November 2008

• Still time to RSVP for 150th Anniversary Celebration
• SCMA endorses new Medicare payment option
• Dr. Ian Hoffman wins “Article of the Year” award
• SCMA website continues to grow
• Dr. Thomas McCarthy dies at 60
• Supervisors approve residency consortium; one hurdle left
• Physicians can still get paper EOMBs from Medicare
• Balance billing regs apply to care provided on or after 10/15
• CMA House adopts resolution to ban smoking in casinos
• Free diabetes podcasts available from CDC
• NORCAL applications available in writable PDF format
• Health care conference in Santa Rosa on Nov. 12
• Dr. Stacey Kerr publishes book on hospital homebirths
• Dr. Allan Bernstein writes headache booklet for Krames

Still time to RSVP for 150th Anniversary Celebration

Tickets are still available for SCMA’s 150th AnniversaryCelebration on Tuesday evening, Nov. 11. The tickets are FREE to active andretired SCMA members, and $75 for spouses or guests. General admission is $95.

The event will be held at the Vintner’s Inn, 4350 BarnesRd., Santa Rosa, starting at 6 p.m. To RSVP or to purchase tickets, e-mailscma@scma.org or call 525-4359. Credit card payments can be accepted over thephone.

Major sponsors of this historic occasion include KaiserPermanente, NORCAL, Sutter Medical Foundation North Bay, and Sutter MedicalGroup of the Redwoods. Additional sponsorship is being provided by CMA, themedical societies of CMA District 10, Marsh, Pacific Foundation  for Medical Care, Redwood Regional MedicalGroup, Sonoma County Department of Health Services, St. Joseph Health System,and about a dozen other local health organizations and businesses.

On Oct. 23, the SCMA Alliance presented SCMA with an Allieaward for “Outstanding Contribution to the Community.” And on Nov. 4, theSonoma County Board of Supervisors will issue a proclamation recognizing SCMAfor its 150 years of service.

SCMA endorses new Medicare payment option

In response to a Medicare study of various options forrevising its payment localities, SCMA has endorsed Option 3, which wouldseparate high-cost metropolitan statistical areas (MSAs) from statewidelocalities.

In an Oct. 26 letter to Medicare, SCMA President Dr. KirkPappas and former president Dr. Brad Drexler noted that “none of the otheroptions adequately address payment inequities and will therefore not have anadequate effect on patient access to physicians.”

Medicare is accepting comments about the study, entitled “Reviewof Alternative GPCI Payment Locality Structures,” until Nov. 3. The study canbe downloaded at http://www.cms.hhs.gov/PhysicianFeeSched/downloads/ReviewOfAltGPCIs.pdf.Comments should be sent to MPFS@cms.hhs.gov.

Dr. Ian Hoffman wins “Article of the Year” award

Dr. Ian Hoffman, a residentphysician in the Santa Rosa Family Medicine Residency, has won the Article ofthe Year award from SCMA for “The Devil’s in the Details,” which appeared inthe Spring 2008 issue of Sonoma Medicine.

Hoffman’s article provides aneye-opening look at the influence of drug-company detailers who regularly visitphysicians’ offices, offering free samples and other gifts. He concludes, “Thelong-ingrained and widely accepted practice of interacting with pharmaceuticalrepresentatives will be a hard habit to break. As physicians, the question wemust answer now is whether conditions are right for us to move away from the ‘freelunch’ on our own, or do we need regulatory laws to break us of the habit?”

The full text of Hoffman’sarticle appears on the SCMA website at http://www.scma.org/magazine/articles/?articleid=77.

SCMA website continues to grow

SCMA continues to add newmaterial its newly revised website at http://www.scma.org. Launched in October,the site includes a full list of member benefits, current and past issues ofSonoma Medicine, and a variety of resources for physicians. Credit card paymentcapabilities and an online directory of SCMA physicians are also in the works.

Suggestions for improving thewebsite should be sent to Steve Osborn at sosborn@scma.org or 525-4325.

Dr. Thomas McCarthy dies at 60

Dr. Thomas McCarthy, an ob/gynwho practiced in Santa Rosa for 26 years, died of brain cancer on Oct. 28. Hewas just 60 years old.

Dr. Cheryl Kellert, McCarthy’slongtime partner at Santa Rosa Ob/Gyn Medical Group, remembered him as anastute diagnostician and an excellent teacher. “As a partner,” she recalled,“he put his personal needs only after the group’s needs. He was a real teamplayer.”

McCarthy was well known in thecommunity for his dual role as doctor and as pastor at the Hope Chapel, achurch he founded in 1989. In a 1997 article for Sonoma County Physician (nowSonoma Medicine), he wrote, “The roles of pastor and physician work hand inhand. … While I do not actively evangelize patients in my practice, I do try tohelp them understand the non-physical roots of their problems and encouragethem to seek solutions other than antidepressants.”

Dr. Thomas Garrett, one ofMcCarthy’s former partners, remembered that, “The staff loved him. He wasalways up; he had a great sense of humor. He was respected by his colleagues inother specialties, and he saw the big picture.”

McCarthy’s death comes justweeks before his former practice is scheduled to close. “The heart of our groupdied when he got ill,” said Kellert. “He went into medicine because it’s aprofession and a calling, not because it’s a job.”

Services will be held in thePerson Theater in the Wells Fargo Center for the Arts at 2 p.m. on Friday, Nov.7.

Supervisors approve residency consortium; one hurdle left

Nearing the end of a longprocess, the Sonoma County Board of Supervisors has approved a deal transferringcontrol of the Santa Rosa Family Medicine Residency from Sutter Health to aconsortium of local health providers, including Sutter, Kaiser, Memorial, theSouthwest Health Center, the Dept. of Health Services and UCSF.

The deal, in the works since2007, must still be approved by the Accreditation Council for Graduate MedicalEducation, probably in early 2009. Once that happens, the consortium will takeover the program, and resident physicians will receive training not only atSutter, but also at Kaiser, Memorial and Southwest.

“The consortium structure willnot only provide a broader base of financial support, but will also offer aricher, more diverse learning experience for physicians,” said Sutter CEO MikeCohill. Sutter will contribute more than $4 million annually to the consortium,with Kaiser providing an additional $2.7 million per year.

Physicians can still get paper EOMBs from Medicare

Medicare payment problems continue to plague doctors’offices across California. In the most recent glitch, some physicians beganreceiving Medicare checks without an attached Explanation of Medicare Benefits(EOMB) because Medicare mistakenly switched those physicians to “electronicremittance advice (ERA) only” status.

Physicians who want to keepreceiving EOMBs should submit a letter to Medicare via CMA. Simply download thesample letter on the SCMA website at http://www.scma.org/i/userimages/Medicare_EOMB_request.pdf.Complete the letter with your specific information, then fax to Frank Navarroat 916-551-2046. The letter can also be used to request copies of EOMBs notincluded with previous payments.

Physicians can expect to beginreceiving paper EOMBs within three days from the date CMA receives their faxedrequest. For further details, contact Frank Navarro at fnavarro@cmanet.org or916-551-2046.

For other Medicare paymentproblems, call CMA toll-free at 800-786-4262 or visit the “Resources” sectionof the SCMA website at http://www.scma.org.

Balance billing regs apply to care provided on or after 10/15

Despite the vigorous efforts oforganized medicine, the Department of Managed Health Care (DMHC) regulationthat prohibits “balance billing” of HMO patients for out-of-network emergencyservices took effect on Oct. 15.

DMHC has indicated that theprohibition applies only to services provided on or after the regulation’seffective date. Bills sent after Oct. 15 for services provided before Oct. 15are not affected.

For more information, see CMA’sBalance Billing Advocacy Toolkit available to members only athttp://www.cmanet.org/member. CMA published the toolkit to help physicians dealwith the uncertainty caused by this regulation and to answer any questions theyhave about their rights and responsibilities.

CMA and a coalition of providergroups have filed a lawsuit against DMHC arguing that the regulation isunlawful and unenforceable because DMHC lacks the authority to regulatedoctors. The lawsuit also alleges that the regulation violates the intent ofthe Knox Keene Act, which is to ensure that HMOs provide adequate physiciannetworks to provide care for their enrollees.

For more detail, contactSamantha Pellon at 916-551-2872 or spellon@cmanet.org.

CMA House adopts resolution to ban smoking in casinos

The CMA House of Delegates hasadopted a resolution to support legislation mandating smoke-free gaming venuesas a prerequisite for issuing or renewing gaming licenses. The resolution byformer SCMA president Dr. Brad Drexler was one of many approved by the House atits annual meeting in Sacramento in early October. Other resolutions addressedprescription data mining, tax deductions for uncompensated care, and physicianstaffing of retail health clinics.

For a complete list ofresolutions, visit http://cmanet.org/member.

Free diabetes podcasts available from CDC

A series of 10 podcasts titled“Clinical Diabetes Management” is now available for free download from the CDCwebsite. The podcasts feature interviews with pharmacists, podiatrists, optometristsand dentists on preventing diabetes complications and working as part of thediabetes care team. The podcasts promote a team approach to comprehensivediabetes care and provide simple care recommendations to clinicians aboutmaking cross-disciplinary referrals.

The podcasts cover periodontaldisease, preventing vision loss, living with vision loss, preventingamputation, and the pharmacist's role in diabetes, among other topics. Toaccess the podcasts, visit http://www.cdc.gov/podcasts and search for “ClinicalDiabetes Management.”

For more free resources ondiabetes prevention and control, visit http://www.ndep.nih.gov.

NORCAL applications available in writable PDF format

All applications andquestionnaires on the NORCAL website have been converted to writable PDFformat. Applicants can download the forms to their computers and complete themonline. There is no need to fill them out by hand, which was previously theonly option.

To download an application,visit http://www.norcalmutual.com/resources/applications.php.

Health care conference in Santa Rosa on Nov. 12

A health care conferencesponsored by the North Bay Business Journal will be held on Wednesday morning,Nov. 12, at the Hyatt Vineyard Creek Hotel in Santa Rosa. The featured speakeris Dr. David Greenberg, a vice president at the Buck Institute, who willdiscuss regenerative medicine, diseases in aging, and the latest stem-cellresearch. His speech will be followed by panel discussions on health caredelivery and health insurance.

Tickets are $45 per person. Toregister, contact Linda Perkins by Nov. 7 at 521-5265 or events@busjrnl.com.

Dr. Stacey Kerr publishes book on hospital homebirths

Santa Rosa family physician andPress Democrat columnist Dr. Stacey Kerr has just published “Homebirth in theHospital” a 224-page book on integrative childbirth. The book features storiesof 15 women who had integrative childbirths in a hospital setting. Published bySentient Publications, the book is available at local bookstores or at http://www.homebirthinthehospital.com.

Dr. Allan Bernstein writes headache booklet for Krames

Dr. Allan Bernstein, a SantaRosa neurologist and headache specialist, did all the science writing for a newpatient guide to headaches from Krames, a leading publisher of patienteducation materials. The 16-page booklet, now in its third edition, will beused in doctors’ offices throughout the country.

Stephen Banks, MD
Radiation Oncology*
3555 Round Barn Cir.
Santa Rosa 95403
522-6875 Fax 576-0445
sbanks@rrmginc.com
Stanford Univ 1993

John Chan, MD
Obstetrics & Gynecology*
Gynecologic Oncology*
100 Brookwood Ave.
Santa Rosa 95404
576-7557 Fax 576-7786
chanjohn@obgyn.ucsf.edu
UC Los Angeles 1995

Lee-may Chen, MD
Obstetrics & Gynecology*
Gynecologic Oncology*
100 Brookwood Ave.
Santa Rosa 95404
576-7557 Fax 576-7786
Lee-may.chen@ucsfmedctr.org
Univ Michigan 1992

Thomas Duckett, MD
Urology*
500 Doyle Park Dr. #303
Santa Rosa 95405
575-1833 Fax 575-1892
duckett@sutterhealth.org
Loyola Univ 1995

Alvaris Duffis Jr., MD
Diagnostic Radiology
401 Bicentennial Way
Santa Rosa 95403
393-3452 Fax 553-3589
alvaris.w.duffis@kp.org
Univ Pennsylvania 1984

Gabriel Flaxman, MD
Family Medicine
3320 Chanate Rd.
Santa Rosa 95404
547-2220 Fax 303-3187
flaxmeg@sutterhealth.org
Drexler Univ 2008

Henry Flores, MD
Surgery*
451 March Ave. #B
Healdsburg 95448
433-8844 Fax 433-8836
floreshc@sutterhealth.org
Univ Minnesota 1994

Stephen Fuette, MD
Emergency Medicine*
401 Bicentennial Way
Santa Rosa 95403
393-4000 Fax 393-4741
stephandreb@aol.com
Univ Southern California 1999

Catherine Hurley, MD
Family Medicine
3320 Chanate Rd.
Santa Rosa 95404
547-2220 Fax 303-3187
hurleyc@sutterhealth.org
Jefferson Med Coll 2008

Bonnie Kneibler, MD
Family Medicine*
8465 Old Redwood Hwy. #320
Windsor 95492
838-6685 Fax 838-6686
kneiblb@sutterhealth.org
Rush Med Coll 1982

Lisa Kremer, MD
Rheumatology*
Internal Medicine*
4725A Hoen Ave.
Santa Rosa 95405
576-3322 Fax 576-3323
kremerl@sutterhealth.org
Univ Minnesota 1989

Elizabeth Martinez-Augustin, DO
Internal Medicine*
Geriatric Medicine*
401 Bicentennial Way, MOB West #110
Santa Rosa 95403
393-3062 Fax 393-4389
lizmartinezdo@yahoo.com
Western Univ Health Sciences 1999

Anabel Ruiz, MD
Family Medicine
3320 Chanate Rd.
Santa Rosa 95404
547-2220 Fax 303-3187
ruiza4@sutterhealth.org
Johns Hopkins Univ 2008

Libby Schaefer, MD
Family Medicine
3320 Chanate Rd.
Santa Rosa 95404
547-2220 Fax 303-3187
schaefe@sutterhealth.org
Harvard Med Sch 2008

Adrienne Silver, MD
Pediatrics*
3975 Old Redwood Hwy.
Santa Rosa 95403
566-5271 Fax 566-5292
adrienne.m.silver@kp.org
Univ Colorado 1996

David Suchard, MD
Occupational Medicine*
Medical Toxicology
Environmental Medicine
1260 N. Dutton Ave. #244
Santa Rosa 95401
546-2880 Fax 546-2828
dsuchard@sonic.net
UC San Francisco 1992

Barbara Turner, MD
Family Medicine*
8465 Old Redwood Hwy. #320
Windsor 95492
838-6685 Fax 838-6686
turnerb2@sutterhealth.org
UC Irvine 1987

* board certified

MEDICAL OFFICE SPACE
Suite available: Perkins Medical Center, Sonoma. 1800+/- sq ft. $2890/mo.707-996-4519.

HOW TO SUBMIT A CLASSIFIED AD
To submit a classified ad for News Briefs or Sonoma Medicine, contact NanPerrott at nperrott@rhscommunications.com or 707-525-4226. The cost is onedollar per word.

October 2008

• Don't miss SCMA's 150th Anniversary Celebration!
• SCMA Task Force Devises Solutions for Specialty Access
• Still Time to Submit Photos for SCMA Physician Directory
• District 10 Endorses Resolution to Mandate Smoke-Free Casinos
• Improved SCMA Website Readied for Launch
• Ob-Gyn Medical Group Closing in November
• More Doctors Working for Health Centers
• Dec. 6 is “Flu Shot Saturday”
• Palmetto Medicare Payment Problems Persist
• CMA Takes Legal Action to Stop Prohibition on Balance Billing
• Governor Signs Bill to Close Insurance Fee Loophole
• Transgender Health Conference in Rohnert Park Oct. 10-11
• Life-Sustaining Treatment Orders Available Online
• Free Screening for Arterial Disease and Aneurysms
• Drug Abuse Institute Launches Physician Website

Don't miss SCMA's 150th Anniversary Celebration!

All SCMA members are encouraged to attend the association’s 150th Anniversary Celebration on Tuesday evening, Nov. 11, at the Vintner’s Inn, 4350 Barnes Rd., Santa Rosa. Tickets, which include dinner, are FREE to active SCMA members.

To help defray costs, SCMA is actively seeking sponsors for the event, such as medical groups, hospitals, and pharmaceutical companies. Potential sponsors should contact Cynthia Melody at 525-4359 or cmelody@scma.org. See the attached sponsor flyer for more details.

SCMA members should RSVP for the event as soon as possible, either by e-mailing scma@scma.org or calling 525-4359. Credit card payments can be accepted over the phone.

See you at the Celebration!

SCMA Task Force Devises Solutions for Specialty Access

Plans to improve access to orthopedic and endocrinology services for underserved patients were presented at the Sept. 10 meeting of SCMA’s Specialty Access Task Force.

Dr. Jeff Sugarman, leader of the orthopedics subgroup, reported that a referral algorithm has been developed, and that the group is trying to establish an “ortho hub,” probably at the Southwest Community Health Center (SCHC). An e-mail describing the access problem and the “ortho hub” was recently sent to all the orthopedic surgeons in Sonoma County.

The endocrinology group leader, Dr. Gerald Eliaser, reported that about two-thirds of the county’s safety net referrals to the SCHC Chanate Family Practice Center’s endocrinology clinic, attended by Dr. Yuichiro Nakai, are referred for thyroid issues. Residency physicians, led by Dr. David Schneider, will be taking over management of thyroid patients, freeing Dr. Nakai and several other local endocrinologists to deal with non-thyroid problems for the safety net.

The next meeting of the Task Force, which is co-sponsored by the Redwood Community Health Coalition, is scheduled for Nov. 5. Physicians interested in attending the meeting or assisting the task force should contact Cynthia Melody at cmelody@scma.org or 525-4359.

Still Time to Submit Photos for SCMA Physician Directory

The deadline for submitting photos for the 2009 SCMA Physician Directory is Oct. 31, so there’s still time to get your picture taken, even if you missed previous photo sessions. Your photo is the most prominent element of your Directory listing, and a recent color portrait is strongly recommended.

Members can use any local photographer or even submit their own high-resolution photo to sosborn@scma.org. Duncan Garrett, a photographer whose work often appears in Sonoma Medicine, can take portraits at his Santa Rosa studio for just $50, a significant savings over standard rates. He can be contacted at 578-8192 or duncan@duncangarrettphoto.com. His studio address is 3565 Airway Drive, Santa Rosa.

District 10 Endorses Resolution to Mandate Smoke-Free Casinos

CMA’s District 10 delegation, which includes SCMA, has endorsed a resolution by Dr. Brad Drexler to ban smoking in tribal gaming venues. Such venues are currently exempt from the statewide ban on smoking in indoors public spaces.

The resolution will be presented at CMA’s annual House of Delegates meeting in October. If enacted, CMA will support legislation to ban smoking at tribal casinos. The National Council of Legislators from Gaming States is already considering similar recommendations.

Improved SCMA Website Readied for Launch

The first phase of an improved version of the SCMA website will soon go online, thanks to a grant from the Pacific Foundation for Medical Care. The revised site will not only include Sonoma Medicine, but also the Physician Directory, SCMA News Briefs, and a wealth of resources for local physicians. The site will be fully searchable, using the latest database technology.

Ob-Gyn Medical Group Closing in November

Santa Rosa Ob-Gyn, one of the longest-running medical groupsin Sonoma County, will close on Nov. 21. Dr. Cheryl Kellert, the seniorpartner, will move to Bellingham, Wash., and Dr. Garland Herron will relocateto the East Coast.

“Private practice for small groups is impossible,” saidKellert. “I would love to stay, but the reality of cost makes it impossible.”She estimated that 75% of the group’s income goes to overhead. In addition, thegroup hasn’t been paid by Medicare all year because of bureaucratic delays.

Kellert joined Santa Rosa Ob-Gyn in 1985. Over the years,several prominent local ob-gyns worked for the group, including former SCMApresidents Drs. John Bodle and Thomas Garrett. Another longtime partner, Dr.Thomas McCarthy, left the group last year for health reasons.

More Doctors Working for Health Centers

The number of doctors working full- or part-time at local health centers continues to increase. As of September, 65 local physicians were on staff at health centers affiliated with the Redwood Community Health Coalition (RCHC), including facilities in Alexander Valley, Guerneville, Healdsburg, Occidental, Petaluma, Roseland, Sonoma and Santa Rosa, as well as Indian Health. That represents a 44% increase from 2005, when only 45 physicians were on staff at those facilities.

An additional 36 physicians enrolled in the Santa Rosa Family Medicine Residency work at the Chanate Family Practice Center, which is also affiliated with RCHC.

Dec. 6 is “Flu Shot Saturday”

This year’s “Flu Shot Saturday”will occur on Saturday morning, Dec. 6. During that time, anyone can get a flushot for a suggested donation of $10 at locations throughout Sonoma County.Children under 18 must be accompanied by a parent or guardian, and no one willbe turned away due to inability to pay.

For information about times andlocations, call 565-4477 or visit www.sonoma-county.org/flu.

Palmetto Medicare Payment Problems Persist

The transition in Medicareadministration from NHIC to Palmetto GBA is causing serious payment problemsfor many California physicians. CMA continues to receive a high number ofcomplaints from members who have not received payment for claims submitted bothprior to and after the transition. Several members have been forced to accesscredit lines to meet payroll and business expenses, and some are fearful thatthe situation may cost them their practice.

While CMA has been successful ingetting resolution for physicians who contact CMA’s Center for EconomicServices, doctors who are going directly to Palmetto are finding it impossibleto get through on their phone lines. Practices that do get through are facingwait times of as much as three hours.

CMA Takes Legal Action to Stop Prohibition on Balance Billing

In late September, CMA and a coalition of health care providers filed a petition with the Superior Court in Sacramento seeking an injunction against a regulation recently finalized by the Department of Managed Health Care (DMHC). The regulation expands the definition of “unfair billing pattern” to include a practice commonly known as “balance billing.” DMHC asserts that the new regulation gives them the authority to bring enforcement actions against physicians who balance bill.

“Balance billing” occurs when insurers refuse to pay in full for emergency services provided to their policyholders by doctors or hospitals with whom the insurers do not contract. Faced with the insurers’ refusal to pay their bills in full, physicians often bill policyholders for the remaining balance.

Governor Signs Bill to Close Insurance Fee Loophole

Gov. Schwarzenegger has signed SB 1379, which closes a loophole that allowed health insurance companies to use fines imposed by the state to offset their fees to the Department of Managed Health Care. Instead, the bill directs the fines to a loan repayment program and the state’s high-risk insurance pool.

Transgender Health Conference in Rohnert Park Oct. 10-11

Life-Sustaining Treatment Orders Available Online

Free Screening for Arterial Disease and Aneurysms

Drug Abuse Institute Launches Physician Website

The National Institute on Drug Abuse has created a new website, www.nida.nih.gov/medstaff.html, intended to help physicians stay current with prevention and treatment of drug abuse. The site includes the latest clinical trials and detailed information on drugs of abuse.

Susan Dehnad, MD
Obstetrics & Gynecology
3317 Chanate Rd. #2C
Santa Rosa 95404
570-1130 Fax 571-2478
Mercer Univ 2003

Robin Knuttel, MD
Dermatology*
181 Andrieux St. #103
Sonoma 95476
938-9880 Fax 938-9879
sonomaskin@aol.com
Tufts Univ 1986

Timothy Regan, MD
Family Medicine*
401 Bicentennial Way
Santa Rosa 95403
Univ Minnesota 1980

Kyle Rhodes, MD
Ophthalmology
104 Lynch Creek Way #15
Petaluma CA 94954
762-3573 Fax 762-6873
Baylor Med Coll 2003

Thomas Schlesinger, MD
Ophthalmology*
3536 Mendocino Ave. #380
Santa Rosa 95403
575-5353 Fax 523-7729
Univ Southern California

Ashley Smith, MD
Dermatology*
990 Sonoma Ave. #2B
Santa Rosa 95404
579-4239 Fax 579-0459
St. Louis Univ 2003

Zunairah Syed, MD
Family Medicine
5900 State Farm Dr.
Rohnert Park 94928
206-3036 Fax 206-3041
Dow Med Coll 2001

* board certified

For Lease. Primemedical/dental office suite near Memorial Hospital. Call owner at 707-576-0777.

Medical Office Space.Suite available: Perkins Medical Center, Sonoma. 1800+/- sq ft. $2890/mo.707-996-4519.

October 2008

September 2008

• Sharps Can No Longer Be Placed in Household Waste
• Free Directory Photo Sessions Scheduled
• Reminder: SCMA 150th Anniversary on Nov. 11
• Magazine To Publish Special Commemorative Issue for 150th
• Number of Local Kaiser Physicians Up 30% Since 2005
• Coalition Posts Online Survey for Mental Health Providers
• Medicare Posts Interim Study for Revising Payment Localities
• Court Halts 10% Medi-Cal Cut
• Doctors Affected by State Budget Can Apply for Loans
• Physicians Spared from New Reporting Requirements
• Obesity Prevention Advocacy Workshop in Oakland Sept. 13
• End-of-Life Conference in Petaluma Oct. 24-25
• "Silent PPO" Guide Available from CMA
• Dr. Emily Keram Testifies at Hamdan Trial
• Center for Well-Being Honors Several SCMA Physicians
• New Physician Leaders at West County Health Center

Sharps Can No Longer Be Placed in Household Waste

Effective Sept. 1, home-generated sharps waste can longer be placed in household trash, recycling or yard-waste containers. The ban applies to lancets, needles and other sharps used for administering medications to humans or animals.

The new state law will primarily affect about one million Californians who self-inject medications at home. Instead of disposing of sharps in their household waste, they will now have to use one of the methods listed below. Physicians should inform their self-injecting patients about the new procedures.

Deputy Health Officer Dr. Mark Netherda urged compliance with the new law, noting, “It is an important way to prevent accidental exposure to serious infections such as HIV and hepatitis B and C.” Improperly disposed sharps pose a significant health risk to anyone who comes into contact with them.

Free Directory Photo Sessions Scheduled

Free portrait sessions for the 2009 SCMA Physician Directory have been scheduled for Sept. 30 to Oct. 3. Members who need new or updated photos for the directory are urged to take advantage of this complimentary service from RCL Portrait Design. Coat and tie are requested.

Sessions will be held at the following locations and times:

Life Learning Center, 1144 Montgomery Dr. (across from Memorial Hospital), rooms 2 and 3:
* Tuesday, Sept. 30: 7 a.m. to 1 p.m.
* Friday, Oct. 3: 7 a.m. to noon

Sutter Medical Center, 3325 Chanate Rd., rooms to be determined:
* Wednesday, Oct. 1: 7 a.m. to 2 p.m.
* Thursday, Oct. 2: 7 a.m. to 2 p.m.

To make an appointment, call RCL toll-free at 800-951-8712.

Reminder: SCMA 150th Anniversary on Nov. 11

SCMA will soon be mailing invitations to all members for the association’s 150th anniversary celebration on Nov. 11 at the Vintner’s Inn in Santa Rosa. Tickets, which include dinner, are free to SCMA members and $75 for a member’s spouse or guest.

The invitations include an RSVP postcard. You can also reserve a spot by contacting SCMA at 525-4359 or scma@scma.org. See you at the celebration!

Magazine To Publish Special Commemorative Issue for 150th

The Fall issue of Sonoma Medicine, SCMA’s award-winning magazine, will commemorate the association’s 150th anniversary, with articles by Gaye LeBaron, local historian Jeremy Nichols, and Drs. Joseph Clendenin, Allan Bernstein, James Gude and Colin Kopes-Kerr. Photos and documents from SCMA’s archives will be included as well.

Physician groups, hospitals and other providers interested in placing commemorative ads in this special issue should contact Nan Perrott at nperrott@rhscommunications.com or 525-4226. The deadline is Sept. 9. Ad rates are posted on the SCMA website at http://www.scma.org/magazine/advertising.html.

Number of Local Kaiser Physicians Up 30% Since 2005

The number of physicians working full-time at Kaiser facilities in Santa Rosa and Petaluma increased by almost 30% in the past three years, from 211 to 273, according to SCMA’s physician database. During the same time period (2005 to 2008), the total number of physicians working in the county increased by just 5%, from 976 to 1026, even as the number of non-Kaiser physicians declined by 2%, from 765 to 753.

The newest numbers confirm long-term trends in Sonoma County health care, with Kaiser gaining an ever-bigger share of local physicians and patients. The Permanente Medical Group now employs about 30% of the primary care physicians and 23% of the specialists in the county.

Coalition Posts Online Survey for Mental Health Providers

Physicians and other mental health providers are encouraged to complete a brief online survey posted by the Mental Health Coalition of Sonoma County. The anonymous survey will be used to improve mental health services throughout the community.

The survey, located on the coalition’s website at http://www.mentalhealthcoalitionsc.org, includes 22 multiple-choice questions and a box for comments. All told, it should take only a few minutes to complete.

The coalition’s website also includes a survey for the general public. Both surveys will remain posted until a sufficient number of comments are received. Results will published shortly thereafter.

Medicare Posts Interim Study for Revising Payment Localities

Medicare has posted an interim study of different options for revising its GPCI payment localities. The study, “Review of Alternative GPCI Payment Locality Structures,” is available for download at http://www.cms.hhs.gov/PhysicianFeeSched/downloads/ReviewOfAltGPCIs.pdf.

Medicare is asking doctors and other interested parties to submit comments about the study to MPFS@cms.hhs.gov by Oct. 20. By statute, Medicare is required to adjust physician fee schedules periodically to account for geographic differences in cost. Eighty-nine payment localities across the country, including several in California, have not been adjusted since 1997.

CMA’s own study of possible alternative payment locality configurations is in the early stages of development. CMA will communicate proposed changes to the locality configurations after the study is completed.

Court Halts 10% Medi-Cal Cut

A federal court in Los Angeles has enjoined the 10% cut in Medi-Cal reimbursement rates that took effect July 1, finding that the cuts would irreparably harm access to health care for nearly 7 million Californians. The California Medical Association hailed the decision as an important step for health care in California, and for the health and lives of the millions of Californians who benefit from the state’s safety net.

“This is the third court in five years to find that the state of California has put at risk the access to health care for millions of Californians by underfunding the Medi-Cal program,” said CMA President Dr. Richard Frankenstein. “Hopefully, lawmakers get the message that they cannot balance the budget on the backs of the state’s poor or those who provide their health care. The state safety net needs to be strengthened, not weakened.”

Even prior to the cuts, California ranked at the bottom of the country in Medi-Cal funding, and spent less per beneficiary than any other state. Since the cuts took effect, many providers have been forced to reduce or completely stop services for Medi-Cal beneficiaries.

Doctors Affected by State Budget Can Apply for Loans

As the state budget gridlock drags on, physicians affected by the delay can apply for loans from community banks or from CMA’s endorsed line of credit with the Bank of America. The latter--which offers credit-line amounts up to $250,000 and rates as low as Prime plus 1%--requires a Bank of America business checking account. To apply, visit a Bank of America center or call 888-600-4000.

CMA estimates that 2,000 of its 35,000 members could be adversely affected financially by the budget delay. The California Dept. of Health Services will be issuing Voucher of Claim letters to Medi-Cal providers outlining the exact amount owed by the state. Providers will be paid that amount by the state controller’s office when the budget is resolved.

For more details, call the CMA member helpline at 800-786-4842.

Physicians Spared from New Reporting Requirements

In response to months of persistent lobbying by CMA, a bill that could impose unlimited data reporting requirements on health care providers (AB 2967) has been amended to exclude physicians and physician groups.

CMA has long supported efforts to improve medical outcomes, the stated intent of AB 2967. However, prior to being amended, the bill would have required physicians to give a newly created state agency as much patient data as the agency demanded. This new bureaucracy would be in addition to the current outcomes reporting program under the Office of Statewide Health Planning and Development.

By being excluded from AB 2967, physicians are also saved from paying the tens of millions of dollars in costs related to the legislation.

Obesity Prevention Advocacy Workshop in Oakland Sept. 13

End-of-Life Conference in Petaluma Oct. 24-25

"Silent PPO" Guide Available from CMA

CMA’s Center for Legal Affairs has published a free “Silent PPO Action Guide” to help physicians understand the complexities of health plan contracting and protect themselves from unlawful or unauthorized leasing of their health plan contracts. The revised guide incorporates new case law that gives physicians more power to extricate themselves from “silent PPOs.”

Health plans often lease their networks of contracted physicians to other third-party payors, such as self-insured employers. These “silent PPOs” allow third-party payors to take advantage of discounted rates that health plans have negotiated with their contracted physicians. Health plans, which make a great deal of money by leasing their physician networks, often conceal silent PPO clauses in lengthy contracts and use language that applies in perpetuity.

CMA’s guide helps physicians detect and prevent silent PPO activity. The guide is available through CMA ON-CALL (document #1907) in the members-only section of CMA’s website at http://www.cmanet.org. Or contact Samantha Pellon at 916-551-2872 or spellon@cmanet.org.

Dr. Emily Keram Testifies at Hamdan Trial

Santa Rosa psychiatrist Dr. Emily Keram served as a defense expert witness in the recent Guantanamo Bay trial of Salim Hamdan, the former driver for Osama bin Laden. Keram, who has spent more than 120 hours evaluating Hamdan since March 2005, testified that he only took the job to support his family and that he “feels dead inside” after several years of detention, including solitary confinement and sleep deprivation.

Although Hamdan was convicted by a military tribunal of providing support to Al-Qaeda, he was acquitted of the more serious charge of conspiracy in Al-Qaeda attacks against the United States. He will be eligible for release in December.

“I have great respect for the neutrality of the military commission members,” said Keram, who specializes in forensic psychiatry. “Given the constraints of the process, they applied the law fairly.”

Center for Well-Being Honors Several SCMA Physicians

The Northern California Center for Well-Being will honor Drs. Kirk Pappas, Mary Maddux-González and John Shearer at its Celebration of Dreams event on Friday, Sept. 19. The three SCMA members are among several community leaders receiving awards from the Center. The keynote speaker, Dr. JoDean Nicolette, will discuss medical ecology.

Tickets for the event, which runs from 11:30 a.m. to 1:30 p.m. at the Santa Rosa Country Club, cost $65 each. To purchase, call 575-6043.

New Physician Leaders at West County Health Center

Allison Bacon, MD
Family Medicine
3320 Chanate Rd.
Santa Rosa 95404
576-4100 Fax 576-4185
bacona@sutterhealth.org
Loma Linda Univ 2008


Annemieke de Lange, MD
Family Medicine
3320 Chanate Rd.
Santa Rosa 95404
576-4100 Fax 576-4185
Loma Linda Univ 2008

Anne French, MD
Family Medicine*
PO Box 1493
Eldridge 95431
938-6787
St. Louis Univ 1996

Mark Netherda, MD
Family Medicine*
625 Fifth St.
Santa Rosa 95404
565-4599 Fax 565-7627
mnetherd@sonoma-county.org
George Washington Univ 1988

* board certified

OFFICE FOR SALE OR LEASE
Fully equipped medical office, 1,000 square feet, $285,000. Doctors Park, Santa Rosa. Or: lease for $2,000/month. Very competent medical staff looking for work. 707-577-0768.

MEDICAL OFFICE SPACE
Suite available. Perkins Medical Center, Sonoma. 1800+/- square ft. $2,890/month. 707-996-4519.

FOR LEASE
Prime medical/dental office suite near Memorial Hospital. Call owner at 707-576-0777.

HOW TO SUBMIT AN AD
To submit a classified ad for News Briefs or Sonoma Medicine, contact Nan Perrott at nperrott@rhscommunications.com or 707-525-4226. The cost is one dollar per word.