2018 July/August

JULY / AUGUST 2018

VOLUME 24 | NUMBER 4

Congratulations to all Award Honorees this year!

Awardees (Left to Right): Dr. Ruma Kumar (Outstanding Achievement in Medicine); Dr. Suchada Nopachai (Outstanding Contribution in Community Service); Dr. John Tatman (Outstanding Contribution in Medical Education); Dr. Martin Fishman (Robert D. Burnett, MD Legacy Award); Dr. Thomas Dailey (Outstanding Contribution to the Medical Association); John and Gini Mitchem (Citizen’s Award); Dr. Sameer Awsare (Benjamin Cory, MD Award); William Parrish (William C. Parrish, Jr. Leadership in Healthcare Award); and Suzanne Jackson on behalf of the SCCMA Alliance Foundation (Special Recognition Award).

SCCMA Equals Exceptional Leadership

SCCMA Past Presidents and President at the 2018 Awards Banquet.

Left to Right: Past Presidents Drs. Elliot Lepler, Steve Jackson, Philipp Lippe, Kenneth Blumenfeld (Current President), Tom Dailey (also Awardee and CMA Trustee), Jim Hinsdale (also CMA Past President and Current AMA Delegate), Martin Fishman (also Awardee), Tanya Spirtos (also Vice-Speaker of HOD), Sameer Awsare (also Awardee), Scott Benninghoven, Seham El-Diwany, and Eleanor Martinez.

BULLETIN THE

Official magazine of the Santa Clara County Medical Association and the Monterey County Medical Society

700 Empey Way • San Jose, CA 95128 • 408/998-8850 • www.sccma-mcms.org

MEMBER BENEFITS

Feature Articles

5 Introducing April Becerra, CAE: New Chief Executive Officer

CME Tracking

9 Member Spotlight: Dr. Alfred Sadler

Discounted Insurance

10 MCMS’s “Physician of the Year” Banquet and Installation

Billing/Collections

Financial Services Health Information Technology Resources House of Delegates Representation

12 MCMS Banquet Photos 14 CURES 2.0 Mandatory Use Begins October 2, 2018 22 SCCMA Award Presentations and Installation 30 SCCMA Awards Banquet Photos

Human Resources Services

Departments

Legal Services/On-Call Library

6 Message From the SCCMA President

7 Message From the Outgoing SCCMA President

8 Message From the MCMS President

Legislative Advocacy/MICRA Membership Directory APP for the iPhone Physicians’ Confidential Line Practice Management Resources and Education

16 Medical Times From the Past 19 Classified Ads 36 Reimbursement Advocacy 37 Discount Ticket Program

Professional Development Publications Referral Services With Membership Directory/Website Reimbursement Advocacy/ Coding Services Verizon Discount JULY / AUGUST 2018 | THE BULLETIN | 3

The Santa Clara County Medical Association OFFICERS

CHIEF EXECUTIVE OFFICER

COUNCILORS

President Kenneth Blumenfeld, MD President-Elect Seema Sidhu, MD Past President Seham El-Diwany, MD VP-Community Health Cindy Russell, MD VP-External Affairs Erica McEnery, MD VP-Member Services Open VP-Professional Conduct Faith Protsman, MD Secretary Martin Wong, MD Treasurer Anh Nguyen, MD

April Becerra, CAE

El Camino Hospital of Los Gatos: Lewis Osofsky, MD El Camino Hospital: Gloria Wu, MD Good Samaritan Hospital: Vinit Madhvani, MD Kaiser Foundation Hospital - San Jose: Hemali Sudhalkar, MD Kaiser Permanente Hospital: Open O’Connor Hospital: Cathy Angell, MD Regional Medical Center: Heather Taher, MD Saint Louise Regional Hospital: Scott Benninghoven, MD Stanford Health Care / Children's Health: John Brock-Utne, MD Santa Clara Valley Medical Center: Clifford Wang, MD

CMA TRUSTEES - SCCMA Thomas M. Dailey, MD (District VII) Kenneth Blumenfeld, MD (District VII)

BULLETIN THE

Official magazine of the Santa Clara County Medical Association and the Monterey County Medical Society

THE MONTEREY COUNTY MEDICAL SOCIETY

Printed in U.S.A.

OFFICERS

Managing Editor Pam Jensen

Opinions expressed by authors are their own, and not necessarily those of The Bulletin, SCCMA, or MCMS. The Bulletin reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted in whole or in part. Acceptance of advertising in The Bulletin in no way constitutes approval or endorsement by SCCMA/MCMS of products or services advertised. The Bulletin and SCCMA/MCMS reserve the right to reject any advertising.

Address all editorial communication, reprint requests, and advertising to: Pam Jensen, Managing Editor 700 Empey Way San Jose, CA 95128 408/998-8850, ext. 3012 Fax: 408/289-1064 pjensen@sccma.org © Copyright 2018 by the Santa Clara County Medical Association.

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President Maximiliano Cuevas, MD President-Elect Christopher Burke, MD Past-President Craig Walls, MD PhD Secretary Alfred Sadler, MD Treasurer Steven Harrison, MD

CHIEF EXECUTIVE OFFICER April Becerra, CAE

DIRECTORS E. Valerie Barnes, MD David Holley, MD Jeffrey Keating, MD William Khieu, MD

Phillip Miller, MD Walter Mills, MD James Ramseur, MD Stephen Saglio, MD

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By the SCCMA Executive Search Committee

he SCCMA Council is pleased to announce the appointment of April Becerra as its new CEO, replacing Bill Parrish who retired on June 30th after 23 years serving as CEO. April will be only the fourth CEO in the organization’s 142-year history.

April previously served as executive director for the Silicon Valley Chapter of the American Institute of Architects as well as the CME and Professional Development Manager for the California Society of Anesthesiologists. She comes by way of Phoenix, AZ where she owned her own association management company. She has served as the chief executive for a variety of associations including the Arizona Society of Physician Assistants, the Arizona Health Systems Pharmacists and many other professional and charitable organizations.

In her role with SCCMA, she also participates as a member of the Medical Executive Committee of the California Medical Association (CMA) and is a member of the American Association of Medical Society Executives (AAMSE).

She received her Certified Association Executive designation through the American Society of Association Executives (ASAE) where she is also a current member. She also has completed Arizona State University’s Non-Profit Management Institute program. April will also serve as CEO for the Monterey County Medical Society and the Bureau of Medical Economics.

April’s leadership and considerable experience in both association management and finance, has made her the outstanding candidate for the role. She has demonstrated throughout her nearly 30-year association career the ability to work successfully in different environments, designing and leading strategies that resulted in impressive value creation.

“I am humbled and honored to be serving as the new CEO for the Santa Clara County Medical Association. I believe that transitions can be an exciting and energizing time. I’m looking forward to building on the incredible work of my predecessor, Bill Parrish who has elevated SCCMA into a leading advocate for quality, ethical healthcare in our community. We’ve made a name for ourselves by building alliances, protecting patient access to quality healthcare and taking a stand when we know it’s the right thing to do.”

April is a resident of Redwood City, has three adult sons, two grandchildren and is an avid cyclist who you will find riding the beautiful roads the bay area has to offer on the weekends.

Please join us in welcoming April to our SCCMA family.

April can be reached by email at: april@sccma.org or phone: 408.998.8850 ext 3024 JULY / AUGUST 2018 | THE BULLETIN | 5

The following speech was presented at SCCMA’s Annual Awards Banquet and Installation Dinner on June 5, 2018.

President, Santa Clara County Medical Association

KENNETH S. BLUMENFELD, MD, FAANS

MESSAGE FROM THE

SCCMA PRESIDENT

Inaugural Speech

Kenneth S. Blumenfeld, MD, FAANS is the 20182019 president of the Santa Clara County Medical Association. He is a boardcertified Neurological Surgeon with Sutter Health/Palo Alto Medical Foundation and is currently practicing with South Bay Brain and Spine. He also is adjunct clinical professor in Neurological Surgery at UCSF.

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onight’s banquet has a lengthy agenda and I have learned from past experience that brevity is to be valued. So, in that spirit let me start by thanking the Santa Clara County Medical Association for their trust and for the honor to serve as president.

I joined this Medical Association in 1992 and have been an engaged member ever since. I have served as a Delegate to the CMA House of Delegates and been an Executive Committee Officer. My extracurricular activities in organized medicine have included being the CMA Council on Legislation Chair, Chief of Staff at Good Samaritan Hospital, and President of the California Association of Neurological Surgeons. Currently I am a trustee for the Board of CMA, an AMA Delegate from organized neurosurgery, and a member of several national committees and joint sections.

I mention these activities because I believe they have prepared me to lead the Santa Clara County Medical Association into the future. Our Association is a vital, fluid, and in my opinion, keystone organization. In fact, I believe it is undervalued.

You might ask why I would say that? It is because I have learned that grass roots are important.

Many of the battles that we need to fight and the issues to be addressed are local. And despite socioeconomics and market forces that might seem to divide doctors, I believe wholeheartedly there are more concerns and efforts that bind us.

In the next year as your president I hope to bring the doctors of Santa Clara County together with activities and projects that highlight our com-

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mon interests. In doing so I am optimistic that we can build membership and make that membership more meaningful and worthwhile. This year promises to be an active one especially with upcoming elections and a new legislative cycle. The medical challenges in our community are large and ongoing.

There is much work to do.

Lastly, I want the Santa Clara County Medical Association to be transparent and invite participation. That begins with me. So please feel free to contact me. I will readily give out my personal cell number and email address. Once again thank you for your trust and support. Let’s make this a great year.

Cell: (408) 348-1800 Email: kennethblumenfeld@mac.com

President, Santa Clara County Medical Association

SEHAM EL-DIWANY, MD, FAAP

W

elcome to SCCMA’s 39th Annual Awards Banquet. This is when the outgoing president gives their farewell speech outlining the challenges and accomplishments of the year. Though clearly there is a lot to talk about, my last act as your president will be to boldly go where few presidents have gone before— brevity.

This year was full of exciting challenges and achievements for SCCMA and I am eternally grateful to all of you for your hard work and support.

One of this year’s most substantial changes is that after 23 years as CEO, Bill Parrish is retiring. Even with an entire year’s notice, our expedition to find his successor was no walk in the park.

Thankfully, I am happy to report that SCCMA has appointed April Becerra as our next CEO. Please join me in welcoming April to SCCMA. Much of the credit goes to Dr. Scott Benninghoven as Chair of the Search Committee for achieving this monumental task. Of course, Bill Parrish played a vital role in the selection process and for working with April through the ongoing transition period. On behalf of the Medical Association and the last 23 years of leadership, I would like to extend our sincere appreciation to Bill for his long service and wish him the best.

Another important challenge and accomplishment for us has been lobbying against a major piece of legislation known as “California Health Care Cost, Quality, and Equity Commission” or AB-3087.

This bill basically “legislates” prices that health care providers can charge for their services. The bill was introduced by District 27 Assemblyman Ash Kalra of West San Jose (some of you may remember him from last year’s Annual Awards Banquet). I am happy to report that this bill was buried in the Assembly Appropriations Committee just a few weeks ago.

CMA has led the charge on this issue but it is worth pointing out that SCCMA has been acknowledged for it’s lobbying effort at the CMA Legislative Day in Sacramento.

There were many other accomplishments within the SCCMA this year. One thing we are particularly proud of is our membership participation. Recruitment and participation are ongoing struggles for all medical societies given the nature of our profession. I am proud to announce that last year we increased membership and SCCMA has the highest number of “full-dues-paying-members” in California. Thanks to the ongoing commitment of our leadership including Bill Parrish, our membership dues have not increased for the last 15 years and are considered the lowest for any metropolitan area in California. We can only continue this process if we continue to recruit new members and retain our seasoned veterans. We will continue to make cutting edge progress by blending experience, challenging work, and innovation.

Finally, in closing, I would like to thank the SCCMA administrative team for their tireless day to day efforts in running the Association and I would like to extend my warmest congratulations to Dr. Ken Blumenfeld, the incoming president of SCCMA. Let me be the first to publicly say “Good luck with that.”

SCCMA PRESIDENT

The following speech was presented at SCCMA’s Annual Awards Banquet and Installation Dinner on June 5, 2018.

MESSAGE FROM THE OUTGOING

Outgoing President’s Address

Seham El-Diwany, MD, FAAP is the 2017-2018 president of the Santa Clara County Medical Association. She is a board certified pediatrician with The Permanente Medical Group and is currently practicing with Kaiser Permanente San Jose.

JULY / AUGUST 2018 | THE BULLETIN | 7

Care Coordination: Patient Support

President, Monterey County Medical Society

MAXIMILIANO CUEVAS, MD, FACOG

MESSAGE FROM THE

MCMS PRESIDENT

T

Maximiliano Cuevas, MD, FACOG is the 2018-2019 president of the Monterey County Medical Society.

He is currently the Chief Executive Officer at Clinica de Salud del Valle de Salinas.

his discussion continues with the concept of patient support within the care coordination model for those patients in need of a referral or transition of care. Last time I was walking the hallway after a surgical case and got involved in a discussion on care coordination. This time my colleagues came “prepared;” they actually had material scratched on a notepad and we sat down in the Physicians’ Lounge for a cup of coffee and a bagel. And this is after a laparoscopic hysterectomy procedure, but our case provided a great “backdrop” for going over some of the concepts that we have discussed.

Our patient had a number of chronic conditions that had to be addressed before she was scheduled for surgery. We reviewed how the “Go-To” person had made referrals with various consultants’ “Go-To” people and all of this was completed within two weeks.

Our patient was cleared for surgery and here we were now discussing what worked and why.

Again, we got bogged down in a discussion on access to care for the office. In dealing with the concept of creating a good schedule for the practice we recognized that data suggests that about 15% of outpatient visits result in a referral. We determined that when the schedule produces 40 visits, we will have 6-7 referrals that will be made. Our “Go-To” person spends about five minutes making each referral after all clinical and billing information has been completed. Approximately 35 minutes per day on making referrals is calculated into the workday. Then about 70 minutes (10 minutes per referral follow-up) is added into the workday for previous referrals. Some of this time is spent making sure that a consult report is received on each referral, updating the health record including the Health Care Guidelines, and updating the tracking record to make sure that we are up-to-date on our referrals. We figured that it takes about 120 minutes per day for referral management for that staff. What about the transitions management tasks? Our patient was about to enter into this aspect of our care coordination model.

A specific person must be designated to handle the patient support, logistical, and information management issues associated with referrals and care transition. Our “Go-To” person handles these tasks. The “Go-To” person (Referral Coordinator) uses an electronic system (e-referral) to transmit patient information, to make appointments, and to track the referral process. The necessary patient information, including

8 | THE BULLETIN | JULY / AUGUST 2018

the patient’s clinical, demographic and insurance information, is put together and made ready to send to the consultant’s office. What is necessary patient information?

The information necessary for the consultant should be standardized. Currently, in Monterey County, we are working with a few offices to begin the process of discussing what is the “necessary patient information.” Our goal will be to develop a “protocol” to include the information that will facilitate the process for our patient to get a consult within one to two weeks to start and then shorten this time as we move forward.

In addition to assembling the patient’s clinical, demographic, and insurance information, we want to make sure that lab results are available and that prior authorization has been obtained.

The “Go-To” person can assist our patients by identifying barriers that may impair their ability to get the needed care that we are prescribing. We have identified that, at times, the issues of lack of transportation or language (85% of our patients speak a language other than English) and our “Go-To” person either handles these logistical issues or connects them to local services or other staff in our office (we are a community health center).

Our office considers the process of tracking referrals and care transitions as very critical to making sure that our patients receive access to great care. Tracking these allows us to identify problems quickly and to take action when patients have failed to show up for the specialty consult. We do not want to waste time for the patient or for the consultant that is waiting for the arrival of the patient. Tracking the care transitions allows us to follow-up quickly with patients discharged from the hospital or the emergency room. Our office is alerted as to the admission of our patient (post hysterectomy, in this case) and they anticipate a one- to two-day stay, then discharge. Staff will expect to see the patient for a wound check and make sure that pain medications are appropriate for our patient.

Office staff working together and coordinating with our physicians helps to ensure that our patients have a great experience as they move through our care process. The delivery of care has to be carefully coordinated so that we can evaluate each step of the process and make necessary changes quickly. We are now working on completing a checklist for post-hospital follow-up care that will assist us in reducing hospital readmissions.

MEMBER SPOTLIGHT: Dr. Alfred Sadler

A Carmel Doctor Wrote the Law on Organ Donation 50 Years Ago, and It Remains a Model to this Day.

B

By Sara Rubin

eginning in the 1960s, when human-growth hormone therapy was just emerging to treat very short children, medical examiners in Los Angeles and Minneapolis made a habit of harvesting pituitary glands from cadavers. They’d take the glands, located at the base of the brain, so HGH could be isolated, extracted, then injected into patients.

The news got out that coroners were taking people’s pituitary glands – they’d been doing so without notification to next of kin – and the medical community had a public relations nightmare, not to mention an ethical dilemma, on their hands.

At the same time, in the summer of 1967, identical twin brothers – Alfred, four minutes older, and Blair Sadler – were fresh out of medical school and law school, respectively. They were new at the National Institutes of Health, and Alfred remembers the news of the secret pituitary scheme getting out.

“They said, ‘Sadlers: This is our first problem. What are we doing wrong here?’” Alfred recalls. “NIH said, we don’t want to get in trouble here, any more than we already are. Frankly, it was one of those things that nobody had thought through.”

The Sadlers are the kind of pair who like to think things through, deliberating in philosophical terms about questions of law and medicine. They first realized they might have a good thing going when they got the chance to colead a seminar and chose to focus on what are known as Good Samaritan laws, protections for medical professionals (or laypeople) who intervene as passersby in a medical emergency – in some states lacking such laws, they’re not protected legally if the patient dies.

“We did some research on that subject, for no other reason than it was interesting,” Alfred says. “We found that some states had statutes that actually protected the physician or nurse. We gave a talk and thought, ‘People will listen to us young squirts.’”

And listen they did. In 1968, when the brothers were just 27, they published an article titled “Transplantation and the Law: The Need for Organized Sensitivity” in The Georgetown Law Journal. (It was bumped from the first to the second story, to make room for “A recollection of Robert Kennedy as a Lawyer.”)

Both Sadlers talk about their early career rise as “serendipity” – just as they found a niche that interested them from a medical and a legal standpoint, the first successful heart transplant in South Africa made international headlines.

“The public interest just skyrocketed in the issue,” Blair says. They went on to help draft a state law allowing organ transplantation, and the National Conference of Commissioners on Uniform State Laws – formed in 1892, and later renamed the Uniform Law Commission – circulated the blueprint to all 50 states.

It was adopted everywhere within three years, among the fastest on record in the commission’s history.

“There was a lot of luck that we were in the right place at the right time,” Alfred says.

Organ transplantation laws remain a gold standard today of a uniform law, adopted state by state, that’s held up to the test of time. Fifty years later – and with a notably less cooperative legislative backdrop – the Sadlers are presenting July 20 and 21 in Louisville, Kentucky, when the Uniform Law Commission meets. (On this year’s agenda: regulations related to autonomous vehicles, drones and electronic wills.)

After passing their law, allowing people to opt in as donors of hearts, corneas, livers, kidneys, lungs, pancreas, bone and bowel, the pair went on to start a physician assistant certification program at Yale, then to the Robert Wood Johnson Foundation. Blair never practiced law; he landed at UC San Diego, where he still teaches, and for 26 years was CEO of the Rady Children’s Hospital.

Alfred did go into medicine, though he never transplanted an organ or did a surgery his entire career. He wrapped up his medical residency in his mid-30s – “the old guy in the group” – and went into internal medicine, then urgent care.

He moved to Carmel in 1981, and practiced medicine until he retired three years ago. (The Sadlers are now 77.)

“It’s very gratifying, 50 years later, to still see a sound and stable legal framework for something this powerful that’s saving so many lives and improving so many lives,” Blair says. “It’s based on core American values.”

Those values, he says, are volunteerism, consent, autonomy and individuality, noting anyone can opt in accordingly, or choose not to: “It’s not a big government program.”

“This is sort of the best of America. It’s a gift – making the ultimate gift of life.”

To learn about organ donation in California and register as a donor, visit donatelifecalifornia.org.

This article was originally published in the Monterey County Weekly. It is reprinted with permission. www.montereycountyweekly.com JULY / AUGUST 2018 | THE BULLETIN | 9

MEMBER NEWS & HAPPENINGS

MCMS’S PHYSICIAN OF THE YEAR BANQUET AND INSTALLATION

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he Monterey County Medical Society held its annual Physician of the Year Banquet and Installation on Thursday evening, June 7, 2018, at the Bayonet Black Horse in Seaside. Approximately 115 members and special guests attended.

Maximiliano Cuevas, MD, was installed for his second term as MCMS’s president for 2018-2019. Dr. Cuevas has been with Clinica de Salud del Valle de Salinas, since 1986 –First as a practicing OBGYN (Obstetrician & Gynecologist) in Salinas, and currently as CEO. Dr. Cuevas graduated from University of California Davis School of Medicine in 1981 and has been in practice for 36 years. He completed a residency at Kern Medical Center.

Dr. Cuevas has been a member of MCMS/ CMA for 28+ years. He has also served as a Director on the Board and Executive Committee.

Serving in the current fiscal year with Dr. Cuevas are: Craig Walls, MD, PhD, as past president; Christopher Burke, MD, as presidentelect; Alfred M. Sadler, Jr., MD, as secretary; and Steven W. Harrison, MD, as treasurer. The MCMS board of directors are Valerie Barnes, MD; David Holley, MD; Jeffrey Keating, MD; William Khieu, MD; Philip Miller, MD; Walter Mills, MD; James Ramseur, Jr, MD; and Stephen Saglio, MD. Award honoree Alfred M. Sadler, Jr., MD, FACP received an award for “Physician of the Year.” Dr. Sadler was born in New York and attended public schools in Allentown, PA. He is

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a graduate of Amherst College, Amherst, MA in 1962 and the Drexel University College of Medicine, Philadelphia, PA. In 1967, after completing a surgical internship at the Hospital of the University of Pennsylvania, he joined the U.S. Public Health Service at the National Institutes of Health. He and his twin brother, Blair, a lawyer, analyzed medical-legal issues including; the procurement and use of human tissues and organs for transplantation; the use of human subjects in clinical research; and the licensure and certification of allied health personnel.

In 1968, they helped draft the Uniform Anatomical Gift Act, which was adopted by all 50 states during the next three years and provides the legal foundation for the national network of organ sharing and transplantation that we have today.

Dr. Sadler started working on the credentialing of physician assistants in 1968 and has been involved with PAs ever since. In 1970, he was appointed Assistant Professor of Surgery and Public Health and Director of the Yale Trauma Dr. Maximiliano Cuevas was installed for his second term as MCMS President for Program. He chaired the Connecticut Ad2018-19. visory Committee on Emergency Medical the founding president of the Physician AssisServices (EMS) and led a statewide study, which spurred legislation to establish regional tant Education Association (PAEA) in 1972 and EMS systems in Connecticut. During that year worked with the AMA and the AAMC to dehe founded and directed the Physician Assistant velop accreditation standards for PA programs Program at the Yale School of Medicine. He was and with the NBME to develop the first national certifying examination for PAs.

In 1973, Dr. Sadler joined the Robert Wood Johnson (RWJ) Foundation, in Princeton, NJ, as a Senior Officer.

At RWJF he worked to foster the training of physicians in primary care, encourage the further development of physician assista nts, e x p a n d the Clinical Scholars Dr. Alfred M. Sadler, Jr, MD receives Program, and “Physician of the Year” Award. enhance the field of emergency medicine. He was a Founding Fellow of the Institute of Society, Ethics and the Life Sciences (the Hastings Center) in 1969.

By 1976, Dr. Sadler’s clinical interests evolved to primary care. He completed an internship, residency and clinical fellowship in internal medicine at Massachusetts General Hospital and the Harvard Medical School, Boston, MA. In 1979, he was appointed the first chief of Geriatric Medicine at the Center for the Health Sciences at the UCLA School of Medicine and helped establish its geriatric medicine division.

In 1981, he left academic medicine for private practice on the Monterey Peninsula. During the next 32 years, he practiced general internal medicine in Monterey; established, with a PA, a health center for the underserved in Marina; served as Medical Director of a retirement community in Carmel Valley; directed the Harden Urgent Care Center in Salinas, directed the Employee and Occupational Health Department of the Salinas Valley Memorial Hospital; and instructed PA and Nurse Practitioner students from Stanford and San Jose State Universities. He is past trustee, president and historian of the PA History Society. He speaks widely at PA programs nationally – giving Commencement addresses, leading White Coat Ceremonies and teaching the history of the profession.

Dr. Sadler has received many awards and recognitions, which include Alpha Omega Alpha, the National Kidney Foundation’s Distinguished Service Award, the Jack W. Cole award at Yale University, the Distinguished Service Award from PAEA, the Lifetime Achievement Award from the American College of Physicians, Northern California Chapter, an Amherst College Copeland Colloquium speaker, an honorary PA from the American Academy of Physician Assistants, a Fellow of the American College of Physicians, one of 40 “Luminaries” selected by RWJF on its fortieth anniversary, the “Lifetime Achievement Award” at his 50th Gradua-

tion exercises from Drexel College of Medicine in 2016, and an Honorary Doctor of Science degree from Marshall B. Ketchum University, Fullerton, CA in 2016.

He is the coauthor of numerous articles on organ transplantation and physician assistants, and four books: “The Physician’s Assistant: Today and Tomorrow,” “Issues Confronting New Health Practitioners,” “Emergency Medical Services – the Neglected Public Service,” and “The Physician Assistant: An Illustrated History”. With brother Blair, he recently completed two articles for the Hastings Center Report on “Organ Transplantation and the Uniform Anatomical Gift Act – a Fifty Year Perspective”.

Dr. Sadler is the Secretary/Director of the Monterey County Medical Society. He serves as a senior advisor to CSUMB in establishing their master’s Physician Assistant Program, which is scheduled to open with 33 students in January 2019.

Dr. Sadler has lived in Carmel for 37 years. His wife Edi is an accomplished artist, Family Nurse Practitioner, and Certified Diabetes Educator.

The annual banquet was a great success and a lot of fun! MCMS members, their families, and special guests enjoyed a fantastic meal, camaraderie, and a great program to wrap-up the evening.

Thank You

to our sponsors who have helped make this event possible.

GOLD

S I LV E R

COOP E R ATI V E OF

AMERICAN PHYSICIANS

B RO N Z E

JULY / AUGUST 2018 | THE BULLETIN | 11

Past Presidents Drs. James Hlavacek, E. Valerie Barnes, and James Ramseur.

MONTEREY COUNTY MEDICAL SOCIETY

“Physician of the Year” and Installation JUNE 7, 2018

Leslie Sorensen (MCMS’s Membership Coordinator), William Parrish (Retiring CEO) and Jean Cassetta (Membership Director).

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Clyde Roberson (Mayor of Monterey) and his wife Dottie.

Dr. James Ramseur, Jr. (Past President) and William Parrish (Retiring CEO).

Dr. John Schatz and his wife Valerie, and Dr. William Lewis.

Dr. James Hlavacek (Past President), April Becerra (Incoming CEO), and Dr. Alfred Sadler, Jr. (Physician of the Year).

Dr. Maximiliano Cuevas (President), Dr. Alfred Sadler (Physician of the Year), and William Parrish (Retiring CEO).

Dr. James Hlavacek (Past President), Dr. Alfred Sadler (Physician of the Year), and William Parrish (Retiring CEO).

Dr. William Khieu and April Becerra (Incoming CEO).

CMA Trustees Drs. Tom Dailey and Donaldo Hernandez present William Parrish with a beautiful Retirement gift and a Resolution from the California Legislature.

JULY / AUGUST 2018 | THE BULLETIN | 13

CURES 2.0 MANDATORY USE BEGINS OCTOBER 2, 2018

The Controlled Substance Utilization Review and Evaluation System (CURES) was certified for statewide use by the Department of Justice (DOJ) on April 2, 2018. Therefore, the mandate to consult CURES prior to prescribing, ordering, administering, or furnishing a Schedule II–IV controlled substance becomes effective on October 2, 2018. Visit www.mbc.ca.gov/CURES for detailed information regarding CURES 2.0.

Note: The phrase “controlled substance” as used in this guide refers to a Schedule II, Schedule III, or Schedule IV controlled substance.

WHEN MUST I CONSULT CURES? •

The first time a patient is prescribed, ordered, administered, or furnished a controlled substance, unless one of the exemptions on back apply.

•

Within the twenty-four hour period, or the previous business day, before prescribing, ordering, administering, or furnishing a controlled substance, unless one of the exemptions on back apply.

•

Before subsequently prescribing a controlled substance, if previously exempt.

•

At least once every four months if the controlled substance remains a part of the patient’s treatment plan.

WHAT PROTECTIONS ARE THERE FOR PRESCRIBERS? • There is no private cause of action for a prescriber’s failure to consult CURES. • For complete information on the mandatory requirement to consult CURES,

“First time” is defined as the initial occurrence in which a health care practitioner intends to prescribe, order, administer, or furnish a controlled substance to a patient and has not previously prescribed a controlled substance to the patient.

— Health and Safety Code (HSC), § 11165.4(a)(1)(B)

please read HSC § 11165.4.

• If you have any further questions, please seek legal counsel.

HOW CAN I GET HELP WITH CURES? For general assistance with CURES, including training and CURES usage support, contact the California DOJ at (916) 210-3187 or CURES@doj.ca.gov.

For Direct Dispensing assistance, contact Atlantic Associates, Inc. at (800) 539-3370 or cacures@aainh.com.

(Rev. 05-2018)

WHAT EXEMPTIONS ARE THERE TO CONSULTING CURES? •

A health care practitioner is exempt from consulting the CURES database before prescribing, ordering, administering, or furnishing a controlled substance in any of the following circumstances:

•

•

Licensed Clinic, or

•

Outpatient Setting, or

•

Health Facility, or

•

County Medical Facility

The facilities listed are specifically defined in statute commencing with HSC § 1200, § 1248, § 1250, and § 1440, respectively.

•

In the emergency department of a general acute care hospital, and the controlled substance does not exceed a non-refillable seven-day supply.

•

As part of a patient’s treatment for a surgical procedure, and the controlled substance does not exceed a non-refillable five-day supply when a surgical procedure is performed at a

•

•

Licensed Clinic, or

•

Outpatient Setting, or

•

Health Facility, or

•

County Medical Facility, or

•

Place of Practice

“Place of Practice” is defined as a Dental Office pursuant to Business and Professions Code § 1658.

The patient is receiving hospice care.

What if it is not reasonably possible for a prescriber to access the information in CURES in a timely manner?

•

What if I determine that consulting CURES would result in a patient’s inability to obtain a prescription in a timely manner and thereby adversely impact the patient’s medical condition?

•

A prescriber may provide a non-refillable five-day supply if they make this determination. The prescriber must document in the patient’s medical records the reason for not consulting CURES.

WHAT IF I EXPERIENCE TECHNICAL DIFFICULTIES WITH CURES? There are exemptions to consulting CURES if there are technical difficulties accessing CURES, such as CURES is temporarily unavailable for system maintenance, or you experience temporary technological or electrical failure and CURES cannot be accessed (e.g., power outage due to inclement weather).

A prescriber should contact the CURES Help Desk at (916) 210-3187 or cures@doj.ca.gov for assistance accessing their CURES account.

Note: A prescriber must, without undue delay, seek to correct any cause of the temporary technological or electrical failure that is reasonably within their control.

MEDICAL BOARD OF CALIFORNIA

2005 Evergreen Street, Suite 1200 Sacramento, CA 95815

CONTACT

•

If another individual with access to CURES is not reasonably available, a five-day supply of the controlled substance can be prescribed, ordered, administered, or furnished as long as there is no refill allowed. In addition, the prescriber must document in the patient’s medical records the reason for not consulting CURES.

(916) 263-2382 www.mbc.ca.gov webmaster@mbc.ca.gov

FOLLOW

•

While the patient is admitted to, or during an emergency transfer between a

@MedboardOfCA @MedicalBoardCA @MedboardOfCA

Great Moments in Medical History The Deadliest Natural Disaster in Human History

By Gerald E. Trobough, MD Leon P. Fox Medical History Committee In the winter of 1918, at the height of World War l, an influenza virus erupted and rapidly spread throughout the world. It traveled to every continent including the Pacific Islands and the Arctic. There was only one region on Earth that did not report an outbreak. It was on the isolated island of Marijo, in Brazil’s Amazon River Delta. The virus was labeled Influenza A, sub-type H1N1 that was nicknamed the Spanish Flu. It infected approximately 500 million people, resulting in 50 to 100 million deaths worldwide. The 1918 world’s population of 1.8 billion lost 3%–5% of its citizens to this deadly killer.

The United States lost approximately 675,000 people, including 43,000 servicemen. Fifty percent of the soldiers who died in the First World War, was from the virus and not at the hands of the enemy.

It is said that the Spanish Flu killed more people in 24 weeks than HIV/ AIDS killed in 24 years (50 million versus 36 million). It took the lives of more people in one year than the Black 16 | THE BULLETIN | JULY / AUGUST 2018

Death (plague), in the Middle Ages, caused in a century.

The flu of 1918 was named the Spanish Flu because of the false impression that Spain was hard hit by the flu when they reported that eight million Spaniards caught the flu in May and June of 1918. Wartime censors minimized the numbers of deaths in Europe and the United States. The lower statistics prevented the world from knowing the full extent of the pandemic.

Spain was not a participant in WW l, and was not subject to censors.

CHARACTERISTICS OF INFLUENZA VIRUSES

It is believed that all influenza viruses originate in birds. The viruses mutate rapidly and trade genes with other influenza viruses. The virus can easily spread to pigs, and from pigs to humans, where they can trade genes with other human viruses creating new influenza strains.

These strains can then pass from person to person becoming more or less virulent and deadly.

ORIGIN OF THE OUTBREAK

Experts debate the geographic origin of the

pandemic. Some believe it started in China or France. However, the most convincing evidence points to Haskell County, Kansas. In January 1918, several cases of the flu were reported by a family physician. On March 4, 1918, a company cook at nearby Fort Riley, Kansas reported sick. One week later, 100 soldiers were seen at the hospital with flu symptoms and in another seven days, 500 soldiers had the flu. In the early months, many of the soldiers improved after

to a phenomenon called “cytokine storm” which is an over- reaction in the body’s immune system. A stronger immune system in a 20-40 year old would have more damage to the body’s tissue and organs resulting in death. Another reason for the high mortality rate can be explained by results of research done at the University of Wisconsin in 2008. Investigators discovered three specific genes labeled PA, PB1, and PB2.

These genes enabled the virus to invade the lung and cause this viscous pneumonia.

Twenty percent of those infected in the second wave died, whereas in the usual flu epidemic the death rate is 0.1%. There was a higher death rate in pregnant women. In 13 studies, the death rate ranged from 23% to 71%. If the mother survived the flu, the fetal death rate was 26%.

DID THE SPANISH FLU HELP THE ALLIES WIN THE WAR? several days and were able to be deployed. They were sent to the East Coast and Europe carrying their virus. The death rate was not above normal at this time.

In August and September 1918, a second wave of a more virulent strain of Spanish Flu appeared in France. At about the same time, the virus hit Boston and spread West. This strain was much different than the first wave and was unlike any flu strain ever seen. It was highly fatal and attacked young healthy adults (99% of the deaths were in people less than age 65). Most other flu cases attack young children, adults over 65, and the immuno-compromised persons.

The symptoms came quickly and violently.

Headache, fever, and muscle aches came first followed by shortness of breath, cough, and pneumonia. The sickest patients developed cyanosis (blue pale skin) and usually died within hours in respiratory failure. Post-mortem exams revealed a viscous consolidation in the lungs. Those who survived often developed a secondary bacterial pneumonia that was fatal.

A third wave of a mutated, less lethal, strain of the Spanish Flu occurred in the early months of 1919. This transition is a common occurrence in influenza viruses. Very few deaths occurred and the epidemic was over by the summer of

1919.

WHY WAS THE FLU OF 1918 SO DEADLY?

Recent research on the 1918 influenza virus reported that the virulence was probably related

Leon P. Fox Medical History Committee

The Leon P. Fox Medical History Committee meets bi-monthly, the first Monday at noon (lunch provided). The purpose of the committee is to identify, collect, and preserve archival material, memorabilia, and artifacts representing the medical history of Santa Clara County. A guest speaker gives a historical presentation at each of the meetings, which is then transcribed for SCCMA’s Medical History archives.

If you are interested in serving as chairman of this committee, please contact Pam Jensen at SCCMA at (408) 998-8850 or pjensen@sccma.org.

Political scientist Andrew Price-Smith, believes the Spanish Flu aided the allies in World War l. He has collected data showing that the morbidity and mortality from the flu was higher in Germany and Austria than in Britain and France. Soldiers on both sides were too sick to fight effectively. A truce and armistice were signed on November 11, 1918 bringing an end to World War l.

COULD A SIMILAR INFLUENZA PANDEMIC RECUR 100 YEARS LATER

According to an expert, John M. Berry, author of “The Great Influenza,” the answer is yes.

The avian virus known as Influenza A, H5N1 would be a likely culprit. This virus was first discovered in China in 1997 and was noted to be very virulent. It killed 6 of 18 people infected in Hong Kong. China killed over 1 million chickens to try and stop the bird flu. In 2004, the virus resurfaced that led to the killing of 100 million chickens in China to finally kill the virus. However, the virus had established itself in the wild bird population. Fortunately, so far, there is no evidence of sustained person to person transmission of the virus. In July 2013, the World Health Organization announced there have been a total of 630 confirmed cases of H5N1 reported and 375 have died. This is a 60% fatality rate.

Billions of dollars have been spent researching the H5N1 virus and developing vaccines. Companies in the United States, Canada, Britain, France and Australia have approved vaccines that are stockpiled waiting for an epidemic, should it occur.

JULY / AUGUST 2018 | THE BULLETIN | 17

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Legacy offers a broad range of wealth management services to SCCMA and MCMS physician members and their families. Such services include: • Financial Planning, Risk Management, Educational & Retirement SCCMA Planning Projections 09-03-15 • Liquidity Management and Cash Flow Analyses • Estate Tax and Charitable Planning • Existing Portfolio Analysis • Design and Implementation of Investment Strategies Member Savings!

Legacy offers a one-hour complimentary financial planning check-up to Association members (this is a $500 savings). For more information, please call Michelle Hamilton, CFP®, MBA at (408) 452-7700 or email michelle@lwallc.com.

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18 | THE BULLETIN | JULY / AUGUST 2018

Classifieds

OFFICE SPACE FOR RENT/LEASE MEDICAL OFFICE SPACE FOR LEASE • SANTA CLARA Medical space available in medical building. Most rooms have water and waste. Reception, exam rooms, office, and lab. X-ray available in building. Billing available. 2,500– 4,000 sq. ft. Call Rick at 408/228-0454.

MEDICAL SUITES • GILROY First class medical suites available next to Saint Louise Hospital in Gilroy, CA. Sizes available from 1,000 to 2,500+ sq. ft. Timeshare also available. Call Betty at 408/8482525.

BEAUTIFUL MENLO PARK OFFICE TO SHARE New office, upscale and modern – to share with existing pain management practice.

Ideal for psychologist or psychiatrist. Contact Dr. Maia Chakerian at 408/832-3930.

OFFICE SPACE FOR LEASE AND OR SALE Medical office space 1,969 sq. ft. on Jackson Avenue opposite to Regional Medical Center for sale or lease, with option to buy. Very

METRO MEDICAL BILLING, INC.

• • • • • •

Full Service Billing 25 years in business Bookkeeping ClinixMIS web based software Training and Consulting Client References

Contact Lynn (408) 448-9210 lynn@metromedicalbilling.com

well maintained office building. Please call 408/926-2182 or 408/315-4680.

riflovin@allianceoccmed.com for additional information.

MEDICAL OFFICE SPACE TO SHARE • CAMPBELL

WANTED FAMILY PHYSICIAN

Specialist wanted to share a private office with family practitioner in Campbell. Hamilton/Winchester area. Contact Mary Phan at (408) 364-7600.

MEDICAL OFFICE TO SHARE • LOS GATOS Newly remodeled. Next to ECH-LG 2,400 sq. ft. Doctor’s office, five exam rooms, waiting room, reception area. Can bring own staff or share. Surgery Center, PT, and radiology in building. Ample parking. Call Elena at (408) 374-1110.

EMPLOYMENT OPPORTUNITY OCCUPATIONAL MEDICINE PHYSICIANS • PRIMARY CARE, ORTHOPEDICS, & PHYSIATRY Our occupational medical facilities offer a challenging environment with minimal stress, without weekend, evening, or “on call” coverage. We are currently looking for several knowledgeable and progressive primary care and specialty physicians (orthopedist and physiatrist) interested in joining our team of professionals in providing high quality occupational medical services to Silicon Valley firms and their injured employees. We can provide either an employment relationship including full benefits or an independent contractor relationship. Please contact Rick Flovin, CEO at 408/228-0454 or e-mail

Family medicine physician needed to share a growing outpatient practice. Start at 16 hours/week and share patient load. Practice caters to 75% PPO, rest Medicare and HMO. Contact ntnbhat@yahoo.com / 408/8396564.

FOR SALE ENDOCRINOLOGY PRACTICE FOR SALE • MOUNTAIN VIEW Long established practice with revenue of $1.1 million on 2.5 doctors. High referral rates from physicians and other patients.

Pent-up demand indicated by long waiting times for appointments. Photos available.

Offered at only $403,800. Contact Medical Practices USA. info@MedicalPracticesUSA. com. 800-576-6935. www.MedicalPracticesUSA.com.

OFFICE SPACE FOR LEASE AND OR SALE Medical office space 1,969 sq. ft. on Jackson Avenue opposite to Regional Medical Center for sale or lease, with option to buy. Very well maintained office building. Please call 408/926-2182 or 408/315-4680.

OFFICE EQUIPMENT FOR SALE Powered Procedure Table, Brewer Assist 7000 – used. $2,000. Autoclave, Ritter M7 Speedclave – used. $500. Both in excellent condition. Call (408) 355-4659.

Visit our Website: metromedicalbilling.com JULY / AUGUST 2018 | THE BULLETIN | 19

HealthMed Realty is a Full-Service Commercial Real Estate Firm specializing in Medical & Dental Real Estate. Put our experience on your side and we will save you time and money. Call us today! (408) 217-6000 OPPORTUNITY IN PRIME DOWTOWN SARATOGA LOCATION FOR SALE

14639 Big Basin Way, Saratoga, CA 95070 The property consists of two (2) commercial condominium units perfect for an investor, or an owner/user seeking an opportunity to acquire an investment property they can partially occupy. The top floor of the condo is approximately 1,867 rentable square feet, and is 100% leased.

The ground floor of the project is approximately 1,473 rentable square feet, and is vacant and excellent for insurance, real estate, or other professional service, or retail use. Call to tour!

1,250 FOR SALE/LEASE  $625,000

88 Tully Rd, San Jose Fully plumbed dental suite with 4 operatories (2 are equipped with chairs & cabinetry). Located at Tully Rd & Curtner Ave.

1,211 SF FOR LEASE

6,116 SF FOR LEASE

1045 W El Camino Real Ste C, Mtn. View

100 E Hamilton Ave, Campbell

New buillding exterior. Suite in shell condition. Close to Google and Downtown Mtn. View. Medical / Dental use allowed with CUP.

Freestanding Building with Monument Signage Available . Elevator served with ample parking. Tenant improvements available. Easy access to Hwy 17 & 280.

10,576 SF FOR LEASE

981-1,535 SF FOR LEASE

550 Lakeside Dr, Sunnyvale

2664 Berryessa Rd, San Jose

Freestanding office/medical building.

The property has ample parking (5/1000) and great signage. Excellent access to Fwy 101.

2,262 SF FOR LEASE

1,586 SF FOR LEASE

1253 W El Camino Real, Sunnyvale

1660 Hillsdale Ave, San Jose

Two-building retail center anchored

by BevMo! Prominent El Camino Real frontage. Approximately 50,000 VPD traffic count.

Do you have an office EMERGENCY? Call us at (408) 217-6000 20 | THE BULLETIN | JULY / AUGUST 2018

Medical/Dental Office building.

Built out and plumbed dental suites. Central vacuum and compressor. Close to Hwy 680.

Fully plumbed dental suite.

Close to Cambrian Park / Willow Glen neighborhoods. Vacuum/ Compressor available 4 operatories.

scan me to see our latest availabilities

945 SF FOR LEASE

483-922 SF FOR LEASE

2,566-3,429 SF FOR LEASE

1,052-2,211 SF FOR LEASE

1787 Landess Ave, Milpitas

10430 S. De Anza Blvd, Cupertino

2450 Samaritan Dr, San Jose

Existing restaurant build-out can be used for dental/medical or retail use with drive-thru available. Easy access to Hwy 680 to Hwy 880.

Medical/Dental office building.

Located in central Cupertino by Civic Center, City Hall, and Apple HQ. Close to Hwy 280 and Hwy 85.

Flexible medical suite in a singlestory building located across from Good Samaritan Hospital. Easy access to Hwy 85.

1,478 SF FOR LEASE

1,902 SF FOR LEASE

813-2,885 SF FOR LEASE

1,317-1,960 SF FOR LEASE

15100 Los Gatos Blvd, Los Gatos

14901 National Ave, Los Gatos

393 Blossom Hill Rd, San Jose

15899 Los Gatos Almaden Rd, Los Gatos

Ideal for medical or professional office use. 5 private offices/exam rooms. Elevator served. Easy access to Hwys 85 and 17.

Immediate access to Good Samaritan Hospital and Hwy 85.

Elevator served. Existing medical impromvents.

Premier class A medical office building with diverse tenant mix.

Convenient access to Hwys 85, 87 & 101.

2550 Samaritan Dr, San Jose Medical/Office Building with 3 large offices, bathroom, waiting area and break room. Located across from Good Samartian Hospital.

2-story medical office building.

Close to Good Samaritan Hospital and Mission Oaks Hospital. Elevator served. EZ access to Hwys 85 & 17.

1,132-2,882 SF FOR LEASE

2,200 SF FOR LEASE

1,130-2,270 FOR LEASE

1,750 SF FOR LEASE

877 W. Fremont Ave, Sunnyvale

10601 S. De Anza Blvd, Cupertino

555 Knowles Dr, Los Gatos

920 N Bascom Ave, San Jose

Medical and dental suites available in a park-like setting medical office project. Easy access to Hwy 280 and 85 and minutes to the peninsula.

Mixed-use property with a mix of office, medical and retail tenants.

Minutes from Apple campus and easy access to Hwy 280 and 85.

750-1,615 SF FOR LEASE

892-4,909 SF FOR LEASE

1200 SF FOR LEASE

5,387 SF FOR LEASE

2242 Camden Ave, San Jose

3803 S. Bascom Ave, Campbell

2504 Samaritan Drive, San Jose

2930 Aborn Square Rd, San Jose

Class A medical office building less than 1 mile from Good Samaritan Hospital. Easy access to Hwys 17 and 85. Exceptional visibility.

Single-story building right across the street from Good Samaritan Hospital. Highlights 3 exam rooms, private office, and lab area.

BRAND NEW exteriors, lobby & full ADA upgrades! Close to Good Samaritan Hospital & Los Gatos.

Easy access to Hwys 880 & 17.

Class A Medical Building right next to El Camino Hospital. Flexible terms available. Excellent access to Hwy 85.

Fully plumbed dental suite with 5 operatories in the Rose Garden area. Great corner visibility. Easy access to Hwy 280 and Hwy 880.

Neighborhood shopping center with wide array of retail tenants anchored by Ross Dress For Less.

High traffic area. EZ access to 101.

690 Saratoga Ave | Suite 200 | San Jose, CA 95129 408-217-6000 T | 408- 457-8803 F www.HealthMedRealty.com Lic. 01902032

JULY / AUGUST 2018 | THE BULLETIN | 21

MEMBER NEWS & HAPPENINGS

Santa Clara County Medical Association Award Presentations and Installation

The Fairmont Hotel’s Club Regent, in San Jose, provided the setting for Santa Clara County Medical Association’s Annual Awards Banquet and Installation. Nearly 200 members and guests were in attendance this year.

Seham El-Diwany, MD, 2017-18 SCCMA President, following her outgoing president’s speech, presented Kenneth Blumenfeld, MD, with the presidential gavel

Kenneth Blumenfeld, MD, 2018-19 SCCMA President 22 | THE BULLETIN | JULY / AUGUST 2018

Dr. Seham El-Diwany receives an appreciation plaque from Dr. Kenneth Blumenfeld for her outstanding leadership as President for 2017-18.

for 2018-2019. Serving in the current fiscal year with Dr. Blumenfeld are: Seema Sidhu, MD, as PresidentElect; Cindy Russell, MD, as Vice President of Community Health; Erica McEnery, MD, as Vice President of External Affairs; Faith Protsman, MD, as Vice President of Professional Conduct; Seham El-Diwany, MD as Past President; Anh T. Nguyen, MD, as Treasurer; and Martin K. Wong, MD, as Secretary. The SCCMA Councilors are: Cathy Angell, MD (O’Connor Hospital); Vinit Madhvani, MD (Good Samaritan Hospital); Heather Taher, MD (Regional Medical Center); Hemali Sudhalkar, MD (Kaiser Foundation Hospital – San Jose); Clifford Wang, MD (Santa Clara Valley Medical Center); Scott Benninghoven, MD (Saint Louise Regional Hospital); Gloria Wu, MD (El Camino Hospital); Lewis Osofsky, MD (El Camino Hospital of Los Gatos); and John Brock-Utne, MD (Stanford Health Care / Children’s Health).

The evening’s festivities culminated with the recognition of those who have dedicated their lives to furthering the high quality of medical care.

Dr. Blumenfeld made the following presentations:

JOHN AND GINI MITCHEM CITIZEN’S AWARD This award is given to an individual(s) who is not a member of the Medical Association, who has achieved public recognition for a significant contribution in the health field.

John and Gini Mitchem are both highly educated people who have enhanced mental health services in our community greatly. Their story also begins on a personal level when their adult child was diagnosed with schizophrenia. Those of you who have dealt with mental health issues understand that this was not a problem easily addressed or fixed. It is an issue that requires community support. That was how and why they became involved with the National Alliance on Mental Illness Santa Clara County. This organization provides support, education, and advocacy for people with severe mental illness such as schizophrenia, bipolar disorder, clinical depression, and PTSD. Importantly they also provide services for the families of these individuals. John and Gini have been tireless volunteer activists and leaders and thereby have played a pivotal role in the vast expansion and success of the NAMI SCC organization. It is a great honor to recognize John and Gini Mitchem as the recipients of our Citizen’s Award.

MARTIN L. FISHMAN, MD ROBERT D. BURNETT, MD LEGACY AWARD This award is given to a physician member of the Medical Association who has demonstrated extraordinary visionary leadership, tireless effort, selfless long-term commitment, and success in challenging and advancing the health care community, the well-being of patients, and the most exalted goals of the medical profession.

Dr. Martin Fishman is a Californian, born in San Francisco and raised in Southern California. He attended UC Berkeley for his Pre-Medical studies and graduated from UC San Francisco Medical School AOA. He then finished a residency in Ophthalmology at Washington University and a Fellowship at the National Eye Institute of NIH. He has served as Chief of Staff of Los Gatos Community Hospital, President of the California Association of Ophthalmology, and President of the SCCMA. He served on the Board of Trustees of the CMA and of The Health Trust of San Jose for nine years. He is an Adjunct Clinical Professor of Ophthalmology at Stanford Medical Center, where he has taught Ophthalmic Pathology for over 40 years and been Chief of the Pathology Section of the Basic Science Course for much of that time. He also went back to school in 1995 to earn a Master’s Degree in Public Administration in Health Care through St. Mary’s College.

Dr. Fishman continues his medical practice as a founding partner in Spectrum Eye Physicians. He also continues to lead annual volunteer medical surgical groups to Guatemala, as part of an ongoing program, “Seeing Again Guatemala” that has provided over 15,000 patients with medical eye care and has performed over 1,500 cataract operations, restoring sight to the totally blind. He is currently President Elect of the Los Gatos Rotary Club. He is a devoted husband and father having been married to Barbara for 50 years and raising two children and hopefully spoiling his two grandchildren. Please join me in saluting this year’s Robert D. Burnett, MD Legacy award winner Martin Fishman, MD.

Continued on page 24 JULY / AUGUST 2018 | THE BULLETIN | 23

SAMEER V. AWSARE, MD BENJAMIN CORY, MD AWARD This award is for a physician member of the Medical Association who has displayed forward-looking, pioneering ideas, enterprise, enthusiasm, and prolonged professional stature and ability.

Dr. Sameer Awsare embodies the attributes represented by the Cory award – pioneering ideas, ability and, professional stature. Sameer received his medical degree from the University of California Irvine in 1989 and completed his residency in internal medicine at the Kaiser Permanente Medical Center at Santa Clara where he stayed on as an internal medicine attending. He then became involved in the education of medical students and residents and served on the clinical competence, peer review, and ethics committees. He also served as Chief of Medicine at the Kaiser Permanente Campbell facility. He has since been on the Board of The Permanente Medical Group (TPMG) for 16 years fulfilling the roles of secretary and vice chair. Currently he is the secretary and chair of the governance committee of the Mid-Atlantic Permanente Group board.

Sameer’s participation in SCCMA began in 1993. He has chaired the Bioethics Committee and was on the Executive Committee from 1997 to 2001 as well as from 2010 to 2015. He served as the SCCMA President from 2013 to 2014. He has been a passionate advocate on behalf of our patients and physicians.

Today in his role as Associate Executive Director of the Permanente Medical Group Sameer oversees Adult and Family Medicine, pharmacy, mental health, risk adjusted coding, revenue cycle, outside medical services, pain services and the opioid initiative. He is a nationally respected speaker on drug use management and opioids. He has a history of volunteer work that has included participation as a voluntary clinical faculty member at the Stanford School of Medicine and extended to volunteerism at the Julian Street Homeless Shelter and Hurricane Katrina mission. Please welcome our Benjamin Cory MD award winner Dr. Sameer Awsare.

WILLIAM C. PARRISH, JR. WILLIAM C. PARRISH, JR. LEADERSHIP IN HEALTHCARE AWARD This award is named after the beloved long-time executive director of the Santa Clara County Medical Association and recognizes an individual whose leadership, innovation, and dedication have resulted in profound improvement to healthcare in Santa Clara and has left a lasting 24 | THE BULLETIN | JULY / AUGUST 2018

in internal medicine at the University of California, Davis. She joined the Permanente Medical Group immediately after completing her residency but wasn’t done with her education as she went on to complete an executive leadership program at Harvard in 2008 and palliative care education and practice program also at Harvard in 2016.

It is hard in a brief introduction to cover all of her activities and achievements. Within the Kaiser system and beyond she has been a leader and educator. She has championed efforts at treating chronic disease and been a proponent of life care planning at all levels. And as might be anticipated from her advanced training she has been instrumental in developing and implementing palliative care and end-of-life options for our community.

It is with great esteem and admiration that we recognize Dr. Ruma Kumar with this award.

JOHN TATMAN, MD OUTSTANDING CONTRIBUTION IN MEDICAL EDUCATION

impact on the physicians and patients of the County.

What can you say about an individual who is so appreciated that we have chosen to create a new Legacy Award, not to mention used the word “beloved.” Bill came to the Santa Clara County Medical Association 23 years ago. In truth we stole him from Kaiser Permanente. During his tenure as CEO he has increased our membership making us the strong delegation we are today. He has been fiscally responsible increasing our reserves by over 100%, paid off our debt, re-organized the Bureau of Medical Economics, created long-term financially favorable leases, and even assumed administrative oversight of the Monterey County Medical Society.

But what most of us have appreciated and will remember about Bill has been his friendship and unwavering support. As he has aptly stated “good things happen when one combines knowledge and strong relationships.”

It is with much appreciation and respect that we present this award to Bill.

This award is for a physician member of the Medical Association who has exhibited sustained interest and participation in one or more medical education activities over and above the membership at-large.

Continued on page 26

RUMA KUMAR, MD OUTSTANDING ACHIEVEMENT IN MEDICINE AWARD This award is for a physician member of the Medical Association who, during his medical career, has made unique contributions to the betterment of patient care, for which he has received widespread recognition.

Ruma Kumar, MD received her medical degree from the University of Southern California School of Medicine in June 1992. She then completed her internship and residency JULY / AUGUST 2018 | THE BULLETIN | 25

THOMAS M. DAILEY, MD OUTSTANDING CONTRIBUTION TO THE MEDICAL ASSOCIATION This award is given to a physician member of the Medical Association who has exhibited sustained interest and participation in one or more activities of the Association over and above that expected of the membership at-large.

Thomas Dailey MD received his medical degree from UCLA, completed an internal medicine residency at Boston City Hospital, and pulmonary/critical care fellowship at UCSD. He joined The Permanente Medical Group and SCCMA in 1989. He has served on the Council, and just about every Committee including Executive, Bioethics, Awards, Environmental Health, and Membership Committees. He has also been a Delegate for many years.

He served as President from 2010 until 2011 and since 2012 has represented District 7 as a CMA trustee on their Board. I can think of no more deserving person then Tom to receive the “Outstanding Contribution to the Medical Association” award.

SUCHADA NOPACHAI, MD OUTSTANDING CONTRIBUTION IN COMMUNITY SERVICE

John Tatman, MD received his medical degree from the Ohio State University College of Medicine in 1980. He then went on to complete an obstetrics and gynecology residency, also in Ohio, in 1986. In 1988 he finished his Fellowship and gynecologic oncology at M.D. Anderson Cancer Center.

Following his completion of fellowship Dr. Tatman joined the staff of the Kaiser Permanente Medical Center in Santa Clara, California as an attending gynecologic oncologist. He was also given a clinical assistant professorship at Stanford University.

Through the years Dr. Tatman has chaired many committees and departments. He has written papers, made presentations and even done volunteer work.

However, tonight he is being recognized for a crowning achievement, “the gift that keeps on giving,” which is teaching other doctors how to be better doctors. Tonight’s award is to honor his tireless and generous activities as a teacher and mentor to several generations of medical students and residents.

It is with great admiration and pleasure that we recognize Dr. Tatman with this award.

26 | THE BULLETIN | JULY / AUGUST 2018

This award is given to a physician member of the Medical Association who has exhibited sustained interest and participation in one or more activities of the community over and above that expected of the membership at-large.

Suchada Nopachai, MD received h e r

medical degree from the Southern Illinois University School of Medicine in 1997 and completed an obstetrics and gynecology residency in 2001 at Wayne State University of Detroit. From there she made her way back to California and joined the The Permanente Medical Group in San Jose. Dr. Nopachai, like most of our awardees tonight, has been an exemplary physician with a history of distinguished service, participation in leadership, and the recipient of multiple awards. However, her award tonight is the result of a terrifying personal experience and a subsequent selfless realization of the need to help others. It was on a cold February morning that she witnessed the collapse of her 4-yearold child, Alex, on a playground. He was in cardiac arrest and if not for the efforts of firefighters and paramedics and the miracle of CPR and defibrillation he wouldn’t still be with us. But it was from this event that Dr. Suchada was able to recognize an opportunity. From that point on CPR, AED education, and training became her passion. She has worked extensively with Kaiser Permanente, CMA, the American Heart Association, and at the Santa Clara County Emergency Medical Services. Thanks to her efforts our community is a safer place. It is a great honor to recognize Dr. Nopachai as the recipient of our “Outstanding Contribution in Community Service” Award.

SCCMA ALLIANCE FOUNDATION

(PRESENTED TO SUZANNE JACKSON ON THEIR BEHALF)

SPECIAL RECOGNITION AWARD This award is given in recognition and appreciation for the many years of dedicated service to the physicians, patients, and community of Santa Clara County by the Santa Clara County Medical Association Alliance Foundation.

The SCCMA Alliance Foundation has served our community greatly but is now to be transitioned into an endowed charitable foundation. Accepting the award on behalf of the Alliance Foundation is Suzanne Jackson. She has been a driving and perpetuating force for many years.

Suzanne shared the following history of this wonderful philanthropic group: The history of the Women’s Auxiliary began nine decades ago. In 1934, the wives of 35 physicians formed a support group for physicians and their families. The “War Service Award” was presented to the Auxiliary for volunteer work in 1944. Post WWII, they sponsored a public forum on cancer awareness. Through fundraising, the Auxiliary provided medical equipment to the Palo Alto Stanford Hospital.

During the 1940’s and 1950’s, the Auxiliary initiated the Good Emergency Mother Substitutes (GEMS), a 6-week child care training program for junior high students, training over 5,000 young people in babysitting skills.

In the 1960’s, the International Health Project was established, collecting medical supplies, excess drugs and equipment for the Direct Relief Foundation in which 23 countries were served.

In the 1970’s, the Auxiliary initiated the Parental Stress Hotline, a crisis intervention telephone service for parents needing assistance with their teens. This program grew to become an independent United Fund agency.

The 1980’s witnessed our Infant Love Seat, the first infant car seat loaner program for mothers leaving the hospital with their newborn infants. In addition, we began the project called Vial of Life, an in-home program to alert EMT’s of the medications and health issues of patients.

Toward the end of the decade, Auxiliary Districts 1 and 2 were combined, and in 1984 the Auxiliary celebrated its 50-year anniversary.

In the 1990’s the Auxiliary’s name was changed to the Santa Clara County Medical Association ALLIANCE. We procured and provided public high school classes with the Teen Survival Guides and the Parents’ Guide to Teen Parties. The Alliance also adopted an AMA Alliance program to teach first through third graders the benefits and fun of healthy lifestyles. Over a period of four years, we distributed the “Be a Winner – Shape up for Life” series to over 60,000 school children in the Santa Clara County Schools.

As we entered the new century, the Alliance continued with its philanthropic activities by donating tens of thousands of dollars to multiple organizations including: Breathe America, the Clean Slate Tattoo Removal Program at the Valley Medical Center (VMC), Fetal Alcohol Spectrum Task Force, the Tympany Center, and EMQ Celebrating Families. A sampling of some of our volunteer activities included: gift wrapping at Loaves and Fishes, Health Fairs, the Santa Clara County Food Pantry, VMC holi-

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day tree decorating, and helping with Stanford’s and the Cancer Society’s Wig Bank program.

In 2009, the Alliance celebrated its 75th anniversary of community service and philanthropy. At the end of this first decade of the new millennium, news media stories had begun to report that young children and babies had to be rescued from closed cars in warm weather. Tragedies did occur as temperatures in these closed vehicles reached over 110 degrees!

The “Not Even for a Minute – Never” program was initiated to increase awareness of the dangers of leaving a child in a locked car. Tens of thousands of stickers were distributed to remind people to never leave your child in a locked car alone. These stickers were distributed at health fairs, community events, schools, and police and fire departments throughout the county.

Our SCCMA Alliance also held many fun activities with the medical community, including: Bunco nights, bocce ball, wine tastings, pool parties, luncheons and dinners. And, for the past four decades, we have actively participated in the SCCMA’s and CMA’s legislative advocacy activities both locally and in Sacramento.

In 2012, we worked to become a 501c3 charitable organization IRS tax designation. We also established an Amazon/Smile.com purchasing account that provides a donation from AMAZON to the Alliance Foundation based on a percentage of your purchase.

The Alliance in Partnership With the Medical Association On October 10, 2015, the Alliance co-sponsored the highly successful “Wireless Technology and Public Health Forum” under the leadership of Dr. Cindy Russell, Chair of the SCCMA Environmental Health Committee.

The SCCMA Bioethics Committee endeavored to establish an Advanced Care Planning Program throughout the county. The Alliance aided in co-sponsoring and collecting funding for this project. Two sessions of the “Respecting Choices” program was presented in November 2016.

In April of this year, the Alliance co-sponsored the showing of the award-winning film “Generation Zapped” – which addressed the use of

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wireless technologies, digital devices and their potential adverse effect on our health and wellbeing. A panel of experts led by Dr. Russell then discussed this issue.

Indeed, for nearly a century, members of the SCCMA Alliance have committed ourselves to our mission of service to the medical community. We currently are in a period of transition and welcome the continued support of the SCCMA.

Thank You!

Jim and Bonnie Hinsdale

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Dr. Ruma Kumar (Award Honoree) poses with her wonderful family.

SANTA CLARA COUNTY MEDICAL ASSOCIATION

Annual Awards Banquet and Installation JUNE 5, 2018

Photos: Brandon Vaccaro Studio 30 | THE BULLETIN | JULY / AUGUST 2018

Dr. John Tatman (Award Honoree) poses with his lovely wife Harn-Zi Chen.

William Parrish (CEO) and his lovely wife Luanne.

Dr. Eleanor Martinez (Past President) and Dr. Sameer Awsare (Award Honoree and Past President).

Dr. Suchada Nopachai celebrates her special honor with her family and firefighter friends.

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Thank you to Luanne Parrish for sharing your husband Bill Parrish with SCCMA for 23 years!

Dr. Martin Fishman (Award Honoree) celebrates his special evening with his family.

Award Honorees, Drs. Ruma Kumar and Suchada Nopachai pose with colleagues.

SCCMA-BME staff photo – Having fun of course!

Dr. Seham El-Diwany (President 2017-18) and her husband Monir.

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Dr. Kenneth Blumenfeld (201819 President) and his lovely wife Ellen.

Bill Parrish (Award Honoree and CEO) and April Becerra (Incoming CEO)

Dr. Jim Hinsdale (Past President and Sponsor) and Dr. Kenneth Blumenfeld (Incoming President and CMA Trustee).

(L to R) Sheal and Sohun Awsare, Dr. Sameer Awsare (Award Honoree and Past President), Urmilla Jog, Dr. John Tatman (Award Honoree) and his wife Harn-Zi Chen; (Back row) Dr. Tom Dailey (Award Honoree and Past President) and his wife Rosemary and daughter Ellen, and Christopher Takeuchi.

(Head table) L to R: Jessie and Ellen Blumenfeld, Dr. Kenneth Blumenfeld (President 2018-19), April Becerra (Incoming CEO), Dr. Scott Benninghoven (Past President) and his wife Pamela, Monir El-Diwany, PhD, Dr. Seham El-Diwany (President 2017-18), and William Parrish (CEO).

Dr. Steve Jackson (Past President) and his lovely wife, Suzanne Jackson (Award Honoree – SCCMA Alliance Foundation).

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(L to R) Dr. Thomas Sugarman (ACCMA President), Mizgon Darby, Benjamin Pither, Joe Greaves (ACCMA Executive Director), Keith Darby (SMCMA Executive Director), Linda and Donald Waters (Retired ACCMA Executive Director), Chris and Sheila Foley (Standard Business Machines – Sponsor), and Frank Blackwell (Mercer – Sponsor).

Dr. Ken Blumenfeld (Incoming President), Dr. Seham El-Diwany (President 2017-18), and Dr. Seema Sidhu (President Elect).

(L to R) Ed Ryu and Michelle Hamilton (both from Legacy Wealth Advisors – Sponsor), Dr. R. Lawrence Sullivan, Dr. William Ricks, Dr. Tanya Spirtos (Past President), Dr. Eleanor Martinez (Past President), Debbi Ricks (Past President SCCMA Alliance), Dr. Elliot Lepler (Past President), Dr. David Adamson, Dr. Steve Jackson (Past President) and his wife Suzanne (Award Honoree – President SCCMA Alliance Foundation).

Dr. Sameer Awsare (Award Honoree) poses with his nephews and Aunt.

34 | THE BULLETIN | JULY / AUGUST 2018

Dr. Suchada Nopachai (Award Honoree) enjoys her special honor with family and friends.

A special thank you to Kaiser for your very generous sponsorship!

Award Honoree Dr. Tom Dailey celebrates his special evening with his beautiful family.

Dr. Martin Fishman celebrates his special evening with his wonderful family and friends.

Bill Parrish (Award Honoree and CEO) poses with Dr. Cindy Russell (VP Community Health) and Dr. Eleanor Martinez (Past President).

Dr. Jim Hinsdale presents a Resolution to William Parrish from the California Legislature.

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REIMBURSEMENT ADVOCACY

State Budget Includes 10 New CPT Codes Eligible for Supplemental Tobacco Tax Payments Governor Jerry Brown last month signed a $139 billion California budget for the 2018-2019 fiscal year. The budget continues the Administration’s commitment to using the Proposition 56 tobacco tax funding to provide supplemental payments for Medi-Cal providers, with $500 million in tobacco tax funds allocated to improve provider reimbursement through supplemental payments. The total funding for provider payments is approximately $1.3 billion.

DHCS plans to allocate the tobacco tax funds to increase payments for a total of 23 CPT codes, which includes 10 new preventive CPT codes.

The supplemental rate proposal is contingent on federal approval, and would be effective July 1, 2018.

CPT CODE 99201 99202 99203 99204 99205 99211* 99212 99213 99214 99215 90791* 90792* 90863* 99381 99382 99383 99384 99385 99391 99392 99393 99394 99395

DHCS has proposed increasing the supplemental payment for the currently eligible CPT codes to 85 percent of Medicare (a 40 percent average increase in payments for these eligible codes compared with 2017 – 2018 payment levels). The 10 newly added preventive CPT codes would be paid at 100 percent of Medicare.

The supplemental payments would apply to both fee-for-service and managed care delivery systems. A full list of the eligible CPT codes is listed below.

The supplemental rate proposals are effective July 1, 2018, contingent on receipt of federal approval, which was requested through a State Plan Amendment on June 29, 2018.

2017 – 2018 SUPPLEMENTAL AMOUNT $10.00 $15.00 $25.00 $25.00 $50.00 $10.00 $15.00 $15.00 $25.00 $25.00 $35.00 $35.00 $5.00

2018 – 2019 SUPPLEMENTAL AMOUNT $18.00 $35.00 $43.00 $83.00 $107.00 $10.00 $23.00 $44.00 $62.00 $76.00 $35.00 $35.00 $5.00 $77.00 $80.00 $77.00 $83.00 $30.00 $75.00 $79.00 $72.00 $72.00 $27.00

* The supplemental payment on these four codes remains unchanged with their existing supplemental payment already between 90 – 120 percent of Medicare.

36 | THE BULLETIN | JULY / AUGUST 2018

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