The Message, June 2011

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A MON T HLY NE WS M AG A ZINE OF S P O K A N E C O U N T Y M E D I C A L S O C I E T Y – J U N E 2011

Health Information Technology IS IN THE AIR WE BREATHE

By Brad Pope, MD SCMS President


May SCMS The Message Open2


2011 Board of Trustees Brad Pope, MD President Terri Oskin, MD President-Elect Anne Oakley, MD Vice President David Bare, MD Secretary-Treasurer Gary Knox, MD Immediate Past President Trustees: Keith Kadel, MD Michael Cunningham, MD Paul Lin, MD Randi Hart, MD Gary Newkirk, MD Carla Smith, MD Rob Benedetti, MD Audrey Brantz, MD Louis Koncz, Jr. PAC David McClellan, MD

T a b l e o f C o n t e n ts

Health information technology is in the air we breathe . . . . . . . . . . . . . . . . . . . . . .

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Implementing an Electronic Medical Records System . . . . . . . . . . . . . . . . . . . . . . . . 2 A New Beginning in Health IT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 The Providence Epic Journey – Transforming the Healthcare Experience . . . . . . . . . . . . . . 5 Community, Collaboration and Cooperation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Project Access Update. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 COPE online training tool helps physicians prescribe painkillers safely . . . . . . . . . . . . . . . 7 “Tell Us Your OPINION” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 FYI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Meetings Conferences and Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 CME Schedule. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Membership Recognition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Controlled Substance Prescription Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Classifieds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Positions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

"Fools admire, but men of sense approve" Alexander Pope

Spokane County Medical Society Message Terri Oskin, MD, Editor A monthly newsletter published by the Spokane County Medical Society. The annual subscription rate is $21.74 (this includes the 8.7% tax rate). Advertising Correspondence Quisenberry Marketing & Design Attn: Jordan Quisenberry 518 S. Maple Spokane, WA 99204 509-325-0701 Fax 509-325-3889 jordan@quisenberry.net All rights reserved. This publication, or any part thereof, may not be reproduced without the express written permission of the Spokane County Medical Society. Authors’ opinions do not necessarily reflect the official policies of SCMS nor the Editor or publisher. The Editor reserves the right to edit all contributions for clarity and length, as well as the right not to publish submitted articles and advertisements, for any reason. Acceptance of advertising for this publication in no way constitutes Society approval or endorsement of products or services advertised herein. Correction Noted The Angel Flight website was incorrectly listed in the May 2011 newsletter. The correct website address is www.angelflightwest.org.

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Health information technology is in the air we breathe By Brad Pope, MD SCMS President Not a day goes by when we don’t use health information technology (HIT). It’s everywhere, making patient care better and our jobs easier. Many of us probably think of electronic medical records (EMR), but HIT is so much more than EMR implementation. It has transformed how a person engages in his healthcare and how providers practice medicine. By taking advantage of its full potential, HIT will improve the health of our population. Just at this single point in time, HIT offers: Access to the world’s medical literature: Both providers and patients can embrace this fantastic reality and use it every day. Electronic medical records: No more lost charts. Information that’s organized usefully. Enough said. Interconnectivity between providers and facilities: Now the emergency room, primary care provider, consultant, lab and imaging facilities can all contribute and view patient information so that the right care is given at the right time, with no redundancy, no matter where the patient presents. Child Profile is one exemplary platform. Patient registries: These flexible data lists are making it the standard to reach out to patients for planned care, prevention and chronic disease management. The old paradigm “one patient-one problem-one doctor appointment” is not enough. Alone it leaves too many patients in your practice with unaddressed needs. Population management will be a necessary component in the new paradigm of care. E-communication with our patients: Patients no longer need a formal appointment to get their quick questions answered. Communicating through secure e-mail, texting and web browsers is becoming increasingly convenient and efficient for all. Direct order entry: Now when I order a prescription in the exam room, the prescription is filled and waiting for my patient when she arrives at the pharmacy. Patients needn’t wait and nobody makes an error reading my handwriting. In the meantime, the computer has cross-checked my prescription to make sure I haven’t mistakenly prescribed a drug the patient is allergic to or that could interact with her current medications. Performance reporting: Whether we like it or not, most physicians will get reports on our clinical care performance in the

future. Performance reporting is still in its infancy and fraught with challenges, but in the long run, care will improve because providers will respond constructively to the useful information that’s reported. Performance transparency: Patients, their insurers and their employers will also expect performance information about their providers’ health outcomes, patient safety and costs. Medical groups will be prompted to improve their performance and care systems. Payment reform: Thanks to HIT’s ability to collect, organize and report health information, the healthcare industry is now better able to reform our payment methods, so we’ll evolve from paying just for volume of RVU (relative value unit) production to paying for what really matters: outcomes. In the future, providers will want to deploy case management, disease registries and e-mail communication because we know they assure better care and because the new payment methods reward us for providing better care. Health IT is the wave of the future—and already medical education is leveraging it to produce a new generation of healers who will practice in fundamentally different ways than I have. Remember, young people born after the late 1970s are digital natives–confident in the world of technology and personal devices and comfortable with such broad access to information. Case in Point: The Health Care Team Challenge Recently I served as a judge at Washington State University’s (WSU) Health Care Team Challenge where I observed the digital natives in action. Three interdisciplinary teams of health sciences students from WSU, Eastern Washington University and the University of Washington competed on a clinical case study designed by faculty members. The students represented medicine, physical therapy, occupational therapy, dental hygiene, dentistry, communication disorders, physicians’ assistants, pharmacy, nursing nutrition and exercise physiology, speech and hearing. The teams interviewed a patient with ALS (Lou Gehrig's Disease) who volunteered for the competition. They were given just a few days to research evidence-based care and the condition’s latest issues and treatments, and recommend an interdisciplinary care plan. Then the faculty revealed new developments that required the teams to collaborate and adjust the care plan. It was a fun and stimulating exercise, and I was inspired to see the students working together in such a coordinated, integrated manner. The point is that these future healers expect HIT to assist them in their roles. And so will their patients. We need doctors to lead in the changes associated with HIT advances, for the good of our patients. Many within our SCMS community already are. In this issue of the SCMS The Message you will read of other examples of healthcare providers leading this change. I hope you find these stories inspiring and encouraging.

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Implementing an Electronic Medical Records System By Robert Hartnett Director of Human Resources/Purchasing Arthritis Northwest Six years ago, Arthritis Northwest decided that their physicians and staff were ready to face one of the biggest challenges a medical practice can face. They had prepared all they could and were ready to make the faithful leap to using Electronic Medical Records (EMR). Although I was not yet a member of the team during their successful transition, I was given the privilege of speaking with those who headed the project to learn more about the planning and processes involved and hear about what went well, what didn’t and what would have been nice to know before it all began. The EMR implementation first began with the transition to a new Electronic Practice Management (EPM) system four months earlier. Not every group decides to implement a new EPM when moving towards an EMR system, but Arthritis Northwest found it was the best way to integrate the two systems as a whole to meet their needs of care provision. IT support was present from the beginning of the EMR transition to make sure technical specifications and other needs were addressed. IT was able to help evaluate the practice needs regarding wireless and server communication and also assisted in ordering the wiring and computers needed for the EMR system. The physicians initially wanted to use tablets in all the exam rooms, but disruptions in the wireless setup caused unpredicted issues. The tablets could not be used efficiently and it resulted in the additional expense of work on the wireless service and terminal servers. Bills for IT services also increased as was expected for the regular EMR maintenance and fixes. To create useful templates for both the EPM and EMR and to help maintain effective communication, a lead team was created that represented each department of the practice. The leads were aware of all project aspects and timelines and met regularly to make sure each department kept up with their assigned preparation tasks. The team was provided information from a core user group that met weekly to discuss project deadlines and limit the stress put on individual departments. While open communication was important, it was felt that too many ideas and fear of certain aspects of the EMR project would not help the process, so some communication was kept more as a need-toknow basis and limited to monthly updates at staff meetings. Approximately 3 months before going live, the practice started scanning charts. If an entire chart was scanned, the paper chart was stamped “FULL SCANNED,” while the partially scanned charts were stamped “PARTIAL SCAN.” Initially, charts were scanned alphabetically by patient name, but it was later decided to start scanning for upcoming patient appointments. Chart

scanning became focused more on the doctors’ need for labs, x-rays and other clinical information and how far back in the patients’ history they wanted to view them. It was thought that it may have been more productive to first categorize the amount of labs, x-rays, and other clinical information needed with an established history timeline and then start with an alphabetical scan of patients’ charts. Three weeks prior to going live, training was performed in all departments, beginning with a group of core users trained first to serve as trainer-users. Training took place during normal business hours, allowing one person from each department to be away. The physicians were the last to be trained. EMR vendor support was present throughout the entire first week for both EPM and EMR transitions. On “Go-Live” with the EPM, the practice was somewhat surprised that every patient needed to be treated systematically as a new patient. Schedulers had to scan every insurance card and enter current addresses before creating an encounter. This created a huge bottleneck at the front office and wasn’t something that really could have been avoided. On “Go-Live” with EMR, the practice needed to enter past medical histories, medication lists, and operations of patients. This took a lot of time from both the physicians and staff. Additional time was accounted for in the plans for the EMR transition, but this was underestimated since going live resulted in more time than expected to process routing sheets, perfect paperless billing, and perform other data entry tasks. Going live for EPM and EMR was a success and went very well for Arthritis Northwest. They experienced the expected slowdown in patient flow and waiting times had increased, but everyone began to see the light at the end of the tunnel after several months. The practice was soon able to refine their templates for better ease of use of by physicians and scanning abilities had improved the quality of scans into patient charts. Third party vendors were also able to interface with the new system, allowing for lab order results to pass directly into charts and introducing an enhanced billing collection process. In hindsight, here are some key lessons learned: • Basic computer knowledge of all EMR users should be determined • Basic keyboard skills should be evaluated and training provided if necessary • Data input can be better prepared prior to going live and also used as a training tool • Charts can be better prepared with past medical histories prior to going live • Real scenarios with “test patients” would be helpful for about one week

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Continued from page 2 • Wireless capabilities and terminal server requirements should be carefully evaluated • Dragon Dictation has limitations on some server setups, so determine early if that is what your physicians want to use (our group is now utilizing Dragon for all providers) In the end, the EPM and EMR transition has helped Arthritis Northwest to continue to provide quality care, but in a more efficient and systematic way that also brings the ability to maintain valuable information about the clinical outcomes of patients.

A New Beginning in Health IT By Mysti Reneau Being of self-described “older worker” age, Willy Kelly was having a hard time finding employment. He wasn’t alone. According to recent US Bureau of Labor statistics, Kelly, unfortunately, fit into one of the hardest hit groups from the recent economic downturn - males, over the age of 45, who have some college education but lack degrees.* These unemployed workers find it very difficult to obtain Willy Kelly with keyboard sustainable employment after unexpected job layoffs and downsizing. In 2008, it happened to Willy Kelly not just once, but twice – the first time from a computer software company, and then just 12 weeks later from a marketing company. The second layoff was only 8 weeks after Kelly was hired, when that company decided to downsize too! It was a tough time. Today, he is the Information Technology Manager at Quincy Valley Medical Center. He feels his success in finding employment can be attributed, in part, to his decision to go back to school at the Community Colleges of Spokane with the help of funding from an American Recovery & Reinvestment Act Workforce Development grant. The grant gave him the opportunity to learn about the new and emerging field of Health Informatics. The Health Informatics program at Spokane Community College is funded through the Region A Community College Consortia to Educate Health Information Technology Professionals led by Bellevue College. Part of the HITECH Act, this program is designed to rapidly create or expand health IT academic programs at community colleges throughout the U.S. The

purpose is to educate health IT professionals, who can then facilitate the implementation and support of electronic medical records (EMRs). The program is administered by the Office of the National Coordinator (ONC) for health IT. Spokane Community College provides ONC-approved training for unemployed healthcare and/or information technology workers; as well as incumbent health IT workers who want to expand their knowledge about the new ONC meaningful use requirements. SCC provides this workforce development program for Eastern Washington. Because of Kelly’s many years of experience in computer networking, he was a perfect fit for the on-line program, which focuses on “Practice Workflow/ Information Re-Design Specialist.” Although he was already taking computer courses at Spokane Falls Community College to refresh his skills, Kelly felt participating in the SCC program would give him a thorough understanding of the new health requirements Willy Kelly with electrical systems associated with EMRs. He also hoped it would help him garner future employment in health IT. He soon found that having an IT background was a good place to start, but there was still much to be learned in the area of electronic health systems. “Medical terminology was the hardest course for me by far,” says Kelly. “Understanding workflows and how that works was probably the most beneficial part of the program. I think the knowledge I received in the courses on workflows and meaningful use environments mattered a lot in getting this position.” Kelly has been immersed in electronic health records implementation since he started his new job March 2 – just one day after the hospital began implementation of the new CPSI system. In only a few months, the critical access hospital and adjoining clinic that serve the Quincy Valley area, have jumped headlong into the EMR platform that they hope will better serve their patients. Currently, the system includes bedside charting, admitting, pharmacy and laboratory functionality. Kelly says Computerized Physician Order Entries (CPOEs) are coming soon. It’s an exciting time to be in health IT and Willy Kelly recognizes that fact. “I think it is going to get even more intense with wireless mobile charts with access points throughout the hospital,” said Kelly. ”Everything is moving that way,…and although privacy is always an important issue, we are even looking at HIPAA compliant chat software.” Despite the new innovations, Kelly also realizes that some reluctance to change still exists within the healthcare industry. One of the biggest challenges in implementing the type of system that can do all of these functionalities is the initial time commitment needed for entering information into the computer Continued on page 5

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Angela M. Ball, MD Family Practitioner Northeast Washington Medical Group Colville, WA “As a rural physician, I’m grateful for Physicians Insurance’s efforts at outreach. They bring educational opportunities directly to my community. Only a local insurance firm could provide such specialized attention.”

Every physician needs a good foundation.®

www.phyins.com Seattle, WA ( 206) 343-7300 or 1-800-962-1399 . Spokane, WA (509 ) 456-5868 or 1-800-962-1398 Endorsed by the Washington State Medical Association

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Continued from page 3 system - a difficult task when not all clinical staff are as computer savvy as others and there is still some reluctance to change existing practices. Still, Kelly feels that in the end, the patients will be the true beneficiaries. As for his new work environment, Willy Kelly relishes the challenge. “I am enjoying working and interfacing with clients, customers, directors, etc.,” says Kelly. “It is a bit of a challenge, but it gives me current management experience in the medical software field and it allows me to do a little bit of everything!” *“The Composition of the Unemployed and Long-Term Unemployed in Tough Labor Markets” US Bureau of Labor Statistics, www.bls.gov/opub/mlr/2010/art1full.pdf

The Providence Epic Journey – Transforming the Healthcare Experience

In any journey that is transformational in nature, it is imperative to establish a set of principles to guide such challenging work. We have adopted the following guiding principles for our Epic journey: • Keep the patient at the center of all our work • Work together as one ministry committed to excellence • Ensure that every decision affecting clinical care will be reviewed by clinicians • Reduce unnecessary clinical and administrative variation through standardization • Value simplicity as we strive for good , not perfect • Set and follow realistic schedules • Make project decisions respecting both excellence and stewardship • Engage in rigorous, transparent design and planning • Align all system and regional health care entities with this work

By Jeff Collins, M.D., Chief Medical Officer, Providence Health Care Our Providence vision: “Together as people of Providence, we will answer the call of every person we serve: Know me, care for me, ease my way.” In 2010, Providence clinical and administrative leaders completed a comprehensive evaluation of clinical information systems’ challenges and capabilities and made the bold decision to implement the Epic suite of medical records throughout the entire 5-state Providence system. Epic is an integrated suite of healthcare software tools that supports all the functions of patient care, including registration, scheduling, ambulatory and acute care settings, as well as ancillary systems for lab, pharmacy and radiology, billing and financial information, and patient portals for medical record access. The Providence goal, in its transition to Epic, is to provide a connected experience for patients across a variety of care settings, consistent workflows for caregivers, a streamlined billing process and more reliable, safer care. In pursuit of consistent, high quality, affordable care across all care settings and communities, Providence intends to use Epic’s powerful patient focused clinical IT platform to reduce variability, collect and share clinical data so that we can compare outcomes and promote continuous improvement of the care we provide, and ensure that patients and caregivers will know what to expect in all care settings, leading to safer, more reliable care. Systemwide standardization is the only way we can effectively collect and share “apples to apples” data; and comparing common data is the only way we can continue to improve quality and truly transform healthcare.

All Epic applications leverage the same central database, such that we can create and maintain a single medical record for each patient across all care settings. Patient information from various clinics, physician offices and hospitals can be connected and integrated in a clinically relevant manner. These integrative functions allow us to promote evidence based practice, reduce unwarranted clinical variation and collect and share clinical information in a process of ongoing continuous process improvement. This will require system wide agreement on administrative and clinical standards and workflows and will require widespread input from hundreds of people across our delivery system, especially clinicians. Ultimately we hope to achieve: • The best care for every patient every time • Population health improvement, affordability and an improved patient experience • Standardized workflow processes and reduced variability • Best support of our vision We are now in the process of defining the Providence iteration of the Epic system, which we call the Providence Build. We have three key tasks: the development of clinical content, the definition and validation of clinical workflows, and evaluation and integration of third party vendors for applications not a part of the Epic system.

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Continued from page 5 The Providence Epic Build is a product of the Epic organization itself and incorporates in an ongoing systematic fashion the input of other Epic users across the country. In other words, we benefit from every Epic user that went before us as the system improves with each new user organization. And, they represent some of the best healthcare systems in the world, including 18 in the Pacific Northwest – Group Health, Kaiser, Legacy, Swedish, MultiCare, Order of St. Francis, Mercy, OHSU, Geisinger, Cleveland Clinic and Sentara to name a few. In addition, the Providence Alaska region has already implemented Epic in its ambulatory and inpatient settings. We are using their experience on which to base the Providence Epic build. Epic will support – but never replace – the knowledgeable and compassionate human touch of caregivers. Fully implemented, Epic will help us build a predictable, reliable experience for patients and caregivers, leading to consistent, high-quality care for those we serve. At the present time, ambulatory facilities and providers in eastern Washington are scheduled to go live in third quarter 2012 and Providence hospitals in fourth quarter 2012.

Community, Collaboration and Cooperation By The Informatics Committee Achieving secure, effective health information exchange (HIE) through the application of state-of-the-art health information technology (HIT) is one of the acknowledged goals of healthcare reform. While the efficient electronic exchange of patient data is important, the most critical element to the success of any HIE is a shared community vision. This communal sense of purpose is where the most important goals are identified and where improved quality of care, enhanced patient safety and better

patient outcomes are carefully weighed and balanced with individual stakeholder expectations of improved operational efficiencies, reduced costs and increased revenues. In a robust healthcare environment that fosters competing business interests and multiple EHR systems and platforms, there is an urgent need in the greater Spokane community to keep our HIE efforts focused on the primary needs of the patient, regardless of the healthcare setting where they seek care. This patient-centric approach requires the secure exchange of data between providers and across care settings. In years past, our community has always been very successful at implementing these important interconnectivities and nurturing an environment conducive to shared care coordination. In fact, promoting understanding, and assuring continued collaboration and cooperation between provider organizations to the overall benefit of our patients, are important functions of the Spokane County Medical Society’s Medical Informatics Committee. If the exchange of data is important to patient care, then identifying the barriers to the effective communication of patient information must become an important objective. This year, the Medical Informatics Committee has focused on the decisionmaking (and implications) behind the adoption of various EHR systems among providers in our community. We’re asking important questions, including what decisions have been made and what is the philosophy behind these decisions? How do these decisions support or take away from the best interests of our patients? Is there something we can do as a medical society to promote positive HIE within our community? As physicians, we believe that it is important to understand the differences in these systems, the possible interfaces (or lack thereof) between systems that are being considered or under development, and each stakeholder’s level of trust and collaborative spirit concerning the quality and exchange of data. Ultimately, our community will need an HIE governance structure that develops creative solutions to resolve conflicts over the management and exchange of vital health information.

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Project Access Update

Benefits • Stewardship of donated resources

By Lee Taylor Director, Project Access Spokane

• Minimizes specialists’ support staff time • Eliminates unnecessary appointments

I want to offer some additional information about what Project Access does, and the value of our services to specialists donating medical care. Here are the two topics for this month: 1. Project Access partnerships with the private and community primary care clinics. 2. Project Access services and benefits that make patient referrals to specialists more efficient and cost effective.

Primary Care and Project Access The strong partnership with primary care providers is one of the key components in the Project Access system of care for the lowincome uninsured population in Spokane County. Primary care for Project Access patients is provided by private and community clinics. Those clinics refer patients to specialists through Project Access. Project Access also has a limited number of additional primary care appointments available through our program. Project Access has strong partnerships with the primary care providers. Those partnerships ensure that the right patient goes to the right specialist at the right time, with the required protocol of examinations and tests completed prior to the specialist visit. We work with each referring clinic, combining resources to maximize the efficiency of service delivery, from patient application through follow-up with the primary care provider. Once patients are qualified for the program, Project Access staff takes over, managing the referral process. Each case is reviewed to confirm the referral is appropriate for symptoms, diagnosis and specialty. The review ensures that the patient diagnosis requires specialty care based on protocols suggested by physicians on the Project Access Therapeutics Committee. The Project Access patient coordinators manage patient appointments, including referrals for tests and getting them re-connected with the primary care provider after the specialist’s treatment.

Project Access Services and Benefits Services • Patient applicant screening • Referral coordination • Medical screening • Appointment scheduling • Patient follow-up and outcome tracking • Low-cost access to prescriptions • Transportation and interpreter services

• Maximizes efficiency of appointments • Increases the likelihood of successful short-term outcome • Eliminates time wasted on ill-prepared referrals • Facilitates equitable distribution of charity patients If you would like to discuss how we can strengthen your partnership with Project Access, or begin a new partnership, we want to talk with you. And, as usual, please call me with any ideas that you would like to share, at 220-2651or email me at lee@spcms.org.

COPE online training tool helps physicians prescribe painkillers safely UW School of Medicine – Online News May 13, 2011 UW Medicine has announced the creation of an up-to-date online training tool that will help doctors and other prescribing providers respond to new U.S. Food and Drug Administration (FDA) requirements concerning opioids, commonly known as painkiller medications. Prescription opioid abuse is now the fastest growing form of drug abuse in the U.S. According to the Centers for Disease Control and Prevention (CDC), unintentional drug overdose is a leading cause of injury death in 17 states. The FDA’s Risk Evaluation and Mitigation Strategy for chronic opioid prescribers, announced in late April, is aimed at educating providers on how to reduce risks associated with opioid treatment of chronic non-cancer pain. All opioid manufacturers must be fully compliant with the FDA’s Risk Evaluation and Mitigation Strategy within 120 days. Developed over a period of six years, COPE (Collaborative Opioid Prescribing Education), the UW’s interactive, educational training tool, is designed to help prescribers and patients improve communication when making decisions about chronic opioid therapy. Doctor-patient trust is necessary in decision-making; otherwise, patients may be less likely to follow medication instructions, or they may take extra doses or combine them inappropriately with other medications or alcohol. They may even seek out multiple prescribers or try to obtain medications from outside the medical system. These practices increase the risk of both accidental overdose and abuse. “COPE is unique because it goes beyond typical factual content about opioid pharmacology and effectiveness of opioids for pain to provide training about goal setting and communication skills ,” said Mark Sullivan, UW professor of psychiatry and behavioral sciences. Continued on page 9

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A Multidisciplinary Approach to Improving Quality of Life. Physical Medicine & Rehabilitation Psychology Interventional Spine Pain Medicine EMG/NCS Jamie Lewis, MD Phone: 509.464.6208

Patricia Fernandez, PsyD

Fax: 888.316.1928 May SCMS The Message 8

Spokane, Washington


Continued from page 7 “COPE offers videotaped clinical scenarios that provide learning opportunities and can help build trust between doctors and patients so that they are able to have the kind of crucial conversations needed to address chronic pain.” UW Medicine’s leadership in pain management dates to the early 1960s, when it established the world’s first multidisciplinary pain clinic. Washington is the first state to issue an opioid dosing guideline that may become a model for other states. The state passed a bill that will require mandatory education and use of a prescription-monitoring program and a clinical tracking tool to be implemented in the state as of July 1. Medical specialists are working with the UW Center for Commercialization on broad dissemination of the COPE tool. COPE is the only web-based training proven to be effective in a randomized trial. More information about COPE may be found at: www.COPE-pain.org.

“Tell Us Your OPINION” for the August edition of The Message magazine regarding the following issues:

(509) 747-6194

• Physician Reimbursement, Payment Reform, SGR

If your patient needs wound care:

• Developing Accountable Care Organizations, Care Coordination • Advanced Directives, End-of-Life Issues • Informatics – EMR, HIE in Spokane Community, Meaningful Use,

We specialize in difficult wound care

ICD-10 • MQAC Rules regarding Pain Management, Opioid Use/Abuse

We offer comprehensive assessment, treatment & wound management

• Patient Protection and Affordable Care Act • Patient Centered Medical Home Model • Physician – Hospital Relations, Medical Staff Issues, Physician Employment and Contracting We are interested in the OPINIONS of our members, not the facts about an issue. Submit your letters to michelle@spcms.org on or before June 17. RULES • Submissions must include name and contact information. No names or contact information will be printed in The Message. • SCMS will strive to present a broad spectrum of opinions. • The Editor reserves the right to determine which opinions are

The primary provider is informed of the patient's progress towards healing Our providers previously practiced at the Sacred Heart Outpatient Wound Clinic We coordinate wound care with community agencies for care continuity throughout the healing process

printed. • There will be an opportunity in the future for rebuttal opinions. • Opinion letters must be non-offensive to the public or other SCMS members (no “trash talk”). • Opinions are to be no more than 850 words.

Surgical Specialists of Spokane SHDB Clinic (509) 747-6194 | 105 W 8th Ave. Ste 7010 w w w. s p o k a n e s u r g e r y. c om

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IS PLEASED TO INTRODUCE

SHAWN MOEHRING ENSURE YOUR PATIENTS GET EXCEPTIONAL REHABILITATION CARE! • Shawn is one of the 120 McKenzie Diplomats in the country. (McKenzie Assessment and Treatment proven twice as effective as standard Therapy, Long, 2004) • Specialty Trained in treating spine and extremity injuries • Over 15 years of experience. • One on One care for every patient, every visit! Rapid Recovery focused on education, Shawn Moehring MPT, Dip. MDT, CEAS

patient independence, and long-term self-management. TRY SPINE TEAM SPOKANE REHABILITATION, AND SEE THE DIFFERENCE.

TO SCHEDULE AN APPOINTMENT, CALL (509) 363-3100 OR FAX RECORDS TO (509) 363-0300.

Valley Office 1117 N. Evergreen Rd. Ste. 2 Spokane, WA 99216

www.SpineTeamSpokane.com

North Office 510 E. Holland Ave. Spokane, WA 99218

Providence Inland Vascular Institute is located on the Providence Sacred Heart and Holy Family campuses.

Providence proudly welcomes Inland Vascular Institute to our team.

The clinic offers comprehensive diagnostic and state-of-the-art treatment for vascular disease. Thomas R. Pellow, MD, FACS Gregory K. Luna, MPH, MD, FACS M. Kathleen Reilly, Phd, MD, FACS Stephen P. Murray, MD, FACS Joseph A. Davis, MD, RPVI Ryan D. Nachreiner, MD, FACS Megan Hoefer, MD Sandra Tidwell, ARNP

PROVIDENCE INLAND VASCULAR INSTITUTE For an appointment call 509.838.8286 or 800.215.6489

phc.org

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Providence Inland Vascular Institute 122 W. Seventh Central Medical Office Bldg. Suite 420 & 410 212 E. Central, Suite 245 Spokane, WA 99204 Spokane, WA 99208


FYI NIH and ASAM launch new screening resources A free, nationwide service ha s been launched to help primary care providers seeking to identify and advise substance-abusing patients. The service, Physician Clinical Support System for Primary Care (PCSS-P), offers peer-to-peer mentorship and resources on incorporating screening and follow-up into regular patient care. PCSS-P is a project of the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and the American Society of Addiction Medicine (ASAM). For more information access http:// drugabuse.gov/newsroom/11/NR4-08a.html.

In Memoriam

Robert Patrick Sagerson, MD Robert P. Sagerson (Bob) was born in Johnstown, PA, son of Dr. Robert J. Sagerson and Eulalia Lavelle Sagerson. He passed away on May 4, 2011. He graduated from Mt. St. Mary's College in 1936 and from the University of Pennsylvania Medical School in 1940. He interned at Mercy Hospital in Pittsburg and became a resident in radiology at Peter Bent Brigham Hospital in Boston. He spent 47 months on active duty during WWII as a radiologist in the Army Medical Corp. After discharge from the Army, he returned to Boston for further training. He served as an instructor in radiology at the Harvard Medical School. In 1947 Dr. Sagerson joined the radiology partnership of Harris and Brocker and was the third radiologist in Spokane, WA. He was on the staff of Sacred Heart, Deaconess and St. Luke's Hospitals. He served as President of the Staff at Sacred Heart Hospital. In 1967 he opened his solo practice in the Paulson Building and over the years, had at one time or another, Dr. Merle Moberly and Dr Patrick Hughes as associates. In 1981 he retired from the practice. He is survived by his wife of 63 years, Jean Hoyt Sagerson, and by three children, Ronald Newman Sagerson of Grapeview, WA, Suzanne Love (husband Bob) of Grapeview, and Marybeth Porter (husband Tom) of Spokane. He is survived by eight grandchildren and five great-grandchildren. Their daughter, Nancy Newman Sagerson, died in 1952. Bob is survived by his sister Natalie Hoadley (husband Bob) of Gibsonia, PA. He was preceded in death by his sister, Mary Patrice Mayer of Johnstown, PA and his brother, John L. Sagerson, of Orlando, FL. He enjoyed golf. He was a charter member of the Pacific Northwest Radiology Society. He was a good doctor, a good husband, a good father, a good man.

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Providence Pediatrics is now open in the Indian Trail Professional Building and near Providence Holy Family in the Central Medical Office Building. The clinic offers comprehensive pediatric medical and behavioral care for children from birth to 18 years in a friendly, family-centered atmosphere. Accepting new patients.

Providence proudly welcomes Pediatrics to our team.

A. Chris Olson, MD Deborah Icenogle, MD

Providence Pediatrics 212 E. Central, Suite 440 Spokane, WA 99208 For an appointment call 509.252.9602

PROVIDENCE PEDIATRICS

phc.org Riverpoint Rx.pdf

1/20/10

10:55:21 AM

A Personalized Approach to Your Health Riverpoint Pharmacy is one of the few remaining pharmacies that can still offer customized medications through pharmaceutical compounding. We can provide: • Individualized strengths, combinations and flavorings • Specialized dosage forms such as topical gells and slow release capsules • Sterile compounds such as preservative-free eye drops, injectibles and custom nebulizer solutions • Veterinary compounding Our specially trained pharmacists also offer personalized consultations in: • Nutrition evaluation and planning for improved health • Bioidentical Hormone Replacement Therapy for men and women • Review of medications and supplements • Pain management options for chronic pain and special needs

R iverpoint P

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Your treatment. Custom designed. (509) 343-6252 | 528 E. Spokane Falls Blvd. #110 www.riverpointrx.com

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Kim Alexander, ARNP Kathie Moody, PA-C Suzy Corcoran, ARNP

New Indian Trail Location!

5011 W. Lowell, Suite 100 Spokane, WA 99208 For an appointment call 509.385.0610


Meetings, Conferences and Events Institutional Review Board (IRB) – Meets the second Thursday of every month at noon at the Heart Institute, classroom B. Should you have any questions regarding this process, please contact the IRB office at (509) 358-7631. Caduceus Al Anon Family Group – Meets every Thursday evening from 6:15 pm until 7:15 pm at 626 N. Mullan Road, Spokane, WA. Non-smoking meeting for spouses and significant others of Healthcare Providers who are in recovery or who may need help seeking recovery. Facilitated 12 Step Al Anon Format. No dues or fees. Contact 509-928-4102 for more information. Physician Family Support Group — Physicians, physician spouses or significant others, and their adult family members share their experience, strength, and hope concerning difficult physician family issues which may include medical illness, mental illness, addictions, work-related stress, life transitions, and relationship difficulties. The meetings are on Tuesdays from 6:30 pm – 8 pm at Sacred Heart. Format: 12 Step principles for everyone, confidential and anonymous personal sharing; no dues or fees. Contact Bob or Carol at 509-624-7320 for more information. How to Deal with Problem Employees and Avoid Employee Lawsuits – WSMA Practice Management This half-day seminar will give you a thorough understanding of the critically important employment law principles to keep your practice out of jeopardy. An attorney experienced in handling lawsuits and employmentrelated matters for medical practices will teach you how to deal with problem employees, including how to use employee manual policies, job descriptions, work performance evaluations, performance improvement plans, separation agreements and other key documents to reduce your legal risk. Sample documents will be provided for your use. Friday, June 17 Spokane Valley Hospital. Contact Jenelle Dalit at 1(800) 552-0612 or jcd@wsma.org for more information. WSMA and UW Physician Leadership Course for physicians who want to know more about healthcare leadership. This is a 10-week course involving online and in-person learning in partnership with the University of Washington Graduate Programs in Health Administration and the UW Professional and Continuing Education. Dates for the next course start September 23 and go to November 18, 2011. If you are interested in the course or have a physician(s) in your organization you would like to nominate, please email Jennifer Hanscom. Applicants are asked to submit a cover letter outlining their interest in the course and the goals they hope to accomplish, a CV and a letter of reference from a supervising or mentor physician. Please send these documents to Jennifer before August 1, 2011. The course is limited to 30 individuals, and the tuition is $2,000. If you have any questions about the WSMA/UW Physician Leadership Course, please contact Jennifer Hanscom at the WSMA Seattle office (206) 4419762 or 1 (800) 552-0612 (jen@wsma.org).

Legislating Pain Care: How State Bill 2876 will affect your practice. Washington State Bill 2876 requires healthcare boards/ commissions who oversee Washington prescribers to develop and adopt rules regarding pain management by June 30, 2011. The rules address assessment, therapy and monitoring of patients with chronic non-cancer pain and particularly emphasize when a primary caregiver should seek consultation from a pain specialist and the definition of such a specialist. Inasmuch as pain is the most common presenting symptom for patients seeking medical care, it is not surprising that both the law and the subsequent rules have elicited widespread interest and controversy. Legislating Pain Care Conference to be held June 18, 2011 at the UW Campus – Kane Hall. This conference will present the “whys, whats and wherefores” of Bill 2876 in a series of lectures and case-based panel discussions (including Q & A) of appropriate patient evaluation and treatment of the patient in pain. Cost $165 all registrants. The University of Washington School of Medicine designates this live activity for a maximum of 6.5 AMA PRA Category 1 Credits™. For more information contact CME Registrar at (206) 543-1050 or email cme@uw.edu. Movement Disorder Review Course - The course offers 6.5 hours of Category I CME and is open to all healthcare professionals treating persons with movement disorders. The course focuses on Parkinson's disease, essential tremor and other tremor disorders, restless legs syndrome, chorea, tics and dystonia as well as psychiatric aspects of movement disorders and the use of pharmacologic agents, neurotoxins and DBS in the treatment of Movement Disorders. The conference is scheduled for Saturday, June 25th, Renaissance Seattle Hotel. For questions or registration information, please contact Kelly E. Lyons, PHD, University of Kansas Medical Center, (913)588-7159 or email kelly.lyons@att.net.

SPOKANE COUNTY MEDICAL SOCIETY CONTINUING MEDICAL EDUCATION 2011 Program Schedule SEPTEMBER Moderate (Conscious) Sedation and Analgesia Thursday, September 08, 5:30 – 9:15 pm Deaconess Health and Education Center (SCMS’ annual program to satisfy JCAHO requirements and provide a refresher course to members of the medical community in order to increase patient safety.)

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OCTOBER Endocrinology Update 2011 Thursday, October 06 Deaconess Health and Education Center 5:30 – 9:15 pm (Three one-hour topics will be presented)

NOVEMBER Orthopaedic Update 2011 Date TBD, 5:30 – 9:15 pm Deaconess Health and Education Center (Three one-hour topics will be presented)


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Cancer evolves at a rapid speed. So do our physicians. They have chosen the fields of oncology and hematology to specialize in and are the region’s leading board certified, fellowship-trained cancer experts. Pushing the limits, they conduct hundreds of clinical trials every year, publish articles for world-recognized scientific journals and customize treatment plans for every patient. Because no two cancers – or patients – are exactly alike.

Meet the physicians of Cancer Care Northwest. View their full profiles at: cancercarenorthwest.com/doctor-profiles

»

cancercarenorthwest.com

» 509.228.1000

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comprehensive innovative compassionate integrated


MEMBERSHIP RECOGNITION FOR JUNE 2011 Thank you to the members listed below. Their contribution of time and talent has helped to make the Spokane County Medical Society the strong organization it is today. JUNE 20 Years Lloyd M. Halpern, MD 6/6/1991 Alan D. Alyea, MD

6/19/1991

Steven W. Hong, MD

6/19/1991

Thomas J. Kass, MD

6/19/1991

Katherine R. Tuttle, MD 6/19/1991 Mark Mendez-Vigo, MD 6/24/1991 10 Years Stephen F. Lewis, MD 6/5/2001 J. Craig Whiting, MD

6/27/2001

Visit our updated website • View "The Message" Online

• Legislative updates

-Full current and past issues available

-Connect with SCMS on Facebook and stay informed

• Membership information

• Connect to Medicor

-Information about credentialing, committees, bylaws, etc.

-The online medical library is a SCMS membership benefit.

• CME information -Topic and dates for upcoming CME courses

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Controlled Substance Prescription Requirements By Jeff Collins, MD Chief Medical Officer, Sacred Heart Medical Center A recent interpretation of Federal Regulations has resulted in retail pharmacies not accepting prescriptions for controlled substances unless all required elements are present. This has caused multiple problems for patients who present an incomplete controlled substance prescription to a retail pharmacy. Per 21 CFR 1306.05(a, d, and f) and 21 CFR 1306.05(f) a complete controlled substance prescription includes all elements listed below. These elements must be completed by the prescriber or an agent of the prescriber. A complete controlled substance prescription includes all following elements: • Date of issuance • Full Name of Patient • Address of Patient • Drug Name

requently, missing information on a controlled substance F prescription includes the patient address and prescriber DEA. This information was often completed by the retail pharmacy since it did not impact the intent of the prescription. However, recent information reveals that this practice is currently not acceptable under Federal Regulations. As such, all prescriptions for controlled substances must include the required elements prior to providing the written prescription to the patient. Prescriptions for controlled substances that do not contain all required elements will likely result in either a phone call to clarify missing information (for CIII, IV, and V medications) or the prescription will be returned to the patient and the patient will be required to obtain a complete prescription (as required for all CII medications since they require a written prescription). Immediate Action Needed by Prescribers: Ensure all discharge prescriptions for controlled substance prescriptions contain all required elements. This includes writing out the patient address and the prescriber’s DEA. Ongoing Action: We are working with IRM to include the patient address on all discharge prescriptions. This should be on discharge form early next week. We will continue to monitor this issue as it is being discussed at various State Associations and the Washington State Board of Pharmacy. We will update you should any new information become available.

• Strength • Dosage form • Quantity Prescribed • Directions for use • Name/signature of prescriber • DEA registration number of the prescriber

Karry Home A Kindle Kontest! Tell us about this interesting piece of medical history and enter to win an Amazon Kindle! (Hint: this is an early piece of lab equipment originally patented in 1927). Winning a Kindle 6” 3G Wireless Reader is easy and fun! (a $189.00 value) Simply go to our website at http://spcms.org , find this picture on one of our web pages and follow the simple instructions to enter our contest. Are we being too obvious? Of course! We’re holding this contest to increase interest among our members in both our monthly newsletter, “The Message” and our newly redesigned website. May SCMS The Message 18


The following physicians/physician assistants have applied for membership, and notice of application is presented. Any member who has information of a derogatory nature concerning an applicant’s moral or ethical conduct, medical qualifications or such requisites shall convey this to our Credentials Committee in writing 104 S Freya St., Orange Flag Bldg #114, Spokane, Washington, 99202.

PHYSICIANS Craigg, Gerald B. R., MD Internal Medicine Loma Linda U (1996) Internship/Residency: East Tennessee State U (1999) Practicing with Sound Physicians since 5/2011 Florez, Claudia, MD Pediatrics/ Neonatal – Perinatal Medicine Med School: Escuela Colombiana De Medicina (2001) Internship: Driscoll Children’s Hospital (2005) Internship/Residency: Georgetown U Hospital (2008) Fellowship: Vanderbilt U Medical Center (2011) Practicing with Pediatrix Medical Group beginning 8/2011 Gaur, Shobhana, MD Internal Medicine Med School: Gandhi Medical College, India (2002) Internship/Residency: Wright State U (2008) Practicing with Rockwood Clinic, PS beginning 8/2011 Khan, Shireen E., MD Diagnostic Radiology/Pediatric Radiology Med School: Washington U, St. Louis (1993) Internship: Hennepin County Medical Center (1994) Residency: U of Minnesota (1998) Fellowship: Children’s Hospital and Regional Medical Center (1999) Practicing with Radia Inc., PS beginning 7/2011

Residency: Massachusetts General Hospital (2004) Fellowship: Massachusetts General Hospital (2005) Practicing with Anesthesiology Associates of Spokane beginning 9/2011 Parekh, Susanne G., MD Anesthesiology Med School: U of Michigan (2000) Internship: Newton-Wellesley Hospital (2001) Residency: Massachusetts General Hospital (2004) Practicing with Anesthesiology Associates of Spokane beginning 9/2011 Ro, Susie I., MD Neurology/Clinical Neurophysiology Med School: McGill U, Canada (1999) Internship: Brigham and Women’s Hospital (2000) Residency: Yale-New Haven Hospital (2003) Fellowship: Beth Israel- Deaconess Medical Center (2005) Practicing with Northwest Neurological, PLLC since 5/2011 Sanchez, Sean I., MD Internal Medicine/Nephrology Med School: U of Michigan (2004) Internship/Residency: Emory U (2007) Fellowship: Emory U (2009) Practicing with Rockwood Kidney & Hypertension Center beginning 8/2011 Singh, Satinder, MD Internal Medicine/Nephrology Med School: U College of Medical Sciences, India (2001) Internship/Residency: SUNY Upstate Medical U (2008) Fellowship: SUNY Upstate Medical U (2011) Practicing with Rockwood Kidney & Hypertension Center beginning 10/2011

LoCascio, Elizabeth S., MD Internal Medicine/Pediatrics Med School: Brody School of Medicine (2003) Internship/Residency: Brody School of Medicine (2007) Practicing with Rockwood Clinic, PS beginning 10/2011

Sukut, Chadd J., MD Dermatology/Mohs Micrographic Surgery Med School: U of Washington (2006) Internship/Residency: Southern Illinois U (2010) Fellowship: Southern Illinois U (2011) Practicing with Advanced Dermatology and Skin Surgery, PLLC beginning 8/2011

Mitchell, Bryan S., MD Orthopaedic Surgery/Orthopaedic Sports Medicine Med School: Dartmouth (2005) Internship/Residency: U of Rochester (2010) Fellowship: Aspen Sports Medicine Foundation (2011) Practicing with Orthopaedic Specialty Clinic of Spokane, PLLC beginning 9/2011

Sunidja, Aditya P., MD, MPH Diagnostic Radiology Med School: Boston U (2003) Internship: Newton-Wellesley Hospital (2004) Residency: St. Vincent Hospital/Worcester Medical Center (2008) Fellowship: Children’s Hospital Boston (2009) Practicing with Radia Inc., PS beginning 7/2011

Owen, Deborah H., MD Obstetrics and Gynecology Med School: Duke U (1986) Internship/Residency: George Washington U (1990) Practicing with Obstetrix Medical Group of WA, Inc., PS beginning 8/2011

Wood, Benjamin T., DO Obstetrics and Gynecology Med School: Michigan State U College of Osteo Med (2007) Internship/Residency: Sparrow Hospital (2011) Practicing with Rockwood OB/GYN Center beginning 8/2011

Parekh, Shyam D., MD Anesthesiology/Cardiothoracic Anesthesiology Med School: U of Michigan (2000) Internship: Newton-Wellesley Hospital (2001) May SCMS The Message 19


PHYSICIANS PRESENTED A SECOND TIME Bringhurst, Jade R., MD Emergency Medicine Med School: U of Utah (2008) Practicing with Hospital Physician Partners (Valley) beginning 7/2011 Cedars, Leonard A., MD Obstetrics and Gynecology/Maternal-Fetal Medicine Med School: U of Texas, Southwestern Medical (1974) Practicing with Obstetrix Medical Group of Washington, Inc, PS beginning 7/2011 Cranny, Dean R., MD Family Medicine Med School: Ross U, West Indies (2001) Practicing with Rockwood Clinic, PS beginning 7/2011 Gopalani, Sameer, MD Obstetrics and Gynecology/Maternal-Fetal Medicine Med School, Thomas Jefferson U 1997 Practicing with Obstetrix Medical Group of Washington, Inc, PS beginning 7/2011 Hall, Dustin J., DO Obstetrics and Gynecology Med School: Michigan State U, College of Osteo Medicine (2007) Practicing Rockwood Clinic, PS beginning 9/2011 Harding, James A., MD Obstetrics and Gynecology/Maternal-Fetal Medicine/Family Medicine Med School: U of Vermont (1983) Practicing with Obstetrix Medical Group of Washington, Inc, PS beginning 7/2011

Sajnani, Nitin V., MD Internal Medicine Med School: NDMVP Samaj Medical College, India (2003) Practicing with Sound Physicians beginning 5/2011 Singh, Harnek, MD Internal Medicine Med School: Osmania U, India (1990) Practicing with Sound Physicians beginning 5/2011 Shen, Yu L., MD Pediatrics Med School: U of Washington (2008) Practicing with Rockwood Valley Clinic beginning 8/2011 Sorensen, Tanya K., MD Obstetrics and Gynecology/Maternal-Fetal Medicine Med School: U of Washington (1985) Practicing with Obstetrix Medical Group of Washington, Inc, PS beginning 7/2011 Taha, Assad M., MD, PhD Surgery/Surgical Critical Care Med School: American U of Beirut, Lebanon (1980) Practicing with Surgical Specialists of Spokane beginning 8/2011 Waller, Sarah A., MD Obstetrics and Gynecology Med School: Tulane U (2004) Practicing with Obstetrix Medical Group of Washington, Inc, PS beginning 7/2011 Ward, Joshua Q., MD Anesthesiology Med School: Medical College of Virginia (2007) Practicing with Anesthesia Associates, PS beginning 6/2011

PHYSICIAN ASSISTANTS

Humble, Byron I., DO Orthopedic Surgery Med School: Kirksville College of Osteo Medicine (1998) Practicing with Rockwood Clinic, PS beginning 6/2011 Jawed, Irfan, MD Internal Medicine/Pain Medicine/Medical Oncology/Hospice and Palliative Care Med School: Dow Medical College, Pakistan (1996) Practicing with Cancer Care Northwest beginning 7/2011

Quella, Alicia K., PA-C School: U of Iowa (1999) Practicing with Valley Hospital Emergency Department (Hospital Physician Partners) beginning 5/2011

Madarang, Wilfred Alex O., MD Family Medicine Med School: St Luke’s College of Medicine, Philippines (2003) Practicing with CHAS beginning 9/2011 Peterson, Suzanne E., MD Obstetrics and Gynecology Med School: U of Washington (2003) Practicing with Obstetrix Medical Group of Washington, Inc, PS beginning 7/2011 Rai, Pragya, MD Pediatrics Med School: U of Science and Technology, Bangladesh (1999) Practicing with Providence Pediatric Pulmonology beginning 8/2011

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REAL ESTATE Luxury Condos for Rent/Purchase near Hospitals. 2 Bedroom Luxury Condos at the City View Terrace Condominiums are available for rent or purchase. These beautiful condos are literally within walking distance to the Spokane Hospitals (1/4 mile from Sacred Heart, 1 mile from Deaconess). Security gate, covered carports, very secure and quiet. Newly Remodeled. Full appliances, including full-sized washer and dryer. Wired for cable and phone. For Rent $ 850/month. For Sale: Seller Financing Available. Rent-to-Own Option Available: $400 of your monthly rent will credit towards your purchase price. Please Contact Dr. Taff (888) 930-3686 or dmist@inreach.com. All Costs Included--Upscale View Condo One of a kind, separate entrance condo built into an upscale home on the north side. (Owners rarely in residence) This home is located in a quiet, upscale-gated community, with panoramic views overlooking a small lake and golf course. It is totally turnkey furnished, dishes, linens, cleaning supplies etc. All new appliances, modern decor. One bedroom (king size bed/rollway for guests) one bath, complete laundry room w/full size wash/dryer and one car garage with extra storage. ALL COSTS ARE INCLUDED! Heat/AC, Utilities/Water, Cable TV, Internet/Wi-Fi, Long Distance phone. Golf and walking trails right out the door. Close to Holy Family Hospital and Whitworth College. Please call 954-8339 for details. Also willing to rent "unfurnished.” For Sale: 17718 E Linke Rd, Greenacres WA $649,900 Elegance redefined featuring a custom-built rancher and horse property situated on 5 breathtaking acres. For you over 3,800 sq feet, opulent master bedroom, formal dining, open floor plan & a gourmet kitchen. For your horses a 56’ x 48’ metal show barn, heated tack room, 12x12 wash area, 11 matted stalls, mechanical horse walker. Everything to accommodate you & your equestrian needs. Offered by John L Scott Real Estate – John Creighton at (509) 979-2535. For a virtual tour www.tourfactory.com/709316. MEDICAL OFFICES/BUILDINGS Good location and spacious suite available next to Valley Hospital on Vercler. 2,429 sq ft in building and less than 10 years old. Includes parking and maintenance of building. Please call Carolyn at Spokane Cardiology (509) 455-8820. Northpointe Medical Center Located on the North side of Spokane, the Northpointe Medical Center offers modern, accessible space in the heart of a complete medical community. If you are interested in locating your business here, please contact Tim Craig at (509) 688-6708. Basic info: $23 sq/ft annually. Full service lease. Starting lease length 5 years which includes an $8 sq/ft tenant improvement allowance. Available space: *Suite 210 - 2286 sq/ft *Suite 209 - 1650 sq/ft *Suite 205 - 1560 sq/ft *Suite 302 - 2190 sq/ft

For Lease 3700 sq ft of second floor space in a new 18,900 sq ft building available. It is located just a few blocks from the Valley Hospital at 1424 N. McDonald (just South of Mission). First floor tenant is Spokane Valley Ear Nose Throat & Facial Plastics. $22 NNN. Please call Geoff Julian for details (509) 939-1486 or email gjulian@spokanevalleyent.com. Sublease: Furnished Medical Office Space ~ Need immediate space for one or more north Spokane care providers? This shared suite is ready for occupancy; all furniture and exam room equipment included. Two exam rooms, one provider office, one nurse’s station and shared surgery suite, medical records storage area, reception and waiting area. 963 sq ft total, original lease $23/ sq ft; will negotiate lower rate. Excellent location in a full-service medical building with lab and full radiology services. For more information, call (509) 981-9298. South Hill – on 29th Avenue near Southeast Boulevard - Two offices now available in a beautifully landscaped setting. Building designed by nationally recognized architects. Both offices are corner suites with windows down six feet from the ceiling. Generous parking. Ten minutes from Sacred Heart or Deaconess Hospitals. Phone (509) 535-1455 or (509) 768-5860. North Spokane Professional Building has several medical office suites for lease. This 60,000 sf professional medical office building is located at N. 5901 Lidgerwood directly north of Holy Family Hospital at the NWC of Lidgerwood and Central Avenue. The building has various spaces available for lease from 635 to 6,306 usable square feet available. The building has undergone extensive remodeling, including two new elevators, lighted pylon sign, refurbished lobbies, corridors and stairways. Other tenants in the building include, pediatricians, dermatology, dentistry, pathology and pharmacy. Floor plans and marketing materials can be emailed upon request. A Tenant Improvement Allowance is Available, subject to terms of lease. Please contact Patrick O’Rourke, CCIM, with O’Rourke Realty, Inc. at (509) 624-6522 or cell (509) 999-2720. Email: psrourke@comcast.net. OTHER Closing OB/GYN practice – For sale 2 exam tables, 1 electric exam table (like new), colposcope, non-stress test machine, speculums, metal filing cabinets, office supplies, waiting room chairs and bookcases. Call 747-6600 for more information.

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POSITIONS AVAILABLE PHYSICIAN OPPORTUNITIES AT COMMUNITY HEALTH ASSOCIATION OF SPOKANE (CHAS) Enjoy a quality life/work balance and excellent benefits including competitive pay, generous personal time off, no hospital call, CME reimbursement, 401(k), full medical and dental, NHSC loan repayment and more. To learn more about physician employment opportunities, contact Kelly McDonald at (509)444-8888 or kmcdonald@chas.org. OUTREACH CLINIC AT HOUSE OF CHARITY – This is an opportunity to volunteer and bring to the underserved in our community first line medical care. We need one or two more doctors to help us. We see the homeless, predominantly, two afternoons each week. Join four Board MDs and twelve RNs to rotate once or twice monthly in an excellent, well-equipped clinic with pharmacy. If you are completely retired, the state will pay for your medical license and malpractice. For more information and to sign up, call Dr. Arch Logan, Medical Director, at (509)326-0255 or Ed McCarron, Director of the House of Charity, at (509)624-7821. PROVIDENCE PHYSICIAN SERVICES is recruiting for BE/BC Pediatricians to join us in Spokane, the urban center of spectacular eastern Washington. Excellent opportunity to join a collegial, physician-led medical group affiliated with the region’s most comprehensive and caring hospitals. Providence offers generous hiring incentives, competitive compensation, comprehensive benefits and flexible work arrangements to fit individual needs. Contact: Mark Rearrick, mark.rearrick@providence.org, (509) 4746605, www.providence.org/physicianopportunities. PEDIATRIC HOSPITALISTS OPPORTUNITIES: If you would like the opportunity to participate in the growth of our pediatric services at Deaconess and Valley Medical Centers, please consider joining our multi-disciplinary team. We need four to five Pediatric Hospitalists at either facility. You will be working with nurses with many years of pediatric expertise. You will be part of a team of hospitalists providing 24-hour coverage/365 days per year. Please contact Evelyn Torkelson Director, Physician Recruitment, at torkele@empirehealth.org for more details.

competitive benefits and opportunity for paid on-call duty. Join a stable Medical Staff of 30+ psychiatrists, physicians and physician assistants. Contact Shirley Maike, 509.565.4352, email maikeshi@ dshs.wa.gov. PO Box 800, Medical Lake, WA 99022-0800. URGENT CARE POSITION – First Care Med Centers has four Urgent Care locations in Spokane, WA. We are seeking a Board Certified physician with comparable Urgent Care experience for a full-time position. Excellent salary and benefits package with flexible work schedule - 12-hour shifts and no call. Please contact Evelyn Torkelson at torkele@empirehealth.org or (509)473-7374. SPOKANE REGIONAL OCCUPATIONAL MEDICINE (SROM) has an opportunity for a physician. Our treatment approach takes a comprehensive view that encompasses the medical, psychosocial and functional outcomes of the injured worker and follows best practices as defined by Washington State L&I’s Center of Occupational Health and Education (COHE). SROM is affiliated with Valley Hospital and Medical Center, Deaconess Medical Center and Rockwood Clinic. This affiliation provides exceptional administrative support, offers state of the art diagnostic services’ improving our ability to diagnose and treat, and a referral system that is unmatched. For more information contact Evelyn Torkleson, physician recruiter at (509)473-7374 or email at torkele@ empirehealth.org. QTC MEDICAL GROUP is one of the nation’s largest private providers of medical disability evaluations. We are contracted through the Department of Veterans Affairs to manage their compensation and pension programs. We are currently expanding our network of Family practice, Internal medicine and General medicine providers for our Washington Clinics. We offer excellent hours and we work with your availability. We pay on a per exam basis and you can be covered on our malpractice insurance policy. The exams require NO treatment, adjudication, prescriptions to write, on-call shifts, overhead and case file administration. Please contact Katrina Nudo at 1-800-260-1515 x2226 or email knudo@ qtcm.com or visit our website www.qtcm.com to learn more about our company.

EASTERN STATE HOSPITAL PSYCHIATRIST - ESH is recruiting for a psychiatrist. Joint Commission accredited, CMS certified, state psychiatric hospital. 287 beds. Salary $161,472 annually with

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SLEEK NEW ROOMS . NEW LUXURY SPA . NEW RESTAURANTS .

SOME THINGS , HOWEVER , WILL NEVER CHANGE .

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ATTEND AN INFORMATION MEETING We invite you to come learn more about Gonzaga’s new hybrid-model MBA in Healthcare Management program, with online and weekend classes for working professionals: Wednesday, June 1st, 5:30 - 7 PM at Gonzaga’s Jepson Center RSVP AT: www.gonzaga.edu/MBAinfomtg

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May SCMS The Message 25

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