November 2013

• RSVP now for SCMA Awards Dinner on Dec. 5

• The Big 3: Medicare, Obamacare, MICRA

• Partnership HealthPlan to absorb Medi-Cal rate cuts to local physicians

• Time to update or verify your Physician Directory listing

• Donations needed for health careers scholarships

• SCMA Alliance seeking gardens in Healdsburg and Windsor for annual tour

• CMA delegates meet to discuss critical health care issues, set policy

• Message from CMA President Dr. Richard Thorp

• PEOPLE

• MEDICAL ORGANIZATIONS

• RESOURCES AND EVENTS

• CLASSIFIEDS

• APPLICANTS

• ABOUT SCMA

RSVP now for SCMA Awards Dinner on Dec. 5

All local physicians are encouraged to RSVP for the annual SCMA Awards Dinner, which runs from 6 to 9 p.m. on Thursday, Dec. 5. The event will be held at the Vintner’s Inn, 4350 Barnes Rd., Santa Rosa. Tickets are free for SCMA members; spouses, guests and nonmembers are $50 each.

Outstanding Contribution awards will be presented to Dr. Robert Mims, a retired endocrinologist, Dr. Peter Brett, a medical oncologist, and Dr. Walt Mills, a family physician and former SCMA president. The Article of the Year award will be given to Dr. Ted Hard for “Into the Valley of Wolves,” which appeared in the Spring 2013 issue of Sonoma Medicine. Finally, a special Recognition of Achievement will be bestowed upon the Northern California Center for Well-Being.

The evening begins with a social hour at 6 p.m., followed by dinner and the awards presentation. Dinner choices include “duet” (chicken and fish) or stuffed portobello mushroom. To RSVP, or to purchase tickets, contact Rachel Pandolfi at 707-525-4375 or rachel@scma.org. Mail orders can be sent to SCMA, 2901 Cleveland Ave. #202, Santa Rosa, CA 95403. Please indicate dinner choice.

For more details, click on the link below.

SCMA Awards Dinner flyer

The Big 3: Medicare, Obamacare, MICRA

The current federal and state landscape for healthcare has three dominant features, according to chief CMA lobbyist Elizabeth McNeil: Medicare payment reform, implementation of Obamacare, and a nascent attempt to gut California’s Medical Injury Compensation Reform Act (MICRA). Speaking to about 80 physicians, spouses and guests at the Fountaingrove Inn in Santa Rosa on Oct. 23, McNeil offered a whirlwind tour of all three features, pausing at times to describe some of their intricate details.

The meeting was emceed by SCMA President Dr. Stephen Steady, and McNeil was formally introduced to the crowd by local CMA Trustee Dr. Peter Bretan, a urologist with offices in both Sebastopol and Novato. Encouraging his colleagues to be more politically active, Dr. Bretan observed that modern life is no longer “survival of the fittest,” but rather “survival of the most politically allied.”

McNeil began with a recap of the recent government shutdown, expressing the view that Congress is even worse than it looks, and that it’s not fixing anyone’s problems. The challenge, she said, is getting Congress to do something productive, particularly in the face of determined Tea Party activists who are trying to dismantle the government. She praised local congressmen Jared Huffman and Mike Thompson, noting that Thompson serves on the powerful Ways & Means Committee and is a Medicare expert.

The House Energy & Commerce Committee did unanimously pass a Medicare SGR (sustainable growth rate) overhaul in July, explained McNeil, but the legislation has been languishing, with several obstacles to clear before it can come to a vote in the full House and Senate. McNeil emphasized that without the overhaul, physicians may face up to a 30% pay cut from Medicare. The bill also includes the long-awaited “GPCI fix” that would raise Medicare reimbursement rates in Sonoma County by at least 3%, and in Marin County by at least 5%.

Turning to the Affordable Care Act, better known as Obamacare, McNeil noted that the Covered California website is faring significantly better than its much-maligned federal cousin, www.healthcare.gov. Nonetheless, the initial physician directory on Covered California was rife with errors and has been taken down until mid-November. She offered the example of one doctor who was incorrectly listed as speaking Arabic, Turkish, Spanish, Russian and Farsi, and she urged physicians to check their listings once the directory goes back up.

McNeil’s tour concluded with a MICRA update. Trial lawyers have begun collecting signatures to put their anti-MICRA initiative on the November 2014 ballot. Besides raising the current $250,000 cap on non-economic damages to more than $1.1 million, the measure would mandate physician drug testing. The anti-MICRA campaign has already turned vicious, said McNeil, describing how one group recently circulated a flyer accusing recent CMA President Dr. Paul Phinney, a Sacramento pediatrician, of being a drug addict.

Both McNeil and Dr. Bretan urged physicians to donate to the pro-MICRA campaign. Dr. Bretan explained that if donations are made via medical staff organizations, hospitals will match them two for one. Donations can also be made to the Californians Allied for Patient Protection website at www.micra.org.

McNeil’s speech was followed by a lively question-and-answer session, with topics ranging from the role of specialty societies to implementation of a single-payer system.

Partnership HealthPlan to absorb Medi-Cal rate cuts to local physicians

Partnership HealthPlan, which operates the managed Medi-Cal program throughout the North Bay, will absorb the mandated Medi-Cal rate cuts to physicians during the next year. “The state’s fiscal crunch has always been a challenge to us,” said Partnership CEO Jack Horn, “but we’re very happy that we can keep these cuts away from our doctors for the time being.”

Legislation mandating the cuts was signed by Gov. Jerry Brown in 2011, but they are only now being implemented. Because Partnership is a county-organized health system, it can use its resources to absorb some of the cuts. The state has also exempted certain specialties from the cuts. “Moving forward,” said Horn, “we’re confident that our managed care initiatives will bring even more savings which we can use to help our providers.”

Time to update or verify your Physician Directory listing

The one-page verification form for the 2014 Sonoma County Physician Directory will soon be mailed to all local physicians and should be returned to SCMA as soon as possible. The form allows doctors to update or verify their listing in the Directory, a standard reference guide used at medical offices throughout the county.

Because the Directory is sold to the public and posted on the Internet, please do not list your personal phone number, home address or personal email address. SCMA strongly recommends that you list only your office phone, office address and office email.

The Physician Directory, entering its 57th edition, features photographs and detailed listings for all SCMA members, including their specialty(s), special medical interest and medical training. Specialty, city and phone for nonmember physicians are included as well. If you’re a nonmember and want a more detailed listing, contact Rachel Pandolfi at rachel@scma.org or 707-525-4375 about joining SCMA. You can also join online at www.scma.org/join.asp.

Donations needed for health careers scholarships

Local physicians can support students pursuing health careers by donating to the annual Holiday Greeting Card project sponsored by the SCMA Alliance & Foundation. Physicians and others who contribute to the project have their names listed on the greeting card, which is sent to the entire medical community.

Project chair Barbara Ramsey said, “The Alliance is proud to create opportunities for donors to effect real change in the life of a student who has the ambition and vision of becoming a healthcare professional.” Earlier this year, the Alliance awarded $28,000 to 10 local students, using money raised from the greeting card and other projects. They hope to surpass that total for the next round of grants.

A mailing about the scholarship fund will be arriving in local offices shortly. Physicians can donate by returning the enclosed pledge card or by visiting the Alliance website at www.scmaa.org.

SCMA Alliance seeking gardens in Healdsburg and Windsor for annual tour

Next year’s SCMA Alliance Garden Tour, an annual fundraiser, will be held in Healdsburg and Windsor, and the Alliance is seeking gardens of any size to include on the tour. If you have a garden that you would like to display, or know someone who does, please contact Meta Lightfoot at alliance@scmaa.org. The tour usually takes place in May.

CMA delegates meet to discuss critical health care issues, set policy

More than 500 California physicians convened in the Disneyland Hotel in Anaheim on Oct. 11-13 for the 2013 House of Delegates, the annual meeting of the California Medical Association. Each year, physicians from all 53 California counties, representing all modes of practice, meet to debate resolutions related to healthcare policy and to elect CMA officers. Delegates at this year’s meeting:

• Approved a resolution that encourages increased reporting of patient immunizations to the California Department of Public Health for purposes of vaccination, disease control and prevention.

• Voted to support revision of HIV consent requirements to allow all health care providers to order a test for HIV when appropriate and to encourage routine HIV testing for all patients who are evaluated for other sexually transmitted diseases.

• Called on CMA to support the use of graphic image labeling on cigarette and other tobacco packaging that warns of the health impact of smoking.

• Endorsed the National Transportation Safety Board’s 2013 recommendation that the legal blood alcohol limit for operating a motor vehicle be decreased from .08 percent to .05 percent or lower.

• Directed CMA to promote that providers need to identify children and adults who are food insecure to avoid detrimental development and comorbidities and refer them to appropriate programs and services.

• Directed CMA to request that the Centers for Medicare and Medicaid Services eliminate its “outpatient patient observation” status, which is placed upon patients whose anticipated hospital stay is 48 hours or less. Delegates noted that this practice places undue financial burden on patients and creates administrative hassles for physicians.

• Called on CMA to support efforts to develop benefit designs in the health benefit exchange that appeal to the young and healthy to boost the risk pool; and to support legislation allowing federal and state income tax deductibility of all out-of-pocket health care expenses.

• Asked that CMA support legislation requiring health insurance companies to pay physicians for telephone or other electronic patient management services.

• Called on CMA to support the development of a secure, interoperable, nationwide health information exchange network.

The full actions of the House of Delegates are available to members on the Documents tab at www.cmanet.org/hod.

Message from CMA President Dr. Richard Thorp

[Dr. Thorp, a Paradise internist, was installed as CMA president during the recent House of Delegates meeting in Anaheim.]

In October, I was honored and humbled to stand before more than 400 delegate physicians from across geographies, specialties and modes of practice at the California Medical Association (CMA) Annual House of Delegates meeting in Anaheim. I want to share with you the messages I shared with our colleagues, as I believe it is important to be unified as one voice moving forward in this tumultuous time of change in healthcare.

First and foremost, we can agree that this is an incredible time to be part of our profession. We are living history as new models of integrated care and innovative technologies become a thing of the present, rather than a dream of the future. Patients will have access to treatment and medicine that they have never been exposed to, and with our work and research, we can offer our patients additional years, if not decades, with their loved ones.

Although we are at the pinnacle of discovery in the treatment of disease, this profession is also under serious attack, and so we must work more diligently than ever before. We cannot make the mistake of tempting our adversaries with complacency.

I practice in Paradise, a small town in Northern California, just a few hours outside of Sacramento. I can tell you first hand, as the medical director of a rural health clinic and as president/CEO of a private multispecialty primary care group (internal medicine, family medicine, hospitalist medicine and pediatrics), that communities like mine are feeling the changes ahead of us the most.

Between cuts to California’s Medicaid program (Medi-Cal) and the Congressional stalemate that continually threatens the future of Medicare, running a practice is a constant challenge. As attacks on California’s Medical Injury Compensation Reform Act (MICRA) continue and unknown curveballs are thrown our way, we must stand together with one voice--that is the only way that we will prevail.

My hope for us in this next year is that physicians of California remember and are inspired by how far the profession has come as we face the new challenges of the future. We live in the golden age of medicine: a time when the future of medical treatments is bright and getting brighter every day, and when we speak in unison, we have a powerful voice!

Offering safe, quality, accessible and affordable health care to our patients is why we joined this noble profession. Whatever fight may come before us this next year, let us stand and live by CMA's mission statement: Promoting the science and art of medicine, the care and well-being of patients, the protection of the public health and the betterment of the medical profession.

PEOPLE

Drs. Brad Drexler, Dan Lightfoot, Francesca Manfredi, Anthony Lim, Richard Powers and Stephen Steady represented SCMA at the recent CMA House of Delegates meeting in Anaheim (see accompanying story). During the meeting, delegates approved the following local appointments to CMA committees: Dr. Peter Bretan, a Sebastopol urologist and CMA trustee, to the Council on Ethical Affairs, the Committee on Medical Services and the Committee on Nominations; Dr. Catherine Gutfreund, a Santa Rosa family physician, to the Bylaws Committee; and Dr. Madeline Huber, a Santa Rosa ob/gyn, to the Committee on Professional Liability.

Three Santa Rosa ophthalmologists--Drs. Robert Anderson, Gary Barth and Daniel Rich--and two anesthesiologists--Drs. Kate Black and Jeffrey Kuhn--donated their services on Oct. 26 to repair the eyesight of two dozen local day laborers and agricultural workers. The patients all suffered from pterygium growths caused by overexposure to wind, dirt and sun. “Many agricultural workers suffer from pterygium growths without a convenient way to have the safe and essentially curative 30-minute surgical procedure,” said Dr. Barth. The Oct. 26 event, dubbed “Make a Difference Day,” was organized by Operation Access, which arranges medical care for uninsured patients. Dutton-Goldfield Winery is supporting the endeavor by donating 5% of the proceeds of its wine sales from Oct. 26 to Nov. 3 to Operation Access.

Thirteen physicians have joined the Annadel Medical Group, bringing the total number of doctors in the St. Joseph-affiliated group to 60. The new members include vascular surgeons Dr. Douglas Green and Dr. Douglas Jicha, internists Dr. Eran Matalon and Dr. Scott Peterson, family physicians Dr. Trienek Kylstra and Dr. Elisa Washburn, pediatricians Dr. Armanda de Pala and Dr. Laurie Doolittle, podiatrists Dr. Don Griffith and Dr. Michael Johnson, physiatrist Dr. Christie Campbell, palliative care specialist Dr. Merle Miller, and general surgeon Dr. Jeffrey Borut. About a dozen more physicians are scheduled to join the group in the next few months.

Internist Dr. Patricia Dahl, who has practiced throughout the Bay Area, has joined Healdsburg Primary Care and Healdsburg District Hospital.

Dr. Danielle Oryn, medical director of the Petaluma Health Center, is one of 32 clinicians chosen statewide to participate in the California Healthcare Foundation’s Healthcare Leadership Program. The part-time fellowship, conducted by faculty from UCLA and UCSF, helps physicians develop skills in decision making, strategic planning and administration.

At their annual Allie Awards luncheon on Oct. 23, the SCMA Alliance presented awards to Lisa Sugarman, for outstanding contribution to the Alliance, and to Gina Merwin, for outstanding contribution to the community.

MEDICAL ORGANIZATIONS

Construction has begun on an 80,000 square foot medical office center adjacent to the new Sutter Medical Center in Santa Rosa. Several tenants--including Santa Rosa Surgery Center, Santa Rosa Orthopaedics and Sutter Pacific Medical Foundation--have already signed leases for the office building, which is scheduled to open next fall, along with the new hospital.

Sonoma Valley Hospital has received a $1 million gift from the Weill Family Foundation to support the hospital’s new emergency wing, scheduled to open in December. Sandy Weill, the former Citigroup CEO who lives in Sonoma, said in a statement, “We believe having a good local hospital is essential and we want to help Sonoma create a modern emergency center that will be an asset for the entire Sonoma Valley.”

Southwest Santa Rosa may soon be home to a Kaiser Permanente medical office building, pending corporate approval. In a statement, Kaiser spokesman David Ebright confirmed that “Kaiser Permanente is currently performing due diligence as it explores the possibility of purchasing land in Santa Rosa on which to build a medical office building to serve its current and future members.” City officials indicated that the property is a 10-acre parcel near Stony Point Road.

RESOURCES AND EVENTS

The SCMA Alliance is sponsoring a holiday concert by the Santa Rosa Children’s Chorus on Sunday afternoon, Nov. 24, at the Fountaingrove Golf Club in Santa Rosa. The event, which runs from 4 to 6 p.m., includes a light buffet and beverages, along with a cash wine bar. Tickets are just $18 for adults and $10 for children. To purchase tickets, send a check by Nov. 19 to the SCMA Alliance, PO Box 1388, Santa Rosa 95402. For more details, contact Sally Ebrahim at 318-458-0955.

The Northern California Center for Well-Being has published its Fall Wellness Class Schedule to help patients improve their health. Classes cover a range of topics--from chronic conditions to healthy weight and tobacco cessation--and are held at several locations in Santa Rosa and Petaluma. Insurance plans cover most classes, and financial assistance is available. Patients can register by visiting www.norcalwellbeing.org or calling 707-575-6043.

CMA’s Institute for Medical Quality and the PACE program at UC San Diego are cosponsoring a Stepping Up to Leadership conference in San Antonio, Texas, on Nov. 7-9. The conference trains medical staff leaders in issues of communication, problem solving, and improving outcomes for patients and staff. Because of a grant from the Physicians Foundation, cost is as low as $595 for all three days. To register, visit www.physician-leadership.org.

SCMA members can get registration discounts for the Napa Primary Care Conference: Caring for the Active and Athletic Patient, to be held at the Napa Valley Marriott from Nov. 6 to 10. The conference is designed for physicians and medical professionals who care for active and athletic patients or who themselves lead such a lifestyle. Topics include common medical and musculoskeletal problems, healthy lifestyles and personal wellness. The conference offers up to 16 hours of CME. To register, visit the conference website.

The following CMA webinars are scheduled for November and December. Webinars, which are typically worth one CEU credit, begin at 12:15 p.m. and run until 1:15 or later. To register, visit www.cmanet.org. Seminars are free for CMA members and their staff; cost for nonmembers is $99 per person.

• Managing Difficult Employees and Reducing Conflict (Nov. 13)

• ICD-10 Documentation for Physicians: Part 1 (Dec. 5)

• ICD-10 Documentation for Physicians: Part 2 (Dec. 12)

• ICD-10 Documentation for Physicians: Part 3 (Dec. 19)

CLASSIFIEDS

Primary care/immediate care physicians needed

Physicians and MD medical director needed for new primary care/immediate care facilities located in Pittsburg/Antioch and San Rafael. Ideal for semi-retired MDs or if part time work desired. 6 hr shifts--7 a.m. to 1 p.m. or 1-7 p.m. Prior supervision of NP/PAs and Medi-Cal existing provider credentialing a plus. Send CV and inquires to MD@practiceconsultants.net.

SCMA members get free classifieds!

SCMA members can place free classified ads in News Briefs or Sonoma Medicine. Cost for nonmember physicians and the general public is $1 per word. To place a classified ad, contact Linda McLaughlin at Linda@scma.org or 707-525-4359.

APPLICANTS

Jeffrey Borut, DO, Surgery*, 106 Lynch Creek Way #9B, Petaluma 94954

Laurie Doolittle, MD, Pediatrics*, 1550A Professional Dr. #200, Petaluma 94954, Tulane Univ 1995

Wendy Dryden, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Virginia Univ 2013

Valerie Ebel, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Rush Univ 2013

Kareen Espino, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, UC Irvine 2013

Olivia Gamboa, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Univ North Carolina 2013

Jerald Gerst, MD, Occupational Medicine, Emergency Medicine*, Internal Medicine*, 5900 State Farm Dr., Rohnert Park 94928, UC Davis 1973

Sara Keck, MD, Medical Oncology, 101 Rowland Way #320, Novato 94949, New York Med Coll 2006

Gabriel Klapman, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, UC Los Angeles 2013

Trieneke Kylstra, MD, Family Medicine*, 4750 Hoen Ave., Santa Rosa 95405, Univ Cincinnati 1996

Toni Marie Ramirez, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Virginia Univ 2013

Georgina Ramirez-Azcarraga, MD, Family Medicine*, 401 Bicentennial Way, Santa Rosa 95403, UC Irvine 1991

Carlos Sandoval, MD, Orthopaedic Surgery*, 401 Bicentennial Way, Santa Rosa 95403, UC Los Angeles 2003

Alexandra Takayesu, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Univ Hawaii 2013

Morgan Theis, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Stanford Univ 2013

Bentley Thomason, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, UC Irvine 2013

Ashmi Ullal, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, UC Davis 2013

Elisa Washburn, DO, Family Medicine*, 500 Doyle Park Dr. #G04, Santa Rosa 95405

Tracy White, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, UC San Francisco 2013

* = board certified; italics = special medical interest

ABOUT SCMA

The Sonoma County Medical Association, a 501(c)(6) nonprofit association, supports local physicians and their efforts to enhance the health of the community. Founded in 1858, SCMA is affiliated with the California Medical Association and the American Medical Association.