2022 - May/Jun - SSV Medicine by Sierra Sacramento Valley Medical Society

Sierra Sacramento Valley Serving the counties of El Dorado, Sacramento and Yolo

May/June 2022

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Sierra Sacramento Valley

MEDICINE 4

Loud and Proud at the State Capitol

Ira Chasnoff, MD

Angelica Martin, MS III and Eduardo Martin, MS II

PRESIDENT’S MESSAGE

Paul Reynolds, MD

EXECUTIVE DIRECTOR’S MESSAGE

MICRA Agreement Heads Off Ballot Battle

Aileen Wetzel, Executive Director

The Role of Medicine In Creating Peace Caroline Giroux, MD

False Victories a Legacy of Child Abuse Prevention Act

Healthy Beginnings Targets Perinatal Substance Abuse Brandon J. Craig SSVMS Communication and Partnerships Coordinator

Creating a New Generation of Rural Physicians Savanna Nickols, MS

The Path to a Dream: “I Knew I Belonged in Medicine” Gonzalo Ursua

A Call to Action From Future Leaders

POETRY

Being Human

Eric Williams, MD

We welcome articles from our readers by email, facsimile or mail to the Editorial Committee at the address below. Authors will be able to review articles before publication. Letters may be published in a future issue; send emails to SSVMedicine@ssvms. org. All articles are copyrighted for publication in this magazine and on the Society’s website. Contact the Sierra Sacramento Valley Medical Society for permission to reprint.

Board Briefs

New SSVMS Members

The Delta's Doctor

Ken Smith, Managing Editor

Visit Our Medical History Museum 5380 Elvas Ave. Sacramento The museum is gradually reopening. Visit our website at ssvms.org/museum for updates and virtual events.

VOLUME 73/NUMBER 3 Cover photo: Lupines bloom in spring near Folsom, California.

Photo by David Evans, MD

Official publication of the Sierra Sacramento Valley Medical Society

5380 Elvas Avenue Sacramento, CA 95819 916.452.2671 916.452.2690 fax info@ssvms.org

SSV Medicine is online at www.ssvms.org/Publications/SSVMedicine.aspx

May/June 2022

Sierra Sacramento Valley The Mission of the Sierra Sacramento Valley Medical Society is to bring together physicians from all modes of practice to promote the art and science of quality medical care and to enhance the physical and mental health of our entire community.

2022 Officers & Board of Directors

Paul Reynolds, MD, President J. Bianca Roberts, MD, President-Elect Carol Burch, MD, Immediate Past President District 1 Jonathan Breslau, MD District 2 Adam Dougherty, MD Judith Mikacich, MD Susan Murin, MD Vanessa Walker, DO District 3 Ravinder Khaira, MD

District 4 Shideh Chinichian, MD District 5 Christina Bilyeu, MD John Coburn, MD Farzam Gorouhi, MD Roderick Vitangcol, MD District 6 Marcia Gollober, MD

2022 CMA Delegation District 1 Reinhardt Hilzinger, MD District 2 Lydia Wytrzes, MD District 3 Katherine Gillogley, MD District 4 Anand Mehta, MD District 5 Sean Deane, MD District 6 Marcia Gollober, MD

District 1 Alternate Tanuja Raju, MD District 2 Alternate Janine Bera, MD District 3 Alternate Toussaint Mears-Clark, MD District 4 Alternate Shideh Chinichian, MD District 5 Alternate Joanna Finn, MD District 6 Alternate Natasha Bir, MD

At-Large Delegates R. Adams Jacobs, MD Barbara Arnold, MD Megan Babb, DO Jonathan Breslau, MD Carol Burch, MD Amber Chatwin, MD Angelina Crans Yoon, MD Mark Drabkin, MD Rachel Ekaireb, MD Gordon Garcia, MD Ann Gerhardt, MD Farzam Gorouhi, MD Richard Jones, MD Steven Kmucha, MD Sam Lam, MD

Charles McDonnell, MD Leena Mehta, MD Sandra Mendez, MD Taylor Nichols, MD Tom Ormiston, MD Sen. Richard Pan, MD Neil Parikh, MD Hunter Pattison, MD Paul Reynolds, MD Ernesto Rivera, MD J. Bianca Roberts, MD Ajay Singh, MD Lee Snook, MD Tom Valdez, MD John Wiesenfarth, MD

At-Large Alternates Brea Bondi-Boyd, MD Christine Braid, DO Lucy Douglass, MD Douglas Gibson, MD Karen Hopp, MD Arthur Jey, MD Justin Kohl, MD

CMA Trustees, District XI

Adam Dougherty, MD

AMA Delegation Barbara Arnold, MD

Editorial Committee

Vong Lee, MD Scarlet Lu, MD Derek Marsee, MD Taylor Nichols, MD Ashley Rubin, DO Alex Schmalz, MD Ashley Sens, MD Asmaneh Yamagata, MD Robert Oldham, MD Margaret Parsons, MD Sandra Mendez, MD

Megan Babb, DO Sean Deane, MD Caroline Giroux, MD Robert LaPerriere, MD Karen Poirier-Brode, MD

Gerald Rogan, MD Kayla Umemoto, MS II Michelle Ann Wan, MS III Lee Welter, MD Eric Williams, MD James Zhou, MS II

Executive Director Managing Editor Webmaster

Aileen Wetzel Ken Smith Melissa Darling

Sierra Sacramento Valley Medicine

HOSTED BY LOCAL PHYSICIANS

Listen and subscribe to Joy of Medicine - On Call on your favorite Podcast App or visit joyofmedicine.org

Sierra Sacramento Valley Medicine, the official journal of the Sierra Sacramento Valley Medical Society, is a forum for discussion and debate of news, official policy and diverse opinions about professional practice issues and ideas, as well as information about members’ personal interests. Advertising rates and information sent upon request. Acceptance of advertising in Sierra Sacramento Valley Medicine in no way constitutes approval or endorsement by the Sierra Sacramento Valley Medical Society of products or services advertised. Sierra Sacramento Valley Medicine and the Sierra Sacramento Valley Medical Society reserve the right to reject any advertising. Opinions expressed by authors are their own, and not necessarily those of Sierra Sacramento Valley Medicine or the Sierra Sacramento Valley Medical Society. Sierra Sacramento Valley Medicine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. Not responsible for unsolicited manuscripts. ©2022 Sierra Sacramento Valley Medical Society SIERRA SACRAMENTO VALLEY MEDICINE (ISSN 0886 2826) is published bimonthly by the Sierra Sacramento Valley Medical Society, 5380 Elvas Ave., Sacramento, CA 95819. Subscriptions are $26.00 per year. Periodicals postage paid at Sacramento, CA and additional mailing offices. Correspondence should be addressed to Sierra Sacramento Valley Medicine, 5380 Elvas Ave., Sacramento, CA 95819-2396. Telephone (916) 452-2671. Postmaster: Send address changes to Sierra Sacramento Valley Medicine, 5380 Elvas Ave., Sacramento, CA 95819-2396.

| FEATURED CONTRIBUTORS |

Paul Reynolds, MD

Caroline Giroux, MD

SSVMS President Dr. Reynolds reports on the contingent of physicians and medical students from the region who visited the state Capitol to highlight priority issues during CMA's Legislative Advocacy Day.

paul.d.reynolds@kp.org

Eric Williams, MD imango@att.net

Dr. Williams beautifully shows us what “Being Human” really means: celebrations and sorrows, elation from new discoveries, the joy of love and pain of grief, and how laughter makes the heart sing.

David Evans, MD devans@sacent.com

Dr. Evans has provided SSV Medicine with several striking cover photos, and this month's is no exception. His photos range from lovely scenics to whimsy and even zombies. Visit davidaevans.com for more.

Ira Chasnoff, MD

cgiroux@ucdavis.edu

Physicians have a role in promoting peace, whether it is within a household or across borders, Dr. Giroux says. We must also give patients a sense of peace within themselves and demonstrate it in our interactions.

irachasnoff@gmail.com Dr. Chasnoff writes about what he has coined the “GoodEnough Syndrome,” how it has lead to failure for children of parents with substance abuse issues, and how Sacramento County is stepping up.

Gonzalo Ursua

Savanna Nickols, MS III

Gonzalo Ursua, a junior at Arthur A. Benjamin Health Professions High School, says White Coat Week is another big step along his path from his hometown in Mexico to his dream of becoming a doctor.

Rural California faces an inequity in health care because of a shortage of physicians practicing in those areas. A new program at UC Davis is working to recruit a new generation of rural physicians

ssvmedicine@ssvms.org

Angelica Martin, MS III acmart@ucdavis.edu

srnickols@ucdavis.edu

Eduardo Martin, MS II mart2418@msu.edu

A new generation of physicians don't want to “stay in their lane” and are not just embracing the sociopolitical elements of medicine. They want to be trained as advocates for medicine and their patients. The next generation of physicians, Angelica and Eduardo say, will be practicing medicine with a different philosophy at its foundation, a more holistic approach that takes into account the effects of public policy on their patients.

May/June 2022

| PRESIDENT’S MESSAGE |

Loud and Proud at the State Capitol SSVMS Joins CMA for Legislative Day

ogether, a medical society like SSVMS can overcome challenges far larger than any one of us could take on by ourselves. One physician can tell a legislator what ails the practice of medicine, but when several hundred physicians share their stories legislators truly begin to take notice. More than 350 SSVMS and CMA physicians and medical students descended upon the state Capitol on Tuesday, April 19 for CMA’s 48th Annual Legislative Advocacy Day. Through visits to key legislators and staff, they did a great job of enhancing awareness among policymakers of the challenges physicians face today and to show their support of two CMA-sponsored bills. Assembly Bill 2132 (Villapudua) would establish a pilot program for the California Future Physician

By Paul Reynolds, MD paul.d.reynolds@kp.org

Fund. This program would identify and select individuals from diverse underrepresented communities and would fund their community college or undergraduate educations through completion of their residencies. The participants must commit to practicing in rural or medically underserved areas after residency. The field of medicine in our state is not representative of California’s diversity: just 7% of physicians in the state are Latino and 3% are Black, while nearly 40% of Californians are Latino and approximately 6% are Black. Further, in just eight years California will need an extra 10,500 primary care physicians to effectively treat its population. This bill would provide incentives for future physicians, help fill gaps in rural health care and increase diversity. Senate Bill 250 (Pan) would tackle prior authorization reform. A 2021 survey found that physicians average 41 prior authorizations per week; that works out to about two working days each week spent on the administrative paperwork necessary. That same survey found that 91% of physicians with a proven track record said prior authorizations interfere with continuity of care and negatively impact clinical outcomes. This bill would allow physiSSVMS member physicians, staff and medical students get ready for their first meeting cians to focus more on during CMA's 48th Annual Legislative Advocacy Day. Joining them is Emily Berry (in dark dress on right) of Assemblymember Ken Cooley's staff. treating patients and 4

Sierra Sacramento Valley Medicine

less on administrative bureaucracy. Administrative burdens continue to be a driving force of physician burnout; the emphasis on addressing these issues at the legislative level by CMA will go a long way towards easing the suffering felt by physicians. SSVMS physician and medical student advocates met with six legislators to ask for support on these two bills and to share how these bills can improve access to care and support physician workforce diversity. Medical students from the UC Davis School of Medicine and California Northstate University College of Medicine joined our delegation and shared personal stories of accruing a Rachel Ekaireb, MD (left) joins medical students for a Capitol selfie. staggering amount of debt — a clear barrier to entry to many others wanting to enter the authorization can be difficult to grasp for those without field. Meanwhile, physicians shared their frustrations experience in medicine. The example that hit home for with prior authorization and how it inhibits their ability several legislators was a story from one of our attendees, to serve patients. an emergency room physician, who often prescribed Legislators often know a little about a lot due to Zofran in the ER. For a recent patient, a preauthorizathe variety of issues they face and while debt is easy tion was required. By the time the authorization came to understand, the administrative process of prior through, the patient had needlessly suffered through his nausea and had been discharged. SB 250 would curb these health plan abuses and put medical decision-making back in the hands of physicians. I want to offer a big thank you to the SSVMS members who joined us for CMA’s Legislative Advocacy Day this year. Your voice matters, especially when it is backed by the voices of your colleagues telling their stories and bringing their experiences with patients to life. When we are together, as one, there is so much we can do. J. Bianca Roberts, MD, Paul Reynolds, MD and medical students from California Northstate University meet with Assemblymember Jim Cooper of Elk Grove. May/June 2022

| EXECUTIVE DIRECTOR’S MESSAGE |

MICRA Agreement Heads Off Ballot Battle Legislation Protects Key Elements That Ensure Californians Have Access to Care

n April 27, a historic compromise was announced on MICRA and the ballot measure scheduled for November was pulled by its proponents. Instead, legislation was immediately introduced with the terms of the agreement and leaders in both the state Senate and Assembly promised quick passage. The central feature of the agreement are modifications to the provisions concerning economic damages. The current law limits recovery of non-economic damages to $250,000, regardless of the number of defendants. Under the legislation that we expect the governor to quickly sign, the limit for cases not involving a patient death will increase to $350,000 with that number rising incrementally to $750,000 over the next 10 years. After that, it will increase by 2% each year to account for inflation. The limit in wrongful death cases will increase to $500,000, with an incremental increase over the next decade to $1 million. A 2% adjustment for inflation will also be made beyond that point. The proposal will create three separate categories for a total of three possible caps in each case, but a health care provider or health care institution can only be held liable for damages under one category regardless of how the categories are applied or combined. The new categories include one cap for health care providers, regardless of the number of providers or causes of action; one cap for health care institutions, again regardless of the number of providers or causes of action; and one cap for unaffiliated health care institutions or providers at that institution that commit a separate and independent negligent act. Coming to a compromise preserves MICRA’s underlying principles of ensuring access to care and protecting patients from facing runaway costs. Important guardrails found in the current law will remain unchanged, including the one-year statute of limitations to file a 6

Sierra Sacramento Valley Medicine

By Aileen Wetzel awetzel@ssvms.org

case, advance notice of filing a claim, the option of binding arbitration, early offers of proof for making punitive damages allegations, and allowing other sources of compensation to be considered when courts are making award determinations. This agreement heads off what would have been an expensive and contentious campaign against a dangerous initiative that could have substantially raised health care costs for all Californians. It would have reduced access to care and harm patients who need care the most, including those served by Medi-Cal, community clinics, safety net providers and school-based health centers. Had the measure passed, it likely would have

CEO Dustin Corcoran called the compromise a balanced proposal that modernizes MICRA while strengthening provider protections. resulted in substantial increases in the cost of malpractice insurance and could have opened physicians to pay a greater portion of claims under a vague new category of lawsuit called “catastrophic injury.” CMA CEO Dustin Corcoran called the compromise a balanced proposal that modernizes and updates MICRA while strengthening provider protections and providing injured patients with fair compensation. In addition to CMA, negotiations included the California Hospital Association, California Dental Association, medical malpractice insurance companies, community clinics, Planned Parenthood and other members of the broad Californians Allied for Patient Protection coalition that has worked for decades to protect access to health care through MICRA. The agreement was reached shortly before this magazine was printed, so please watch for further details and updates in the days ahead through various SSVMS and CMA communications.

THANK YOU Mercy General Hospital Mercy San Juan Medical Center Methodist Hospital Marshall Hospital

Sutter Davis Hospital Sutter Medical Group Sutter Medical Center Sacramento Woodland Memorial Hospital

Physician Education Fund Medical Staff Donations to Protect MICRA

| OPINION |

The Role of Medicine In Creating Peace The Revolution for Peace Begins From the Inside Out

was too young when the Vietnam war ended to be aware of this two-decades long complete nonsense, and more interested in watching The Little House on the Prairie. During the Romanian dictatorship of Nicolae Ceaușescu, I was too busy trying to find a boy to exchange my first kiss with. During the war in Rwanda, I was too shocked by the overdose of surreal gore, too petrified by the helplessness and guilt that came from living in a privileged culture to be able to think beyond my textbooks. I had to study hard to go into medicine and, you know, help change the world. Growing up in Canada, this welcoming land with an apparently overly apologetic culture (from what was reflected to me about my natural inclination after I emigrated), and which is not considered particularly militaristic, war felt like it was often occurring on another planet. It looked like dystopia, passing through our living room through a cathodic screen showing a really bad movie. And you can always turn off the knob if the movie gets interminable. But there comes a time when we can no longer live in denial or make excuses. As a young adult, I eventually embraced my high sensitivity and easily drained empathetic nature by reading or watching the news more. I even joined my first protest with a carefully and proudly handmade thought-through sign after former U.S. President George W. Bush launched the attack on Iraq. I eventually became a psychiatrist and suddenly extra preoccupied by the silent wars within households, between romantic partners, parents and children, siblings, in alleys of disadvantaged neighborhoods, and on school premises between classmates. They continue to happen every day and have prolonged impact. Wars would continue to pop up regularly in the news, as would unforgivable acts of human rights violations such as separation of children at the Mexico-U.S. border, terrorist attacks, and hate crimes. 8

Sierra Sacramento Valley Medicine

By Caroline Giroux, MD cgiroux@ucdavis.edu

“It feels like World War III.” I have heard that a couple of times recently, as we cannot help but reflect on and witness with terror the military acting-outs of Russia towards Ukraine. Seeing the news has brought such an unpleasant déjà-vu sensation. What can we do? What can I do? We are told not to judge what we don’t understand, but I believe there is an important exception to that core belief. War is often incomprehensible. And yet, we should judge it. Severely. Hiding behind the principle of a total non-judgmental stance makes us accomplices of the unacceptable, the abominable, the preventable. I remember vividly in elementary school the topic of an oral presentation. It was about sharing what we would do if we had some magical powers. Despite

Art uses the soul as the unlimited raw material for selfexpression, Dr. Giroux says. She recently returned to creating art, including this haunting piece.

unhesitatingly, sincerely, simply (but at the same time, also grandiosely?) saying I would end all wars, I felt a bit embarrassed, almost finding my idea cliché in comparison to my friend who was taking drama lessons and made me envious of her own fantasized, poetically described superpowers that consisted of becoming invisible so she could get her favorite candy incognito from the corner store along with the ability to wring clouds to end drought. But I now look at this deep wish from a more naïve version of me with a mixture of tenderness and admiration. We need more people to visualize that same dream of peace so it can manifest for good. Visualizing or sharing during an oral exposé is noble

We must not only talk about peace as an ideal but demonstrate how to feel and enact it in every interaction. but not sufficient. I have fought various metaphysical battles, often to no avail. I have been forced by life circumstances to strive to become a dragon slayer. I have decided to embrace my sacred rage. But I have often felt like giving up, feeling dismissed or failed by systems supposed to help improve the world. When my love burning inside me had nowhere to go, I could not be left stagnating. Maybe an opportunity has come to channel my life energy before it dissipates into a vacuum and becomes wasted. I try to cultivate joy and create beauty by celebrating any moment or

tiny accomplishment of life. I have recently returned to painting, drawing and creating collages. Art uses the soul as the unlimited raw material for self-expression, centering each person in his or her own place on Earth while embroidering each individual into the fabric of existence. We must not only talk about peace as an ideal but demonstrate how to feel and enact it in every interaction, both with our environment and with each other. I think of the care my mother puts into her gardening magic. If we shared half the love for each other she has for her tomatoes we would all be in a better place. We, as mental and other health professionals, are in a very privileged position to help our patients develop a sense of peace towards themselves and their pasts. There needs to be a revolution of peace from the inside out. People we serve, and ultimately all people, can choose to do that. Peace starts behind closed doors, within households, in the couple’s bedroom, at the dinner table, in the school yard during recess, in the classroom, in the forest, in the ocean. Peace starts in utero when a mother puts her hands on her seismic belly with tenderness and love, wishing this new child of the world a safe haven full of possibilities. Peace is never far when a couple can still hold hands while arguing. Newly found peace begins with reaching out to that neighbor, who looks so different. It starts with a round table where everyone feels equal and entitled to have or reclaim their voice. Peace acts as the solvent to finally remove obstacles to love May/June 2022

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and the fear of otherness. So I think a shift can occur and we can feel more empowered to be part of a change when we formulate the need as one of peace expansion rather than war eradication. War won’t happen if there is peace. But it will be hard for peace to be heard if we focus too much on loudly opposing war. So how do we do this, concretely? Where do we start? I think we must examine the structure and content of our lives to make sure they are fully aligned with moral and humane core values not based on materialism or pseudo-abundance. Giving more from the overflow of our self-compassionate beings can lead to a life of meaning. Meaning is like a fraternal twin of joy: both often potentiate each other. Joy and meaning can be enacted in giving, or in art, where peace is the main medium, and mixed with an unapologetically passionate dedication, the sweat of the work. Peace is as essential to our cluttered co-existence as silence is to music. We should prescribe music, art and other languages of the soul more often. A former colleague I had the honor to work with referred to his guitar (as Woody Guthrie did) as a “fascism-killing machine.” Just as I was finalizing this essay, an enactment of peace appeared in the moonlit sky in the form of a loud murmuration of birds. Their interconnectedness reminded me that we have the power to go from otherness to togetherness. Peace is this prayer, this mantra, this whisper of the soul we should repeat until it happens for real.

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| PUBLIC HEALTH |

False Victories a Legacy of Child Abuse Prevention Act "GoodEnough Syndrome" Leaves Law to Address Prenatal Substance Abuse Lacking; Sacramento County Steps Up

tand ten feet away from a wall. Now walk halfway to the wall and stop. Continue in this manner, walking half the distance each time you move forward. As you advance, you’ll see the wall coming closer — you may even be able to touch it. But you’ll never make it all the way to the wall. This dilemma, first presented by the philosopher Zeno and later expanded upon by Aristotle as an argument against pluralism — the belief in the simultaneous existence of many things rather than one — is an apt illustration of what I have come to call the “GoodEnough Syndrome,” a mindset of moving forward inch by inch without ever really making progress. It’s a pattern of thinking that sedates like an opiate, convincing us that going halfway is “good enough.” When it is time to sit down and discuss policy, the Abilene Paradox — a termed coined in 1974 by George Washington University’s Jerry Harvey for the social phenomenon in which members of an organization make collective decisions that lead them to take actions contrary to what they actually want to do and thereby arrive at results that are counterproductive — takes over. It occurs in organizations in which agreement is reached and action is taken even though most individuals in the group, if polled privately, would say the result is something they do not desire. Best intentions lie behind most examples of the GoodEnough Syndrome, but the results are characterized by policies and practices that use the lowest common denominator of achievement to define success — usually financial or political success rather than human success. Multiple forces grounded in political and economic realities elbow their way to the front of the room, dilute the best intentions, and drive us toward that lowest common denominator through which we can claim success.

Sierra Sacramento Valley Medicine

By Ira Chasnoff, MD irachasnoff@gmail.com

Efforts to improve the lives of children have been greatly inhibited by the GoodEnough Syndrome. It is perhaps the result of an underlying lack of conviction among policymakers, but political pressure also plays no small role and even well-intentioned bills can fall prey to the effacing effects of compromise. That was the case on June 25, 2003, when President George W. Bush signed the Keeping Children and Families Safe Act, reauthorizing the Child Abuse Prevention and Treatment Act (CAPTA) through federal fiscal year 2008. Within this reauthorization were a number of additions to the eligibility requirements states had to fulfill in order to receive their federal share of child abuse prevention money. Among these additions, one stands out: the requirement that hospitals and all health care personnel inform the state’s child welfare system if a child is born “affected” by maternal use of illegal drugs during pregnancy or exhibits withdrawal symptoms resulting from prenatal drug exposure. The child welfare system was then responsible for developing a “plan of safe care” for every reported drug-exposed infant and referring these children to early intervention services for infants and toddlers with disabilities. At first glance, the program, funded through Part C of the 2004 federal Individuals with Disabilities Education Act, appears to be a good idea. The intended goal of this provision was to develop a system that ensures all children born at risk due to maternal substance abuse will have access to early intervention services. From a moral perspective, no one could argue with the program’s intent; to vote against it would be to forever wear the slurs “anti-child” and “pro-drug abuse.” But the reality is that although the legislation passed easily, it moved only halfway to the desired outcome. No funds were made available to institute training for hospitals or health care personnel on how to recognize

a substance-exposed child. Worse, it was unclear what the term “affected” really meant. Would a positive urine toxicology qualify a child as “affected?” Also, where was alcohol in the legislation? Although alcohol is the leading preventable cause of intellectual disabilities among this population of children, the bill specifically excluded prenatal alcohol exposure as a condition for referral. Critics speculated that the CAPTA legislation was unduly influenced by the economic interests of the beer, wine, and liquor industries. Undoubtedly, the presence of a robust alcohol lobby does not make for healthy discourse about the proper course of intervention for alcohol-exposed children. In light of what is known in the scientific community about the health and developmental risks alcohol poses to these children, passage of the bill in its diluted form can only be seen as the result of a crisis of confidence as stakeholders backed off when it came time to settle on CAPTA’s final language. Over the next two decades, the reauthorization language of CAPTA has fortunately evolved to the point that the current legislation, due to be passed with bipartisan support in spring of this year, has expanded the designation of risk to include children born with signs of effect from “all substances,” including alcohol and, apparently, prescription drugs. But even now, the legislation does not indicate what “affected” means nor provide guidance to states as to how to effectively implement the legislation. Rather than establishing a

The Child Abuse Prevention and Treatment Act was intended to give children better outcomes in cases of prenatal substance abuse, but a willingness to settle for “good enough” diluted its impact. straightforward and comprehensive structure toward helping children who may be affected by prenatal substance abuse, the end result of the legislation has been to create a void in awareness and lack of clarity in the steps health care providers and child welfare agencies must take. It has become incumbent on local agencies to fill the gaps left when Congress settled for good enough instead of something more productive. Sacramento County is stepping up to fill the gaps caused by the GoodEnough Syndrome with its Healthy Beginnings program, a free awareness and training program for health care professionals. The educational programs that will be presented through this initiative will focus on creating and sustain-

ing programs that incorporate public health outreach to identify where children are at risk and how providers can identify the risk posed to children by substance abuse. Healthy Beginnings also has the goal of removing the stigma of substance abuse so that pregnant women will be less hesitant to seek help for the benefit of their unborn children. CAPTA has unquestionably suffered a failure to launch: a 2018 study conducted in Iowa by my research team found that 82% of physicians who deliver care to newborns had never heard of the CAPTA legislation that was supposed to be guiding their decision as to whether to inform child welfare authorities of a child with prenatal substance exposure. Even more

May/June 2022

Policies and practices of the GoodEnough Syndrome… • Are reactive rather than proactive; • Are grounded in terms of financial rather than human cost; • Focus on singular problems or diagnoses rather than co-occurring disorders; • Determine service access based on eligibility rather than need; • Restrict range, intensity, and duration of services; • Define success in terms of broad quantitative measures geared to participation and contact rather than client-oriented outcomes; • Are designed within systems rather than across systems; • Allow service integration to substitute for systems integration.

alarming, 71% of judges who oversee child welfare and juvenile justice courts were completely unaware of the CAPTA legislation. If we were to conduct a similar survey in Sacramento County today, we would likely have the same outcomes. Fortunately, Sacramento County has chosen not to settle for good enough and is proactively reaching out to providers so that the vulnerable children CAPTA was created to protect will have a chance at better outcomes. Healthy Beginnings, along with greater awareness of the proper actions to take when encountering substance abuse by a pregnant patient, will improve the lives of the children and families who reside here in Sacramento County. Ira Chasnoff, MD is an award-winning author, researcher and lecturer. He is a professor of clinical pediatrics at the University of Illinois College of Medicine in Chicago and is also president of NTI Upstream, a research organization that is partnering with Sacramento County on its Healthy Beginnings program.

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| PUBLIC HEALTH |

Healthy Beginnings Targets Perinatal Substance Abuse Provider Training, Community Outreach Work to Reduce Stigma So Women Will Get Help

hrough SACCounty Healthy Beginnings, Sacramento County is initiating a prevention and intervention program aimed at educating health care professionals and the community on the effects of use of alcohol and drugs during pregnancy. “SACCounty Healthy Beginnings will promote a healthy and safe environment for Sacramento County’s families and children through outreach and education for professionals and community members, addressing perinatal substance use prevention and intervention,” said Michelle Besse, human resources program planner at the county’s Substance Abuse and Treatment Services agency. “We want to empower Sacramento families to thrive physically, socially, and emotionally, free from the effects of substance use and misuse in pregnancy.” SSVMS is currently in the process of finalizing a contract that will provide free CME trainings, consultations, support and education to encourage medication assisted treatment (MAT) for pre-and post-natal women who are suffering from opioid use disorder. CME and continuing education trainings will be available for physicans and mid-level providers along with assistance for applying for X-waivers that allow the outpatient use of buprenorphine. Through Healthy Beginnings, Sacramento County will implement universal screening programs that utilize a validated screening instrument for all pregnant women to identify those who are at risk for alcohol, tobacco, marijuana, and illicit drug use. The goal is to engage each woman in an educational intervention that will motivate her to make healthy decisions for herself and her unborn child while not making prenatal clinics an arm of the child welfare system. Early intervention and treatment services through Healthy Beginnings will be based on the child’s needs rather than eligibility criteria. The county will support 15

Sierra Sacramento Valley Medicine

By Brandon J. Craig bcraig@ssvms.org

Register Now for Free Training Dr. Ira Chasnoff will lead free, live training on substance abuse in pregnancy and how it affects mothers and newborns May 23, 24 and 25 through Sacramento County's Healthy Beginnings program. Registration is required. To learn more or to register, contact Michelle Besse, human services program planner, at bessem@ saccounty.net.

the needs of infants and young children and their families, including expanding early intervention services to include infant mental health strategies. Pending agreement on the contract, SSVMS will help Sacramento County provide quality, research-based educational and training opportunities for all health care professionals who provide services to pregnant and parenting women, families, and children of all ages. The county recognizes that a one-time training does not have a long-term impact on changing clinical care, so follow-up consultation and technical assistance will be provided on an as-needed basis. Healthy Beginnings will also include a social media campaign across multiple platforms that will make reliable, science-based information available to all community members and bring trusted resources into all homes. Above all, it will attempt to remove the stigma around substance abuse difficulties in general and specifically substance use and misuse during pregnancy. By focusing on treatment rather than judgment, Healthy Beginnings will help remove disincentives women with substance abuse issues have toward receiving care. May/June 2022

Honors Medicine 2022 2

More than 150 members, medical students and guests convened at the Elks Tower for a night of comraderie, wine tasting, magic and recognition at this year's SSVMS Honors Medicine event on April 23. 1) Gary Chu, MD, receives the Medical Honor Award for his contribution to community health. 2) JaNahn Scalapino, MD (center) receives the Golden Stethoscope Award from SSVMS President Paul Reynolds, MD and Margaret Parsons, MD. 3) Magician Kevin Blake wows his panel of volunteers with his mind-reading abilities.

3 16

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Photos by Scott Duncan Photography

4) Friends visit Henry Go, MD, recipient of the Special Recognition Award for over 60 years serving the Delta community. 5) Pete Miles, MD enjoys a moment with J. Bianca Roberts, MD and her husband, Vernon. 6) Giuseppe Sanfillipo of the Calif. Dept. of Public Health, Jason Gritti, MD, Kevin Nguyen, MD, and Kai-Ting Huh. 7) SSVMS Board Member Rick Vitangcol, MD. 8) SSVMS Alliance co-presidents Gabby Neubeurger (left) and Susan Brownridge accepted the Medical Community Service Award on behalf of the Alliance. 9) UC Davis and California Northstate University medical students.

8 May/June 2022

| FUTURE OF MEDICINE |

Creating a New Generation of Rural Physicians UCD Program Targets Disparity in Care

here is a widening imbalance between rural populations and the number of physicians serving them. Although almost a quarter of the U.S. population lives in rural areas, only about 12% of the health care workforce practices there, resulting in significant health care disparities for rural populations. Health care professional schools have tried to combat this problem by creating pipeline programs to help increase the number of professional students returning to practice in rural areas. While these programs face significant challenges in reaching students in geographically dispersed regions, the increased reliance on online tools during the COVID-19 pandemic has provided an opportunity to assess how virtual mentoring can aid in developing long-term professional relationships and increase student preparedness for health care careers. The UC Davis School of Medicine created the Program in Medical Education for the Rural Underserved in response to the physician shortages in rural California. A new extension of the program was created this year specifically to reach high school students in these communities. Known as Priming Rural Interest via Mentorship Enhancement (PRIME), it’s an eight-week program conducted virtually that addresses barriers students said could keep them from entering a professional career in health care. Their level of concern about these perceived obstacles was measured through surveys conducted before they participated in the program and then again after its completion. The PRIME program was implemented at four high schools located in designated Rural Urban Commuting Area (RUCA) communities, including Winters, Esparto, Arcata and Fairfield. Junior and senior students from each high school were recruited by contacting school administration and selection for participation was based on a first-come first-serve basis until a program

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By Savanna Nickols, MS III srnickols@ucdavis.edu

capacity of 60 students was reached. Students interested in the program completed an informed consent and an interest survey to determine their preferred session topics during the program. The PRIME program consisted of eight 90-minute sessions over the course of nine weeks. The session topics, determined by the needs expressed on the interest survey, included the time it takes to enter medicine, qualifying for aid, resume building, the opportunities in health care, how to build mentoring relationships, and how to address barriers and manage stress. They were also given an introduction to physical exams and clinical cases they might encounter. Prior to the start of the program, financial worries were cited by 80% of students as the biggest concern they had toward pursuing a career in health care. About half had concerns about going to college, while 43% said they were worried about the academics and time involved. Of the 54 students that completed the interest survey, 35 met the criteria for completion at the conclusion of the program by attending at least six of the eight sessions. Upon completion, the number of students expressing financial concerns decreased by 8.6 percent while those having concerns about college decreased by 14.3 percent. The number of students worried about the time commitment decreased by 2.9 percent. However, the number of students who had concerns about academics increased by 6.6 percent. Although these changes were statistically significant due to the relatively small sample size, it is important to note that upon completion of the program, 15 students reported having fewer concerns overall, 10 students reported no change in concerns, and 10 students reported additional concerns. A clearly beneficial result of the students' time in the

PRIME program was that 72 percent said they felt more knowledgeable about the steps necessary to go to medical school and one-third believed they could achieve the goals they initially set for themselves upon completion of the program. Forty percent of students felt more confident in being able to balance the different aspects of their life including school, work, self-care The UC Davis School of Medicine Rural-PRIME class of 2023. and managing stress during challengA strength of this program was that it was completed ing times. Importantly, 23 percent of students who entirely via a virtual platform. This allowed participacompleted the program specifically expressed interest in tion from students at disparate locations as well as becoming a physician. the involvement of many UC Davis faculty and guest Interestingly, the program resulted in increased presenters. The virtual setting also allowed students to concerns about academics. Possible reasons for this collaborate with other high school students from similar include that students may be more informed about the backgrounds and discuss key issues. academic steps and content involved in preparing for The virtual setting does have limitations, however. medical school or studying medicine. Additionally, it Participants said they would like more hands-on activishould be considered that these concerns were increasties and in-person sessions. This may have been in part ing in the context of the COVID-19 pandemic and due to “Zoom fatigue” as students were attending many the transition to online learning, when students were of their classes virtually. Future iterations of PRIME may experiencing increased worries about how that would seek to address this through creating more interactive affect their overall academic success. sessions within the virtual setting, as well as providing Overall, the PRIME program was able to reach options for in-person programming when possible. students from multiple rural communities in Northern A limitation of the study is that it relies on pre- and California, provide education about health care profespost-survey data, which can be dependent on acute sions, and increase awareness about the pathways to feelings and perceptions. Later versions of this program becoming a physician. Additionally, the program led to could include more consistent surveying during the an overall decrease in concerns about finances, college, program and additional follow-up surveys after compleand time management as barriers to pursuing a health tion. This would allow for further assessment of specific care profession. session outcomes and impacts, as well as assessing the Although not all students envisioned themselves long-term impact the program had on students. entering the health care field, our findings suggest that Pipeline programs, such as PRIME and SSVMS’s Future — like the SSVMS Future of Medicine program — PRIME of Medicine, have shown to be effective in empowerwas effective at providing a safe space for students to ing students to achieve their goals and in connecting become exposed to medicine and to meet professionals students to the necessary information, resources, and who could provide the mentoring essential toward mentorship they need to be successful. The results of increasing the number of rural health care workers. the pilot program and feedback from the participants Especially in rural areas, this information and mentorwill be used to advance the program and potentially ship is not always easily accessible through the student’s make it available to additional communities. PRIME will existing social network, including family members, continue to create more interest in health care careers teachers, or school counselors. Notably, the program among students and inspire the creation of a new had a positive impact on student self-efficacy, which generation of physicians to address the disproportionate is crucial for self-actualization regardless of what field health disparities impacting our rural communities. they pursue. May/June 2022

| FUTURE OF MEDICINE |

The Path to a Dream: "I Knew I Belonged in Medicine" With the Help of SSVMS Physicians, White Coat Week Gives Students an Inside Look at a Career in Health Care The SSVMS Future of Medicine program gives high school students — many from communities severely underrepresented in medicine — an introduction to a career in health care. The pandemic limited access to health facilities last year, but this spring students were able to shadow health care professionals in real-life experiences during the first White Coat Week. Gonzalo Ursua, a junior at Arthur A. Benjamin Health Professions High School in Sacramento, shares the impact his three days with a range of physicians had on him.

hen I lived in Mexico, 12 very formative years, it was known that only a few of the wealthy students in my hometown could go even to high school, let alone medical school. It didn’t matter how you performed academically or what potential you demonstrated. I never even bothered thinking about my career path — it would’ve been an unrealistic daydream. I only started thinking about it once I moved to the U.S. It was overwhelming! Where do you even begin? My passion and favorite subject in school was science, but I’d reached out to a lot of people and had a lot of conversations. After some soul-searching, I knew I belonged in medicine. But then what? Luckily, this is when I heard about SSVMS’s Future of Medicine program and White Coat Week. I had my opportunity to gain insight on all the different roles in a clinic. I found myself thinking about what I valued most in a career, particularly when my mentors were sharing what medicine has meant to them or what they were willing to do or withstand for that career. What struck me was how they treated patients — I hadn’t seen that type of passion or emotional connection before! I want to put that energy out into the world; to treat people I’ve never met and be a positive force for them. Future of Medicine and White Coat Week can take a 20

Sierra Sacramento Valley Medicine

By Gonzalo Ursua ssvmedicine@ssvms.org

student’s interest in medicine and transform it into a calling. I hope others can experience that same inspiration. At the end of the program, I was asked about my participation and what it meant. It struck me as an odd question but I thought back to how I’d viewed my career possibilities before the program. White Coat Week eased me. It no longer felt impossible to be a doctor; in fact, it felt like the most important thing I could have was that passion and then I’ll be able to make it all work out. I had been stressed and anxious about how difficult medical school was and how rigorous the path to physicianhood is. Indeed, everyone I asked about medical school said that it can be stressful, but that the time passed quickly and they weren’t able to recall the hard times nearly as well as the good. I’m grateful to everyone — every doctor, nurse, medical professional, and medical student — who helped me and took time to include and acknowledge a student like me who’s very interested in medicine. I’ll never forget this experience and I hope to provide others these same feelings when I have the opportunity. I know how much it can positively impact someone’s life.

Gonzalo Ursua with Francisco Garcia, MD.

Clockwise, from top left: Christopher Wong with Kristian Borofka, DO at River Bend Medical Associates; Shreya Thota and Pantea Hashemi, MD at University Skin Institute; Shaan Merchant with Travis Miller, MD and staff at the Allergy Station in Roseville. May/June 2022

| FUTURE OF MEDICINE |

A Call to Action From Future Leaders Gen Z, Millennials Embrace the Sociopolitical Landscape of Medicine, Activism

istorically, a physician’s role was to acquire medical knowledge and heal physical ailments. Acquiring excellent clinical skills and medical knowledge was separated from the ideology that led John Snow, a physician and one of the pioneers of public health epidemiological research, to step out of his “lane” and approach his patients with a wider lens that included public health concepts. In doing so, he changed what it meant to be a physician and the practice of medicine for generations after him. In the previous issue of SSV Medicine, Dr. Paul Reynolds shared his reflections on how the medical field and medical education has changed. His thoughts on the changing perception of the role of a physician sparked our peers and us to reflect on what being a physician means to our generation, one we believe is embracing the sociopolitical landscape of medicine and the need to be trained in health policy. Our generation, mostly Millennials and Generation Z, are experiencing a unique, some might say unprecedented, medical training environment. The “once in a lifetime” COVID-19 pandemic has displayed how income, housing, environmental barriers, racism, and other factors exacerbate health outcomes and ultimately dictate who lives and who dies. We understand it is irresponsible and dangerous to ignore what we are seeing, and we are ready to act. Seeing the stress the pandemic has placed on our most vulnerable patients has caused many of us to broaden our definition of what it means to be a physician to one that includes health policy at its core. Previously, conversations about the sociopolitical aspects of health had been left to the field of public health or had been taken on by a select group of physicians driven to incorporate the work into their practice. In stark contrast, the current generation of medical students are showing their desire and eagerness to step 22

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By Angelica Martin, MS III By Eduardo Martin, MS II mart2418@msu.edu acmartin@ucdavis.edu

out of their traditional lane and adopt this more holistic model of medicine. This is a call for action. As future health care leaders, we are ready to be trained on how to testify in front of legislators, support grassroots movements, incorporate social determinants of health into our clinical assessments and plans, and improve our health care system. The recent enthusiastic attendance for the new advocacy course, First Aid for Health Policy, at UC Davis School of Medicine is proof. Since 2020, over 200 medical students, or half of the first and second-year classes, have voluntarily signed up for a lunch-time lecture series that focuses on developing advocacy skills. The lecture series focuses on building the basics of health advocacy in an approachable manner without jargon. Everything from how a bill becomes a law to how to conduct a legislative visit is discussed. The success and popularity of this prototypical course at UC Davis shows that health policy has a place in medical education beyond just an elective course. The next generation of physicians, our generation, is embracing the sociopolitical landscape of medicine, is ready to be trained in advocacy and health policy, and will be practicing medicine with a different philosophy at its foundation. We are the next generation of health care leaders. We dream of a system that allows our patients to thrive and not just survive. We dream of a system that allows all people, regardless of their socioeconomic standing, to live healthier lives. We need a system that acknowledges that our patients are more than just their diseases or health conditions. We understand that the health of our patients is shaped by their lived environment, their stressors, their access to equitable health care, and their experiences with discrimination and racism. Our generation of physicians, the future of health care, is embracing the sociopolitical landscape of medicine. Train us. Include us. Support our dreams. We are ready.

THANK YOU SPONSORS! DIAMOND

GOLD

S I LV E R

H O N O R S 20 MEDICINE 22 Golden Stethoscope Award JaNanh C. Scalapino, MD Medical Community Award SSVMS Alliance

Medical Honor Gary S. Chu, MD Special Recognition Award Henry Go, MD

| POETRY |

Being Human Being human is not meant to be experienced alone. We survive through the companionship of others.

By Eric Williams, MD imango@att.net

We sense their presence as easily as we feel a cool breeze in the heat of the blazing sun on a hot summer's day. Even in the soundless darkness of a moonless night we know when there is a presence …and we each reach out… The beauty of being human lies in our ability to revel in each other’s successes and lament at the grief and loss of a stranger. We smile at the attempt of a child’s first steps and our hearts beat in unison as they rise up from all-fours, to knees, pull upright, cruise then release and reach. We celebrate with them as it is as much our success as it is their own. The pain of being human is both yours and mine. When I see your hurt and I see you cry, I too hurt deeply within my bones and my joints and it stills my heart. If you in that moment feel that you will never smile then neither can I. And when you laugh in that moment of heavenly joy my heart rises to the heavens — and it sings as though the angels have rested on my shoulders and there is peace. Your pain is my pain, your joy is my joy and that is us being human. Being human is success, and failure. Being human is joy and grief, gain and loss. Being human is equanimity under duress; bravery, war, struggle, strife, hunger and survival. Being human is music and dance, celebration and longing. Being human is communication and negotiation, understanding and compromise and yes, cruelty and compassion.

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Being human is questioning and looking up toward the stars negotiating the heavens. The mind of a human seeks patterns and reason and truth. We see the beauty in math and science more than for the science itself. Being human means enjoying the relationship and rationale of numbers and the predictable story they tell. Being human means we get to enjoy the amazing story of the possibilities of probability and the demonstration of the imagined, expected but not yet proven. Being human is the elation which comes with the delight of a new discovery. Being human is Mother Teresa and Nelson Mandela. It is Homer and Chinua Achebe. It is Winston Churchill and Abraham Lincoln. Being human is the son and daughter and the gold star parents of those lost in wars. Being human is being parents of the children of Columbine and Sandy Hook and Parkland and Stoneman Douglas and… too many more. Being human is me as I write this and tears begin to flow and I am pained by being human. Then I hear power and bold optimism of the music of Aaron Copland's ‘Fanfare for the Common Man,’ I hear Passenger perform ‘All the Little Lights’ and I think of my own children; their successes and their struggles and I smile as I marvel at how being human grants us the opportunity to cry one moment and the hardihood to smile the next and to hope. May/June 2022

| BOARD BRIEFS |

Board Briefs March 14, 2022 THE BOARD: Received an update regarding committee activities from Peter Hull, MD, Chair, Emergency Care Committee. Approved the January 2022 Financial Statements and 4th Quarter 2021 Investment Reports and Recommendations. Approved proposed amendments to the investment policies for Sierra Sacramento Valley Medical Society, the Community Service, Education and Research Fund and the Employee Pension Plan. Approved the following changes to the SSVMS delegation to the CMA: Appointment of Douglas Gibson, MD to Alternate-Delegate Office 21; Dropped from the delegation for nonpayment of SSVMS/CMA dues: Drs. Neil Parikh, Vijaya Reddy and Rishi Sikka. Approved the following Membership Reports: January 24, 2022 For Active Membership — Kyle J. Adams, DO; Maryam Amir, MD; Suchdeep S. Bains, MD; Satnaam S. Bassi, MD; Shiva Bhandaru, MD; Cedrick S. Bradley, MD; Brent A. Feldt, MD; Amy W. Fong, MD; Daniel Gondi, MD; Shreya S. Gondi, MD; John Halloran, DO; Anthony L. Jackson, MD; Amanda L. Jamal, MD; Christopher Y. Jeu, DO; Jaison John, MD; Lily E. Johnston, MD; Raheel A. Khan, DO; Thong D. Le, MD; Suegene K. Lee, MD; Allison C. Levitt, MD; Melanie J. Madriaga, DO; Neeta Malviya, MD; Jaspreet K. Mann, DO; Rini Mathew, DO; Lynn M. McAlister, DO; Roberto A. Molera, Jr., MD; Steven W. Nakano, MD; Timothy P. Nguyen, DO; Chirag V. Patel, MD; Tanvi Patel, MD; Mukund Ramkumar, MD; Sameera Rana, MD; Jessica K. Rouse, MD; Shivani S. Ruben, MD; Pooria Salari, MD; Sukhman S. Sandhu, MD; Sahar Sarkeshik, DO; Salma A. Shabaik, MD; Adrianna B. Sung, DO; Tony D. Veletto, MD; Jiao Xue, MD. For Resident Active Membership — Jena K. Fujimoto, MD; Andrea M. Gonzalez-Falero, MD; Karyn S. Mallya, MD; Sam Panahipour, MD; David V. Pham, MD. 26

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For Reinstatement to Active Membership — Richard L. Bauer, MD; Arun R. Krishnan, MD; Hailey R. MacNear, MD; Scott B. McCusker, MD. For Retired to Active Membership — Helen M. Biren, MD For Retired Membership — Edward Bubienko, MD; Franklin J. Chinn, Jr., MD; E. Brant Dyer, III, MD; Wendy A. Dyer, MD; William A. Junglas, MD; Julie A. Sporrer, MD; Katherine S. Stewart, MD; Don S. Yokoyama, MD. For Resignation — Dennis G. Bechini, DO; Abida Faiz, MD; Danish Javed, MD; Ron Martin G. Menorca, MD; Roy E. Schutzengel, MD. For Transfer of Membership — Nasim Fazel, MD (to Placer-Nevada); Robert B. Lurvey, MD (AlamedaContra Costa); Alexandria Meyers, MD (FresnoMadera). February 28, 2022 For Active Membership — Omnia D. Awad, MD; Hannah M. Bechtold, MD; Samhita Bhargava, MD; David M. Brandman, MD; Tatiana C. Santamaria, MD; Timothy M. Dempsey, MD; Diana L. Dremsa, MD; Nancy O. Ekeke, MD; Cameron E. Gaskill, MD; Daniel C. Herman, MD; Alejandro Jimenez, MD; Rajbinder K. Mann, MD; Phillip M. Murray, MD; Na’amah Razon, MD; Amadeo D. Rivera, MD; Richard Ruben, MD; Joshua I. Santos, MD; Kurt Swartout, MD; Peter A. Than, MD; Sophia A. Traven, MD; Amanda T. Whitaker, MD; Shaina M. Willen, MD. For Resident to Active Membership — Anjali J. Cera, MD; Raymond Gong, MD; Satinderpal S. Khera, MD; Angel M. Mendoza-Gonzalez, MD; Minhthao T. Nguyen, DO. For Change in Status from Active to Active 65/20 — Tim Grennan, MD. For Retired Membership — Ezra A. Amsterdam, MD; David M. Asmuth, MD; Robert A. Azevedo, MD; Hilary A. Brodie, MD; Hans U. Bueff, MD; Thomas A. Bullen, MD; Henry Chang, MD; Steven Dorfman, MD; Kenneth A. Frank, MD; Harjinder S. Goa, MD; Rose C. Jensen, MD; Amitabha Karmakar, MD; Spencer J. Kwong, MD;

| NEW MEMBERS |

New SSVMS Members The following applications have been approved by the Sierra Sacramento Valley Medical Society. Information pertinent to consideration of any applicant for membership should be communicated to the Society. — Adam Dougherty, MD, Secretary.

New Active Members *Physician specialty abbreviated following name.

Omnia D. Awad, MD, OPH, The Permanente Medical Group Hannah M. Bechtold, MD, AN, UC Davis Health Samhita H. Bhargava, MD, PD, UC Davis Health David M. Brandman, MD, NS, UC Davis Health Anjali J. Cera, MD, NPM, UC Davis Health Tatiana Chadid Santamaria, MD, HOS, Mercy Medical Group Valerie D. Curtis, MD, HOS, Sutter Medical Group Emmanuel S. De Jesus, MD, IM, Sutter Medical Group Timothy M. Dempsey, MD, EM, UC Davis Health Diana L. Dremsa, MD, PMD, UC Davis Health Nancy O. Ekeke, MD, IM, The Permanente Medical Group Cameron E. Gaskill, MD, SO, UC Davis Health Raymond Gong, MD, PTH, UC Davis Health Daniel C. Herman, MD, PM, UC Davis Medical Group - Davis Alejandro Jimenez, MD, IM, UC Davis Medical Group Midtown Satinderpal S. Khera, MD, R, The Permanente Medical Group

Rajbinder K. Mann, MD, FP, The Permanente Medical Group Angel M. Mendoza-Gonzalez, MD, IM, The Permanente Medical Group Phillip M. Murray, MD, P , UC Davis Health Minhthao T. Nguyen, DO, END, UC Davis Health Na'amah Razon, MD, FP, UC Davis Health Amadeo D. Rivera, Jr., MD, IM, The Permanente Medical Group Richard A. Ruben, MD, FP, Mercy Medical Group David E. Sahar, MD, PS, UC Davis Health Joshua I. Santos, MD, PUD, UC Davis Health Kurt Swartout, MD, IM, Mercy Medical Group Peter A. Than, MD, GS, UC Davis Health Sophia A. Traven, MD, ORS, UC Davis Health Jennifer R. Urban, MD, D, Sutter Medical Group Amanda T. Whitaker, MD, ORS, UC Davis Health Shaina M. Willen, MD, PD, UC Davis Health

Daniel G. Lewis, MD; Andrew J. Linn, MD; R. Paul Miller, MD; Mary K. Moleta, MD; Elizabeth H. Moore, MD; Stanley M. Naguwa, MD; Michael J. Novotny, MD; David W. Ottman, MD; Paul C. Riggle, MD; Christine M. Roland, MD; James R. Sehr, MD; Pamela N. VerderBautista, MD; Thomas L. Voegeli, MD; Eleanore L. Wolpaw, MD; Eric S. Williams, MD; Den Y. Yoneda, MD.

March 14, 2022

For Resignation — Christopher H. Brophy, MD; Mark T. Dillon, MD; Shannon S. Dillon, MD; Nolan M. Giehl, MD; Richard N. Gray, MD; William E. Guthrie, MD; Elita M. Hagos, MD; Tasmin Khan, MD; Aristeo Lopez, MD; Natalia Y. Obzejta, MD; Swati Rao, MD; Marguerite W. Spruce, MD; Merin M. Stephen, MD; Richard K. Sun, MD; Kearnan A. Welch, DO.

For Resignation — Robert C. Benzl, MD; Uma Chandavarkar, MD; Henry Chen, MD; Stacy D. D’Andre, MD; Sina Dadfarmay, MD; Johanna C. Fuentes-Valdes, MD; Sukhraj S. Kahlon, MD; Robert A. Lanflisi, MD; Anne E. Ray, MD; Victoria Belle Y. Shin, DO; Luke B. Simonet, MD; Felicia C. Tang, MD; Pierre T. Vo, MD.

For Transfer of Membership — Zoe F. Sun, MD.

For Transfer of Membership — Michael Y. Hun, MD (Placer-Nevada).

For Active Membership — Valerie D. Curtis, MD; Emmanuel S. De Jesus, MD; Jennifer R. Urban, MD. For Reinstatement to Active Membership — Laura J. Pierce, MD; David E. Sahar, MD. For Retired Membership — Roy A. Berry, III, MD; David A. Evans, MD; Joseph M. Young, MD.

May/June 2022

| THE LAST WORD |

The Delta's Doctor For Over 60 Years, Henry Go, MD Has Been Courtland's Go-To Health Care Provider

a clinic six days a week, making hospital rounds, driving r. Henry Go brings a whole new meaning to the down bumpy country roads to make house calls and term "continuity of care." deliver babies in the middle of the night.” He is a native of the Delta, born and raised in Those babies in the book were more of the fourCourtland, where he still lives with his wife, Dr. Barbara legged variety, however. The book was All Creatures Arnold. He arrived into the world with the assistance Great and Small, James Herriot's recollections of life as a of Raymond Primasing, MD, the local doctor who later veterinarian in Yorkshire. became his partner and mentor. Dr. Go took over the Dr. Go's father died when he was four and he was practice in the 1970s and is still going at age 88. sent by his mother to live on the ranch of his uncle, Dr. Go was honored April 23 at the SSVMS Honors Lincoln Chan, where Dr. Go had been born in a small Medicine awards and banquet. He received a special farmworker's cottage. recognition award for Chan, one of the largest his longevity and value pear farmers in the counto the Courtland commutry who was known as nity, where he has been The Bartlett Pear King, the only doctor in town effectively became a for most of his career. father to Dr. Go. “He is the anchor for Each July, Rosie would the community,” said deliver pears to the Stan Eddy, a local electriphysicians, nurses, nuns, cian and former chief of and hopsital operators the volunteer fire departwho helped Dr. Go care ment. “I've had a lot of for his patients. He also trouble in my life, broken makes a mean pear pie, back, broken everything. Rosie said. Dr. Go has always been When Dr. Go arrived there to help me out.” at UC Berkeley, he made a “Henry Go has been in life-changing choice, his practice for over 60 years Special Recognition Award recipient Henry Go, MD daughter Adrienne said. and is as much a fixture “At college orientation, he put pre-med on his college in the Delta as the pear trees and maybe the river itself,” registration because the guy next to him encouraged SSVMS Executive Director Aileen Wetzel said. “He's a him to do so,” she said. He went on to get his medical modest man who probably doesn't feel the need to be degree from UCLA. ‘honored,’ but we certainly did. He's the embodyment You can still find Dr. Go every Monday, Wednesday of the family physician who has served thousands of and Friday in his office, which is still located, appropripatients and multiple generations in his community.” ately, at the corner of Primasing Ave. and River Road, “There was I book I read as a child and I was barely a block from where he was born, serving his convinced it was written about my dad,” his daughter Delta patients. — Ken Smith Rosie Go said. "The story followed a rural doctor running 28

Sierra Sacramento Valley Medicine

Closer to home + enhanced referrals = easier access to world-class care Kelly Haas, M.D. Pediatric Gastroenterologist

UC Davis Health offers nationally ranked expertise — now with added convenience for our referring providers From the most delicate robotic and catheter procedures to the latest precision therapeutics, we’re proud to offer up-to-the-minute diagnostic and treatment options for both adult and pediatric referring providers across Northern California and the Central Valley. Your referred patients benefit from shorter drives, less traffic gridlock, affordable lodging, and more support from local family and friends. We also offer robust telehealth and telemedicine options, for both initial consultations and follow up care. Referring your patients to UC Davis Health specialty and subspecialty care is now easier than ever. Our physician referral liaison team is here to serve as direct lines of communication — helping to navigate and expedite referrals.

Our liaisons can also help to: ■

■

Facilitate access to our secure EMR system, PhysicianConnect Arrange meetings and/or webinars with our clinicians Assist with UC Davis Health clinical trials and telemedicine Keep you abreast of new services, providers and research programs Share information about CME and events such as tumor boards, grand rounds, symposiums, etc.

Reach out to your local Physician Referral Liaison today:

Tracy Bayne | 916-281-8734 | thbayne@ucdavis.edu

referrals.ucdavis.edu

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