February 2016 by SMCMA

S a n M at e o C o u n t y

February 2016

Physician

IN S ID E

S A N M AT E O C O U N T Y M E D I C A L A S S O C I AT I O N

Volume 5 Issue 2

Why I volunteer

Collegiality: Itâ&#x20AC;&#x2122;s good medicine

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S a n M at e o C o u n t y

Physician Editorial Committee

February 2016 - Volume 5, Issue 2

Russ Granich, MD, Chair; Judy Chang, MD; Uli Chettipally, MD; Sharon Clark, MD; Carri Allen Jones, MD; Edward Morhauser, MD; Gurpreet Padam, MD

Columns

Sue U. Malone, Executive Director Shannon Goecke, Managing Editor

SMCMA Leadership Michael Norris, MD, President; Russ Granich, MD, President-Elect; Alexander Ding, MD, SecretaryTreasurer; Vincent Mason, MD, Immediate Past President Alex Lakowsky, MD; Richard Moore, MD; Michael O’Holleran, MD; Joshua Parker, MD; Suzanne Pertsch, MD; Xiushui (Mike) Ren, MD; Sara Whitehead, MD; Douglas Zuckermann, MD; Dirk Baumann, MD, AMA Alternate Delegate; Scott A. Morrow, MD, Health Officer, County of San Mateo;

Editorial/Advertising Inquiries San Mateo County Physician is published ten times per year by the San Mateo County Medical Association. Opinions expressed by authors are their own and not necessarily those of the SMCMA. San Mateo County Physician reserves the right to edit contributions for clarity and length, as well as to reject any material submitted. Acceptance and publication of advertising does not constitute approval or endorsement by the San Mateo County Medical Association of products or services advertised. For more information, contact the managing editor at (650) 312-1663 or sgoecke@smcma.org.

President’s Message: Complications and The Knick.................................... 5 Michael Norris, MD

Executive Report: SMCMA members qualify for additional 5% discount on workers’ compensative rates............................................ 7 Sue U. Malone

Feature Articles Why I volunteer......................................................................................... 8 Michael T. Margolis, MD

Collegiality: It’s good medicine . . ............................................................ 10 Claire Serrato, MD, MPH

Of Interest SMCMA welcomes new members..........................................................12 Membership updates, classified ads, index of advertisers. . ................14

On the cover: Heart, by Flickr user Mozzercork https://www.flickr.com/photos/mozzercork/with/109582266/). Reprinted with permission under Flickr Creative Commons license.

4 SAN MATEO COUNTY PHYSICIAN | FEBRUARY 2016

President’s Message

Complications and The Knick A few months back, I recommended The House of God, a semi-autobiographical account of an intern’s experiences in the 1970s. Another book worth checking out is Atul Gawande’s first book, Complications: A Surgeon’s Notes on an Imperfect Science, published in 2002. Gawande uses specific experiences from his years as a surgical resident at a Harvard-affiliated hospital, examining the way we practice medicine—the triumphs, the failures, and the inevitable complications. He tells histories of flawed physicians and flawed systems, resulting in patient harm. Gawande wrote the book with the approval of his chief of surgery, which is surprising given the sometimes unfavorable accounts of human error. But we are human, after all. The author states, “All doctors make terrible mistakes,” and later continues, “…doctors will sometimes falter, and it isn’t reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it.” As I neared the last pages, one sentence struck me deeply: “What we are drawn to in this imperfect science, what we covet in our way, is the alterable moment-the fragile but crystalline opportunity for one’s know-how, ability, or just gut instinct to change the course of another’s life for the better.” A great book. Dr. Gawande has written several subsequent more celebrated books, but you definitely don’t want to miss this one.

The passing of the torch...

I also recommend you catch The Knick, a series that concluded its second season on Cinemax in December. It is set at Knickerbocker Hospital in New York City in the early 1900s. The story is centered around the chief surgeon, who just happens to be addicted to cocaine. Of course, we all know that William Halsted, one of the fathers of modern American surgery, was also a cocaine user. The series is graphic in its portrayal of the rather primitive nature of surgery in those early days. Many of the themes have actual history to support their inclusion. Produced by Steven Soderbergh, “The Knick” features Clive Owen as Dr. Thackerey, the obviously troubled surgeon.

Michael Norris, MD President

Dr. Gawande wrote, “We are drawn in to this imperfect science, what we covet in our way, is the alterable moment--the gragile but crystalline opportunity for one’s know-how, ability, or just gut instict to change the course of another’s life for the better.”

Be sure to reserve the evening of Thursday, June 23 for the SMCMA annual meeting at Hiller Aviation Museum in San Carlos. More information will be available in the coming weeks. ■

FEBRUARY 2016 | SAN MATEO COUNTY PHYSICIAN 5

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6 SAN MATEO COUNTY PHYSICIAN | FEBRUARY 2016

Executive Report

Sue U. Malone Executive Director

SMCMA members qualify for additional 5% discount on workers’ compensation rates The San Mateo County Medical Association and California Medical Association are pleased to welcome Preferred Employers Insurance Group as the sponsored carrier for Workers’ Compensation program. Preferred is working with Mercer Health and Benefits Insurance Services, the program administrator, to implement best practices in risk management and help meet your coverage needs. The program offers safety, stability, and service, as well as competitive rates. Preferred’s Medical Provider Network of credentialed medical professionals helps manage claims costs while provide quality care, as well as the option to refer injured employees to CMA members for treatment. For more information, call Mercer at 800-842-3761, email CMACounty.Insurance.Service@ mercer.com, or visit www.countyCMAMemberInsurance.com. This information is also available on the SMCMA website homepage under “News Alerts.” ■

The Workers’ Compensation program offers safety, stability, and service, as well as competitive rates.

FEBRUARY 2016 | SAN MATEO COUNTY PHYSICIAN 7

WHY I VOLUNTEER by Michael T. Margolis, MD

Medical volunteerism is, like other forms of humanitarian work, a labor of the heart and soul. Somehow—and for reasons that sometimes cannot be put into words— something clicks at just the right time in a physician’s life and compels him or her to leave family and medical practice behind, travel to some foreign place, and “roll up their sleeves” and get “down and dirty” to help people in need. It can be lonely being away from home. The work is hard, gritty and frequently accompanied by a variety of physical discomforts, including the pain of travelling long distances often over crappy terrain, sore muscles and joints from hauling equipment, dysentery from drinking contaminated water, and the usual blood, sweat and tears of helping very ill poor people with limited medical resources. But they can also savor the knowledge that at least some lives were saved, quality of life was improved, new friends were made, and a richer understanding of the world was gained. The benefits outweigh the discomforts. Most of the time physicians return home from a mission feeling that they got more out of their experience than the patients they’d served. They feel a sense of fulfillment. One physician described this phenomenon to me when he said the mission experience “recharges the batteries.” I agree. So what actually compels someone to volunteer? It depends on the person. Some do it out of a sense of duty to mankind, some for the opportunity to travel, and some for no explicable reason. It’s just the right thing to do. For me the impetus was a lecture I attended on vesico-vaginal fistulas in Africa by Professor Tom Elkins in 1992. During his lecture, I had an epiphany. I realized that I had to go to Africa to fix fistulas. So, I called Dr. Elkins, whom I’d never met before, and explained that I had to go to Africa with him to fix fistulas. He replied, “Well. I’m going to Ghana in three months...want to come along?” That’s all it took. I learned to fix vesicovaginal fistulas in young women suffering from Obstetric trauma, and it was the best month of my professional life. There are a variety of obvious possible explanations why one should consider volunteering on a medical mission. One, obviously, is to help those in need. The U.S. is the most affluent country in the world, and there are countless millions of less fortunate people at the other extreme of the financial spectrum. The quantity and quality of the pathology that afflict people in these poorer countries would boggle most people’s minds. We live far more fortunate lives but we have the ability to help 8 SAN MATEO COUNTY PHYSICIAN | FEBRUARY 2016

minimize some suffering by making a small sacrifice in our own comfort and income to help those in need. Another advantage is that volunteers gain an international perspective of medicine across the globe.We get to see the world from an entirely different perspective, and this often changes our overall demeanor back home. It’s awfully humbling to come home after such trips and think about what we were complaining about just before we left. We find ourselves less likely to complain about the temperature of our frappuccino or other such silliness after returning from these trips. This is a good thing. Another, less touted reason is the concept of the medical emissary. Whether intended or not, the medical mission physician is an emissary from the United States to the rest of the world. Our actions and behaviors are judged by our hosts, which is all the more reason we need to display the highest level of professionalism, courtesy, humility and decency. This is a rather cool thing, I think. There is a feeling of great satisfaction and achievement that comes with being recongnized for representing the better side of human nature. Furthermore, it’s highly rewarding to look in the eyes of a host colleague as they are firmly shaking your hand and thinking you for all you’ve done to help. Another extremely important reason to participate is that we can teach what we know to those wanting to learn. Given our vast resources, U.S. physicians often have skills and knowledge our colleagues from less developed countries simply don’t have. This is not to say that we are any smarter or more skilled than them—quite the contrary. African physicians typically study in a very stringent educational environment and take their studies very seriously. What they lack, however, are the resources, equipment, instruments and supplies necessary to put their knowledge to use. It’s awfully hard to learn surgical technique if you can’t afford to purchase a scalpel. It goes without saying however that we also learn from our hosts. Education is a two-headed coin. It’s amazing to see how these colleagues without resources can learn to adapt to the situation and still provide proper medical care. I’ve seen many surgeries performed with wholly inadequate instruments and tools that would otherwise belong in a medical museum

team leader to actively survey the political, geographic, and medical situation in the host country and abort at any given time should there be concerns. Using common sense caution I believe that it is as safe to go on missions as it is to travel anywhere in the United States. Indeed, there are plenty of cities in this country where I feel far less safe.

back home. Sometimes it takes a little “MacGyvering” as it were, but damn if they don’t get the job done anyway. Another benefit is that we do make new friends, which is never a bad thing. Not only do we bond and develop close friendships with our team members but we also make friends with host physicians, nurses, hospital administrators, and other volunteer physicians from around the world. I’ve personally met and befriended physicians from Germany, England, Switzerland, Uganda, Ghana, and Peru, and these friendships I hold quite dear. Now, what are the reasons not to consider volunteering? As stated above, it requires time away from home and family, time away from work, loss of income, the pain and discomfort of travel, and some risks. It takes a strong spouse and children to put up with the globetrotting and gallivanting mission physician. Our families worry about us while were gone, and we worry about them as well. While abroad we might miss special moments and milestones happening without while we’re away, not to mention just the warmth and comfort of home. These sacrifices can be justified when considering the greater good being achieved, but they are sacrifices nonetheless. Time away from work obviously poses a financial burden to the volunteer. However, when we consider that the loss of two weeks’ income while we volunteer Opposite page: A patient is prepped for surgery; This page: Dr. Margolis (standing, far left) and fellow volunteers

may be equivalent to (if not more than) the total yearly income of the colleagues we are helping, then the numbers add up, at least by my math. Obviously, time away from work takes away from time with our patients and we have to rely on call groups to cover us while we’re gone. But with the advent of inexpensive world phones, it’s not that difficult to keep up on our patients and help manage their care from abroad. Another disadvantage is the sheer discomfort of traveling. To travel from San Francisco to a hospital in Western Uganda requires a total of 21 hours flight time, two layovers, one night in a hotel, and six hours of ground travel. I’ve always found the most uncomfortable part of any mission trip to be the time cooped up in a plane or in a “bone shaker” on the road. Other discomforts include bug bites, parasites, dehydration, and jetlag, to name a few. There is no question that we push ourselves a bit out of our physical comfort zone when on these trips. Fortunately, beer is a universal liquid, and I’ve yet to visit a host country that did not have adequate “medicinal quantities” of this substance. The efficacy of Malarone and ciprofloxacin, by the way are not adversely affected by the consumption of beer in my experience. I’m frequently asked about the risks involved in medical missions. The answer is simple. I never personally travel or lead a team of volunteers to any location where there are risks of violence, civil unrest, war, or incurable diseases. I have aborted trips to northern Sudan because of rebel attacks on the capital, and I have aborted trips to Uganda because of Ebola outbreaks. It is the responsibility of the

Finally, I’d like to profile the typical medical volunteer. Those colleagues I’ve had the honor of working alongside are more often than not highly skilled and excellent physicians, enthusiastic and hard working, quiet and unassuming, modest, humble and altruistic at heart. It is not to say that non-volunteers do not possess the same characteristics, but those that volunteer must be recognized for the good they do. For those interested in volunteering there are a variety of organizations in the Bay Area that offer opportunities to join medical missions. One of those is MedLend in Burlingame founded by Dr. Henry Hamilton in 2000 to providing free health care services and resources for people in the world’s poorest countries. In fact, as I write this, I’m preparing for a surgical mission that will take me to Uganda from February 26 through March 7. For those who are unable to personally volunteer, donations of medical equipment, supplies or money are always welcome. For those who can do neither, that’s okay! The fact that you’ve read to the end of this article shows that you at least have some interest in the subject, and that’s good enough! ■

About the author Dr. Michael T. Margolis practices Pelvic Surgery and Urogynecology at Bay Area Pelvic Surgery in Burlingame. He is one of a handful of Subspecialty BoardCertified and Fellowship-Trained Pelvic Surgeon/Urogynecologists in the country. He has been in the full-time practice since 1991and has performed more than 25,000 surgical procedures. He is also an active mission surgeon, caring for underserved women throughout Africa and South America.

FEBRUARY 2016 | SAN MATEO COUNTY PHYSICIAN 9

COLLEGIALITY: IT’S GOOD MEDICINE by Claire Serrato, MD, MPH

In 2014, national health expenditures in the United States grew 5.3% to $3.0 trillion ($9,523 per person) and accounted for 17.5% of the Gross Domestic Product (cms.gov). With the Affordable Care Act comes a new medical reimbursement landscape, from a simple productivity model to more of a value-based compensation with shared cost to patients. Value is measured by patient satisfaction, short-term and long term-outcomes, as well as keeping patients healthier and out of the hospital. As physicians, we are asked to provide this patientcentric care, all the while holding down costs. This is indeed no easy undertaking, particularly when techsavvy patients expect and demand prompt responses to more detailed questions in a culturally sensitive, integrative environment Each patient wants a communication vehicle that is facile for them, but also protects their privacy with high-level encryption. Although we have many brilliant minds in America in economics, public heath, law, sociology and medicine, the complexities of providing this “new age” medicine while abiding by regulations of the 20,000+ pages in the ACA documents remains a daunting task. Even more challenging is finding a way to provide this type of comprehensive cost-effective care in a manner that also allows one enough time and energy to have a life outside of medicine. Patient convenience and minimally invasive treatments are often reciprocal to the physician’s time and effort. Everyone has an opinion about tackling the health care spending crisis, but the answers are not easily attained. Collegiality among physicians is key to the solution. As a response, some physicians, nurses, and other allied health professionals have decided that they would rather be employees, trying to rely on systems’ models to control costs. After all, most physicians are not taught how to calculate true costs of care, including public health costs. Others continue to remain independent and try to provide value to their patients. Foundation or independent, there are tradeoffs for the individual physician and the patient. Regardless of the choice of practice situation for the provider, collegiality among all types of practitioners to find solutions to our inefficient system is paramount to the future of healthcare in this country.

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Unfortunately, for a variety of reasons, distrust has developed between the employed physicians and the independents. Mr. Steven Brill, who published America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System, learned the hard way why medical care is not “just a business” to be handled like any other business in the United States. He charged hospital executives with unethical billing practices, wherein the care provided had little relationship to the value of that service. For him, the MRI was a “symbol of profligate American health care”; however, on April 3, 2014 when he stared up from a gurney into the face of the CEO of New York–Presbyterian Hospital Steven Corwin, he would have begged to pay cash for the MRI to diagnose his life-threatening aortic aneurysm. Even with stateof-the-art nursing and recovery services, he says the rehab was “horribly routine” and a cough was “torture.” Before his own illness, he had railed against the rich executives, quoting their outrageous salaries. Yet, his criticism softened as he realized that healthcare is much more personal and more emotionally charged than any other business. Like many Americans, he had felt the “damn the torpedoes” attitude toward cost when it was him in a hospital bed. Mr. Brill proposes his idea of how to “fix” the runaway costs in the U.S. medical system: allow smart CEOs to be responsible for providing stellar care, but also enact regulations that would improve efficiency and cut costs. The attributes of an effective leader for this healthcare crisis are not those of the medieval king’s power, prestige and privilege, but rather those of a modern team’s passion, purpose and people. When we have 17.5% of the GDP being spent on healthcare, there is no time for a narcissistic, greedy bully at the top. And “people” means a collegial team striving for excellence in this field. Finding win-win scenarios for employed and independent physicians may help find solutions to the multifaceted issues facing medicine today. Integrative approaches are needed to prevent and attack diseases such as obesity (at an annual cost of $145 billion) and diabetes (at an annual cost of $245 billion). Expensive tertiary care solutions require individuals with

special skills, training and experience to work together efficiently and effectively. Comanagement between foundation and nonfoundation cardiovascular experts provides one example of this new era of collegiality in the Sutter system. The idea is to allow complementary talents for particular subsets of patients to be combined for better patient outcomes. Transparent financial incentives, responsibility, accountability, and equal enfranchisement provide the navigation to more cost-effective and patient-centric solutions. Cooperative interaction among colleagues should allow synergy to occur for excellence in patient care. Each physician has taken a similar pledge. The Modern Version of the Hippocratic oath states, “I will not be ashamed to say ‘I know not,’ nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery. I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.” As physicians, this does not mean we must be slaves to our patients or provide care for free. Negotiating openly, transparently, and in good faith for a fair price for the value you provide is ethical. The oath also does not mean we never make mistakes; but seeking forgiveness when we do make mistakes is the smart, principled response. To refuse the underpinnings of this oath, for whatever reason, may mean it is time to find a business other than healthcare. ■

About the author Dr. Claire Serrato is a board-certified OB/ GYN who has been in private practice for almost 20 years in the Bay Area. She trained at UCSF Medical Center for medical school and residency. She received her BS in business economics and her MPH from UCLA. She has privileges at Mills- Peninsula, CPMC and Sequoia Hospitals. She has a special interest and intensive training in pelvic ultrasound and minimally invasive gynecology.

Value of Membership

S an M ateo MEDICAL c

a ss o c i a t i o n

“

I am a member of the SMCMA because I believe very strongly that physicians need to come together as a unified force in order to successfully navigate all the changes in the healthcare landscape.

“

NIKI SAXENA, MD Pediatrics SMCMA Past-President

Why SOLO and SMALL PRACTICE GROUP PHYSICIANS need to be SMCMA/CMA members: 1. Empower your practice. When you join SMCMA/CMA, you hire a powerful professional staff to protect you and your practice from legal, legislative and regulatory intrusions. 2. Have a voice. SMCMA is the voice of San Mateo County physicians and relies on your participation to transform health care in California. 3. Keep current. Stay up-to-date on issues affecting San Mateo County physicians with our complimentary publications and website, smcma.org. 4. Get connected. Network with other medical professionals and keep current on vital healthcare issues with our educational seminars and social events. 5. Save time and money. SMCMA members enjoy special discounts on a variet of goods and services to help your practice thrive.

Join SMCMA/CMA Today! ■ 650-312-1663 ■ www.smcma.org/join

The Institute for Medical Quality (IMQ) is looking for physicians interested in becoming surveyors for the Ambulatory Care, Corrections, or CME Review Programs. The Ambulatory Program accredits surgery centers, offices, and medical groups in California. The Corrections Program reviews healthcare in jails and juvenile facilities, and the CME Program reviews providers of CME. Surveyors contribute directly to the improved quality of care, interacting with colleagues throughout the state, and observing best practices and innovation beyond their own medical community. The time commitment is generally 3 to 4 surveys a year. Survey travel expenses plus honorarium are paid. The general qualifications for an IMQ surveyor are: 1. 2. 3. 4. 5.

CMA membership is required (or other state medical association) Meaningful involvement in a related program Active in medicine Peer recommendations A letter of recommendation from the county medical society

The qualities sought in an IMQ surveyor are excellent communication skills, diplomacy, efficiency, fairness, flexibility, good judgment, reliability, ability to present ideas in a constructive and positive manner, and enthusiasm for learning. For more information, please call Jill Silverman at (415) 882-5151 or email: jsilverman@imq.org, or visit www.imq.org.

FEBRUARY 2016 | SAN MATEO COUNTY PHYSICIAN 11

MIEC Belongs to Our Policyholders!

Toni Brayer, MD Board of Governors

Philosophy is Important In 2016 MIEC will be the only MPLI carrier distributing dividends in California. It’s time to join the company whose philosophy puts policyholder-owners first. MIEC has never lost sight of its original mission, always putting policyholders (doctors like you) first. For 40 years, MIEC has been steadfast in our protection of California physicians with conscientious Underwriting, excellent Claims management and hands-on Loss Prevention services; we’ve partnered with policyholders to keep premiums low. Added value: n No profit motive and low overhead n Dividends for a TEN year average savings of 31.4%*

For more information or to apply: n www.miec.com n Call 800.227.4527 n Email questions to underwriting@miec.com * On premiums at $1/3 million limits. Future dividends cannot be guaranteed.

MIEC 6250 Claremont Avenue, Oakland, California 94618 • 800-227-4527 • www.miec.com SMCMA_ad_01.19.16

SMCMA_ad_01.19.16.indd 1 12 SAN MATEO COUNTY PHYSICIAN | FEBRUARY 2016

MIEC Owned by the policyholders we protect.

1/19/16 2:59 PM

SMCMA welcomes new members

Helen Lin, MD *Internal Medicine Redwood City

Matin Mazidi, MD *Obstetrics-Gynecology San Mateo

Tomio Miyai, MD *Cardiovascular Disease, *Critical Care Medicine, *Pulmonary Disease/SSF

Eun-Ha Park, MD *Ophthalmology SSF

Marc Philippe, MD *Family Medicine San Mateo

Justin Low, MD *Pediatrics Redwood City

Neelu Mehra, MD *Family Medicine, *Hospital Medicine Redwood City

Gulpana Mohammad, MD *Family Medicine SSF

Eunice ParkRobertson, MD Emergency Medicine SSF

Sudha Rao, MD *Pathology Redwood City

Elizabeth Lyons, MD *Pediatrics Redwood City

Ann Minn, MD *Radiation Oncology SSF

Shahrod Mokhtari, MD *Internal Medicine Redwood City

Patrick Pezeshkian, MD Neurological Surgery Redwood City

Rachna Rekhi, MD *Pediatrics SSF

Tyler Macy, MD *Otolaryngology, Head & Neck Surgery Redwood City

Charles Mitchell, MD *Cardiovascular Disease, *Internal Medicine Redwood City

Brian Niehaus, MD *Psychiatry Redwood City

Kim Pham, MD *Obstetrics-Gynecology Redwood City

Ira Schwalb, MD *Anesthesiology Redwood City

FEBRUARY 2016 | SAN MATEO COUNTY PHYSICIAN 13

Walk with a Doc returns April 2 - PHYSICIAN VOLUNTEERS NEEDED!! Walk with a Doc is a free program of the SMCMA Community Service Foundation that provides in which community members enjoy a walk with local physicians while discussing healthy living and health-related issues along the way. Our 2016 program will feature 26 walks at 13 picturesue locations throughout San Mateo County, with a special emphasis on the natural trails and open spaces that make the Peninsula such a beuatiful place to call home. Walks take place on Saturday morning, at 10:00 a.m., from April 2 through October 15, 2016, excluding holiday weekends. The programâ&#x20AC;&#x2122;s success relies heavily on the participation of our enthusiastic physicians. You can help by attending one or more walks as a physician volunteer and/or advertising Walk with a Doc to your patients. Dates and locations are posted at smcma.org/walkwithadoc.

FOR SALE: WELL ESTABLISHED MEDICAL WEIGHT LOSS PRACTICE IN MARIN COUNTY, CA Fall in love with practicing medicine again. Create work-life balance and achieve financial freedom. Work with highly motivated, capable people, excelling in many facets of their lives, who have struggled with their weight and know clearly that they cannot do it alone. This all cash practice offers a flexible schedule and provides other income streams besides doctor visits. A motivated doctor can take advantage of a significant opportunity to continue to grow this referral based practice. This is and will continue to be an active ongoing practice. The seller will enable a smooth transition.

Email BariatricPracticeForSale@gmail.com

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INDEX OF ADVERTISERS

In Memoriam Sheldon Gross, MD November 28, 2015

Alan Rider, MD December 21, 2015

Robert Telfer, MD December 27, 2015 14 SAN MATEO COUNTY PHYSICIAN | FEBRUARY 2016

California Academy of Family Physicians.............................................................14 Cooperative of American Physicians............................................ Inside Back Cover Institute for Medical Quality..................................................................................6 The Magnolia of Millbrae.....................................................................................4 Medical Insurance Exchange of California (MIEC)................................................12 Mercer.......................................................................................Outside Back Cover NORCAL.......................................................................................Inside Front Cover Tracy Zweig Associates........................................................................................14

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The CMA/SMCMA’s exclusive new Workers’ Compensation program can help your practice save money! Savings

CMA members qualify for an additional 5% discount* on top of Preferred Insurance’s already competitive rates. Preferred’s rates are set for long term consistency, and are managed by focusing on safety and injury prevention, fraud prevention and the control of medical costs for your practice by getting employees back to work as soon as practical.

Service Mercer’s team of insurance advisors is knowledgeable about the needs of physicians and is available to walk you through the application process. Preferred’s claims examiners are experts in helping members with an employee injury or illness claim. Plus Preferred’s payroll management and flexible payment plans help you manage your premiums in the way that works best for you and your practice’s cash-flow needs.

Safety In addition to mandatory CalOSHA information and videos on workplace safety, Preferred’s team of Risk Advisors are available for consultations when you need them. They also have a strong fraud prevention policy and as a California-based carrier, they know exactly what it takes to do business successfully in this State.

Stability Preferred Insurance prides itself on its stability, which includes maintaining some of the best and most consistent pricing available for CMA members. And because of its Medical Provider Network of credentialed medical professionals, claim costs can be closely monitored and managed while providing quality care to injured employees.

Call Mercer today at 800-842-3761 for a premium indication. CMACounty.Insurance.service@mercer.com or www.CountyCMAMemberInsurance.com.

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Mercer Health & Benefits Insurance Services LLC • CA Ins. Lic. #0G39709 • Copyright 2016 Mercer LLC. All rights reserved. • 74612 (2/16) 777 South Figueroa Street, Los Angeles, CA 90017 • 800-842-3761 • www.CountyCMAMemberInsurance.com • CMACounty.Insurance.service@mercer.com