2014 Officers and Board of Trustees
Spokane County Medical Society Presents
MEDICINE 2014 FRIDAY, SEPTEMBER 26, 2014 7:00 AM – 5:00 PM
RED LION HOTEL AT THE PARK
W 303 NORTH RIVER DRIVE, SPOKANE, WA 99201
Agenda & Faculty 7:00 AM
Registration / Light Breakfast
7:45 AM
Welcome and Introductions Deborah Wiser, MD (Program Chair)
8:00 AM
Common Peripheral Neuropathy Issues in Primary Care Scott Carlson, MD
9:00 AM
Current Challenges and Trends in the Management of the Adult Patient with Congenital Heart Disease C. Chris Anderson, MD
10:00 AM
Break
10:30 AM
Shared Decision Making with Patient Decision Aids David Arterburn, MD
11:30 AM
Lunch
12:30 PM
Healthy Mouths / Healthy Bodies James N. Sledge, DDS
1:30 PM
Chronic Diarrhea: What Should I do Next? Wichit Srikureja, MD
2:30 PM
Break
3:00 PM
Medicinal Cannabis and Chronic Pain: Science-Based Education in Times of Legalization Gregory T. Carter, MD
4:00 PM
Resident Presentations: Transgender Patients: An Update on Treatments and Patient Perspectives Rachel Wright, DO Celiac Disease Robert Lichfield, DO
5:00 PM
David Bare, MD President
COURSE OBJECTIVES: At the conclusion of this program participants will be able to: • Understand a useful examination approach to foot-drop to guide further evaluations. • Understand common causes of painful polyneuropathy and identify a rational approach to neuropathic pain treatment. • Understand a reasonable approach to carpal tunnel syndrome. • Identify epidemiologic trends in adults with congenital heart disease and discuss issues of access to quality healthcare for the adult patient with congenital heart disease. • Review management of common late-term complications in repaired and unrepaired congenital heart disease. • Discuss issues of family planning, pregnancy, and parenting unique to the adult patient with congenital heart disease. • Identify the key components of a shared decision-making process and understand the value of incorporating patient decision aids into clinical practice. • Describe the two major diseases of the mouth. • Explain the connection between oral disease and diabetes. • Identify the patient with chronic diarrhea; understand diagnostic strategy and medical therapy for the patient with chronic diarrhea. • Describe the major pharmacological effects of cannabinoids and identify the primary components of the endocannabinoid system. • Explain and describe the risks and benefits of cannabis; identify the main distinctions between appropriate medicinal use of cannabis versus recreational or other less compelling uses. • Understand options and barriers for treatment of the transgender patient; identify risks of treatment and other risk factors for the transgender patient. • Describe the appropriate diagnostic approach to Celiac Disease and review long term risk factors for patients with this disease. • Discuss the differences between celiac and gluten intolerance. CME Category 1
The Spokane County Medical Society designates this live activity for a maximum of 7.0 AMA PRA Category 1 Credit(S)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.
Cancellations must be made by September 12, 2014 for a refund. Fax form to (509) 325-5409 or mail to SCMS: Spokane, WA 99202
President’s Message: What is the Cost to Educate a Provider and Can We Do It Better? . . . .
Anne Oakley, MD Immediate Past President
In-Depth Interview: Sally Aiken, MD: Solver of Puzzles . . . . . . . . . . . . . . . 3
J. Edward Jones, MD Vice President Gary Newkirk, MD Secretary-Treasurer Trustees Charles Benage, MD Audrey Brantz, MD Karina Dierks, MD Elizabeth Grosen, MD Clinton Hauxwell, MD Louis Koncz, PA-C Frank Otto, MD Fredric Shepard, MD Carla Smith, MD Brian Tryon, MD Newsletter Editor – Matt Hollon, MD
Early Registration by 8/29/14
Registration Fee after 8/30/14
Physician Member (MD, DO)
$150
$175
Physician Non-Member (MD, DO)
$200
$225
PA Member
$100
$125
PA Non-Member
$125
$150
Retired Member
$95
$120
Allied Health (ARNP, RN, Etc.) Resident/Medical Students*
$85
$110
0
$25
Please Circle:
*Registration Fees for the 1st 20 Paid by the Spokane County Medical Society Foundation
Medical Education: On Being a Physician . . . . . . . . . . . . . . . . . . .
1
5
Medical Education: Full Circle . . . . . . . . . . . . . . . . . . . . . . . 6 Medical Education: Grief: A Reflection on Patient Autonomy . . . . . . . . . . . . . 7 Hospice Spokane: End of Life Part III: Hospice Care . . . . . . . . . . . . . . . . 8 Group Health: New Name for Accountable Care Organization: CareUnity . . . . . . . . . 10 Dental Emergencies Needing Treatment (DENT) Program Addresses Access to Oral Health Care in Spokane . . . . . . . . . . . . . . . . 11 Big Brothers Big Sisters: Changing Perspective for Children in the Inland Northwest . . . . . 13
7.0 Total
The Spokane County Medical Society designates this activity for a maximum of 7.0 hours in Category 1 credits to satisfy the re-licensure requirements of the Washington State Medical Quality Assurance Commission.
Spokane County Medical Society Presents MEDICINE 2014
Orange Flag Building, 104 S Freya St, Suite 114
Matt Hollon, MD President-Elect
In The News: Eric Johnson, MD; Brian Peterson, MD . . . . . . . . . . . . . . . 14
The Spokane County Medical Society is accredited by the Washington State Medical Association CME Accreditation Committee to sponsor continuing medical education activities for physicians.
Adjourn
Meal Preference: Regular Vegetarian Other: Name: E-mail Address: Credentials/Degree: Specialty: Day Phone: ( ) Address: City: State: Zip: Please make prepayment by: My check made payable to SCMS is enclosed. VISA MC Account Number: Name on Card: Exp. Date: Billing Address & Zip:
Table of Contents
Total Due:
Spokane County Medical Society The Message A monthly newsletter published by the Spokane County Medical Society. Advertising Correspondence SCMS Publications Attn: Saraj Bailey 211 W 2nd Ave Spokane, WA 99201 509-343-0123 Fax 509-325-3889 Saraj@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.
In Memoriam . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Membership Recognition . . . . . . . . . . . . . . . . . . . . . . . . 15 SCMS Statement of Support for Medical Education . . . . . . . . . . . . . . . . 15 New SCMS Members . . . . . . . . . . . . . . . . . . . . . . . . . 19 Classified Ads / Real Estate / Medical Offices / Buildings . . . . . . . . . . . . . . 21 Meetings / Conferences / Events / Positions Available . . . . . . . . . . . . . . . 22 Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Retired Physicians Golf Tourney Another Success . . . . . . . . . . . . . . . . 24
“Summer afternoon—summer afternoon; to me those have always been the two most beautiful words in the English language.” –Henry James
President’s Message
WHAT IS THE COST TO EDUCATE A PROVIDER AND CAN WE DO IT BETTER?
to cover the portion of resident salaries,
around $90,000 per resident FTE per year
school in conjunction with the community
teaching expenses and indirect hospital
times the percent of Medicare patients the
colleges which allows advanced students
costs associated with the academic
hospital serves. So if the hospital serves 30%
to earn college credits while they are still
mission attributable to the care of Medicare
Medicare patients it would receive about
in high school. Any program that shortens
beneficiaries, using a complex allocation
$27,000 for each FTE resident slot per year.
the course of training decreases the cost.
formula. However, there are other program
Currently Providence is the only teaching
In some countries this selection process
expenses associated with medical education
hospital in our area and currently has 80
dips into the elementary level classes to
that are not reimbursed by Medicare and still
slots. This number includes the six new slots
identify gifted children who are started
significantly affect the competitiveness and
that were added as of July 1.
even earlier into STEM (science, technology,
quality of the educational programs (about $4,500 annually per resident). Medicare is the largest single program providing explicit support for GME. In federal fiscal year 2011, the Medicare program paid hospitals that train residents approximately $3.2 billion dollars in direct graduate medical education (DGME) funds, out of approximately $15 billion in DGME-related costs. DGME payments cover a portion of the direct costs of training residents, such as residents’ stipends and benefits, teaching physicians’ salaries, other direct costs (e.g., a GME office to administer programs, accreditation By David Bare, MD
proposed. We had an opportunity to share
yearly. For a four-year degree that would be
SCMS President
this with key members of the Department
between $52,000-$240,000 not including
of Social and Health Services who listened
books, housing and meals. According to
carefully to our dialogue and recognized
Bloomberg.com, the median four-year cost
the needs for which we were advocating.
to attend medical school -- which includes
However what they put back on our plate is
outlays like living expenses and books
what I want to discuss with you today. “How
-- for the class of 2013 was $278,455 at
can we do provider training and in particular
private schools and $207,868 at public ones,
Graduate Medical Education in a more
according to the Association of American
efficient, effective way?”
Medical Colleges, a nonprofit group of U.S.
I would like to share with you the second big health care issue that was discussed while we were in Washington, DC last month: Graduate Medical Education (GME) needs in our local community. We were asking as a group for more slots for
schools.1 Those costs are the responsibility
fees, educational space, etc.), and related overhead expenses. The amount of Medicare DGME payments a teaching hospital receives is related to the share of the hospital’s inpatients who are Medicare beneficiaries. Once a hospital has asked for and received their requested number of resident slots it is very difficult to increase those numbers (No pun intended but you could says it takes an act of congress!) Congress passed a law in 1997 that imposes a hospital-specific limit on the number of residents that Medicare will
residents in the existing residency programs
First let’s look at the current system by
in family medicine and internal medicine
which an intelligent motivated student
and help with expansion of residencies
gets the training they need to become a
into the areas of psychiatry, pediatrics,
physician. Medical schools require students
radiology and general surgery. We were also
to have a degree from a certified institution
asking for funding to help with the Spokane
with certain pre-requisite classes. So all
The cost of GME in the United States is
gets paid for each Full Time equivalent
Teaching Health Center that Washington
of the individuals pursuing that educational pathway. Most students will have a total debt of $240,000 to $360,000 at the end of their eight year training before residency.
pay for. In general, the limit (often referred to as the hospital’s resident “cap”) is based on the number of residents that a hospital trained in 1996. The amount a hospital
applicants to a medical school will receive
subsidized by the federal government
resident (there are rules related to how
State University Spokane, Providence Health
a degree which, depending on where they
through direct and indirect Medicare
this is determined) is variable but it is in a
Care and Empire Health Foundation have
attend, can cost from $13,000 to $60,000
payments. Those payments are intended
general way calculated on a baseline of
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
1
| T H E M E S S A G E | J U LY, 2 0 1 4
As you can imagine as our population is growing and our need for more residency slots in our local hospitals increases so will the expense of supporting and maintaining those residents. One way around the “cap” that was set in 1996 is through the addition of such enterprises as Teaching Health Centers for which the consortium as described above has applied. This would eventually give Providence 39 more residency slots over the next five years. From graduation of high school to actually hanging up a shingle for purposes of practicing
engineering and mathematics) programs that have students training in advanced (college) classes even earlier---again decreasing the amount of time to a degree. Teaching Health Centers is another way the government can save money by having residents working in Federally Qualified Health Centers increasing the number of patients being seen while being trained on the same dollar. Using information technology and online teaching for large groups of residents reduces the residency staff required for those purposes and further reduces costs.
medicine costs around $525,000. Much of
These are only a few of the many things
even undergraduate degrees are paid for
that are or could be done differently. I know
through federal loans. So Uncle pays for a
that there are many ideas you might also
large percentage of the cost that goes into
have regarding ways to change education
educating physicians. Obviously in this time
of physicians and decrease the cost while
of budgetary discretion things are tight
maintaining the quality of such an education.
related to expansion (or in many cases even
As a medical society this is yet another area
sustaining current programs).
that we can proactively give input to our
So the question is, “Can this be done any more efficiently or effectively?” Neither Dean nor I have “the” answer to this question but there are some avenues that are already in place that might save some time and money in the process and obviously many other ideas that are available to revamp the whole system. Something that many of our young people are currently doing that
legislators so changes upon which we agree. Who out there is interested in pursuing further discussion of this topic so we might have a task force that meets related to brainstorming ideas? Let us know through the SCMS website or calling or emailing Dean Larsen (dean@spcms.org) or me dbare@chas.org with that interest. We look forward to hearing from you. n
decreases the time to college graduation has to do with such programs as “Running Start”.
1 Lorin, Janet (2013) Medical School at $278,000 Means
Such programs locally are run by the high
Even Bernanke Son Has Debt Bloomberg.com
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
2
| T H E M E S S A G E | J U LY, 2 0 1 4
In-Depth Interview
In-Depth Interview
such as how to cut strips for blocks, pulling
together and ability to complete a large
Association of Medical Examiners in
strings, etc. She learned about fabrics, how
project despite the seemingly overwhelming
April, 2004, was re-accredited in May
to piece the fabric blocks together and how
amount of work required are characteristics
of 2009 and accredited again in June
quilts are assembled.
demonstrated repeatedly throughout Dr.
of 2014. The National Association of
Aiken’s educational and professional history.
Medical Examiners (NAME) is the
As an adult, Dr. Aiken has found that
SALLY AIKEN, MD: SOLVER OF PUZZLES
quilting helps her relax during stressful
A self-described jock and daughter of a
times. When her three children were
Physical Education teacher, Dr. Aiken grew
younger, quilting provided a refuge, even
up in a home where exercise and activity
if she was only able to spend 20 minutes
played a central role in her life. As with
or a half-an-hour working on a project.
many people who have found professional
Her children called her time spent quilting
success, Dr. Aiken did not and does not
“Mom’s Double-Secret Quiet Time.” More
spend a lot of time watching television; she
recently, she has been fortunate to have a
would much rather be doing anything else
space in her home where she can leave out
to occupy her free time. In an era before
her materials and current projects, saving
Title IX ensured girls had equal access to
her time and enabling her to work on a
sports, she was the president of the Girls’
project for a few minutes each day if that is
Athletic Association and organized weekly
the only time she has available to spend. Dr.
athletic events for her peers. Dr. Aiken
Aiken has also found that quilting provides
recalled an example of when the group
her with an opportunity for time to think
had to go bowling for their athletic activity
and focus, something she finds especially
because the boys were using the gym and
beneficial when she’s working through
their activities were given preference
a particularly complicated case as the
over the girls’ needs. Whereas most young
medical examiner.
women today would take for granted their
Dr. Aiken’s pattern choices for her quilts are not surprising. While most quilters might choose blocks requiring larger strips of fabric and thus less cutting and easier
ability to participate in sports, Dr. Aiken was forced to seek out opportunities for participation in athletics on her own. An avid skier, distance swimmer, bicyclist and competitive runner, she still prioritizes
By Bonny Laughary
must collect information, examine evidence
then try to recreate the intricate patterns
work, Dr. Aiken’s chosen patterns are
SCMS Accounting Assistant
and determine a solution based on the data
and arrangements at home on her own.
often challenges comprised of tiny blocks
available. The role requires persistence,
Since her mother did not sew, Dr. Aiken
pieced intricately together into complicated
diligence and the ability to focus on details
had to learn how to sew independently as
designs. Unlike many quilters who spend a
while still working toward the “big picture.”
well, though she now describes the sewing
great deal of time on the colors and fabric
Dr. Aiken’s ability to overcome obstacles
Although at first glance quilting and the
knowledge needed for quilting as fairly
choices for a quilt, she is more interested
and persistence in achieving her goals
activities of a medical examiner may seem
basic and essentially “the ability to sew
in the geometry of the patterns of the quilt
as demonstrated in her choices of
wholly unrelated, Dr. Aiken has found that
in a straight line.” Interested in math from
design. For a particularly complicated
hobbies and athletic endeavors is also
she has been able to apply some of the
an early age, she enjoyed studying the
quilt, she often relies on her daughter,
evident in her recent achievement as
characteristics of her role as a medical
angles and geometry of quilts and the ways
an art student, to provide guidance as to
a medical examiner with the Spokane
examiner to her quilting hobby.
in which the fabric blocks were pieced
the best fabric selection, layout and color
County Medical Examiner’s Office. The
together to form ornate shapes and designs.
choices for a specific design. The attention
Spokane County Medical Examiner's
She took several quilting classes and
to detail for so many small cuts, precision
Office achieved the distinction
learned the basic techniques for quilting,
required to perfectly piece the fabric pieces
of Accreditation by the National
In popular culture, medical examiners are often portrayed on television and movies as slightly peculiar characters, eccentric doctors who spend their days gleefully performing unsavory tasks in windowless basement labs. On the contrary, Spokane County Medical Examiner Sally Aiken, MD easily defies this stereotypical description. As a medical examiner, Dr. Aiken’s responsibilities may be broadly summarized as solving puzzles. A medical examiner
As a young girl, Dr. Aiken was fascinated by antique quilts. She would often examine them to see how they were assembled and
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
3
| T H E M E S S A G E | J U LY, 2 0 1 4
national professional organization of forensic pathologists, physician medical examiners, medical death investigators, death investigation system administrators and consultants who perform the official duties of medicolegal investigation of deaths of public interest in the United States. Most members work as Medical Examiners or Coroners. Accreditation is a rigorous process and requires a lengthy inspection by an independent Medical Examiner appointed by the organization. The accreditation requirements are 30 pages long and include 350 items covering things such as how many autopsies are performed each year, how specimens are labeled, death investigation protocols, etc. Of 2,342 death investigation systems in the United States, currently there are only 85 fully NAME accredited Medical Examiner/ Coroner Offices. The Spokane County Medical Examiner's Office is accredited until 2019. n
exercise despite the demands of her profession and makes time for those activities in her daily life.
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
4
| T H E M E S S A G E | J U LY, 2 0 1 4
Medical Education
Medical Education
ON BEING A PHYSICIAN ESSAY CONTEST WINNERS
By Judy Swanson, MD
The Committee has encouraged residents to
exemplify the qualities of the caring and
Faculty Attending
participate, resulting in a teaching module
compassionate medical student, resident
Internal Medicine Spokane Residency
in the Annals of Internal Medicine for the
and physician.
WWAMI MS3 Internal Medicine
residents entitled “The Prison Patient”.
Clerkship Director
Our members have contributed poems
Assistant Clinical Professor
and essays that have been published in
University of Washington
the Annals and the American Journal of
Staring at the EMR screen instead of looking at a person, it’s easy for the patient to transform into a box to check. Their story is becoming submerged in a sea of documentation. And we forget the reason we became a physician in the first place. The Medical Humanities Committee was started four years ago to remind medical students, residents and ultimately physicians of the patient we see before us. Chaired by Judy Swanson MD, the leadership also includes Darryl Potyk, MD and Jeremy Graham, DO.
Medicine. Time and money have been contributed to a medical humanities selective for the first and second-year medical students at Riverpoint Campus. The selective involves discussing varying perspectives of physicians as seen through art, essays and novels against a background of the history of medicine.
A generous contribution from the Shikany Endowment has led to the establishment of an annual essay contest entitled “On Being a Physician”. The purpose of the essay is to encourage Spokane medical students and residents to reflect on how interactions with patients have led to personal growth as a physician. We are proud to announce that this year’s winners include Rachel Wright from Family Medicine Residency Spokane and Katherine Grette from the Riverpoint second-year medical student class.
We also have a featured speaker at our sessions at the Spokane Society of Internal Medicine who speaks to the humanities, and the Osler Awards have been established to honor those who best
If you are interested in being part of the Medical Humanities Committee, please email Judy Swanson at Judy.Swanson@ providence.org. n
FULL CIRCLE By Rachel Wright, DO The blood dripped down her legs as the razor glided smoothly over her skin. She looked closer, startled and frightened. After cleaning off, Mrs. S called her primary care doctor to explain what happened. Several hours later, a blood test revealed that she likely had a blood cancer, and her primary care doctor sent her to the hospital for admission. I met Mrs. S shortly after her arrival and discussed her presenting story. She appeared very honest, courageous, and sarcastic, despite carrying a severe diagnosis. Over the subsequent days, more blood work confirmed that she had a rare form of leukemia, with a poor prognosis, particularly given her age. My daily rounds began to feel somewhat insignificant once she was started on high dose chemotherapy and had active involvement of the oncologist. I would ask Mrs. S about her day, and since she used to work in hat retail, our daily conversations often involved hats. In getting to know her, I discovered she had been divorced for many years and had several grown children. As her treatment intensified, Mrs. S never gave up or showed any signs of allowing the disease to overpower her. Her children would rotate staying at the bedside, and my conversations were honest with them about the plan, to the best of my understanding. I also discussed the extreme risks of infection, particularly when her defensive blood cells dropped to zero because of the chemotherapy. One day, our supervising doctor asked us to do bedside rounds, where the team gathered around the patient to discuss the case. Being the resident who was primarily following this patient, I approached this discussion with some trepidation. I wasn’t sure how to tell a difficult story in front of the patient. I took a deep breath and rested my hands on the plastic bedside railing, standing close to Mrs. S. I began her story, from day one when she noticed the bleeding in the shower. I recounted the recent blood work, the chemotherapy that she was getting, and the progress of her disease
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
5
| T H E M E S S A G E | J U LY, 2 0 1 4
to this point. One of the patient’s brothers, approximately the age of my father, wiped the tears off his cheeks as I spoke. My conclusion was unknown, and I stated my beliefs about Mrs. S’s strength and our hope for the best. The next morning, during my routine rounds, I sat down once again to ask Mrs. S how she was doing that day. She was alone this time; her children had not yet arrived. She looked into my eyes, and said she wanted me to know that her daughters were very grateful that I was her doctor. This confirmed for me, that despite the fact that I wasn’t ordering labs, medicines, or any additional workup, my presence meant something to her. I squeezed her hand, thanked her, and continued on my day. The next morning, something changed. I found Mrs. S panting, sitting at the side of the bed, having just vomited. She looked dramatically different, her skin an ashen grey color, and panic was in her eyes. She had a fever overnight, the one thing we dreaded now that her defensive blood cells were nonexistent. Later that morning, after starting numerous antibiotics, we transferred her to the intensive care unit, where the intensive care team took over. I carried on with my hectic morning and had a chance to stop by and see her late that afternoon. Her breathing was rapid, as it is with severe infection and acidity of the blood. I approached her bedside. She stared at me, her eyes communicated fright, and she mumbled nonsensically. It seemed like she wanted to tell me something, but she couldn’t get the words out. I squeezed her shoulder and told her it was all right. I looked at her family surrounding her bedside, and reiterated what the intensive care team had already told them—that things don’t look good. Her children and her brother sincerely thanked me, shaking my hand. I felt hollow inside as I gave my condolences. I had to leave at that point because a pregnant patient of mine was going to deliver at another hospital. Mrs. S’s family was pleased to hear of an anticipated beginning of life, as their loved
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
6
one was near the end. I visited my pregnant patient, a 19-year-old without any familial support, that I had been seeing in clinic for the past nine months. Her labor would likely be several hours away, but I decided to stay in the call room overnight, knowing that without anyone at her bedside, she appreciated my involvement. I set my alarm for two a.m. to check on the progress of her labor. Her labor was still in the earlier stages when I called the nurse, but after the phone call I couldn’t get back to sleep. I felt a very strong urge to talk to the nurse for Mrs. S. Deciding not to ignore that feeling, I contacted her. “Funny you should call”, she said, “Because she actually passed away about ten minutes ago. It was very peaceful; her family was all at the bedside.” I got out of bed and drove quickly to the other hospital at that time, hoping to, once again, give my condolences to her family. By the time I got there, the room was empty. I arrived just in time to see Mrs. S’s body being wheeled down the hallway on a gurney, covered in a white sheet. I returned to the other hospital, and later that morning, I coached my 19-year- old patient to push out a healthy baby girl. The infant cried and kicked in my arms as I placed her on the young mother’s chest, and tears filled my eyes. To be able to experience the end of one life and the beginning of another in the same night is juxtaposition unique to Family Medicine. The beginning of life is renewing, invigorating and exciting. I believe that it restores my energy to devote myself wholly to those who are suffering. I have decided early in my career that there are no boundaries to compassion. Whether I am treating patients at the beginning of life or at the end, or during the continuum between, the responsibility and significance of being a physician will be ever present in my mind and my actions. My goal is to be truly present in each moment, with each patient, and to be compassionate in all circumstances. I will use the skills I have learned and the skills I have been given to meet the needs of those patients I serve. n
| T H E M E S S A G E | J U LY, 2 0 1 4
Medical Education
Hospice Spokane
GRIEF: A REFLECTION ON PATIENT AUTONOMY By Katherine Grette, MS 2 I walk into the darkened room and sit on the bedside commode to talk to the frail
she has lived. She made a choice. She
Suddenly, what I know does not matter.
sacrificed her health to create the life
She is the only important consideration.
she wanted.
Her values, her reasoning, her life. I hope
woman dying in the hospital bed. She
Throughout the last two years of my
barely opens her eyes when I speak to her,
education, I have learned much about
and her words are nearly drowned out by
medication regimens and the management
the sound the machine that is providing
of disease. I have learned about the
the oxygen she needs to speak. Only two
cocktail of sometimes debilitating side
months before, she lived at home, cooked
effects that come along with the things I
her own meals, and beat anyone who dared
will ask patients to do and to take. I have
to challenge her in a game of Scrabble.
learned how to help patients to make
Still, she manages to smile when I say my name. She is the one dying, but she asks about me. She is soft spoken and sweet, but stubborn as she tells me stories of raising children and
appropriate decisions regarding their health. I have talked with mentors, with my classmates, and with nurses about how challenging it is to get patients to comply with medical advice. But none of that helps me in this moment,
arrhythmia and a bundle block since she
as I sit with my dying grandmother and
was a child. When pregnant the first
understand that my existence hinged on
time, she was told that her heart was too
her unwillingness to follow medical advice.
She carried and delivered her son anyway. Now, three sons, a daughter, eleven grandchildren, and three greatgrandchildren later, she has lived. Her last year may have been hell, with a pacemaker, a defibrillator, and a heart attack, but she has lived. She may have struggled with hypertension, diabetes and congestive heart failure, but she has lived. She may have had to lead this quiet life because of her choice to raise children, but she has lived. She may have exasperated a parade of cardiologists who could not convince her to comply with their plans for her health, but
and that I see her face whenever I meet with a patient who has failed year after year to follow the advice that decades of science and medical research has determined to be standard of care. I hope that I recognize there are parts of my patients’ lives that are hidden from me, so far from my existence that I cannot understand their role in health and happiness. As a physician, when some
END OF LIFE PART III: HOSPICE CARE
young woman kisses her grandmother’s cheek, when she laughs about the time grandma fell headfirst into the fishpond,
grandchildren. She has lived with an
weak to continue with the pregnancy.
that this moment stays with me forever,
when she says “I love you” for the last time, it is not my medical advice or the extra months or years that will matter. For my grandmother, and doubtless for
By Valerie Logsdon, MD
with a primary goal of alleviating the
Hospice Spokane
suffering of dying. She pioneered the use
physicians (the attending physician and
of opioids to control pain and advanced the
a hospice physician) that the prognosis is
concept of total pain: all encompassing
six months or less if the disease runs its
others, what matters is having lived the
Hospice care is equated with end of life
Surely, this moment is an important part of
way that she wished. Sons and daughters,
care. It is generally accepted that most
who I am as a person. This woman taught
graduations and weddings, grandchildren
people would prefer to die at home if they are
me that gentleness is strength, that family is
and great grandchildren gave her life more
terminally ill. Hospice allows this to happen.
worth sacrifice, and that respect for others
meaning than a “healthy” life alone ever
brings personal satisfaction. And now she
would have.
lies on the bed before me, and I know far too much about what is happening inside of her body. I can picture the immobility and her failing heart together creating the weeping wounds on her legs. I can see her lungs fill with fluid as her heart fails. All at once, medicine is too personal. I have always been able to separate myself from the patient before me, but watching her die is breaking the façade that I have built.
Hospice care is best suited for patients who hope for quality at the end of life. It is an
illness (general debility or failure to
first US hospice program in Connecticut
thrive do NOT qualify). Disease specific
opened. Hospice remains a concept of
guidelines have been created: they are
care that assures comfort when cure is not
related to decline, functional limitations,
possible. It is guided by the principle that
comorbidities and vary according to
dying is a normal process with the goal of
geographic area.
this experience is humbling, profound,
of illness has started to decline and the
and simple. All the medical expertise I
efforts to cure or slow the progression of
can offer is no substitute for the personal
that illness are simply not working.
neither hastening or postponing death.
into the patient-doctor relationship.
Hospice began as a philosophy of care. In
In the United States, Hospice is frequently
May I always regard my patients’ values
Joseph’s Hospice in London. In the early
above my own. n
60’s, Dr. Cicely Saunders formulated the
experience of living that someone brings
1905 the Irish Sisters of Charity founded St.
| T H E M E S S A G E | J U LY, 2 0 1 4
normal course • the physician must specify a terminal
Hospice came to America in 1974 when the
appropriate form of care when the trajectory
basic principles of hospice care: vigilant
7
distress that is experienced by the dying.
The professional lesson I have gained in
attention to the details of a patient’s illness
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
physical, emotional, spiritual and social
• the patient must be “certified” by two
defined by the Medicare Hospice Benefit which was instituted in 1983 under Medicare Part A. It is an entitlement that covers comprehensive end-of-life care. In order to be eligible for the benefit:
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
• the patient must waive traditional Medicare parts A and elect the Hospice benefit. Once a patient has entered Hospice, the attending/referring physician continues to manage the patient’s care. The cost of care CONTINUED ON NEXT PAGE
8
| T H E M E S S A G E | J U LY, 2 0 1 4
Hospice Spokane CONTINUED FROM PREVIOUS PAGE related to the terminal diagnosis is covered by the Hospice (Medicare Part A and D continue to cover treatments/medications for non-related diagnoses). A patient may revoke the benefit at any time; it may also be reinstated after revocation. There is no requirement for a do-not-resuscitate order (although many inpatient units, including the ones in Spokane require a DNR order for admission.) Patients who stabilize or do not decline may need to be discharged from Hospice care.
Group Health • Emergency services
of 50-150 and 55.6% >150. In the US, the
• Ambulance and transport services
percentage of not-for profit hospices
• Short-term inpatient stays in hospice
is 32%, for-profit 63% and government
facility, hospital, skilled care for
funded 5%.1 There are three hospices
management of acute symptoms
here in Spokane; one non-profit and two
• Short-term continuous nursing care in the home for crisis care of acute symptoms • Inpatient respite periods (maximum of five consecutive days) when caretakers require a break from care • Bereavement counseling: offered to family for one year following death, but grief counseling may begin before the patient’s death.
Required services covered by the Medicare Hospice Benefit include:
Quite an impressive list of benefits, right? Medicare is clearly the largest payor for
• Interdisciplinary Team Supervision of care
these services, but Medicaid and other
• Medical supervision: staff available 24 h/
private insurances cover them, also Hospices
day “on call”
are paid a per diem rate depending on the
• Physician services
level of care. There are four levels of care
• Case management by RN with intermittent
(routine home care, continuous home care,
nursing visits
general inpatient care, and respite care).
• Social work services
This rate is intended to cover essentially
• Pastoral counseling/spiritual support by
all of the expenses related to treating the
hospice chaplain
patient’s terminal illness. 96% of hospice
• Home-health aide services (bathing)
care is provided at the routine home care
• Dietary counseling, PT, OT, speech/
level: currently in Spokane, that rate is
respiratory therapy as needed • Volunteer services (must comprise a minimum of 5% of all patient care) • Medicines (most hospices have
$167/day. Payment varies by geographic location; private insurance tends to pay less, and Hospices that are Medicare certified must cover all services required
formularies that may not include particular
to palliate the terminal illness even if the
medications (especially expensive ones)
patient is not covered by Medicare and does
when less expensive alternatives are
not have the ability to pay (as mandated
available. Medications are reviewed
by our government). As hospice care has
by the hospice medical director and
increased (costing increasingly more money),
nonformulary medications may be
Medicare continues to tighten the rules for
approved. Similar approval processes
reimbursement, with no equivalent increase
extend to procedures (blood draws/
in the per diem, making it harder for hospices
transfusions)
to survive.
• Durable medical equipment (hospital bed, walker, O 2)
of patients served by hospice has
• Medical supplies
increased. 15.7% have a daily census of
• Laboratory services • X-ray and radiation therapy
fewer than 50 patients, 28.7% a census
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
9
CAREUNITY
for-profit. It is hoped that hospice care will add comfort and dignity to the end of life and
Group Health
collaborative way,” says Elaine Couture,
Children’s Hospital and Holy Family Hospital.
allow more people to die at home. In
Cooperative
chief executive of Providence Health Care in
Altogether, CareUnity is the largest ACO in the
2010, the CDC issued a special report on
and Providence
Eastern Washington and chair of the CareUnity
region, with access to nearly 700 physicians and advanced practitioners.
death and dying: they noted an increase
Health Care have announced a new
Board of Directors. “To offer a better patient
in the percentage of people dying at home
name and brand for their jointly-owned
experience and make care more affordable, we
among those aged 65 and older (15% 1989
Accountable Care Organization (ACO). Called
must change the way providers communicate,
to 24% in 2007). In 2010, 42% of all US
CareUnity, the new name and brand identity
coordinate, share financial risk and empower
deaths involved hospice care. Yet at the
expresses the vision of both organizations—
patients. CareUnity focuses on adhering to
same time there has been an increase in
collaborating to deliver care that is in the
established, evidence-based guidelines and
the percentage of people experiencing a
best interest of the community.
finding care pathways and processes that are
2
hospitalization in the last 90 days of life,
proven to provide the best health outcomes for
CareUnity currently coordinates care for 42,000 patients who seek care from providers at Providence Medical Group, Group Health and Columbia Medical Associates. “CareUnity is committed to finding local
and an increase in transitions at the end
Group Health and Providence formed a
of life. Short hospice stays have increased
private ACO in 2012, a consortium of health
and the number of patients using hospice
care providers who have committed to
CareUnity is the region’s most
for 3 days or less has increased. Of
deliver coordinated, seamless and affordable
comprehensive ACO, offering the
these late hospice referrals, 40.3% were
care and who have agreed to accept
full continuum of care – from health
preceded by hospitalization with an ICU
accountability for the clinical and financial
education and prevention, physician visits,
stay. 3 Although hospice referrals have
outcomes and overall health status of the
hospitalization, rehabilitation therapy and
increased, we may not be truly changing
patients they serve.
home health services to end-of-life care.
CareUnity works directly with health
CareUnity includes health care providers from
and capabilities of both organizations
When all is said and done, the hospice model
insurance companies and employers with
Group Health, Providence Medical Group and
and through new models of payment to
can work well at the end of life. In the end,
self-funded health plans to understand
Columbia Medical Associates. Pivotal to the
providers, CareUnity is achieving three
it is not about giving up, but about giving
their health care objectives around access,
success of the coordinated physician group are
goals – enhanced patient health, an
comfort, control, dignity and quality to life. n
quality, cost and patient experience—and
nearly 200 primary care physicians who serve
improved patient care experience, and more
then designs a coordinated care option that
as the medical home for patients throughout
affordable care.”
will drive improvement to those targets.
the region. These primary care physicians
our end of life care.
1. National Hospice and Palliative Care Organization. NHPCO facts and figures; hospice care in America. 2011 edition. Available at: http://www.nhpco.org/files/public/Statistics_ Research/2011_Facts_Figures.pdf. Accessed June 10, 2014. 2. Health, United States, 2010: with special feature on death and dying. National Center for Health Statistics. Available at: http://www.cdc.gov/nchs/ data/hus/hus10.pdf. Accessed June 10, 2014.
Over the past few years, the number
GROUP HEALTH COOPERATIVE AND PROVIDENCE HEALTH CARE ANNOUNCE NEW NAME AND BRAND FOR ACCOUNTABLE CARE ORGANIZATION:
3. Teno, JM et al. Change in End-Of-Life Care for Medicare Beneficiaries: Site of Death, Place of Care, and Health Care Transitions in 2000, 2005, and 2009. JAMA 2013;309(5):470-477.
| T H E M E S S A G E | J U LY, 2 0 1 4
“We believe the name CareUnity truly represents the commitment of our two organizations to provide care in a more
patients.”
solutions to fix our broken health system
coordinate patient care among specialists, urgent care centers and hospitals, including Providence Sacred Heart Medical Center &
by creating a patient-centered ACO to care more effectively for residents of our community and the surrounding region,” says Kelly Stanford, vice president of Eastern and Central Washington for Group Health Cooperative and president of CareUnity. “By drawing on the strengths
For more information contact Joe Robb, Providence Health Care (509) 474-3081 or Angela Matson, Group Health (509) 241-7146. n
ARTHRITIS NORTHW EST
Celebrating 30 years as the largest single specialty practice dedicated to serving the needs for the prevention, diagnosis, and management of patients with rheumatic diseases throughout the Inland Northwest. We track patient’s response to therapy at each visit, in real-time, by using a software tool developed exclusively at Arthritis Northwest known as JointMan™ care portal. This cutting edge technology enables us to quantify and enhance quality measures that result in better patient outcomes, enhanced patient compliance, and the prevention of untoward events. The JointMan™ care portal is also being used by many of our colleagues as we strive in a spirit of partnership to improve the health of all of our patients. • Physical Examination/Consultation • Treatment of acute and chronic inflammatory diseases • Tracking patient's response to therapy in real-time using JointMan™ care portal • Joint injections for inflammatory & Osteoarthritis • Weight Loss Programs • Researched Nutraceuticals
• Anti-Inflammatory Nutrition • Hands-On Musculoskeletal Therapy • Exercise Prescriptions • Smoking Cessation • Expertise pursuing challenging diagnoses and coordinating care with PCP’s, orthopedists and other specialists.
Arthritis Northwest | Rheumatology 105 West 8th Avenue, Suite 6080 | Spokane, WA 99204 | (509) 838-6500 www.arthritisnw.com
Howard M. Kenney, M.D. Jeffrey B. Butler, M.D. Gary L. Craig, M.D. Sean P. LaSalle, M.D. Eric C. Mueller, M.D. Christopher M. Valley, N.D. Diana M. Webster, ARNP Erin E. Saunders, PA-C Dale R. Raschko, PA-C Kari M. Holman, PA-C
Group Health
Medical Sciences
DENTAL EMERGENCIES NEEDING TREATMENT (DENT) PROGRAM ADDRESSES ACCESS TO ORAL HEALTH CARE IN SPOKANE By Keith Baldwin, Oral Health Consultant,
40,000 newly insured Apple Health Adult
Clinic, N.E. Washington Health Programs
Empire Health Foundation and
Dental patients are now looking for a dental
Lake Spokane Community Dental Clinic
Karen Davis, DENT Care Manager, Better
provider since the Washington Legislature
and the Spokane District Dental Society
Health Together
re-instated the adult dental program on
Foundation sponsored IDEA Clinic housed
January 1, 2014.
at the YVFWC at Riverstone, among others.
“Lack of access to oral health care contributes to profound and enduring oral
The DENT program’s goal is to reduce the
health disparities in the United States,”
number of individuals who present with
according to a report by the Health
a chief complaint of oral pain, infection
Resources and Services Administration
or other oral disease, to one of the two
(HRSA). Many vulnerable and underserved
Providence Health Care hospital Emergency
populations face persistent system barriers
Rooms, by 50% over two years. The ER
to accessing oral health care. A definitive
seems to be the provider of choice for
report was developed by the Surgeon
individuals seeking a dental provider and
General in 2000 which overwhelmingly
have Apple Health or are self-pay, even
establishes the case for improving oral
though the ER has few dental resources
health as it is integral to general health².
Dr. Darin Neven is also facilitating the development of an Epic based electronic referral to CHAS dental providers with care management support by Karen Davis, DENT Care Manager at BHT. Karen Davis will also help patients schedule a follow-up visit with their medical home or primary care
• Identify patient-specific conditions and
Spokane Regional Health District (SRHD) and
patients and Medicaid Eligible adults.
medical treatments that impact oral health
PHC, the Washington State Collaborative,
Pediatricians are acutely aware of the
(dry mouth, for instance, a consequence
“Oral Health Improvement Plan 2009-2014”
Access to Baby and Child Dentistry (ABCD)
of some prescriptions, can cause
and the Washington State Board of Health,
program for children 0-6 years of age and
additional caries and gum disease).
“Recommended Strategies to Improve the
how beneficial it has been to their patients
Oral Health of Washington Residents,”
and practices.
• Identify patient-specific oral conditions and diseases that impact overall health
authored by Spokane’s Jim Sledge, DDS, a
(oral infections can exacerbate diabetes
Washington State BOH member and faculty
and/or cardiac disease).
of the University of Washington School of
• Integrate epidemiology of caries,
Dentistry (UWSOD) Regional Initiatives
periodontal diseases, oral cancer
in Dental Education (RIDE) program in
and common oral trauma into the risk
partnership with EWU, WSU and WWAMI.
assessment (and don’t forget to refer
The BOH strategies address issues in Health
patients to oral health professionals for
Systems, Community Water Fluoridation,
definitive dental care).
Sealant Programs, Interprofessional Collaboration, Oral Health Literacy,
The IOHPCP initiative “strives to improve
Surveillance and Work Force. The goals
access for health detection and preventive
complement Healthy People 2020, reduce
interventions by expanding oral health
oral health disparities, guide Washington
The DENT Program encourages primary
clinical competency of primary care
State BOH rules and policy development and
to provide dental treatment or relief
care providers to integrate oral health
clinicians, leading to improved oral and
provide leadership on public health policies
Similar findings from a Community Health
from dental pain. The DENT program will
competencies into their practices
overall health.”
that focus on oral health.
Needs Assessment in Spokane County
accomplish this goal through a formal
with support from the WDSF. HRSA
led Providence Health Care (PHC), the
referral process initiated by the physicians
has developed a report, “Integration
The DENT Program complements and
Take advantage of resources from the
Washington Dental Service Foundation
and other providers from the two ER’s, to
of Oral Health and Primary Care
actually responds to other local and state
ABCDE and Apple Health Adult Dental
(WDSF) and Empire Health Foundation
a Dental Provider Network developed and
Practice (IOHPCP)”, that outlines this
initiatives such as the Community Health
programs to understand how you can benefit
(EHF), to collaborate on the development of
managed by Karen Davis, the DENT Care
opportunity to improve patient care.
Needs Assessment carried out by the
your primary care practice and your younger
the Dental Emergencies Needing Treatment
Manager at BHT.
It notes strategies incorporating core
(DENT) Program. EHF is in the planning and implementation stages of the program through their Better Health Together (BHT) affiliate and will begin accepting patients for referral to dental services in late June 2014.
Karen Davis will be working with the ER Social Workers to provide care management to patients and facilitate the referral process with patient education, on time scheduling assistance to reduce
physician to coordinate their dental and medical treatment.
community of providers to help improve the oral health of our population; while dramatically improving access to dental care outside of the emergency room. To quote Dr. David Bare from his May article in the SCMS The Message, “Let us members of the SCMS, begin to look at the local scene regarding health care here in the Spokane region. Let’s focus on our strengths and our weaknesses using the criteria of improving population health, improving the patient experience of care and reducing the per capita costs. We can make this a change from me to us and realize that a group effort composed of individual efforts is far better than individual effort on its own.” n
of comprehensive physician exams, emphasis of the oral health-systemic connection and referral to oral health professionals for definitive dental care.
no-shows for dental appointments,
HRSA identifies the following competencies
do with me as a medical professional in the
and support for additional community
for Primary Care Providers that impact oral
Spokane community, you might ask? What
resources such as transportation, housing
health and overall health:
happens in your patients’ mouths may have
or mental health services. A number of
a lot to do with their medical condition; it has
local dental providers are discussing their
been shown that oral health, or lack of it,
participation with the DENT Program. They
has a profound effect on diabetes, cardiac
include Community Health Association
conditions, and the need for pain control,
of Spokane (CHAS), Yakima Valley Farm
just to name a few medical issues. And,
Workers Clinic (YVFWC) Riverstone Dental
11
sustainable and scalable to the larger
clinical competencies into the provision
What does a dental access program have to
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
A successful DENT program will be
Our business is turning them into realities. We do this by helping our clients plan and manage their financial resources. Fee-only.
• Conduct patient-specific, oral health risk assessments on all patients (this is supported locally by the Interprofessional training at WWAMI, WSU and EWU health related educational programs).
| T H E M E S S A G E | J U LY, 2 0 1 4
For a complimentary consultation or brochure, call: Greer Gibson Bacon, CFP® (509) 838-4175 or (888) 864-8827 assetplanning.com
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
12
| T H E M E S S A G E | J U LY, 2 0 1 4
Big Brothers Big Sisters
In The News
CHANGING PERSPECTIVE FOR CHILDREN IN THE INLAND NORTHWEST makes a point to be very engaged with Dylan and makes sure that the time that they spend together is very intentional. Eric tries to encourage and empower Dylan whenever possible. If you ask Dylan, he will tell you that being a Little Brother has been a lifechanging experience for him. Eric attended Dylan’s parent-teacher conferences so By Melissa Smith, Big Brothers Big Sisters,
that he can help enforce and support Dylan
Fundraising Coordinator
with what he needs help with. In 2013, Eric coached Dylan’s little league baseball team
Over the past 50 years, Big Brothers
and also taught him how to snow ski. One
Big Sisters has been helping children
thing they really like to do together is fixing
in the Inland Northwest by providing
up properties that Eric owns.
them with a mentor. We provide those children who are facing adversity with
The most important aspect of their friendship
strong and enduring, professionally
is that Eric has been able to show Dylan how
supported one-to-one relationships
much he cares about him. Because of Eric’s
that change their lives for the better,
dedication to their relationship, Dylan trusts
forever. This allows us to help children realize their potential and build their futures, not to mention it helps to strengthen our community. In 2013, we participated in a large, multiyear study to see what the effects are of mentoring children. One of the biggest things that came out of the study was that children, also known as “Littles”, enrolled in our mentoring program are significantly less likely to encounter adolescent depression than their peers. We conclude that this is because those children have an adult in their life that provides attention and shows them that they care, they provide direction and give them advice, but most of all they have someone
Little Brother Dylan and Big Brother Eric
On April 3, 2012, Big Brother Eric met his Little
HOW TO GET INVOLVED
great bond and friendship that we see lasting a long, long time. Their Match Support Specialist says that Eric has become “like an uncle” to not just Dylan, but also to his three brothers. Eric makes a point to be very involved in Dylan’s life. Dylan’s mom, a single mother of four, says that Eric does an unbelievable job of making all of the boys in their family feel important, while at the same time keeping the focus on his relationship with Dylan.
Right now, we have 47 boys on our waiting list who are excited to be matched with a Big Brother. We need more volunteers to step up to become mentors to these boys. If you have time to meet with a child 2-4 times per month (with an 18-month commitment), live in Spokane County and have an enjoyment and concern for children, you would be the perfect mentor in the Big Brothers Big Sisters program. To start the enrollment process or learn more about the details of becoming a “Big”, go to our website (http://
in their life that is a constant upon which
Eric is married with a young daughter and
www.nwbigs.org/bigs/) or give Ken Shelton
they can rely.
even though he stays busy with that, he
a call at (509) 328-8310 x214. n
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
13
musculoskeletal and spine interventional
WELCOME BRIAN PETERSEN, MD, TO
procedures.
Dr. Eric Johnson received the 2014 Presidential Leadership Award from
THE PROFESSIONAL SUBSPECIALIST RADIOLOGY TEAM
Away from work he enjoys spending time with his wife and two daughters. His
Whitman College, Walla Walla,
A Spokane native, Dr. Brian Petersen comes
hobbies include golf, skiing, entertaining,
Wash. in recognition of his lifetime
to Inland Imaging from the University of
and watching anything sports related. Dr.
of accomplishments and service
Colorado where he served as Chief of MSK
Petersen will practice in Spokane. n
to Whitman College and the local
Radiology, MSK Fellowship Director and
community. Johnson is a 1972 graduate
medical director of University of Colorado
of Whitman and is a private practice
Imaging at Colorado Center. He achieved the
physician at Deaconess Hospital. He
rank of Associate Professor of Radiology
served as a colonel in the U.S. Air
and Orthopaedics.
Force Reserve as part of the 446th Aeromedical Staging Squadron, serving as a critical care air transport team leader in Operation Iraqi Freedom as well as Operation Enduring Freedom in Afghanistan. He has completed several humanitarian missions worldwide.
Dr. Petersen completed his radiology residency at the University of Colorado, Denver and his musculo-skeletal fellowship at the University of Wisconsin, Madison. His professional interests include sports imaging, MSK tumor imaging, and
Brian Petersen, MD
and support in all aspects of his life…home, school, friends, etc.
months and years since then, they have built a
INLAND IMAGING IS PLEASED TO
PRESIDENTIAL LEADERSHIP AWARD
Eric and really looks to him for guidance
SPOTLIGHT OF A MATCH
Brother Dylan for the first time. Over the past
ERIC JOHNSON, MD RECIPIENT OF THE 2014
| T H E M E S S A G E | J U LY, 2 0 1 4
Coeur Coeur Coeur Coeur d’Alene d’Alene d’Alene d’Alene Lake, Lake, Lake, Lake, Rockford Rockford Half Black Bay, 145’ Bay, 2 Round Rock frontage, homes, Bay, 265’ Beach Es4690 sq ft, 175’ frontage tates, 90’ 3 bdrms, frontage, (extra lot frontage, 4 baths, 4018 sq ft, 2 car detached ga2 lots (90’ & 85’), 5 bdrm, 4 bath, 4200 sq has 124’ frontage), 6 bdrm, 5 bath, 5452 3 bdrms, 3 baths, 2720 sq ft, 2 c garage, rage w/guest quarters above, dock/boat ft plus 768 sq ft guest home: 1 bdrm, 1 sq ft, guest quarters, boat garage, dock boat dock, great views. $765,000 slip, great deck. $1,895,000 bath, 2 car garage. Gated. $1,995,000 system, 20x36 shop. $975,000 Hayden Coeur Coeur Coeur Lake, d’Alene d’Alene d’Alene Lake, Yellow Lake, Lake, Banks Sunup Rockford CottonArea, 107’ Bay, 75’ Bay, 77’ wood Bay, frontage, frontage, frontage 100’ frontage, Main 3 bdrms, 3 bdrms, lot, gated 1 bath 2 baths, commuHome: 3 cottage, includes bunk cabin, great dock new boat dock, lots of parking and room nity of Forest Shores, area of high quality bdrms 1 bath, 1724 sq ft; Guest: 1 bdrm, with slip, fireplace, nestled in the trees for garage, close to store and boat gas. homes, water system, fantastic view 1 bath, 560 sq ft., furnished. $429,500 offering great privacy. $440,000 Cabin is in mint condition. $625,000 down lake chanel. $399,500 ROCK CREEK RIDGE AT SUNUP BAY Coeur d’Alene Lake, ID www.rockcreekridgeatsunupbay.com
Waterfront Lots: 2-6 acres with 95’ to 350’ frontage Starting at $449,500 Ridge Lots: 4-20 acres, 800’ frontage community beach w/boat slip Starting at $149,000
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
14
All Waterfront Properties on All Lakes only at
www.21Waterfront.com
BILL FANNING BROKER (509) 999-5444
fanning@21waterfront.com
| T H E M E S S A G E | J U LY, 2 0 1 4
SPOKANE COUNTY MEDICAL SOCIETY STATEMENT OF SUPPORT FOR MEDICAL EDUCATION
IN MEMORIAM
WALTER DARYL “BILL” KELSCH, MD Walter Daryl “Bill” Kelsch, MD passed away on June 05, 2014. Bill is now with his beloved wife Phyllis, who passed away in August 2013. He was born on August 7, 1925, in Glendive, Mont. After graduating from Dawson County High School, he attended the University of Montana. His studies were interrupted by his service in the Navy during the war in the Pacific, stationed in Hawaii. After the war he returned to U of M to earn both a BA and BS by 1949. While working at the Northern Pacific Hospital in Missoula, he met Phyllis, who was the love of his life. They were married in 1950 and moved to North Dakota where he earned a Master’s degree in Chemistry. He continued his studies at the University of Washington, receiving his MD in 1955, and
Recent statements from both the University of Washington (UW) and Washington State University (WSU) regarding expansion of medical education in Eastern Washington caught the attention of the leadership of the Spokane County Medical Society (SCMS). After lengthy discussion and consideration, the Board supports the expansion of medical education in our region guided by these
The empathetic, intelligent, accomplished men and women who
Anesthesia Associates of Spokane, serving the Spokane community
aspire to serve our communities in Washington State as physicians
for many years. He was an avid golfer and played bridge, cribbage
and who will be our future colleagues must be kept at the center of
and poker with his family and friends. He is survived by his sister,
this conversation about medical education expansion.
(Norman); Patty Bartholomew (Douglas); Lt. Col. (ret.) Steven Kelsch (Col. Sue Fraser) and Judy Kelsch; eight grandchildren and Olivia, his nine-month old great-granddaughter. He will be missed by all who knew and loved him.
Craig Barrow, MD, Russell Oakley, MD D. Scott Redman, MD Brad Bachmeier, PA-C
principles:
later specialized in Anesthesiology. He was a founding member of
Donna Wright (Don) of Visalia, CA; his four children, Barbara Fortunate
Providence announces its new north side orthopedics location
Providence Orthopedics – North is conveniently located on the Holy Family Hospital campus. Our doctors are board-certified and subspecialty trained, offering patients a superior level of surgical and non-surgical orthopedic treatments. Services include: joint reconstruction/revision, fracture care, complex foot and ankle surgery, arthroscopic surgery, pediatric care and sports medicine.
PROVIDENCE ORTHOPEDICS - NORTH
Providence Orthopedics - North 212 E. Central Ave., Suite 245 Spokane, WA 99208
SCMS fully endorses any and all efforts that increase access for these men and women to world class medical education by expanding the number of medical students in Eastern Washington.
Accepting new patients. To make a referral, call 509.252.1977.
SCMS encourages both universities to continue providing students
For a complete listing of Providence Medical Group physicians, visit phc.org.
with access to the best medical educators from both institutions
MEMBERSHIP RECOGNITION FOR JULY 2014 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.
while maintaining, through partnership, the opportunities unique to WWAMI to learn throughout the region in incredibly diverse training sites.
Resident-centered and locally-owned, offering the finest senior living environments, Rockwood Retirement Communities delivers the retirement lifestyle you want and deserve. We offer two unique full-service communities with high standards of excellence to meet your life’s changing needs.
In addition to the increase in medical students, SCMS urges the expansion of residency slots in Eastern Washington. This expansion should occur not only in current residency programs, but also in additional critical specialty residencies now absent in Eastern Washington such as pediatrics and general surgery.
50 Years J Thomas Rulon, MD
7/13/1964
SCMS encourages local medical community participation in training the next generation of physicians. SCMS expects the
40 Years Lawrence E. Klock, MD
7/1/1974
Lawrence G. Schrock, MD 7/15/1974 10 Years Daniel M. D’Hulst, MD
7/1/2004
Nicholas T. Ranson, MD
7/1/2004
Trent A. Sanders, MD
7/1/2004
Barbara A. Smit, MD
7/1/2004
Ronald D. Hardy, MD
7/21/2004
participating universities will make available plentiful, flexible and outstanding educational opportunities for physicians to develop requisite academic and advanced teaching skills. SCMS supports a collaborative regional approach by all involved institutions of higher learning in advancing the highest quality medical education and training in Eastern Washington. With this in mind, the Board at SCMS recognizes that while transitions can be challenging, there are wonderful opportunities
Staci M. Hestdalen, MD 7/21/2004
before us. The Spokane County Medical Society looks forward
David M. Munoz, MD
7/21/2004
to taking an active, participatory role in this process through our
James D. Reggin, MD
7/21/2004
Medical Education Task Force and our members. n
Resident’s Happiness is
Our Success.
Independent • Assisted • Skilled • Memory Care
Spokane’s Retirement Choice for over 50 Years. SPOK ANE COUNT Y MEDICAL SOCIE T Y |
15
| T H E M E S S A G E | J U LY, 2 0 1 4
rockwoodretirement.org 800-727-6650
It’s time to CELEBRATE SUMMER SEPTEMBER 7, 2014 • SPOKANE POLO CLUB • NOON – 4 PM
OUR SPONSORS
•
POLO TOURNAMENT MATCH
•
SILENT & LIVE AUCTION
•
PARADE OF HATS
•
CIGAR & WHISKEY TENT
•
CHAMPAGNE DIVOT STOMP
•
RAFFLE & SWAG BAGS
REGISTER ONLINE AT WWW.RMHCSPOKANE.ORG/EVENTS
QUESTIONS? CALL 509-624-0500
New SCMS Members The following physicians and 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 to the Spokane County Medical Society, 104 South Freya Street, Orange Flag Building, Suite 114, Spokane, Washington, 99202. PHYSICIANS
Fisher, Thomas, DO Obstetrics & Gynecology Med School: Kansas City U (2007) Internship: Oregon Health & Science U (2008) Residency: Oregon Health & Science U (2011) Fellowship: Albert Einstein College of Medicine (2014) Joined SRM Spokane 07/2014 PHYSICIANS PRESENTED A SECOND TIME
Schmitt, William, MD Otolaryngology Med School: U of Wisconsin (2008) Internship: Mayo Clinic (2009) Residency: Mayo Clinic (2013) Fellowship: Auckland District Health Board, New Zealand (2014) Joining Columbia Surgical Specialists 08/2014 Pates, Jason, MD Obstetrics and Gynecology Med School: Uniformed Services U of Medicine (2001) Internship: Uniformed Services U of Medicine (2004) Residency: Uniformed Services U of Medicine (2007) Joining Obstetrix Medical Group 08/2014 Bartsch, Stephen, MD Pulmonary Med School: Loma Linda (2004) Internship: Kettering Medical Center (2005) Residency: Kettering Medical Center (2007) Fellowship: Penn State U (2013) Joined Spokane Critical Care 07/2014 Fair, Jamie, MD Internal Medicine Med School: U of Washington (2011) Internship: Providence Internal Medicine Residency Spokane (2012) Residency: Providence Internal Medicine Residency Spokane (2014) Joined Critical Care Associates 07/2014 Ahmad, Naila, MD Rheumatology Med School: Wright State U (1998) Internship: U of Illinois (1999) Residency: U of Illinois (2001) Fellowship: U of Washington (2003) Joining Rockwood Main Clinic TBA Khan, Ahsan, MD Internal Medicine Med School: Kasturba Medical College (1998) Internship: Northeastern Penn Hospital Program (2002) Residency: Northeastern Penn Hospital Program (2004) Joining Rockwood Clinic Hospitalists 08/2014
Hooper, Stephen, MD Anatomic and Clinic Pathology Joined Incyte Diagnostics 07/2014 Obregon, Victor, MD Obstetrics and Gynecology Joined Obstetrix Medical Group 06/2014 Chesnut, Cameron, MD Dermatology Joined Dermatology Specialists of Spokane 07/2014 Persoon-Gundy, Jo, MD Internal Medicine Joining Rockwood Hospitalists TBA Eiseman, Heidi, MD Ophthalmology Joining Rockwood Eye Clinic 08/2014 Schmutz, Daniel, MD Emergency Medicine Joining Northwest Pacific Emergency Physicians TBA Preiss, Benjamin, DO Emergency Medicine Joining Northwest Pacific Emergency Physicians 08/2014 Mourton, Susannah, MD Gynecology Oncology Joining Cancer Care Northwest 08/2014
EASTERN WASHINGTON PHYSICIAN HEALTH COMMITTEE (EWPHC) EWPHC is a “quick call” to find assistance
Assistance is available to you in the following areas:
Marital and Family Issues
Death of a Spouse or Family Member
Drug/Alcohol Misuse
This commi�ee, a fusion of the former SCMS commi�ee and one including members of medical staffs of Community Health Services and Providence Health Care Hospitals, meets quarterly to educate ourselves about physician health issues, review u�liza�on and sa�sfac�on with the Wellspring Employee Assistance Program (EAP) and plan ac�vi�es, programs and resources to address needs in those areas.
Lawsuit Educa�on and Support
Some of the guiding principles of the commiƩee are:
MQAC/OSTEO Board Issues
Boundary Issues
The medical profession and healthcare community should foster physician well‐being
Disrup�ve Behavior
A sense of community with one’s peers is vital to personal well‐being
Elder Care
Assess the changes in the healthcare environment
Prac�ce Management
Physician Commi�ee Members
Bray, Jeffrey, MD Obstetrics and Gynecology Joined Obstetrix Medical Group 07/2014 Allar, Rory, MD Ophthalmology Joining Spokane Eye Clinic 10/2014 Maestas, Lisa, DO Radiation Oncology Joined Rockwood Oncology & PET/CT Services 07/2014
(Name and Contact Informa�on) Jim Shaw, Chair 710‐3151 Barry Barnes
255‐6557
Michael Metcalf
927‐4102
Paul Russell
954‐4989
Steve Brisbois
953‐3798
Michael Moore
747‐5141
Robert Sexton
624‐7320
Andi Chatburn
624‐2313
Mira Narkiewicz
889‐5599
Tasca Snow
565‐4000
Deb Harper
443‐9420
Sam Palpant
467‐4258
Alexandra Wardzala
990‐1938
Michael Henneberry
448‐2558
Tad Pa�erson
939‐7563
Hershel Zellman
993‐4274
Greg Loewen
844‐8476
Rod Peterson
944‐5781
Cabling, Marven Gerel, MD Internal Medicine Med School: U of Philippines (2006) Internship: U of Connecticut (2009) Residency: U of Connecticut (2011) Fellowship: U of California, Los Angeles (2012) Fellowship: Loma Linda (2014) Joined Providence Medical Group E. WA Rheumatology 07/2014
PHYSICIANS ASSISTANTS
Edinger, Lara, DO Neurology Med School: Philadelphia College of Osteo. (2009) Internship: Mercy Catholic Medical Center (2010) Residency: Drexel U (2013) Fellowship: U of Virginia (2014) Joining Rockwood Neurosurgery & Spine Center 08/2014
Stockdale, Lori, PA-C Physician Assistant School: U of Alabama (2002) Joined Northwest Heart & Lung 07/2014
Caduceus Al Anon Family Group ‐ Meets every Thursday evening from 6:15 pm un�l 7:15 pm at 626 N. Mullan Rd., Spokane, WA. Non‐smoking mee�ng for spouses and signicant 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 informa�on.
Knabel, David, PA-C Physician Assistant School: U of Washington MEDEX (2010) Joining Deaconess Medical Center TBA
Physician Family Alanon Group ‐ Physicians, physician spouses or signicant others and their adult family members share their experience, strength and hope concerning difficult physician family issues. This may include medical illness, mental illness, addic‐ �ons, work‐related stress, life transi�ons and rela�onship difficul�es.
Barker, Bryce, MD Orthopedic Surgery Med School: Tulane U (2007) Internship: U of Colorado (2008) Residency: U of Missouri (2013) Fellowship: Ohio State U (2014) Joining Rockwood Main Clinic 08/2014
Wilcox, Phillip, PA-C Physician Assistant School: U of Washington MEDEX (2010) Joined Rockwood Pulmonary & Critical Care Center 06/2014
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
We meet Tuesday evenings a�er 6pm. The format is structured by the 12‐Step Alanon principles. All is conden�al and anony‐ mous. There are no dues or fees. To discuss whether this group could be helpful for you, contact Bob at (509) 998‐5324.
19
| T H E M E S S A G E | J U LY, 2 0 1 4
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
20
| T H E M E S S A G E | J U LY, 2 0 1 4
Classified Ads
REAL ESTATE
AVAILABLE FOR IMMEDIATE SALE! GREAT DOWNTOWN INVESTMENT ON LIGHTED CORNER NEAR HOSPITALS AND I-90. 14,000 s.f. for $325,000 (Only $27.00/s.f.)! 7,000 s.f. on first floor and 7,000 s.f. partially finished basement. Full HVAC, good roof, sprinkler and security system. Could be medical offices, general offices, commercial/retail or even storage. For more information, please call Gordy at 404.822.8488 or email gordy@flagshipgroup.com MEDICAL OFFICE SPACE AVAILABLE FOR SUBLET IN DEACONESS MEDICAL BUILDING at 801 West 5th Avenue. 1400+ sq. ft. to accommodate two to three practitioners. Prime location on main floor and nicely decorated. Available December 1, 2014. Call (509) 953-9417 for details. RIVER FRONT AND ACREAGE, 3300ft², 4 Bedroom Home for Lease (Or Sale) $1,850/ month. Close in but feels like the country. Four bedroom, three and ½ bath, master suite with corner jetted tub and large walkin closet, open living and dining area with great views and gas fireplace, family room with wood stove, attached two-car garage and detached two-place carport. Forced air natural gas furnace. Large multilevel deck and patio looking toward river. Wooded acres on the Little Spokane River with private trails, sandy beach and swimming hole. Plentiful wildlife. School bus comes to front drive. Mead school district. Close to Whitworth, shopping and freeways but very quiet and secluded. Cable hookup. Grounds are river irrigated. First and last plus cleaning deposit. Utilities not included. No indoor pets. $150/month grounds maintenance fee if you choose not to do it yourself. Contact Scott (509) 435-7099. For photos go to Craigslist - http://spokane. craigslist.org/apa/3984125910.html.
COMFORTABLE THREE-BEDROOM HOME in quiet neighborhood for rent. Good storage in kitchen, gas stove, dishwasher, refrigerator, washer/dryer and fireplace. Comes furnished or can negotiate. Close to Hamblen Grade School, Sac Middle School and Ferris High School. Three bedrooms, three baths, large living room, family/TV room, master bedroom has private bathroom, two-car garage. Large windows in living room look out into large fenced yard with automatic sprinkler system (front and back). Snow blower and lawnmower provided. Call (408) 594-1234 or (509) 993-7962. ONE OF COPELAND’S BEST NORTH SIDE HOMES on over fifty acres with meadows, trees, complete privacy and gorgeous views. This home offers contemporary living at its best featuring four bedrooms, four bathrooms, threecar garage, hard rock maple floors, cabinets and built-ins, three balcony decks plus a patio with water feature. The second level has a distinctive master suite with custom built-ins, large walk-in closet, lovely master bath with lowboy toilet and bidet, a large sitting room with built-in shelving, raised gas fireplace and extraordinary views! The main floor great room boasts granite, stainless appliances, oversized pantry and very functional laundry suite with chute. Super-efficient geothermal heating and cooling affords economical year ‘round comfort. Twenty minutes from Holy Family Hospital. Mead schools! $665,000 Call Marilyn Amato at (509) 979-6027. NEW 2,400 SQ. FT.. HOME located five minutes from downtown Spokane in country setting. Three bedrooms, three bathrooms, full kitchen and completely furnished. $250.00 day/$1,000.00 week/$3,000.00 month with a month maximum stay unless arranged by owner. Call Sheri at (208) 641-9069 or email 209homedesign@gmail.com.
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
21
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, 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 washer/dryer and one car garage with extra storage. ALL COSTS ARE INCLUDED! Heat/ AC, Utilities/Water, Cable TV, Internet/WiFi, Long Distance phone. Golf and walking trails right out the door. Close to Holy Family Hospital and Whitworth University. Freeway access to south hill hospitals. Call (509) 954-8339 for details. Available immediately. Willing to rent “unfurnished.” CONDO FOR RENT- Very nice and clean 2BR, 2BA one-level, 1200 sq. ft. 7th and Monroe, City views, one block walk to Deaconess, Shriners, shopping. Convenient to SHMC, Rockwood and downtown. Covered under-building parking. Quiet, nicely updated, fireplace, dishwasher, washer/dryer, elevator. $800 month. Call (509) 263-1746 for more information and to see.
MEDICAL OFFICES/BUILDINGS NEW MEDICAL PLAZA - Downtown Spokane has available a 2,000 sf Ambulatory Surgery Center within a newly constructed integrated medical plaza. Medical Plaza is comprised of complimentary clinical specialties including dermatology, age management, wellness programs and a medical spa. Surgery Center is ready for immediate custom build out to your specifications. Conveniently located within one mile of two major hospitals at the intersection of 3rd and Sherman. Plenty of onsite parking with heated sidewalks. Building amenities include shared conference room, beautiful lobby, coffee kiosk and more. Partnership/ ownership opportunity possible subject to terms of lease. Financing available. For further information, and to schedule a tour, contact John Driscoll at (509) 624-1184, ext. 1123.
| T H E M E S S A G E | J U LY, 2 0 1 4
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 medical office spaces available for lease from 635 to 10,800 contiguous usable square feet. and has undergone extensive remodeling, including two new elevators, lighted pylon sign, refurbished lobbies, corridors and stairways. Other tenants in the building include urgent care, family practice, pediatrics, dermatology, dentistry, pathology and pharmacy. Floor plans and marketing materials emailed upon request. A Tenant Improvement Allowance is available, subject to terms of lease. Contact Patrick O’Rourke, CCIM, CPM®with O’Rourke Realty, Inc. at (509) 624-6522, mobile (509) 999-2720 or psrourke@comcast.net.
MEETINGS/CONFERENCES/EVENTS PHYSICIAN FAMILY ALANON GROUP: Physicians, physician spouses or significant others and their adult family members share their experience, strength and hope concerning difficult physician family issues. This may include medical illness, mental illness, addictions, work-related stress, life transitions and relationship difficulties. We meet Tuesday evenings after 6 p.m. The format is structured by the 12-Step Alanon principles. All is confidential and anonymous. There are no dues or fees. To discuss whether this group could be helpful for you, please contact Bob at (509) 998-5324.
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. SPOKANE COUNTY MEDICAL SOCIETY presents MEDICINE 2014: 7.0 Hours of Category 1 CME credit, sponsored by the Spokane County Medical Society. The program will focus on the more challenging management issues that clinicians encounter. The conference will be held on Friday, September 26, 2014 at the Red Lion Hotel at the Park. Visit the Spokane County Medical Society website for more information and to view the program brochure at www.spcms.org or contact Karen Hagensen (509) 325-5010 or karen@ spcms.org.
POSITIONS AVAILABLE ESTABLISHED SPOKANE CLINICAL RESEARCH COMPANY is seeking primary care and specialty physicians interested in serving as Principle Investigators or as Sub-Investigators. There is an opportunity to assume an on-going research portfolio and to join new studies that are opening in the spring of 2014. For more information, contact Dalyn Boehm or John Driscoll at Premier Clinical Research at (509) 343-3710 or research@premierclinicalresearch.com. PHYSICIAN (OB/GYN AND URGENT CARE) OPPORTUNITIES AT COMMUNITY HEALTH ASSOCIATION OF SPOKANE-SPOKANE LOCATIONS (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 CHAS Human Resources at (509) 444-8888 or hr@chas.org. Visit our website to learn more and to apply www.chas.org.
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
22
NORTHWEST MEDICAL SPECIALTY EVALUATIONS seeks Board Eligible / Board Certified Physicians for SSI examinations. Flexible hours. No call or ongoing patient care responsibilities. This is an excellent way to supplement your clinical income. Call for more information. kcave@nwmse.com or (509) 588-7340 BC/BE PEDIATRICIAN WANTED, SPOKANE The State of Washington Division of Disability Determination Services seeks a BC/BE pediatrician to perform contract service in our Spokane office. Contract services include the evaluation of physical impairment severity from medical records and other reports, utilizing Social Security regulations and rules of law. Medical consultants function as members of the adjudicative team and assist staff in determining eligibility for disability benefits. Reimbursement: $65/hour base; potential for $68/hour for high productivity. Interested physicians should contact Chief Medical Consultant Dr. Gene Profant at (360) 664-7454 or Spokane Office Manager David Bennett at (509) 329-2508. This position reviews interesting cases; teaching is thus an integral function. Hours are quite flexible. 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 Psychology, Psychiatry, Physical Medicine and Rehabilitation, Family Medicine, Occupational Medicine, 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 Maggie Dillon directly at (909) 978-3548 or mdillon@qtcm.com or visit our website www.qtcm.com to learn more about our company.
| T H E M E S S A G E | J U LY, 2 0 1 4
Classified Ads PROVIDENCE FAMILY MEDICINE RESIDENCY SPOKANE - Immediate opening with Providence Family Medicine Residency Spokane (PFMRS) for a full- time BC/ BE FP physician who has a passion for teaching. PFMRS is affiliated with the University of Washington School of Medicine. We have seven residents per year in our traditional program, one per year in our Rural Training Track and also administer OB and Sports Medicine Fellowships. This diversity benefits our educational mission and prepares our residents for urban & rural underserved practices. We offer a competitive salary, benefit package and gratifying lifestyle. Please contact Linda Barkley, Program Assistant at (509) 459-0688 or Linda. Barkley2@providence.org. PROVIDENCE MEDICAL GROUP (PMG) – Eastern Washington has immediate opportunities for BE/BC Family Physicians to join our expanding primary care team in Spokane, eastern Washington’s largest city. Newborns to geriatrics, no OB. Excellent compensation and benefits. PMG – Eastern Washington is our physicianled network of more than 450 primary and specialty care providers in multiple clinic locations in Spokane and Stevens County. PMG partners with some of the region’s most advanced hospitals: Providence Sacred Heart Medical Center & Children’s Hospital, Providence Holy Family Hospital, Providence Mount Carmel and Providence St. Joseph’s Hospital. Contact Mark Rearrick at mark.rearrick@providence.org or (509) 474-6605 for more information. MID-LEVEL OPPORTUNITIES AT COMMUNITY HEALTH ASSOCIATION OF SPOKANE-Family Practice ARNP and Physician Assistant needed in Spokane, WA and Moscow, ID. 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 employment opportunities, contact CHAS Human Resources at (509) 444-8888 or hr@ chas.org. Visit our website to learn more and to apply www.chas.org.
PROVIDENCE MEDICAL GROUP (PMG) – Eastern Washington is recruiting for an excellent Family Medicine physician to join our care team in Spokane Valley, a scenic suburb of Spokane. Full-time opportunity with our growing medical group in what will be a large, state-of-the-art medical ambulatory center (construction completion target is spring 2014). No OB. Outpatient only. Competitive compensation and comprehensive benefits. PMG – Eastern Washington is our physician-led network of more than 450 primary and specialty care providers in multiple clinic locations in Spokane and Stevens County. PMG partners with some of the region’s most advanced hospitals: Providence Sacred Heart Medical Center & Children’s Hospital, Providence Holy Family Hospital, Providence Mount Carmel and Providence St. Joseph’s Hospital. Contact Mark Rearrick at mark.rearrick@providence.org or (509) 474-6605 for more information.
SPECTRUM HEALTHCARE RESOURCES has an immediate opportunity for a civilian Family Practice Physician at Fairchild Air Force Base. This contract position offers: Full-time; Outpatient setting; Monday through Friday, 7:30am to 4:30pm; Manageable patient load (20-25 per day) and Shared on-call responsibilities (mostly telephone consulting). The position will have the following requirements: Current and unrestricted medical license; Successful completion of a family medicine residency; Board Certified by the ABFM or AOBFP; BLS, ACLS, PALS and Ability to work in a team setting. Contact Spectrum recruiter Lisa Paska for more information at Lisa_Paska@spectrumhealth. com or (314) 744-4107.
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
23
MANN-GRANDSTAFF VA MEDICAL CENTER in Spokane has immediate opportunities for Psychiatrists, Emergency Medicine Physicians, Internists, and Hospitalists and an immediate opening for a Director of the Emergency Department. Recruitment incentives and Education Debt Reduction Incentives may be available. Please contact Rodney Gile (509) 434-7590 (Rodney.gile@ va.gov) or Robyn Highbarger (509) 434-7393 (Robyn.Highbarger@va.gov) for specific information about positions. We are looking for a COMPASSIONATE AND SKILLED FAMILY/INTERNAL MEDICINE PHYSICIAN/ FINAL YEAR RESIDENT for our growing clinic in the Olympic Peninsula. This setting provides a place and all the resources for setting up your own private practice in a complete turnkey manner with regulatory and administrative matters taken care of professionally. The organization is physician led and takes care of physicians very well. We would expect the new physician to start with some urgent care hours and slowly transition to a full time private practice primary care. Candidates signing up in during their residency are eligible for a $1000 per month stipend for the remainder of their residency. For further details, please call (509) 414-6390. FULL-TIME LICENSED PHYSICIAN ASSISTANT (PA) wanted for expanding clinic in Spokane, Washington. Currently patients are seen four days per week, Monday through Thursday, 8 a.m. to 5 p.m. Approximately 24 patients per day. This could expand into five days a week in the future. No call, weekends or holidays. Fabulous benefit package offered, including vacation and CME benefits. Starting salary depends on experience. Submit resume and cover letter to Kris Norton, Office Manager Inland Neurosurgery & Spine Associates, P.S. 105 W 8th Ave, Ste. 200 Spokane, WA 99204 or knorton@neuroandspine.com.
| T H E M E S S A G E | J U LY, 2 0 1 4
N.E. WASHINGTON HEALTH PROGRAMS LOON LAKE COMMUNITY HEALTH CENTER is seeking a family practice ARNP or PAC. The ideal candidate will enjoy working with a medical team that is dedicated to the mission of NEWHP and have the ability to work autonomously. The Loon Lake clinic is nestled in the rural area of Loon Lake in N.E. Washington State. The area allows for the recreational enthusiast who enjoys, skiing, hiking, hunting, fishing, snowshoeing, horseback riding and any other outdoor event that you desire. Competitive salary and benefits. N.E. Washington Health Programs is also a NHSC/State student loan repayment eligible site. Please send resume to NEW Health Programs/Attn: HR DTR/PO Box 808/ Chewelah, WA 99109 or email to: vickien@ newhp.org. EOE & Provider PHYSICIAN-BE/BC FAMILY MEDICINE - General Full Time, Spokane, WA Columbia Medical Associates (CMA) is a multispecialty medical group with more than 40 clinicians in 12 locations throughout the Spokane, Wash. region. The providers of CMA are dedicated to providing patient-centered, evidencebased medical care for the 70,000 patients the organization serves each year. CMA employs 200 health care professionals and accepts all types of insurance. CMA is a subsidiary of Group Health Cooperative and its physicians are employees of Group Health Physicians. Benefits include: Full malpractice indemnification, medical/ dental/vision benefits, 401(k), 4 weeks paid vacation, CME, long-term disability, long-term care benefits. Competitive salary offered. Spokane is located on the eastern side of the state. Its unique location provides year round activities including skiing, hiking, boating and kayaking. Small town charm, pleasant neighborhoods, affordable housing and a highly rated school system make Spokane a great place to live and an unparalleled place to raise a family. Columbia Medical Associates is an Equal Opportunity Employer committed to a diverse and inclusive workforce. Interested candidates may send a CV to Jessica Billings at billings.j@ghc.org.
PHYSICIAN WANTED NATIVE PROJECT/ NATIVE HEALTH CLINIC—Consider joining a growing, innovative, community health clinic in Spokane, WA. NATIVE offers patient-centered care in a medical home that provides medical, dental, mental health, chemical dependency and preventative health services in a multidisciplinary practice model and needs a Family or Internal Medicine physician. Physician benefits include competitive salary and excellent medical, dental and life insurance benefits, 401(k), paid licenses and CMEs, I.H.S. and NHSC loan repayment and signing bonus. At NATIVE’s beautiful facility, we serve people of all ethnicities, income levels, ages and medical or behavioral health needs. For more information contact Dylan Dressler, Clinic Manager, at (509) 483-7535 or our website at www.nativeproject.org for the complete job description.
RETIRED PHYSICIANS GOLF TOURNEY ANOTHER SUCCESS By Patrick Freuen, MD 2014 Sr. Physicians Chair
Tournament Winners Patrick Freuen and Joe Rush
The morning started off with a light rain,
OTHER
but it did not faze the 24 golfers at the MEDICINAL CANNABIS AND CHRONIC PAIN PROVIDER SURVEY The State of Washington Attorney General’s office has granted researchers from the University of Washington an opportunity to develop and deliver a comprehensive CME program for health care providers regarding the scientific basis, clinical applications, and legal ramifications for using medicinal marijuana to treat chronic pain. To inform the development of the training and to collect information about current beliefs and practices around medical marijuana, the researchers are inviting healthcare providers in Washington state to complete a one-time 10- minute anonymous survey. Consider sharing your perspective. For more information and to respond to the survey, visit http:// adai.uw.edu/mcacp/.
SPOK ANE COUNT Y MEDICAL SOCIE T Y |
Retired Physicians Annual golf tournament at the Manito Golf Club held on Friday, May 16. Lunch and the presentation of prizes followed the golfing. Patrick Freuen won first place with a 66 in the under 17 division. David Maccini and Frank Browne tied for second place with 72. In the 17 & over division Joe Rush took first place with a 73, Ronald Smith took second with a 74 and Bruce Johnson was third with a 75. Roy Zimmer won the Super Senior award with a 79. Thank you to Click Distributing for supplying wine for the prizes and Inland Power and Light for providing drawing giveaways. This golf outing is about fellowship and renewing old friendships among colleagues. If you are a retired/senior physician golfer and did not receive a flyer, please contact Shelly at SCMS at (509) 325-5010 with your information.
24
| T H E M E S S A G E | J U LY, 2 0 1 4
SPOKANE COUNTY MEDICAL SOCIETY - ORANGE FLAG BUILDING 104 S FREYA ST STE 114 SPOKANE, WA 99202 ADDRESS SERVICE REQUESTED
Please Recycle
PRSRT STD U.S. Postage
PAID
Spokane, WA Permit No. 307