S a n M at e o C o u n t y
Physician
July/August 2013 | Volume 2, Issue 7
A publication of the San Mateo County Medical Association
SMCMA Annual Meeting featuring Abraham Verghese, MD
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Editorial Committee Russ Granich, MD, Chair; Sharon Clark, MD; Edward Morhauser, MD; Gurpreet Padam, MD; Sue U. Malone, SMCMA Executive Director; Shannon Goecke, Managing Editor
SMCMA Leadership Amita Saxena,, MD .....................................................................President Vincent Mason, MD ........................................................ President-Elect Michael Norris, MD ............................................. Secretary- Treasurer Gregory C. Lukaszewicz, MD ........................... Immediate Past President Manjul Dixit, MD; Russ Granich, MD; Edward Koo, MD; C.J. Kunnappilly, MD; Susan Nguyen, MD; Michael O’Holleran, MD; Irwin Shelub, MD; Chris Threatt, MD; Kristen Willison, MD; David Goldschmid, MD, CMA Trustee; Scott A. Morrow, MD, Health Officer, County of San Mateo; Dirk Baumann, MD, AMA Alternate Delegate
Editorial and Advertising Inquiries San Mateo County Physician is published ten times per year by the San Mateo County Medical Association. Members are encouraged to submit articles, commentary and letters to the editor. 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. Advertising in San Mateo County Physician is a great way to reach out to the San Mateo County medical community. Classified ads begin at $40 (for up to five lines) for members. 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 managing editor Shannon Goecke at (650) 312-1663 or sgoecke@smcma.org. Visit our website at smcma.org, like us atfacebook.com/smcma, and follow us at twitter.com/SMCMedAssoc. © 2013 San Mateo County Medical Association
S a n M at e o C o u n t y
Physician
J u ly / A u g u s t 2 0 1 3
Introduction | Russ Granich, MD This issue of San Mateo County Physician highlights some of the great people of our medical association. We’ve included a profile of our new association president, Niki Saxena, MD, a pediatrician in Redwood City. Dr. Saxena’s first President’s Message is also included in this issue. We’ve also profiled my colleague, endocrinologist Marc Jaffe, MD, recipient of the SMCMA Distinguished Award. Dr. Jaffe accepted this award at the SMCMA Annual Meeting on June 27, which featured popular physician/author Abraham Verghese, MD. You can find photos and a recap of the Annual Meeting inside this issue as well. The San Mateo County Physician Editorial Committee is also in search of new members. If you are interested in getting involved, contact the managing editor at (650) 312-1663 or sgoecke@smcma.org. Have a safe and enjoyable summer!
President’s Message | Creating the Change We Want to See...Together. . ............................................................. 5 Amita Saxena, MD Executive Report | Trial Lawyers Push to Put MICRA Changes in Voters’ Hands . . ................................................... 7 Sue U. Malone SMCMA 2013 Annual Meeting of Members.................................... 8 Amita “Niki” Saxena, MD: 2013-14 President of the San Mateo County Medical Association. . ...................................... 11 Marc Jaffe, MD: 2013 Recipient of the SMCMA Distinguished Service Award .......................................... 13 Upcoming Educational Programs. . ................................................ 16 Member Updates, Classified Ads, Index of Advertisers............... 18
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President’s Message | Amita Saxena, MD
Creating the Change We Want to See...Together
To do the right thing, to do the best we could, never complain, never take advantage, don’t give up, don’t be afraid. —Family motto of President Harry S. Truman I can’t change the direction of the wind, but I can adjust my sails to always reach my destination. —Jimmy Dean It is a great honor and privilege to be writing my first column as the newly-inducted 2013-2014 President of our San Mateo County Medical Association. I’d like to take this opportunity to thank Dr. Greg Lukaszewicz for his leadership and hard work as our previous President. I’ve been a practicing pediatrician and member of this organization since 1996, when I joined a private pediatric practice after finishing residency. What else happened that year? Bill Clinton won re-election for another term and Atlanta hosted the Summer Olympics. In medicine, a new class of drugs called “protease inhibitors” was looking promising for AIDS patients, an improved version of the PSA screening test was available for prostate cancer screening, and sildenafil was patented. Exciting times, indeed! I think it’s safe to admit now that general pediatrics was not my first choice as a medical student. I had flirted with OB/ GYN, surgery and even neonatology during my medical school rotations. But from the first moment I worked in a general pediatric clinic, I knew this was the right specialty for me. I enjoyed forming long-term relationships with children and their families and watching them evolve over time as they came in for well visits. I also found it very satisfying to help a child feel better when acutely ill; thankfully, in pediatrics there are more happy endings to illnesses than sad ones. There was enough to challenge me clinically and keep me on my mental toes, and there was also enough laughter and joy to keep my emotional side happy. I really can’t imagine doing anything else!
I also was lucky to find a practice model that worked for me—private, single-specialty group practice. At a time when many of my medical school and residency cohorts were deciding to join larger stable groups, I embarked on what seemed like a risky move: working in an independent small group where there are no safety nets and no guarantees of success. In addition to learning clinical pearls as I practiced, I also began learning how to manage a business from the ground up. I found, to my surprise, that I really enjoyed learning about the business side of medicine. Understanding how the financial/legal/business side works, both locally and globally, actually helped me understand how many of the clinical guidelines fit into a broader public health perspective. I now think it is critical for new physicians coming out of training to have exposure to these issues; they need to understand the current context of medicine in order to move forward with all the changes that are already happening, without sacrificing their commitment to quality of care. In 2011 Dr. Eileen Chan and I opened up a brand new pediatric practice in Redwood City. It was a huge leap of faith and more than one person thought we were a little “sanity-challenged” to move in a direction that was so different from what everyone else seemed to be doing. Like many of you, we felt strongly that the heart and soul of primary care really is about building relationships with patients and their families, and that process is fostered by smaller offices and environments that foster continuity of care. The response from patients has been very positive, and we feel very lucky to be able to continue to grow and move forward in creating our vision for a modern pediatric office. I’ve seen quite a few changes in the healthcare landscape here on the Peninsula since I started practice 17 years ago. Medical groups have come and gone, IPA’s have folded, physicians have changed practice models and hospitals continued on next page
july/august 2013 | SAN MATEO COUNTY PHYSICIAN 5
President’s Message | Amita Saxena, MD
Creating the Change We Want to See...Together {continued} have formed new and different alliances. On a national level, change is everywhere: books by Atul Gawande and Eric Topol that advocate radical shifts in healthcare delivery models are being hailed as game changers, telemedicine and mHEALTH apps are re-inventing the traditional doctorpatient visit, and computers are no longer just for storing information, but are being used as diagnostic tools such as IBM’s Watson. The irony seems to be that we are pushing forward with incredible clinical advances at a time when financial pressures are raising questions about the very sustainability of our medical systems. As physicians it seems we are in the eye of the storm that is healthcare reform. How do we navigate this? How can we leave this system of medicine in a better state for our children and their children? I’m not sure any one of us will be able to create the “perfect solution” that addresses these questions, and if we continue with partisan approaches such as specialist vs. primary physician or employed vs. independent physician we are setting ourselves up for certain gridlock.
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I believe there is safety in numbers, and when we come together with purpose and intent our voices get magnified and heard at the highest levels. When we keep our patients at the center of our efforts, we can build bridges across specialties to create a profound positive impact. We do have the power to create the change we want to see; it may be difficult but we have the ability to do difficult things. The SMCMA is your organization: it reflects the diversity and strength of more than 1,100 physician members. I hope to open up dialogue and start conversations that remind us of our shared goals, and my hope is to connect us again as members of a great and noble profession no matter what our individual practice model may be. There is room for all of us in the house of medicine, and each of us is critical to its success in the future. I look forward to hearing your thoughts and opinions as we navigate this year together. Thank you! ■
Executive Report | Sue U. Malone
Trial Lawyers Push to Put MICRA Changes in the Hands of Voters By now I assume you are aware of the ballot initiative the trial lawyers are pushing to get on the November 2014 ballot that, among other things, would change MICRA (the Medical Injury Compensation Reform Act), which was enacted in 1975. This Act has been instrumental in keeping medical malpractice rates low in California, compared to many other states across the nation. The sponsors of this initiative will need to gather a minimum of 800,000 signatures to get the initiative on the ballot. Though a huge undertaking, the trial lawyers have the money to hire the signature gatherers to make this happen. As this effort moves forward, I want to make sure you are equipped to respond to your patients, friends, and relatives about why maintaining MICRA in its present form is so very important to medicine. If the voters approve such an initiative, it will 1) increase meritless lawsuits and lawyer fees; 2) increase health care costs; 3) will not improve quality of care; and 4) will reduce patient access to health care services. As the Affordable Care Act goes into effect in January 2014, this couldn’t happen at a worse time. MICRA provisions include unlimited recovery for all economic or out-of-pocket costs, including: • unlimited recovery for all past and future medical costs; • unlimited recovery for any past and future lost wages; • unlimited recovery for punitive damages (a court-awarded sum that is considerably higher than the measurable value of the injury); • up to $250,000 for non-economic damages (damages sought for pain and suffering, mental anguish, or a loss of enjoyment in life); and • lawyers are paid on a sliding scale, so more money goes to the patient, rather than the lawyers. Because of MICRA’s protections, California has lower medical liability rates than many other states. According to 2012 figures for San Mateo County, physicians savings are an average of $99,481. That goes a long way in supporting your dues payments
to SMCMA/CMA, well beyond the life of a doctors practice., about 50 years!
2012 San Mateo County MICRA Savings Chart General Surgery
Internal Medicine*
OB/GYN
Average
San Mateo County
$22,286
$6,315
$29,263
$19,263
Miami & Dade Counties, FL
$190,088
$46,372
$201,808
$146,089
Nassau & Suffolk Counties, NY
$127,233
$34,032
$204,684
$121,983
Wayne County, MI
$121,321
$35,139
$108,020
$88,160
FL-NY-MI Average
$146,214
$38,514
$171,504
$118,744
MICRA Savings
$123,928 $32,199
$142,316 $99,481
* Non-invasive Data from Medical Liability Monitor Annual Rate Survey Issue, Vol. 37. No. 10, October 2012. Annual rates with limits of $1 million/$3 million.
Lower medical liability rates means doctors, hospitals, and community clinics can remain operational and treating patients. New York is an example of a state without tort reform. In this state, 19 counties are without obstetricians, 22 are without internal medicine specialists, and 15 do not have surgical specialty doctors, according to a 2010 study by The Center for Health Workforce Studies. Accordingly to a July 2012 story in The New York Times, several hospitals in NYC are partially or completely without liability insurance due to the high cost of liability premiums. ■
july/august 2013 | SAN MATEO COUNTY PHYSICIAN 7
2013 A nnual M eetin g o f M em b ers The San Mateo County Medical Association held its 108th annual meeting of members on June 27, 2013, at the Peninsula Golf and Country Club in San Mateo. Nearly 200 people turned out for this special event. Outgoing SMCMA President Gregory Lukaszewicz, MD, a vascular surgeon with Kaiser Permanente in South San Francisco, graciously thanked his colleagues and friends for their support, and introduced incoming President Amita “Niki” Saxena, MD, a Redwood City-based pediatrician. Forty-year SMCMA members Stephen Hurst, MD, and Robert Telfer, MD, were also honored for their longtime support of organized medicine. The Distinguished Service Award was given to Marc Jaffe, MD, an endocrinologist at Kaiser Permanente in South San Francisco, for his work in implementing an innovative cardiovascular disease (CVD) riskreduction clinical practice for Kaiser patients, and ultimately translating this strategy into a national model for CVD prevention. Finally, keynote speaker Abraham Verghese, MD, took the stage. Dr. Verghese is Professor for the Theory and Practice of Medicine at the Stanford University School of Medicine, Senior Associate Chair of the Department of Internal Medicine, and
Outgoing SMCMA president Gregory Lukaszewicz, MD; Keynote Speaker Abraham Berghese, MD; and Incoming SMCMA President Niki Saxena, MD.
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author of three bestselling books, most notably the 2009 bestselling novel, Cutting for Stone. During his remarks, Dr. Verghese reflected on his youth and his love of books, and how novels such as W. Somerset Maugham’s Of Human Bondage and A. J. Cronin’s The Citadel had inspired him to become a doctor. He also spoke of his experiences treating early AIDS patients in rural Tennessee in the 1980s. He was fascinated by the migration patterns of gay men— from the conservative small towns where they were born and raised, to the gay-friendly cities where they found freedom and acceptance, and finally, stricken with AIDS, back “home” again to die. He considered writing a scientific paper on the topic, but felt that the “cold, unimaginative language of science” would be at odds with his desire to document the journeys his patients had taken and describe the grief and loss. After the death of a particularly special patient, he decided he would “learn how to tell the story.” Thirty years, one graduate degree in creative writing from one of the country’s most esteemed programs, and three best-selling books later, Veghese delighted SMCMA members and their guests with his amazing ability to “tell the story.” SMCMA is thankful to all the members who turned out for this very special evening. ■
Jennie Wong; Donald Cheu, MD; and Distinguished Service Award Recipient , MD.
Top row, left to right: Stephen Hurst, MD and William Tatomer, MD; Michael Norris, MD and Robert Benner, MD; Second row: Leslie Weil, MD and Marvin Firestone, MD, JD; Sonia Declerq, MD and Eric Denys, MD; Bottom row: Dan Polcyn and Lindsay Flaherty of Stanford Hospital & Clinics; Jamie Iturribarria and Pamela Karkazis of Health Diagnostics.
july/august 2013 | SAN MATEO COUNTY PHYSICIAN 9
The Officers and Board of Directors of the SMCMA would like to thank the following organizations for their generous support of the 2013 Annual Meeting of Members:
Pace Wealth Management Group Of Wells Fargo Advisors, LLC
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amita “niki” saxena, md 2013-14 President of the San Mateo County Medical Association
Redwood City pediatrician Amita “Niki” Saxena, MD, stepped up to her new role as President of the San Mateo County Medical Association in July, following prior service as President-Elect and Secretary Treasurer. She is the fourth woman physician, and the first minority woman physician, to serve as president of the association. Born in northern India, Dr. Saxena and her family came to the United States when she was a toddler. She went on to earn an undergraduate degree in biochemistry from UC Berkeley and a graduate degree in cell biology from San Francisco State University. Before medical school, she worked in research in several Bay Area pharmaceutical companies. Passionate about improving public health but longing for a more hands-on approach, Dr. Saxena picked up and moved to St. Louis to study medicine. After flirting with obstetrics/ gynecology and neonatal as potential specialties, she ultimately settled on pediatrics. She returned to the Bay Area and completed her residency and internship in pediatrics at Stanford University Hospital. Dr. Saxena joined the San Mateo County Medical Association in 1996, the same year she joined Kid Kare Associates, a single-specialty group practice in Redwood City. She eventually became a managing partner of the practice. After nearly fifteen years, Dr. Saxena, along with colleague Eileen Chan, MD, took a leap of faith and launched Pediatric Wellness Group (PWG) in Redwood City. Their vision was to integrate the traditional practice setting with a wellness focus designed to support patients’ well-being beyond the practice setting. The practice’s goal is “to deliver integrated medical services achieved through the use of modern and evidencedbased medicine, time-honored values of exemplary customer service and accessibility, and facilitation of communication for all levels of care.” Managing a bustling pediatric practice has given Dr. Saxena the opportunity to learn about “back end” of running a business. “Understanding how the financial/legal/business side works, both locally and globally, actually helped me understand how many of the clinical guidelines fit into a
Amita “Niki” Saxena Recent Experience Pediatric Wellness Group, Redwood City CEO and General Pediatrician 2011-present Kids Kare Associates, Redwood City Managing Partner and Pediatrician 1996-2011
Education University of California, Berkeley Bachelor of Arts, Biochemistry San Francisco State University Master of Arts, Cell Biology St. Louis University School of Medicine Medical Doctor Board Certified in General Pediatrics
Professional Affiliations American Academy of Pediatrics 1993-present California Medical Association 1996-present San Mateo County Medical Association 1996-president SMCMA Board of Directors 2008-present
Recent Volunteer Activities Peninsula College Fund Mentor to underpriveleged youth 2010-present Arpan Global Charities Provided general pediatric care in India January 2008 Samaritan House Volunteered in pediatrics free clinic 2001-2005
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july/august 2013 | SAN MATEO COUNTY PHYSICIAN 11
Niki Saxena, MD, 2013-14 SMCMA President {continued} broader public health perspective,” said Saxena. Constantly motivated to improve upon the operation of her group practice, Dr. Saxena also aspires to someday earn another degree-this time an MBA.
Q&A
SMCMA Executive Director calls Dr. Saxena “a reasoned and thoughtful person who cares about the well-being of others. Though she does not flaunt her accomplishments, she is motivated to excel at whatever she undertakes.”
Niki Saxena, MD
Clearly, one thing Dr. Saxena excels at is patient care. She and the other physicians and medical professionals in their office receive consistently stellar reviews from patients and their families. Dr. Saxena especially appreciates the opportunities for continuity of care provided by a small practice, and has been seeing many of her patients, and their siblings, for years. “My family of four have been patients of Dr. Niki Saxena for over 13 years and believe that the care that we have received over the years has consistently been exceptional,” raved one parent. Dr. Saxena also works hard to promote healthy living in the community, reaching out to the public and volunteering at free clinics. Recently, she and her colleagues held a community health fair in the parking lot of their practice. Whether she’s focused on the concerns of the patient in front of her, or envisioning innovations in the delivery of care, Dr. Saxena brings an enthusiasm that is both infectious and inspiring. A longtime supporter of organized medicine, she joined the SMCMA Board of Directors in 2008, and is well-positioned to have a productive and meaningful term as association president.
with
What do you see as the biggest challenges facing the medical profession today? Financial sustainability, adapting to changing expectations from patients and payors, navigating the exponential increase in knowledge and clinical advances, maintaining choice for both patients in terms of coverage models and physicians in terms of practice models, defining the role of the physician in the new paradigm of medicine [both public health and private sector]. What is the most rewarding part of your job? Working with children and their families. I get so many reminders of why I have a great job: handdrawn pictures from kids, hugs from kids and parents, hearing parents tell me “my child wanted to come see you because they said you could make them feel better,” having kids tell me they want to be a doctor just like me when they grow up, watching kids grow up…and watching as the office gets flooded with treats at the holidays! Why do you think it’s important for physicians to support organized medicine? Organized medicine is the voice at the table that influences public policy and gets a chance to participate in the debates and create solutions. I belong to both a specialty society and the CMA; to me they are complementary and equally important. My specialty society addresses concerns I may have about my particular field, but it doesn’t always address local issues that are vital to how I practice medicine.
Dr. Saxena (far left) and staff of Pediatric Wellness Group.
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continued on page
17
Marc Jaffe, MD 2013 Recipient of the SMCMA Distinguished Service Award
Kaiser Permanente endocrinologist Marc Jaffe, MD, loves a puzzle. He was one of those kids who dismantled his toys to find out what made them work. This curiosity prompted him to major in linguistics at UC Berkeley, and he briefly considered a career as a linguistics professor or even a cryptographer with the CIA. Ultimately, he chose to follow the path of his father, internist/pediatrician Donald Jaffe, MD, and his mother, geriatric nurse Helen Jaffe, RNP, and study medicine. After completing his studies at Baylor College of Medicine, Jaffe completed his internship and residency in internal medicine at the University of California, San Diego, followed by a fellowship in Diabetes, Endocrinology, and Metabolism, and postdoctoral research in Diabetes and Immunology, at the University of California, San Francisco. Board-certified in Internal Medicine and Diabetes, Endocrinology and Metabolism, he joined Kaiser South San Francisco in 1993. Endocrinology was a natural focus for Jaffe, with glands and hormones serving as the pieces of his puzzle, and the well-being of the patient the ultimate “solution.” “Even though I liked science, math, and problem solving,” said Jaffe,” What I really liked was how science, math, and problem solving could affect people’s lives.” And while patients were receiving quality one-on-one care from their physicians, Jaffe and others realized that more could be done to identify at-risk patients and intervene before serious problems developed. Additionally, there was much more that could be done to analyze patient data to facilitate the delivery of evidenced-based care and have a greater impact on public health. In 2000, Jaffe headed up the creation of the Kaiser Permanente Northern California Hypertension Program to support research on the recognition, detection, and
Marc Jaffe, MD Current Positions Clinical Leader, Kaiser Northern California Cardiovascular Risk Reduction Program Clinical Leader, Kaiser National Integrated Cardiovascular Health Guideline Team Subchief of Endocrinology, Kaiser Permanente South San Francisco Medical Center Associate Clinical Professor of Medicine, University of California, San Francisco
Education University of California, Berkeley Bachelor of Arts, Linguistics Baylor College of Medicine Medical Doctor
Honors and Awards Received Kaiser National Care Management Institute Award for Outstanding Contribution in Diabetes (2006) Kaiser South San Francisco Hospital Mark Lim Clinical Excellence Award (2006) Kaiser Permanente Everyday Hero Award (2006) San Francisco Bay Area Consumers’ Checkbook Top Doctor Award—Endocrinology (2007) Kaiser Permanente Physician Education and Development Award for Diabetes Education (2007) Kaiser Permanente Teaching Award for Excellence in Continuing Medical Education Award (2008) Kaiser Permanente Sidney Garfield Exceptional Contribution Award (2009) Kaiser Health Plan James A. Vohs Quality Award for ALL/PHASE Community Implementation (2010) San Mateo County Medical Association Distinguished Service Award (2013) Kaiser South San Francisco Medical Center Lifetime Achievement Award (2013)
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july/august 2013 | SAN MATEO COUNTY PHYSICIAN 13
Marc Jaffe, MD, Recipient of the 2013 SMCMA Distinguished Service Award {continued} treatment of hypertension. Between 2001 and 2009, the size of the program doubled, from 300,000 to 600,000 patients with diagnosed hypertension; as did hypertension control rates, from 41% to 80%.
development, serving since 2009 as clinical leader of the Kaiser National Integrated Health Guideline Team. Jaffe’s colleague, Michelle Caughey, MD, Physician in Chief at Kaiser Permanente South San Francisco and a former president of the SMCMA, calls Jaffe “...a visionary and definitely ahead of his time in his approach to managing the risk factors for heart attack at stroke. He has been one of the prime movers in this effort to do what’s right for his patients.”
Jaffe was also at the helm in 2003, when the program was expanded to target the 12% of patients (200,000+ individuals) at highest risk for developing coronary artery disease, diabetes, and coronary heart disease risk equivalents such as stroke and peripheral artery disease. Despite his achievements, Jaffe has been nothing if not The Kaiser Permanente Northern California PHASE humble, gracious, and eager to also recognize the invaluable (“Preventing Heart Attacks and Strokes Every day”) assistance and support of his colleagues. In particular, he enrolled patients in a therapeutic program of four cardiocited the more than 7,000 physicians at Kaiser Permanente protective medications (aspirin, statins, an ACE inhibitor, and a beta blocker) and recommended four healthy lifestyle changes (tobacco cessation, physical activity, healthy eating, and weight One of Dr. Jaffe’s two beloved 1963 Mercury Comets. management). Again, Jaffe’s curiosity and love of “tinkering” came into play as outreach models and treatment plans were fine-tuned in order to identify and more effectively treat more patients. “We have many effective tools at our disposal,” said Jaffe, “and it’s our opportunity and obligation to provide these to the members we serve.” The results have been phenomenal. From 2000 to 2010, heart attacks amongst patients of Kaiser Permanente Northern California declined by 42%, and the relative incidence of serious heart attacks that do permanent damage declined by 62%. Since launching the program with community clinics, public hospitals and health systems in California in 2005, there are now 46 locations using this program in ambulatory clinics and community health center settings across the country. In 2010, Kaiser Permanente’s ALL (Aspirin, Lisinopril and Lipid-Lowering Medication)/PHASE Initiative was honored with The Care Continuum Alliance Quality Impact Award for the “Greatest Impact on Health.” In addition to the hands-on task of providing patient care, Dr. Jaffe is also at the forefront of strategy and policy
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Northern California who do the hard work, taking care of the patients and implementing the programs. He also thanks his Chiefs (Executive Directors Phil Madvig and Michelle Caughey, South San Francisco Physician in Chief John Skerry, and South San Francisco Chiefs of Medicine Sally Yu and Karl Chan) his for allowing him the freedom to innovate, and his colleagues at the Oakland Kasier Permanente Regional Offices with whom he collaborates on the cardiovascular programs (Joseph D. Young, Rick Dlott, Eileen Kim, and Warren Taylor).
One might not expect Jaffe to have much spare time, but he manages to find a healthy balance between work and leisure. Family is clearly a great source of joy. He and wife Lisa, an ESL (English as a Second Language) elementary school teacher, have known each other since attending nursery school in Belmont, as well as San Mateo High School together. They are devoted parents to daughter Alex, a college junior with a penchant for business, and son Adam, a high school junior with a fondness for both science and drama.
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Jaffe also loves old cars, and is the proud owner of two 1963 Mercury Comets. On a sunny day, you might just see him driving one, top down, to work in South City. It should come as no surprise to anyone that Jaffe does all the work restoring his Comets himself, including rebuilding the engines, electrical systems, bodywork, and other projects. Would someone with such a strong desire to understand how things work, and a passion to make things work better, have it any other way? ■
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july/august 2013 | SAN MATEO COUNTY PHYSICIAN 15
Trial Lawyers’ Initiative to Raise Limits on Non-Economic Damages In July, Robert Pack, who has aligned himself with Consumer Watchdog and the Consumer Attorneys of California (the statewide trial lawyers group), filed papers to place on the November 2014 statewide ballot an initiative that, if passed in its current form, would raise the limit on non-economic damages in medical malpractice awards from the current limit of $250,000 set by the MICRA legislation to an amount equal to the change in the Consumer Price Index (CPI) retroactive to the 1975 date of enactment. That would raise the limit, or “cap,” to $1.2 million and continue to raise it each year with an amount indexed to the CPI for each year. There would continue to be a limitation on lawyers’ fees, but it would rise because it is an incremental percent of damages awarded (graduated from 40 percent of the first $50,000 to 15 percent of amounts of $600,000 or above). The initiative also includes a variety of provisions relating to physician drug testing and prescription drugs, but the primary motivation is to lift MICRA’s cap and give California’s trial attorneys access to the massive jury awards they have sought for almost four decades. Fortunately a broad cross-section of doctors, community clinics, nurses, hospitals, EMTs, labor unions, local governments, employer groups and others support MICRA and oppose the changes proposed in this initiative. That is not to say, however, that we will not have to organize a huge battle to defeat this proposed initiative. Organized medicine will do all that it takes to protect MICRA in the legislature or at the ballot if the trial lawyers move forward to qualify this measure.
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Walk with a Doc! Walk with a Doc is a program of the SMCMA Community Service Foundation that encourages healthy physical activity for county residents of all ages. Walkers enjoy onehour walks with physician volunteers and can ask questions about general health topics along the way. Have you walked with us yet? It’s not too late! Join us for our final walks of 2013! Sign up at www.smcma.org/ walkwithadoc, or call (650) 312-1663. Saturday, September 7, 2013 Central Park San Mateo Saturday, September 21, 2013 Leo J. Ryan Memorial Park Foster City
~ Upcoming CMA Webinars ~ Medicare: Proposed Changes for 2014 Wednesday, August 28, 2013 • 12:15 – 1:15 p.m. This webinar will focus on proposed policy changes to the physician fee schedule for the year 2014 (excluding any discussion on the SGR, or revised payment methodology). This discussion will provide an opportunity for physicians to hear how new or revised policies may impact their practice, and allow them to provide input to CMA during the Notice and Comment period.
California’s Health Benefit Exchange: The Positives and Perils of Contracting Wednesday, September 11, 2013 • 12:15 – 1:45 p.m. Beginning in 2014, individuals and small employers will be able to purchase health insurance coverage through the state’s health insurance exchange, Covered California. A surge of physician contracting efforts may occur as these plans attempt to ensure adequate networks are in place prior to January 1, 2014. In this presentation, you will learn more about California’s exchange and what it will mean for physicians. You will also gain an understanding of some of the risks and benefits of being contracted to provide services to exchange enrollees. These webinars are free to CMA members and their staffs, $99 for all others. To register, visit www.cmanet.org/events, or contact the CMA Member Help Center at (800) 786-4262 or memberservice@cmanet.org. Please register at least one hour before the webinar.
Q&A with Niki Saxena, MD, 2013-14 SMCMA President {continued from page 12} What has been most satisfying about serving on the SMCMA Board? I get to meet the people who are making policy decisions and speak up for my patients and my colleagues. My fellow board members are wonderful physicians with their own viewpoints and experience, and I enjoy discussing issues and sharing ideas with them. I get to see how my little corner of medicine fits into a much broader landscape.
my parents, and a deep seated stubbornness and tenacity that gets triggered whenever I hear the words “you can’t possibly do that!” What do you know now that you wish you had known when you first became a doctor? Knowing who your patient is, what their fears/ hopes/expectations are…is just as important as knowing what their symptoms are.
What do you hope to achieve with the SMCMA during your year as president?
What is something people might be surprised to know about you?
Opening up dialogue, bridging silos and connecting physicians across different practice models. If we want to navigate change successfully, we need to stand together with a unified voice.
I trained in East Indian Classical dance and had my Arangetram (graduation recital) in 1988.
What motivates you? Curiosity and the willingness to change, a desire to help make things better, a work ethic I learned from
San Mateo County Medical Association
family picnic All SMCMA members and their families are cordially invited to our first-ever Family Picnic. Join us in the majestic redwoods of Huddart Park for delicious food and family fun! Sunday, August 25, 2013 11:30 a.m.-3:00 p.m.
Huddart County Park 1100 Kings Mountain Road, Woodside Miwok Picnic Shelter (Follow the signs)
This event is free to SMCMA members, but we kindly request your advance RSVP. There is a small parking lot adjacent to our picnic shelter. SMCMA will provide you, via email or fax, with a pass to enter the park for free. Please RSVP at www.smcma.org/familypicnic, or call (650) 312-1663.
july/august 2013 | SAN MATEO COUNTY PHYSICIAN 17
Breathe Again !!
NEW SMCMA MEMBERS
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18 San Mateo county physician | july/august 2013
Ramona Rico, MD PD*/San Mateo
in memoriam
Philip Caulfield, MD June 27, 2013
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