Summer 2023

VOL . 74 N O.2 Su mme r 2 0 23

Did you know that 69% of patients won’t consider a healthcare provider with an average online rating under 4.0?*

What are your patients saying about you?

If you’re not managing your online reputation, your patients are doing it for you!

Visit www.CAPphysicians.com/online or scan the QR code.

*PatientPop 4 Steps to Improve your Google Reviews Star Rating https://www.patientpop.com/blog/4-steps-to-improve-your-google-reviews-star-rating/

Request your free copy of How to Build and Manage a Sterling Online Reputation and take control of your practice’s digital presence. You’ll learn how to: • • • • •

Claim and build your online profiles Manage patient reviews Optimize your practice website Implement social media best practices And more!

Medical professional liability coverage is provided to CAP members through the Mutual Protection Trust (MPT), an unincorporated interindemnity arrangement organized under Section 1280.7 of the California Insurance Code.

Join America’s leader in occupational health

Take your career where you want it to go.

540 medical centers and 150+ onsite clinics nationwide.

Unlimited opportunity.

• Choose where to take your career, from patient care to medical leadership • Work normal business hours with no on-call • Focus on patient care - we’ll handle the paperwork • Contribute to the future of workplace health & safety

Email Concentra_Careers@Concentra.com for more information. ©2023 Concentra, Inc. All rights reserved.

042623

ADPHYSDINCAQ2

816 21st Street • Sacramento, California 95811 www.familydocs.org Phone (415) 345-8667 • Fax (415) 345-8668 E-mail: cafp@familydocs.org

Officers and Board

Staff

President Raul Ayala, MD, MHCM

Lisa Folberg, MPP Chief Executive Officer lfolberg@familydocs.org

Immediate Past President Lauren Simon, MD, MPH, FAAFP President-elect Alex McDonald, MD, FAAFP Speaker Anthony "Fatch" Chong, MD Vice-Speaker Kim Yu, MD, FAAFP Secretary/Treasurer Brent Sugimoto, MD, MPH, FAAFP Chief Executive Officer Lisa Folberg, MPP Foundation President Ron Labuguen, MD, FAAFP AAFP Delegates Lee Ralph, MD Michelle Quiogue, MD AAFP Alternates Lisa Ward, MD, MPH, FAAFP Shannon Connolly, MD, FAAFP CMA Delegates Kimberly Buss, MD Felix Nunez, MD Sumana Reddy, MD, FAAFP Kevin Rossi, MD, FAAFP CMA Alternate Delegates Raul Ayala, MD, MCMH Noemi Doohan, MD, PhD Adia Scrubb, MD, MPP David Tran, MD

Karen Alvarado Advocacy Assistant kalvarado@familydocs.org Anita Charles Program Assistant acharles@familydocs.org Morgan Cleveland Manager of Operations & Governance mcleveland@familydocs.org Jerri Davis, CHCP Vice President, Professional Development, CME/CPD lisenberg@familydocs.org Laurie Isenberg Director of Education and Professional Development jdavis@familydocs.org Christine Lauryn Manager, Member Communications clauryn@familydocs.org Josh Lunsford Vice President, Membership & Communications jlunsford@familydocs.org Pamela Mann, MPH Executive Director, CAFP Foundation pmann@familydocs.org Catrina Reyes, Esq. Vice President, Policy and Advocacy creyes@familydocs.org Jonathan Rudolph Manager, Finance jrudolph@familydocs.org Tiyesha Watts Legislative & Policy Advocate trwatts@familydocs.org

Brent Sugimoto, MD, Editor Josh Lunsford, Managing Editor The California Family Physician is published quarterly by the California Academy of Family Physicians. Opinions are those of the authors and not necessarily those of the members and staff of the CAFP. Non-member subscriptions are $35 per year. Call 415-345-8667 to subscribe.

4

California Family Physician Summer 2023

pcipublishing.com Created by Publishing Concepts, Inc. David Brown, President • dbrown@pcipublishing.com 800.561.4686 ext 103 For Advertising info contact Michelle Gilbert • 800.561.4686 ext 120 mgilbert@pcipublishing.com

EDITION 46

Su mme r 2 0 23

features POP! CELEBRATING THE SPECTRUM OF FAMILY MEDICINE 16 What is POP? 18 Welcome to Newport Beach

Susan Glockner, MD,FAAFP

20 Careers Will Change: Medicine, Transition, and You 21 Building Physician Confidence in Providing Medication for Opioid Use Disorder (MOUD) 26 Dr. David Bazzo Awarded the 2023 Family Physician of the Year Award 28 Interview with Dr. Raul Ayala

departments 6 Editorial

Family Docs Need Love Too

Brent K. Sugimoto, MD, MPH, AAHIVS, FAAFP

8 Immediate Past President's Message: Challenge Accepted 10 Political Pulse

Governor’s Budget Preserves Key Investments in Health Care

13 Trauma Informed Family Medicine

Trauma Informed for the Health of Mom and Baby

14 Advocacy Update

AMAM Focuses on Health Equity

22 CAFP Foundation

2022 Annual Report

24 CEO's Message

Dance Parties and Other Pain Relievers

Lauren Simon, MD,MPH, FAAFP Jeff Luther, MD, FAAFP Robin Linscheid, MD, FAAFP Catrina Reyes, Esp Ronald Labuguen, MD Lisa Folberg, CEO

Your Online Resource for Continuing Medical Education. Visit education.familydocs.org

editorial

Brent K. Sugimoto, MD, MPH, FAAFP, AAHIVS

Family Docs Need Love Too Senator Josh Newman (D-Fullerton) introduced a resolution in the California Senate to declare March 26, 2023, to April 2, 2023, Family Physician Week. Although its adoption was all but certain, I detected a faint flutter in my stomach as roll call commenced.

It turned out my apprehension was unwarranted. In an era of vitriolic political division, it was remarkable to see every single senator, Republican and Democrat, support the resolution. It seemed that Family Medicine was something that all sides could agree on.

As you may be aware, the CAFP adopted a strategic goal of “Raising the profile of Family Medicine.” It is one pillar in the strategy to reestablish our broken health care system on a sounder foundation built on primary care. This is only possible if the world knows our value; how, for example, we—the specialists in primary care— increase the life expectancy of communities over 2.5 times more than other specialties (Basu et al., JAMA Internal Med, 2019).

However, we must also recognize the benefit of raising family medicine’s profile extends beyond reputation.

Fellow family physicians benefit when they see the value of their own work affirmed. Our overworked and stressed colleagues are helped by knowing they are seen, because being recognized signifies that others see our work as meaningful and has worth.

Family physicians need a little love right now.

A Medscape Physician Lifestyle & Happiness Report (2023) found that compared to prior to the COVID-19 pandemic, the proportion of physicians reporting being at least somewhat happy with their jobs dropped from 75% to 48%. In the 2022 Medscape Physician Burnout & Depression Report, 51% of Family Physicians reported burnout, and we were the fifth-most burned out among all specialties, and the most burned out amongst outpatient specialties.

Dr. Christina Maslach, professor emeritus at University of California at Berkeley, and a pioneer in the understanding of burnout described it as a three-legged stool that depended on a sense of decreased accomplishment, depersonalization, and exhaustion.

Other researchers have found that the concept of selfefficacy—the belief in one’s competence to cope with stressful or challenging demands—may be protective 6

California Family Physician Summer 2023

against burnout. Indeed, Shoji et al. (2016) in Anxiety Stress Coping showed that self-efficacy has an inverse relationship with burnout: higher self-efficacy is associated with lower rates of burnout. Supporting this finding, Bernales-Turpo et al., (2022) in the Journal of Primary Care and Community Health, found that a higher sense of self-efficacy improved work performance.

It logically follows that higher self-efficacy, or a belief in one’s capacity to face challenges, should correlate with a higher sense of accomplishment. Taking these findings together, one can see how self-efficacy can destabilize one leg of Maslach’s three-legged stool, the sense of decreased accomplishment.

After the vote, my state senator rushed over to speak with me. First, I have ever only approached my representatives, never the other way around. Second, if in my wildest dreams one of them had come to me, it would have been at no more than the most languid pace.

My senator had taken note of my practice, a community health center in her district, and she wanted to thank me for the work that my organization did for her constituents.

She told me that we provided an important service and that we played a vital role in the community.

To express how her affirmation of my work’s value lifted my spirits could only be an understatement.

Returning to clinic after my visit to the State Capitol, I noticed one of the family doctors, who was newer to practice, seemed to be struggling that day. I went to go check in with her and we commiserated a bit about inbox and the brokenness of health care for the medically underserved. It was clear that work weighed visibly on her. I decided to tell her about my visit to Sacramento.

“She really said that about us?” she exclaimed in astonishment as she turned her attention back to her patients.

I was surprised by how much she brightened up.

I do not think any of us expects to be thanked for the work we do as Family Physicians. Even so, receiving that appreciation can mean the world when one of us hits a rough day, or week, or when it feels like things can never be better. Never should we acquiesce to what is broken in health care, but we must always remember to give ourselves reminders that, even in this system, we matter.

NEW FROM CDC

Introducing the new HIV Nexus.

Stay up-to-date with CDC’s guidance on HIV care and services.

Visit HIV Nexus for answers to your questions about HIV screening, prevention, and treatment. Make it your go-to source for the latest information and tools across the HIV prevention and care continuum.

Visit HIV Nexus to access resources from the Centers for Disease Control and Prevention: cdc.gov/HIVNexus.

TM

immediate past president’s message

Lauren Simon, MD, MPH, FAAFP, CAFP Immediate Past President

Challenge Accepted “Are you a doctor?” I was asked this by a group of young women in the HOSA - Future Health Professionals organization, who noticed the “California Family Medicine” scarf I was wearing at our recent CAFP All Member Advocacy Meeting (AMAM) in Sacramento where our two organizations were staying at the same hotel. As we descended in the elevator, picking up students on each floor, I happily answered their excited questions about being a Family Physician and encouraged them to pursue becoming physicians. Wearing this scarf reminds me of so many of our incredible CAFP members whom I have met throughout California and the energizing Academy educational, legislative and membership events where I represented you while serving as your President. We were fortunate this year, with fewer COVID restrictions, to have more opportunities to meet again in person, increase advocacy, share stories, and support each other, and take group photos (even some with the scarf!). Warm and versatile with an inspiring message included no wonder this scarf is worn by Family Physicians!

This has been a remarkable year for CAFP and our members, a year which highlights that each individual Family Physician can and does make a difference in our communities and our specialty. CAFP Past President Dr. Jay W. Lee, from Orange County, was elected to the American Academy of Family Physicians (AAFP) Board of Directors. Dr Jasmeet Bains, from Bakersfield, became the first Family Physician elected to the California State Assembly. I had the privilege to work with the CAFP Justice, Equity, Diversity, and Inclusion (JEDI) Task Force led by Dr. Shannon Connolly, on the strategic plan to incorporate a JEDI lens as CAFP makes future policy decisions.

The CAFP Board subsequently approved a permanent JEDI Committee for CAFP. At AMAM, it was an honor to have our special guest, Secretary Xavier Becerra of United States Health and Human Services virtually attend our meeting. He congratulated me on my CAFP President year and excitedly welcomed our wonderful new CAFP President, Dr. Raul 8

California Family Physician Summer 2023

Ayala. Dr. Monica Hahn from San Francisco won the AAFP 2022 public health award for her work challenging systemic oppression and structural racism in medicine. Our delegation to the AAFP Congress of Delegates successfully advocated for our priority CAFP resolutions which were subsequently passed and became AAFP policy. We are thankful to our incredible CAFP legislative team who help us advocate for the needs of our members, learners, and patients. Several of our CAFP members were also selected to serve on AAFP Commissions.

While at the AAFP Congress of Delegates in Washington, DC my home Congressman Pete Aguilar, whom I had initially met while advocating for healthcare needs of people in our community, invited me to join him and his wife at a reception for Congress and to join his wife at the First Lady’s Luncheon. It was an experience of a lifetime! Notably, that experience was initiated by one Family Physician speaking up to make a difference, as so many of you do.

I am proud to be a California Family Physician. Our Family Physicians have passionately accepted the challenge to care for people of all ages, all life’s circumstances, and social determinants of health, to advocate for them and to teach our medical students, residents, and other learners to do the same. Many of us have the privilege to care for people in our most marginalized and underrepresented communities and advocate for improved health equity. No matter what the setting, I know our California Family Physicians uphold the dignity of everyone.

This year as we celebrate the 75th anniversary of our Academy and prepare to move into our new headquarters in Sacramento close to the Capitol ,where we will continue to advocate for Family Physicians and our patients, I marked this 75th Anniversary by making a “challenge coin” with the California bear and the CAFP scarf depicted on it thanking our leaders for all they have done and anticipating what is to come. As I presented our wonderful CAFP Board and staff their coin, I know they will continue to accept the challenge.

It has been my honor to serve as your 2022-23 CAFP President and I look forward to a wonderful year ahead as Dr. Raul Ayala serves our amazing Family Physicians in California as our new CAFP President. Thank you.

FREE TO FOCUS ON KARLY.

With healthcare’s constant complexities and distractions, it can be difficult to focus on patients.

We can help, with proven medical professional liability insurance and so much more. So you are free to focus on delivering superior patient care.

• Medical Professional Liability Insurance • Claims Analytics • Risk Mitigation • And more

Insurance products issued by Preferred Professional Insurance Company® (NAIC# 36234) and Coverys Insurance Company (CA# 6122-6), 11605 Miracle Hills Dr., Suite 200, Omaha, NE 68154-4467.

California Family Physician Summer 2023

9

Jeff Luther, MD, FAAFP Chair, Legislative Affairs Committee

political pulse

Governor’s 2023-24 Proposed Budget Preserves Key Investments in Health Care Governor Gavin Newsom released his 2023-24 Budget Proposal on Tuesday, January 10, 2023. Despite a projected budget deficit, the budget proposal preserves key investments in recent budgets to advance state priorities and values, including making healthcare affordable and accessible, regardless of immigration status, and investing in the primary care workforce by maintaining Song-Brown funding. The 2023-24 Governor’s Budget proposes spending of $296.9 billion in total state funds, consisting of approximately $223.6 billion from the General Fund, $70.4 billion from special funds, and $2.9 billion from bond funds. 23.2 percent of total state expenditures is dedicated to health-related expenditures.

$2.1 billion ($1.6 billion General Fund) in 2024-25, and approximately $2.5 billion ($2 billion General Fund) ongoing, inclusive of In-Home Supportive Services costs, to expand full-scope Medi-Cal eligibility to all income-eligible adults ages 26 to 49 regardless of immigration status on January 1, 2024.

•

CalAIM - The Budget maintains the approximately $10 billion total funds commitment to continue transforming the health care delivery system through California Advancing and Innovating Medi-Cal (CalAIM).

•

Behavioral Health Continuum - The Budget maintains over $8 billion total funds across various Health and Human Services departments to expand the continuum of behavioral health treatment and infrastructure capacity and transform the system for providing behavioral health services to children and youth.

•

Public Health Infrastructure Investment - The Budget maintains $300 million ongoing General Fund to modernize state and local public health infrastructure and transition to a resilient public health system. Of this amount, $100 million General Fund supports increased state public health capacity in foundational public health areas such as emergency preparedness and response and workforce development and training. The remaining $200 million General Fund is for local health jurisdictions to expand public health staffing and reduce health disparities.

•

Healthcare Workforce - The Budget maintains over $1 billion General Fund to the Department of Health Care Access and Information (HCAI) to strengthen and expand the state’s health and human services workforce. These investments include funding for increasing nurses, community health workers and social workers, and supporting new individuals coming into the workforce in behavioral health, primary care, and reproductive health.

This commitment will be fulfilled, but over more time due to declining General Fund revenues.

•

Reproductive Health Services - The Budget includes $200 million ($15 million General Fund) in 2024-25 for a

The 2023-24 budget includes: • Primary Care Rate Increases - The Budget includes $22.7 million ($8.6 million General Fund) in 2023-24 and $57.1 million ($21.7 million General Fund) ongoing for primary care and obstetric care provider increases. The Administration will continue to evaluate the need for additional targeted provider rate increases at the May Revision.

•

Medi-Cal Expansion - The Budget maintains $844.5 million ($635.3 million General Fund) in 2023-24,

continued on page 12 10

California Family Physician Summer 2023

surgical fire Sequential pulses to a polyp ignited a

in the patient’s airway.

Surgical fires were among the 10 most common sentinel events reported by hospitals to the Joint Commission in 2021.* If a sentinel event happens and a ProAssurance insured is involved, they have direct access to medical liability claims specialists and risk management consultants with experience navigating these types of malpractice claims.

We’ve seen the worst you can imagine and have the expertise to help reduce risk and ensure a vigorous defense from day one.

The principle of fair treatment guides every action we take in defense of our physicians and healthcare providers.

* The Joint Commission, Sentinel Event data released for first 6 months of 2022. Visit: bit.ly/3zzsloj

ProAssurance.com • 800-282-6242

continued from page 10

grant program focused on supporting access to family planning and related services, system transformation, capacity, and sustainability of California’s safety net.

This funding builds on the 2022 Budget Act investments for reproductive health services and continues California’s progress to provide comprehensive family planning and related services as California grapples with the effects of recent federal actions.

•

•

•

Emergency Response and SMARTER Plan Implementation - The Budget reflects $176.6 million General Fund in 2023-24 to continue the state’s efforts to protect the public’s health against COVID-19, consistent with the Administration’s SMARTER Plan, and maintain significant information technology systems, including the California COVID Reporting System for laboratory data management and CalCONNECT for case and outbreak investigation.

Opioid and Fentanyl Response - The Budget includes an additional $93 million in Opioid Settlement Funds over four years beginning in 2023-24 to support youth- and fentanyl-focused investments for the Department of Health Care Services and for the Department of Public Health as follows: o

$79 million for the Naloxone Distribution Project to increase distribution to first responders, law enforcement, communitybased organizations, and county agencies.

o

$10 million for fentanyl program grants to increase local efforts in education, testing, recovery, and support services.

o

$4 million to support innovative approaches to make fentanyl test strips and naloxone more widely available.

Federal Public Health Emergency Extension - The Budget assumes a two-quarter extension of the federal Public Health Emergency through mid-April 2023 and enhanced federal funding through the end of the 2022-23 fiscal year.

Budget Shortfall: The Governor’s Budget forecasts that General Fund revenues will be $29.5 billion below the 2022 Budget Act projections, and California now faces an estimated budget gap of $22.5 billion in the 2023-24 fiscal year. The Governor’s Budget does not propose to draw from the State’s reserve accounts to close the budget gap. Rather, to close the budget gap, the State will be focusing on one-time and near-term spending instead of costly long-term obligations; tying or “triggering” a handful of new ongoing programs to sufficient revenue availability in 2024-25 ($3.9 billion); implementing funding delays ($7.4 billion), reductions and “pullbacks” ($5.7 billion), and fund shifts ($4.3 billion); and limited revenue generation and borrowing ($1.2 billion). If, however, economic and revenue conditions deteriorate in the spring, then the Administration may propose withdrawals from reserve accounts, as well as additional program reductions. Some of proposed solutions to the budget shortfall include: 12

California Family Physician Summer 2023

•

Managed Care Organization Tax - The Budget proposes the renewal of the Managed Care Organization (MCO) Tax effective January 1, 2024, through December 31, 2026, to help maintain MediCal program funding for the Medi-Cal expansion to all income eligible individuals and minimize the need for reductions to the program. The Administration will explore opportunities over the next few months to increase the MCO Tax to provide support for the Medi-Cal program.

•

Partial Public Health Workforce Reductions - The Budget reduces funding for various public health workforce training and development programs by $49.8 million General Fund over four years to help address the budgetary problem.

•

Workforce Funding Delays - The Budget defers $68 million in 2022-23 and $329.4 million in 2023-24 for certain HCAI healthcare workforce programs, including for nursing initiatives, community health worker, and social workers. These programs remain fully funded, but these funds will be appropriated later than initially anticipated—$198.7 million in both 2024-25 and 2025-26.

•

Behavioral Health Continuum Infrastructure Program Delays - The Budget delays the last round of behavioral health continuum capacity funding of $480.7 million General Fund appropriated in the 2022 Budget Act for 2022-23 to $240.4 million in 2024-25 and $240.3 million in 2025-26. A total of $1.2 billion has been awarded to date, and the Budget maintains $480 million General Fund for crisis and behavioral health continuum grant funding to be awarded in 2022-23.

•

Covered California Subsidy Transfers - Last year, the Budget provided a contingency in case federal subsidies were not extended for Health Care Marketplaces, including Covered California. Federal subsidies were extended until 2025, so the contingency was placed in the Health Care Affordability Reserve Fund (HCARF) to ensure that state-only premium subsidies are available again in the future when they are most needed. Due to declining General Fund revenues, the Budget transfers the available HCARF balance of $333.4 million to the General Fund. These funds will be returned after federal subsidies end, which is scheduled in 2025-26.

The final Budget Bill must be passed by midnight on June 15, 2023. From now till then, CAFP will work with legislative offices and allies to support the Governor’s proposals to expand and improve health care in California and to maintain the General Fund expenditure allocated to the Song-Brown program for primary care graduate medical education (GME) programs.

CAFP’s Key Contacts receive these updates through the weekly Legislative Update. To receive information on what’s happening in Sacramento, sign-up to be a Key Contact https://www.tfaforms.com/379954.

Editor's note: The budget was passed on June 27.

feature ar ticle

Robin Linscheid, MD, FAAFP

Trauma Informed for the Health of Mom and Baby As I dragged myself out of my call room and made my way to our OB triage, I reminded myself that there was trauma present for this patient: an individual with minimal prenatal care, a history of substance use disorder (SUD) and refusal to stay despite the warnings of the nurse taking care of her. The fact that she showed up at all was an incredible step and one that was not easy for her to take. I stood next to her bed and explained why I was concerned for her and her baby and why it is important to stay and pursue labor induction.

She behaved reasonably as I sat down next to her and tried to find out why she did not want to stay. I learned more about her history of substance use and the trauma she had experienced, which kept her from following up with her prenatal care. She cared deeply for her baby, but also for her other children at home, which felt more important and pulled her away from the hospital. Though I did not agree with the rationale behind her decision to leave against medical advice, I listened. I wanted her to know that I was going to take care of her in whatever capacity she would allow me to and that what I wanted was the same as she wanted: a safe and healthy mom and baby.

who have a SUD are also more likely to have histories of trauma (Devries et al., 2014), including sexual or physical abuse, and abuse or witnessing abuse in childhood (Cafferky et al., 2018; Muchimba, 2020; Stein et al., 2017; Tripodi & Pettus-Davis, 2013; Ullman et al., 2013).” They often have inadequate or no prenatal care despite coming into contact with the medical community at some point in their pregnancy.

If we do not use a trauma-informed lens when we care for these vulnerable patients, we will miss the opportunity (and often only chance) to engage them in care. The California Maternal Quality Care Collaborative (CMQCC) has an incredible resource for providers called the Mother & Baby Substance Exposure Initiative Toolkit, https://www.cmqcc. org/resources-toolkits/toolkits/mother-baby-substanceexposure-initiative-toolkit. It offers a comprehensive review of how to care for our prenatal patients with substance use disorder.

Our pregnant patients with substance use disorder are a marginalized and especially stigmatized subset of patients within an already vulnerable patient population. When I visited one of our treatment centers for opioid use disorder it was heartbreaking to hear that their pregnant patients felt judged by other patients seeking the same treatment. They had to find ways to create a safe space for their pregnant patients so they would feel welcome in the waiting room.

The patience of the staff taking care of her was low and my fatigue was high, but I knew this patient needed and deserved my time and attention. I discussed the concerning variables in her baby’s heart rate which could indicate lack of oxygen to her baby. She listened and reflected on my We need to dispel this stigma and create a more welcoming statement of concern, but ultimately left the hospital. I felt and trauma-informed environment to provide patients with defeated and worried for the rest of the night about this the care they need and deserve. This includes developing patient and her baby’s safety. I did not have to worry long coping strategies for trauma or PTSD and relational because a few hours later she returned, in active labor and techniques that take into consideration positive and negative ready to stay. She thanked familial and partner influences me for sitting with her and One of CAFP’s strategic priorities is to help family and promote a safe and listening. She felt heard. caring treatment environment. physicians practice more intentionally through a Although she did not follow trauma informed, resiliency-oriented healthcare lens It is important to advocate my initial advice, she did (TIROH). Please join us at our 2023 family medicine POP for patient autonomy and listen to me and when she got home and started conference where we present both a plenary session teach them how to be an integral part of their own care. feeling more uncomfortable and a two-hour workshop on this very important topic. Empowering our patients to came back because she Also, visit www.familydocs.org/aces for more helpful be their own advocates and felt comfortable returning viewing patient care through information and resources. knowing we would still take care of her.

Clinical team members who bill Medi-Cal must complete a trauma-informed lens helps to increase diversity, equity a certified ACEs Aware Core Training to qualify to According to the Substance and inclusion in our medical Abuse and Mental Health receive Medi-Cal payment for conducting system and leads to better Services Administration ACE screenings. health for our most vulnerable (SAMHSA) multiple studies populations.

Check out AcesAware.org/training. have shown that “Women California Family Physician Summer 2023

13

advocacy update

Catrina Reyes, Esq.

VP of Advocacy & Policy

AMAM FOCUSES ON HEALTH EQUITY In March, almost 200 family physicians, residents, and medical students from across the State met in Sacramento for CAFP’s All Member Advocacy Meeting (AMAM).

AMAM is an opportunity for CAFP members to shape policy. CAFP policies, which guides CAFP’s advocacy, begin as resolutions that are submitted by CAFP members for consideration by the CAFP Board of Directors. At AMAM, the authors of resolutions have the opportunity to present their resolution to AMAM delegates and the Board, and the Board has the opportunity to hear testimony from AMAM delegates supporting, opposing, or proposing amendments to resolutions. This year, 17 resolutions were presented and attendees provided testimony for Board consideration.

Also during AMAM, AAFP President, Dr. Tochi Iroku-Malize conferred fellowship on the newest group of fellows and swore in CAFP’s newly elected officers and president. We also celebrated the efforts and achievements of those who worked to advance issues important to family physicians.

Kimberly Buss, MD, MPH, was awarded the Hero of Family Medicine award, which is presented annually to a CAFP member who has gone above and beyond the call of duty to advocate for patients, colleagues, and the family medicine specialty. During the celebrations, there was a surprise virtual appearance by U.S. Secretary of Health and Human Services, Xavier Becerra. Secretary Becerra recognized the work of family physicians in their communities and expressed that he is looking forward to collaborating on ways to increase access to care.

AMAM provides CAFP members with training and education on pressing health care issues so you can be effective advocates for your patients and specialty.

This year’s AMAM focused on health equity to address two of CAFP’s strategic goals – system transformation and prioritizing justice through equity, diversity, and inclusion. The keynote speaker was Jahmal Miller, Chief Administrative Officer of Mercy Medical Group. In 2013, Governor Jerry Brown appointed Mr. Miller to serve as the Deputy Director of the California Department of Public Health’s Office of Health Equity and the State’s lead advisor on issues related to reducing health and mental health disparities and achieving health equity for all Californians. At AMAM, he talked about his professional journey in the fight for health equity and how physicians can take actionable steps to promote health equity.

Following his presentation, we took a hands-on approach to promoting equity with a training on ‘Evaluating Policy 14

California Family Physician Summer 2023

with an Equity Lens,’ presented by Courtnee Melton-Fant, PhD, MS, an Assistant Professor in the Division of Health Systems Management and Policy at the University of Memphis.

Advocacy training is a key component of AMAM so attendees received a legislative briefing of CAFP’s advocacy priorities from CAFP’s Legislative Affairs Committee Chair, Jeffrey Luther, MD, FAAFP, and the advocacy team. After which, there were two advocacy training tracks - Crafting Your Message, Telling Your Story, and Meeting with Your Legislator presented by speech and leadership coach, Nina Surya, and for the more seasoned advocate, training was provided on other advocacy avenues including running for office and serving on advisory committees, presented by political strategist, Danielle Cendejas.

Thanks to the fundraising savviness of the Family Physicians Political Action Committee (FP-PAC) Chair, Shannon Connolly, MD, FAAFP, and FP-PAC Board members, the FP-PAC had a record-breaking amount of donations raised at AMAM. FP-PAC is the only political action committee in California that has the sole mission of promoting family physicians and family medicine.

During Lobby Day, FP-PAC contributors attended a donor reception with legislative guests Assembly Member Corey Jackson (District 60, Moreno Valley), Assembly Member Mike Fong (District 49, Alhambra), and Assembly Member Juan Alanis (District 22, Modesto).

Because of your support, we were able to help elect the first family physician to the California State Assembly, Dr. Jasmeet Bains. Assembly Member Bains joined her fellow family physicians at AMAM to talk about her victorious journey to the State Assembly. Assembly Member Bains is already making a great impact in the Legislature. She was appointed to be Chair of the Committee on Aging and Long-Term Care and has introduced a number of bills to improve access to care and to address the fentanyl crisis.

CAFP’s Lobby Day was held in-person and in meetings with legislative offices, CAFP family physician advocates educated legislators and their staffers on the breadth of family physician training and the diverse populations family physicians serve. Over the course of over 60 legislative meetings, advocates asked legislators to support CAFP’s sponsored bill – AB 85 authored by Assembly Member Weber on social determinants of health – and to continue to maintain the General Fund expenditure

allocated to the Song-Brown program for primary care graduate medical education (GME) programs. AB 85 requires health plans and insurers to provide coverage and reimbursement for social determinants of health screenings and to provide primary care providers with adequate access to community health workers or social workers. AB 85 also creates a working group to create a standardized model and procedures for connecting patients with community resources, to assess the need for a centralized list of accredited community providers, and to determine gaps in research and data to inform policies on system changes to address social determinants of health.

The week of AMAM was Family Physician Week. Senator Josh Newman authored SCR 23, a resolution designating the week of March 26, 2023 to April 2, 2023 as Family Physician Week. Senator Newman presented the resolution on the Senate Floor on National Doctors Day – March 30, 2023.

Make sure to join us next year! Save the date for the 2024 All Member Advocacy Meeting - April 13-14th, Lobby Day April 15th. To stay in the loop on CAFP’s advocacy efforts, sign up to be a Key Contact.

Join a team that’s been helping to redefine what it means to be a community clinic for 50 years.

Vista Community Clinic has outstanding opportunities for Full-Time and Part-Time Family Physicians. Join a team of dedicated, motivated and enthusiastic team players who make a difference in the community.

Vista Community Clinic is a federally qualified, not-for-profit healthcare clinic with state-of-the-art clinics. We provide healthcare throughout the Southern California regions of North San Diego, Orange and Riverside Counties.

Our compensation and benefits program includes: Competitive compensation, sign-on bonus, relocation bonus, health, dental, vision, company-paid life, longterm disability, flexible spending accounts , 403(b) retirement plan, malpractice coverage, CME allowance and no oncall hours. We are a NHSC loan repayment eligible organization.

Salary (full-time): $250,000 – $267,000/year For more information visit www.vcc.org or email hr@vcc.org EEO/AA/M/F/Vet/Disabled

50 years

1972-2022

Help Your Patients Make Better Informed Decisions About Their Care For Advertising Information, contact:

Michelle Gilbert mgilbert@pcipublishing.com

1-800-561-4686 ext. 120

The California Prostate Cancer Coalition, founded in 1997 as a 501(c)(3) not-for-profit organization, is dedicated to saving men’s lives!!! www.prostatecalif.org https://naspcc.org/docs/informed-decision-9-11-17.pdf www.naspcc.org California Family Physician Summer 2023

15

16

California Family Physician Summer 2023

California Family Physician Summer 2023

17

feature stor y

Susan Glockner, MD, FAAFP

Welcome to Newport Beach!

As a member of the CAFP for over three decades, I’m excited that our Clinical Forum + FM Summit (aka POP) conference is coming to my neighborhood. My grandfather, who after serving in WWII by helping to design radar, bought the first two story house on Little Balboa Island right after the war; thus, I spent my summers as a Newport Beach Orange County rat. There is something for everyone. So, here is a bullet point list for some fun!

For families, there are tons of things to do within 5 miles of POP: Beaches – for waves to surf, bodyboard or to watch sunsets go to the Balboa Peninsula.

Marine Ave (on island) – commercial hub with restaurants from seafood to Italian Basilic is my favorite for dinner – a small Swiss place, so get reservations.

Wilma’s – my favorite for breakfast – does not take reservations.

MUST Do – Balboa bar or Frozen banana at Dad’s or the Frozen banana store (Too Sweet – newer competitor but with great chocolate and candies)

Newport Pier – better surfing, has some rental options: https://15thstsurfsupply.com/

Back Bay – more rentals and even romantic gondola ride evoking Venice.

Balboa Pier – great pier to walk out to for Ruby’s diner – hamburgers and milkshakes.

Paddleboards and Kayaks: https://www.newportdunes. com/watersports/

Fun Zone nearby on the bay side with Ferris Wheel Arcades and good donuts Pavilion (1920’s building): deep sea fishing, harbor or whale watching boat trips. Rent small power boats or popular electric Duffy’s to cruise the bay Take the hour long ferry (https://catalinainfo.com/) to Catalina Island for a day trip to snorkel, bike, play mini-golf, zipline, hike, see buffalos, or rent more boats. Better yet, spend a night or two with lots of casual seafood restaurants. You can even do a zipline through the canyons.

Ferry ride ($1.25 per person) to Balboa Island – great 1.75 mile walk around Balboa Island – great for walking, dining, and calm bay beaches for under 12 year olds 18

Rent a bike, E-bike, paddleboard or kayak: https:// sports-rents.com/

California Family Physician Summer 2023

Pediatric ENT Disorders: What the Primary Care Clinician Should Know Today Saturday, September 23, 2023 - www.choc.org/entconference

21st Annual Academic Day for Neonatologists Wednesday, November 1, 2023 - www.choc.org/academicday

use c ode "SUM MER" to sav e $25 off th ese confe rence s!

NeoBrain: An Interactive Educational Forum Thursday - Saturday, November 2 - 4, 2023 - www.choc.org/neobrain Visit our websites to view topics, speakers, and more! - Registration is open now These events have been approved for AMA PRA Category 1 CreditTM

www.choc.org @chocdocs

California Family Physician Summer 2023

19

feature stor y

Careers Will Change: Medicine, Transition and You A group of family physicians brainstormed topics for presentations at this year’s Family Medicine POP! Long COVID? Yes. Diabetes? Of course. Career transition?

Wait… career transition? Suddenly everyone had something to say. Members of the group, from residents to retirees, all had a story about their own struggle with identity, failure and change in their careers.

“I felt stuck in my first job after residency and felt like I failed when I wanted to leave.”

“When I decided to shift to a specialized practice, I struggled with my identify as a family physician.”

“While it was one of the hardest things I’ve ever done, I finally mustered the confidence to quit and go after my dream job.”

Join Jay Lee, MD, MPH, FAAFP at POP’s session Transitions: Supporting Your Leap of Faith and Search for Fulfilment as he brings family physicians from a variety of career junctures to the stage to share an open conversation about transitions in practice. Let’s shine some light on this topic and support each other through the ups and downs of the life of a family physician.

Change is necessary and inevitable. Med students become residents, residents get their first job, and their second, many move into administration, part-time work for various reasons and ultimately retirement. So why talk about it?

Because we don’t talk about it enough and we need to support each other through the inevitable change that comes with being a family physician.

Between 2020 and 2022, with COVID raging, nearly half of U.S. physicians changed jobs. Prior to the pandemic, a third of U.S. physicians said that while they are generally happy in their current job, they would be open to a new opportunity if the right one came along. Another quarter stated that they were looking for a new job for a variety of reasons, while another nine percent were unhappy and definitely looking to change.

No career is static. Even if you stay in one job for 50 years, which is rare indeed, family medicine is constantly changing. Changes in science, technology and social norms keep family physicians on their toes, regardless of title or station. As you and your position evolve, you’re not stuck doing one thing all the time. However, the struggle with change remains.

Doctors tend to be their own harshest judges, whether the changes are prompted by outside influence or inner 20

California Family Physician Summer 2023

motivation. Among U.S. workers, physicians are more likely than others to feel the effects of imposter syndrome, a phenomenon in which you feel inadequate despite a track record of competence. Symptoms, especially emotional exhaustion and questioning your accomplishments, were more common among women, and young and unmarried physicians.iii Imposter syndrome leads to harsh selfcriticism and self-blame when a job doesn’t work out, especially in early career positions. Dissatisfaction for any reason, plus imposter syndrome is a perfect formula for physician burnout.

What can be done to make career transition more natural and freer from self-judgement? Experienced physicians, who often appear to have it all together, can describe their own “failure résumés” for junior colleagues to demonstrate that role models also have difficulties.

De-stigmatizing and normalizing help-seeking could also contribute to more professional fulfillment. Sharing stories of change, identifying and leaning on your support networks, building confidence to reach out to others for help and advice, and so much more will be discussed at this year’s Family Medicine POP: Celebrating the Spectrum of Family Medicine. Please join us!

Physician career changes 2020-2022i I changed jobs

I changed to a non-clinical career I have not changed jobs I retired

References: https://chghealthcare.com/blog/physicians-changed-jobs-survey/ Survey: Nearly half of physicians changed jobs during the pandemic https://chghealthcare.com/blog/physicians-changed-jobs-survey/ Survey: Nearly half of physicians changed jobs during the pandemic https://med.stanford.edu/news/all-news/2022/09/physiciansimposter-syndrome.html Physicians experience imposter syndrome more often than other U.S. workers https://med.stanford.edu/news/all-news/2022/09/physiciansimposter-syndrome.html Physicians experience imposter syndrome more often than other U.S. workers

feature stor y

Building Physician Confidence in Providing Medication for Opioid Use Disorder (MOUD) Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and one’s life experiences - yet viewed by too many, including physicians, as a moral failing. Way too many patients living with opioid use disorder (OUD) are not receiving treatment - easy, effective treatment that has been shown to save lives. Despite evidence that medications for addiction treatment (MAT) are effective and represent an overall costsaving method for treating OUD, 60-80% of people who use opioids do not have access to these medications. (https:// www.ajpmonline.org/article/S0749-3797(18)30074-6/fulltext) The opioid crisis has certainly not gone away, and deaths continue to skyrocket which is why in December, 2022, President Biden signed the Mainstreaming Addiction Treatment (MAT) and Medication Access and Training Expansion (MATE) Acts. These bills were passed to expand access to buprenorphine for the treatment of opioid use disorder and normalize and enhance substance use care across healthcare settings.

MAT allows for any California provider who has a current DEA registration that includes Schedule III authority to now prescribe buprenorphine for OUD. Effective June 27, 2023, MATE requires new or renewing DEA registrants to attest one time to having received 8 hours of training on opioid or other substance use disorders through an accredited source, like the CAFP. Previous training received, including the DATA-2000 waiver training to prescribe buprenorphine counts towards this requirement. Training hours do not have to be completed in one session and can be satisfied through cumulative sessions. This is meant to provide clinicians with a basic understanding of OUD and hopefully, inspire many more to start saving lives and providing important treatment.

Every a primary care provider needs to learn how to talk to patients about drug use without judgment so that we can even identify those in need of treatment. Reinforcing the stigma around people who use drugs may drive them away before treatment can even begin. There are resources and tools to help ease the transition toward compassionate understanding and careful conversation around opioid use. Showing respect and promoting health and dignity with all patients is important - but especially vital with your patients who use drugs.

CAFP is moving full speed ahead to share education and resources about Opioid Use Disorder (OUD), and especially about medication for OUD and why more family physicians need to provide these services. If you haven’t already done so, please access the resources, tools, and education all accessible through https://familydocs.org/sud: The Family Docs Podcast, OUD Series – Four episodes featuring CAFP members talking about the nitty gritty of MOUD MOUD Champions Network – Connecting those experienced in MOUD with those just getting started. Sign up as a Champion to help advance healing!

CME about SUD, OUD, and MOUD – CAFP has over fourteen hours of accredited education available to you through our Homeroom learning system.

And now you can add Family Medicine POP to the list! POP will feature over three hours of OUD programming, including a main stage session, Sunday morning table talk with colleagues, and the optional Saturday afternoon two-hour FDA-REMS approved CME workshop, Pain Management and Opioids: Balancing the Risks and Benefits, free of charge to attendees.

Building confidence in MOUD – that’s one great reason among many to come to Family Medicine POP this August. See you there!

Job Title: Family Medicine Physician Location: Anaheim and Santa Ana, CA Job type: Per Diem Job category: Medical/Clinical Providers UCI Family Medicine is recruiting staff physicians to provide patient care within our clinics. We are seeking per-diem physicians who are interested in a flexible schedule.

Candidates who are interested in part-time work, and/or who are senior residents or fellows who are expected to complete training in June ’23 are encouraged to apply. This position pays an hourly rate of $110.25.

Requirements: • Family physician; board-certified, full-scope ambulatory health care services including care of children, adults and the elderly • Experienced in providing and/or oversight of pre-natal care • Leadership skills; ability to motivate, inspire, communicate with faculty, residents, staff, and peers to maintain a professional, team-based approach in the care of patients • Proficiency in Spanish (preferred) • M.D. or D.O. from an accredited institution with appropriate clinical training and experience.

Application URL (Job ID: 50694-1A): https://careersucirvine.ttcportals.com/ EOE

California Family Physician Summer 2023

21

CAFP Foundation

Ronald Labuguen, MD

CAFP Foundation President

CAFP Foundation Releases 2022 Annual Report For the CAFP Foundation, 2022 represented a year of reflection and innovation — a year that allowed us to sharpen our strategic focus, reinvent our approach to programming, and reshape our board leadership with new, diverse perspectives. We continued to learn from several inflection points over the last couple years — some caused by the pandemic, others by radical listening and observing.

These include: Lesson 1: Progress in building the next generation of family physicians requires collaboration with our partners and members. It's an honor to join forces with those who believe and invest in our mission. We are grateful to our funders who make educational programming possible, like the California Residency Program Collaborative; to our volunteers who dedicate their time and expertise to teach workshops, like the Chief Resident Leadership Development program; to the Student-Resident Council who co-design activities, such as the community outreach and mentorship projects; and to our supporters who give generously to our scholarship and research initiatives.

Lesson 2: Programs must adapt to meet the needs of our learners. Since 2014, our Procedures Workshop has introduced medical students to the field of family medicine by teaching common office-based procedures done by family physicians. In 2022, this shifted when residents, too, started asking for more hands-on procedures practice. We realized that the pandemic reduced the number of opportunities for residents to build confidence and demonstrate competencies in certain procedures necessary to graduate. As a result, we developed a resident-only track as part of the workshop,

22

California Family Physician Summer 2023

which included advanced procedures like point of care ultrasound, colposcopy/endometrial biopsy, IUD placement, skin biopsies, and toenail removal. What I love most about this program is that it is designed by California medical students and family medicine residents for medical students and residents — another wonderful example of member collaboration!

Lesson 3: Having a clear vision of who we are and the role we wish to play in our field is essential for the Foundation's future. In August 2022, the Board of Trustees went through a strategic planning process, which encouraged us to reflect on our mission, values, and our "why". We also imagined the future of the organization — asking ourselves: What does success look like? How can we be good stewards of our resources? What meaningful role can we play in a student's/resident's path to becoming a family physician? Having eight new board members truly enhanced the discussion with fresh ideas, new perspectives, and diverse expertise; and we're excited to share what we came up with — a strategic framework that will ground the Foundation's work over the next 3 years.

As we look back at what we accomplished together, and ahead at what's to come, I am inspired by the heart of our CAFP community and the enthusiasm of our rising family physician generation. The days are long for students and residents and the path to physician-hood is challenging. My hope is that when our members come to the Foundation, they find overflowing encouragement, joy, support and belonging.

It's such an honor to be part of this journey and I extend my deepest thanks to each of you.

Department of Family and Community Medicine (ZSFG) - Core Faculty

Special CME Program (21.75)

Medical Review Officer Training Medical Review Officer Training and Certification Exam On-Site and Online Las Vegas, NV December 8-10, 2023 Approved for 21.75 AAFP prescribed credits For more information:

800-489-1839 www.aamro.com

All AAMRO training programs include the latest information on hair, sweat, oral fluids, and interpretation of opiates in the field of drug and alcohol testing

FACULTY POSITION DESCRIPTION Zuckerberg San Francisco General Hospital Family and Community Medicine Department of Family and Community Medicine, UCSF Appointment As: Assistant, Associate, or Full HS Clinical Professor or Professor of Clinical Family and Community Medicine, depending on experience and qualifications. FCM is a National Health Service Corps site and this position may qualify for loan repayment assistance under this program.

JOB RESPONSIBILITIES This is a core faculty position in Family and Community Medicine at Zuckerberg San Francisco General Hospital.

Proposed job responsibilities include direct patient care; teaching; and administration.

Final job description will be written at time of determining terms of faculty appointment.

Qualifications: MustbecertifiedbytheAmericanBoardof FamilyMedicine by time of hire and have a valid (or eligibility for) California medical license.

Musthavepreviousteachingand/orcurriculardevelopment experience. Prior experience and commitment to working with underserved populations, racially and ethnically diverse patients and staff is essential.

Application Requirements: CV, Cover Letter, Statement of Contributions to Diversity, StatementofTeaching,and3Departmentsolicitedreferences.

Beginning Date of Appointment: Appointment to commence as soon as possible.

Cut-off Date for Applying: File by March 31, 2023. Open until filled.

Please apply online at: https://apptrkr.com/3848597 Applicants’ materials must list current and/or pending qualifications upon submission.

Contact: Isabel Lee, MD Department of Family and Community Medicine San Francisco General Hospital, Ward 83 995 Potrero Ave., Ward 83 San Francisco, CA 94110 Isabel.Lee@ucsf.edu To apply for this position, please submit online through the unique link above to the UCSF AP Recruit portal with an e-mail notification to Selena Estrada @ Selena.Estrada@ucsf.edu, at time of application.

UC San Francisco seeks candidates whose experience, teaching, research, or community service that has prepared them to contribute to our commitment to diversity and excellence.

The University of California is an Equal Opportunity/ Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.

California Family Physician Summer 2023

23

c e o ’s m e s s a g e

Lisa Folberg CEO

Dance Parties and Other Pain Relievers If you missed the 2023 CAFP All Member Advocacy Meeting (AMAM), you missed sessions on running for office and crafting your message, you missed the opportunity to discuss and debate future CAFP policy and meet with Legislators to advocate for primary care and family medicine. You also missed an epic group dance session.

When we danced to About Damn Time by Lizzo at AMAM everyone felt great. For me it is a go-to song to lift my mood.

AMAM was that tune for attendees. I have heard many family physicians talk about CAFP events such as AMAM, the CAFP POP meeting (the conference formerly known as Clinical Forum) and local chapter meetings as the “antidote to burnout.”

Primary Care Physician Needed at Visalia Family Practice 107 N. Hall St. Visalia, CA 93291 If you’re looking for the perfect place to live and work, we invite you to consider Visalia Family Practice Medical Group in Visalia, California.

Established over 35 years ago we have a built-in-patient base with a cohesive group of providers that will help you thrive in your career and achieve a balance in todays practice environment.

• Start immediately, looking for 2 positions, established and new providers encouraged to apply • Work/life balance with clinic hours • $220,000 to $240,000 per year* ◊ Potential Recruitment Assistance Available • Partnership Opportunity • Benefits Package *Encounter Bonus in addition to Base Salary

Visalia Family Practice prides itself in being a traditional family medicine clinic. We’ve created a very down to earth, family oriented, and congenial atmosphere. We’re the perfect fit for doctors who want low stress, a low cost of living, high satisfaction, and a happy, healthy environment for raising a family and enjoying your free time.

To apply and for more information visit :

www.vfpmg.com/career-listings/family-physician You may contact Breana Bergdorf, Administrator by phone at 559-625-9200 or email at bbergdorf@vfpmg.org

24

California Family Physician Summer 2023

There is no doubt that connecting with colleagues, feeling heard and dancing are great ways to feel better and get energized. These things are important, you need this stress relief, but even our amazing CAFP events are not enough to solve “burnout.” In reality, we can’t fix physician burnout without fixing our broken health care system. The root of physician burnout is a system that is physically exhausting and morally damaging.

At AMAM, an attendee stood up to testify on a resolution relating to physician burnout. She noted that the general approach we have taken to physician burnout is the equivalent of getting the canary out of the coalmine, giving it some resiliency training and sending it back to the coalmine.

There is value in meditation, healthy lifestyle changes, professional connections and impromptu Lizzo conga lines, but we can’t expect these pain relievers to heal the physician psyche that is injured and reinjured by a system that expects the undoable.

Your CAFP and AAFP work to provide our members some pain relief through connection, support, empowerment and information. We are also working on fixing the ills of a system infected with misaligned incentives, profit and lack of vision. Through advocacy, we are fighting to reduce administrative burdens and maintain the primacy of the physician-patient relationship. Our advocacy team spends long days and many nights educating legislators about the importance of family medicine and moving from a volume-based, specialtycentric system to a value-based, primary care-centric system.

We see you, we hear you and we are fighting for you.

Primary Care: FM Opportunities

At the end of the day, this is where you want to be.

Join the Banner Health Team, in an outdoor paradise where the beautiful Sierra Nevada and Cascade mountains meet the desert of the Great Basin in Susanville, California – where you’ll have the time to connect with your patients, your practice, your family and the great outdoors! We offer dedication to work/life balance unmatched in our industry. Meaning you get to spend more time doing what you love. That’s HEALTH CARE made easier, LIFE made better!

• $240K Salary Guarantee • $100K Sign-On Bonus • $100K Educational Loan Repayment • Eligible for $50K from California Health Planning • Eligible for Public Service Loan Forgiveness • Eligible for HRSA Educational Loan Repayment • Retention Bonus • Focus on Patient and Provider Well-Being • Top of Market Compensation and Benefits

Join our Provider Talent Network! Register using our job portal: PracticeWithUs.BannerHealth.com Or, email CV: primarycaredocs@bannerhealth.com For information call Martha Gonzales 602.747.4328 Banner Health is an EEO/AA - M/W/D/V Employer.

California Family Physician Summer 2023

25

feature ar ticle

Dr. David Bazzo Awarded the 2023 Family Physician of the Year Award of California, San Diego (UCSD) Interim Department Chair for Family Medicine since July 2020. His influence also includes helping guide policy, advocacy and physician education in his leadership roles at CAFP, the California Medical Association, and the American Academy of Family Physicians, including as President of CAFP in 2020-2021.

He was also appointed by the American Medical Association in 2022 as Chair of the PacWest Reference Committee on.

Furthermore, Dr. Bazzo was promoted in 2022 from Physician Assessment and Clinical Education (PACE) Fitness for Duty Director to PACE Program Director.

The California Academy of Family Physicians (CAFP) is proud to announce David Bazzo, MD, FAAFP, CAQSM was selected as the 2023 Family Physician of the Year.

CAFP presents this prestigious award to an individual who exhibits the finest qualities of Family Physicians, and who goes above and beyond in service to patients, community, and colleagues.

Dr. Bazzo has helped to lead Family Medicine and primary care by serving in leadership roles, educating future Family Physicians, and through community engagement. Dr. Bazzo has served as the University

26

California Family Physician Summer 2023

Dr. Bazzo was recently awarded the UCSD Medical Staff Physician Professionalism Award 2023, and recognized in many areas, including: Castle Connolly Top Doctor in 2022, recipient of the San Diego County Medical Society 2023 Jim Hay Award for distinguished service to SDCMS membership and the entire San Diego community, Best in California Magazine — Doctor Edition in the field of Sports Medicine 2022, and San Diego’s Physicians of Exceptional Excellence “San Diego’s Top Doctors” in the field Sports Medicine, San Diego Magazine in 2022. Dr. Bazzo has received numerous other well-deserved awards throughout his career, and CAFP is proud to add 2023 Family Physician of the Year to this long list of accomplishments.

Congratulations, Dr. Bazzo, and thank you for all you do for family medicine in California! Dr. Bazzo will be recognized as the 2023 Family Physician of the Year at the Family Medicine POP event on August 25-27 in Orange County. You can register to attend this event at www.familydocs.org/pop.

California Family Physician Summer 2023

27

An Interview with Dr. Raul Ayala Your 2023-2024 CAFP President Why did you choose family medicine? Who were the role models who inspired you to go into Family Medicine?

I was born and raised in Mission, Texas, a small rural town in South Texas about 30 minutes from the border. It's a great town known for its citrus. Mission is where I learned about the importance of community, friendship, and being a good neighbor. We all new each other’s families and our values were imbedded throughout that great town. In many small towns there is that one doctor who does everything. My doctor took care of my grandma, delivered babies, did house calls, and would be on the sidelines on Friday Night Football, was in the parades and could be seen enjoying a free lunch at the local restaurant. I later found out he was a Family Doctor.

My love for Family Medicine continued during my undergraduate studies where I volunteered at a homeless shelter. During my time there, I met a compassionate Family Doctor who cared for the homeless in his spare time and again.

I spent time after clinic with him sharing the importance to see beyond the disease being treated, to make an impact on every patient’s life. During medical school, I had the privilege of joining a non-profit organization that started a free clinic in South Texas with the mission to help immigrant families with free health care. It is here where I learned of the importance and impact of government health care programs on individuals and communities. The Family Doctors that I have had the privilege to work with and have mentored me through time have all served beyond the clinic and hospital walls, they showed endless energy and compassion to make a change in our communities.

What piqued your interest in becoming active with your county and state AFP chapters?

It all started when my resident colleague and I decided to enter 28

California Family Physician Summer 2023

a contest where we had to write on the importance of advocacy and leadership. Happily, we were chosen to attend the National Conference of Constituent Leaders (NCCL) in Kansas City. A "YES" to a CAFP dinner and a flight back to California with our CAFP jewel (retired Executive VP) Susan Hogeland, are what started this amazing journey. An invitation in the elevator turned into a 12-year journey that started for me as a resident member of the CAFP board, where I had the privilege of co-leading the resident council across the state and nationally. This allowed the residency council to amplify our voice on important topics affecting our residents. After graduation, I was voted to serve as the Fresno-Kings-Madera President. Along with the chapter board members, we reignited our local activities. This allowed us to interact with one another and collaborate on engaging residency programs, addressing workforce and offering CME. My role expanded on the board as a director and my learnings and collaboration grew in the areas of advocacy, policy, CME,

leadership, practice transformation, wellness, cultural competency, and the joy of medicine. The journey with the academy has been a pathway of growth and learning and most importantly, working with academy members and leaders who support you and ignite the energy you need to continue.

What are the most important challenges for Family Physicians?

Access to equitable care, physician shortages, payment reform, and social determinants of health are some of the most important challenges that we face in caring for our patients. I’ve had the privilege to serve as the medical director for our rural clinic system in California, from the corners of Ukiah down to the entrance of Yosemite and over to the oil fields of Taft. Every one of these towns is unique and special all together. My experience in visiting the various clinics and talking to patients, clinic staff, family doctors, and local government officials is that everyone living in that town wants to succeed, to grow, and to thrive. The Family Physician is positioned best to understand and to make a difference in the lives of our communities.

What has been the best part of being an officer in CAFP so far?

The best part for me is the friendships that have been made throughout this wonderful journey.

Everyone in the academy has a unique talent and has expertise and experience in just about every subject possible and this makes us stronger. The learnings from each of the talented members has given us an ability to represent CAFP in the state, across the country and globally. continued on page 30

County of Santa Cruz

Invites You To Apply for the Position of:

Clinic Physician Health Services Agency

LIVE Here. WORK Here. PLAY Here.

• Bilingual (English/Spanish) Candidates Encouraged to Apply • Salary: $247,333 - 267,488 Annually • Sign-on incentive pay • Comprehensive benefits to eligible employees and their dependents To apply and for more information, visit: www.santacruzcountyjobs.com You may contact us by phone at (831) 454-2600 or e-mail at personnel@Santacruzcounty.us

Health Sciences Clinical Professor Series - Assistant/Associate Clinical Professor, Gottschalk Plaza (JPF08167) APPLICATION WINDOW:

Open April 14, 2023, through Friday, Jul 14, 2023, at 11:59pm (Pacific Time)

POSITION OVERVIEW:

UC Irvine Family Medicine is recruiting a full-time faculty member to join a dynamic academic department dedicated to excellence in patient care, medical education, scholarship and community engagement. We are seeking an excellent family physician with a strong commitment to medical education. This position is offered in the Health Sciences Clinical Professor Series at the Assistant or Associate level. This position will be based at the Gottschalk Plaza and will be moving to a beautiful new multidisciplinary Center for Ambulatory Care as part of the new Irvine Medical Campus by early 2024.

The incumbent will participate in ambulatory patient care, fellow supervision, resident teaching, medical student precepting; perform university and public service, and demonstrate professional competency and activity.

REQUIREMENTS:

M.D., D.O. or M.D./Ph.D. from an accredited institution with appropriate clinical training and experience. Board Certification in Family Medicine and eligibility for UCI Medical Center medical staff privileges. Candidates must have demonstrated capabilities for teaching, professional service and/or research suitable to the HS Clinical Professor series.

SALARY RANGE:

Positions are dependent upon funding. The salary range for this position is $82,200-$129,300. This position includes membership in the health sciences compensation plan, which provides for eligibility for additional compensation. Initial appointments are for one year and renewal is based on availability of support.

VIEW THIS POSITION ONLINE: https://recruit.ap.uci.edu/JPF08167 TO APPLY: Please log onto UC Irvine’s RECRUIT located at https://recruit.ap.uci.edu/JPF08167 CAMPUS INFORMATION:

The University of California, Irvine is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC nondiscrimination policy.

As a condition of employment, you will be required to comply with the University of California Policy on Vaccination Programs – With Updated Interim Amendments. All Covered Individuals under he policy must provide proof of receiving the COVID-19 Vaccine Primary Series or, if applicable, submit a request for Exception (based on Medical Exemption, Disability, Religious Objection, and/ or Deferral based on pregnancy or recent COVID-19 diagnosis and/or treatment) no later than the applicable deadline. All Covered Individuals must also provide proof of receiving the most recent CDC-recommended COVID-19 booster or properly decline such booster no later than the applicable deadline. New University of California employees should refer to Exhibit 2, Section II.C. of the SARSCoV-2 (COVID-19) Vaccination Program Attachment for applicable deadlines. All Covered Individuals must also provide proof of being up-to-date on seasonal influenza vaccination or properly decline such vaccination no later than the applicable deadline. Please refer to the Seasonal Influenza Vaccination Program Attachment. (Capitalized terms in this paragraph are defined in the policy.) Federal, state, or local public health directives may impose additional requirements.

California Family Physician Summer 2023

29

continued from page 29

to lead any community in need. We must continue the transformation, where we can change every corner of society, from that newborn baby, supporting a colleague through an illness, the patient needing support through the substance use disorder, that policy in your clinic to provide equitable health care, speaking in legislative chambers supporting reproductive rights, in city council to provide safe places for the homeless, we as Family Physicians do this now, the next step is to amplify the voice of our patients, our colleagues, and our specialty.

What brings you joy in practice?

The joy of medicine is integrated into the physician-patient relationship, being able to care for people holistically by considering medical, behavioral, social, and spiritual aspects of care. Also being able to care for people in various environments and modalities of care to improve whole person care. Another aspect of joy to mention is working with a care team that believes in the mission to support and enhance the care of our patients. Team-based care brings joy for our staff, medical providers and patients.

What is your message to the next generation of Family Physicians – what will sustain them?

For us to sustain our health care workforce and the joy of medicine it is important we wake up remembering the “why” we came into health care. We need to look at the opportunity we have been given to serve as doctors and practice graciously and serve our patients. We also need to look at our communities and the immense need to provide equitable care and look at collaborative models to ensure we address the social determinants of health.

When the pandemic hit and in a state of emergency, we started drive-through testing, vaccine distribution, we collaborated with our local county health departments, police and fire departments, the school districts as well as non-profit organizations to deliver care that was needed for the community.

The common thread during that moment was to care for one another and keep each other safe. That experience taught me an important lesson, when talented people come together and are focused, organized and collaborative, they can deliver the best outcome in the most compromising of events we may face. I say we are one phone call, one hello, one meeting, one opportunity from a collaborative model that benefits the community.

We as Family Physicians are well trained and best positioned

30

California Family Physician Summer 2023

We are in a new age, times are changing, some are good and some not as pleasant, there is one thing that is the same — the love we have for our patients, the love we have for our community, the love we have for another. We must stand up and move in the direction of change, we have the strength, we have been chosen, be that voice that changes that child to be the next Family Doctor. The change for a better tomorrow is not for us, it is for our children and many generations to come.

Finally, what are three things CAFP members may not know about you?

-I love to BBQ. -I love boots.

-I used to race cars.

A leader and innovator in the future of health care

Adult & Family Medicine Physician Opportunities Northern & Central California - Ask us about our enhanced compensation!

The Permanente Medical Group, Inc. (TPMG) has a longstanding reputation for progress and quality service that not only offers you the stability you need for a fulfilling career, but also the freedom to explore innovative ideas. We invite you to join our over 9,000 physicians at one of our 22 medical centers or numerous clinics throughout Northern and Central California and become part of our 75-year tradition.

A FEW REASONS TO PRACTICE WITH TPMG:

When you join Kaiser Permanente in Northern or Central California, you'll enjoy the best of both big city and small town amenities. Our locations offer family-oriented communities, spacious parks, tree-lined streets, excellent schools, great shopping, outstanding restaurants, and a multitude of cultural activities. You’ll also enjoy nearby destinations such as the Napa Valley wine country, San Francisco, Lake Tahoe, and the stunning shoreline of the Pacific Coast.

• We demonstrate our commitment to a culture of equity, inclusion, and diversity by hiring physicians that reflect and celebrate the diversity of people and cultures.

For more information about our career opportunities and wage ranges, please visit: northerncalifornia.permanente.org.

FAMILY MEDICINE: Contact Bianca Canales at: Bianca.Canales@kp.org or 510-421-2183 INTERNAL MEDICINE: Contact Harjit Singh at: Harjit.X.Singh@kp.org or 510-295-7857

Ask us about our enhanced compensation for AFM Physicians!

• Work-life balance focused practice, including flexible schedules and unmatched practice support.

• We can focus on providing excellent patient care without managing overhead and billing.

No RVUs.

• Amazing benefits package, including comprehensive medical and dental, moving allowance and home loan assistance (up to $250,000 - approval required), and more!

$200,000-$325,000 FORGIVABLE LOAN PROGRAM (based on location and experience)

Available exclusively to Internal Medicine and Family Medicine Physicians, the Forgivable Loan Program is just one of many incentives we offer in exchange for our Primary care Physician’s dedication and expertise.

CONNECT WITH US: We are an EOE/AA/M/F/D/V Employer. VEVRAA Federal Contractor.

California Family Physician Summer 2023

31

CALIFORNIA ACADEMY OF FAMILY PHYSICIANS 816 21st Street Sacramento, California 95811

miec_2022_CAFP_bleed.pdf

Presorted Standard U.S. POSTAGE PAID

Fayetteville, AR Permit No. 986 1

4/15/22

10:52 AM

Every physician deserves to be insured by a company like MIEC. As a reciprocal exchange, MIEC is

entirely owned by the policyholders we protect. Our mission to protect physicians and the practice of

medicine has guided us over the past 47 years. Our Patient Safety and Risk Management team continues to

provide policyholders timely resources and expert advice to improve patient safety and reduce risk. To learn more about the benefits of being an MIEC policyholder, or to apply, visit miec.com or call 800.227.4527.

Get a quote today.

Medical Malpractice coverage for individuals, groups and facilities.

Acupuncture, Psychiatry, and other specialty coverages available.

miec.com | 800.227.4527

Insurance by physicians, for physicians.™