S A N M AT E O C O U N T Y
July-August 2016
Physician
IN SIDE
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 7
Introducing SMCMA’s 2016-17 President Dr. Russ Granich
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S a n M at e o C o u n t y
Physician Editorial Committee Russ Granich, MD, Chair; Judy Chang, MD; Uli Chettipally, MD; Sharon Clark, MD; Carri Allen Jones, MD; Edward Morhauser, MD; Gurpreet Padam, MD Sue U. Malone, Executive Director Shannon Goecke, Managing Editor
SMCMA Leadership Russ Granich, MD, President; Alexander Ding, MD, President-Elect; Sara Whitehead MD, SecretaryTreasurer; Michael Norris, MD, Immediate Past President Janet Chaikind, MD; Uli Chettipally, MD; Mamatha Chivukula, MD; Paul Jemelian, MD; Alex Lakowsky, MD; Richard Moore, MD; Joshua Parker, MD; Xiushui (Mike) Ren, MD; Brian Tang, 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 smcma@smcma.org. Visit our website at smcma.org, like us at facebook.com/smcma, and follow us at twitter.com/SMCMedAssoc.
July/August 2016 - Volume 5, Issue 7 Columns President’s Message: Why we are here........................................................ 5 Russ Granich, MD
Feature Articles Photo album from the 2016 SMCMA annual meeting. . ........................... 6 Photos by Ginger Tree Photography
Dr. Russ Granich, 2016-17 president of the San Mateo County Medical Association. . ................................................. 9 Bronwyn Hogan
Dr. David Goldschmid, recipient of the SMCMA Distinguished Service Award. . .................................................. 11 Bronwyn Hogan
Of Interest New SMCMA members............................................................................ 13 Member updates, classified ads, index of advertisers.......................... 14
Š 2016 San Mateo County Medical Association
Cover photo by Scott Buschman, Scott Buschman Photography, San Mateo, California. http://www.buschmanphoto.com/
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4 SAN MATEO COUNTY PHYSICIAN | JULY-AUGUST 2016
July-August 2016
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 7
Physician President’s Message
Why we are here We live through turbulent times for medicine. The government is trying to cut what they pay, they add on regulations, insurers are often difficult, etc. It is easy to get lost and focus on the business of medicine instead of the practice of medicine. It is always better to remember our goals and concentrate on the journey, not on the roadblocks. At some point, while merely children, we decided to become physicians. And like most youth, we approached the world with hope and excitement as we embarked on the education that would define who we are in our community. We worked hard to achieve good grades, we set our minds on that goal to get into medical school. We felt that our skills and intellect could be used to aid and help others, to make the world a healthier place, to provide sustenance and take care of countless others who would rely on and trust us with their lives. Do you remember what you wrote and said when asked by interviewers why you want to be a physician? That was a defining moment when we set our goals as to the type of person we want to be and to be remembered as. For most of us it was a more noble and glorious reason than as a way to make money or obtain security. Now, many years later, do you still feel the same way? Actions speak louder than words, so look at your own actions and see how they define who you are. Does it match the definition you once created? Do you come to the aid of a distressed patient or send them to urgent care because they missed their appointment? How often have you gone to see someone on your day off or at their home because you wanted to make sure they were doing well, and because you knew your presence would provide more comfort than another treatment or procedure?
The passing of the torch...
When we graduated medical school, we all took an oath, the majority took the Hippocratic Oath. The original oath was written more than 2,700 years ago. Many medical schools stopped using an oath over the years until after WWII. The medical community realized how some physicians deviated from what most considered obvious and eternal truths. We experimented on people without their consent, the Nazis did unspeakable and horrible things, all in the name of science. During the Third Reich, medical students were prohibited from taking an ethical oath. In 1948 the World Medical Association revised the Hippocratic Oath and encouraged all students to take it or one of the other similar oaths. In 1964 it was modernized and became more secular. Let’s look at what is in the oath. We will respect and share knowledge. We will do whatever we can to treat our patients but not to excess. Medicine is an art and as such, warmth, sympathy and understanding may be more important than drugs or procedures. Respect our limits and not be afraid to ask for help. Protect privacy. We treat a person, not a disease, and that includes how his illness affects his family and economic stability. Prevention of disease is better than cure. We are members of society and have a special obligation to all others, whether healthy or infirmed. And finally: “If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.”
IN S ID E
Russ Granich, MD President
We will do whatever we can to treat our patients but not to excess. Medicine is an art and as such, warmth, sympathy and understanding may be more important than drugs or procedures.
Introducing SMCMA’s 2016-17 President Dr. Russ Granich
Take some time and sit down with your spouse, a friend or colleague. Leave the regulators, insurers and bankers outside the door. Share and discuss why you chose to be a physician and what it really means to you. When you go to work, remember that what you do is a privilege and an honor and the person, that human being, whom you are going to treat, has faith and trust in you to do the right thing. ■ JULY-AUGUST 2016 | SAN MATEO COUNTY PHYSICIAN 5
2016 ANNUAL MEETING
Michael Norris, MD, and Russ Granich, MD
Uli Chettipally, MD, and Subha Aahlad, MD
Joyce Goldschmid, David Goldschmid, MD, Michelle Graf, Solomon Graf, MD, Renee Schwall, Matt Schwall, Josh Schwall, Alice Graf, and Clark Schwall
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JUNE 23, 2016
Ray Gaeta, MD, and William Brose, MD
Members of the Jadallah family: Henrietta, Aileen, Dr. Adil Jadallah, Aileen, and Carina
David Jacoby, MD, Gail Jacoby, MD, Robin Hoff, and John Hoff, MD
SMCMA President-Elect Alex Ding, MD
JULY-AUGUST 2016 | SAN MATEO COUNTY PHYSICIAN 7
Retired Pan-Am stewardessess
Don Horsley; Susan Ferreilli, and John Ferrelli
Josh Goldschmid, Joycr Goldschmid, and Barry Sheppard, MD
Michael Norris, MD, and Michael Glafkides, MD
8 SAN MATEO COUNTY PHYSICIAN | JULY-AUGUST 2016
Introducing
DR. RUSS GRANICH
2016-217 President of the San Mateo County Medical Association Born in Long Island, New York, this self-proclaimed workaholic earned an average of seven course credits per semester during college, Dr. Russ Granich studied bio-chemistry at Cornell, and received his medical degree from Boston University. It was after breaking up with a longtime girlfriend that Granich decided that he needed to leave Beantown. After considering the obvious choices of New York and Chicago, Granich settled on San Francisco, ending up at the California Pacific Medical Center. His original career path was to enter emergency medicine, but instead opted for internal medicine. Once his residency was completed, Granich opened up his own practice in San Francisco.
he was attending. A doctor approached him, and told him about some of the struggles he had faced in his career, including burn-out, and fatigue and how one simple suggestion Granich made turned his career around.
“I had no business acumen at all, and I could not make ends meet,” admitted Granich. “I did some ridiculous things like put in a computer billing system, which in those days, was expensive. I actually spent $3500 on a laser printer! I still have trouble believing it.”
“He reminded me that I had once suggested that before he entered the exam room, to take a moment and say ‘I love you’ before seeing the patient,” said Granich. “Because of that one small suggestion, he said that he started enjoying his work again, and remembered that it is an honor and a privilege to care for his patients.”
“I started moonlighting, driving to Santa Cruz and Lodi to take on emergency room shifts; consulting for a pediatric oncologist (to help with his older patients) and working in an occupational medicine clinic,” he added. “I did what I could for a steady wage.” As luck would have it, Granich was interviewed by the Los Angeles Times as a new doctor starting out in private practice for a 1987 article titled “Bay Area Physician Overload: Shape of Future?” “One never knows how one might influence another life. Years later, after I joined Kaiser Permanente, I met a doctor who unfolded a crinkled newspaper article, the very same LA Times article that examined my own early struggles. He told me that article was the reason he stayed away from the private practice route, and instead, joined Kaiser Permanente.” Another reminder of the influence that Granich has had over his colleagues surfaced at a recent retirement dinner
This attitude of respect, and treating the patient as a family member (up to saying “I love you” before entering the room) has served Granich well in his palliative care work. He started his storied career with Kaiser Permanente in July 1990. By December of that year, he was living in Colorado Springs, called up as a U.S. Army reservist for Desert Storm. Twelve days earlier, his first son was born. “Fortunately my wife and son were able to be with me. It was not an easy time but I did enjoy that six-month experience. I am very patriotic,” said Granich. He left the service a few years later at the rank of Major. Upon returning to the Bay Area, Granich spent seven years as a clinic physician at Kaiser Permanente Fremont, and saw patients at the hospital in Hayward. Eventually he transferred to the Hayward facility, becoming Kaiser’s first
JULY-AUGUST 2016 | SAN MATEO COUNTY PHYSICIAN 9
San Mateo County Physician: What is your current state of happiness? Dr. Granich: It’s exactly where it’s supposed to be. Dr. Granich at the SMCMA annual meeting with neice Leah Block. left, and wife Monica Granich.
full time hospital based specialist (i.e. hospitalist). And soon after, Granich became Chief of Hospital Medicine. “Any organization I join, I eventually run,” he jokes. As he was ready for a change, he stepped down as Chief in 2005, and left the Hayward facility in 2006, tiring of the arduous commute from San Francisco. But Granich left his mark on the department, building it up to 25 physicians, expanding into the newly opened Kaiser Permanente Fremont hospital, and pioneering the use of physician assistants to work with hospital based specialists. He spent a year in the South San Francisco facility practicing hospital medicine, but realized that the difficult schedules required of him conflicted with his expanding family responsibilities (a second son was born in 1993). And he had already started developing his interest in palliative care during his time as a hospitalist in Hayward. He joined the Continuum of Care in 2007, initially seeing patients at nursing homes. “The Continuum of Care addresses care that is outside of the hospital,” explained Granich. “Home health, hospice, dialysis, home based care and nursing home care are all big parts of this service.”
He has big plans for his tenure as president of the Association, and hopes to spend part of his time in the role reminding physicians of their calling, and suggesting ways to make their practices more meaningful. “Why are we doctors?” he asked. “We mustn’t lose sight of the answer, and strive to take better care of our patients, and of ourselves.” ■
PROUST QUESTIONNAIRE San Mateo County Physician: What is your current state of happiness? Russ Granich: It’s exactly where it’s supposed to be. SMCP: What are the qualities you value in your friends? RG: Humor, openness, honesty, camaraderie, enjoying food, enjoying fun. SMCP: Who are your favorite authors? RG: Wilbur Smith, Lee Childs, Judith Anodea.
He became Chief of Community Based Medicine, Geriatrics, Medical Director for Hospice and Medical Director for Home Health in 2007, where he now spends most of his time in palliative care, hospice, and supervising a Home Based Palliative Care program.
SMCP: Who are your heroes in fiction?
Granich also has a regional role with Kaiser Permanente of Northern California, serving as the Physician Lead for SNF, Home Health, and Elder care.
RG: Thomas Jefferson, Benjamin Franklin, FDR, Albert Einstein, Thomas Edison, Charles F. von Guten, MD, PhD.
“Basically I’m the chief of chiefs,” he explains.
10 SAN MATEO COUNTY PHYSICIAN | JULY-AUGUST 2016
RG: Jack Reacher, James Bond (Sean Connery, of course!) SMCP: Who are your heroes in real life?
Honoring
DR. DAVID GOLDSCHMID
2016 Recipient of the SMCMA Distinguished Service Award “I just want to take care of people,” said Dr. David Goldschmid, 2016 recipient of the SMCMA Distinguished Service Awared. And take care of people he does. Dr. Goldschmid is the medical director of the Clinic by the Bay, located in between San Francisco and Daly City. Tapped by Sue Malone, executive director of the SMCMA to lead clinic operations, he has been seeing patients there, from all walks of life for almost three years. “It reminds me of my time in Canada,” said Goldschmid. “I do what must be done to help people feel better, regardless of their socio-economic status.” After receiving his medical degree from the University of Michigan, Ann Arbor, Goldschmid continued his medical training, interning at Wellesley Hospital in Toronto, and then completing his residency at Jewish General Hospital of McGill University in Montreal, Quebec. He left Canada to establish his private practice in San Jose. By Goldschmid’s own account, he was really, really busy, he was working really hard, and it was hard to adjust to the insurance “stuff.” He closed his practice and took on the challenges of the ER, first in the valley, in Sacramento, and ending up at Seton Med-
ical Center, staying on for 30 years, and serving as the medical director for 25 of those years. “I loved it. Patients came in, and I took care of them,” added Goldschmid. It was during his time at Seton that Goldschmid joined the SMCMA. “I began noticing systems problems,” he said. “By joining the medical association, I was able to get things fixed.” Goldschmid tells the poignant story of a baby who died in the ER because of an epidural bleed from an automobile accident. He could not find a neurosurgeon to take care of the child despite many attempts to contact someone who could care for the patient. At that time, there was no trauma system in San Mateo County. This episode led Goldschmid, with the backing of the SMCMA, San Mateo County trauma doctors, and the San Mateo County Board of Supervisors to suggest and implement the San Mateo County trauma system that is still used to this day. “We now send trauma victims to Stanford, which is outstanding, or to San Francisco General, which is super-outstanding. To this day, this system works. And I could not have done it without the support of the SMCMA.”
JULY-AUGUST 2016 | SAN MATEO COUNTY PHYSICIAN 11
Goldschmid has collaborated on other fixes with the Association. Recounting a rave that occurred at the Cow Palace, Goldschmid tells of the five under-age comatose patients who appeared within an hour to the ER, prompting an activation of the disaster system. After working for almost two days straight, Goldschmid again reached out to Sue Malone. Following multiple meetings with Supervisor Adrienne Tessier, and Fiona Ma, who was then a member of the California State Assembly, came the creation of legislation that would make it virtually impossible to host such events at large public venues. “And there hasn’t been another rave there since,” added Goldschmid. “I was there for the second one, and I did not want to see a third one. Goldschmid tells of yet another successful collaboration with the SMCMA. He was heartbroken to watch an elderly patient languish on a ventilator in the ICU at Seton. As she had no relatives or friends to speak for her, a government conservatorship was to be assigned. With the support of the Association, a hospital policy was created that assigns the duty of patient advocate to the hospital, through the Ethics Committee, and not the government. This request now takes but a few days, not weeks.
“That’s why I love working at the clinic. I take care of people who may be falling through the cracks,” he added. Many people visit the doctors and nurses at the Clinic by the Bay. They are just regular people, according to Goldschmid. Some are people who may have lost their jobs and cannot afford COBRA. Patients who are seen must meet residence and income eligibility requirements. The all-volunteer staff at the clinic is comprised of physicians, registered nurses, nurse practitioners, medical students and residents. The doctors are from a variety of specialties – some of them are sub-specialists, some are surgeons. And Goldschmid keeps it running smoothly. “Both San Mateo and San Francisco Counties have been very supportive, and have helped us to treat people who were very sick,” he added. When he is not helping patients at the clinic, Goldschmid goes on tour with the San Francisco Symphony, as their physician. He and his wife also takes on babysitting responsibilities every Monday and Wednesday for their two grandchildren who live in the Bay Area. “And we have two more in Seattle,” he said. “I am thrilled to receive this award,” added Goldschmid. “The San Mateo County Medical Association has been a great tool to get things quietly fixed. I am proud to be a member.” ■
“These are big projects that may have taken some time to implement, but they serve our patients well now,” said Goldschmid.
SMCMA welcomes new members
Tyler Aguinaldo, MD *Internal Medicine *Diabetes, Endocrinology & Metabolism Burlingame
Ann Lee, MD Physical Medicine & Rehabilitation Palo Alto
Wen Liang, MD *Family Medicine Burlingame
Michael McNamara, MD Internal Medicine *Medical Oncology Burlingame
Stacy Porter, MD Intternal Medicine Menlo Park
Maria Samsovor, MD Clinical Genetics, Hospice & Palliative Medicine San Bruno
Rabia Siddik-Ahmad, MD *Obstettrics & Gynecology Burlingame
Brian Tang, MD *Pediatrics Redwood City
Joseph Walsh, III, MD *Cardivascular Disease, *Interventional Cardiology, Burlingame
Elizabeth Zambricki, MD Otolaryngology Burlingame
Fifty-Year Active Members
Forty-Year Active Members
Peter Benson. MD
Michael Girolami. MD
Michael Cowan MD
David Jacoby, MD (pictured below)
Adil Jadallah, MD (pictured below)
David Sugarman, MD
Paul Wachter, MD
Stephen Weller, MD
SMCMA 2016 ANNUAL MEETING EVENT SPONSORS Gold Sponsor
Silver Sponsors
Palo Alto Medical Foundation Mills-Peninsula Health Services
NORCAL Mutal Insurance Company Cooperative of American Physicans Kaiser Permanente Redwood City
Bronze Sponsors
Kaiser Permanente S San Francisco
Gilead Sciences
Sequoia Hospital
Mercer
Stanford Healthcare
The Magnolia of Millbrae
First Republic Bank
Thank You
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In Memoriam James Dudley, MD June 5, 2016
Nurse Practitioners Physician Assistants
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Etidal (Dolly) Basily Tadros, MD June 27, 2016
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