The Message, November 2011

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A MON T HLY NE WS M AG A ZINE OF SPOKANE COUNTY MEDICAL SOCIETY – NOVEMBER 2011

THE VALUE OF SCMS MEMBERSHIP

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

T a b l e o f C ont e nts

The Value of Membership Your Medical Society: What Have We Done for You Lately? . . . . . . . . . . . . . . . . . .

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Comments From Your Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 The Imperative for Change! Really? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Spokane Prescription Opioid Task Force . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 The Value of Advocacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 SCMS Advocacy Pays Off! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 SCMS Supports Our PA Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Don’t Forget the Value of Our Electronic Medical Library MEDICOR . . . . . . . . . . . . . . 7 SCMS at Work for You . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Our Community of Professionals Value the SCMS Partnership . . . . . . . . . . . . . . . . . . 7 Women Physicians Get Together . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 L. Gordon Moore, M.D. Speaks to SCMS Membership . . . . . . . . . . . . . . . . . . . . . . 9 Don’t Forget to Have Fun! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Project Access Thank You . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 In the News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 FYI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Washington Prescription Monitoring Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Spokane County Medical Society Message Terri Oskin, MD, Editor A monthly newsletter published by the Spokane County Medical Society.

The annual subscription rate is $21.74 (this includes the 8.7% tax rate).

Advertising Correspondence Quisenberry Marketing & Design Attn: Jordan Quisenberry 518 S. Maple Spokane, WA 99204 509-325-0701 Fax 509-325-3889 jordan@quisenberry.net All rights reserved. This publication, or any part thereof, may not be reproduced without the express written permission of the Spokane County Medical Society. Authors’ opinions do not necessarily reflect the official policies of SCMS nor the Editor or publisher. The Editor reserves the right to edit all contributions for clarity and length, as well as the right not to publish submitted articles and advertisements, for any reason. Acceptance of advertising for this publication in no way constitutes Society approval or endorsement of products or services advertised herein.

Spokane Society of Internal Medicine’s 63rd Annual Meeting . . . . . . . . . . . . . . . . . . . . 21 Continuing Medical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 New Physicians and Physician Assistants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Positions Available . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Membership Recognition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Classifieds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

"The value of a man should be seen in what he gives and not in what he is able to receive."

- Albert Einstein

November SCMS The Message Open3

The Value of Membership Your Medical Society: What Have We Done for You Lately?

By Brad Pope, MD In the 126 years that the SCMS has existed, we’ve changed with the times. Back in the 1980s when I first joined as a family physician, my primary reason was to gain access to hospital privileges in one convenient step. Traditionally SCMS appeared to act like a small-business chamber of commerce.

Members practiced mostly in physician-owned small businesses and SCMS promoted and represented their interests. The society also provided a platform for socializing.

I’ve benefited tremendously from SCMS, particularly by meeting physicians and physician assistants whom I had never met before.

My perspective has broadened on what it’s like to be a doctor in this town. I’ve enjoyed working with the Board of Trustees and society members on community issues.

SCMS has taught me about subjects that I hadn’t paid attention to previously. I’ve gained insight into the need for professionalism and its importance. I’ve grasped the nuances of tort reform and why it has been so difficult to achieve. I’ve also witnessed the influence of the healthcare industry as an important engine in our region’s economy.

As SCMS president I’ve learned a great deal attending Washington State Medical Association annual meetings. The group has a tough job trying to represent the extremely diverse perspectives of its membership: witness a discussion about a single-payer system and you’ll know what I mean. Attending the meetings helps me understand peoples’ values and observe how policy is developed.

For me, SCMS provides the opportunity to be an active citizen in our community. I didn’t join to persuade people to think the same way as I do, but to better understand my colleagues’ differing points of view. I want to speak knowledgeably about them and to grasp how healthcare decisions are made at the local, state and national level, so that I know what’s coming my way in my professional life.

In this month’s issue, you’ll find several articles “In this month’s issue, showcasing how SCMS you’ll find several brings value to our members. articles showcasing This is an interesting era for SCMS because healthcare how SCMS brings value is in the midst of a huge to our members.” transformation. More physicians are joining large organizations, thereby removing themselves from the day-to-day decision making and operations authority of the business. The traditional “professional small business advocate” paradigm of SCMS may need to expand to address other priorities set by the members. SCMS also hasn’t presented as many opportunities for socializing as it used to.

Maybe you have some ideas you can share in this regard.

SCMS endeavors to change to keep pace with the issues important to its members. We would like to know how we’re doing. We need to know what you think we could do to help you be the best physician or physician assistant you can. Please join the conversation and send me your feedback at pope.p@ghc.org.

Comments From Your Leadership As the Medical Director of the Community Health Association of Spokane I wanted to play a part in decision-making at the county level for patient care. I found that the SCMS was the group that crossed political and organizational boundaries to be able to accomplish that desire. I have found that the leadership here is very forward thinking and attempt always to serve their members and serve their members’ patients. It has also allowed me to network with other providers here in the community which is very helpful for me personally and also for my organization.

David Bare M.D. Medical Director Why did I become involved with the Spokane County Medical Society Board of Trustees? The first comment that comes to mind is that I was in the “wrong place at the wrong time.” But the truth is more along the line of attending a meeting, when a fellow physician approached me about being on the Spokane County Medical Society’s Board of Trustees. He told me they needed someone from the north side and asked if I would be interested.

After discussing the time commitments and duties I decided to become more engaged. Once on the Board I went from being a trustee to an officer. As a trustee and an officer I have had the opportunity to work to have the voice of the Spokane medical community heard from Washington State to Washington, DC. In answering the question it could be said that I was asked by a friend… and the rest is history.

Terri Oskin, M.D. SCMS President-Elect

The Imperative for Change! Really?

What Determines the VALUE of SCMS Membership?

By Keith Baldwin, SCMS CEO OK, I did plagiarize part of the title from a book I am reading about change in the association model. It seems that the firsthand challenges noted by the consultant/author: loss of market share, increased competition for members’ time and shrinking resources, are impacting the traditional role and success of associations across many sectors of the economy.

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The Value of Membership Continued from page 1 You’re not surprised, right? I started reading this book after the SCMS Executive Committee had already had several discussions about pursuing an enhanced “strategic planning” process. The strategic planning is intended to augment the traditional Priority Survey done each year to gather feedback from members about their interests and subsequently, how the SCMS should be using resources on behalf of members. It’s no coincidence that a nonmember survey was also done to gather opinions as well, to build a baseline of information for the planning process.

The SCMS has applied for a Responsive Grant from the Empire Health Foundation (EHF) to help support the cost and be stakeholders in the process. A consultant/facilitator would be engaged to contact some SCMS members and other leaders in the medical community (back to that later) to gain their perspective, do other research and preparation to support several workshops with participants/stakeholders and to prepare a document containing goals/tactics/follow up activities, using an online tracking system to keep it current. Importantly, the process would need to determine and understand the needs of the membership and how those opinions relate to the larger medical community and the public at-large.

The EHF has been a supporter/partner with SCMS on Project Access (PA) and now with the Emergency Department Collaboration project as well. Antony Chiang, CEO, asked Lee Taylor, PA and me to consider, “What will the SCMS/PA look like in five years?” We thought our member programs and list of community-wide conversations, such as PA and the Spokane Prescription Opioid Task Force (SPOTF), were explanatory enough.

We decided that they might not be and began the discussion with the SCMS Executive Committee about how we could answer that question. The enhanced Strategic Planning process is partially a result of those discussions.

If we are to be successful with an enhanced strategic planning process, it seems that we need both an internal AND an external view of the issues. That is the reason for including other stakeholders. They may (and some certainly do) have different perspectives about the value of the SCMS and/or what changes might be considered to make it even more successful in the future.

Is the SCMS positioned to play a leadership role in the discussions and plans for the future of health/wellness care in Spokane and in this region? Can and should SCMS be involved in the significant changes occurring in the nation and state related to reducing costs, improving care and creating a healthier community? Are these and other questions legitimate issues for SCMS to pursue with others in the community? Can SCMS members, coming from diverse practice settings and system models, be a membership organization that can provide leadership on these issues?

Don Berwick, who leads Centers for Medicare and Medicaid Systems (CMS), observed that, “we face a paradox with respect to pursuit of the Triple Aim: care, health, cost. From the viewpoint of the United States as a whole, it is essential; yet from the viewpoint of individual actors responding to current market forces, pursuing the three aims at once is not in their immediate self-interest.

Among other conditions, achieving the Triple Aim requires an integrator: an entity that accepts responsibility for all three components of the Triple Aim for a specified population.” Can SCMS and its members become an integrator for some parts of the health system in Spokane based on its unique position of

leadership across the medical community and the public at-large?

What successful leadership role can or will SCMS play in the future and can that be identified through a STRATEGIC Planning process? Let’s find out!

Spokane Prescription Opioid Task Force

By Gary Knox, MD The SCMS provided the leadership to develop The Spokane Prescription Opioid Task Force (SPOTF), which was created out of a need to address the high rate of unintended opioid deaths in Spokane County and the significantly increasing rate of use and abuse of opioid prescription medications. A number of sources, including Medicaid, had pointed out that Spokane County had a significant problem with the use and abuse of prescription opioids. In addition, many physicians were frustrated with their ability to safely manage patients with chronic pain issues, especially management of opioids to control chronic pain. The number of people seeking pain control had burgeoned and overwhelmed many of the providers offering services to patients.

In a response to many of the same issues occurring across the State and at the same time, the State Legislature passed guidelines for the use of opioids in the treatment of chronic non-cancer pain.

The MQAC expanded the existing rules, as did a number of other professional groups, to take effect on January 2, 2012.

The SPOTF developed initiatives early on with the support of this community wide coalition which includes law enforcement, the drug court, pharmacists and retail/hospital pharmacies, WSU College of Pharmacy, physicians, and providers of pain management services. These initiatives have been significantly accomplished and include: • Ongoing advocacy for sustainable funding for the WA DOH Prescription Monitoring Program (PMP), • Expanding the use of the Consistent Care Program at PSHMC ED to other patients in the community needing care coordination for their use of opioids to manage their chronic non-cancer pain, using a process for accepting and posting patient information on the Bulletin page in the MEDITECH PCI module, • A “Uniform Pain Management Agreement” that incorporates the essential elements and meets the requirements of the law, which can be used as a baseline for all provider agreements, • A discussion of appropriate access to and use of the pain management information on MEDITECH and at the pharmacy, • The development of formal (Grievance Committee) and informal means for communicating with providers about their opioid prescribing behaviors in an informative and educational manner, especially those who frequently prescribe and/or prescribe with a high dosage,

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The Value of Membership Continued from page 2 • The creation of a “category” (called Opioid-Related Disorders) of materials (web links, documents) in Medicor, • The development of dental protocols, between ED physicians and Dental providers, that provide for a 48 hour appointment horizon, • Encouraging providers to participate in a survey to evaluate the diffusion and acceptance of Washington State’s Interagency Guideline on Opioid Dosing for Chronic Non-cancer Pain.

The SPOTF is an example of the leadership role that SCMS has taken in the community “to improve and preserve the health of the citizens in our community,” a core of the SCMS Mission Statement.

The Value of Advocacy Higher Education Legislative Tour Visits Spokane

By Barb Chamberlain WSU – Director of Communications and Public Affairs Stories of personal attainment and reminders of how essential postsecondary education is to every employee and employer highlighted a hearing held September 20 by the House Higher Education Committee at the Riverpoint Campus.

The first in a series of meetings being held around the state, the day focused on pipeline and educational attainment issues such as college readiness, student transfer and transition challenges.

All five higher education institutions presented a number of creative and collaborative programs, from the I-BEST program through Community Colleges of Spokane, which couples basic English skills with job training, to the partnerships in health education at Riverpoint.

Sheila Masteller, VP for advocacy, Providence Health and Services; Keith Baldwin, CEO of the Spokane County Medical Society; and College of Nursing instructor Lynette Vehrs, who also represented the Washington State Nurses Association, all spoke of the trend toward a team approach in health education and how that will affect the health care workforce of the future.

All three agreed that the move toward measurement of outcomes rather than volume of activity and a shift toward wellness care rather than "illness care" are inevitable, making new approaches to the education of health professions essential.

A second panel on educational attainment included a presentation on STEM (Science, Technology, Engineering & Mathematics) education by Joan Kingrey of the WSU College of Education at WSU Spokane, covering both the Riverpoint Advanced Math Partnership and Project Lead the Way. Cecilia Arroyo, a master's student in the 4+1 interior design program who also received her bachelor's from WSU Spokane, shared her personal story of educational attainment. A firstgeneration college student whose Mexican-American parents encouraged all three of their children to earn a baccalaureate, as well as go on to graduate school, Arroyo described the importance of programs that enabled her to envision a career path rooted in higher education and the opportunity to serve as a mentor herself.

Another committee meeting was held at Central Washington University in Ellensburg on September 20 and a non-committee meeting at WSU-Tri Cities and Columbia Basin College was held on September 22. The series continued in October at Seattle University and Skagit Valley Community College, and then in November a culminating meeting for the series will be held at South Puget Sound Community College.

A panel on workforce and higher education examined the aerospace and healthcare industries, with WSU Spokane chancellor Brian Pitcher presenting plans for growth in the health professions.

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The Value of Membership SCMS Advocacy Pays Off! Build It and They Will Come

By John McCarthy, MD Assistant Dean for Regional Affairs UWSOM On Wednesday, October 5 the big earth moving machines were rumbling, the Governor had a shovel in her hand, and the official groundbreaking for the new Biomedical and Health Sciences Building at Riverpoint campus occurred. This is an important step in terms of preparing to bring four years of medical and pharmacy education to the community. Things continue to advance in a positive fashion along these lines in spite of the state’s very difficult fiscal environment. This building will be able to handle the future growth in our community’s medical education which will manifest with more medical students doing more education in our local area.

hour notification that the lead speaker, who had endured eight hours in airports and on airplanes to get here, was not able to land.

The interest in building a teaching community is impressive and is integral to filling a building with well prepared, inquisitive students.

The leaders of UME and GME are striving to create an environment which fosters preparation for the medical team of the future. This is an exciting time to be participating in the growth of medical education. A community of medical educators is here and ready to engage, a building is started, two universities are partnering to make this happen, the business community is wholly supportive, health systems are working on ways to fully engage, the community at large is behind the project and the needs in the community are imminent.

SCMS Supports Our PA Members MEDEX Graduates First Master’s in Spokane

By Steve Meltzer, PA-C Director, Outreach and Eastern Washington Education Programs

WSU Spokane Chancellor Brian Pitcher, pharmacy student Erik Nelson, nursing student Trevor McLay, WA State Governor Christine Gregoire, ASWSUS (student body) president Holly Burke, medical student Ben Arthurs and WSU President Elson S. Floyd. Photo by Judith Van Dongen, WSU Spokane One of WWAMI Spokane’s inaugural students, Ben Arthurs (now an MS4), spoke at the groundbreaking ceremony about his experience in Spokane and the formative experience that Spokane offered him.

He was eloquent and noted his appreciation for the community which has taught him and his colleagues in the classroom, the clinic, and the hospital. He epitomizes what growth in medical education will mean for this community – great physicians-in-training with ties to the community, who are from the Eastern side of the state, who add more to the community than they take away, and (with any luck at all) who will be back here working as our partners and leading the next generation of physicians. Ultimately, they will be taking care of us as we age and if you are anything like me, you want them to be well trained and excellent.

The building will serve as a physical manifestation of the expansion of medical training in Spokane. At the same time, we continue to work at strengthening our faculty and its reach into the community so that we are prepared for expansion of both GME (residencies) and UME (medical school education). To that end, we held our second faculty development workshop and over 70 preceptors were in attendance. We had positive feedback in spite of the one

The University of Washington’s MEDEX Northwest Physician Assistant Program graduated its first class of Masters of Clinical Health Services students on August 26th at the Lincoln Event Center in Spokane. Dr. Gary Knox, associate medical director of Rockwood Clinic and immediate past-president of the SCMS, was the featured keynote speaker. Dr. John McCarthy, WWAMI assistant dean for graduate medical education offered welcoming remarks to the 27 graduates and their families. The room was filled to capacity with over 250 attendees.

Ruth Ballweg, MPA, PA-C Opening the ceremonies, Ruth Ballweg, MPA, PA-C, division director of MEDEX, commented on the history of MEDEX as one of the first PA programs in the country, and that MEDEX recently became part of the UW Department of Family Medicine. As the first Master’s graduates, the students completed a capstone research project during the past year; the presentations and posters earlier in the week were excellent and students were very excited about their projects.

Dr. McCarthy welcomed and updated the audience on the success of moving forward plans to develop a full medical

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The Value of Membership Continued from page 5 school in Spokane and the opportunities the Riverpoint Campus provides with a rich complement of health professions programs from the three universities: WSU, EWU and UW. The UW School of Medicine - with local medical students, residents and the MEDEX physician assistants – will have an increasing role to play in healthcare access and service delivery in the region.

PAs since the early 1980s and PAs now comprise about 20% of the total providers and one-third of the number of physicians. PAs were originally only in primary care, but now are a vital part of specialty departments such as dermatology, nephrology, radiology, urgent care, GI/hepatology and multiple surgical specialties.

Steve Meltzer, PA-C addressing the Medex graduates Using quotes from Albert Einstein, Dr. Knox reflected how new problems can’t be solved using “the same thinking we used when we created them.” Implementation of the medical home model is one way Rockwood is reshaping its services – including PAs as part of that solution – to stay on the forefront of medical care.

MEDEX Graduating Class

He also used an anecdotal story to reflect on another Einstein quote “not everything that can be counted, counts.” The story was about one of the Rockwood orthopedic PAs who helped identify a unique problem in a young teenager. Using more than just lab results (things that can be counted), he relied upon good exam skills and experience to help guide him successfully to healing (things that can’t be counted). He noted that this story illustrated how sometimes the most fulfilling experiences as a medical provider occur in using everything you know and sense; instincts and experience do count!

Gary Knox, MD addressing Medex graduates Dr. Knox, in addressing the graduates, noted that there are about 80 physician assistant members in the SCMS including a voting member on the Board of Directors and several on committees.

PAs have been accepted as members since 1997. Speaking of Rockwood Clinic, Dr. Knox commented that they have been utilizing

As graduation concluded, the students were excited about taking their national board exams and starting their new careers across the country in primary care, medical and surgical specialties and PA residency programs. Best of luck to all!

Photos by Riant Photography

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The Value of Membership Don’t Forget the Value of Our Electronic Medical Library MEDICOR

By George McAlister, MLA Director of Health Information Resources

The MEDICOR project (http://spcmsmedicor.org) is an innovative, Web-based electronic medical library system under continuous development since 2006. A cooperative venture to support clinical decision-making, MEDICOR proudly serves the greater Spokane medical community, receiving financial support from the Spokane County Medical Society (SCMS) and the two major Spokane area health systems: Community Health Systems (Deaconess Medical Center, Valley Hospital & Medical Center and the Rockwood Clinics) and Providence Health & Services (Sacred Heart Medical Center & Children’s Hospital and Holy Family Hospital). Medicor offers clinicians: • A Standard Search Engine. Clinicians experience the same “look and feel” when searching for patient care information across hundreds of sites.

• Easy, Remote Access. Clinicians have 24/7 Internet access using a standard Web browser to a wide array of electronic patient care resources.

as an important clearinghouse to share new developments in health information technology (HIT) and health information exchange (HIE). Recognizing the importance of technology to the improvement of health in our community, members of the committee seek to build and nurture the relationships necessary to improve access to vital patient care information. While the opportunity to share experiences and to educate colleagues about HIT and HIE issues is important, the Committee also works to assure that organizations within our community, with often diverse and competing interests, continue to collaborate for positive patient outcomes and improved community health. The Medical Informatics Committee generally meets on the first Thursday of each month at 6:45 A.M. in the SCMS conference room.

School-Based Health Centers in Spokane County

By David Bare, MD Community Health Association of Spokane A new effort is under way to bring school-based health centers (SBHCs) to Spokane County with the goal of opening a pilot health center in a school. We want to improve the health and wellness of our children and youth and help ensure they have the opportunity to succeed in school. School health centers are a proven way to increase access to care, improve attendance, respond to risky behaviors sooner and even save money through reduced emergency room visits.

Behind the Scenes

• A Way to Search Multiple Databases Simultaneously.

Clinicians can query up to 10 databases simultaneously

• Credentialing Process

using one powerful, easy to use interface, but can still

• Single-System Security Badges

go to each native interface for more expert searching.

• The Message (our monthly newsletter)

• An A-Z List of Electronic Journals. Clinicians can search or browse a complete and updated list of highly organized electronic journals. Search by title, subject,

• Annual Pictorial Directory/ Electronic Pictorial Directory Access (for members only) • Social Events

database provider, etc.

• Easily Find Full-Text Information. The full text of a journal article is one click away through a highly sophisticated link resolver system.

• Continuing Medical Education Programs • Physician/Citizen of the Year Award • Support to Community Events/Organizations

• A personal space to create, store and retrieve customized lists of most-frequently used resources.

: Spokefest – Step-up Spokane – Bicycle Helmet Ordinance – Christ Clinic

For more information about MEDICOR or to see if you qualify for a free ID/password, please contact George McAlister at 509-3255010 or george@spcms.org

SCMS at Work for You Medical Informatics Committee

By George McAlister, MLA Director Health Information Resources In this time of challenges, change and innovation in the healthcare industry, the Medical Informatics Committee serves

Our Community of Professionals Value the SCMS Partnership In the early 50’s my father pioneered in systemizing a personal and business professional approach for physicians. At that time physician’s offices were not the efficient service providers they

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An investment in your practice manager

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An investment in your practice www.wsmgma.org

Invest in the tools to create a more streamlined, profitable practice. The WSMGMA helps more than 500 practice managers and administrators across the state with ideas to improve staff efficiency, increase reimbursement, and improve operations.

Find out more about Washington’s premiere membership association of medical group practice managers and administrative professionals.

Washington State Medical Group Management Association

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The Value of Membership Continued from page 7 are today. Being involved in the Community of Professions is a comfortable and natural way for our firm to continue the support of the medical community that we have long been associated with for my whole professional career.

Paul M Fruci, Sr. Fruci & Associates "US Bank greatly appreciates our relationship with the Spokane County Medical through its Community of Professionals partnership. It allows us access to the medical community and the ability to understand the issues that affect the medical providers in our area. By understanding these issues, we can improve our products and methods to best to serve the needs of

Women Physicians Get Together On August 23 a Women Physicians’ Event Planning meeting was held. Fourteen physicians came together to discuss possible future events for women physicians in Spokane. Those present enjoyed the comradery of the evening and discussed continuation of casual social events as opposed to more structured events.

this unique community."

Dave Walker US Bank The two best things we have enjoyed as being sponsors of the Medical Society have to be working with the staff; they have been so fun and so great in helping us to help the medical community. We wonder if the medical community knows just how big a resource they are or could be. The second thing would be networking and getting to know the other sponsors of the Medical Society. These are the best of the best in the region at what they do for their clients.

Travis Prewitt & Brad Desormeau UBS - The Prewitt Group

It was decided the next gathering will be a potluck on Thursday, December 01 at 5:30 p.m. at 1629 East 46th Avenue. All female physicians are encouraged to attend. Watch for more details!

L. Gordon Moore, M.D. Speaks to SCMS Membership “Working Together to Benefit Patients”

The Spokane County Medical Society is a cornerstone in Spokane’s medical community. Sterling Savings Bank applauds their good work and through the Community of Professionals wants to partner with them in helping to provide the very best to our medical community!

Sterling Private Banking provides exceptional service and exclusive benefits to a select group of clients with complex financial and banking needs. We take the time to fully understand our clients’ financial affairs, both personal and business, in order to develop integrated solutions. We specifically work with professional service firms and their partners, high net-worth individuals, and not for profit organizations and their board members.

Keith Kristin Private Banking Sterling Savings Bank

Women physicians discussing upcoming events

By Keith Baldwin, SCMS CEO A diverse group of SCMS members met to hear a presentation about the potential for using information related to patient experience to improve patient outcomes and create a dialogue with payers about sharing the benefits with providers. L. Gordon Moore, M.D., who is a Family Medicine Practitioner and national leader in improving health delivery in primary care and medical office practices, spoke to the audience Tuesday evening. He serves as advisor, expert and faculty to numerous initiatives, from Iowa to New York, for better health outcomes while bending the cost curve. As a participant in guideline and protocol initiatives and process redesign workshops, Dr. Moore works with all practice models: solo and independent, large hospital-based specialty clinics, community health centers, as well as private and academic practice.

Dr. Moore related the basic premise that, “improving the patient experience is directly related to improved outcomes for patients.”

He gave a number of examples where using an online patient survey as a basis for improving the patient experience in the practice setting, showed a greater improvement in patient outcomes than the measurement of clinic factors and resulting process improvement efforts. The premise is that “a collaboration of physicians improving the patient experience Continued on page 11

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Riverpoint Rx.pdf

1/20/10

10:55:21 AM

A Personalized Approach to Your Health Riverpoint Pharmacy is one of the few remaining pharmacies that can still offer customized medications through pharmaceutical compounding.

We can provide: • Individualized strengths, combinations and flavorings • Specialized dosage forms such as topical gells and slow release capsules • Sterile compounds such as preservative-free eye drops, injectibles and custom nebulizer solutions • Veterinary compounding Our specially trained pharmacists also offer personalized consultations in: • Nutrition evaluation and planning for improved health • Bioidentical Hormone Replacement Therapy for men and women • Review of medications and supplements • Pain management options for chronic pain and special needs

R iverpoint P

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Your treatment. Custom designed.

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

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Format, Table Format and README files.

(with a data repository for evaluation and comparison purposes) can be translated into a discussion with payers about alternative payment models for improved patient outcomes using the patient experience information.” Payers, in a number of locations around the country, are beginning to show interest in alternative payment or shared savings models, according to Dr. Moore.

A new federally mandated version will expand the number to around 140,000—adding codes that describe precisely what bone was broken, or which artery is receiving a stent.

It will also have a code for recording that a patient's injury occurred in a chicken coop.

Indeed, health plans may never again wonder where a patient got hurt. There are codes for injuries in opera houses, art galleries, squash courts and nine locations in and around a mobile home, from the bathroom to the bedroom.

Health insurers, doctors and hospitals are bracing for chaos as they prepare to adopt a new federally mandated format for medical billing. Anna Wilde Mathews has details on Lunch Break.

Some doctors aren't sure they need quite that much detail.

"Really? Bathroom versus bedroom?" says Brian Bachelder, a family physician in Akron, Ohio. "What difference does it make?"

L. Gordon Moore, MD addressing SCMS General Membership Meeting In response to a question from Dr. Pope, Dr. Moore said that there are no examples in Washington at this time of payers considering alternative payment models. The attendees asked numerous questions and had responses that ranged from very optimistic to not interested. Is there potential for physicians to collaborate on improving the patient experience? Could this result in discussions with payers about alternative payment models? Please let Dr. Pope, SCMS President, know if you have other questions or comments about the presentation at pope.b@ghc.org.

Don’t Forget to Have Fun! Walked Into a Lamppost? Hurt While Crocheting? Help Is on the Way New Medical-Billing System Provides Precision; Nine Codes for Macaw Mishaps

By Anna Wilde Mathews The Wall Street Journal, September 13, 2011 Today, hospitals and doctors use a system of about 18,000 codes to describe medical services in bills they send to insurers.

Apparently, that doesn't allow for quite enough nuance.

The federal agencies that developed the system—generally known as ICD-10, for International Classification of Diseases, 10th Revision—say the codes will provide a more exact and up-todate accounting of diagnoses and hospital inpatient procedures, which could improve payment strategies and care guidelines. "It's for accuracy of data and quality of care," says Pat Brooks, senior technical adviser at the Centers for Medicare and Medicaid Services.

Billing experts who translate doctors' work into codes are gearing up to start using the new system in two years. They say the new detail is welcome in many cases. But a few aspects are also causing some head scratching.

W61.11XA: A code for injuries related to macaws.

Some codes could seem downright insulting: R46.1 is "bizarre personal appearance," while R46.0 is "very low level of personal hygiene."

It's not clear how many klutzes want to notify their insurers that a doctor visit was a W22.02XA, "walked into lamppost, initial encounter" (or, for that matter, a W22.02XD, "walked into lamppost, subsequent encounter").

Why are there codes for injuries received while sewing, ironing, playing a brass instrument, crocheting, doing handcrafts, or knitting—but not while shopping, wonders Rhonda Buckholtz, who does ICD-10 training for the American Academy of Professional Coders, a credentialing organization.

A Code for What Ails You

Code V91.07XA, which involves a "burn due to water-skis on fire," is another mystery she ponders: "Is it work-related?" she asks. "Is it a trick skier jumping through hoops of fire? How does it happen?"

Search for diagnoses codes from the International Classification of Diseases, 10th Revision, by typing in a keyword. We've provided a few to get you started.

Much of the new system is based on a World Health Organization code set in use in many countries for more than a decade. Still, the American version, developed by the Centers for Disease

And see the full table of codes at the Centers for Medicare and Medicaid Services site. Click 2011 Code Descriptions -- Long November SCMS The Message 11

Continued on page 13

November SCMS The Message 12

Continued from page 11 Control and Prevention and the Centers for Medicare and Medicaid Services, is considerably more fine-grained.

Y93.J4: A code for injuries received while playing brass instruments.

The WHO, for instance, didn't see the need for 72 codes about injuries tied to birds. But American doctors whose patients run afoul of a duck, macaw, parrot, goose, turkey or chicken will be able to select from nine codes for each animal, notes George Alex, an official at the Advisory Board Co., a health-care research firm.

There are 312 animal codes in all, he says, compared to nine in the international version. There are separate codes for "bitten by turtle" and "struck by turtle."

U.S. hospitals and insurers are bracing for possible hiccups when the move to ICD-10 happens on Oct. 1, 2013, even though they've known it was coming since early 2009.

"You have millions of transactions flowing in the health-care system and this is an opportunity to mess them all up," says Jeremy Delinsky, chief technology officer for athenahealth Inc., which provides billing services to doctors.

Medicare officials say they believe many big insurers and hospital systems are making preparations, but there may be some issues with smaller ones that won't be ready.

With the move to ICD-10, the one code for suturing an artery will become 195 codes, designating every single artery, among other variables, according to OptumInsight, a unit of UnitedHealth Group Inc. A single code for a badly healed fracture could now translate to 2,595 different codes, the firm calculates. Each signals information including what bone was broken, as well as which side of the body it was on.

Some companies hope to grab business from the shift. One medical-coding website operator, Find A Code LLC, has created a series of YouTube videos with the tagline, "Yeah, there's a code for that.� Snow White biting the poisoned apple, the firm says,

may be a case of T78.04, "anaphylactic shock due to fruits and vegetables.� On April 1, the company posted a document with the secret "X-codes" to describe medical conditions stemming from encounters with aliens.

Other coding cognoscenti spot possible hidden messages in the real codes. The abbreviation some use for the new system itself, I10, is also a code for high blood pressure. Several codes involving drainage devices end in "00Z.� Then there are two of the codes describing sex-change operations that end in N0K1 and M0J0. "You could see it ripple through the room as people said, 'nookie and mojo!'" says Kathryn DeVault, who has been teaching ICD-10 classes for the American Health Information Management Association. "Was it purposeful? We don't know."

Code V91.07XA: A code for a 'burn due to water-skis on fire.'

No, it wasn't, says the Medicare agency's Ms. Brooks, who says the codes are built according to a consistent pattern in which each digit has a meaning.

"I couldn't if I wanted to insert a cute message," says Ms. Brooks, who admits that she could be described by Z73.1, "Type A behavior pattern."

Medicare and CDC officials say codes were selected based on years of input from medical experts in various fields. Codes describing the circumstances of injuries are important for public-health researchers to track how people get hurt and try to prevent injuries, they say.

Being able to tabulate risks tied to locations such as chicken coops could be "important as far as surveillance activities" for public health research, says Donna Pickett, a medical systems administrator at the CDC. She says the current code for a badly healed fracture is so vague it isn't useful.

Another CMS official, Denise M. Buenning, compares ICD-10 to a phone book. "All the numbers are in there," she says. "Are you going to call all of the numbers? No. But the numbers you need are in there."

November SCMS The Message 13

November SCMS The Message 14

November SCMS The Message 15

For orthopedic care that makes you feel this good, we’ve got you covered.

Getting you back to an active lifestyle is the reason The Joint Restoration Center at Valley Hospital offers a wide range of advanced orthopedic services from experienced physicians.

• Knee and hip joint replacements, as well as spinal and neck implants • Cartilage restoration • Fracture and tissue repair • Orthopedic surgeon available 24/7 to treat emergencies

Make Valley Hospital and Medical Center your choice for orthopedic care.

Visit www.spokanevalleyhospital.com/physicians to find an orthopedic specialist.

12606 East Mission • Spokane Valley

A d va n c e d O r t h o p e d i c C a r e . R i g h t H e r e .

November SCMS The Message 16 52752_VHMC_Ortho_7_5x10c.indd 1

12/17/10 3:07 PM

In the News Helen Schmidt, MD Named Physician of the Year by HCAW The Homecare Association of Washington recently named Helen Schmidt, MD of Spokane Valley Physician of the Year. Dr. Schmidt helped to establish a home-based, primary care practice in 2006 that has evolved to become HouseCalls, a service of Family Home Care, providing primary medical care for more than 1,200 of the most homebound medically fragile patients in the Spokane community.

All of the websites require a password that can be obtained from Lance Heineccius, WSMA Director of Performance Improvement, Foundation for Health Care Improvement (206) 956-3657 or Lance@ wsma.org.

Big Changes Coming Soon — L&I Provider Network and New COHEs Historic workers’ compensation reforms will affect every provider that does business with L&I: • L&I is creating a network that will serve injured workers covered by L&I as well as those of self-insured employers.

• Network standards are being developed now and enrollment for attending providers will begin in early

Byron Wright, MD Cancer Liaison

2012.

• L&I will expand the Centers for Occupational Health and

Physician Byron Wright, MD, of Cancer Care Northwest, recently received a three-year appointment as cancer liaison physician for the cancer program at Deaconess Medical Center in Everett. As liaison, Dr. Wright will provide leadership and support to the cancer program, which is an important component of the Commission on Cancer of the American College of Surgeons.

FYI

Education (recruiting soon for 2013 expansion) • Beginning in 2013, workers will be able to see a nonnetwork provider for their first visit only.

• Also in 2013, L&I will launch incentives for network providers who use occupational-health best practices.

Find out what’s going on and how it will affect you - Join the L&I Medical Provider News e-mail list — the best way to stay up to date — by going to www.Lni.wa.gov and entering “Medical Provider News” in the search box. Information is also available at www.

ProviderNetwork.Lni.wa.gov Physician Prescribing Data: The Choice Is Yours.

WSMA Foundation’s Clinical Performance Improvement Network (CPIN) Launches New Communication Tool To help facilitate discussion among people interested in clinical improvement topics, there are four online discussion forums available.

The forums can be accessed from the WSMA Foundation CPIN website (www.wsma.org/CPIN) or directly by using the links listed below.

General CPIN Discussion Forum - use this forum for general

The American Medical Association believes that only you should have the power to decide how your prescribing data are used. The Physician Data Restriction Program (PDRP) is making that possible.

The program is free and available to all physicians, regardless of AMA membership.

The PDRP lets you choose:

Register. Prohibit pharmaceutical reps from accessing and using your individual prescribing data. Visit the PDRP website.

discussion about CPIN topics. http://www.quicktopic.com/46/H/ tCEKa9apjD5

Don’t register. Continue to allow pharmaceutical reps to view your

Clinical Improvement Forum - use this forum for discussion

Learn more at ama-assn.org/go/prescribingdata

data to identify your needs and preferences. No action required.

about specific clinical issues. http://www.quicktopic.com/46/H/ Qif3KxEX4wXjF

Care Coordination Forum - use this forum for discussion about care coordination topics. http://www.quicktopic.com/46/H/ n5dvZSZXW9J

Practice Transformation Forum - use this forum for discussing practice transformation ideas. http://www.quicktopic.com/46/H/ B8BBiRGikffpp November SCMS The Message 17

A Multidisciplinary Approach to Improving Quality of Life Physical Medicine & Rehabilitation Psychology

Physical Therapy

Interventional Spine Pain Medicine EMG/NCS Jamie Lewis, MD Patricia Fernandez, PsyD Brandon Byquist, DPT

Phone: 509.464.6208 Fax: 888.316.1928 Spokane, Washington November SCMS The Message 18

Washington Prescription Monitoring Program – What Providers Need to Know What is a Prescription Monitoring Program (PMP)?

The PMP, referred to as Prescription Review, is a secure online database that will be used across Washington State to improve public health. Practitioners will have access to their patient’s information before they prescribe or dispense drugs. This will allow them to look for duplicate prescribing, possible misuse, drug interactions, and other potential concerns. More information means better patient care.

Which practitioners can access data?

Physicians, pharmacists, dentists, physician assistants, nurse practitioners, and other licensed clinicians and professionals authorized by the Washington State Department of Health.

Are there tools to help me?

Yes. In addition to the website (www.wapmp.org) and the Dispenser factsheet (www.wapmp.org/wapmpfiles//Dispenser_Factsheet.pdf), frequently asked questions (FAQ) sheets by profession and a “Quick Tips” for how to log in and register are coming in December 2011.

What prescription information is collected?

Information will include:

Which drugs does the Washington PMP monitor?

• Patient name, address, and date of birth

Prescription Review collects data on Schedules II, III, IV, and V controlled substances. You can find a list of these medications and more information at: http://apps.leg.wa.gov/RCW/default. aspx?cite=69.50.

What does it do?

• Prescriber and dispenser information • Drug name and dosage, and the prescribing and dispensing dates.

What are the benefits?

Prescription Review will protect the public and will:

• Prescription Review is a centralized database that will hold controlled substance prescription information for all patients across the state.

• Dispensers† will submit data to the database.

• Prescribers will be able to review prescription history information and look for potential interactions.

• It will protect patient safety and deter prescription drug misuse.

What do I need to do?

• Dispensers will begin submitting data to the system beginning on October 7, 2011.

• Practitioners will be able to register and create an account on our website (www.wapmp.org) in November and December 2011.

• Practitioners will be able to request and receive patient prescription information beginning January 2012.

Increase: • Quality of patient care • Confidence when prescribing/dispensing • Efficiency of medical care

Decrease: • Drug misuse • Accidents and potential deaths • Crime rates • Taxpayer costs For more information, visit the website (www.doh.wa.gov/hsqa/PMP/ default.htm) or ask Chris Baumgartner (PMP Director) at 360-236-4806 or prescriptionmonitoring@doh.wa.gov. †A dispenser is a practitioner or pharmacy that delivers to the ultimate user a schedule II, II, IV, or V controlled substance.

Is this new?

While many states around the country, including our neighbors Idaho and Oregon, have PMPs, it is new to Washington. State Law Chapter 70.225 RCW authorized the Washington State Department of Health to establish a Monitoring Program.

Do other states have a similar program?

Currently 48 states have laws that authorize the establishment and operation of a PMP. Thirty-six of these states’ programs are up and running. Find more information on these programs on the Alliance of States with Prescription Monitoring Programs website: www. pmpalliance.org/.

November SCMS The Message 19

FAMILY Now providing comprehensive HOME prosthetic and orthotic patient care for adults and children CARE VALLEY ORTHOPEDIC

Spokane Valley 509-922-5040 Coeur d’Alene 208-765-3080 Sandpoint 208-265-0100 Post Falls—Opening November 2011 For more information and practitioner profiles, go to www.kpoidaho.com

We’re with you and your patients

Every Step of the Way

November SCMS The Message 20

Spokane Society of Internal Medicine’s 63rd Annual Meeting to Include Special Lectures

By Matt Hollon, MD MPH, SSIM Program Chair 2012 and Jennifer Anderson, SSIM Executive Director The Spokane Society of Internal Medicine’s 63rd annual scientific meeting will be held at the Spokane Convention Center on February 24th and 25th 2012.

This will be an exceptional meeting so mark your calendars!

This year’s SSIM meeting features outstanding regional and national speakers. Half of the meeting is devoted to managing diabetes and obesity in the face of the current epidemic and includes nationally renowned speakers Dr. Paul Ciechanowski (speaking on depression and diabetes) and Dr. Irl Hirsch (two talks covering updates in diabetes) both from the University of Washington. Our regional diabetes expert, Dr. Carol Wysham, staff endocrinologist at the Rockwood Clinic, will speak on managing diabetic complications.

The meeting also includes Dr. Ken Fujioka, attending endocrinologist at the Scripps Clinic in San Diego and Director of both Nutrition and Metabolic Research and The Center for Weight Management. Dr. Fujioka will speak on current management of obesity. We are also excited to welcome Dr. Karen Lee, New York City’s Director of The Built Environment as this year’s Stier Memorial Lecturer. She will speak on how the structure of our surrounding environment influences physical activity levels and present innovations that increase the public’s physical activity.

The Stier Memorial Endowment and Lectures in Medicine were established in 1994 by Alton R. Stier, MD and Robert A. (Bud) Stier, MD in honor of their late father. The intent is to bring outstanding physicians and scientists to present their knowledge and philosophy to physicians and other healthcare professionals in the Inland Northwest and to the public. A requirement of this series is that the lecturer presents his/her expertise in both a professional and a public forum. The public forum lecture is coordinated through the Area Health Education Center at Washington State University. Dr. Lee’s public lecture will be given at the Riverpoint Campus at 4:00 PM on Thursday, February 23rd.

The year’s SSIM meeting is also pleased to welcome Dr. Steve Schroeder, Past President of The Robert Wood Johnson Foundation and currently the director of The Smoking Cessation Leadership Center at University of California, San Francisco. Dr. Schroeder has been selected this year as the Dr. Sam Shikany Educational Endowment lecturer. His talk will address the ongoing need to confront tobacco use. His talk will be paired with Dr. Joe Merrill from the University of Washington who will speak on managing opioid addiction.

The Dr. Sam Shikany Educational Endowment is sponsoring Dr. Schroeder’s lecture in keeping with the wishes of Dr. Shikany, a longtime Spokane physician. He spent his entire medical career in Spokane after completing an internship at Sacred Heart Medical Center. When he retired from private practice he became medical director for the SHMC Employee Health Services, and also helped establish a downtown clinic for the poor, at what is now called the House of Charity. During 16 years of volunteer service, Sacred Heart placed his “salary” into an endowment account. Dr. Shikany asked that the money in this fund be used for primary care teaching to “give back” to the Spokane medical community that he loved so much.

This year we welcome for the first time the involvement and gracious support of the Washington Chapter of the American College of Physicians (ACP) as our lead sponsor. On Saturday morning, ACP will host an interest and fellowship breakfast for members and those interested in membership. Also on Saturday, the Washington State ACP governor Carrie Horwitch, MD MPH, will talk to meeting attendees on ACP’s national initiative, “High Value, Cost Conscious Care” – this promises to be an incredibly practical talk at a time of crisis in the cost of health care in our country. In addition to the governor’s talk, there will be updates in endocrinology, critical care, and cardiology modeled on the national ACP’s Multiple Small Feedings of the Mind session as well as an update in general internal medicine for both hospitalists and primary care providers.

We thank our major supporters who make this meeting possible – Providence Sacred Heart Medical Center and Holy Family Hospital, Deaconess Medical Center and Valley Hospital, Inland Imaging, Rockwood Clinic, Group Health Cooperative, PAML, Premera, Inland Northwest Health Services and Physicians Insurance.

All in all, the meeting will be an amazing opportunity for both hospitalbased and office-based internists, as well as other specialists and primary care providers to hear updates on a broad range of areas relevant to the care of the adult patient and receive up to 12 Category I AMA PRA credits. And since the long-range weather forecast is for another La Nina winter (lots of snow in the Northwest) for those traveling to Spokane, consider making an extended weekend out of it (meeting ends midday Saturday) by visiting one of the five major ski areas (Schweitzer Mt., Silver Mt., 490 North, Mt. Spokane, Lookout Pass) within a 2-hour drive from downtown Spokane. For further information go to http://www.spokanesocietyim.org or e-mail spokanesocietyim@gmail.com.

Continuing Medical Education The Columbia Basin Medical Conference (15 AMA Category 1 Credit Hours) will be held on November 4 & 5, 2011 in Moses Lake.

For more information visit www.russocme.com or email russocme@ gmail.com.

STD Update - The Spokane Regional Health District and the Seattle STD/HIV Prevention Training Center sponsored two-day

November SCMS The Message 21

Continued on page 22

Continued from page 21 STD Update course January 19 and 20 at St. Luke’s Rehabilitation Institute in Spokane. This course provides participants with training in the most recent advancements in the epidemiology, diagnosis and management of viral and bacterial STDs, and was designed for clinicians in the Spokane area who diagnose and treat patients with sexually transmitted infections. CMEs and CNEs are available.

Presentations will be conducted by several notable figures including Dr. Jeanne Marrazzo, current Medical Director of the Seattle STD/ Sexually Transmitted Diseases/HIV Prevention and Training Center, and Dr. Devika Singh, Internal Medicine Physician of Seattle, Washington. The cost to register is $100. Seating is limited and pre-enrollment is required by January 10. CME: The University of Washington School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The University of Washington School of Medicine designates this educational activity for a maximum of 13.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Please visit www.seattlestdhivptc.org for online registration and payment information. Any additional questions can be directed to Alexandra Hayes, Health Program Specialist at the Spokane Regional Health District at 509-324-1635 or ahayes@spokanecounty.org.

CPIN WEBINAR: The Washington Patient-Centered Medical Home Collaborative - Tuesday, November 15, 2011 – 12:15 to 1:15 PM The Patient-Centered Medical Home Collaborative is a learning process for medical teams to improve primary care for their patients. From September 2009 through September 2011, 32 teams in Washington have created and operated patient-centered medical homes, under a project jointly sponsored by the Washington State Department of Health and the Washington Academy of Family Physicians. In a medical home, the physician and care team build strong relationships with the patient and the patient’s family. The team coordinates care with specialists or other health providers.

Patient-centered care makes the patient a partner in health care decisions. This webinar will present the lessons learned from this two-year collaborative, followed by a lively question and discussion period. All sessions are free for medical groups, physicians and all other care providers. There is a fee of $75 for all others. This activity has been approved for AMA PRA Category 1 Credit™ and also American Academy of Family Physicians Preferred CME credit.

Physicians should claim only the credit commensurate with the extent of their participation in the activity. Register online at www.wsma.org/ CPIN OR send the following information in an e-mail titled CPIN Nov 15 to kho@wsma.org: Name, Phone, Clinic/Group and Number of Participants

Office Based Treatment of Opioid Dependence: ThurstonMason is partnering with UW and others to sponsor the FREE Cat 1 CME scheduled for Saturday, November 5 in Shelton. It will satisfy a training requirement (2010 HB 2876) needed to obtain a waiver to prescribe buprenorphine in the office-based setting. For questions and registration please contact: Mary Catlin, BSN, MPH, mccatlin@u. washington.edu or (206) 616-3961.

WSMA & UW Physician Leadership Course - In partnership with the University of Washington Graduate Programs in Health Administration, and UW Professional and Continuing Education, the WSMA is offering a 40+ hour interactive hybrid distance learning course that will focus on leadership and conflict management, strategic planning and management, safety and quality management, finance, and communication and advocacy. This combination of face-to-face and online learning will enable physicians to begin developing and honing their leadership skills in a convenient manner without needing to take significant time away from their practice or personal lives. This course is made possible through a grant from the Physicians Foundation. The course will be led by Dr. Ed Walker. The course will be held March 30-June 8, 2012. The application deadline is January 1, 2012. During the spring 2012 course, the in-person classes will be held March 30 and March 31 at the Riverpoint Campus in Spokane, WA. Course participants will then have eight weeks of online instruction and interaction, finishing with a third in-person session and closing ceremony on June 8 at the Riverpoint Campus in Spokane. The course is limited to 30 physicians. The tuition for the course is $2000 for WSMA members and $2550 for non-members.

The WSMA designates this live activity for a maximum of 24 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The WSMA designates this online enduring material for a maximum of 16 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This enduring material activity, WSMA/UW Physician Leadership Course Online, has been reviewed and is acceptable for up to 16 Prescribed credits by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of participation in the activity. To apply for participation in the Spring 2012 course, please send your letter of interest, CV and a letter of recommendation to Jennifer Hanscom at jen@wsma.org.

Seattle WSMA address is 2033 6th Ave, Suite 1100, Seattle, WA 98121.

If you have any questions about the WSMA/UW Physician Leadership Course, please contact Jennifer Hanscom at the WSMA Seattle office (206) 441-9762 or 1 (800) 552-0612 (jen@wsma.org).

Meetings, Conferences and Events Institutional Review Board (IRB) – Meets the second Thursday of every month at noon at the Heart Institute, classroom B. Should you have any questions regarding this process, please contact the IRB office at (509) 358-7631.

Caduceus Al Anon Family Group – Meets every Thursday evening from 6:15 pm until 7:15 pm at 626 N. Mullan Road, Spokane, WA. Non-smoking meeting for spouses and significant others of Healthcare Providers who are in recovery or who may need help seeking recovery. Facilitated 12 Step Al Anon Format. No dues or fees. Contact 509-928-4102 for more information.

November SCMS The Message 22

Continued on page 23

Continued from page 22 Physician Family Support Group — Physicians, physician spouses or significant others, and their adult family members share their experience, strength, and hope concerning difficult physician family issues which may include medical illness, mental illness, addictions, work-related stress, life transitions, and relationship difficulties. The meetings are on Tuesdays from 6:30 pm – 8 pm at Sacred Heart.

Format: 12 Step principles for everyone, confidential and anonymous personal sharing; no dues or fees. Contact Bob or Carol at 509-624-

We’ll come to you because we care.

7320 for more information.

“For over 40 years we’ve provided the best home healthcare to the Inland Northwest, and today we're ranked as one of Medicare's elite agencies in the country. No wonder over 95% of our clients would recommend us. Call me personally to see why we're the right choice for you and your clients."

– Mike Nowling President Family Home Care & Hospice

Call Today 509.473.4900 www.familyhomecare.org November SCMS The Message 23

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

PHYSICIANS Cahill, Deborah L., MD Obstetrics and Gynecology Med School: U of Washington (1982) Internship: U of New Mexico (1983) Residencies: U of New Mexico (1984), U of Washington (1987) Practicing with Obstetrix Medical Group of Washington, Inc., PS beginning 11/2011 Dinglasan, Catherine J.C., MD Family Medicine Med School: U of East Ramon Magsaysay Medical Center (Philippines) 2000 Internship/Residency: U of Pittsburgh Shadyside Family Medicine Residency (2005) OB Fellowship with Family Medicine Spokane beginning 1/2012

Fishman, Michael S., MD Diagnostic Radiology Med School: Ohio State U (1987) Practicing with Radia, Inc., PS since 1/2010 Kalisvaart, Jennifer L., MD Pediatrics Med School: Baylor College of Medicine (2004) Practicing with Sacred Heart Children’s Hospital beginning 11/2011 Lyko, Adam A., MD Endocrinology Med School: Loma Linda U (2001) Practicing with Rockwood Clinic, PS since 10/2011 McManus, Shea E., MD, MPH Internal Medicine Med School: Tulane U (1994) Practicing with Hospital Specialists PLLC (Holy Family) beginning 12/2011 Patel, Yashma R., MD Neurology Med School: J.J. M. Medical College, India (2001) Practicing with Rockwood Clinic since 9/2011 Schillinger, David S., MD Emergency Medicine Med School: Drexel U (1983) Practicing with Hospital Physician Partners (Valley Hospital) since 10/2011

Reyta, Virginia D, MD Pediatric Medicine Med School: Far Eastern University (Philippines) (1993) Internship Veterans Memorial Medical Center (1994) Residency: Nassau U Medical Center (1999) Practicing with Rockwood Clinic beginning 1/2012

PHYSICIANS PRESENTED A SECOND TIME Borgnes, Erik M., MD Diagnostic Radiology Med School: Wayne State U (1992) Practicing with Radia Inc., PS since 3/2009

Srikureja, Wichit, MD Gastroenterology Med School: Loma Linda U (1997) Practicing with Providence Adult Gastroenterology beginning 11/2011

PHYSICIAN ASSISTANT

Chaganur, Kavitha, MD Internal Medicine Med School: Vijayanagar Institute of Medical Sciences, India (2004) Practicing with Providence Sacred Heart Medical Center Hospitalist beginning 4/2012

Sassone, Justin W., PA-C School: Eastern Virginia School of Medicine (2011) Practicing with Rockwood Clinic since 10/2011

Corn, Ayumi I., MD Anatomic/Clinical Pathology Med School: U of Oklahoma (1994) Practicing with InCyte Pathology since 10/2011 Corn, Todd D., MD, PhD Internal Medicine Med School: U of Oklahoma (1997) Practicing with PPS PSHMC Hospitalist since 10/2011 Edgehouse, Kristin A., DO Pediatrics/Pediatric Hematology/Oncology Med School: Philadelphia College of Osteo (2004) Practicing with Judy Felgenhauer, MD, PS, Sacred Heart Children’s Hospital since 10/2011

November SCMS The Message 24

POSITIONS AVAILABLE OUTREACH CLINIC AT HOUSE OF CHARITY – This is an opportunity to volunteer and bring to the underserved in our community first line medical care. We need one or two more doctors to help us. We see the homeless, predominantly, two afternoons each week. Join four Board MDs and twelve RNs to rotate once or twice monthly in an excellent, well-equipped clinic with pharmacy. If you are completely retired, the state will pay for your medical license and malpractice. For more information and to sign up, call Dr. Arch Logan, Medical Director, at (509)326-0255 or Ed McCarron, Director of the House of Charity, at (509)624-7821.

HOSPITALIST: FIND YOUR PASSION HERE - Isn’t it Time for Something Better? Group Health Permanente, the Northwest’s premier multi-specialty group, is currently seeking a BC/BE Hospitalist to join our Spokane team. Group Health is dedicated to providing innovative and patient-centered care to communities throughout Washington. Physicians will round on and care for Group Health patients in the hospital setting for a 100% Hospitalist opportunity. Affordable housing, highly rated schools and year round activities, Spokane is an unparalleled place to raise a family. A flexible schedule, generous benefits and competitive salaries make this an opportunity worth exploring. For additional information or to submit your CV, please contact Nancy Longcoy at longcoy.n@ghc. org or Office: 206-448-6132; Cell: 206-612-7731 PROVIDENCE PHYSICIAN SERVICES is recruiting for BE/BC Pediatricians to join us in Spokane, the urban center of spectacular eastern Washington. Excellent opportunity to join a collegial, physician-led medical group affiliated with the region’s most comprehensive and caring hospitals. Providence offers generous hiring incentives, competitive compensation, comprehensive benefits and flexible work arrangements to fit individual needs.

Contact: Mark Rearrick, mark.rearrick@providence.org, (509) 4746605, www.providence.org/physicianopportunities.

PEDIATRIC HOSPITALISTS OPPORTUNITIES - If you would like the opportunity to participate in the growth of our pediatric services at Deaconess and Valley Medical Centers, please consider joining our multi-disciplinary team. We need two more pediatric hospitalists to complete our team and participate in a flexible schedule. You will be working with nurses with many years of pediatric expertise. You will be part of a team of hospitalists providing 24-hour coverage/365 days per year. Please contact Evelyn Torkelson Director, Physician Recruitment, at torkele@empirehealth.org for more details.

EASTERN STATE HOSPITAL PSYCHIATRIST - ESH is recruiting for a psychiatrist. Joint Commission accredited, CMS certified, state psychiatric hospital. 287 beds. Salary $161,472 annually with competitive benefits and opportunity for paid on-call duty. Join a stable Medical Staff of 30+ psychiatrists, physicians and physician assistants. Contact Shirley Maike, 509.565.4352, email maikeshi@ dshs.wa.gov. PO Box 800, Medical Lake, WA 99022-0800.

PHYSICIAN OPPORTUNITIES AT COMMUNITY HEALTH ASSOCIATION OF SPOKANE (CHAS) Enjoy a quality life/work balance and excellent benefits including competitive pay, generous personal time off, no hospital call, CME reimbursement, 401(k), full medical and dental, NHSC loan repayment and more. To learn more about physician employment opportunities, contact Toni Weatherwax at (509)444-8888 or hr@chas.org.

SPOKANE REGIONAL OCCUPATIONAL MEDICINE (SROM) has an opportunity for a physician. Our treatment approach takes a comprehensive view that encompasses the medical, psychosocial and functional outcomes of the injured worker and follows best practices as defined by Washington State L&I’s Center of Occupational Health and Education (COHE). SROM is affiliated with Valley Hospital and Medical Center, Deaconess Medical Center and Rockwood Clinic. This affiliation provides exceptional administrative support, offers state of the art diagnostic services’ improving our ability to diagnose and treat, and a referral system that is unmatched. For more information contact Evelyn Torkelson, physician recruiter at (509)473-7374 or email at torkele@ empirehealth.org.

QTC MEDICAL GROUP is one of the nation’s largest private providers of medical disability evaluations. We are contracted through the Department of Veterans Affairs to manage their compensation and pension programs. We are currently expanding our network of Family Practice, Internal Medicine and General Medicine providers for our Washington Clinics. We offer excellent hours and we work with your availability. We pay on a per exam basis and you can be covered on our malpractice insurance policy. The exams require NO treatment, adjudication, prescriptions to write, oncall shifts, overhead and case file administration. Please contact Gia Melkus at 1-800-260-1515 x5366 or email gmelkus@qtcm.com or visit our website www.qtcm.com to learn more about our company.

PRIMARY CARE INTERNIST WANTED (Pullman) - Immediate opportunity for BE/BC primary care internist to join a privately owned, multi-specialty, physician practice. Palouse Medical offers a competitive employment package, guaranteed first year salary, comprehensive benefits and partnership potential. Dedicated to delivering quality care, we are proud to offer an extensive array of patient services and on-site laboratory and imaging departments.

We can’t wait to introduce you to the communities that we love and serve. Call Theresa Kwate at (509) 332-2517 ext. 20 or email tkwate@ palousemedical.com. Contact us today and discuss your future at Palouse Medical!

CONTRACT BACK-UP PHYSICIAN 4 + HOURS/MONTH Octapharma Plasma is hiring a Contract Back-Up Physician in our Spokane, WA Donor Center! This position requires just 4 hours per month. GENERAL DESCRIPTION Provide independent medical judgment for issues relating to donor safety, health and suitability for plasmapheresis and immunization. Provide federal and international mandated training and supervision of donor center medical staff to assure compliance with applicable laws. We provide on-the-job training. WHO IS OCTAPHARMA PLASMA? Octapharma Plasma, Inc. is dedicated to improving the health and lives of people worldwide. OPI owns and operates plasma collection centers critical to the development of life-saving patient therapies utilized by thousands of patients globally.

Learn more at www.OctapharmaPlasma.com! APPLY TODAY! Apply today by sending your resume/CV to Careers@OctapharmaPlasma.com!

PREMIER CLINICAL RESEARCH, an independent dedicated research facility here in Spokane with 20 years of research experience is looking for a Pediatrician to be a part of our physician network for future studies. For more information please contact: April Gleason, Director of Business Development, (509) 390-6768, premierclincalresearch@gmail.com Continued on page 26

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Sublease: Furnished Medical Office Space ~ Need immediate

WANTED... NURSE PRACTITIONER FOR NORTH SIDE FAMILY PRACTICE OFFICE. Looking for a dynamic & energetic NP with 3 years practice experience (preferably in family medicine). 30-35 hours/week, one weekend call every 3 months. Communication skills and concise charting skills a must! Send resumes to: lfisher@inwhealth.net.

space for one or more north Spokane care providers? This shared suite is ready for occupancy; all furniture and exam room equipment included. Two exam rooms, one provider office, one nurse’s station and shared surgery suite, medical records storage area, reception and waiting area. 963 sq ft total, original lease $23/sq ft; will negotiate lower rate. Excellent location in a fullservice medical building with lab and full radiology services. For more information, call (509) 981-9298.

REAL ESTATE

South Hill – on 29th Avenue near Southeast Boulevard Luxury Condos for Rent/Purchase near Hospitals. 2 Bedroom Luxury Condos at the City View Terrace Condominiums are available for rent or purchase. These beautiful condos are literally within walking distance to the Spokane Hospitals (1/4 mile from Sacred Heart, 1 mile from Deaconess). Security gate, covered carports, very secure and quiet. Newly Remodeled. Full appliances, including full-sized washer and dryer. Wired for cable and phone. For Rent $ 850/month. For Sale: Seller Financing Available. Rent-to-Own Option Available: $400 of your monthly rent will credit towards your purchase price. Please Contact Dr. Taff (888) 930-3686 or dmist@inreach.com.

For Sale: 17718 E Linke Rd, Greenacres WA $649,900 Elegance redefined featuring a custom-built rancher and horse property situated on 5 breathtaking acres. For you over 3,800 sq feet, opulent master bedroom, formal dining, open floor plan & a gourmet kitchen. For your horses a 56’ x 48’ metal show barn, heated tack room, 12x12 wash area, 11 matted stalls, mechanical horse walker. Everything to accommodate you & your equestrian needs. Offered by John L Scott Real Estate – John Creighton at (509) 979-2535. For a virtual tour www.tourfactory.com/709316.

MEDICAL OFFICES/BUILDINGS

Good location and spacious suite available next to Valley Hospital on Vercler. 2,429 sq ft in building and less than 10 years old. Includes parking and maintenance of building. Please call Carolyn at Spokane Cardiology (509) 455-8820.

- Two offices now available in a beautifully landscaped setting.

Building designed by nationally recognized architects. Both offices are corner suites with windows down six feet from the ceiling. Generous parking. Ten minutes from Sacred Heart or Deaconess Hospitals. Phone (509) 535-1455 or (509) 768-5860.

North Spokane Professional Building has several medical office suites for lease. This 60,000 sf professional medical office building is located at N. 5901 Lidgerwood directly north of Holy Family Hospital at the NWC of Lidgerwood and Central Avenue.

The building has various spaces available for lease from 635 to 6,306 usable square feet available. The building has undergone extensive remodeling, including two new elevators, lighted pylon sign, refurbished lobbies, corridors and stairways. Other tenants in the building include pediatricians, dermatology, dentistry, pathology and pharmacy. Floor plans and marketing materials can be emailed upon request. A Tenant Improvement Allowance is Available, subject to terms of lease. Please contact Patrick O’Rourke, CCIM, with O’Rourke Realty, Inc. at (509) 624-6522 or cell (509) 999-2720. Email: psrourke@comcast.net.

Clinical Space for Lease - Built in January 2011. 1128 sq ft, four exams rooms, two administrative offices, one office with a counter (electronic bar for laptops, etc.), restroom, reception area and waiting room. Rates are negotiable. Interested parties contact Sharon Stephens at Bates Drug Stores, Inc. 3704 N. Nevada, (509) 489-4500 Ext. 213 or Sam@batesrx.com.

Northpointe Medical Center Located on the North side of Spokane, the Northpointe Medical Center offers modern, accessible space in the heart of a complete medical community.

If you are interested in locating your business here, please contact Tim Craig at (509) 688-6708. Basic info: $23 sq/ft annually. Full service lease. Starting lease length 5 years which includes an $8 sq/ft tenant improvement allowance. Available space: *Suite 210 - 2286 sq/ft *Suite 209 - 1650 sq/ft *Suite 205 - 1560 sq/ft *Suite 302 - 2190 sq/ft

Membership Recognition for October 2011

For Lease 3700 sq ft of second floor space in a new 18,900 sq ft building available. It is located just a few blocks from the Valley Hospital at 1424 N. McDonald (just South of Mission). First floor tenant is Spokane Valley Ear Nose Throat & Facial Plastics. $22 NNN. Please call Geoff Julian for details (509) 939-1486 or email gjulian@spokanevalleyent.com.

Carl P. Garabedian, MD

Thank you to the member listed below. His contribution of time and talent has helped to make the Spokane County Medical Society the strong organization it is today.

10 Years

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11/1/2001

AD Visit our updated website • View "The Message" Online

• Legislative updates

-Full current and past issues available

-Connect with SCMS on Facebook and stay informed

• Membership information

• Connect to Medicor

-Information about credentialing, committees, bylaws, etc.

-The online medical library is a SCMS membership benefit.

• CME information -Topic and dates for upcoming CME courses

November SCMS The Message 27

November SCMS The Message 28

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SPOKANE COUNTY MEDICAL SOCIETY - ORANGE FLAG BUILDING 104 S FREYA ST STE 114 SPOKANE, WA 99202

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WINE MAKER’S DINNER SERIES 3 HORSE RANCH VINEYARDS OCTOBER 6TH, 2011 AT 6 PM SPRING VALLEY VINEYARDS NOVEMBER 3RD, 2011 AT 6 PM $65 A PERSON Join us for an exclusive wine maker’s dinner on the deck prepared by Chef Adam Hegsted and his staff. Serving a locally inspired nine-course meal, paired perfectly with a selection of alluring wines.

Space is limited.

Purchase tickets at the casino ticket sales booth or Enoteca.

Get two $25 dining credits, plus two $50 EPC credits, and top it all off with a one-night stay in our brand new hotel wing.

Both guests must be Rewards members. Based on deluxe room double occupancy and availability. Available 7 days a week. Expires one year from purchase date.

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