Summer 2022
SERVING SAN JOAQUIN,
TUOLUMNE, ALPINE, AMADOR AND CALAVERAS COUNTY PHYSICIANS
A career that f lew by MICRA Modernizations • CMA Bill Aims to Lower Barriers • Residents Report
SUMMER 2022
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HEALTHCARE PROFESSIONALS
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ProAssurance.com SUMMER 2022
VOLUME 70, NUMBER 2 • JUNE 2022
PICTURED ABOVE: GOSWAMI FAMILY
12 MANY HATS BUT ONE GOAL
42 RESIDENTS REPORT
22 MICRA MODERNIZATIONS
46 PRACTICE NEWS AND
25 BILL AIMS TO LOWER BARRIERS
SUMMER 2022
RESOURCES
50 PUBLIC HEALTH UPDATE
28 A CAREER THAT FLEW BY
52 IN MEMORIAM
34 IN THE NEWS
54 NEW MEMBERS
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PRESIDENT Raghunath Reddy, MD PRESIDENT ELECT Cyrus Buhari, DO TREASURER Nguyen Vo, MD BOARD MEMBERS Hyma Jasti, MD, Shahin Foroutan, MD, Neelesh Bangalore, MD, Stephen Tsang, MD, Maggie Park, MD, Sujeeth Punnam, MD, John Zeiter, MD, Alain Flores, MD, Manreet Basra, MD, Sanjeev Goswami, MD
MEDICAL SOCIETY STAFF EXECUTIVE DIRECTOR Lisa Richmond MEMBERSHIP COORDINATOR Jessica Peluso ADMINISTRATIVE ASSISTANT Maria Rodriguez-Cook
SAN JOAQUIN PHYSICIAN MAGAZINE EDITOR Lisa Richmond EDITORIAL COMMITTEE Lisa Richmond, Raghunath Reddy, MD MANAGING EDITOR Lisa Richmond CREATIVE DIRECTOR Sherry Lavone Design
COMMITTEE CHAIRPERSONS CMA AFFAIRS COMMITTEE Larry Frank, MD DECISION MEDICINE Kwabena Adubofour, MD
CONTRIBUTING WRITERS Jo Ann Kirby, Raghunath Reddy, MD, Lory Mercer BSN, RN, PHN Mariya Rabovsky-Herrera BSN, RN, PHN
MEDICAL EDUCATION PROGRAMS R. Grant Mellor, MD PUBLIC HEALTH COMMITTEE Maggie Park, MD SCHOLARSHIP LOAN FUND Gregg Jongeward, PhD CMA HOUSE OF DELEGATES REPRESENTATIVES Robin Wong, MD, Lawrence R. Frank, MD
THE SAN JOAQUIN PHYSICIAN MAGAZINE is produced by the San Joaquin Medical Society SUGGESTIONS, story ideas are welcome and will be reviewed by the Editorial Committee.
James R. Halderman, MD, Raissa Hill, DO Richelle Marasigan, DO, Ramin Manshadi, MD
PLEASE DIRECT ALL INQUIRIES AND SUBMISSIONS TO:
Kwabena Adubofour, MD, Philip Edington, MD
San Joaquin Physician Magazine
Harpreet Singh, MD
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
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Please join us for the
ANNUAL MEMBERSHIP DINNER honoring our
2022 Lifetime Achievement Award Recipient
PAUL A. WATERS, MD Young Physician Award Recipient
SANJEEV GOSWAMI, MD
SUNDAY, JUNE 5, 2022 Cocktail Hour 6:00pm | Dinner 7:00pm
STOCKTON GOLF & COUNTRY CLUB 3800 Country Club Boulevard | Stockton, California
Additionally, we will honor the passing of the gavel from Raghunath Reddy, MD to Cyrus Buhari, DO
Reservations may be limited and will be offered on a first come, first served basis. Please RSVP at www.sjcms.org or 952-5299. SUMMER 2022
PR E M IE R L E VE L S P ON S OR S
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EXECUTIVE DIRECTOR’S REPORT
BRIGHTER DAYS AHEAD
As you have likely heard, an agreement has been reached which will modernize and update MICRA. A 2022 initiative directly targeting physicians and threatening access to health care will no longer be on the ballot this November.
LISA RICHMOND
Californians Allied for Patient Protection (CAPP) led a broad coalition, which included the California Medical Association, to champion an agreement that removes FIPA (Fairness for Injured Patients Act) from the ballot and updates the 47-year-old medical malpractice law. Understandably, we have heard our members’ valid concerns about the compromise. Along with the virtual town hall opportunities that have been provided, included in this issue are articles outlining how the compromise maintains imperative protections for physicians while providing long-term predictability and affordability of medical liability insurance premiums. As always, please reach out to me or SJMS leadership for more information or to discuss further. On a lighter note, in late April, our Decision Medicine committee reviewed applications and conducted our first, in person interview session since 2019! We are so excited for this year’s class and getting back to a (more) normal program this summer. A special thank you goes out to Drs. Kwabena Adubofour, Marina Castillo, Alain Flores, Hyma Jasti, George Khoury and Sujeeth Punnam for volunteering their time. It is always inspiring and fun to hear from these bright students. We are still looking for physicians to mentor a student on either July 13 and/or July 20 from 9am-2:30pm. They are all at least 16 years old, mature and HIPAA certified. Our goal is for the student to truly experience a “day in the life” of a physician, so we ask mentors to involve them in their day with patients as much as possible. Most have had limited access to physicians and welcome any opportunity to interact one on one. Please email Lisa@sjcms.org if you are interested in participating this summer. More information about Decision Medicine can be found at www.sjcms.org. Finally, we are looking forward to celebrating our 2022 Young Physician and Lifetime Achievement Award recipients, Drs. Sanjeev Goswami and Dr. Paul Waters, respectively, on Sunday, June 5. We know you will enjoy reading the enclosed feature articles on both accomplished, deserving physicians. Details regarding the dinner may be found in the enclosed ad. Have a wonderful summer,
Lisa Richmond
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60 Years of Compassionate Care Doctors Hospital of Manteca began 60 years ago with the mission to provide the best care possible to Manteca. Today, we are a top employer in the community with over 370 employees and a staff of more than 180 physicians – many board-certified in their specialty. From emergencies and screenings to surgical and procedural services, we deliver expertise and compassionate care close to home. Doctors Hospital of Manteca offers: • 24-Hour Emergency Care and Convenient Online Check-Ins • Advanced Orthopedics for Knee and Hip • Family Birthing Center • Imaging Services, Including 3-D Mammography • Surgical Services, Including Weight Loss Surgery • Women’s Health • Wound Care Center
•
Accredited as a Comprehensive Center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®), a joint program of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS) •
Designated as a Blue Distinction® Center+ for Bariatric Surgery
•
Designated as a Blue Distinction® Center for Knee and Hip Replacement
•
Recognized as a Certified Quality Breast Center of Excellence in the National Quality Measures for Breast Centers program
To refer a patient, call (844) 632-5727 or visit DoctorsManteca.com 1205 E. North St. Manteca, CA 95336 8
SAN JOAQUIN PHYSICIAN
SUMMER 2022
A message from our President > Raghunath Reddy, MD
MICRA MODERNIZATION! A COMPROMISE!!! As you all are aware, recently, the Micra Modernization deal was signed and is now making its way through the legislature to take effect from January 1, 2023. A broad coalition, California Allied for Patient Protection (CAPP), including CMA leadership, negotiated the modernization and claim it as a historic and win-win for patients and physicians alike. Historic yes, however only time will tell us whether it is infamous or famous as implications are significant for both patients and physicians and for the healthcare in general. CMA and the coalition have done a great job in safeguarding several provisions of “MICRA as you know from 1975” and these include: • Advance notice of a claim • Option of binding arbitration • 1 year statute of limitations to file •O ther sources of compensation to be allowed in determining the award • Ability to pay awards over a period of time • L imitation on attorney fee (Commensurate increase with obvious increase of noneconomic cap) • A ttorney fee remains part of settlement or award and not separately billed to defendant. ABOUT THE AUTHOR Raghunath Reddy, MD is the current president of the San Joaquin Medical Society and practices family medicine at Stockton Primary Care Medical Center
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Effective Jan 1, 2023, features of new deal include, • I ncrease in Noneconomic cap to $350k for non-death cases and $500k for wrongful death cases
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A message from our President > Raghunath Reddy, MD
• I ncremental yearly increase of $40k and $50k for 10 years and 2% annual inflationary adjustment after 10 years for non-death cases and wrongful death cases respectively •B y 2033 Cap increases to $750k for non-death cases and $1million for wrongful death cases •O ne cap cumulative for all Healthcare providers in a single common case •O ne cap for all Healthcare institutions in a single common case •O ne cap for unaffiliated health care institutions or providers at that institution. • J ust culture concept and admission of sympathy etc. non discoverable • 2 tier system, limiting attorney fee Among other factors that resulted in CMA and coalition favoring negotiated settlement are the following facts. •R epeated attacks on MICRA repeal, the cost of financing to fight the ballot measure initiatives •P rogressive loss of pro MICRA support in Legislature. •N o change in cap for 47 years seen as unfair by many voters in focus groups •T he catastrophic negative implications should the November ballot initiative prevail Is it worth it? Well, it is a compromise, and the word says it all, you gain some, you lose some and it is hard to have everyone involved in the deal to be happy about the outcome. The CMA and coalition are upbeat and very positive about the new deal and feel this puts an end to
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any future risk of repeals or ballot initiatives given the COLA link and other provisions. I am not yet aware the physician response statewide, however some local physicians have been upset and vocal in expressing their very valid concerns and frustration. Some of which included concern about increase in the dramatic non-economic damages cap over time, increase malpractice premiums, difficulty recruiting physicians and potential increase in frivolous lawsuits. SJMS and CMA have given members opportunities to learn about the agreement, ask questions and address their concerns with multiple town hall forums with SJMS and CMA leadership, which have been well attended. This may seem like Monday morning quarterback but are realistic and genuine concerns of the physicians from the trenches with many years of experience and wisdom in several different specialties. Hopefully, the CMA and coalition’s vision and optimism bears out to be true and win-win for patients and physicians alike. I have always looked at healthcare as a giant wheel with many spokes, the two biggest being patients and physicians and one cannot risk hurting either of these and, expect the wheel to stay in motion. Folks, as I sign of with this article as President of SJMS, I take the opportunity to sincerely express my thanks, gratitude, and appreciation to each and every one of you, it has been an honor, privilege and pleasure to serve… and lastly please join me in welcoming our incoming President Dr. Cyrus Buhari, who will take over the reins in July 2022.
SUMMER 2022
STOCKTON LODI MANTECA TRACY SONORA JACKSON
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MANY HATS BUT ONE GOAL Dr. Goswami’s servant heart gives back here and abroad BY JO ANN KIRBY
SUMMER 2022
Serving as chief of staff for St. Joseph’s Medical Center, the recipient of the San Joaquin Medical Society’s Young Physician Award has been working tirelessly on the front lines of the pandemic as a pulmonologist seeking the best care and practices for Covid-19 patients. It’s a battle he has trained his entire life to lead and just one of many roles Dr. Sanjeev Goswami shepherds. “We thought it would be three to six months and here we are more than two years later,” Dr. Goswami, who coordinates critical care at Dameron Hospital, Lodi Memorial and SJMC, said. “But this is what you train for, this is why you become a doctor. This is our war zone. It was a learning process because we’d never dealt with it and we are practicing evidence-based medicine.”>>
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He spent hours researching what had worked for colleagues who had experienced surges on the East Coast and other regions before the numbers began to climb here, but as new variants attacked over the subsequent months, what once worked was no longer effective. It was a constantly changing medical landscape that challenged and motivated him.
“I never let it get me down. Every day is a new day,” he said. “Every day there was a new trial to read about. Every day, you learn something new.” That indefatigable spirit and quest for knowledge is coupled with a desire to serve. He credits his work ethic to his father, who joined India’s army at the age of 16. Dr. Goswami was the first in his family to graduate from college and said his father instilled in him the belief that nothing is impossible if one works hard and puts their mind to it. It’s a trait he and his wife Pinki, a nurse practitioner, preach to their two children, Kartik and his sister Archana. “The most awe-inspiring trait about him is his work ethic,” Kartik, who is in medical school, said. “He will grind day and night no matter how tired he is to ensure the job is done. If he has a goal in mind, he will get the job done no matter how many hours it takes to complete.” At the age of 48, those goals include helping his community, whether it’s here, or back in India. Dr. Goswami grew up in a small village where he didn’t have much. He tells his children
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that all the kids would get together to watch a game of cricket on one of the only TVs in the village. Today, Dr. Goswami is working to help lift others out of poverty and to help keep rich cultural traditions alive. To that end, he has spearheaded an effort to build the Stockton Hindu Cultural and Community Center at the Shiva-Vishnu Temple of Stockton for young people to “get off their iPhones” and learn about such important traditions such as meditation. Back in India, he and his family are building a school in the village where his dad grew up. “Every year we add a room,” he said of the elementary school. “My goal is to add more capacity so that it expands to high school.” His friend, Dr. Miroslav Djokic, said Dr. Goswami is a man of integrity who is a successful leader because he has the community’s best interests at heart. “Every time I thought that he had reached significant heights and that he might be approaching (his) limit, he breaks through and goes on to the next level,” Dr. Djokic adds that Dr. Goswami is like a brother to him and serves as trustee for his family trust. “He is a great friend and partner, I know that he’s a fantastic father and family man and person of high ethical standards,” he added. Dr. Goswami attended medical school in India, completed his internal medicine residency in Ohio, and served a critical care medical medicine fellowship at the prestigious Brown University followed by a pulmonary and critical medicine fellowship at the University of Texas. He is an active researcher whose work has been published, including most recently regarding Covid-19. He values his work with colleagues and staff, cherishes his friendships and is proud of his wife and children. “My wife has played a very important role in my success,” he said. “She has always supported me with all the hats I’ve worn,” he said. That especially includes his fellowship at Brown where he worked more than 100 hours a week.
SUMMER 2022
With his humble beginnings, he is grateful his father was able to spend the last 10 years of his life living with his doctor son and family. “He saw me struggling but he saw me make it,” Dr. Goswami said of his father who died peacefully at his son’s Stockton home from pancreatic cancer. His own son, Kartik said that his father is a caregiver at heart. “He always has the goal of making sure all his family here and abroad are stable, happy and secure,” Kartik said. “If I can be half of what he is, I would be very proud.”
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THE MOST AMAZING CARE ANYWHERE® Parents and providers choose experienced care teams at Shriners Children’s Northern California to provide children with congenital conditions and complex medical needs compassionate, innovative treatment. Shriners Children's Northern California is part of an international pediatric health care system of hospitals, clinics, ambulatory surgery centers and global outreach. Our personalized approach allows children to rise to their full potential. We provide a full range of programs, services and support, caring for children in a welcoming, warm and reassuring environment. Our core signature specialty pediatric clinical programs include: Burns Pediatric Rehabilitation o Comprehensive Inpatient Rehabilitation o Spinal Cord Injury Pediatric Surgery o Chest Wall Malformations o Colorectal Disorders o Urology
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Call: (916) 453-2191 | Fax: (916) 453-2395 | Email: referrals.ncal@shrinenet.org Online Referral Form: www.shrinerschildrens.org/referandtransfer SUMMER 2022 16 SAN JOAQUIN PHYSICIAN
50 Years of Humankindness from the Heart. Honoring James D. Morrissey, MD, for 50 years of caring for the hearts of San Joaquin Valley. In 1972, Dr. Morrissey joined the medical staff at St. Joseph’s Medical Center, where he performed the area’s first open heart surgery in 1974. Over the course of his 50-year tenure, Dr. Morrissey has completed thousands of heart surgeries at St. Joseph’s and led the way in pioneering numerous “firsts” in cardiac care. His skills and expertise have earned him many awards and achievements, including the San Joaquin Medical Society Lifetime Achievement Award in 2011 and the St. Joseph’s Medical Center Champion of Community award in 2018. With Dr. Morrissey’s leadership, St. Joseph’s Heart and Vascular Institute has become a top program nationally, and the first choice for heart patients in the Central Valley. Thank you, Dr. Morrissey, for your dedication and commitment to your patients, and for all that you do to advance cardiac care and the health of our community. Join us in honoring Dr. Morrissey by scanning the QR code to share your memories, photos, and words of gratitude on Dr. Morrissey’s “Kudoboard.”
SUMMER 2022
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About the AMA STEPS Forward™ Playbook series This Playbook is part of the AMA STEPS Forward™ interactive practice transformation program. Each Playbook in the series highlights key messages and links to free online toolkits, videos, podcasts, and practical tools to start creating change today. The objective of the Playbook series is to offer you a high-level overview of an area that you can choose to dive deeper into at your own pace. Access the digital Playbook for the optimal experience. To fully engage with the Playbook and access all the relevant links, scan this QR code to view the PDF on your smart device or computer.
About the AMA STEPS Forward™ practice innovation strategies The AMA STEPS Forward program offers practice innovation strategies that allow physicians and their teams to thrive in the evolving health care environment by working smarter, not harder. Physicians looking to refocus their practice can turn to AMA STEPS Forward for proven, physician-developed strategies for confronting common challenges in busy medical settings and devoting more time to caring for patients. This collection offers more than 70 online toolkits and other resources that help physicians and medical teams make transformative changes to their practices, including in the areas of managing stress, preventing burnout, and improving practice workflow. The AMA STEPS Forward™ Innovation Academy expands on the program to give participants the flexibility to customize their practice transformation journey. The Innovation Academy offers a spectrum of opportunities to learn from peers and experts, including webinars, telementoring, virtual panel discussions, bootcamps, and immersion programs. Learn more at www.stepsforward.org.
Taming the Electronic Health Record Playbook authors: Jill Jin, MD, MPH; Jessica Reimer, PhD; Marie Brown, MD, MACP; Christine Sinsky, MD, MACP AMA STEPS Forward also acknowledges the authors of the individual toolkits referenced in the Taming the EHR Playbook for their contributions: Melinda Ashton, MD (Getting Rid of Stupid Stuff); Peter Basch, MD, MACP (EHR Optimization); John Bulger, DO, FACOI, FACP (Choosing Wisely); Catherine DesRoches, DrPH (Sharing Clinical Notes With Patients); Jane F. Fogg, MD, MPH (EHR Optimization); Matt Handley, MD (Choosing Wisely); Kevin Hopkins, MD (Patient Portal Optimization); James Jerzak, MD (EHR Inbox Management); Christopher Joseph (EHR Optimization); CT Lin, MD, FACP (EHR Optimization); Margaret Lozovatsky, MD (Patient Portal Optimization, EHR Optimization); Paola Miralles (Sharing Clinical Notes With Patients); Wendy K. Nickel, MPH (Choosing Wisely); James Rice, MD, MHA (Patient Portal Optimization). © 2022 American Medical Association https://www.ama-assn.org/terms-use
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Introduction 50% of the physician’s day
spent on EHR and desk work1
37% of visit time with
patients spent on non-clinical tasks1
1 to 2 hours
of extra work each day, including long hours before and after clinic completing “between visit” work1
1.
Sinsky C, Colligan L, Li L, et al. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med. 2016;165(11): 753-760. doi:10.7326/M16-0961
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Introduction
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The EHR Problem: How Did We Get Here?
T
he electronic health record (EHR) has profoundly changed the practice of medicine and is perceived as both a blessing and a burden by clinicians who use it. Most physicians who did not begin their training and enter practice using a sophisticated EHR only learned enough to “get by.” Younger physicians who did go through medical training using a modern-day EHR typically did not have the bandwidth to focus on mastering the EHR along with their medical knowledge. Furthermore, the near-universal adoption of virtual care and telehealth during the COVID-19 pandemic has increased patient expectations and awareness about EHR-based communication tools, resulting in increased physician time spent on the EHR.2
Meanwhile, the EHR has evolved dramatically, in both positive and negative ways. While most EHRs now have customizable tools that, if used optimally, can save physicians time, there are also many more unnecessary “clicks” and automated messages clogging up inboxes. The EHR burden is a major contributor to physician burnout, and it has become a problem that individual physicians cannot fix on their own. It is imperative for organizations to learn how to “tame” the EHR by implementing effective team-based care principles and responding to feedback for continuous system-level improvement.
2.
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Physicians don’t quit their jobs, their patients, or their bosses; they quit their inboxes. —CT Lin, MD, FACP, FAMIA; Chief Medical Information Officer, UCHealth-Colorado
Holmgren AJ, Downing NL, Tang M, Sharp C, Longhurst C, Huckman RS. Assessing the impact of the COVID-19 pandemic on clinician ambulatory electronic health record use. J Am Med Inform Assoc. 2021;ocab268. doi:10.1093/jamia/ocab268
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How Can We Tackle This Problem?
What’s In Your Control?
The EHR problem can be thought of as encompassing a few buckets:
To accomplish any of these changes, it is imperative to work with leadership. Some changes will be easy to make, others will be more difficult. Some changes may be institution- or organization-specific, while others may be governed by federal regulations. Having a shared understanding between leaders and practicing clinicians of “what’s in your control” helps overcome inertia (or resistance to change) while building trust and transparency (Table 1).
•
• •
the volume of unnecessary work that is being done (eg, extra clicks and mental bandwidth spent on filtering signal from noise, patient questions and requests that could have been avoided with better teamwork and workflow re-engineering) the volume of necessary work that needs to be done, but can be shared by nonphysician team members (eg, chart review, order entry, documentation, inbox management) the technology itself
This Playbook will focus on addressing each of these buckets so that individual clinicians and their practices can:
1.
2.
3.
Minimize the unnecessary work by deimplementing nonessential rules and looking upstream to stop irrelevant notifications and results from entering the inbox
Who Is This Playbook for? This Taming the EHR Playbook is for:
• • • • •
Daily EHR users (eg, physicians, physician assistants, nurse practitioners, nurses, medical assistants) Organizational leaders (eg, Chief Medical Information Officers [CMIOs] and Chief Compliance Officers [CCOs]) Medical directors Practice managers Operations leaders
Manage the necessary work by utilizing team-based care principles to offload inbox management, order entry, and documentation from physicians alone
Anyone interested in maximizing the benefits and minimizing the burdens of the EHR can learn from the content outlined and linked to within this Playbook.
Become more personally proficient at using EHR technology
This Playbook contains highlights from 11 AMA STEPS Forward™ toolkits.
Access the digital Playbook for the optimal experience. To fully engage with the Playbook and access all the relevant links, scan this QR code to view the PDF on your smart device or computer.
SUMMER 2022
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MICRA Modernization 2022 Historic agreement brings new and sustained era of stability around malpractice liability. In a historic agreement, Californians Allied for Patient Protection (CAPP) and the Consumer Attorneys of California have announced a consensus on legislation to modernize the Medical Injury Compensation Reform Act (MICRA). The modernized approach to MICRA— introduced as Assembly Bill 35 in the legislature and jointly authored by Assembly Majority Leader Eloise Reyes and Senator Tom Umberg—will extend the longterm predictability and affordability of medical liability insurance premiums, while keeping MICRA’s essential guardrails solidly in place for patients and providers alike. For decades, California’s landmark medical malpractice laws have successfully struck a balance between compensatory justice for injured patients and maintaining an overall health care system that is accessible and affordable for Californians. Over the years, California’s physician and provider communities have repeatedly defended MICRA through expensive battles at the ballot, in the courtroom and in the legislature. This year, with the so-called Fairness for Injured Patients Act (FIPA) slated for the November 2022 ballot, we were again facing another costly initiative battle that could obliterate existing safeguards for out-of-control medical lawsuits and result in skyrocketing health care costs. “For the first time in a generation, we were met with an opportunity to achieve a meaningful consensus between competing interests through a modernized MICRA framework that could protect both the rights of injured patients while keeping MICRA’s essential guardrails solidly in place for patients and providers alike,” says Robert E. Wailes, M.D., president of the California Medical Association (CMA). “At times like these, we have an obligation to protect patient care and to seize a historic opportunity for a brighter future for California’s health delivery system.”
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The Threat If approved by voters, the FIPA initiative would have effectively eliminated MICRA’s cap on non-economic damages by creating a new, broadly-defined category of injuries not subject to the cap. This would have resulted in a significant increase in litigation with unpredictably high verdicts and no less than an immediate doubling of malpractice insurance premiums. The non-partisan state legislative analyst predicted FIPA would have resulted in more than $11 billion a year in increased health care costs. This would have had a chilling effect on the entire health care system, with the trickledown effect borne primarily by low-income patients, who would face higher costs and restricted access to care. The initiative also directly targeted physicians, putting personal assets at risk.
A Modernized Framework A new consensus has been reached between health care, legal and consumer advocates on legislation to modernize MICRA. This agreement unifies stakeholders and puts the interests and wellbeing of Californians ahead of historic conflicts. The compromise reflected in this legislation will ensure that health care is accessible and affordable, while balancing compensation for Californians who have experienced health care related injury or death. “This balanced proposal modernizes and updates MICRA while preserving its essential guardrails, strengthening provider protections and providing for fair compensation for injured patients,” said Dustin Corcoran, CMA CEO and Chair of the Campaign to Protect Access and Contain Costs. “This framework is essential to our shared goal of health access for all Californians. We look forward to working with the Legislature and the Newsom Administration to enact this historic proposal.”
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The modernized framework preserves MICRA’s protections while providing a fair and reasonable increase to MICRA’s established limit on non-economic damages for medical negligence starting on January 1, 2023 – with gradual increases over the next 10 years and a 2.0% annual inflationary adjustment thereafter. Other important guardrails of MICRA will continue unchanged, including advance notice of a claim, the one-year statute of limitations to file a case, the option of binding arbitration, early offers of proof for making punitive damages allegations and allowing other sources of compensation to be considered in award determinations. Critical MICRA guardrails that will remain in place with modest updates include the ability to pay awards of future damages over time and limits on plaintiff’s attorney’s contingency fees. “This compromise will help to ensure that community health centers across California that serve some of our state’s most vulnerable patients will have continued access to safe, affordable health care,” said Jodi Hicks, Planned Parenthood Affiliates of California President and CEO. “It was important for Planned Parenthood to have a voice in this process because the proposed initiative would have caused significant harm to California’s safety net. We’re pleased to see a solution that creates long-term stability and protects access to care for those who need it most.” CAPP reached the agreement with the initiative’s proponent, Nick Rowley, and the Consumer Attorneys of California, the state’s largest organization representing plaintiffs’ attorneys.
Changes to the MICRA Cap Current law limits recovery of non-economic damages to $250,000, regardless of the number of defendants. The modernized framework would increase the existing limit to $350,000 for non-death cases and $500,000 for wrongful death cases on the effective date of January 1, 2023, followed by incremental increases over 10 years to $750,000 for non-death cases and $1,000,000 for wrongful death cases, after which a 2.0% annual inflationary adjustment will apply. The proposal will also create three separate categories of caps, which could apply depending on the facts of each case: + One cap for health care providers (regardless of the number of providers or causes of action) + One cap for health care institutions (regardless of the number of providers or causes of action) + One cap for unaffiliated health care institutions or providers at that institution that commit a separate and independent negligent act A health care provider or health care institution can only be held liable for damages under one category, regardless of how the categories are applied or combined.
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New Protections for Benevolent Gestures and Statements of Fault Often, a patient’s decision to file a medical malpractice lawsuit is triggered by a failure in communication, not negligence. The modernized framework establishes new evidentiary protection for all pre-litigation expressions of sympathy, regret or benevolence, including statements of fault, by a health care provider. Allowing physicians and patients to have full and open conversations about adverse events and unexpected health care outcomes will foster greater trust and accountability, while facilitating improved patient safety.
Next Steps The proposal reflected in this legislation strikes a prudent and patient-focused balance between fair compensation to injured patients and the need for universal, high-quality and cost-effective health care. More significantly, in the shadow of the most sweeping public health crisis in a century, it demonstrates a unifying willingness to put the interests of California patients ahead of divisive political positions. Our broad and diverse coalition of physicians, community health centers, dentists, hospitals, nurses and hundreds of other organizations dedicated to affordable, accessible health care will be working closely with the Newsom Administration and the California Legislature to ensure this updated approach to medical negligence cases is enacted and signed into law. CMA and the provider community remain united and committed to the principle of high-quality health care that is accessible and affordable to all Californians.
Californians Allied for Patient Protection (CAPP) is the large and diverse coalition working to protect access to health care through the Medical Injury Compensation Reform Act (MICRA). Its membership includes the California Medical Association (CMA), California Hospital Association, California Dental Association, CMA’s component medical societies, medical malpractice insurance carriers, community clinics, Planned Parenthood Affiliates of California and many more. (You can see the full membership at micra.org.) CAPP and its members also made up the core of Californians to Protect Patients and Contain Health Care Costs, the campaign CMA has been leading to defeat this dangerous ballot measure. CAPP reached the agreement with the initiative’s proponent, Nick Rowley, and the Consumer Attorneys of California, the state’s largest organization representing plaintiffs’ attorneys.
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The right specialists for your cancer journey. Hearing the words “you have cancer” can be overwhelming. At St. Joseph’s Cancer Institute, our patient navigators can answer questions, explain treatment options, and help guide your patients through their cancer journey. St. Joseph’s is the only accredited cancer center and NAPBC® Breast Center in San Joaquin County. With certified oncology specialists, state-of-the-art technology, and comprehensive support services, your patients can be assured St. Joseph's is the right place for care. Learn more at dignityhealth.org/stockton/cancercare.
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CMA sponsored bill aims to lower barriers to entry for incoming medical workforce On March 30, 2022 Assemblymember Carlos Villapudua (D-Stockton) announced AB 2132, the California Future Physician Fund, to address California’s shortage of physicians and medical professionals. “Although California continues to provide leading policies that ensure our residents can find health care insurance as needed, we remain vulnerable to the shortage of medical professionals across our state,” said Assemblymember Villapudua. “The financial barriers to entry have created significant gaps in our workforce – thus hindering our access to care – for many of our rural and underserved populations. Our physician shortage is creating longer delays in health care service, drives to offices or hospitals, and wait times for patients, which in turn discourages people from seeking care until absolutely necessary.” Medical students on average graduate with more than $280,000 in debt, and will often pay over $400,000 in totality after interest. This debt creates a strong deterrent to enter the medical field for those with lower incomes, especially when scholarships and grants are not guaranteed. These financial challenges can also prevent professionals from seeking employment in rural or underserved
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communities, where salaries tend to be lower than those offered in other areas of the state. The California Medical Association (CMA) is sponsoring AB 2132 to establish the California Future Physicians Fund, which would create a pilot program to provide scholarships to students in underserved communities from undergrad through medical school. Following the completion of their residency programs, these students will continue to provide care in the same communities they were educated in for a specified period of time. >> “As a Stockton native and physician, I know all too well that this area lacks the number of primary care providers and specialists that it needs. This problem will continue to negatively affect access to care for our community. The CA Future Physician Fund will empower our young people and provide them the opportunity to succeed and serve in the communities that raised them,” said Cyrus Buhari, M.D., president-elect of the San Joaquin Medical Society. “I have always dreamed of becoming a doctor, but the cost and hurdles of undergrad, medical school and residency are a huge barrier. By creating that end-to-end support, the CA Future
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Physician Fund represents opportunity that will give students like me the chance to pursue their dreams to be doctors and serve their communities,” said Alynna Nguyen, a senior at Stockton’s Health Careers Academy. “California needs more primary care physicians – more than 11 million Californians live in an area that has a shortage of primary care providers. When I matched at San Joaquin General, I was beyond proud to bring back my medical education to serve the community that I call home. This program is so important because it will give others the same opportunity that I have by increasing our physician pipeline, nurturing a community example to inspire and empower more diverse young people to become doctors, and creating strong, community connections between patients and their doctors,” said David Araiza, M.D., Resident at San Joaquin General Hospital. In 2020, California led the nation in federally designated Health Professional Shortage Areas. This continues to threaten the wellbeing of too many communities across our state as we aim to expand access to quality and efficient health care to every Californian.
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SAN JOAQUIN PHYSICIAN 27 GILLPRIMARYCARE.COM • ACCEPTING NEW PATIENTS
A career that f lew by From house calls to afterhours urgent care, Dr. Paul Waters delivered The San Joaquin Medical Society’s Lifetime Achievement Award honors Dr. Paul Waters for his dedication, innovation, and service to the community over his long career as a family practitioner specializing in obstetrics. At his Lincoln Village home, Dr. Waters and his wife Suzanne recently reflected on his vocation while thumbing through a stack of photos from his 2019 retirement party that depict a doctor with a wide range of hobbies, talents and causes that have kept him on the go over his lifetime. Known for his calm demeanor, he harkens back to a time when doctors still made house calls. He would visit his sickest patients at their homes when he was building his practice and gained a reputation for being dedicated to his those under his care. >>
BY JO ANN KIRBY
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A licensed pilot, Dr. Waters is something of a Renaissance man. He enjoyed flying, skiing, fishing, and traveling to far-flung locales. Today, he keeps busy overseeing nearly a dozen rental properties with his devoted wife, gardening and even woodworking. “There are probably a lot of people out there more deserving than I of this honor,” he said, with characteristic Midwestern humility that hints at his Iowan roots. “It was all rewarding, taking care of people and hopefully helping them stay healthy or regain their health. It was very enjoyable interacting with patients for so long over the years that they almost seem like friends.” To this day, he still runs into former patients who are eager to chat with their former doctor. “He practiced 54 years before retiring and loved his patients who were extremely loyal to him as their doctor,” said his friend and colleague, Dr. Edward Schneider, in nominating him for the award. “He was wellrespected by the entire medical community.”
Dr. Waters was born February 26, 1935, in Atlantic, Iowa. He completed his undergraduate degree at Creighton University and graduated from its medical school. An internship in Fresno brought him to the Central Valley and then to San Joaquin General Hospital. The draft was in place in the early 60s when he decided to serve his two-year commitment and he was stationed at hospitals at Fort Sam Houston in Texas and then Fort Benjamin Harrison in Indiana. He came back to Stockton and entered private practice in 1964. Tragically, his first wife was killed in a car accident leaving the widower on his own with a 7-year-old- son and 2-year-old daughter. A second chance at love with Suzanne Hopman, a widow with an 8-year-old son and 3-year-old daughter, whom he married in 1968, led to a long and thriving marriage. Their blended family includes a son of their own together, Brian, who followed in his father’s footsteps by graduating from Creighton University School of Medicine.
They have one grandson they dote on who they hope will come out from Texas to attend University of the Pacific. “Everyone came here for parties,” Suzanne recalls, of their busy Lincoln Village home that was once bustling with five children. “They were into everything, Little League, softball, you name it.” She kept the household running, along with the washing machine, which enabled her husband to thrive in his career. Their stacks of photos depict a lively and loving marriage.
“ I t was a balancing act truly, lots of hours and a lot of work.” “Here we are dressed up as Dracula and Bride of Dracula,” Suzanne Waters said, as they recalled memories of past Halloween festivities. Together, they delved into charity work. He worked with Su Salud to bring medical care to the underserved, and she got involved in volunteer work, as well. “It was a balancing act truly, lots of hours and a lot of work,” she said. The couple organized fundraisers to drum up money for the community. They were benefactors of the Stockton Symphony, the Child Abuse Prevention Council, Mary Graham Children’s Shelter and other civic and humanitarian organizations. Despite Dr. Waters’ long hours in private family practice, where he delivered 20 to 30 babies a year, he also managed to find time to help fill a need for emergency urgent care in Stockton with four other colleagues. The idea of a nighttime clinic flourished and he, along with his partners, would spend one night and one weekend every five weeks staffing the Stockton Medical Clinic until the concept of urgent care
clinics took off. “It was kind of innovative, because we hadn’t heard of anything of that sort and afterwards, there developed a lot of the freestanding urgent care clinics, so I’d like to think we were sort of the instigators,” Dr. Waters said. “You know, when you were building a practice, the emergency rooms would call you after hours to come down. It was a matter of setting something up where people could come to you after hours, rather than running all over town to see them.” Dr. Waters served as chief of medicine at Dameron Hospital for a year and also served on the board of directors at St. Joseph’s Medical Center for one year. He was on the founding board of directors for Omni Health Plan and served a yearlong stint as president of Omni IPA. He instructed family practice residents at San Joaquin General Hospital, making the rounds with residents, and offering them office experience at his practice. Doctors he mentored this way include Dr. Schneider, Dr. John Bylsma, Dr. Steve Nelson,
“ L ast night we were at dinner at Miguel’s and a woman at a table across from us looked familiar,” Dr. Waters said. It turned out to be a former patient who told him he was sorely missed. “In the end, I guess I did make a difference.” Dr. Eric Chapa and Dr. Walt Wager, all of whom ended up staying in the local community to practice medicine. “He brought me into his practice until I had established my own patient population and opened my own office across the hall,” Dr. Schneider said. “He continued to be a resource for me for consultation in difficult cases for many years.” Eventually, the high cost of medical malpractice insurance convinced him it was time to retire in 2018. Otherwise, he would still enjoy working on a part-time basis. “Last night we were at dinner at Miguel’s and a woman at a table across from us looked familiar,” Dr. Waters said. It turned out to be a former patient who told him he was sorely missed. “In the end, I guess I did make a difference.”
In The News
IN THE
NEWS
Providing staff, physicians, and patients with relevant & up to date information
Michael Herrera, D.O.
Anitra Williams, DNP, RN
Michael Herrera, D.O., Announced as CMO of St. Joseph’s Medical Center Michael Herrera., D.O., was announced April 19, as the new Chief Medical Officer (CMO) at St. Joseph's Medical Center. Dr. Herrera joined the Medical Staff at St. Joseph’s Medical Center in 1997. During his tenure, Dr. Herrera has been the EMS Director and Physician for the Emergency Department (ED), Medical Director and Chair of the ED, Chairman of the Credentials Committee, Chair of the Integrated Quality Committee, Assistant Medical Director of the ED, Chief of Staff, and currently, Medical Director of Quality and Case Management. In this role, Dr. Herrera has had a significant impact on quality metrics and care processes that have had positive impacts on patient care in our community.
Anitra Williams, DNP, RN, Named CNO at St. Joseph’s Medical Center Dr. Williams began her new role as Chief Nursing Officer at St. Joseph’s Medical Center in January 2022. She started her career at St. Joseph’s as a staff nurse in the float pool in 1999. Over the years, she went on to work as a staff nurse in Oncology and in the Post Anesthesia Care Unit (PACU), where she became the supervisor in 2009. In 2011, Anitra became a Nursing Director overseeing multiple units in the hospital, and in 2016, Anitra was appointed the Director of Nursing Operations, managing the Nurse Staffing Office, Float Pool, and Education.
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Dr. Williams has been a strong leader and advocate for education. This is highlighted by the development of the Leadership Academy for Nurse Shift Managers and the foundation of the HOPE program to educate and train new registered nurses, which she founded as part of the
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organization’s larger educational efforts with HealthForce Partners and HealthCareer Academy. St. Joseph’s Opens Electrophysiology Cath Lab On April 6th, Joseph's Medical Center opened a dedicated Electrophysiology (EP) Cath lab. The opening of the EP Cath lab is a state-of-the-art addition to our Heart & Vascular Institute. The equipment works to closely monitor your heart rhythm, identify rhythm problems, and provide insight on how what can be done to Electrophysiology Cath Lab control it. St. Joseph’s Medical Center National Recognized with “A” Leapfrog Hospital Safety Grade St. Joseph’s is proud to once again receive the nationallyrecognized “A” Leapfrog Hospital Safety Grade for Spring 2022. The Leapfrog grading is the only ratings program based on prevention of medical errors and coinciding harm to patients and ranges from “A” to “F” on over thirty performance measures including but not limited to errors, accidents, and infections. St. Joseph’s most recently earned an “A” grade in Fall 2021.
Dr. James D. Morrissey
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Dr. James D. Morrissey Honored for 50 Year with St. Joseph’s Medical Center St. Joseph’s Medical Center is honoring Dr. James Morrissey, chief of cardiothoracic surgery, for 50 years of service. Dr. Morrissey joined the medical staff
at St. Joseph’s in 1972, where he performed the area’s first open heart surgery in 1974. His specialties include cardiovascular, cardiothoracic and vascular surgery. Over the course of his 50-year tenure, Dr. Morrissey has completed thousands of heart surgeries at St. Joseph’s Medical Center and led the way for numerous “firsts” in cardiac care. Among his many awards and achievements, he is a recipient of the San Joaquin Medical Society Lifetime Achievement Award in 2011 and the St. Joseph’s Medical Center Champion of Community award in 2018. Because of Dr. Morrissey’s leadership, St. Joseph’s Heart and Vascular Institute has become a top program nationally, and the first choice for heart patients in the Central Valley. It has also received many accolades, such as Designate STEMI Heart Attack Receiving Center, Designated Cardiac Center of Excellence, Designated Stroke Center, and in 2022 it received the CommonSpirit Health Transcatheter Aortic Valve Replacement (TAVR) Center of Excellence. Thank you, Dr. Morrissey, for your dedication and commitment to the health of our community, and for all that you have done and continue to do, to advance cardiac care. Health Plan of San Joaquin, providers, and community team up for healthier birth outcomes! CDC’s most recent numbers paint a grim picture of rising U.S. maternity mortality rates. The total rate in 2020 was 23.8 deaths per 100,000 live births compared with 20.1 in 2019. However, risks for Black/African American mothers are even higher – each is nearly three times more likely to die from pregnancyrelated causes than Whites, Hispanics, and Asians. Black/ African American babies die at two times the rate of White, Hispanic and Asian babies before they turn one. The preterm delivery rate among Black/African Americans in San Joaquin County is 13.3 percent. Health Plan of San Joaquin actively partners with primary care providers as they reach out to every Medi-Cal prenatal patient. Each receives multiple contacts, including at least one phone call and pertinent materials during each trimester. For complex pregnancies, support services are offered with an HPSJ care manager and health navigator. High risk pregnancies are supported with a social worker and case management team. In turn, HPSJ network providers are supported in their care for HPSJ patients with a rich trove of Me + My Baby Prenatal
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In The News
IN THE
NEWS Program online materials at hpsj.com/prenatal/. Providers also can order supplies of printed materials – including the upcoming, even more culturally sensitive trimester booklets – by emailing healtheducation@hpsj.com. The redesigned Member Incentives Program, myRewards, is now available via the member portal, www.hpsj.com/ myrewards/. There pregnant HPSJ patients can earn $25 gift card incentives for timely prenatal care visits throughout their pregnancy. Providers can strongly encourage their HPSJ patients to engage with the website for myReward incentives, plus a wide range of prenatal and postpartum information and support. HPSJ patients also have warm hand-offs to local resources including San Joaquin County’s Black Infant Health Program at Public Health Services of San Joaquin County (sjcphs.org) and the High Risk Maternal and Child Health division of Stanislaus County Health Services Agency, at www.schsa.org/PublicHealth/programs/pages/ highRiskMaternalAndChildHealth.shtm. Referral forms for all of these programs are available at www.hpsj.com/formsdocuments/. HPSJ Among Top Ranked California Health Plans for Timely Access HPSJ Credits Its Network Providers: “THANKS! Once again, we could not have done this without you!” In April 2022, Health Plan of San Joaquin (HPSJ) received from the California Department of Managed Health Care (DMHC) its Measurement Year (MY) 2020 Timely Access Report. The MY 2020 Timely Access Report presented unique challenges due to the COVID-19 pandemic. However, overall appointment availability increased in comparison to previous years, in part due to a greater number of appointments available through telehealth during the public health emergency. Health Plan of
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Providing staff, physicians, and patients with relevant & up to date information
San Joaquin said it is proud to consistently have high scores across “Commercial, Individual/Family, and Medi-Cal plans combined” for urgent and non-urgent appointments. • Across Commercial, Individual/Family, and Medi-Cal plans combined, HPSJ achieved 90% for both urgent and non-urgent appointment wait times across all provider types (primary, specialty, non-physician mental health, and ancillary). • Across Medi-Cal plans, HPSJ achieved 96% across all provider types (primary care, specialty, non-physician mental health, and ancillary) for non-urgent appointments. • Across Medi-Cal plans, HPSJ achieved 85% for urgent appointments across all provider types (primary care, specialty, and non-physical. For a second year, HPSJ points for this success to the active partnership with their providers. This is a partnership that not only promoted urgent and non-urgent care access for HPSJ patients, but it also illustrates how each provider partner went the extra mile to respond with accurate, complete reporting of timely compliance data. That they did so while safely reopening to welcome patients back during the pandemic is even more impressive. NOTE: Urgent is defined as 2 days with no required prior authorization and 4 days with required prior authorization. Non-urgent care is defined as 10 business days (primary care physicians), 15 business days (specialists), and for mental health 10 business days (non-physician) and 15 business days (ancillary providers).
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Health Plan of San Joaquin’s Back-To-Care Initiative- Caravan for Health In order to facilitate well care exams, HPSJ is this summer engaging providers and members at local community events with Caravan for Health (CFH). Events include local baseball games through Modesto Nuts and Stockton Ports partnerships, the 27th Annual Tracy African American Chamber Juneteenth Festival and more opportunities throughout the summer. HPSJ is notifying their members they can make an appointment with their primary care physician to complete their well care visit or attend a local health fair. At these CFH events, HPSJ members will receive giveaways that include backpacks for school-age children with school supplies, women’s/men’s self-care items and other health education material. Members have two options to receive a child’s backpack. HPSJ will provide backpacks with school supplies to provider network partners. If a provider cannot store the items in their practice, they will be given vouchers to pass along to their HPSJ patients after they complete their back-to-care office visit. Or HPSJ members can visit a Caravan for Health summer event, complete an exam or screening and pick up their backpack (with a photo ID, member ID card and Child Immunization Card). For more information, HPSJ providers can visit www.hpsj.com/care. Adventist Health extends partnership with Dameron Hospital Adventist Health has reaffirmed its intent to maintain a two-hospital healthcare system in San Joaquin County by announcing a new five-year management services agreement contract with Dameron Hospital in Stockton. Originally established in January 2020, the agreement places administrative oversight for Dameron’s operations and planning in partnership with Adventist Health’s leadership structure. This agreement also includes an option for full hospital acquisition at any time over the life of the contract. “This contract extension represents a significant commitment by Adventist Health to the people of San Joaquin County,” said Dameron Hospital Board President Bill Trezza. “This new extended window of opportunity for continued improvements at Dameron and integration with Adventist Health Lodi Memorial will provide our community with more healthcare options in the future. Considering the positive changes and investments in Dameron that we have already seen, we’re excited about where our hospital will be five years from now.” “This is really great news for everyone in the community,” said Adventist Health San Joaquin County President and CEO
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Terri Day. “By combining the strengths of Adventist Health Lodi Memorial and Dameron Hospital, we’ve been able to expand many of our services over the past two years despite the challenges presented by the COVID-19 pandemic.”
AH Lodi Memorial Cancer Center Adventist Health Lodi Memorial Cancer Center introduces new PSMA imaging technology The Cancer Care Center at Adventist Health Lodi Memorial has launched the use of prostate-specific membrane antigen (PSMA) PET/CT imaging technology, bringing the most advanced prostate imaging to the Lodi community. Using PMSA Positron Emission Tomography (PET) scans, advanced imaging agents that contain a radioactive tracer are injected into the body. The antigen then attaches to PSMA proteins, which in tandem with a CT scan, effectively shows where cancer may be present. The Adventist Health Lodi Memorial Cancer Center is the first in the area to offer PSMA PET/CT imaging. Using PYLARIFY® (piflufolastat F 18), an FDA-approved radioactive diagnostic agent, the team at Adventist Health Lodi Memorial can identify suspected metastasis or recurrence of prostate cancer more effectively than ever before. “PSMA will dramatically improve our ability to properly stage and treat prostate cancer,” said Cancer Center Medical Director, Dr. Travers McLoughlin. "It will enable earlier diagnosis and thereby help us provide the best treatment possible for our patients. It truly is a game changer. We are blessed to be able to offer it in our community.” PSMA PET imaging is the latest in a series of new technologies launched at the Adventist Health Lodi Memorial Cancer Center that includes the Invenia ABUS (Automatic Breast Ultrasound) device and the Sentimag Tumor Localization System.
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In The News
IN THE
NEWS
Providing staff, physicians, and patients with relevant & up to date information Dr. Jennifer McNeil is a board-certified surgeon practicing with Dameron Hospital in Stockton and specializes in colon and rectal surgery with an emphasis on abdominal and anorectal disorders. Using laparoscopy and other minimally invasive procedures, she provides surgical treatment for colon and rectal cancer, inflammatory bowel disease (IBD), pelvic floor issues, fecal incontinence and more.
Dr. McNeil also treats patients with anorectal problems to include hemorrhoids, fissure, fistula, anal cancer and some inflammatory conditions. Dr. DeAndrea Sims Dr. Jennifer McNeil She offers in-office banding of internal hemorrhoids when appropriate, which can allow for early return to work and Adventist Health Welcomes New Surgeons to avoid surgery for hemorrhoids, if possible. Dameron Medical Group Dr. DeAndrea Sims is a general surgeon practicing with Earlier in her career, Dr. McNeil was a member of the United Dameron Hospital in Stockton, California. Originally from States Army. During this time, she attended medical school and Guam, she attended medical school at Howard University of served in various positions, including as chief of general surgery Medicine and completed her post graduate training in Stockton at Womack Army Medical Center at Fort Bragg. She also was at San Joaquin General Hospital. She is proficient in surgical recognized numerous times throughout her Army career for her treatment of benign and malignant breast disease, gallbladder, contributions to foreign and domestic operations. hernia and intestinal disorders using laparoscopic and robotic surgery techniques. Dr. McNeil is dedicated to providing the most minimally invasive and effective care to her patients so that they return to Dr. Sims, a board-certified surgeon, loves helping patients and their daily life as quickly and comfortably as possible. treating ailments in need of surgery. Her practice as a surgeon allows her to interact with patients and families, directly Dr. McNeil is currently accepting referrals at the Dameron impacting their health and quality of life for the better. Specialty Surgery Clinic located at 530 West Acacia Street, Suite 1, in Stockton. For more information, please call 209-242-7098 Dr. Sims is currently accepting referrals at the Dameron or visit www.dameronhospital.org/mcneil. Specialty Surgery Clinic located at 530 West Acacia Street, Suite 1, in Stockton. For more information, please call 209-242-7098 or visit www.dameronhospital.org/sims.
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Finding and fixing from the inside out. Interventional radiology offers minimally invasive options. Our interventional radiology team at St. Joseph’s Medical Center can treat many conditions that once required surgery through minimally invasive techniques, resulting in decreased risks, less pain, and shorter recovery times for patients when compared to traditional surgery. Whether your patients are suffering from back pain, chronic kidney disease, heart and vascular conditions, cancer, or men’s or women’s health issues, interventional radiology treatments are available to address many health concerns. St. Joseph’s interventional radiologists have a wealth of experience and expertise in minimally invasive treatments. Some of those treatments include peripheral arterial and venous disease, radioembolization for liver cancer, cryoablation for kidney cancer, and balloon kypohoplasty for vertebral compression fractures. For more information, visit dignityhealth.org/stockton/IR or call IR scheduling at (209) 467-6323.
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Closer to home + enhanced referrals = easier access to world-class care Kelly Haas, M.D., Health Sciences Clinical Professor Specialties: Pediatric Gastroenterology, Pediatric Hepatology, Pediatric Nutrition
UC Davis Health offers nationally ranked expertise — now with added convenience for our referring providers From the most delicate robotic and catheter procedures to the latest precision therapeutics, we’re proud to offer up-to-the-minute diagnostic and treatment options for both adult and pediatric referring providers across Northern California and the Central Valley. Your referred patients benefit from shorter drives, less traffic gridlock, affordable lodging, and more support from local family and friends. We also offer robust telehealth and telemedicine options, for both initial consultations and follow up care. Referring your patients to UC Davis Health specialty and subspecialty care is now easier than ever. Our physician referral liaison team is here to serve as direct lines of communication — helping to navigate and expedite referrals.
Our liaisons can also help to: ■
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Facilitate access to our secure EMR system, PhysicianConnect Arrange meetings and/or webinars with our clinicians Assist with UC Davis Health clinical trials and telemedicine Keep you abreast of new services, providers and research programs Share information about CME and events such as tumor boards, grand rounds, symposiums, etc.
Reach out to your local Physician Referral Liaison today: Joaquin Muñoz | 916-701-7161 | joamunoz@ucdavis.edu
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RESID
ENTS' REPORT A PLACE FOR ALL NEWS HIGHLIGHTING RESIDENTS AND GRADUATE MEDICAL EDUCATION
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The NEW Resident’s Report is dedicated to all the good news related to our hard-working residents training at San Joaquin General Hospital and St. Joseph’s Medical Center. Please email your submissions, written in third person with accompanying photo to Lisa@sjcms.org. SAN JOAQUIN PHYSICIAN
ST. JOSEPH’S EMERGENCY MEDICINE RESIDENT TEAM WINS SECOND PLACE AT REGIONAL SIMULATION COMPETITION The emergency medicine (EM) residents of St. Joseph’s Medical Center (SJMC) won second place on April 1, 2022, at the SIMposium competition during the Society of Academic Emergency Medicine Western Regional Conference held at Stanford University. Other contenders included EM resident teams from Stanford University, UC Davis, Kaweah Health, and Kaiser Permanente Central Valley. Teams
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competed in the management of simulated patient encounters designed around the theme of “Tech Failures”. During the first round, the SJMC team successfully managed and resuscitated a patient with an LVAD failure and concomitant GI bleeding. Other cases included failures of different medication pumps as well as having completely no electricity in the building. The SJMC team advanced with Stanford to the finals, managing a pediatric patient in DKA with failure of his insulin pump and subsequent cerebral edema. Despite their expert management, the SJMC team narrowly lost in the final round but took home the second-place award and the respect of their regional peers. The SJMC team consisted of EM residents
SJMC Emergency Medicine residents
LONG LOST MICRA LEADLESS PACEMAKER FOUND IN THE RIGHT PULMONARY ARTERY Two Internal Medicine resident physicians, Dr. Solomon Badejoko and Dr. Parampreet Singh from St. Joseph’s Medical Center, Stockton, CA SJMC Internal Medicine residents attended the recent American College of Cardiology Annual Scientific Session & Expo in Washington DC from April 2-4, Drs. Kandria Ledesma, Manny Lopez, and Juliana Thong. 2022. This meeting attracted thousands of cardiology experts Additionally, Drs. Kim “Ivy” Pham and Kyle Hill drafted and from all over the world. submitted a case of a van inhabitant that sustained carbon monoxide and cyanide after an electric fire. Drs. Matthew Dr. Badejoko and Dr. Singh gave a complex case poster Kiefer and Yasmin Soltanian, Emergency Medicine Faculty at presentation, titled “Long Lost Micra Leadless Pacemaker SJMC, were advisors to the resident team. Found in the Right Pulmonary Artery”. The supervising electrophysiologist was Dr. Rashaad Chothia. Based on their literature review, this is the first published
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SAN JOAQUIN GENERAL HOSPITAL GRADUATES MEDICAL SPECIALISTS EACH SPRING Since 1932, every Spring San Joaquin General Hospital has graduated competent Class of 2022 General Surgery residents medical residents with a high level of specialty medical education. San Joaquin case of a successfully retrieved Micra leadless pacemaker, General Hospital sponsors three residency 12 weeks after dislodgment and embolization. Also, there programs: General Surgery, Internal Medicine, and Family are no standard guideline for retrieving such late embolized Medicine. All residency programs are fully accredited by the pacemaker. Moreover, the novel “double-snare technique” was Accreditation Council for Graduate Medical Education. used in order to reduce the risk of collateral cardiac damage. These data make their presentation quite compelling. The residency programs provide community-based education, with comprehensive training in inpatient and outpatient services Micra is one of the smallest leadless pacemakers presently. It and procedural skills, serving a very diverse San Joaquin County is inserted at the right ventricular apex through percutaneous patient population. Medical physicians seeking a specialty cardiac catheterization. through education at San Joaquin General see a wide range of medical conditions. The Hospital trains medical graduates with advanced medical technologies such as robotic surgery and NEUROLOGY AND state-of-the-art medical science practices.
UROLOGY ADDED TO ST. JOSEPH’S GME PROGRAM St. Joseph’s Medical Center is excited to share they have two new specialties in the GME program. The neurology program will be training four residents per year and will have rotations at both UC Davis and another Dignity Health facility, Mercy Medical Group. The urology program will train two residents per year and will have rotations at the VA Sacramento, Sutter Gould, Kaiser Roseville and Manteca/Modesto. In July 2022, there is a projected total of 132 total residents in St. Joseph’s GME program. In addition to urology and neurology, the program also includes anesthesiology, emergency medicine, family medicine, internal medicine, and psychiatry.
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The Hospital’s residency programs are affiliated with the University of California, Davis Medical Center. Hospital residents also receive training and education through Dignity Health- St. Joseph’s Hospital and UCSF Medical Center. The Graduate Medical Education program is overseen by Sheela Kapre, MD, SJGH Designated Institutional Officer and Chief Medical Officer. The intent of the Hospital’s Graduate Medical Education program is to bring experienced specialty physicians to work in the communities of San Joaquin County. Many of the physicians practicing locally were trained at San Joaquin General Hospital. The general surgery class of 2022 features: Danielle Berera, MD, who has received a Surgical Critical Care Fellowship at Stanford University. Ying "Benjamin” Tan, MD, who has received a Minimally Invasive Surgery fellowship at the Cleveland Clinic Florida and Ariel Rodgers, MD, who has received a Burn Surgery fellowship at University of Utah.
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Made for more wishes
Cancer Care close to home We are made for more. More compassion. More time with family. More hope for a healthy tomorrow. That’s why Adventist Health has invested in two cancer care facilities, close to home, with the resources, technology and clinical expertise to provide advanced care for our communities. Our approach combines modern technology with a caring touch from our onsite nurse navigators. Our specialtytrained, board-certified physicians work across campuses, so our patients don’t have to go far for the care they need.
Diana J. White Cancer Institute Medical Oncology | Hematology Infusion Center | Radiation Oncology 900 Mono Way, Sonora 209-536-6940
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Adventist Health Physicians Network Cancer Care 2407 W. Vine St., Lodi 209-333-3056
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Practice News and Resources Free to SJMS/CMA Members!
The Office Managers Forum empowers physicians and their medical staff with valuable tools via expert led educations sessions from industry professionals who are committed to delivering quality healthcare. For the time being, we will be offering Zoom Meetings until we can get back to meeting in person. This monthly forum is normally held on the second Wednesday of each month. Registration is required!
If you don’t receive a monthly invitation via E-Mail, please email Jessica@sjcms.org for the Zoom call info!
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June, 2022: 11:00AM to 1:00PM
“Practice Management 101”
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 and RCMA. Mitzi brings 25 years of experience and expertise in the health care industry. Mitzi started her career working for a
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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.
July, 2022: No Presentation due to facilitating out Decision Medicine Program. Go to our website to learn more! www.decisionmedicine.com
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CMA PRACTICE RESOURCES AMA says a “staggering” 16k providers missed first Provider Relief Fund reporting deadline.
The American Medical Association (AMA) is urging the U.S. Department of Health and Human Services (HHS) to allow more time for physicians who accepted federal COVID-19 relief funds to meet the Period 1 Provider Relief Fund reporting requirements. Although the HHS Health Resources and Services Administration (HRSA) did briefly reopen the reporting portal last month, approximately 16,000 providers still missed the deadline. Providers who received one or more payments exceeding $10,000, in the aggregate, during a “payment received period” are required to report in each applicable “reporting time period.” But many physician practices were unaware of the need to report, or were unable to complete the required reporting, due to the impact of the pandemic. AMA believes non-reporters are primarily small and rural providers who are overwhelmed and have not received sufficient communications about the reporting requirements. “Volume of physician practices that were unaware of the reporting deadline is staggering. We urge
HRSA to release data about these physicians so we can launch a full court communications press to reach them. This would also necessitate more time — at least two additional weeks — to submit a request to report late,” AMA wrote in a letter to HRSA Administrator Carole Johnson. “At a minimum, HRSA should establish an appeal process for those physicians who will now receive a demand letter for repayment of Provider Relief Funds.” Medical board eliminates plastic physician licenses
The Medical Board of California recently phased out plastic medical license cards. In lieu of the old plastic cards, physicians can now use the medical board’s new "Print Your Own" Wallet License Generator that allows individuals with current licenses to generate a digital license and print it on any printer or house the card electronically. In order to generate a license, the medical board first requires identity verification through its license verification app, IDEAL. These printable wallet licenses also include a QR code interested parties can use to view the Department of Consumer Affairs licensee lookup with real-time license status information. To generate your license, visit mbc.ca.gov/WalletCard.
ARE YOU READING CPR? CPR contains the latest practice management news, and tips on reimbursement and contracting related issues.
SUBSCRIBE NOW Sign up now for a free subscription at 48
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SUMMER 2022
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Public Health
Update
Maternal Child and Adolescent Health (MCAH) Programs: Serving Pregnant and Parenting Women throughout San Joaquin County BY LORY MERCER BSN, RN, PHN, MCAH PROGRAMS MANAGER AND MARIYA RABOVSKY-HERRERA BSN, RN, PHN, MCAH COORDINATOR Fredrick Douglas said, “It is easier to build strong children than to repair broken men”. The greatest opportunity to protect and improve the health of our communities begins in pregnancy and infancy. Public Health Services’ MCAH programs support families in raising strong and healthy children, through both direct services and systems-level interventions. As a physician, you may have often felt that your pregnant or parenting patients need extra help, additional education, or case management that you wish you had the time or the resources to address. MCAH is here to help fill in those gaps and provide those resources to your patients as well as provide comfort to you knowing that follow up will be offered to them. Most MCAH services are provided in the home. This creates a different power dynamic than clinic-based services. MCAH staff develop long-term trusting relationships with the whole household - the foundation upon which to motivate meaningful behavior change. Due to COVID-19, MCAH also offers video or telephone appointments in lieu of, or in addition to, in-person home visits. All services are always free of charge to the patient. Referrals are very welcome! If any of the programs listed below would be of interest to you and your patients, please call the MCAH program at 209.468.3004 or by email at mcah-info@sjcphs. org. In return, you will receive a “universal” referral form to
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complete. Once received, MCAH staff will contact your families directly with the program(s) that best fits their needs. MCAH programs include: • Nurse Home Visiting: Public Health Nurses (PHNs) visit medically high-risk mothers, infants, and children. Our nurses are prepared to answer questions, submit referrals and come to visits with equipment to weigh and measure infants and take maternal blood pressures. Home visits with the PHN are approximately every 4 weeks. Eligibility: Anyone who is pregnant, any parent/caregiver of a baby under 1 year old, or a parent/caregiver of a child up to 5 years old with special healthcare needs (any child with medical or developmental needs requiring services beyond that of typical children). • Healthy Families San Joaquin: With over 500 sites in the U.S, the Healthy Families America (HFA) model focuses on strengthening parentchild relationships and interactions and is most beneficial for families with social risk factors or child welfare involvement. Home visits with a Family Support Specialist begin weekly, and then decrease in frequency. This is an evidence-based program; 19 publications of randomized controlled trials found
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drastic reductions in preterm birth rates, incidence of child abuse/neglect, family violence and crime, and found strong increases in child health, maternal health, economic self-sufficiency, and school readiness among families who participated in an HFA program versus those who did not. Eligibility: Anyone who is pregnant or has a newborn less than 2 weeks old. • Black Infant Health: This program addresses racial disparities in birth outcomes by empowering and supporting African American women to have healthy pregnancies and healthy babies. There are 10 prenatal and 10 postpartum group sessions in a culturally affirming setting. Women also have individual appointments with a nurse, a mental health professional, and a family health advocate. Group sessions explore pregnancy and parenting topics, as well as African American history, coping with experiencing bias or racism, and self-advocacy and empowerment. Women identify personal strengths and develop life goals. Eligibility: Black or African American women ages 16 or older, who are pregnant or have given birth in the last 6 months. Ideally, women enroll early in pregnancy in order to receive the full scope of the program. • Safe Sleep San Joaquin: SIDS and sleep-related deaths continue to be a leading cause of infant deaths. Families who do not have a safe sleep environment for their infant can receive a free portable crib after receiving safe sleep education from MCAH staff. Eligibility: Must be pregnant or have a baby less than 6 months old. • Perinatal Equity Initiative: MCAH is funding four community agencies to carry out evidence-based curricula that improve Black and African American birth outcomes. A fatherhood initiative called “Passport to Fatherhood” is offered by Mary Magdalene Community Services. They serve men of any race whose partner is an African American woman, pregnant or less than 3
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months postpartum. Another three community-based organizations: Delta Health Care, California Health Collaborative, and Amelia Ann Adams Whole Life Center, are offering individualized one-on-one support through the “Sista Coach” program for women who are pregnant or less than 3 months postpartum. These agencies report effectiveness of their services back to PHS using Results Based Accountability, and also receive technical assistance from our Public Health staff. • SIDS Program: Per state law, local health departments are notified of every sudden unexpected infant death. A Public Health Nurse reaches out to the family in order to provide bereavement support, resources, referrals, and assistance the family may need. The nurse sends a report on each death to the state SIDS program, so that commonalities and contributing factors can be studied and understood. Referrals for bereavement support are also accepted for pregnancy loss or any infant death. • Comprehensive Perinatal Services Program (CPSP): You may already be participating in CPSP – a program for OB providers to receive increased reimbursement for pregnant patients with Medi-Cal. Our Public Health CPSP Coordinator provides technical assistance to clinics regarding the CPSP program implementation, as well as resources and learning opportunities for OB providers and their clinic staff. If you are a CPSP provider, or considering becoming one, please connect with us so we may assist you! Ensuring that all babies survive and thrive is an issue too multidimensional for responsibility to rest in any one place. We hope that you reach out to us to collaborate, refer, and partner on improving the health of our community. Again, to reach us, call 209.468.3004 or email us at mcah-info@sjcphs.orgLory Mercer, the MCAH Program Manager, can be reached at 209.468.8408 or lmercer@sjcphs.org
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In Memoriam
In Memoriam ROYCE NORTHCOTT 1935-2022
Royce Northcott has joined her friends, family and pets on the next plane of love and consciousness. Born in Modesto California on November 23rd, 1935, she passed on April 28th, 2022 in Fort Pierce Florida, where she was on vacation. She suffered a severe injury while in Fort Pierce which eventually led to her passing. Royce was a school teacher in Los Angeles where she put her husband, Dr. Eugene Northcott through UCLA medical school in the late 1950’s. She was also a school teacher in Miami Florida in the 1960’s, where she supported Dr Northcott through his medical residency. Dr. Northcott passed in the year 2000. In the mid 1960’s the Northcott family traveled from Florida to California twice while Dr Northcott determined which location would be best for his career. Royce made sure both of her children were engaged and that the time in the car’s backseat was used for learning and playing thought provoking games. The Northcotts then decided Stockton was the right place to live and for Gene to start his medical practice. They settled in Morada where Royce and Gene raised their two boys, Christian and Joseph. Royce was one of the most vibrant, friendly and persuasive people you could ever meet and had more friends than you could shake a stick at. She was both a Viking and a princess at the same time. She was absolutely unstoppable when she held a conviction. Royce was very active in the San Joaquin Medical Society and was on the board of directors of their Scholarship Loan Fund starting in 1977. She greatly enjoyed interviewing young women and men who were applying for financial assistance so that they would be able to attend medical school and then return home to practice in the communities where they grew up. When she left the board, she was its longest serving member. Royce was also active for many years in the Medical Society’s Women’s Auxiliary and aided greatly to their fund-raising efforts. She was a member of Children’s Home of Stockton and supported its commitment to give abused and disadvantaged kids a place to live and a chance for a better life. She embraced the goals and programs of Children’s Home and was active for many years in their fund-raising events. Through Children’s Home she made
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many lifelong friendships. She relished their monthly bridge luncheons. Royce was also a member of another bridge group for many years which she thoroughly enjoyed. Royce loved bridge. She was a whiz kid in the stock market and took a modest initial investment to an impressive sum which allowed her to be generous to causes and charities in
which she believed. Royce cared immensely about other people and would give homeless people money on a regular basis, often making her son turn the car around to give someone in need some money. Later in life she met a wonderful man, Clint Waring and they fell deeply in love and became life-long best friends who loved being with each other, playing games together, talking and living life to the fullest. They enjoyed annual trips together to Maui and Florida and spent the majority of their summers and fall having fun at Lake Tahoe. They made each other very, very happy. Royce was preceded by her husband, Dr. Eugene Northcott, her father, William Mensinger, Mother, Jane Mensinger and her brother Michael Mensinger. Royce is survived by her sister, Marcia Coy, her two sons, Joseph Northcott and Christian Northcott, Christian’s wife Keri Northcott and the second love of her life, Clint Waring. We will miss you Royce. You made the world a better place. Donations in lieu of flowers to: Children’s Home of Stockton www.chstockton.org Services to be held at Cherokee Memorial Park, Lodi, California on Friday, May 27th at 12 pm noon.
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REIMBURSEMENT HELP: Members receive one-onone assistance from CMA’s reimbursement experts, who have recouped $33 million from payors on behalf of CMA physicians in the past 12 years. These monies represent actual physician reimbursements that would have likely gone unpaid without CMA intervention. COVID-19: CMA understands that many physician practices are struggling in the wake of the COVID-19 outbreak. We are working closely with state and federal lawmakers to ensure physician practices remain viable, and that physician networks remain robust amid the financial uncertainty created by the COVID-19 crisis.
TELEHEALTH: Telehealth services have proven to be a critical tool for physicians so they can safely provide care to those who need it during the COVID-19 public health emergency. CMA has worked to ensure that government agencies understand the regulatory flexibilities necessary so that physicians can continue serving patients during the COVID-19 pandemic. From telehealth flexibility and payment parity, to waivers on privacy and security requirements to expedite the incorporation of telehealth into practice workflows, CMA has been at the table making sure policymakers understand the needs of physicians and their patients.
“The value that CMA brings to physician practices cannot be understated. Membership is not a cost to my practice – it is an investment. I couldn’t run my practice without it.” Tom McKenzie, M.D. Member since 1991
PHYSICIAN WELL-BEING: CMA believes physician well-being and professional fulfillment are critical factors in maintaining patient access to quality care, and we must address this challenge at the organizational and systemic level. CMA’s Wellness Program launched Care 4 Caregivers Now in March 2020 to provide physicians with one-on-one emotional support from trained medical professionals in a safe, confidential and non-judgmental space. EXPERT GUIDANCE: Staffed by experts with a combined experience of over 125 years in medical practice operations, CMA’s Center for Economic Services empowers physicians by providing resources and guidance to improve the success of their medical practices. Whether it’s identifying and fighting unfair payment practices, improving the efficiency of your practice, or guiding physicians through the contract evaluation and negotiation process, CMA has tools and resources to help.
QUESTIONS? CMA’s live-person call center is available Monday through Friday during business hours at (800) 786-4262 or via live chat at cmadocs.org. SUMMER 2022
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New Members
7 NEW
SJMS MEMBERS THIS SPRING!
...and even more on the way. Lucky Reed, M.D.
Audrey Payne, M.D.
Jay Vithalani, M.D.
Adrian Elliot, M.D.
Philip Ruhl, D.O.
Arthur Chen, M.D.
Maternal and Fetal Medicine 1617 N California St., Ste 2D Stockton, CA 95204 Ross University School of Medicine
Anesthesiology 975 S Fairmont Ave Lodi, CA 95240 University of North Carolina at Chapel Hill
Anesthesiology 975 S Fairmont Ave Lodi, CA 95240 Loma Linda University School of Medicine
Anesthesiology 975 S Fairmont Ave Lodi, CA 95240 College of Osteopathy of the Pacific
Family Medicine 1000 Greenley Road Sonora, CA 95370 University of Health Sci Antigua School of Medicine
Otolaryngology 2545 W Hammer Lane Stockton, CA 95209 University of Illinois College of Medicine
Zachary Nichols, D.O. Internal Medicine 1000 Greenley Road Sonora, CA 95370 Lake Erie College of Osteopathic Medicine
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San Joaquin Medical Society Member Only Benefits • Complimentary Dark Web Compromise Credential Report ✓ Over 11 billion accounts have been compromised – Has yours?
• Complimentary Phone System Assessment ✓ Is your phone bill higher than you would like? Does your phone system allow you to work from anywhere?
• Complimentary Security and Risk Assessment ✓ Have you conducted your Risk Assessment yet? Call Mark Williams @ 209-623-1023 or email mark@ce-technology.com SUMMER 2022
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San Joaquin Medical Society 3031 W. March Lane, Suite 222W Stockton, California 95219-6568
PRSRT STD. U.S. POSTAGE
PAID
Permit No. 60 Stockton, CA
RETURN SERVICE REQUESTED
This summer, join HPSJ’s Caravan for Health initiative and help get our community BACK TO CARE!
As COVID-19 cases decrease and state mandates come to an end, communities are opening up. Valley residents are eager to restore some normalcy- and that includes getting back to care. It is important that we engage patients in their health. • Reconnect with patients and encourage them to catch up on wellness exams • Engage in safety net practices that provide access to preventive care regardless of ability to pay for services
• Help create a “no-wrong-door” health care environment by participating in community clinics and local health fairs • Offer flexible office hours and telehealth
Community wellness depends on all of us working together. Join us! In partnership with
Health Fair Events: May • June • July www.hpsj.com/caravan-for-health 56
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