May 2012 | Volume I /No. 4
SAN MATEO COUNTY PHYSICIAN’S
ART EXHIBIT
A Publication of the San Mateo County Medical Association
THURSDAY, 3-10 -PHYSICIAN’S UPPER LEVEL SAN MATEOMAY COUNTY ACROSS FROM SWAROVSKI
ART EXHIBIT
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SMCMA services
Why I Am a Member A Note from Board Member Niki Saxena, MD I am a general pediatrician in private practice in a small single specialty group, and I have been a member of the SMCMA since 1996. Why am I a member? Because I feel that the SMCMA is an organization that helps give me a voice in healthcare, it gives me a seat at the political table and it assists me in lobbying for changes that will benefit both my practice and my patients. Like all of you I am trying to navigate all the changes in healthcare without losing sight of my original passion - to be the best physician I can be and to provide the best care I can to my patients and their families. As an independent practitioner in a landscape filled with large groups, this can be a challenge. While I firmly believe there is still room for many different models of healthcare delivery, those of us in smaller groups will have to be creative and utilize all of our resources to stay relevant to our patients. I rely on my SMCMA membership to give me access to benefits that help me manage the business side of my practice more effectively. I think it is one of the few organizations that first and foremost keeps the patient in mind; it has always advocated for legislation that improves patient safety while helping physicians continue to practice effective medicine. There is strength in numbers, and while one voice can be heard it is when many of us come together that our collective voice can have a tremendous impact. As physicians, we have the power to direct change. I hope you will join me in working with the SMCMA to help make sure that our voices remain loud and clear as we face a brave new world of medicine in the 21st century. I also take advantage of the many SMCMA member benefits. Of particular note, is the DocBookMD app. I am in an independent single specialty group with five providers. We depend on DocBookMD to help us communicate with each other about our patients in a HIPAA compliant and secure format. We looked at several options that were either cost prohibitive or not compatible with our current EHR. It is easy to use, easy to install, and because we can access it on our smartphones it is very convenient! We feel that DocBooks is a great added benefit to our SMCMA membership, and we would encourage folks to sign up and try it!
SAN MATEO COUNTY PHYSICIAN’S
ART EXHIBIT
THURSDAY, MAY 3-10 - UPPER LEVEL ACROSS FROM SWAROVSKI
About the Cover: The SMCMA hosted its fifth physician art exhibit at Hillsdale Shopping Center from May 3 - 10. The collage on the cover was the actual signage that Hillsdale Mall used to publicize the event.
San Mateo County Physician May 2012 Vol. I / No. 4
Table of Contents President’s Message..........................5 Executive Report................................7 Hormonal Contraception Medical Considerations......................8 Mental Health Resources A Call or Click Away............................9 Celebrating SMCMA Events...............................................10 Goodbyes and Greeting............................................13 News from NORCAL...........................................15 In Memoriam Glenn Zurawski, MD.........................17 Membership Update and Classified Ads..................................18
SAN MATEO COUNTY PHYSICIAN | page 3
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Physician Heal Thyself By gregory Lukaszewicz, MD
As physicians, we treat diseases, care for the sick and console the dying. We also offer advice...lots of advice. However, when it comes to practicing five basic healthy lifestyle practices, which include avoiding tobacco, limiting alcohol, eating a healthy low salt diet with five fruits and vegetables a day, controlling our weight, and exercising 150 minutes a week, how well are we doing with not only providing the advice, but actually practicing it ourselves? A recent study of 1000 primary care physicians presented at the Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism Scientific Sessions 2012, provides some interesting insight into this question. Of the 1000 primary care physicians polled for the study, only four percent admitted to smoking (well below the national average of roughly 20 percent); 27 percent claimed to exercise 150 or more minutes a week; and 38 percent ate five or more servings of fruit and vegetables a day. One important piece of data which has come out of this study is that physicians who practice healthy lifestyles are much more likely to discuss these strategies with their patients. Overall, 66.5 percent of the physicians polled were likely to discuss all five lifestyle recommendations. However, of the physicians who did not exercise, only 50 percent offered these healthy lifestyle recommendations; 65 percent of physicians who exercised one to four
times a week offered this advice; and 75 percent of physicians who exercised five or more times a week discussed these same recommendations. Thus, there is a correlation between a physician’s own lifestyle and the advice he or she offers to a patient. We are all well aware that we face an obesity epidemic in the United States, which is linked directly to our diets and lack of physical activity. This sedentary lifestyle is having a tremendous impact upon our nation’s physical, mental and economic health. Fifty-eight million Americans are now considered overweight, 40 million are obese and three million are morbidly obese. There are roughly 200,000 preventable deaths due to obesity each year. Obesity impacts health in terms of cardiovascular disease, diabetes and gallbladder disease, for example, and costs millions of dollars in terms of lost productivity, restricted activity days and visits to a health care provider. For many people, their physician is their main or only source of healthy nutrition and exercise advice. One of the main impediments to offering this advice has to do with a physician’s comfort level in understanding exactly what advice to offer. By exercising regularly and following a healthy diet, physicians will be much more comfortable in offering this much needed advice. Thus, as physicians we owe it to our patients to lead by example, practice what we preach
and in turn increase the likelihood that we will provide the lifesaving recommendations that so many people need and that we as physicians are in the position to provide. However, we also owe it to ourselves and our families ,and not just to our patients, to take care of ourselves through proper diet and exercise (smoking goes without saying). Exercise rates of only 27 percent and healthy diet rates of 38 percent, though perhaps better than the national average, are still far below what one would expect from doctors. We should already be well aware of the importance of diet and exercise in helping to control such chronic conditions as hypertension, diabetes and hyperlipidemia. Beyond preventing these chronic diseases, performing regular exercise and practicing a healthy diet improves our mood, helps prevent depression, improves our ability to deal with the stress of our busy practices and lives, increases our energy levels, improves our sleep patterns, and generally leads to a greater sense of wellbeing. When we care for ourselves, we benefit and our patients and families benefit. It is a win-win situation all around. As a medical association, we are dedicated to the health of our members and our community at large and will continue to encourage and look for ways to assist our members in finding ways to improve their health and wellbeing. But now, it is a beautiful Sunday and it is time for a bike ride. SAN MATEO COUNTY PHYSICIAN | page 5
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T H E P E N I N S U L A’ S P R E M I E R R E T I R E M E N T C O M M U N I T Y
EXECUTIVE REPORT
Building Community Among Members By sue u. malone Along with many of our regular services to members, such as educational sessions and one-on-one help with coding and payor issues, April and May have been particularly busy. SMCMA, through its charitable foundation, organized a Gala and Silent Auction to benefit our Hepatitis B Free San Mateo program. The Gala was organized by Whitney Wood, who is director of the program and runs screening and testing sites held regularly at churches, health fairs, and centers where Asian and Pacific Islanders gather. You may not know that ten percent of your Asian patients are chronically infected with viral hepatitis B. The program was started by past President, Dirk Baumann in 2009. Congratulations Whitney for an outstanding job. In early May, a week-long display of artistic works of physicians was held at the Hillsdale Mall. The evening of May 3 marked the opening event for members and guests with more than 130 in attendance to view the art and listen to a physician string quartet of John Rosenman, Sam Chan. and Tania Nanevicz, along with Sam Chan’s viola-playing daughter, Clara Chan, who is a member of the S.F. Symphony Youth Orchestra. In all there were 80 works of art by 16 artists.
During the week-long exhibit, which was open to the public after the opening night reception, many mall visitors dropped by to enjoy the work and at times, admire the art produced by their very own physician. Many mediums were displayed including pottery and ceramic art.
members. This summer we intend to host casual gatherings, likely a barbeque for members, guests, and children. Look for information about this upcoming event in the next few weeks. Also, let me know if you agree that periodic strictly social events would be welcome.
I would like to thank all the physician artists who were willing to share their artistic talents with SMCMA and its members to enjoy: Peter Benson, Bella Berzin, Sharon Clark, Michael Glafkides, Sterling Haidt, David Jacoby, Edward Koo, Alan Lash, Frank M. Lee, Steven Machtinger, Stephen Marks, John Quilici, Lorne Rosenfield, Donald Stone, Daniel Switky, and Christopher White. Also, I wish to acknowledge the hard work of Gina Cromosini who greatly assisted in bringing this event to physicians and the public.
SMCMA would also like to expand its community health activities by undertaking other communuity benefit programs. If you have ideas for such activities, please share your views with us.
Bringing physicians together at the Art Exhibit and experiencing the esprit de corps brought to mind that perhaps we have been remiss in not offering physicians a greater opportunity to gather together for the sheer enjoyment of talking to colleagues outside the hospital or clinic setting. Whether it is for networking opportunities or for the pure enjoyment of talking to colleagues, additional social events might be well received by
One particular community health activity that SMCMA intends to host is what is called a “Walk With A Doc.” These walks are put on by an organization called “JustWalk,” which is a free, non-profit program for anyone interested in taking steps for their health. Their “Walk With A Doc” program provides a walking route and environment in which community residents can ask physicians questions about health care topics. We are currently looking for physician volunteers to walk with San Mateo County residents who sign up for the walk and answer health care questions. If you are interested in the “Walk With A Doc” program, please contact SMCMA. We will be further publicizing this event in the coming weeks.
SAN MATEO COUNTY PHYSICIAN | page 7
Hormonal Contraception: Medical Considerations By susan spencer, md In the months leading up to the next Presidential election, it seems that some politicians want to push women’s reproductive health choices back to the 1960’s. Contraception has become a political football. For those of us who provide medical care to women, birth control is an essential part of many of our patients’ lives. Now is a good time to reflect on how far contraceptive options have evolved, despite the vicissitudes of political climate. In the 1960’s, early formulations of estrogen and progestin (E+P) combined oral contraceptive (COC) pills contained high levels of estrogen (150 mcg of mestranol). These high dose pills provided effective contraception, but were associated with significant risk of myocardial infarction (MI), venous thromboembolic events (VTE) and stroke, particularly in women who smoked. Over the last several decades, the trend in COC design is to provide effective contraception while lowering estrogen exposure and reducing estrogen related adverse events. In 2010, a COC pill with the lowest ever estrogen dose, 10 mcg ethinyl estradiol, received FDA approval as an oral contraceptive. By shortening the pill free interval, this 10 mcg pill provides effective contraception despite the very low dose of estrogen. Contraceptive risks depend on hormonal content, and most contraindications are due to the estrogen component. Methods combining E+P include COC, the vaginal ring and contraceptive transdermal patch. Progestin-only methods include the progestin-only pill
page 8| San Mateo county physician
(POP), depot medroxy-progesterone acetate (DMPA), etonogestrel implant and the levonorgestrel intrauterine device (IUD). It is important to note that FDA-approved package labeling of progestin-only methods is in some cases the same as that of estrogencontaining methods, even though risks of VTE differ between estrogencontaining and progestin-only methods.1
and connective tissue disorders such as rheumatoid arthritis and systemic lupus erythematosus without antiphospholipid antibodies. Use of COC is rated category 1 (not restricted) in women with a family history of breast cancer or with BRCA1 or BRCA2 mutations. Varicose veins do not confer an increased risk of VTE, and therefore use of both E+P and progestin-only methods is appropriate.
Different types of progestin in COC, as well as estrogen dose, may confer different degrees of VTE risk. In December 2011, the FDA Reproductive Health and Drug Safety Advisory Committees issued a statement that COC containing the progestin drospirenone may be associated with a higher risk of VTE than COC containing levonorgestrel.2 The FDA recommended that package labeling of drospirenone-containing pills be revised to reflect an up to 3-fold increase in VTE risk.
For women with certain medical comorbidities, progestin-only methods may be safer than E+P methods. In women with a personal history of VTE at low risk of recurrence, or those with a family history of VTE in a first degree relative, progestin-only methods are preferred.
Non-hormonal forms of contraception, such as barrier methods and the copper IUD, are safe choices for many women with coexisting medical conditions. But what if the patient wishes hormonal contraception? The CDC has adapted the World Health Organization (WHO) Medical Eligibility Criteria for Contraceptive Use to provide evidence-based guidelines to assist clinical decision making.3 According to WHO guidelines, E+P methods can be used safely in women who have a range of medical conditions, including well-controlled hypertension, uncomplicated diabetes,
When considering hormonal contraception for women with headache, the WHO cautions that risk assessment depends on accurate diagnosis of the type of headache. Initiation of either E+P or progestin– only methods is unrestricted for women with non-migrainous headaches. However, E+P methods are category 4 (unacceptable risk) for women who have migraine headaches with aura because of elevated risk of stroke. Is hormonal contraception safe for women over 35 years of age? Case control studies of COC with < 50 mcg estrogen found no increase in the risk of MI or stroke in healthy nonsmoking women over 35.1 Non-contraceptive benefits of COC in perimenopausal continued on page 17
Mental Health Resources...A Call or Click Away By juliana fuerbringeR Founded in San Mateo County in 1979, the National Alliance on Mental Illness (NAMI) is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI has more than 1,200 local affiliates across the nation, and it’s a key referral resource for all those living with or caring for someone with mental illness. NAMI is a self-help community, and offers free support groups, resource referrals, education, speakers, and, above all, hope for people coping with the problems accompanying mental illness. The National Institute of Mental Health reports one in four adults, or approximately 57.7 million Americans, experience a mental health disorder in a given year; and 1 in 17 live with serious mental illness. Mental illness is often stigmatizing and isolating, and patients need acceptance and available resources to work toward stabilization and recovery. NAMI can’t eliminate the problems, but does offer a supportive community where people can join others dealing with similar issues. NAMI provides free support groups, referrals for crisis services, residential options, and financial advice--or just help navigating the complex matrix of mental health services. Membership is encouraged, but not necessary, to use NAMI’s offerings for all mental illnesses from schizophrenia to PTSD. Important link between doctors and patients NAMI works closely with the medical community providing a critical link between doctors and patients. The gap between the public’s knowledge of mental illness and its emotional response can be vast. Due to stigma,
people don’t have the same acceptance of mental illness as they may have of “medical” diseases. Doctors can help ameliorate this by including mental health information and resources in waiting and exam areas. NAMI provides this information free of charge. Our goal is to expand our collaboration with doctors in San Mateo County as the mental health system is ever-changing; and maintaining a strong therapeutic alliance means getting resources and help to more people.
issues presented by mental illness. These are held at various times and places in the County.
Based on strong evidence that family groups and peer support help improve recovery, the doctor taking a moment to strongly encourage contacting NAMI to find help is a quick and effective extension of care--just by providing our phone number or website.
Peer to Peer
NAMI Provides… A variety of beneficial touch points and free services depending on timing, location and need: Information and Outreach •
General meetings with relevant speakers open to the public at Mills Hospital; free parking
•
Newsletter with topical articles, resources, and clinical studies lists; online, mailed to members
•
Lending library and free literature distribution to doctors and agencies
•
Speakers’ bureau
•
Resources referrals accessible by phone, websites, walk-ins, groups, etc.
•
Peer and Volunteer opportunities
Support Free support groups, every week, for peers and families learning to cope with
Education Programs Family to Family Free 12-week course open to parents, spouses, siblings, and adult children of persons with mental illness, providing communication and problem-solving techniques, coping mechanisms and self-care skills.
Free 10-week experiential education course for persons with mental illness. Classes are taught by trained peer mentors. In Our Own Voice A recovery education presentation given by trained peer presenters to families, community groups, colleges and professionals. Other programs include the Crisis Intervention Team (CIT), The 5-week Provider Education Program and Parents and Teachers as Allies. Advocacy and Research Both are a strong, ongoing part of NAMI. We welcome referrals and speaker requests... Call us at 650-638-0800 or email to namismc@sbcglobal.net .See our website at www.namismc.org or the national website at www.nami.org. Visit our office: 1650 Borel Place, Suite 130, San Mateo, CA 94402. 9:00am 1:00pm; Monday – Friday. Juliana is the Co-Vice President of NAMI, San Mateo County
SAN MATEO MATEO COUNTY COUNTY PHYSICIAN PHYSICIAN || page page 9 9 SAN
Celebrating SMCMA Events San Mateo Hep B Free Spring Gala
Assemblywoman Fiona Ma presents San Mateo Hep B Free with a Certificate of Recognition. Pictured with the Assemblywoman are Ted Fang, San Francisco Hep B Free Campaign Co-Founder and Dirk Baumann, MD, Chair of the San Mateo Hep B Free Campaign.
SMCMA members Mark Tsuchiyose, MD and Michael Norris, MD enjoy the Gala festivities. Dr. Norris also donated items to the Galaâ&#x20AC;&#x2122;s silent auction.
SMCMA Board Member, Russ Granich, MD, attended the Gala in support of the San Mateo Hep B Free Campaign. He is pictured here with his wife, Monica Granich.
Ulrike Sujansky, MD is pictured here with Bob Horton, Vice President, Strategic Development, Mills-Peninsula Health Services.
SMCMA member Kim Dalal, MD gracefully smiles for the camera while getting ready to bid on Gala silent auction items.
Francine Serafin-Dixon, Nicole Moayer, M.D., Greg Lukaszewicz, M.D., Barry Oberstein, M.D., Sue Malone, Anthony Chiu.
Celebrating SMCMA Events 2012 Physician Art Exhibit
Hillsdale Shopping Center created a special marquee on the storefront that would house this year’s physician art exhibit.
Kristen Willison, MD and Ori Melamud, MD mingle among the other Opening Reception attendees.
Physician artist, Sharon Clark, MD chats with Mark Rosenberg, MD
Physician artist, Edward Koo, MD poses with his family in front of his piece, “Ecclesiastes 9:11”
Physician artist Bella Berzin, MD takes a look at her collection, “Urban Flowers” at the exhibit’s Opening Reception.
Physician quartet John Rosenman, MD, Sam Chan, MD, Tania Nanevicz, MD and Clara Chan provided the entertainment at the Opening Reception.
All photos of the Physician Art Exhibit are courtesy of Scott Buschman Photography
SAN MATEO COUNTY PHYSICIAN | page 11
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Goodbyes and Greetings SMC Physician Editor’s Note By Russ Granich, MD The editorial committee for your San Mateo Physician would like to thank our former Chairman and wish him well. Dr Barry Sheppard has been a major figure in the SMCMA. He was president from 2004-2005. That means he also served in all the other Board of Director officer positions. He served as alternate AMA delegate from 2006 to 2012. Despite having contributed greatly, he continued to devote time and effort by becoming chairman of the editorial committee from 2009 to 2012. During his tenure he was an active contributor to the Bulletin. Barry has decided to move his practice to the East Bay and therefore had to resign his membership in SMCMA. Thank you Barry for all your hard work! Now we would like to welcome you all to your new SMC Physician. It has replaced the “Bulletin”. You certainly have noticed some changes, such as the fabulous photos gracing the cover. It is also longer as we have been able to get more sponsors. We have also expanded our editorial board with new members and I have been appointed Chairman and Editor-in-Chief of the magazine. One of the major influences is our relatively new Managing Editor, Reina O’Beck, MS. Thank you for help. Why have a publication at all? The purpose is to serve you, the physician and member of our association. We do this through announcements, pertinent information and articles of interest. Our goal is to have each edition contain some material of interest to every single one of our members. The best way to do this is to have active participation by you and your
colleagues. Haven’t you always wanted to see your name in print, to have your friends tell you they enjoyed your article? It is very easy and we will help you do just that. The benefits are tremendous. It feels good to contribute and part of why we all became physicians is to help others. It also serves as a way to communicate your thoughts to a broad audience. And, it is free advertising! One of our frequent contributors, Dr Susan Spencer, has been writing because she has a passion for it. However, she will also tell you that her referrals have gone up as a result. In medicine we call that the double effect! If you want to write but don’t feel you have the best skills, we would be happy to help out with some editing. We are looking for certain types of articles. We are going to have a series of articles on why doctors chose their specialty. What made you decide to go into your field? Was it a mentor, a life event or perhaps happenstance? Share your story with your fellow physicians. How about an interesting case, such as the disease without a cure, the baffling unknown, the once in a lifetime case that ended up in your office? Maybe you know a topic that will have broad appeal such as how to approach common problems, what are the latest developments, how do you communicate? Perhaps you will be doing a presentation, why not turn it into an article? This summer we will have an issue revolving around a summer theme. Contribute to that! Do you just have an interesting human
interest story? Always welcome. One thing common to all physicians is an opinion. Feel free to write an opinion piece and perhaps we can provide a counterpoint, such as two recent articles: Death of Clinical Judgment and Birth of Clinical Judgment. We also welcome letters to the editor. What else can you do to help? We always welcome new members so please consider sitting on our editorial board. Not a writer but know one? Then solicit articles on our behalf. Send us a photo or graphic for the cover, we will consider all submissions. We prefer something that reflects our members and our county. You comments and thoughts are always appreciated. We want to make the SMC Physician the best it can be, so please participate and share your wisdom and thoughts with all of us. Email ideas, articles and suggestions to Reina O’Beck at robeck@smcma.org. Dr. Granich is the Chief of Palliative Care Medicine at Kaiser Permanente in South San Francisco.
SAN MATEO COUNTY PHYSICIAN | page 13
News From NORCAL For most doctors who practice as solos or in small groups of two to four physicians, you may now qualify for a seven percent reduction on your NORCAL Mutual premiums.* RISK MANAGEMENT DISCOUNT DETAILS: NORCAL Mutual’s five percent discount for completing two risk management CME credits is now seven percent for policyholders who complete a third CME credit and remain a member of the San Mateo County Medical Association (SMCMA). Risk management CME activities are available to NORCAL policyholders free of charge. CME credits can conveniently be earned online at MyNORCAL, the policyholder log-in area of the NORCAL Mutual website, www.norcalmutual.com. This expanded Risk Management Discount for SMCMA members is applicable to policies renewing January 1, 2012 or later. Policyholders must have earned the three CME credits and have
been active members of SMCMA 90 days prior to their policy renewal in order to receive the seven percent discount in 2012. AN OVERALL RATE DECREASE FROM NORCAL MUTUAL: In addition to offering this extra savings to SMCMA members, NORCAL Mutual is also reducing California rates an overall 7.07 percent. The rate reduction impact per policyholder will vary depending on a number of factors such as the area of the state where they practice and their medical specialty. This overall rate reduction will take effect retroactively to January 1, so that the majority of NORCAL’s policyholders, who renew on January 1 or later, will benefit from the rate decrease. NORCAL will re-rate all policies that were either written or renewed in 2012 and apply the new rates. Policyholders can expect to see their rate adjustment reflected in an upcoming, scheduled billing statement, no later than July 1.
OTHER BENEFITS: NORCAL has also eliminated the age requirement for the retirement tail premium waiver. Policyholders can retire completely and permanently from their practice of medicine at any age, and receive a free tail, as long as they have been a policyholder for the previous five years and remain retired. All other provisions allowing limited work remain unchanged, including, for example, the ability for a physician to work on a limited basis for remuneration, or on a charitable basis, without jeopardizing their free tail. If you have any questions about the Risk Management Discount or the overall rate decrease, please call NORCAL’s Policyholder Services at 877-443-7232 Monday through Friday from 8:00 a.m. – 5:00 p.m. *If you are currently part of NORCAL Mutual’s surcharge program, you are not eligible for the Risk Management Discount Program.
Member Snapshots Photos of SMCMA Members Serving the Association
SMCMA Members Attend Legislative Day in Sacramento to Meet With Local Legislators. Pictured here are Gregory Lukaszewicz, MD (standing), Steven Kmucha, MD, Sue Malone, Elizabeth Kocot, MD, Niki Saxena, MD and John Hoff, MD
SAN MATEO COUNTY PHYSICIAN | page 15
Save the Date - SMCMA Annual Meeting
Thursday, June 28, 2012 Hosted Reception: 6:30 pm/ Dinner: 7:30 pm
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page 16| San Mateo county physician
In Memoriam Glenn Zurawski, MD August 3, 1951 - March 19, 2012
in Houston, TX.
Glenn F. Zurawski, MD, died unexpectedly March 19, 2012, at his home in Palm Springs, CA, after a nine and a half year struggle with brain disease and dementia. He was 60 years old.
Dr. Zurawski held memberships and leadership positions in numerous organizations, including the California Society of Anesthesiologists, serving a term as Speaker. He also was a member of the California Medical Association, the American Society of Anesthesiologists, and the American Medical Association, of which he was an alternate national delegate for the California delegation and was a past President of the Northern California chapter of the AMA.
Dr. Zurawski earned his medical degree from SUNY Upstate Medical Center, Syracuse, NY in 1977. He completed his residency in anesthesiology at the University of California San Francisco in 1980. After completion of his residency, Dr. Zurawski entered into private anesthesia practice and affiliated with Mills Memorial Hospital in San Mateo, CA. He was the founding C.E.O. of his medical group, Anesthesia Care Associates. During this exceptionally busy and active period of his life, Dr. Zurawski earned his Masters degree in Hospital Administration from the University of San Francisco. Prior to his retirement, he practiced for several years at MD Anderson Cancer Center
Glenn enjoyed traveling immensely, and extensively explored Hawaii, Europe, Asia, and Australia. Memorial contributions in Dr. Zurawski’s name may be made to St. Paul’s Lutheran Church, 24 Chestnut Street, Liberty, NY 12754 or to Alzheimer’s Assoc. Mid-Hudson Chapter, 2 Jefferson Plaza, Suite 103, Poughkeepsie, NY 12601.
Hormonal Contraception continued from page 8
women include positive effects on bone density and reduction in vasomotor symptoms, as well as decreased endometrial cancer and ovarian cancer. However, women over 35 who smoke should not use E+P methods. It is important to note that the FDA black box warning against use of COC in women over 35 who smoke applies to all COC, including the lowest 10 mcg dose pill. Clinicians must provide careful counseling to reproductive-aged women with medical conditions who are considering hormonal contraception. As contraceptive methods continue to evolve, we can look forward to options that are better and safer for women. Dr. Spencer is a gynecologist/obstetrician practicing in San Mateo.
References 1.
ACOG Practice Bulletin No. 73: Use of Hormonal Contraception in Women with Coexisting Medical Conditions. Obstet Gynecol 2006; 107(6):1453-1472 (Reaffirmed 2011).
2.
FDA Drug Safety Communication (4/10/2012): www.fda.gov/Drugs/DrugSafety/ucm299305. htm
3.
CDC U.S. Medical Eligibility Criteria for Contraceptive Use, 2010: adapted from the World Health Organization. MMWR 2010;59. www.cdc.gov/mmwr/pdf/rr/rr59e0528.pdf
SAN MATEO COUNTY PHYSICIAN | page 17
Membership Update
Editorial Committee
New Members
Barry B. Sheppard, M.D., Chair Russ Granich, M.D. Edward G. Morhauser, M.D.
Jenny Lee/ *NEP San Carlos Anthony Liu/ OPH Redwood City Leland Luna/ FM S. San Francisco Lydia Hsu/ *OPH Redwood City Alexander Yu/ *IM Redwood City
Classified Ads Burlingame Medical Building Location on El Camino, Burlingame; across from MillsPeninsula Hospital. Two office suites: 800+ square feet and 1700+square feet. Call Ted Baiz, (650) 703-7855. Medical Office Space Available for Sublet Four exam rooms with running water and one MD office available for up to four days weekly. May be able to provide office staff if needed. Excellent location, opposite Peninsula Hospital. For details please contact Bonnie McGuire: Bonnilee@aol.com or 650-259-1480. Medical Office Space to Share Downtown San Carlos Dermatology office. Private rooms with shared reception area and waiting room. Ideal location for Medical/Paramedical practitioner. Ground floor with direct street access. Excellent visibility to a passer-by! Call Darlene (650) 591-8501 Medical Office to Share Downtown San Carlos medical office with large, bright, up to date waiting area. Great professional setting for satellite office or small practice. Three rooms available for dedicated use. Two are 10x10 with vinyl floors and built-in cabinets and sinks. One is 8x10, carpeted with built-ins. Additional 2 rooms a possibility. Shared use of waiting room, reception, bathrooms, and kitchen. Street level with nearby parking. ADA accessible. Laurel St. at Morse. Place a classified ad for $40 for up to five lines for members and $75 for up to five lines for non-members. Contact SMCMA at (650) 312-1663 or smcma@smcma.org.
PAGE 18 | San Mateo county physician
Sharon Clark, M.D. Gurpreet K. Padam, M.D. Michael Stevens, M.D
Sue U. Malone.............................................Executive Director Reina Oâ&#x20AC;&#x2122;Beck..................................................Managing Editor
2011-2012 Officers & Board of Directors Gregory C. Lukaszewicz, M.D...................................President Mary Giammona, M.D......................................President-Elect Amita Saxena, M.D...................................Secretary-Treasurer John D. Hoff, M.D...........................Immediate Past President Alberto Bolanos, M.D. Russ Granich, M.D. Edward Koo, M.D. Vincent Mason, M.D. Kristen Willison, M.D.
Raymond Gaeta, M.D. Robert Jasmer, M.D. C.J. Kunnappilly, M.D. Michael Norris, M.D.
David Goldschmid, M.D. ......................................CMA Trustee Scott A. Morrow........................Health Officer, San Mateo Co. Barry B. Sheppard, M.D. ..................AMA Alternate Delegate
Article Submission Members are always encouraged to submit articles, commentary and Letters to the Editor. Email your submission to the SMCMA Editorial Committee at smcma@smcma.org for consideration for publication in San Mateo County Physician. For editorial or advertising inquiries, please use the contact information provided below.
Editorial and Advertising Offices 777 Mariners Island Boulevard, Suite 100, San Mateo, CA 94404 Tel (650) 312-1663 Fax (650) 312-1664 smcma@smcma.org www.smcma.org Acceptance and publication of advertising in San Mateo County Physician does not constitute approval or endorsement by the San Mateo County Medical Association of products or services advertised. SMCMA reserves the right to reject any advertising. Opinions expressed by authors are their own and not necessarily those of the SMCMA. San Mateo County Physician reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted.
Š Copyright 2012 San Mateo County Medical Association
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SAN MATEO COUNTY PHYSICIAN | page 19
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