Cal adminis demonstrate dated that of 5 old allowed • Page 1 DMHC asse d and man

ic Services for Economento, CA 95814 1 CMA Center Sacram -206 et, #200, • 916/551

2012 owe As a result, they wereCPR • May 2012 • Page 1 of 5 CPR • May the money providers

1201 J Stre rvices@cmanet.org economicse

CMA Practice Resources (CPR) is a free monthly e-mail bulletin from CMA’s Center for Economic Services. This bulletin is full of tips and tools to help physicians and their office staff improve JULY 11TH, 2018:

NO MEETING DUE TO FACILITATING OUR DECISION MEDICINE PROGRAM For more information on our Decision Medicine Program, please visit our website at decisionmedicine.com. We are looking for new Doctors who would be willing to host a student in their office on July 18th and/or July 25th from 9:00AM-2:30PM. If you are interested, please contact Jessica@sjcms.org or call 209-952-5299!

AUGUST 8TH, 2018: TBD

practice efficiency and viability.

SUBSCRIBE NOW

Sign up now for a free subscription to our e-mail bulletin, at www.cmanet.org/news/cpr

Public Health

Update

News Your Patients Can Use: Shutoff Protections and Medical Baseline Rates Help Ensure Access to Life-Saving Equipment and Energy

by Kismet Baldwin, MD and Justine Marcus All of our patients require energy to maintain their health—to heat and cool their homes, cook their meals and warm their bath water. But for patients who rely on electric-powered medical equipment, or have conditions that require additional heat, consistent access to affordable energy can be a matter of life or death. Did you know that your patients who need respirators, kidney dialysis machines, motorized wheelchairs and other life-sustaining equipment at home may be entitled to disconnection protections and a discount on their utility bills?

If you didn’t, you’re not alone. Unfortunately, many healthcare professionals and their patients are unaware of these supports and protections. Electric and gas bills take a huge bite out of household budgets in San Joaquin County, where the median household income is $53,300, which is well below the California median household income of $64,500. Of course, residents who require increased electricity for their medical equipment will incur higher than average energy costs.

56

SAN JOAQUIN PHYSICIAN

SUMMER 2018

This was certainly the case for Ruben. Ruben and his family struggled mightily to pay their skyrocketing PG&E bills, impacted by the increased electricity needed for his kidney dialysis machine. Some months his family’s bills were over $2,000 a month. After he fell behind on payments, PG&E shut off Ruben’s power. He was forced to leave his home and stay with his daughter in order to keep his dialysis machine running and stay cool in the Central Valley heat.

Only after connecting with a local community-based organization did Ruben and his family learn that Ruben was eligible for the Medical Baseline program. Medical Baseline provides a utility rate discount for people who have serious medical conditions and/or need electric-powered medical equipment. Eligibility for Medical Baseline is based on a diagnosed medical condition and/or use of medical device, irrespective of income.

Customers who qualify for Medical Baseline can get more of their gas and electricity at lower rates. For most customers, a baseline amount of electricity, based on average usage in their area, is billed at the lowest rate. Medical Baseline customers get an additional “baseline” allowance of approximately 500 kilowatt-hours of electricity and/or 25 therms of gas each month beyond the “baseline” amount that other customers receive, which can result in a substantial bill reduction. If more than one person in a household qualifies for Medical Baseline, the accountholder can apply for additional allowances for each person.

In addition to the discounts, the Medical Baseline program also protects patients by requiring their utility company alert them of planned outages.

Even with these discounted rates, some patients still fall behind on their utility bills, often struggling financially at the intersection of illness, a fixed income or job loss, and trauma.

Previously, there were no California laws prohibiting utility

companies from shutting off medically vulnerable customers like Ruben, even if they had a life-threatening condition or were on life support.

In 2017 that changed. “The Shutoffs Reduction Act, championed by The Utility Reform Network (TURN), was signed into law. The Act includes provisions that prohibit utilities from shutting off households with a member in home hospice, on life support or otherwise suffering from a lifethreatening condition. A patient’s life should never rest on their ability to pay a utility bill, and this new law works to ensure that no patient is compromised due to inability to pay. In 2018, TURN is working to expand and improve Medical Baseline through SB 1338 – Medical Baseline Reform Bill.

The Healthcare Provider’s Role

As healthcare providers, we can make a difference by informing our patients that they may be eligible to receive a Medical Baseline allowance and that they may be protected from a utility disconnection. If you have patients with arthritis or other conditions for which additional heating or cooling is “medically necessary to sustain the patient’s life or prevent deterioration of the patient’s medical condition” they are also eligible to receive a Medical Baseline allowance. This includes, for example, a patient whose health requires medication to be refrigerated.

The Medical Baseline application is available on PG&E and other utilities’ websites. It must be filled out and signed by the utility account holder and a licensed medical doctor or doctor of osteopathy must certify the household member’s medical situation. Eligible life support equipment can include nebulizers, iron lungs, hemodialysis machines, suction machines, electric nerve stimulators, aerosol tents and other life-sustaining equipment. Helping patients to access the equipment and services they need will enhance their treatment, health and well-being.

About Doctor Kismet Baldwin and San Joaquin County Public Health Services Dr. Baldwin recently joined San Joaquin County Public Health Services as the county Health Officer. She is eager to work with providers to improve the health of the community and encourages anyone in the community to think of and use Public Health Services as a resource when they are caring for patients.

About Justine Marcus and TURN Justine Marcus is a policy fellow with TURN – The Utility Reform Network, where she supports utility justice policy and advocacy campaigns that advance health equity and stable housing for all Californians. TURN believes no one should be cut off from essential electricity, gas or phone service. We hold utility corporations accountable by demanding fair rates, cleaner energy and strong consumer protections.

For any questions about the Medical Baseline Program please contact Gabriela Sandoval, Ph.D. at gsandoval@turn.org or 415-929-8876.

SUMMER 2018

SAN JOAQUIN PHYSICIAN

57

New Members

18 NEW

SJMS MEMBERS THIS SPRING!

...and even more on the way.

Rami Georgies, M.D.

Albert Ferrari, M.D.

Family Medicine

Rheumatology

8001 Lorraine Ave Stockton, CA 95210 Faculty of Medicine University of Aleppo

2505 W Hammer Lane Stockton, CA 95209 Creighton University School of Medicine

Laura Irizarry, M.D.

Sahdev Saharan, M.D.

Family Medicine

Rheumatology

445 W Eaton Ave Tracy, CA 95376

3031 W March Lane #203W Stockton, CA 95219 Maharshi Dayanand University, Rohtak

Steven Kmucha, M.D. Otolaryngology 2545 W. Hammer Lane Stockton, CA 95209 Pritzker School of Medicine of University of Chicago

Randall Yee, M.D. Internal Medicine 165 St. Dominics Drive Suite 201 Manteca, CA 95337 Hines VA and Loma Linda University

58

SAN JOAQUIN PHYSICIAN

Kimberly Mclaughlin, M.D. OB/GYN 1800 N California Street, Women’s Pavilion Stockton, CA 95204 Drexel University College of Medicine

Chun Joey Chang, M.D. Family Medicine 500 West Hospital Road French Camp, CA 95231 University of California School of Medicine - Los Angeles

SUMMER 2018

practice management experts with a combined experience of over 125 years in medical practice operations. Our goal is to empower physician practices by providing resources and guidance to improve the success of your practice.

Zeest Khan, M.D.

Kismet Baldwin, M.D. George Newton, M.D. CALIFORNIA MEDICAL ASSOCIATION

Assistance ranges from coaching and education to Anesthesiology Pediatrics direct intervention with payors or regulators.

General Surgery

TROUBLE GETTING PAID? 66th Annual Yosemite Postgraduate Institute CMA CAN HELP! Nirja Shah, M.D. March 24 - 26, 2017 I’VE RECOVERED 975 South Fairmont Avenue Lodi, CA 95240 Rush Medical College

1601 E Hazelton Ave Fresno Madera Medical Stockton, CA 95205 Ohio State University College of Medicine

7373 West Ln

Society Stockton, CA 95210

Northeastern Ohio University College of Medicine

CMA members can call on CMA’s practice management experts for one-on-one help with payment, billing and contracting issues. If you answer “yes” to any of the following questions, it might be time to call for help.

Anesthesiology

Qingru Wang, M.D.

70,000

$

Indervir Grewal, M.D. 975 South Fairmont Avenue Pediatrics In the past nine years, CMA’s Center for Lodi, CA 95240 7373 after Westobtaining Ln • Are your claims being denied prior • Do you have questions about the new Anesthesiology law on payment from my payors using Services has recovered over MedicalEconomic College of Wisconsin 7373 West Ln Stockton, CA 95210 authorization? and billing for out of network services (Assembly Bill 72)?

CMA’s Center for $15.5 million from payorsStockton, on behalf of CA 95210 West China University of Medical Economic Services Jessica•CMA Willett, M.D. Do you members. have questions about CoveredSt. California?

• DoSchool you need issues?

George’s University of help with Medicare-related Science Medicine Family CMA’s Medicine Center for Economic Services is staffed by • AreHospital your claims not being paid in a timely manner?

• Have you been presented withLee, a managed Shin M.D. care 500 West Road practice management experts with a combined contract and you’re not sure if the terms are over 125 years in medical practice French experience Camp, CA of 95231 Anesthesiology •operations.

Are you not Our being paidisaccording to your contract? consistent with California law? goal to St. Georges University School of empower physician 7373 West Ln practices by providing resources and guidance to Jeffrey Cochiolo, M.D. Medicine Stockton, CA 95210 •improve Are you receiving untimely requests for refunds or is a • Have you done everything you can to resolve an issue the success of your practice.

Diagnostic Radiology University of Cincinnati College of payor recouping money from your check without with a payor, but have hit a brick wall?

Fei Lu Ye, M.D. 7373 West Lnto Medicine Assistance ranges coaching and education first notifying you infrom writing of a refund request?

Registration is now open - Call (559) 224-4224 ext. 118 for Stockton, CA 95210 Family direct Medicine intervention with payors or regulators. more information visit www.FMMS.org Albany Medical or College of Union 500 West Hospital Road University French Camp, CA 95231 Access to CMA’s reimbursement experts is a FREE, members-only benefit.

Chicago Medical School at Need help?

Call 786-4262 or email economicservices@cmanet.org.

Rosalind Franklin University CMA members can call on (800) CMA’s practice management experts for one-on-one help with payment, billing and contracting issues. If you answer “yes” to any of the following questions, it might be time to call for help.

• Do you have questions about the new law on payment and billing for out of network services (Assembly Bill 72)?

• Are your claims being denied after obtaining prior authorization?

• Do you have questions about Covered California?

• Do you need help with Medicare-related issues?

• Are your claims not being paid in a timely manner?

• Have you been presented with a managed care contract and you’re not sure if the terms are

• Are you not being paid according to your contract?

• Are you receiving untimely requests for refunds or is a payor recouping money from your check without

consistent with California law?

• Have you done everything you can to resolve an issue with a payor, but have hit a brick wall?

first notifying you in writing of a refund request?

Access to CMA’s reimbursement experts is a FREE, members-only benefit.

Need help? Call (800) 786-4262 or email economicservices@cmanet.org.

SUMMER 2018

SAN JOAQUIN PHYSICIAN

59

In Memoriam

In Memoriam DR. BRIEN EUGENE ECKER Jun. 25, 1951 - Jan. 26, 2018

Brien E. Ecker passed away unexpectedly on January 26, 2018 at the age of 66. Brien is survived by his loving wife, Kay, with whom he shared 30 years of marriage; his children, Kevin (Heather) Ecker and Jessica (Adam) Rimington and his grandchildren, Adam II & Ava Rimington. He is also survived by his two sisters, Gretchen Zaballos and Marianne Ecker, as well as many cousins, nieces, nephews, friends, and colleagues.

He was preceded in death by his parents William and Anna (O’Brien) Ecker, his brother, William Ecker II, and his sister Patricia (Ecker) Burger.

From the time Brien was a young boy, he knew he wanted to become a physician and he never wavered from that path.

After graduating from Bellarmine College Prepatory, he attended San Jose State University and then attended Stanford University School of Medicine, where he graduated in 1977. He eventually joined

60

SAN JOAQUIN PHYSICIAN

Lincoln Medical Group in Stockton, CA, where he practiced Family Medicine. In 1999, he joined the Gould Medical Group where he continued to practice for the next 17 years. Brien was a physician for 39 years. When he wasn’t working, Brien could be found on the golf course, a passion he developed and religiously played every Wednesday morning with his close friends.

He also enjoyed playing the ukulele and the stock market. He retired, as he intended, at the age of 65, in 2016. Last June, Brien fulfilled his dream of moving, with his wife Kay, to the Pacific Northwest to enjoy retired life. While there, he enjoyed hiking in the great outdoors, traveling, reading, and volunteering at various charities, including the Habitat for Humanity. Brien was a devoted husband, father, papa, friend, and physician. His sudden passing has left a hole in our hearts.

SUMMER 2018

In Memoriam

In Memoriam DONALD EWAN LAMOND, MD Feb. 20, 1927 - Mar. 24, 2018

Donald Ewan Lamond. Born February 20, 1927 to Scottish immigrants William Gow Lamond and Myrtle Lamond (nee Lang) in Winnipeg, Manitoba. While at home in the presence of his children, and after a brief battle with the ignominy of old age Don passed March 24, 2018. A respected neurosurgeon, scholar athlete, patron of the arts, and consummate host, Donald was a renaissance man for all who knew and loved him.

He survived Evelyn, his beloved wife of 62 years, but missed her every day since. He is survived by his 7 children, their spouses, his 18 grandchildren and 2 great-grand children.

A resident of Stockton for the past 59 years, Donald worked tirelessly as one of the area’s first neurosurgeons until his retirement in 1992. Don came of age during the hardship of the depression and WWII. In 1946 his father died, leaving him and his brothers Conrad and Keith, devoted sons to their mother. The era of his childhood led Donald to internalize a set of values that always defined his life: honesty, hardwork, and self-reliance and they shaped the boy into a man.

That man’s world was happily upended when at age 19 he met Evelyn Couper. Their courtship unfolded against the stunning backdrop of Banff and Lake Louise in the Canadian Rockies where they both worked during the summers while students. In 1948 Don began medical school at the University of Manitoba, and in 1950 he married Evelyn. In 1956 the couple moved their growing family to

SUMMER 2018

Detroit, Michigan where Don undertook his residency at Henry Ford Hospital. In 1959, his studies complete and four kids in tow, Donald and Evelyn had opportunity aplenty and they chose Stockton, California. Where else can you have the spectacular skiing of the Sierra Nevada ninety minutes east and the storied beaches of the California coast ninety minutes west and the waterski paradise of the Delta right out your back door. Dr. and Mrs. Lamond loved Stockton and they soon became active members of the community while always maintaining their friendships with their childhood and college friends. He was a founding member of the Sigma Lambda Phi fraternity at college and they continued regular gatherings until recent years.

He received the Dora Bell Howard Award for Distinguished Service to the Stockton Civic Theater. Pops entertained his children and grandchildren with tales of adventure running youth programs in the Canadian wilderness, ice hockey, football and barbershop quartets. His keen intellect, curiosity and fair- mindedness carried him to his final days. Friends and family surrounded him always and he tended to them as ardently as he did his revered garden. He gifted his children and his children’s children with the precious sense of belonging. That sense spilled over to friends as well and it was never more apparent than when you sat down to dinner at Pop’s table where there was always room for one more. Don Lamond asked for only one thing in this world - a little PLU please Peace, Love & Understanding.

SAN JOAQUIN PHYSICIAN

61

In Memoriam

In Memoriam WILLIAM JOSEPH GORHAM, M.D. Sept. 11, 1930 - May 6, 2018

William was born September 11, 1930 in Detroit, Michigan, where he attended public schools. He graduated from the University of Wisconsin and then entered active service in the U.S. Navy where he served as an Ensign from 1953-1956. Upon leaving the service as a Lieutenant, J.G., he attended medical school at the University of Michigan, graduating in 1960, a member of the Alpha Omega Alpha. He completed his internship and residency in Dermatology at Stanford Medical Center, Palo Alto.

He practiced Dermatology in Stockton from 1964 to 1996 and was a member of the San Joaquin Medical Society for 42 years. Upon his retirement from private practice, he maintained his medical license and participated in weekly tumor board evaluations for cancer patients. He is survived by his wife Jeannette and his children Anita, William III (Corie), Monica, and 8 grandchildren.

62

SAN JOAQUIN PHYSICIAN

SUMMER 2018

PRENATAL & POSTPARTUM CARE • HIGH RISK PREGNANCY • GYNECOLOGY • ENDOMETRIOSIS URINARY INCONTINENCE • OVARIAN CYSTIC DISORDER • LAPAROSCOPY • HYSTEROSCOPY DIAGNOSIS & TREATMENT OF CERVICAL, UTERINE, OVARIAN CANCERS • ROBOTIC SURGERY

Gail Joseph, M.D.

SUMMER 2018

SAN JOAQUIN PHYSICIAN

63

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

PRSRT STD. U.S. POSTAGE

RETURN SERVICE REQUESTED

PAID

Permit No. 60 Stockton, CA

The One Thing Hackers Hope You Never Discover Imagine not being able to send or receive e-mail for days, possibly weeks. Don’t think this could happen because you have a reputable anti-virus software installed? If so, you’re operating on a false sense of security and hackers are praying that you keep thinking that way. Here’s why: Most business owners think that because they have anti-virus software installed and a software firewall, that their network is “secure.” Not so. One of the most common stunts hackers pull is breaking through a software firewall to hijack a server. Once they’re in, they use YOUR server to relay spam and other viruses to millions of users in a matter of seconds.

1. In no time flat, your company’s server and email gets “blacklisted”, which means the big email delivery hubs (like Comcast, Google, Verizon, etc.) flag ALL e-mails coming from your server as “dangerous” and won’t let them through; and on the net, you’re guilty until proven innocent, which means it could take days or weeks to get your name cleared. During that time, you are completely without e-mail.

2. Your patients, prospects and vendors start getting Viagra ads and invitations to XXX-rated web sites from your company. Not good.

The absolute best way to make sure this never happens is to invest in a top-grade managed services provider.

This investment is worth twenty times the cost in peace of mind and saved time.