April 2015

Physicians United for a healthy san diego

official publication of SDcMS april 2015

What Would medicine look like Without SdcmS-cma?

SDCMS annual report 2014page 11

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Opinions expressed by authors are their own and not necessarily those of San Diego Physician or SDCMS. San Diego Physician reserves the right to edit all contributions for clarity and length as well as to reject any material submitted. Not responsible for unsolicited manuscripts. Advertising rates and informa-tion sent upon request. Acceptance of advertising in San Diego Physician in no way constitutes approval or endorsement by SDCMS of products or ser-vices advertised. San Diego Physician and SDCMS reserve the right to reject any advertising. Address all editorial communications to [email protected]. All advertising inquiries can be sent to [email protected]. San Diego Physician is published monthly on the first of the month. Subscription rates are $35.00 per year. For subscriptions, email [email protected]. [San Diego County Medical Society (SDCMS) Printed in the U.S.A.]

VolUme 102, nUmber 4ContentSapril

features

SDCMS & SDCMS Foundation Annual Report 2014

12 MICRA GPCI Medi-Cal SGR Covered California

13 Cal Mediconnect Scope of Practice Sunshine Act Health Plans ICD-10 Practice Burdens Practice Financing Physician Workforce CPPPH

14 Military Prescription Drug Abuse Ebola Public Health Office Manager Support

15 Legislator Relations Your Physician Advocate Tangible Member Benefits Communications Events & Socials

16 Seminars & Webinars Physician Leaders SDCMS Financials Your Professional Life Residents SDCMS Membership

17 SDCMS Foundation

EDITOR: James Santiago Grisola, MD MANAGING EDITOR: Kyle LewisEDITORIAL BOARD: Sherry L. Franklin, MD, James Santiago Grisola, MD, Theodore M. Mazer, MD, Robert E. Peters, PhD, MD, David M. Priver, MDMARKETING & PRODUCTION MANAGER: Jennifer RohrSALES DIRECTOR: Dari PebdaniART DIRECTOR: Lisa WilliamsCOPY EDITOR: Adam Elder

SDCMS BOARD OF DIRECTORS

OFFICERSPRESIDENT: J. Steven Poceta, MDPRESIDENT-ELECT: William T-C Tseng, MD, MPH (CMA Trustee)TREASURER: Mihir Y. Parikh, MDSECRETARY: Mark W. Sornson, MDIMMEDIATE PAST PRESIDENT: Robert E. Peters, PhD, MD

GEOGRAPHIC AND GEOGRAPHIC ALTERNATE DIRECTORSEAST COUNTY: Venu Prabaker, MD, Alexandra E. Page, MD, Jay P. Mongiardo, MD, Alt: Susan Kaweski, MD (CALPAC Treasurer)HILLCREST: Gregory M. Balourdas, MD, Thomas C. Lian, MD, Alt: Thomas J. Savides, MDKEARNY MESA: Sergio R. Flores, MD, John G. Lane, MD, Alt: Anthony E. Magit, MD, Alt: Eileen R. Quintela, MDLA JOLLA: Geva E. Mannor, MD, Marc M. Sedwitz, MD, Alt: Lawrence D. Goldberg, MDNORTH COUNTY: James H. Schultz, MD, Eileen S. Natuzzi, MD, Michael A. Lobatz, MD, Alt: Anthony H. Sacks, MDSOUTH BAY: Reno D. Tiangco, MD, Michael H. Verdolin, MD, Alt: Elizabeth Lozada-Pastorio, MD

AT-LARGE DIRECTORSLawrence S. Friedman, MD, Karrar H. Ali, MD, Kosala Samarasinghe, MD, David E.J. Bazzo, MD, Stephen R. Hayden, MD, Peter O. Raudaskoski, MD, Vimal Nanavati, MD (Board Representative), Holly B. Yang, MD

AT-LARGE ALTERNATE DIRECTORSKarl E. Steinberg, MD, Jeffrey O. Leach, MD, Toluwalase A. Ajayi, MD, Phil Kumar, MD, Wayne C. Sun, MD, Kyle P. Edmonds, MD, Carl A. Powell, DO, Marcella M. Wilson, MD

OTHER VOTING MEMBERSCOMMUNICATIONS CHAIR: Sherry L. Franklin, MD (CMA Trustee)YOUNG PHYSICIAN DIRECTOR: Edwin S. Chen, MDRESIDENT PHYSICIAN DIRECTOR: Jane Bugea, MDRETIRED PHYSICIAN DIRECTOR: Rosemarie M. Johnson, MDMEDICAL STUDENT DIRECTOR: Spencer D. Fuller

OTHER NONVOTING MEMBERSYOUNG PHYSICIAN ALTERNATE DIRECTOR: Daniel D. Klaristenfeld, MDRESIDENT PHYSICIAN ALTERNATE DIRECTOR: Diana C. Gomez, MDRETIRED PHYSICIAN ALTERNATE DIRECTOR: Mitsuo Tomita, MDSDCMS FOUNDATION PRESIDENT: Albert Ray, MD (CMA Trustee, AMA Delegate)CMA SPEAKER: Theodore M. Mazer, MDCMA PAST PRESIDENTS: James T. Hay, MD (AMA Delegate), Robert E. Hertzka, MD (Legislative Committee Chair, AMA Delegate), Ralph R. Ocampo, MDCMA TRUSTEES: Robert E. Wailes, MD, Erin L. Whitaker, MDCMA SSGPF DELEGATE: James W. Ochi, MDCMA SSGPF ALTERNATE DELEGATES: Dan I. Giurgiu, MD, Ritvik Mehta, MDAMA ALTERNATE DELEGATE: Lisa S. Miller, MD

departments

4 Briefly Noted: Calendar Welcome New and Returning Members April Is Donate Life Month And More

6 Overweight and Obesity: Its the CarbohydratesBYJOSEPHE.SCHERGER,MD,MPH

19 Candidate Statements: 201516 SDCMS Board of Directors

26 Physician Marketplace: Classifieds

28 Picassos Sketch: It Only Takes a MinuteBYDANIELJ.BRESSLER,MD,FACP

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11

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SDCMS Seminars & Webinars SDCMS.orgfor further information or to register for any of the following SDcMS seminars, webinars, workshops, and courses, email [email protected].

Work-LifeBalanceforPhysicians(workshop)MaY 2: 9:00am12:00pm [email protected]

WorkplaceMisconductandSexualHarassment:Awareness,Prevention,andMitigation(webinar)MaY 7: 12:00pm1:00pm

GuidancetoEffectiveDisciplinaryandTerminationPractices(webinar)MaY 21: 11:30am1:30pm

SocialMediaUpdateandBestPractices:Essentialsfor2015(webinar)MaY 28: 12:15pm1:15pm

calendar

Briefly noteD

Financial&LegalLifeSkillsforPhysicians(workshop)Jun 6: 8:00am12:00pm

SDCMSWhiteCoatGala(event)Jun 13: 6:00pm11:00pm

2015ICD-10-CMCodeSetBootCamp(course)Jun 25: 8:00am5:00pm

TheLeadersToolkit(workshop)Jul 1112: 8:00am4:00pm & 8:00am12:00pm

Community Healthcare Calendarto submit a community healthcare event for possible publication, email [email protected]. Events should be physician-focused and should take place in or near San Diego county.

Controversy equalizes fools and wise men in the same way. And the fools know it.

Oliver Wendell Holmes Sr., American Physician, Poet, Professor, Lecturer, and Author (18091894)

quote of the month

SdcmS-cma memberShip

RyanA.Salahi,MDpsychiatrySan Diego(619) 692-8200

WELCOME RETURNING MEMBERS

DavidW.Fabi,MDorthopaedic SurgerySan Diego(619) 299-8500

BradleyL.Frasier,MDurologyoceanside(760) 637-2500

JosephD.Hebreo,MDnephrologyEscondido(760) 745-1551

MelissaR.Lorang,MDchild and adolescent psychiatryla Jolla(858) 694-3900

RichardA.Parker,DOGeneral practiceSan Diego(619) 229-3922

RonaldA.Zappone,MDpsychiatryla Jolla(619) 823-1697

Welcome New and Returning SDCMS-CMA Members!NEW MEMBERS

YvonneJ.Ahn,MDanesthesiologySan Diego(858) 565-9666

RonaldE.Cann,MDpsychiatrySan Diego(858) 694-3900

OlgaY.Caplin,MDpsychiatrySan Diego(619) 692-8750

MatthewF.Carroll,MDforensic psychiatrySan Diego(858) 694-3900

ThomasR.Coleman,MD,MSpublic Health and General preventive MedicineSan Diego(619) 692-8819

DawnMarieK.DeCastro,MDophthalmologySan Diego(858) 455-6800

DavidM.Dobos,MDchild and adolescent psychiatrySan Diego(619) 692-8232

DavidC.Kunkel,MDGastroenterologySan Diego(858) 657-5088

MichelleI.LozanoCamhi,MDpsychiatrySan Diego(619) 595-4400

EricaC.Niedbalec,MDinternal MedicineSan Diego(619) 713-7899

16thAnnualUCSanDiegoStrokeConference:Stroke360MaY 2 at the Skaggs School of pharmacy and pharmaceutical Sciences (cme.ucsd.edu/stroke)

AdvancesinAddictionJun 67 at the Hyatt regency in la Jolla at aventine (www.sdpscme.com)

SpineInjuriesinSportJul 15 at Scripps Green Hospital (www.scripps.org/sparkle-assets/documents/sports_medicine_seminar_2015.pdf)

CriticalCareSummerSession2015Jul 2325 at paradise point resort, San Diego (cme.ucsd.edu/criticalcare)

Pan-PacificBiomedicalInformaticsTrainingCampauG 313 at the uc San Diego biomedical research facility ii, la Jolla (cme.ucsd.edu/bioinformatics)

AdvancedTherapeuticInterventionstoOptimizeObesityandDiabetesCareSEp 2526 at the San Diego Marriott la Jolla (www.scripps.org/events/advanced-therapeutic-interventions-to-optimize-obesity-and-diabetes-care-september-25-2015)

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April is National Donate Life Month, a time when Donate Life Month or-ganizations highlight the need for life-saving and life-enhancing organ, eye, and tissue transplants and that anyone can be a hero and save lives simply by sign-ing up to be an organ, eye, and tissue donor.

That one decision could help the more than 123,000 people waiting for life-saving organ transplants in the United States. More than 22,000 of those people live right here in California.

People like Caleigh Haber of San Francis-co. She has cystic fibrosis, a genetic disease that can lead to severe lung disease, which makes breathing very difficult. She is on the transplant waiting list for a new set of lungs. But theres no guarantee shell get them.

Each day in the United States, 21 people die waiting because the organ they needed did not become available in time. Organs needed for transplant are heart, lungs, liver, kidney, pancreas, or intestine.

Tissue transplants, meanwhile, save and heal lives. Tissues for transplant include cornea, skin, heart valves, bone tissue, ten-dons, veins, ligaments, and cartilage. More than a million tissue transplants are done each year, and the surgical need for tissue has been steadily rising. Corneal trans-plants, meanwhile, restore sight to nearly 50,000 people each year.

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In 1963 The Journal of the American Medi-cal Association (JAMA) published an article from the University of Wisconsin on a novel, low-carbohydrate diet that achieved rapid weight loss (2). A young, obese Manhat-tan cardiologist named Robert Atkins read the article and tried the diet. He lost his excess weight rapidly and began using it with patients with great success. Atkins appeared on The Tonight Show in 1965, and Vogue magazine did a story on the diet, and it became known as the Vogue diet in the 1960s (3). In 1972 Atkins published his first Diet Revolution book, and the very low-carbohydrate diet rich in fats and protein become known as the Atkins diet (4). Other popular diets followed, calling themselves a modified Atkins, such as The South Beach Diet in 2003 (5).

Meanwhile, in the 1970s mainstream medicine realized that lipids were an important risk factor for cardiovascular disease, the top killer in the industrialized world. By a leap of faith and rational think-ing more than good science, the mainstream nutrition and medical community blamed dietary saturated fat for causing high cho-lesterol and launched new recommended diet programs of less fat and more carbohy-drates, especially complex carbohydrates

PUblic health

overweight anD oBeSityits the carbohydratesbyJosephE.Scherger,MD,MPH

The awareness that a low-carbohydrate diet rich in protein and saturated fat resulted in a lower body weight has a long history. In 1927 nutritionist Gayelord Hauser came to Holly-wood and helped Greta Garbo, Marlene Dietri-ch, and other stars stay lean by avoiding sugars and foods made with flour. Hauser published 19 books between 1930 and 1963, the most famous being Look Younger, Live Longer (1950) (1).

Note: The following article does not necessarily reflect the opinions of the San Diego County Medical Society.


WE ARE PLEASED TO ANNOUNCESynovation Medical Group (Pain Management)

Urgent Care (Dr. Bryan Doonan) Carlsbad Imaging Center Great Smiles (Pediatric Dentistry & Orthodontics) Price-Rite Pharmacy

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CUSHMAN & WAKEFIELD OF SAN DIEGO, INC.CA License No. 13299634747 Executive Drive, 9th Floor San Diego, CA 92121

V I S I B L E

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(43,492 CARS PER DAY )

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1 MILE from Interstate 5(202 , 572 HOUSEHOLDS

WITHIN 20 MINUTE DRIVE)

S T R AT E G I C

North Countys most affluent demographics

($98 ,614 AVG HOUSEHOLD INCOME IN A 5 MILE R ADIUS)

5 0 , 0 0 0 S F existing medical office building

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such as healthy whole grains. Starting in 1980, the overweight and obesity epidemic took off with exponential rises in these con-ditions over the next three decades.

Recent research is showing that the low-carbohydrate diet is largely correct for maintaining a healthy weight (610). Carbohydrates are the main driver of excess body fat by causing fluctuations in blood sugar that increase appetite. Increasing blood sugar causes insulin secretion that drives sugar into cells. What is not burned for energy or stored in the muscles and liver becomes stored fat through lipogenesis. Body fat is hormonally active and causes the four problems of the metabolic syndrome: dyslipidemia, elevated blood sugar, elevated blood pressure, and overweight/obesity. There is a genetic contribution to all this, but the ill effects of carbohydrate intake beyond our energy needs are universal. Excess sugar converted into fat storage reduces LDL particle size and stimulates inflammatory changes in blood vessels, leading to atherosclerosis (6). Replacing fat with carbohydrates, especially grain-based foods, has coincided with an increase in calories consumed (9, 10). Carbohydrates are best obtained from vegetables and whole fruits. Eating more saturated fat and protein reduces hunger and results in fewer calories consumed, the key to the success of low-carbohydrate diets.

Two academic nutrition scientists, Jeff Volek, PhD, RD, and Stephen Phinney, MD, PhD, have gathered the science around the low-carbohydrate diet in their book for professionals, The Art and Science of Low Carbohydrate Living (9). Their work and that of others has vindicated the approach taken by Robert Atkins that saturated fat should be a mainstay of a healthy diet. Eat-ing saturated fat from natural sources such as tree nuts, avocadoes, eggs, meat, and fish reduces hunger and overall calorie intake,

8 april 2015

resulting in lower body fat.Volek and Phinney have also triggered a

trend among high-performance endurance athletes to move away from carbohydrate loading and sweetened energy drinks. They show that a ketogenic diet of steady fat burning will improve performance over burning a temporary supply of carbohy-drates (11). Humans are not like hybrid cars readily able to convert from one energy source to another; in our case, from carbo-hydrate to fat burning. If athletes depend on carbs for energy, there is a drop in energy and muscle cramps when they run out. No more pasta before events eat the steak! Drink water rather than sweet energy drinks and gels and get necessary salt, fat, and pro-tein during long events such as a marathons

PUblic health

The dominant cause and

solution to the overweight and

obesity epidemic remains

hidden in plain sight: Its the

carbohydrates.

and ultramarathons, triathlons, bicycle races, and hiking.

Mens professional tennis is a grueling sport, especially in major events that can go to five sets and over four hours. Of the leading male tennis professionals, Novak Djokovic follows a very low-carbohydrate diet and relies on fat burning during performances (12). Interestingly, in the 2015 Australian Open, the semifinal had Djokovic facing defending champion Stan Wawrinka in a match that went five sets. The score in the final set was Djokovic 60. In the final, Djokovic faced Brad Murray in a four-set match. The score in the final set was Djokovic 60. What role did diet play in this success?

My story is revealing. I started running

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marathons at age 29 and was lean and fit with a 32-inch waist. I stopped running long distances after a few years, and, as someone who loved breads and muffins, my waist increased to 36 inches and my weight went to 192 from about 160. At age 46 my total cholesterol was 211 and my HDL cholesterol was only 37. I returned to running mara-thons and was able to get my weight down to 180 with a total cholesterol of 175 and an HDL of 52. I was happy but my waist was still 36. At age 62 I read Wheat Belly by Dr. William Davis and gave up the grains. In four months my weight was 160, my waist 32, and my total cholesterol was 152 with an HDL of 69. I am running marathons and half-marathons faster than any time in the past 10 years. Best yet, I feel much younger, have very little of the old appetite, and stay awake and alert in the afternoon and even during an evening symphony.

The dominant cause and solution to the overweight and obesity epidemic remains hidden in plain sight: Its the carbohydrates. The food industry flourishes on selling foods made with flour and sugar. These food commodities are the easiest to pack-age and store, and hence result in greater

PUblic health

profits. The food industry also funds major health organizations, nutritional research institutes, and federal agencies that provide dietary recommendations, resulting in much inertia to change (13, 14).

Countering the status quo of boxes of high-carbohydrate foods lining our super-market aisles is a growing worldwide real-ization that eating the food that nature has provided for millions of years is better for us than the more recent breads and processed foods. The Paleo Diet was introduced in 1975 and is becoming a new fashion whether people understand the nutrition behind it or not (15, 16). French physician Pierre Dukan has been promoting a low-carbohydrate diet for more than 30 years, and the Dukan Diet is increasingly popular in Great Britain and France (17).

Walter Willett of the Harvard School of Public Health has been vocal that fat is not the problem and evidence does not support the recommendation against eating less saturated fat, and that excess carbohydrates are to blame for obesity, diabetes, and other metabolic diseases (20, 21). A growing num-ber of physician innovators are using the evidence about carbohydrates to educate

Scientists tend to ignore research findings that might threaten the existing paradigm and trigger the development of new and competing beliefs.


10 april 2015

the public, including William Davis (12, 18), David Perlmutter (19), and Mark Hyman, physician advisor to Bill Clintons nutri-tion advisor who was recently hired by the Cleveland Clinic to lead a new Functional Medicine Institute (20).

Paradigm changes in science and medicine happen slowly. Thomas Kuhn observed that normal science is predi-cated on the assumption that the scien-tific community knows what the world is like, and scientists take great pains to defend those assumptions. Scientists tend to ignore research findings that might threaten the existing paradigm and trigger the development of new and competing beliefs. Changing a scientific paradigm only happens through discovery brought on by repeated encounters with anomaly (21). The paradigm around what is a healthy diet is changing from a low-fat to a low-carbohydrate diet rich in natural fats and proteins.

Dr. Scherger, 34-year member of SDCMS-CMA, is vice president, primary care, and Marie E. Pinizzotto, MD, chair of academic affairs at the Eisenhower Medical Center in Rancho Mirage.

References:1. Gayelord Hauser. Wikipedia.org. Accessed

Feb. 5, 2015.2. Gordon ES, Goldberg M, Chosy GJ. A New

Concept in the Treatment of Obesity. JAMA. 1963;186(1):156-166.

3. Wikipedia, Robert Atkins. Accessed Feb. 5, 2015.

4. Atkins RC. Dr. Atkins Diet Revolution. Ban-tam Books. 1972.

5. Agatson A. The South Beach Diet. St. Martins Press. 2003.

6. Bazzano LA, Hu T, Reynolds K, et al. Ef-fects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial. Ann Intern Med. 2014;161:309-318.

7. Chowdhury R, Warnakula S, Kunutsor S, et al. Association of dietary, circulating, and supplement fatty acids with coro-nary risk; A systemic review. Ann Int Med. 2014;160(6):398-406.

8. Siri-Tarino PW, Sun Q, Hu FB, et al. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010;91(3):535-546.

9. Volek JS, Phinney SD. The Art and Science of Low Carbohydrate Living. Beyond Obesity, LLC. 2011.

10. Jakobsen MU, Dethlefsen C, Joensen AM, at al. Intake of carbohydrates compared with

intake of saturated fatty acids and the risk of myocardial infarction: Importance of the glycemic index. Am J Clin Nutr. 2010;91:1764-1768.

11. Volek JS, Phinney SD. The Art and Science of Low Carbohydrate Performance. Beyond Obesity, LLC. 2012.

12. Davis W. Wheat Belly. Rodale. 2011.13. Campbell TC, Jacobson H. Whole: Rethink-

ing the Science of Nutrition. BenBella Books, 2013.

14. Minger D. Death By Food Pyramid. Primal Blueprint Publishing, 2013.

15. Voegtlin WL. The Stone Age Diet. Vantage Press, 1975.

16. Cordain L. The Paleo Diet. John Wiley & Sons, 2002, 2011.

17. Dukan Diet. Wikipedia.org, Accessed Feb. 18, 2015.

18. Davis W. Wheat Belly Total Health, Rodale, 2014.

19. Perlmutter D. Grain Brain. Little, Brown and Co. 2013.

20. Townsend A. Cleveland Clinic to open Center for Functional Medicine; Dr. Mark Hyman to be director. Cleveland Plain Dealer. www.cleveland.com/healthfit/index.ssf/2014/09/cleveland_clinic_to_open/cente.html

21. Kuhn TS. The Structure of Scientific Revolu-tions. University of Chicago Press. 1962.

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The annual San Diego County All Physician Directory lists contact information for every physician in the county. It is mailed to all 8,800+ San Diego County physicians free of charge. This digest sized directory is a go-to resource for physicians and their office staff.

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2014 SDCMS annual rEport

pHYSicianS unitED for a HEaltHY San DiEGo

WE SAvED MICRA AT THE BALLOT BOx

WE STOppED THE MEDI-CAL CLAWBACk

WE pERMANENTLy ELIMINATED GpCI

12 MarcH 2015

MEDI-CAL

CMA eliminated the 10% Medi-Cal clawback in 2014, saving Medi-Cal providers $42 million.

CMA held off a 10% across-the-board Medi-Cal cut for three years.

CMA secured $41 million to provide technical assistance to Medi-Cal providers to implement EHRs and achieve meaningful use.

CMA created a members-only Medi-Cal Survival Toolkit to help physicians understand the impact the Medi-Cal changes would have on their practices.

CMA collected Medi-Cal access-to-care horror stories to demon-strate Medi-Cal network inadequacy and hindered access to continuous, quality care.

WE FINALLy GOT RID OF THE SGR

After a decade of frustration with 17 last-minute postponements and kicking the can down the road band-aids, the Senate (928) and the House (39237) overwhelmingly passed HR 2 in April 2015. This bipartisan Medicare SGR Payment Reform and Chil-drens Health Insurance Program (CHIP) Re-authorization Act will, among other things: Repeal the SGR and obviate in perpe-

tuity any pending across-the-board Medicare cuts;

Provide 0.5% increases in Medicare each year for four years;

And, in 2019, physicians can choose to participate in one of two payment track options:1. Fee-for-Service Track: Simplifies

and consolidates the existing qual-ity reporting programs, reinstates large bonuses up to 9% and reduces current penalties.

2. Alternative Payment Model Track: Provides 5% bonus payments and allows physicians to develop the new models, such as primary care / specialty medical homes.

HELpING yOU & yOUR pATIENTS NAvIGATE COvERED CALIFORNIA

CMA secured the enactment of SB 964, requiring Medi-Cal managed care plans and insurers offering individual plans through Covered California to provide annual reports to the Department of Managed Health Care (DMHC) about the adequacy of their provider networks and to publicize those reports.

SDCMS and CMA conducted 14 semi-nars and webinars on various Covered California topics.

CMA created a Covered California tool-kit and resources webpage, tip sheets for the first four months, a preparing for 2015 changes guide, patient FAQs, a physician participation lookup tool, an understanding the grace period guide, and physician and Know Your Partici-pation Status guides.

SDCMS produced a matrix to help members answer questions like Am I contracted to see Covered California patients? and How do I check my participation status with these plans? SDCMS provided Covered California implementation assistance for numer-ous member practices.

WE SAvED MICRA AT THE BALLOT BOx

On Nov. 4, 2014, 68% of Californians 72% in San Diego voted No on Prop. 46. Never a foregone conclusion, the rejection of Prop. 46 required a massive expenditure of more than $60 million, with CMAs initial $5 million pledge convincing coalition partners to join and contribute. SDCMS, for its part, worked with local hospital medi-cal staffs and medical groups to alone raise nearly $1 million. In addition, your SDCMS and CMA assembled an exceptional campaign team, built one of the largest, most diverse coalitions in Californias history, conducted extensive polling and focus groups, and ran flawless air and ground games. Ask yourself: What would your practice look like if we hadnt spent $60 million?

WE pERMANENTLy ELIMINATED GpCI

In 2014 we finally resolved San Diego Countys Geographic Practice Cost Index (GPCI) inequity re-turning to San Diegos physicians the roughly $100 million per year taken from them for more than a decade, equating to $12,500 per year per doctor practice on average! Due to a political compromise, the GPCIs per-manent elimination will be phased in over six years, starting in 2017, but the issue itself has at last been put to rest.


Drs. Ted Mazer and Bob Hertzka present Congressman Darrell Issa with an honorary SDCMS membership certificate for his work in helping eliminate GPCI.


CAL MEDICONNECT RESOURCES

SDCMS and CMA produced San Di-ego-specific sample letters for patients, conducted four Cal MediConnect seminars and webinars, produced an extensive FAQ document, and SDCMS devoted its December 2014 issue of San Diego Physician to Cal MediConnect: Is There a Doctor on Board?

STOppING UNSAFE SCOpE ExpANSIONS

CMA defeated an optometry scope-of-practice expansion attempt.

CMA defeated AB 2015, thereby precluding alternative practitioners such as naturopaths from indepen-dently practicing medicine.

DISpUTING SUNSHINE ACT DATA

SDCMS and CMA assisted and con-tinue to assist members in disputing incorrect Sunshine Act data on their financial interactions with manufac-turers of drugs and medical devices.

pOLICING THE HEALTH pLANS

CMA secured a court ruling obligating health plans to take responsibility for payment when they irresponsibly delegate risk.

CMA sponsored AB 2400 to ban so-called all-payor clauses.

CMA prompted the U.S. DHHS to require the California DHCS to change its payment methodology to ensure California physicians get the full benefit of the ACA primary care increase.

CMA urged UHC to delay imple-mentation of its premium desig-nation program to allow time to address serious deficiencies.

At CMAs urging, Anthem fixed in-correct patient ID cards that resulted in claim denials.

CMA urged UHC to make changes with its physician rating and tiering program.

ICD-10 RESOURCES FOR MEMBERS

ICD-10 implementation orientation webinar

five pre-recorded ICD-10 planning webinars

eight ICD-10 webinars in partnership with the Alameda-Contra Costa Medical Association

MITIGATING pRACTICE BURDENS

CMA sponsored AB 1755, signed by the governor, to reduce administra-tive burdens on providers and health facilities when medical information is breached, while ensuring accurate notification to patients.

pRACTICE FINANCING / REIMBURSEMENT

CMA defeated AB 2533, which would have prohibited noncontracted provid-ers from billing for services in excess of in-network reimbursement rates.

MONITORING SAN DIEGOS pHySICIAN

WORkFORCE

SDCMS published the results of its sixth biennial San Diego County Physi-cian Workforce and Compensation survey in 2014, a critically important gauge of physician workforce trends in San Diego County that we can take to our legislators.

CpppH WORkING TOWARD pHySICIAN WELLNESS

California Public Protection and Physician Health (CPPPH), estab-lished in 2009, continued to provide consultation, coordination, education, and network-building for physician providers in 2014, as well as policies and procedures for physician health committees. Regional workshops, in-cluding one hosted every four months by the SDCMS Foundation, connect medical staff and medical group well-being committee members in 39 of Californias 51 counties. Together with coalition partners, CPPPH has also developed guidelines, including how to address the late career physician, and is working on one about dealing with the disruptive physician. CPPPH will soon be addressing things like burnout that put physicians, their practices, and ultimately their patients at risk. Much more information is available at www.CPPPH.org.


Is There a DocTor on BoarD?

official publication of SDcMS December 2014

Cal MediConnect


official publication of SDcMS April 2014

2013 SDCMS Physician Workforce &

Compensation Survey


14 MarcH 2015

MILITARy

We devoted our May magazine to Navy medicine in San Diego.

FIGHTING pRESCRIpTION DRUG ABUSE

SDCMS hosted a CURES sign-up event on Feb. 28, 2014, signing up more than 60 physicians and saving them valuable time.

CMA Created a Members-only Resource: A Physicians Guide to Implementation of SB 866: The New Standardized Prescription Drug Prior Authorization Form

Under the aegis of SDCMS, the San Diego and Imperial County Pre-scription Drug Abuse Medical Task force developed a patient medication agreement (endorsed by SDCMS, HASDIC, and the County of San Diego), saw its Safe Pain Medication Prescribing in Emergency Depart-ments project duplicated in Los Angeles, Ventura, and Orange coun-ties (with awards from the California Hospital Association and National Association of Counties), and helped convince the San Diego Department of Public Health to implement a has-sle-free CURES registration system without the notary requirement.

SDCMS CONvENES pHySICIAN

LEADERS TO DISCUSS EBOLA

On Oct. 20, SDCMS convened nearly 100 chiefs of staff, representatives from the County, politicians, and other infectious disease specialists to discuss Ebola, to share preparation plans for an Ebola patient, and to ask questions of each other. SDCMS GERM Commis-sion San Diego Countys infectious disease leaders continues to address the disease from a clinical perspective.

pROTECTING THE pUBLIC HEALTH

CMA sponsored legislation to re-quire all sugary drink bottles, cans, vending machines, dispensers, and restaurateurs to display a warning.

CMA joined a coalition seeking to increase the tobacco tax by $2 by the end of 2016.

SDCMS kept physicians up to date on 2014 outbreaks: influenza in Jan. and Nov., measles in Feb. and March, wound botulism in March, meningococcal disease in April, MERS, pertussis, tattoo-associated skin infections, and mercury poi-soning in May, pertussis again in June, chikungunya in July, pertussis again in August, enterovirus D68 in September and October, and dengue in November.

SUppORTING yOUR OFFICE MANAGER

SDCMS online office manager forum enables member office man-agers and practice administrators to build a community of mutual support in order to get answers to practice management questions, share best practices, stay abreast of upcoming deadlines, and much more!

Congratulations to Sheila Hendry, PhD, SDCMS 2014 Office Manager of the Year! Sheila was nominated by Wendy M. Buchi, MD, SDCMS-CMA member since 1995, of IGO Medical Group.

SDCMS published the results of its 2013 SDCMS Medical Office Salary Survey in 2014.



official publication of SDcMS May 2014

navy MeDicineSan Diego

in

San DiEGo pHYSician.orG 1 5

CULTIvATING STRONG

LEGISLATOR RELATIONS

SDCMS physician leaders, medical students, and staff traveled to Sacra-mento and Washington, DC, again on several occasions in 2014 to build and maintain strong personal relation-ships with all of our state and federal legislators.

yOUR SDCMS pHySICIAN ADvOCATE AT WORk

Ask Your SDCMS Physician Ad-vocate: In 2014, your physician advocate, Marisol Gonzalez, solved more than 480 member practice problems and

saved them more than $250,000! Ex-amples include prevailing upon CMS to issue a member physician her $12,000 EHR incentive check, pressuring a health plan to issue checks totaling $2,000 owed to a member group, help-ing a member group having difficulty credentialing a new physician, and ensuring a solo member obtained his 0.5% PQRS incentive.

BRINGING yOU TANGIBLE MEMBER BENEFITS

More than 998 SDCMS physicians saved nearly $354,325 with The Doc-tors Company, SDCMS endorsed professional liability carrier, which offers a 5% members-only discount on professional liability insurance.

Our Twitter feed continues to deliver a daily treasure trove of healthcare news to physicians smartphones.

SDCMS created, for members only, a line-by-line analysis of Covered California agreements for Blue Shield, Health Net, Molina, and Anthem Blue Cross.

SDCMS compiled a members-only report of average office and medical staff salaries.

COMMUNICATING TO, FOR, AND FROM pHySICIANS

12 Monthly Magazines to 9,000+ Physicians

26 E-newsletter Blasts (News You Can Use) to 9,000+ Recipients

SDCMS EvENTS & SOCIALS

Our 2014 White Coat Gala installed J. Steven Poceta, MD, as SDCMS president for 201415 and recognized Robert E. Peters, MD, PhD, as SDC-MS president for 201314. More than 200 people attended, including U.S. Representative Susan Davis, Senator Mark Wyland, Assemblymembers Brian Jones and Lorena Gonzalez, and Supervisor Greg Cox.

Physicians of Exceptional Excel-lence Top Doctors: More than 1,600 physicians participated in the 2014 selection of San Diegos Physi-cians of Exceptional Excellence and 775 were selected, the largest number of Top Doctors ever. The Gala took place on Nov. 1 at the Birch Aquarium, with more than 600 attendees the largest number of attendees to date.

SDCMS held three physician mixers in 2014 (April, July, and September) all rousing successes; the La Jolla social had more than 80 physicians in attendance!


16 MarcH 2015

SDCMS & CMA SEMINARS & WEBINARS

We conducted more than 60 members-only seminars and webinars in 2014, covering ACOs, Cal MediConnect, contract negotiations, HIPAA, ICD-10, meaningful use, Medi-Cal, Medicare, OSHA, myriad practice management topics, risk management, workers compensation, and more!

SDCMS pHySICIAN LEADERS

Dr. Horacio Rodiles, SDCMS-CMA member since 1973, was appointed to the United States-Mxico Border Health Commission.

Theodore M. Mazer, MD, was elected Speaker of CMAs House of Delegates in 2014.

Robert E. Wailes, MD, was elected vice chair of CMAs Board of Trust-ees in 2014.

UC San Diegos Commencement and White Coat ceremony processions were led by SDCMS president, J. Steven Poceta, MD.

SDCMS presented at 27 hospital general staff and medical executive meetings in 2014.

53 SDCMS physician leaders at-tended CMAs House of Delegates in 2014, held in San Diego.


MAkING yOUR pROFESSIONAL LIFE EASIER

SDCMS offered a number of profes-sional development workshops for members in 2014, including workshops on advocacy training, medical coding, financial and legal life skills, media training, taming Microsoft Outlook, leadership training, and work-life balance.

RESIDENT pHySICIANS

SDCMS held its annual all-day Preparing to Practice workshop on Feb. 1, 2014, helping almost 100 resi-dent and young physicians establish their post-residency careers.

CMA was instrumental in secur-ing $7 million for primary care residency slots in the 201415 state budget frustrating the argument that Californias physician short-age should be met by expanding the scope of practice of allied health professionals.

SDCMS FINANCIALS

13%governance

26%Infrastructure

5%Foundation

5%advocacy

22%Communication

12%Benefits

6%physician Database

11%physician

engagement

Rent: 11%Credit Card/Bank Charges: 1%Insurance: 1%Miscellaneous expenses: 3%Telephone: 2%Staff Time g&a: 8%

17%advertising & Sales

15%Investments

4%CMa

Commissions

8%Foundation

56%Dues

ExpENSES INCOME

SDCMS MEMBERSHIp INCREASES FOR THE 13TH yEAR IN A ROW!

Affiliate Members: 8Government Members: 155Regular Members: 2,785Leave of Absence Members: 132014 TOTAL: 2,961

Student Members: 393Resident Members: 948TOTAL: 1,341

GRAND TOTAL: 4,302

Retired Members: 720

20

02: 2,029

20

03: 2,056

20

04

: 2,163

20

05: 2,195

20

06

: 2,390

20

07: 2,419

20

08: 2,562

20

09

: 2,578

20

10: 2,652

20

11: 2,670

20

12: 2,683

20

13: 2,813

20

14: 2,961Dr. Mazer

Dr. Wailes

SDCMS Physician Leaders


Since 2008

Improving Health

Changing Lives

$8.9 Millionin donated care thanks to Physicians,Hospitals, Surgery Centers & Ancillary

Healthcare Providers

94%Reduction inWork Days

Missed

902Surgeries

and GIProcedures

9,444Specialty

HealthcareAppointments

2,798+Patients with

ImprovedHealth

88%Reduction inEmergencyDepartment

Visits

22LivesSaved

2 0 1 4 A N N U A L R E P O R T

P R O J E C T A C C E S S

20

02: 2,029

20

03: 2,056

20

04

: 2,163

20

05: 2,195

20

06

: 2,390

20

07: 2,419

20

08: 2,562

20

09

: 2,578

20

10: 2,652

20

11: 2,670

20

12: 2,683

20

13: 2,813

20

14: 2,961

18 MarcH 2015

Celebrating Ten10 Years of Service toOur Community

San Diego County Medical Society Foundation


Notes: (Inc.) After Name = Incumbent Number in Parentheses (#) After Name = Term Length in Years

offiCerS

President-elect:MihirY.Parikh,MD(1) It is a privilege to ask for your support as I run for president-elect of the San Diego County Medical Society. I have been serving

on the SDCMS board for the past nine years, holding various titles along the way, includ-ing young physician delegate, secretary, and treasurer. This election cycle I am running for the president-elect position. I believe in the SDCMS mission to uphold the principles behind Physicians United for a Healthy San Diego. To be united, we need to have a robust membership of many physicians over many modes of practice over the entire county of San Diego. This large member-ship will allow us to represent the doctors voice in delivering quality healthcare in San Diego. This voice needs to be heard through advocacy and at public health events. In the past nine years, I have clearly seen that we have far greater influence when we speak together than when we opine as individu-als. If we cannot carry this influence and demonstrate our relevance, then healthcare

will continue to evolve but without us. I pledge to work on building membership, promoting advocacy, and making San Diego the finest and healthiest city.

Secretary:MarkW.Sornson,MD(1) It is a privi-lege to again ask for your support as I run for secretary of SDCMS. I have served as at-large director for four years, three years

as a representative on the Executive Com-mittee, seven times as a CMA delegate or alternate delegate representing San Diego, and two years on the Insurance and Physi-cian Reimbursement Reference Committee for CMA. Previously, I chaired the CMA Young Physicians Section and authored a successful resolution.

Through these experiences I have seen firsthand that when a medical society speaks with a unified voice and builds rela-tionships, we can make a difference. I was a spokesperson for last years No on 45 CMA campaign, and it was a true pleasure to be a part of that successful advocacy effort. When physicians come together, they are listened to. As secretary, I will continue to be a voice for reasoned discussion, repre-senting all physicians. Ive greatly enjoyed my service on behalf of SDCMS and CMA, and I am honored to ask for your vote to continue.

Treasurer:DavidE.J.Bazzo,MD(1) Ive had the privilege to serve on the SDCMS board of direc-tors since 2009. During this time, Ive seen what advocacy through

organized medicine can accomplish. This past year, the board elected me to serve as its representative to the Executive Committee, allowing me to learn more about the inner workings of our wonderful association. SDCMS is second to none when it comes to representing the needs and interests of phy-sicians in advocating to optimize our ability to help our patients.

The politics of our state and nation have enormous impact on our capacity to keep our patients healthy, safe, and to keep cost controlled. This could not have been more evident than with the defeat of Prop. 46 (MICRA initiative) last year. These events dont happen by accident. As with any process, unless you have a seat at the table, your opinion is not heard. Well, through the work of your county and state medi-cal societies, your voices are heard. Your interests are represented.

The members of the board do have influ-ence and work on your behalf to ensure that physicians have a say in the future practice of medicine. I am proud of my membership and position on the board, and view it as an honor to volunteer to help our organiza-tion. I ask that you continue to place your trust in me to serve our organization by supporting my election as treasurer. Thank you.

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geographiC DireCtorS

LaJolla#1:GevaE.Mannor,MD,MPH(Inc.)(3) I am honored to be considered as one of your La Jolla representa-tives to SDCMS. Since 2002, I have been performing

oculoplastic surgery in the ophthalmology division at Scripps Clinic Medical Group. I obtained my MD at Northwestern and an MPH at Harvard, followed by a residency in ophthalmology at Mount Sinai Hospi-tal, New York, and a fellowship at Yale. I have practiced in various types of clinical settings like academic university depart-ments, VA hospitals, British National Health Service (Moorfields Eye Hospital, London, U.K.), and a U.S. HMO. I am aware of the challenges that todays physicians face. I plan to advocate for my fellow San Diego county colleagues and improve their ability to practice medicine.

EastCounty#2:Alexandra(Alexe)E.Page,MD(Inc.)(3) Serving for three years on the SD-CMS board of di-rectors has offered me the chance to build relationships

with other San Diego County physicians, understanding and representing their views as a delegate to the California Medical As-sociation. I have used the opportunity to transcend specialty interests and work on a united physician voice defining how health-care will evolve.

My knowledge and experience in health systems have evolved from serving as a member and now chair of the Health Care Systems Committee of the Orthopaedic Academy (AAOS). But regardless of spe-cialty or practice environment, paradigms of healthcare delivery from patient-cen-tered medical homes, to ACOs, to bundled payments can change the patient-doctor relationship. Physicians can protect the

care we give our patients by proactively defining how these new healthcare models will evolve in our community. Lessons learned through my specialty academy help guide recommendations and direction for all San Diego physicians.

A cum-laude graduate of Harvard Medi-cal School, after residency in New York I joined Kaiser Permanente in San Diego and have practiced orthopaedics here since 1998. As a member of the SDCMS board of directors, I hope to continue communica-tion among physicians of all disciplines to enhance consensus-building and present a stronger front to other stakeholders in the healthcare system.

SouthBay#2:MichaelH.Verdolin,MD(Inc.)(3)

sdcms elections


NorthCounty#3:MichaelA.Lobatz,MD(Inc.)(3)

NorthCounty#1:PatrickA.Tellez,MD,MPH,MSHA,CMO,NorthCountyHealthServices(3) One of the main goals of healthcare reform has been to

decrease medical costs and the uninsured. While the ACA has afforded many access to basic primary care, we now face the pros-pect of having expanded enrollment into the same system we sought to change before having established financing and payment

reforms designed to support sustainability.Increases in clinical demand and patient

volume will naturally increase health expenditures and expose professional reimbursement as a potential expedient solution to fiscal challenges.

Our opportunity is to lead the discus-sion and implementation of effective management of economic pressures on reimbursement in order to meaningfully impact issues such as contracted physician network inadequacy, physician workforce shortage, and sustainable solutions to pay-ment reform.

Sustaining our Medicare and Medicaid systems as well as our underfunded public health systems will require modification of both financing and delivery of healthcare to meet commonly accepted standards of care and emerging expectations of ac-countability for quality and service.

While success will require hard work, we, as physicians, are aptly qualified to lead that change. As director, I would be privileged and honored to become part of the team effort to facilitate the Societys vision for the future.

geographiC alternate DireCtorS

NorthCountyAlternate#1:NeelimaV.Chu,MD(3) I am honored to be a candidate for SDCMS alternate delegate. I am cur-rently practicing endocrinology and

metabolism at Sharp Rees-Stealy Medical Group (SRSMG). I have been at SRSMG for four years. Prior to that, I was in private practice for nine years in Chula Vista. I continue to serve as a voluntary assistant professor at UCSD, Department of Endo-crinology. I have had the privilege to par-ticipate in the Sharp Leadership Academy. The lessons learned are helping me greatly as the current chief of endocrinology.

I am interested in ensuring that physi-cians have a voice in the future direction of healthcare and that patients have the ability to access a healthcare system that

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can effectively meet both their primary and specialty care needs.

EastCountyAlternate#1:SusanKaweski,MD(Inc.)(3)

at-large DireCtorS

#1:ThomasJ.Savides,MD(2) I gradu-ated from UCSD School of Medi-cine in 1987 and have been a UCSD faculty member in the Division of Gastroenterology

since 1993. My clinical specialty is using

advanced endoscopic procedures for man-agement of GI track cancers, pancreatico-biliary disease, and challenging colon polyps. Clinical research interests have included GI bleeding, application of endo-scopic ultrasound procedures, combined endoscopic surgical procedures, and pan-creatic cystic lesions. I have been active in teaching medical students, residents, and fellows, and served as the training direc-tor for the UCSD GI Fellowship Program. I also served in various leadership positions at UCSD, including GI Clinical Services chief, chair of the Health Sciences Faculty Council, and as a member of the Medi-cal Group Board of Governors. In 2014 I became the chief experience officer for UCSD Health System and am responsible for strategy, leadership, and implementa-tion surrounding the improvement of the total healthcare experience of patients, families, providers, and staff. It is my privilege to serve the members of the San Diego County Medical Society.

#2:KarrarH.Ali,DO(Inc.)(3) I am honored to run for the board of the San Diego County Medical Society again. As an emer-gency physician at Sharp Chula Vista Medical Center

and full partner with California Emergency Physicians (CEP), I am a change agent who seeks to improve medicine at micro and macro levels for our patients, healthcare providers, administrators, and communi-ties. I hold several committee positions at the hospital that focus on efficiency and team-building, as well as being the advo-cacy lead at Sharp.

As an emergency physician, I feel the failure of the healthcare system every day, especially after the Affordable Care Act. While Washington and Sacramento have worked in getting Americans coverage, there are still many holes to fill. And until these holes are filled, I feel the despair of patients who have nowhere to turn because

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their primary physician is not accepting their plan or that they have to wait until af-ter they die before getting to see a special-ist. I feel the frustration of doctors unable to refer their patients or unable to deliver adequate care with the emergency de-partment being the only hope for helping their patients. The impact of this failure is overcrowded hospitals, stress on health-care providers, and continued cost-cutting pressures by administrators.

I believe that the only way we can save our healthcare system is for physicians to be informed and involved advocates, both locally and nationally. My goal as a board member is to advocate our position by educating other San Diego physicians and our representatives in Sacramento. I would specifically like to improve emergency ser-vices and advocate access to primary care.

I thank you for your support.

#4:James(Jim)H.SchultzJr.,MD,MBA,FAAFP,DiMM(3) Jim Schultz is a family physi-cian who practices at Neighborhood Healthcare, a Federally Qualified

Community Health Center serving about 70,000 of the underserved and medically needy. He sees outpatients in Escondido, Pauma Valley, and Temecula, and inpa-tients as part of the California Emergency Physicians hospitalist program. He has been chief medical officer of Neighborhood Healthcare since 2001, and is currently the medical director of the Council of Com-munity Clinics and of Project Access San Diego.

Prior to his role at Neighborhood Healthcare, Jim was medical director and practicing physician at Graybill Medical Group in Escondido, where he began his professional career in 1988. His goals at SDCMS include fairly representing the in-terests of the physicians of North County, and bringing in the voice and perspec-tive of those physicians whose practice is predominantly that of the underserved. He is also a volunteer clinical professor at UCSD in the Department of Family and Preventive Medicine and hosts the Family Medicine Residency PGY-1 Outpatient Gynecology rotation.

#7:Toluwalase(Lase)A.Ajayi,MD(3) I have been involved with the San Diego County Medi-cal Society since I moved to San Diego for fellowship in 2012, but I have

been active in medical organizations since I was a medical student. As a pediatrician, I have previously and currently serve on several executive committees within the American Academy of Pediatricians, and serve as a young physician liaison to the American Medical Association. As a fel-lowship-trained palliative care physician, I make sure that I am an engaged member of the American Academy of Hospice and Palliative Medicine and serve on several committees.

I am diligent in my work and leader-ship within the AAHPM, AAP, and AMA because of my dedication to serving as an advocate for patients who are underrepre-sented and/or who may not be able to ad-vocate for themselves. As a palliative care physician and pediatrician, I am fortunate to be able to work with a large variety of physicians within my different practices.

It would be an honor to have a seat on the board of SDCMS so that I may serve on behalf of all physicians, and I ask for your support. I will be dedicated to you so that we may all continue to be in a position to advocate and provide the best care possible to our patients. I believe progress cannot happen at just one level, but involves col-laborating with people at different levels who believe in the continued improvement of healthcare for the patient, the practitio-ner, and the system.

at-large alternate DireCtorS

#2:StevenChen,MD(1) It is an honor to be considered for a position on the SDCMS board of directors. Although a recent transplant to San Diego, the impor-tance of organized medicine to our ability to function as a profession is not new to me. After faculty positions as the chief of breast surgery at UC Davis, and associate program director of the Surgical Oncology Fellow-ship at City of Hope in Los Angeles, and serving on the board of the county medical societies in Sacramento and Los Angeles, I have recently started an independent surgical oncology practice here with offices in Mira Mesa and Encinitas, with privileges in both the Scripps and Sharp systems.

Having been in academic faculty, an employed surgeon in a foundation model,

sdcms elections

24 april 2015

and now an independent surgeon, I have experienced the breadth of all practice modes and feel that I am well qualified to ensure that the needs of all of these groups are considered in everything that SDCMS does.

I have been fortunate to have served nationally in a number of organizations, including being on the board of the Ameri-can Society of Breast Surgeons and recently completing terms on the Young Physicians Section Governing Council of the AMA, as well as the executive council of the Young Fellows Association of the American Col-lege of Surgeons. I continue to serve on the legislative committees of the American College of Surgeons and the American Society of Breast Surgeons and thus stay up to date on the issues facing the professional practice of medicine.

I fully believe that if we do not defend the profession and act in a professional way, we will lose the right to be a profession. SD-CMS and organized medicine are key links to ensuring that being a physician contin-ues to mean being a professional. I ask for your support to allow me to help represent you and your concerns.

#3:ErinL.Whitaker,MD(3)

VotingEndsatNoononTuesday,May5

*sdcms elections

young phySiCian DireCtor

EdwinS.Chen,MD(Inc.)(1) Healthy and happy physicians take better care of healthy and happy patients. In the dramatically changing health-care landscape,

SDCMS provides a meeting place and a launching platform from which we can ad-vocate for ourselves and our patients. New physicians often find themselves immersed in a healthcare world they never imag-ined. I have had the honor and privilege of serving as the young physician director for the past year, and it has been a won-derful experience. As a young physician who recently started a solo practice, I look forward to collaborating with all of you in sharing our knowledge and experience so that we can better advocate for the medical community and the patients that we serve.

young phySiCian alternate DireCtor

HeidiM.Meyer,MD(1) I am honored to be a candidate for the young physician representative to the SDCMS board. I am a proud graduate of San Diego Countys

medical school at UCSD, where I served as the student delegate to CMA and was mentored by several current and former SDCMS board members. As a resident, I served as the resident member of both the Arizona Academy of Family Physicians and the American Academy of Family Physi-cians board of directors, which exposed me to the politics of medicine on both a state and federal level.

I firmly believe that all medicine is poli-tics, and to deny this is putting our patients and providers at a grave disadvantage. As a primary care provider, I feel it is part of my duty to serve my community and serve as an ambassador to our patients and fel-low providers. Too few of us understand healthcare delivery at our peril and it is groups like SDCMS, and its state and national equivalents, that seek to change that. The opportunity to serve on this board is a welcome one.

reSiDent phySiCian DireCtor

MichaelC.Hann,MD(1) I am a psy-chiatry resident at Naval Medical Center San Diego (NMCSD), and I am running for the position of resi-dent director. I am

a dual-degree graduate of the FIU Herbert Wertheim College of Medicine and FIU Chapman Graduate School of Business in Miami, Florida, where I earned my MD and healthcare MBA. While studying in Miami, I became engaged early on with organized medicine and served on the board of direc-tors for the Dade County Medical Associa-tion for three years. I was recognized at the state level with the Florida Medical Association Foundation scholarship for my contributions to organized medicine. Since coming on to active duty, I have completed the Navys Officer Development School (ODS), where I served as the division officer for 120 naval officers in training. I was recognized as the honor graduate upon completion of ODS and was further rec-ognized with the George T. Smith Award for Military Leadership. I also continue to be actively engaged at NMCSD, where I currently serve as the house staff council representative for the Directorate of Mental Health, as well as a committee member on the Graduate Medical Education Com-mittee (GMEC)/CLER Pathways Patient Safety Committee. Most recently, I had the privilege of serving as a District I delegate to the CMA House of Delegates in Decem-ber 2014. I am committed to representing and advocating for resident physicians and would greatly appreciate your support.

reSiDent phySiCian alternate DireCtor

QuinnC.Meisinger,MD(1) I am happy to join the board of directors as a resident representative. I look forward to a productive year.


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26 april 2015

TOSUBMITACLASSIFIEDAD, email Kyle lewis at [email protected]. sdcms members place classified ads free of charge (excepting services offered ads). nonmembers pay $150 (100-word limit) per ad per month of insertion.

claSSifiEDS repay eligibility, and much, much more! For more infor-mation, please call Anna Jameson at (619) 906-4591 or email [email protected]. If you would like to fax your CV, fax it to (619) 876-4426. For more information and to apply, visit our website and apply online at www.fhcsd.org. [046a]

SEEKING A FOOT/ANKLE SPECIALIST OR HAND SURGEON: Well-established, highly respected, four-physician group, private practice in San Diego seeking a foot/ankle specialist or hand surgeon. Our group is expanding to meet high volume of cases and planned expansion. Potential opportunity for any established subspecialist looking for a permanent practice loca-tion. We have a broad-based primary care referral base, mature EHR, digital X-ray, ultrasound, and DME program. Interested parties, please email your CV in confidence to [email protected]. [326]

FULL-TIME PRIMARY CARE PHYSICIAN: For a busy, well-established pain management practice in Mission Valley. The candidate must be able to provide compas-sionate care in a fast-paced environment. Please send CV to [email protected]. [322]

SEEKING PART-TIME PRIMARY CARE / URGENT CARE PHYSICIAN: For a busy, well-established primary care family practice / urgent care medical practice in Pacific Beach. This position could lead to an associate physician position of the practice for the right person. The candidate must be able to provide compassionate care in a fast-paced environment. Knowledge of musculoskeletal medicine and X-Ray is required. Must be able to suture and have experience with wound care. We have a state-of-the-art medical facility. Please send your CV in confidence for con-sideration to [email protected]. Compensation: Excellent Pay Rate [317]

URGENT CARE PHYSICIAN PER DIEM BC/BE: Arch Health Partners is an award-winning medical foundation affiliated with the Palomar Health System in North San Diego County. Hours: 9:00am9:00pm. Send CV to [email protected] or fax to (858) 618-5820. [312]

GENERAL, FAMILY, OR INTERNAL MEDICINE PHYSICIAN NEEDED IMMEDIATELY: This opening is an independent contractor position. We are a house call practice located in beautiful North San Diego County. We will also provide paid training on our EMR. 85, MondayFriday, 1012 patients per day, and on-call pager 1 week every 3 weeks, telephone call only. No rounds or hospital duties. If interested please sub-mit your CV to [email protected]. We are very anxious to fill this position, and we look for-ward to hearing from YOU! No agencies please. [311]

FULL-TIME PRIMARY CARE POSITION IN SAN DIEGO: Outpatient only office, no calls, no weekends. Please send CV to [email protected]. [308]

SEEKING URGENT CARE PHYSICIAN: Busy prac-tice in El Cajon, established in 1982, seeks a part-time physician. Good pay and working conditions along with the potential to become a full-time posi-tion. Please send CV to [email protected]. [306]

BOARD-CERTIFIED PHYSICIANS, PHYSICIAN ASSISTANTS, AND NURSE PRACTITIONERS NEEDED FOR URGENT CARE: Part-time posi-tions available but a full-time opportunity may be offered to the right candidate. Must possess a cur-rent California medical license and ACLS certifica-tion. Please email or fax CV to (619) 569-2590. Visit www.DoctorsExpressSanDiego.com for more infor-mation. [229a]

PRIMARY CARE JOB OPPORTUNITY: Home Phy-sicians (www.thehousecalldocs.com) is a fast-grow-ing group of house-call doctors. Great pay ($140$220+K), flexible hours, choose your own days (full or part time). No ER call or inpatient duties required. Transportation and personal assistant provided. Call Chris Hunt, MD, at (619) 992-5330 or email CV to [email protected]. Visit www.thehouse-calldocs.com. [037]

PHYSICIANS NEEDED: Internal medicine and fam-ily medicine physician positions currently open. Vista Community Clinic is a private, nonprofit, outpatient clinic serving the communities of North San Diego County with openings for full-time, part-time, and per-diem positions. Current CA and DEA licenses required. Malpractice coverage provided. Bilingual English/Spanish preferred. Forward resume to [email protected] or fax to (760) 414-3702. Visit our website at www.vistacommunityclinic.org. EEO Employer / Vet / Disabled / AA [912]

SEEKING BOARD-CERTIFIED PEDIATRICIAN FOR PERMANENT FOUR-DAYS-PER-WEEK POSITION: Private practice in La Mesa seeks pediatrician four days per week on partnership track. Modern office set-ting with a reputation for outstanding patient satisfac-tion and retention for over 15 years. A dedicated triage and education nurse takes routine patient calls off your hands, and team of eight staff provides attentive sup-port allowing you to focus on direct, quality patient care. Clinic is 2428 patients per eight-hour day, 1-in-3 call is minimal, rounding on newborns, and occasional admission, NO delivery standby or rushing out in the night. Benefits include tail-covered liability insurance, paid holidays/vacation/sick time, professional dues, health and dental insurance, uniforms, CME, budgets, disability and life insurance. Please contact Venk at (619) 504-5830 or at [email protected]. Sal-ary $ 102108,000 annually (equal to $130135,000 full-time). [778]

OFFICE SPACE AVAILABLE

WOMENS HEALTH / WELLNESS OFFICE HAS SPACE AVAILABLE FOR SUBLEASE: Exam room, office, and/or shared staff optional. Fully furnished exam rooms available and ready for use. Location features onsite billing, reception, medical assistants, potential use of in-office procedure room, and a roof-top lounge. If you are interested, please reply with the heading Space for Sublease outlining the details of space and/or staff use desired, with your contact information, and we will contact you to set up a show-ing. Reply to Mrs. Kim at [email protected]. [288]

MEDICAL OFFICE SPACE AVAILABLE FOR SUB-LEASE/SHARE IN UTC/LA JOLLA AREA: Estab-lished orthopedic surgeon seeks tenant to share of-fice space. 4675ft2 in Chancellor Park, near Scripps Memorial Hospital. Completely rebuilt in 2009. Six exam rooms, digital X-ray onsite. Beautiful finishings, spacious waiting room, conference room, break room. Ample space for support staff and a private office for physician. Available immediately, full or part time. Ideal for primary or satellite office. Excellent freeway access (1-5 and 805), first-floor suite located off lobby near main building entrance. For further information, please contact Georgana Bradley at (858) 457-0050 or at [email protected]. [334]

CARLSBAD MEDICAL OFFICE FOR LEASE: Space from 1,00050,000 SF Competitive lease rates and TI allowances Existing tenants include imaging, pharmacy, orthodontics, urgent care, and pain man-agement Highly visible to over 43,000 vehicles per day along Palomar Airport Road Interstate 5 is less than a mile away providing access to over 200,000 households within a 20-minute drive North Countys most affluent demographic with average household income of $98,614 within a 5-mile radius. For further information, please contact: TRAVIS IVES, Cushman & Wakefield, (858) 334-4041, [email protected], Lic. # 1889097 [332]

PRACTICE FOR SALE

OFFICE OF GENERAL PRACTICE FOR SALE: Please contact Dr. Mary Raiszadeh at (858) 750-8984. [329]

PHYSICIAN POSITION WANTED

LOOKING FOR PART-TIME FAMILY PRACTICE: D. (Doyle) Eugene Johnson, family physician with a wealth of experience, looking for part-time position, prefer-ably in North County. Have been a full-time practic-ing certified family physician for 50+ years and would like to continue seeing patients part-time. Had one of the largest solo family practices in San Diego for 25+ years. Excellent references! Continually certified in family practice, ACLS, BLS, regularly use computer-ized records. Will consider locum tenens. Please email [email protected] with particulars. [301]

PHYSICIAN POSITIONS AVAILABLE

OUTPATIENT PRIMARY CARE PHYSICIAN OP-PORTUNITY IN VISTA: Optum is excited to announce a full-time, 100% outpatient primary care physician opportunity (Family Medicine or Internal Medicine) in Vista, CA. This position offers a convenient Mon-dayFriday, 8am5pm schedule in a well-established and highly respected clinic just three miles from the ocean! Contact Kaitlin Osborn if you, or someone you know, may be interested at [email protected] or at (952) 936-3888. [336]

PHYSICIAN NEEDED: Seeking a California-licensed physician to cover contrast injections at an imaging center in Imperial County, 2407 Marshall Ave., Suite A, Imperial, CA 92251. Please call (760) 730-3536 for more details, or fax (760) 720-4833. [335]

MEDICAL DIRECTOR OPENINGS: Our San Diego County and Temecula facilities provide outpatient substance abuse treatment serving patients afflicted with the disease of addiction specifically to the opioid class of drugs. We have openings for part- or full-time medical director at our San Diego and Temecula facili-ties. Qualifications: The physician shall be a licensed physician in the state of California with an unencum-bered license. The physician is responsible, either directly or through a supervisory relationship with other licensed physicians, physicians assistant and / or nurse practitioner. Minimum of two years experi-ence with chemical dependency preferred. Excellent communication skills required. SEND RESUMES TO: [email protected]. [331]

SEEKING FULL-TIME BC/BE EMERGENCY MEDI-CINE OR FAMILY MEDICINE PHYSICIANS: SHARP Rees-Stealy Medical Group, a 450+ physician multi-specialty group in San Diego, is seeking full-time BC/BE emergency medicine or family medicine physi-cians to join our urgent care staff. We offer a competi-tive compensation package, excellent benefits, and shareholder opportunity after two years. Please send CV to SRSMG, Physician Services, 300 Fir Street, San Diego, CA 92101. FAX: (619) 233-4730. EMAIL: [email protected]. [330]

PHYSICIAN POSITIONS AVAILABLE AS WE CON-TINUE TO GROW: Full, part-time, or per-diem flex-ible schedules available at locations throughout San Diego. A national leader among community health centers, Family Health Centers of San Diego is a pri-vate, nonprofit community clinic organization that is an integral part of San Diegos healthcare safety net. We offer an excellent, comprehensive benefits pack-age that includes malpractice coverage, NHSC loan


MEDICAL SPACE FOR RENT / LEASE: Approxi-mately 2,000ft2. Available for lease, in best location of Imperial County. Negotiable. Please contact Dr. Maghsoudy at (760) 730-3536. [328]

SUBLEASE PART-TIME SPACE ON SCRIPPS LA JOLLA CAMPUS: A beautiful office space is available a few times a week for someone looking for a part-time satellite office or someone who only has clinic a few times a week. We are located in HM Poole building on the campus of Scripps Memo-rial La Jolla, two-minute walk from the hospital. Of-fice reception, two exam rooms, and a conference room/break room are available. Our staff use is ne-gotiable. Rates will depend on the needs and usage. Please contact Olga at [email protected] for more information. [325]

NORTH COUNTY / LA COSTA-CARLSBAD OF-FICE SPACE FOR SUBLEASE: Beautiful, new 2,300ft2 office space available for sublease. Minor procedure room, 5 exam rooms. Lasers available. Lo-cated in Bressi Ranch off of El Camino Real. Perfect for dermatology, OB/GYN, wellness / weight loss. Perfect location for North County expansion. Please call Me-lissa at (760) 707-5090. [318]

BANKERS HILL OFFICE SPACE: Office space available in beautiful, updated Bankers Hill medi-cal office that also houses a fully accredited am-bulatory surgery center. Great opportunity for a plastic surgeon, facial plastic surgeon, oculoplastic surgeon or dermatological surgeon. Office is con-veniently located minutes from freeway access and downtown San Diego. Please contact via email at [email protected]. [313]

ALISO VIEJO 5 JOURNEY: Multi Tenant Medical Building with highly successful medical and dental practices. 2 ground floor medical spaces approx. 2,135 and 2,225 rsf available for lease. $2.90 PSF NNN. Beautifully designed. Tenant Improvement Allowance to customize suite is available. For further information please contact Lucia Shamshoian @ 769-931-1134x13 or [email protected]. [298]

LA JOLLA (NEAR UTC) OFFICE FOR SUBLEASE OR TO SHARE: Scripps Memorial medical office building, 9834 Genesee Ave. great location by the front of the main entrance of the hospital between I-5 and I-805. Multidisciplinary group. Excellent referral base in the office and on the hospital campus. Please call (858) 455-7535 or (858) 320-0525 and ask for the secretary, Sandy. [127]

3998 VISTA WAY, IN OCEANSIDE: Medical of-fice space approx. 2,488 rsf available for lease. Close proximity to Tri-City Hospital with pedestrian walkway connected to parking lot of hospital, and ground-floor access. Lease price: $1.75+NNN. Tenant improvement allowance to customize the suites is available. For fur-ther information, please contact Lucia Shamshoian at (760) 931-1134, ext. 13, or at [email protected]. [234]

BANKERS HILL PRIMARY CARE / HEALTHCARE PROFESSIONAL & RESEARCH OFFICE SPACE TO SUBLEASE: 50-year established primary care prac-tice and clinical research office, with currently two internists, have space to sublease to another primary care or primary care / subspecialist, or other indepen-dent healthcare professional, to help curb overhead and, if primary care, help with acute overflow patients needs. Also can provide opportunity to get into clinical research. Contact Jeff at [email protected]. [265]

SCRIPPS XIMED MEDICAL CENTER BLDG, LA JOLLA OFFICE SPACE TO SUBLEASE AVAIL-ABLE: Vascular & General Surgeons have space avail-able. One room consult office available, with one or two exam rooms, to a physician or team. Located on the campus of Scripps Memorial Hospital, The Scripps Ximed Medical Center is the office space location of choice for anyone seeking a presence in the La Jolla/UTC area. Reception and staff may be available. Com-

ible schedules available at locations throughout San Diego. A national leader among community health centers, Family Health Centers of San Diego is a pri-vate, nonprofit community clinic organization that is an integral part of San Diegos healthcare safety net. We offer an excellent, comprehensive benefits pack-age that includes malpractice coverage, NHSC loan repay eligibility, and much, much more! For more infor-mation, please call Anna Jameson at (619) 906-4591 or email [email protected]. If you would like to fax your CV, fax it to (619) 876-4426. For more information and to apply, visit our website and apply online at www.fhcsd.org. [046b]

SEEKING MEDICAL ASSISTANT: We are a private practice situated in Encinitas looking to hire a medical assistant. The medical assistant should be flexible and able to float from the front office (administrative area and reception) to the back office area (examination and treatment areas). Some primary duties involve scheduling, registering and rooming patients, taking vital signs and blood tests, keeping the entire office and storage spaces organized, safe, and clean. Re-quirements include at least three years of work experi-ence in this field with a high school diploma and medi-cal assisting program certificate. Excellent computer knowledge as well as fluent written and verbal com-munication. Please email [email protected]. [327]

PART- OR FULL-TIME NURSE PRACTITIONER WANTED: Busy pain management practice in Mis-sion Valley seeking a nurse practitioner to work with our growing practice. Please fax CV to (858) 756-9012. [323]

PART- OR FULL-TIME PHYSICIAN ASSISTANT WANTED: Busy pain management practice in mis-sion valley seeking a physician assistant to work with our growing practice. Please fax CV to (858) 756-9012. [324]

SEEKING PHYSICIAN ASSISTANT OR NURSE PRACTITIONER: Seeking PA with experience in der-matology or wellness / weight loss to join busy cosmet-ic surgery practice in North County. Beautiful office and support staff. Full complement of cosmetic lasers. Please call Melissa at (760) 707-5090. [319]

SEEKING PHYSICIAN ASSISTANT OR NURSE PRACTITIONER: Part-time, with possibility of full-time, mid-level provider position available in a pri-mary care office in downtown San Diego. This is a wonderful opportunity to learn all aspects of primary care. Prior experience with family medicine, sports medicine, occupational medicine, and/or urgent care is preferred, but new graduates can apply. Must be a certified PA or NP and possess a current California medical license. A DEA license is helpful, but not necessary. Must be comfortable using an EHR sys-tem, but will provide training on our specific system. Wages based on experience. Please email CV to [email protected] or fax to (619) 232-6012. [315]

BOARD-CERTIFIED PHYSICIANS, PHYSICIAN ASSISTANTS, AND NURSE PRACTITIONERS NEEDED FOR URGENT CARE: Part-time posi-tions available but a full-time opportunity may be offered to the right candidate. Must possess a cur-rent California medical license and ACLS certifica-tion. Please email or fax CV to (619) 569-2590. Visit www.DoctorsExpressSanDiego.com for more infor-mation. [229b]

NURSE PRACTITIONER: Needed for house-call physician in San Diego. Full-time, competitive ben-efits pa

April 2015

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