CMA’s Legislative Advocacy Day consistently brings together more than 400 of physician and medical student leaders from all specialties and modes of practice. Attendees will have the opportunity to meet with legislators on priority health care issues.
+ April 9, 2025 + Sacramento + cmadocs.org/legday25
SCCMA is a professional association representing over 4,500 physicians in all specialties, practice types, and stages of their careers. We support physicians like you through a variety of practice management resources, coding and reimbursement help, training, and up to the minute news that could affect your practice. The Bulletin is our quarterly publication.
SCCMA OFFICERS
President | Fahd Rahman Khan, MD
President-elect | Santosh Pandipati, MD
Secretary | Randal Pham, MD
Treasurer | Shahram Gholami, MD
Immediate Past President | Anlin XU, MD
VP-Community Health | Paul Wang, MD
VP-External Affairs | Christine Doyle, MD
VP-Member Services | Sam Wald, MD
VP-Professional Conduct | Lewis Osofsky, MD
SCCMA STAFF
CEO/Executive Director | Marc E. Chow, MS
Director of Membership & Programs | Angelica Cereno
Director of Governance and Advocacy | Emily Coren
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SCCMA COUNCILORS
El Camino Hospital of Los Gatos | Jaideep Iyengar, MD
El Camino Hospital – Mountain View | Carol A. Somersille, MD
Good Samaritan Hospital | Judong Pan, MD
Kaiser Foundation Hospital - San Jose | Haritha Reddy Rachamallu, MD
Kaiser Permanente Hospital - Santa Clara | John Truong, MD
O’Connor Hospital | David Cahn, MD
Regional Medical Center | Raj Gupta, MD
Saint Louise Regional Hospital | Kevin Stuart, MD Santa Clara Valley Medical Center | Open Stanford Health Care/Children’s Health | Karen Kim, MD
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Delegates represent their counties in the California Medical Association (CMA) house of delegates by attending and actively participating in delegation caucus meetings and in all sessions of the house.
Delegates monitor business put before the house to consider, including business at the annual session, and items presented during the year-round resolution process. Delegates are represent their overall constituency and not just their own personal views on issues.
Delegate candidates are team-oriented, knowledgeable on policy issues, willing to play an active role in the delegation and support the goals of the delegation.
Positions are for a two-year term. If you are interested in becoming an alternate delegate to participate in future meetings of the House of Delegates please contact Governance & Advocacy Associate at emily@sccma.org.
MICAH SASTE
Wellness is more than just the absence of burnout—it is a state of thriving as a unique and complex individual within an equally complex environment and system. National organizations, the World Health Organization (WHO), and numerous academic models offer perspectives on wellness, yet it is not a simple box to check or a goal to accomplish. Instead, wellness is an ongoing, dynamic process—a series of incremental steps, a collective awareness, and a shared commitment to an evolving vision.
As the inaugural Physician Wellness Coordinator for the Santa Clara Valley Healthcare (SCVH) system, I spend much of my time immersed in this space— planting seeds for growth while also navigating the realities of practicing medicine. This work is deeply personal; as a pre-med student, I wrestled with the paradox of my father—a dedicated surgeon—suffering a heart attack at the very age I am now. How could a career centered on healing and alleviating suffering be misaligned with health and wellness? The tension between medicine and well-being persists, and our pursuit of wellness must continue.
By objective measures, medicine is not a healthy profession. A 2023 American Medical Association (AMA) report found that 48% of physicians experience persistent burnout. A 2022 JAMA study revealed that one in five physicians plans to leave clinical practice. Additionally, projections from the Association of American Medical Colleges and The Department of Health and Human Services (ASPE, October 2024) estimate a shortage of 139,940 full-time physician equivalents by 2036.
A strong and supported physician workforce is essential for maintaining national health. How, then, do we foster wellness at the individual, team, and system levels? How do we transform our lives and healthcare systems in alignment with the values that drew so many of us to medicine—compassion, patient care, and the alleviation of suffering?
In this article, I outline actionable strategies rooted in the science of wellness, reinforced by personal and system-level experiences, to help individuals and organizations move forward.
1. Coaching: Can You Take the RCT Challenge?
Lotte Dyrbye’s randomized controlled trial on professional coaching concluded that “Professional coaching may be an effective way to improve quality of life and resilience while decreasing emotional exhaustion in some physicians.” This finding, while understated, highlights the transformative power of coaching.
When I stepped into my current role, I tested this intervention personally. Initially framing it as a professional vetting process, I engaged with a coach through our Employee Assistance Program (EAP), Concern Health. Just as coaching had enhanced my athletic performance, professional coaching significantly improved my personal and professional well-being. Having an external observer who helped clarify my values and goals proved invaluable—an experience I highly recommend.
If you are among the estimated 20-30% of physicians experiencing anxiety, depression, or another mental health challenge, seeking professional support is a sign of strength—not weakness.
Research indicates that physician suicide most often results from a convergence of multiple risk factors, with untreated mental health conditions being a leading contributor. Resources are available. If you are struggling or think you might be, seek help. You are not alone.
Discussing self-care in a wellness conversation can feel misguided. Burnout in medicine is not the result of a lack of personal resilience or self-care but rather systemic issues such as leadership dynamics and increasing administrative burdens.
Yet, acknowledging systemic problems as the primary contributor to burnout does not negate the need for personal well-being. Medicine has long celebrated endurance—extreme work hours, sleep deprivation, and missed meals are often seen as badges of honor. But what if we applied the same scientific rigor and compassion to our own health that we bring to patient care? Individual wellness can begin with honoring our physiological and psychological needs and acknowledging that we too are humans who deserve care and
ing clinicians, recognizing everyday heroes, community advocates, and innovative leaders who have made a lasting impact on patient care. This initiative serves as a counterbalance to medicine’s problem-focused culture, offering moments of gratitude, awe, and recognition before we return to our demanding work.
Administrative burdens, particularly those related to the electronic health record (EHR), are among the top contributors to physician burnout. Recognizing this, SCVH adopted strategies from the AMA STEPS Forward Playbook and the work of Dr. Jane Fogg to streamline EHR flow and improve scheduling efficiency.
Our Enterprise Wellness Medical Staff Committee (EWMSC) now includes both our Chief Medical Information Officer and a wellness representative on the Technology Committee. Together, this team has:
• Redesigned message flow to reduce EHR inbox burden
• Enhanced EHR training to improve usability
• Explored AI-driven and team-based strategies to streamline digital tasks
Each intervention has led to a measurable reduction in administrative workload. Additionally, SCVH is now exploring AMA STEPS Forward scheduling strategies. A joint team of nursing and physician leaders will attend the biannual AMA Practice Innovation Boot Camp to co-develop actionable scheduling improvements and teamwork initiatives.
As Leonard Cohen reminds us in his song Anthem, “There is a crack, a crack in everything—that’s how the light gets in.” When engaging in systems change, it’s crucial to start small.
Early in this work, I attempted to “boil the ocean” with enthusiasm—an approach a wise AMA colleague cautioned against. Over time, I’ve learned that meaningful progress begins with a single small, actionable step that can be refined and expanded based on outcomes.
A prime example is the SCVH Mentorship Program. Research shows that mentorship is key to professional fulfillment in medicine. Our initial pilot in the Department of Pediatrics yielded significant positive outcomes, demonstrating the power of structured mentorship. This success allowed us to refine the program before expanding it system-wide, ensuring its sustainability and effectiveness.
Nationally, physician mental health and suicide rates remain alarming, necessitating urgent systemic action. At SCVH, we addressed this through a stronger partnership with Concern Health, expanding workplace support following difficult clinical events.
Leadership played a pivotal role in normalizing mental health care by sharing personal stories in public forums. For example, I openly discussed my experiences with coaching and using the 1-800 psychological first aid support line after a challenging on-call shift. Through intentional messaging, we introduced trauma-informed care principles, emphasizing the importance of thoughtful response over reactive decision-making.
Within this last year, Concern Health reported a doubling in engagement with mental health resources. We then expanded our mental health resource portfolio to include Marvin and better meet the mental health needs of all enterprise members. Marvin now offers on-demand, 24/7 psychological first aid support and affordable, advanced teletherapy to the over 13,000 healthcare workers in our system. The cultural shift is evident: staff members now regularly reach out to me with questions about mental health resources.
As our Wellness Task Force co-Leader, Dr. Gail Wright, wisely reminded me one day while I fixated on perfection before action—just take the first step.
Find one action from this conversation above or resources be-
low that resonates with you. Identify one “crack of light”—whether it’s a pilot program, a team walk, or a shared conversation—and begin.
Wellness is not an endpoint but a series of steps toward aligning healthcare with compassion, sustainability, and well-being. The opportunity to transform medicine in a way that honors the individuals who provide care is both urgent and achievable. Many of us are ready to walk this path together.
Reach out and take the first step.
CMA: California Medical Association Physician Wellness link. Call To explore partnering with CMA to provide physician wellness support, please call (800) 786-4262.
Consider Physician Coaching: Professional coaching may be an effective way to improve quality of life and resilience while decreasing emotional exhaustion in some physicians. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2740206 Dyrbye, L Shanafelt TD, Gill PR, Satele DV, West CP. Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians: A Pilot Randomized Clinical Trial. JAMA Intern Med.2019;179(10):1406–1414. doi:10.1001/jamainternmed.2019.2425
Mental health resources for physicians.
The National Alliance on Mental Health Santa Clara County
Branch offers links to national and local resources. https://namisantaclara.org/resources-2/crisis-support-3/
In a mental health crisis, call 9-1-1 and ask for mental health crisis team or 9-8-8* (for area codes 408, 650, or 699). For all other area codes, call 800-704-0900 and press 1 OR Text RENEW to 7417741 (crisis Text Line)
Books:
Battling Healthcare Burnout: Learning to Love the Job You Have, While Creating the Job You Love by Thom Mayer MD Mayo Clinic Strategies To Reduce Burnout: 12 Actions to Create the Ideal Workplace (Mayo Clinic Scientific Press) by ZStephen Swensen MD and Tait Shanafelt MD
Courses:
Stanford offers a 6 week interactive course for Physician Well-being Director Course through application. https://wellmd.stanford. edu/knowledge-hub/courses-conferences/directorcourse.html
Additional courses are offered through medical societies such as The American College of Lifestyle Medicine’s Physician and Healthcare Professional Well-beingAmerican College of Lifestyle Medicine or the American Academy of Family Practice. Check your own professional society for specialty specific offerings.
The AMA’s Practice Innovation Bootcamp This two-day, in-person AMA STEPS Forward® Innovation Academy boot camp is tailored for clinical and operational change leaders working together to o reduce inefficiencies and create more time. It offers hands-on strategies and expert insights, to streamline workflows, enhance professional fulfillment, and improve patient care. https://www. ama-assn.org/member-benefits/events/september-2025-practice-innovation-boot-camp
Meetings:
APCH and ICPH: The American Conference on Physician Health (ACPH) is a collaborative scientific event hosted by the American Medical Association, Mayo Clinic, and Stanford Medicine. It is committed to enhancing professional satisfaction and addressing burnout. The theme for this year, “Inspire, Innovate, Implement: Systemic Solutions to Strengthen Physician Well-Being,” emphasizes the development of lasting improvements within the healthcare system to support physician well-being. https:// www.physician-wellbeing-conference.org/. The ICPH https:// www.international-conference-physician-health.org/ is held in alternate years and includes the Canadian Medical Association, British Medical Association.
National organizations offering Wellness Resources, Roadmaps, and Recognition
AMA STEPS Forward® is an open-access resource that offers physician-developed strategies to help prevent physician burnout, create the organizational foundation for joy in medicine, and improve practice efficiency. https://edhub.ama-assn.org/steps-forward
The National Academy of Medicine’s (NAM) National Plan for Health Workforce Well-Being plan offers a framework of priorities with actionable tasks to create action plans for hospital systems that align with available resources. https://nam. edu/our-work/key-issues/health-workforce/ The National Academy of Medicine Clinician Well-Being Collaborative is a network of leaders and representatives of many major health professional organizations and health systems across the United States. The Collaborative has convened, published, and shaped the national conversation to advance three goals: raise the visibility of clinician anxiety, burnout, depression, stress, and suicide; improve baseline understanding of challenges to clinician well-being; advance evidence-based, multidisciplinary solutions to improve patient care by caring for the caregiver. Visit their website to join the newsletter and access publications on this topic. https:// nam.edu/our-work/programs/clinician-resilience-and-well-being/
The CHARM-Arnold P. Gold Foundation Charter on Physician Well-Being published in the Journal of the American Medical Association (JAMA), is a landmark document designed to guide groups and individuals to effectively support physician well-being. The document reflects that effective patient care both promotes and requires physician well-being; physician well-being is inter-related with the well-being of all members of the health care team, and physician well-being is a quality marker for effective and efficient health systems. https://jamanetwork.com/journals/jama/ article-abstract/2677478
NIOSH (National Institute for Occupational Safety and Health) published an Impact Well-being Guide: Taking Action to Improve Healthcare Worker Wellbeing. The Guide is designed to help hospital leaders improve professional wellbeing work in their hospitals at the operational level. https://www.cdc.gov/niosh/ docs/2024-109/
Dr. Lorna Breen Heroes’ Foundation offers resources to help remove stigmatizing language from licensing and credentialing applications to decrease the stigma of accessing mental health support. The foundation envisions a future where seeking mental health support is universally recognized as a sign of strength for healthcare workers. https://drlornabreen.org/
The Canadian Medical Association wellness approach focuses on physical, psychological and cultural safety. It offers resources that advance and support safety throughout all aspects of practice and learning environments for health care workers. http://www. cma.ca
The AMA’s Joy In Medicine Healthcare System Recognition program The Joy in Medicine™ Health System Recognition Program helps health systems reduce burnout and foster well-being, allowing both physicians and patients to flourish. It offers guidelines in a clearly delineated task based roadmap format for health system leaders who aim to implement programs and policies that support well-being and potentially qualify for national recognition through the Joy In Medicine Program. https://www.ama-assn.org/ practice-management/physician-health/joy-medicine-health-system-recognition-program
sacredness of healing, or the communal bonds that medicine has historically fostered.
This shift is not new. During the Enlightenment, the rise of reason and science was accompanied by criticism of religious authority and rejection of dogma and superstition. Religious explanations of suffering and healing were supplanted by empirical evidence and mechanistic views of the body.
In contrast, the post-Enlightenment Romantics argued for a more comprehensive understanding of the human experience, one that included considerations of man’s spiritual aspirations, emotional depths, and artistic creativity. In the words of philosopher Richard Tarnas, “God was rediscovered in Romanticism—not the God of orthodoxy or deism, but of mysticism, pantheism, and immanent cosmic process; not the juridical monotheistic patriarch, but a divinity more ineffably mysterious, pluralistic, all-embracing, neutral or even feminine in gender; not an absentee creator but a numinous creative force within nature and within the human spirit.”
Columnist David Brooks describes spirituality as an irresistible attraction to something greater than ourselves: “Some drives are caused by a void. But others are caused by an attraction… Sometimes I feel pulled by a goodness that seems grand and far-off, a divine luminosity that hovers over the far horizon.” Medicine, at its best, offers such a pull. The most fulfilled physicians are not merely completing tasks or earning a paycheck; they are alleviating suffering, restoring hope, and forming sacred bonds with their patients.
An old story speaks to this need for meaning. Three masons were asked what they were doing. The first replied bitterly, “I’m just cutting stones.” The second, with a bit more satisfaction, said, “I’m earning a living for my family.” But the third, radiant with purpose, answered, “I’m building a cathedral where people will come for generations, seeking hope and healing in times of trouble.”
Physicians, like these masons, have a choice in how they frame their work. Are they merely treating diseases? Are they performing tasks to earn a living? Or are they fulfilling a sacred calling, participating in a tradition of healing that stretches back through history?
Physicians are particularly vulnerable to burnout due to their perfectionism, self-reliance, sensitivity to criticism, and reluctance to seek help. Under stress, they often default to fight-or-flight responses or disengagement. When subjected to what Buddhist philosopher Nichiren Daishonin described
as the “eight winds of the world” (prosperity/decline, honor/ disgrace, praise/censure, and pleasure/suffering), their usual rational problem-solving methods may fail, leaving them feeling abandoned by the thinking that once guided them.
Hitting rock bottom can shatter a physician’s perspective, revealing their limitations not as failures, but as doorways to transformation. Franciscan priest Richard Rohr describes this moment as grace in disguise—an invitation to surrender and step into a deeper, more authentic way of being. With this new lens, spiritual truths are no longer dismissed as irrational; they are seen as transrational—beyond reason, and profoundly real.
When burnout leaves physicians feeling adrift without clarity, Buddhist practices offer a healing path. Cultivating loving-kindness, compassion, joy, and equanimity builds resilience beyond logic alone. Twelve transformative actions— mindfulness, patience, morality, reverence, humility, generosity, curiosity, intelligence, wisdom, creativity, vitality, and inspiration—help restore purpose and balance. Rather than grasping for answers, physicians learn to rest in awareness, accept impermanence, and develop the emotional strength to continue their work with clarity and heart.
Christianity sees medicine as part of Christ’s healing ministry, framing caregiving as a privilege and calling. Grace, humility, and sacrificial love (agape) inspire deep compas-
sion while guarding against burnout. Prayer, reflection, and worship renew physicians, helping them reconnect with their purpose and find peace in contributing to something greater. Embracing Sabbath and rest teaches balance between service and self-care.
Hinduism
Hindu philosophy views selfless service (seva) as a path to spiritual fulfillment, aligning medicine with dharma (duty) and karma yoga (action without attachment). Physicians embracing this see their work as both moral responsibility and spiritual practice. Meditation, chanting (japa), and breathwork (pranayama) help manage stress, while ahimsa (non-harming) fosters self-compassion, reminding physicians that self-care is as essential as caring for others.
Islam
Islam emphasizes Tawakkul (trust in God) and service (khidma) as spiritual duties. For physicians, this fosters resilience, reminding them that healing ultimately rests with a higher power. Prayer (Salah), fasting, and charity (Zakat) cultivate discipline, patience, and compassion, helping physicians stay centered amid medical pressures. Grounding their work in faith and surrender, Muslim physicians find solace knowing healing is not solely their responsibility.
Judaism
Jewish spiritual practice fosters well-being and resilience by nurturing purpose, mindfulness, and community. Shabbat encourages detachment from work, allowing physicians to recharge. Prayer and reflection inspire gratitude and humility, reinforcing the sacredness of healing. Ethical teachings
like tikkun olam (repairing the world) and “Whoever saves a single life…saves the whole world” provide deeper meaning. A strong communal support system strengthens physicians personally and professionally.
Beyond religion, many physicians find renewal in mindfulness, gratitude, nature immersion, and creative expression. These cultivate interconnectedness, reminding them they are part of a larger whole. Rituals like journaling, meditation, or quiet reflection offer stillness amid chaos. Some draw from ancestral wisdom, energy healing, or Stoicism for resilience and ethical grounding. Spirituality—religious or secular—helps physicians transcend daily struggles and rediscover meaning in their work.
The soul of medicine is not lost; it is waiting to be rediscovered and rekindled in the hearts of those who feel the call to heal. To heal the epidemic of physician burnout, we need to pause, step back, and reflect deeply, looking beyond operational efficiency, workload, and standard wellness habits. To reclaim medicine’s true meaning, we must remember that healing is not just a job but a vocation, an act of service, and even a form of worship.
The good news is that no physician needs to walk this path alone. A wide range of spiritual perspectives and practices provide spaces for reflection, communities of support, and reminders of the sacred nature of our work. If you want a spiritual mentor to show you the way, look to your colleagues who are navigating their careers with faith-based resolve, purpose, and peace. Their luminous presence may be the guiding light that helps you reconnect with your own spiritual awakening.
For many physicians, exploring spirituality may feel like a daunting leap. But great transformations often demand bold new ways of thinking and being. Just as medical pioneers have repeatedly defied convention to revolutionize healing, we too must push beyond the limits of what we believe is possible. The well-being of our healers is not just a luxury; it is an existential imperative. Without physicians who are whole, the very lives they seek to save are at risk. If we reimagine medicine as a practice that nourishes both body and spirit, we will not only restore our physicians but also safeguard the future of healthcare, preserving its soul for generations to come.
Dr. Chuck welcomes your thoughts and comments. He can be reached at john.chuck@cnsu.edu
APPNA Community Health Center (ACHC) of the SF Bay Area is a safety-net clinic dedicated to providing high-quality, free healthcare services to underserved individuals in our community. We strive to offer care in a culturally sensitive and compassionate environment, ensuring that no one is denied medical attention due to their age, gender, race, religion, or financial status.
The journey of ACHC began with a vision to serve. A small group of passionate volunteers from the APPNA Northern California chapter came together with a shared dream of providing free medical care to those in need. The idea took root and became a reality during one of the most challenging times—the COVID-19 pandemic. ACHC officially launched in the state of California on Dec 6th, 2020.
We started with virtual clinics with a handful of physicians and volunteers, seeing patients in a limited capacity. But through dedication, hard work, and an unwavering commitment to our mission, ACHC has grown into a flourishing community clinic, supported by a team of 50+ volunteers, including physicians from Kaiser Permanente, Palo Alto Medical Foundation, University of California San Francisco, Stanford, and other leading healthcare institutions. Our providers are also covered for malpractice insurance and supplied scribes to better facilitate documentation. We currently offer both in person and virtual visits during our clinic hours.
We are proud to have built a clinic that provides essential healthcare services to disadvantaged individuals who do not have the means to get medical attention.
At ACHC, we believe that healthcare is a basic human right. Our clinic primarily serves:
• Uninsured and underinsured individuals who cannot afford private healthcare.
• Patients from diverse ethnic, cultural, and socioeconomic backgrounds facing barriers to medical care.
• Recent immigrants and refugees who may not have access to affordable healthcare options.
• Non-English-speaking individuals who benefit from our
interpreter services.
• Low-income families and individuals struggling with chronic conditions requiring regular medical attention.
We take pride in being a judgment-free, inclusive, and patient-centered clinic, where every individual is treated with dignity and respect.
One of the cornerstones of ACHC is our commitment to diversity and inclusive leadership. Our executive committee and board are led by strong women leaders who bring passion, expertise, and a commitment to serving the community.
We believe in fostering an environment where women in healthcare take on leadership roles, driving impactful change and ensuring that our clinic continues to thrive and expand its services.
ACHC thrives because of our dedicated volunteers, who come from various backgrounds and bring their unique skills to serve the community. Our volunteer team includes:
• Physicians, specialists, and healthcare professionals from leading medical institutions.
• Medical students, residents, and fellows gaining handson experience in community healthcare.
• Operations, administrative and technology support also play a critical role in managing the logistics, systems, and infrastructure needed for the clinic to function smoothly.
• High school and college students interested in healthcare, public service, and volunteerism.
Our youth volunteer program provides students with valuable exposure to the medical field while instilling in them the importance of giving back to your community.
At ACHC, we are committed to eliminating financial barriers to healthcare by providing essential medical services at no cost. Our current services include:
• General Primary Care & Preventive Medicine
Our physicians provide routine checkups, chronic disease management, and preventive screenings, ensuring our patients receive continuity of care.
• Basic Lab Testing
We offer free laboratory tests for common conditions, allowing early detection and management of diseases.
• Physical Therapy Services
Our clinic provides free physical therapy sessions to help patients recover from injuries and improve mobility.
• Medications & Imaging Services
We offer select free medications and imaging for patients who require additional diagnostic support.
• Telemedicine & EMR Integration
We have fully incorporated Electronic Medical Records (EMR) and telemedicine platforms, enabling us to provide virtual consultations and continuity of care for patients unable to visit the clinic in person.
• Multilingual Interpreter Services
To ensure accessibility for all, we provide interpreter services for non-English-speaking patients, making healthcare more inclusive.
ACHC is a member of National Association of Free and Charitable Clinics (NAFC) and a 501(c)3 registered organization. We are currently offering all pre-booked telephone and video appointments during our clinic hours. Our clinic is open Sunday’s, 9am to 1pm.
We encourage our patients to make an appointment, but are able to see walkin patients if space permits.
Medical consultations are being provided by licensed physi-
cians for common primary care non emergent illnesses (such as diabetes, hypertension, hyperlipidemia, asthma, etc.) and behavioral health conditions (such as depression, anxiety, etc.) to adult patients (18 years and older). We are continuing to foster partnerships with local community organizations and clinical services vendors to best support the needs of our patient population.
Beyond medical care, ACHC is dedicated to community outreach and education, addressing health disparities in the Bay Area. Some of our initiatives include:
• Homeless Healthcare Clinics – Providing basic medical care, hygiene kits, and health screenings to individuals experiencing homelessness.
• Flu Vaccination Clinics – Offering free flu shots to help prevent seasonal influenza outbreaks in vulnerable populations.
• Health Education & Awareness Programs – Conducting workshops and seminars on diabetes management,
Climate change has dramatic ramifications for human health, with varying implications for various demographic groups. Physicians can no longer ignore the implications of climate change to the health of their patients This webinar will review the fundamentals of climate change impacts to human health, how physicians can relate these implications to direct patient care, how physicians can advocate to policymakers to reduce adverse impacts on patient populations, what healthcare can do to reduce its contribution to climate change, and specific concerns to patients in the Bay Area Panelists and physicians will have an open conversation about all of these issues and how be a local climate champion, contributing to the solution.
Speakers:
Rupa Basu, MPH, PhD
Bruce Bekkar, MD
Nate DeNicola, MD
Tuesday April 22 (Earth Day)
Time 6:00 PM - 7:00 PM
Plant-based diets are the key to preventing, treating and even reversing chronic illnesses like obesity, diabetes, and heart disease. The majority of physicians receive fewer than 20 hours of nutrition education during their entire medical education. In this webinar, we will share techniques and best practices for effectively communicating with patients about the intersection of our environment, our food, and our health, and about how food can be medicine for many different conditions Join us for this compelling webinar and learn how you and your patients can be part of the solution for a healthier more sustainable world, by shifting to a plantbased diet.
Ulka Agarwal, MD, is a psychiatrist at California State University, Eas Bay, where she has led plant-based nutrition education programs fo students, staff, and faculty She has conducted clinical trials examining the effects of plant-based diets on mental and physica health, and enjoys educating patients and colleagues on the benefits of plant-based diets for human and planetary health.
Tamiko Katsumoto, MD, is a Clinical Associate Professor in the Division of Immunology and Rheumatology at Stanford University. She is passionate about educating her patients and colleagues on the merits of sustainable plant-rich diets as a strategy to both improve individual health and mitigate climate change and environmental degradation. She is involved in several clinical trials at Stanford and has spent time at Genentech, where she led several global clinical trials in immunology
For Dr. Reena Bhargava being part of the SCCMA is more than just a professional membership—it’s about making an impact. “I joined SCCMA to be a part of the healthcare community, one that has a significant influence on the well-being of our patients and our local and global communities. It’s about connecting with colleagues who share the same passion for improving health outcomes and being part of something bigger than us.”
Dr. Bhargava is an Internist and Clinical Professor with the Institute of Medical Educators, at Kaiser Permanente. Throughout her career, Dr. Bhargava has been guided by a simple but profound piece of advice: “Stay laser-focused on your patient’s clinical needs and care experience.” This mantra has kept her grounded in her mission to provide the best possible care, regardless of the challenges that arise. She also added, “Taking care of my elderly patients - I’m deeply humbled by the amount of trust they have for my advice.”
The accomplishment that she is most proud of is leading the development of Electronic Visits (E-visits) with an excellent interface for patients. It is a decision support tool, which is clinically safe and efficient, (Patient e-Visit Use and Outcomes for Common Symptoms in an Integrated Health Care Delivery System. Reena Bhargava, MD1; Gregg Gayre, MD2; Jie Huang, PhD3; et al. JAMA Netw Open. 2021;4(3):e212174).
Looking toward the future of healthcare, Dr. Bhargava shares, “AI as being the biggest opportunity and biggest challenge in the near future. Our healthcare community has to be part of the workforce that ensures responsible and expedient deployment of AI to support the wellbeing of patients.”
Outside of her demanding role as a physician, Dr. Bhargava makes time for her personal interests, including reading and volunteering, and enjoys listening to music—particularly the works of Sting, her favorite artist. If she was not a physician, she would have pursued a degree in Art History.
Dr. Bhargava’s journey as a physician exemplifies the dedication and resilience that women in medicine bring to the table every day. On National Women Physicians Day, we celebrate her and the countless women who continue to shape the future of healthcare with their expertise, compassion, and leadership.
Christine Doyle, MD Vice President of External Affairs
2025 has started with a bang -- and not in a good way. Why? Confusion.
The federal landscape has been changing dramatically and drastically, on a daily basis. People are frustrated, as the rules keep changing, and there are a lot of unintended consequences.
As I write this, just after the President’s Day holiday weekend, President Trump has signed 65 executive orders in his first month in office. Of those orders, an ever-changing number have been stayed or had a temporary restraining order (TRO) issued by a court, often citing that the order is illegal.
For comparison, President Biden signed a total of 162 executive orders in his entire four year term, 32 in his first month in office. 67 of those (41%) have been revoked by President Trump. President Trump in his first term signed 220; 12 in his first month in office. 72 of those (33%) have been revoked, including the 2020 executive orders 13942 (against TikTok) and 13943 (against WeChat). President Obama signed a total of 276 executive orders in his 8 years in office, and only 16 in his first month in office1
Between the various executive orders, and the disruption caused by the Department of Governmental Efficiency (DOGE) seemingly random firing or dismantling entire departments and divisions, it is nearly impossible (and a fulltime job) to keep up with the day-today changes. Healthcare has not been excluded.
Over the weekend, thousands of Department of Health and Human Services (HHS) employees, considered “probationary” (in their first year of employment, although many were previously contractors), were fired. Staff at the Palo Alto VA were affected as well as all other VA facilities. This also affected physicians and other health professionals at the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), Centers for Medicare and Medicaid Services (CMS), Substance Abuse and Mental Health Services Administration (SAMHSA), and Indian Health Service (IHS). The Indian Health Service firings were rescinded by the Secretary of HHS.
‘CAUSE I CAN’T PRETEND IT’S OK WHEN IT’S NOT, IT’S DEATH BY A THOUSAND CUTS.’ -TAYLOR SWIFT
The newly approved Secretary of Health and Human Services, Robert F. Kennedy, Jr, remains an enigma. Significant concerns about public health, particularly vaccines, remain unanswered2. He has indicated that he wants to focus on chronic disease, which is generally a positive for both individual and societal reasons, but the details are not yet clear. The AMA and other national societies are waiting to see where this is all going.
Information routinely provided by the CDC and National Institute of Health (NIH), including the Morbidity and Mortality Weekly Report (MMWR) were
Climate change is here, and physician engagement is imperative. The devastating fires in Los Angeles this January represent just one example of our evolving planetary crisis: 37,000 acres burned, 29 deaths, and an estimated $250 billion in damages. The fire was fueled by Santa Ana winds and extreme drought following the area’s hottest summer in at least 130 years (1). These statistics fail to capture the human toll: tens of thousands displaced from their homes, lives disrupted, schools closed, hospitals on evacuation notice, medical clinics shuttered, and the terror faced by those forced to flee. Beyond increases in wildfire severity (2), climate change is causing severe weather, decreased air quality, and record-setting heat waves. Locally, Santa Clara County saw the hottest week on record in October 2024, and the September 2022 heatwave caused power outages and care disruptions in three local hospitals.
Why is physician engagement required?
Identified by the World Health Organization (WHO) as the greatest global healthcare threat facing the world in the 21st century, the climate crisis is increasingly understood to be a health crisis. In 2021, the NEJM together with 220 health care journals worldwide simultaneously published an editorial calling for emergency action to limit global temperature increases below 1.5 degrees Celsius, restore biodiversity, and protect health (3). Subsequently, the AMA adopted a policy declaring climate change a public health crisis, advocating for policies that limit global warming, reduce US greenhouse gas emissions, and support climate resilience (4). Our changing climate is projected to have increasingly deleterious effects on human and planetary health. Given the threat to those we are pledged to serve, our engagement in the climate crisis is squarely in our lane as physicians. This article outlines climate change-associated health effects and opportunities for physician involvement, and spotlights recent grassroots efforts of Valley Medical Center SCCMA members towards meaningful climate action.
children, pregnant persons, the elderly, people experiencing homelessness, disabled persons, and persons of color—in short, the patients that many of us care for daily (5).
Severe Weather. In 2024, there were 27 ‘billion-dollar’ severe weather events in the US—the second highest total ever (6). These result in event-related injuries and deaths, increased infectious diseases, water and air quality hazards, PTSD, depression and anxiety. Indirect effects include disruptions to healthcare delivery, treatment delays including surgical and oncologic care, and reduced access to essential medications.
Extreme Heat. Higher temperatures are associated with adverse pregnancy and birth outcomes, increased emergency room visits and hospitalizations, heat exhaustion and heat stroke, elevated cardiovascular and respiratory morbidity, nephrolithiasis, renal failure, and increased suicidality, aggressive behavior, and violence. Risks are highest for outdoor workers, those without access to cooling, and patients on certain medications such as antipsychotics, B-blockers, and diuretics (7).
PHYSICIANS ARE AMONG THE MOST TRUSTED VOICES IN THE US AND CAN LEVERAGE THEIR MEDICAL EXPERTISE TO BE LEADERS IN THIS SPHERE
Reduced Air Quality. Worldwide, air pollution is estimated to cause over 7 million premature deaths annually (8). Combustion of fossil fuels is both a major cause of air pollution and produces greenhouse gas emissions that drive global warming. Climate change is itself increasing ground-level ozone and particulate matter in some locations (9). More severe wildfires further worsen air pollution, erasing approximately 50% of the gains made by the Clean Air Act in many western states (10). Air pollution is associated with increased emergency department visits and hospitalizations, exacerbation of COPD, asthma, ischemic heart disease and CVA, negative birth outcomes, ADHD, dementia, and cancer risk. Respiratory health is further impacted by longer and more intense pollen seasons, worsening allergic airway disease.
How does climate change affect health?
Climate change has many effects on human health; selected topics are discussed below. While all people are at risk, under-resourced individuals face disproportionate harms, particularly those with underlying chronic medical conditions,
Mental Health. Beyond acute effects, climate change can cause chronic stress and eco-anxiety. In a recent national survey, 64% of Americans are at least ‘somewhat worried’ about global warming (11). In a separate survey of US adolescents, nearly 60% reported anxiety about climate change, feeling sad, anxious, angry and powerless, and 26% indicated these feelings negatively affect their daily functioning (5). Eco-anxiety treatment encourages inner resilience, taking action, joining groups and connecting with nature (12).
Addressing climate change falls within our ethical responsibility as physicians. But the problem can feel overwhelming, and few of us feel empowered to engage. The good news is that there are many ways to contribute, leveraging our roles as healthcare professionals. For those of us with eco-anxiety, taking action supports personal wellness and self-efficacy.
Education Physicians are smart people committed to lifelong learning. Understanding how climate change is affecting our patients is key to keeping them safe and healthy, as noted in the AMA’s policy on Climate Change Education (12). Groups such as the Medical Society Consortium on Climate & Health (MSCCH) and Health Care Without Harm offer many educational resources. California-based Climate Health Now welcomes new members and has speakers that are available to give presentations.
Climate-informed Patient Care. Educating patients about the links between climate and health builds their resilience and helps to build social will for climate action. Counseling at-risk patients regarding hazards like air quality and heat are key to anticipatory guidance; patient-appropriate flyers are available at MSCCH-resources/patients. Recommending that patients adopt cleaner transport (walking, biking), home energy efficiency to reduce in-home air pollution, and plant-forward diets with reduced red meat consumption are better for patient health, and benefit planetary health by reducing our carbon footprint. Physicians can lead by example by incorporating these recommendations into their personal lives. Additional impactful work strategies include effective resource stewardship, such as minimizing low-value care and harmful waste, and stressing preventive care, as medical care delivery itself has a large environmental impact.
Advocacy. Physicians are among the most trusted voices in the US and can leverage their medical expertise to be leaders in this sphere (14). Discussing the intersection of climate and health with friends, family, colleagues, and office staff, or posting online, is a great start. Joining a group such as Climate Health Now offers support and amplifies the potential for meaningful action, whether that action is greater sustainability, patient resilience materials, climate-informed patient care, or political advocacy for measures such as the Polluters Play Climate Superfund bill. Finding likeminded individuals in your workplace can promote grassroots climate efforts, as illustrated below.
Following the launch of the federal health sector climate pledge in 2022, several physicians at VMC were motivated to act. Despite no prior expertise with climate change advocacy, they mobilized over 300 healthcare providers to sign a petition in favor of the pledge which required commitment to greenhouse gas reduction targets, an institutional carbon inventory, and a climate resilience plan with particular attention to those at disproportionate risk. An invitation followed to present to leadership: not only was this kind of commitment ethical and the right thing to do, it also supported the mission of “Better Health for All,” Equity and Quality/Safety initiatives, and resource stewardship goals.
Santa Clara Valley Healthcare, which includes VMC as well as O’Conner and Saint Louise Regional hospitals and multiple clinics, signed the pledge in 2023, and formed the institution-wide Climate Action Collaborative. Physicians serve within workgroups including the OR Green Team, Ambulatory Climate Group, Climate Resilience, Waste, Healthy
The Santa Clara County Medical Association (SCCMA) hosted the 46th annual awards gala on Friday, January 10. This year, we took our Annual Awards Gala to a whole new level by hosting the event at the stunning Ameswell Hotel. Situated in the heart of Mountain View, the Ameswell Hotel perfectly captured the spirit of innovation and elegance. From its sleek, modern design to its world-class amenities, this venue provided the perfect backdrop for an unforgettable evening of celebration and recognition.
The Annual Awards Gala brings together SCCMA leadership, members, supporters, advocates, and partners to introduce our new president, Fahd Khan, MD and to celebrate the accomplishments of our outgoing president, Gloria Wu, MD, as she takes on her new role of California Medical Association (CMA) Board of Trustee for District VII. This year, the Annual Awards Gala brought together over 200 guests, celebrating the outstanding individuals and organizations that have made a lasting impact in our community.
From inspiring speeches to heartfelt recognitions, we honored the dedication, passion, and leadership that drive positive change in the medical field. CMA president-elect, René Bravo, MD was the guest speaker of the night. Dr. Bravo is past president of San Luis Obispo County Medical Society, where he also served on its Governing Board and chaired the Physician Wellness Committee for 10 years. Dr. Bravo is a primary care pediatrician who has been serving families and children on the Central Coast for 38 years. He is the founder
and President of Bravo Pediatrics, a 5-physician single specialty group practice where he is the managing partner. Other special guests include California State Assemblymember Patrick Aherns, Santa Clara County Supervisor Sylvia Arenas, and Santa Clara County Supervisor Margaret Abe-Koga.
The night was filled with fun, laughter, and dancing! This event was a beautiful reminder of the power of coming together. A big thank you to all of our supporters, donors, volunteers, and honorees who make our mission possible. We couldn’t have asked for a better venue to honor the incredible individuals and organizations making a difference in our community. A huge thank you to Ameswell Hotel for partnering with us and helping make this night truly special for over 200 guests. Here’s to new beginnings, new spaces, and continued success in the years to come!
To access photo album, please visit the link or scan QR code: https://www.raysyphotography. com/f790646645
Passcode: sccma2025
The Awards Gala gives us the opportunity to highlight distinguished individuals who are making a different in medicine and their communities.
Congratulations to all our award recipients, and a special thank you to our guests for joining us in celebrating their hard-earned achievements.
The Ameswell Hotel is a newly developed hotel that incorporates sustainability, luxury, and innovation into the design inspired by NASA’s Ames Research Center. With putting sustainability first, the Ameswell takes pride in being the “greenest” hotel in Silicon Valley with solar panel powering and eliminating 96% of single-use plastic on premises.
Raffle prizes were given throughout the night
2024 SCCMA President, Gloria Wu, MD delivers her outgoing presidential speech, giving recognition
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We recognize the future earning potential of medical professionals like you and we make it easy to qualify.
• We will exclude monthly payments on 12 month deferred student loans from your qualifying ratio
• We will allow gift funds from relatives for your down payment
• Income from future employment or salary increases can be considered
• You can buy with a down payment as low as 3% of the purchase price
• We even can help those with a low FICO score
CMA has published a new chapter on Federally Qualified Health Centers (FQHCs) in its flagship California Physicians Legal Handbook (CPLH). CPLH is the premier legal resource for California health care law, offering more than 5,500 pages of comprehensive legal information including current laws, regulations and court decisions affecting health care all in a digital handbook.
Physicians for a Healthy California (PHC), the charitable arm of the California Medical Association, recently announced over $30,000 in MedStudentsServe awards to support medical student projects across the state that will enhance the health and well-being of California’s communities.
The 13 medical student organizations and groups awarded in this cycle will support projects ranging from mobile clinics providing critical care to underserved communities, vision screenings for the unhoused, trauma-informed services for survivors of violence, and preventative health fairs tackling chronic disease, to initiatives improving indigenous health literacy and humanitarian aid.
CMA’s legislative prior authorization reform package would implement common-sense reforms to streamline the prior authorization processes, expedite critical care for patients and free up physicians’ time to focus on patients, not paperwork. The legislative package includes: AB 510 (Addis), AB 539 (Schiavo), AB 512 (Harabedian), and SB 306 (Becker).
The active wildfires in Southern California have destroyed thousands of homes, structures and medical practices, as well as displaced thousands of residents and your physician colleagues. In response, the CMA and PHC have launched this donation page to support impacted physicians and their practices.
Donations to the Disaster Relief Fund will be used to reestablish the delivery of medical care to areas of California affected by disasters by providing physicians who are victims of disasters with financial assistance to help restore their medical practices. Donate at: https://phcdocs. org/relief
CMA will host its 51st annual Legislative Advocacy Day on April 9, 2025, in Sacramento. CMA’s Legislative Advocacy Day consistently brings together more than 400 of physician and medical student leaders from all specialties and modes of practice. Attendees will have the opportunity to meet with legislators on priority health care issues. Attendees can expect to get handson experience and learn the nuts and bolts of advocating for their patients and profession.
Register Today! SCCMA will once again provide a free bus to Sacramento. If you are interested in riding on it email emily@ sccma.org.
What it means for doctors and their patients and how to get involved
Date: Tuesday, April 22 (Earth Day)
Location: Zoom
Time: 6:00 PM – 7:00 PM
Registration: FREE
Presenter: Nathaniel DeNicola MD, Bruce Bekkar MD, Rupa Basu PhD
Climate change has dramatic ramifications for human health, with varying implications for various demographic groups. Physicians can no longer ignore the implications of climate change to the health of their patients. This webinar will review the fundamentals of climate change impacts to human health, how physicians can relate these implications to direct patient care, how physicians can advocate to policymakers to reduce adverse impacts on patient populations, what healthcare can do to reduce its contribution to climate change, and specific concerns to patients in the Bay Area. Panelists and physicians will have an open conversation about all of these issues and how be a local climate champion, contributing to the solution. We welcome your ideas.
To register for any of these events, please visit www. sccma.org or scan the QR code
Date: May 6 – May 7
Location: San Diego, CA
The CMA’s third annual Health Information Technology (HIT) Summit will take place May 6-7, 2025, in San Diego. California’s premier health IT event will bring together thought leaders, innovators and health care professionals to explore the intersection of health care technology under the theme “Building the Future.”
As health care continues to evolve through digital innovation and the rise of artificial intelligence (AI), the HIT Summit will offer a deep dive into the tools, strategies and partnerships shaping the industry. Attendees can expect engaging sessions on AI, health information exchange and Qualified Health Information Organizations (QHIOs), and the evolving role of technology in patient care.
This event provides an opportunity for physicians, executives, advocates and allies to find community, engage in hands-on trainings and workshops, and hold in-depth conversations about how they are addressing the issue of health equity in California through their care of underserved communities throughout the state.
Attendees will leave feeling energized and inspired to continue their important work to improve the lives of all Californians. More information coming soon.