Spring 2016

California

FAMILY PHYSICIAN

THEY MAY NOT LISTEN, BUT TAKE YOUR BEST SHOT

12

ARE OPIOID OVERDOSES THE NEW VIETNAM WAR?

18

THE PAGE YOU NEVER WANT TO READ: CODE SILVER

22

PESKY MOSQUITOS: CAUSING MORE THAN THE SUMMER ITCH

26

VOL. 67 NO. 2 Sp ring 2016

Meet Your Incoming CAFP President: Lee Ralph, MD!

Success.

It’s what California’s finest physicians strive for... and what CAP can help you achieve.

Since 1977, the Cooperative of American Physicians (CAP) has provided superior medical professional liability coverage and valuable risk and practice management programs to California’s finest physicians through its Mutual Protection Trust (MPT).

As a physician-directed organization, we understand the realities of running a medical practice, and we are committed to supporting you with a range of valuable programs and services. These include a 24-hour adverse outcomes hotline, HR support, EHR consultation, a group purchasing program, and payment and reimbursement education and support, to name a few.

Prepare for Value-Based Compensation with CAP’s Free Guide As payers move toward a more value-focused model of reimbursement, your practice’s revenue stream may soon be tied entirely to clinical outcomes and patient experience.

CAP’s Physician’s Action Guide to Value-Based Compensation is replete with valuable information and tips to help you stay ahead of the VBC curve and attain fair and prompt reimbursement from public and private payers.

Request your free electronic or hard copy today!

800-356-5672 | CAPphysicians.com/Value

REGISTER BY 6/30/16 AND SAVE UP TO $175 GLOBALACEDEMYCME.COM/RHEUMATOLOGY

Rheumatology NewsÂŽ Internal Medicine NewsÂŽ Family Practice NewsÂŽ present

9

th

AN N U AL

PERSPECTIVES IN RHEUMATIC DISEASES

THIS CONFERENCE IS FOR YOU: $2/?7+>96913=>=, F+736y Phy=3-3+8= 8>er8+6 /.3-38/ %:/-3+63=>= !?<=/ Pr+->3>398/<= Phy=3-3+8 ==3=>+8>= !?<=/= +8. #2+<7+-3=>= CHAIR Daniel E. Furst, MD David Geffen School of Medicine University of California, Los Angeles (UCLA) CO-CHAIRS Brian Mandell, MD, PhD The Cleveland Clinic, OH Professor Iain McInnes, FRCP, PhD, FRSE University of Glasgow, Scotland, UK

7/1/2016

After 8/31/2016

Physician

$275

$375

$450

Physician Assistant

$195

$275

$325

Nurse Practitioner

$195

$275

$325

Nurse (RN)

$195

$275

$325

Pharmacist

$195

$275

$325

Resident

$150

$175

$250

Industry

$695

$695

$795

To make hotel reservations online go to https://resweb.passkey.com/go/SCPRD6 Conference room rate fee is $179-260 per night plus taxes.

Rheumatologic Reflections: Rheumatology & Primary Care Breakouts Stump The Professors: Clinical Cases

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CAESARS PALACE 3570 Las Vegas Boulevard South Las Vegas, NV 89109 (866) 227-5938

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FACULTY Leonard Calabrese, DO The Cleveland Clinic Daniel J. Clauw, MD University of Michigan Health System Marc D. Cohen, MD National Jewish Medical and Research Center Kenneth B. Gordon, MD Northwestern University Feinberg School of Medicine Michelle Petri, MD, MPH, Chairperson Johns Hopkins University School of Medicine Michael Pimentel, MD Cedars-Sinai Medical Center Ruth Ann Vleugels, MD, MPH Harvard Medical School Tuition

EARN UP 13.75 TO CME/ CREDI CE TS

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California FAMILY PHYSICIAN

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Manager, Finance

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YĆľÄ&#x17E;Ć?Ć&#x;ŽŜĆ?Í? Ä&#x201A;ĹŻĹŻ ϴϴϴͲϴϴϰͲϴώϰώÄ&#x201A;ĹśÄ&#x161; Ä&#x201A; , >d,Ä&#x17E; Z Z^ Ć&#x152;Ä&#x17E;Ć&#x2030;Ć&#x152;Ä&#x17E;Ć?Ä&#x17E;ĹśĆ&#x161;Ä&#x201A;Ć&#x;Ç&#x20AC;Ä&#x17E; Ç Ĺ?ĹŻĹŻ Ĺ&#x161;Ä&#x17E;ĹŻĆ&#x2030; Ç&#x2021;ŽƾÍ&#x2DC;

4

California Family Physician Spring 2016

12 They May Not Listen, But Take Your Best Shot

Jeffrey Luther, MD, FAAFP

14 Meet Your Incoming President: Lee Ralph, MD 18 Are Opioid Overdoses the New Vietnam War?

Carol Havens, MD

22 The Page You Never Want to Read: Code SILVER 26 Pesky Mosquitos: Causing More than the Summer Itch

Lauren Simon, MD, MPH Shelly Rodrigues, CAE, FACEHP

6

Editorial

Public Health Lessons in Self-Destruction

Nathan Hitzeman, MD

8

President’s Message

Passing the Gavel

Jay W. Lee, MD, MPH

9

PCMH Corner

PCPCC Reviews Annual PCMH Evidence

10 Political Pulse

Family Medicine Residency Programs Facing $40 Million Fiscal Cliff

30 EVP’s Forum

Public Health Continues to be a Priority for Your Academy

Leah Newkirk Carla Kakutani, MD Susan Hogeland, CAE

For upcoming CD acƟǀiƟes ǀisit familydocs͘orgͬcme California California Family Family Physician Physician Spring Fall 2016 ϮϬϭϰ

5

EDITORIAL

ȱ ȱ ĵ ǰȱ ȱ

Public Health Lessons in Self-Destruction KƵƌ ŽĸĐĞ ŚĂĚ Ă ƌĞĐĞŶƚ DĞĚŝͲ Ăů ĂƵĚŝƚ͕ ĂŶĚ ǁĞ ǁĞƌĞ ĂĚǀŝƐĞĚ ƚŽ ĚŽ ďĞƩĞƌ Ăƚ ƐĐƌĞĞŶŝŶŐ ĨŽƌ ůĞĂĚ ƉŽŝƐŽŶŝŶŐ ĂŶĚ ƚƵďĞƌĐƵůŽƐŝƐ ŝŶ ĐŚŝůĚƌĞŶ͘ /͛ǀĞ ŶĞǀĞƌ ƐĞĞŶ Ă ĐĂƐĞ ŽĨ ĐŚŝůĚŚŽŽĚ ůĞĂĚ ƉŽŝƐŽŶŝŶŐ ŝŶ ŵLJ ϭϯ LJĞĂƌƐ ŽĨ ƉƌĂĐƟĐĞ͕ ĂŶĚ /͛ǀĞ ƐĐƌĞĞŶĞĚ ƉůĞŶƚLJ͘ DĂLJďĞ ƚŚŝƐ ǁŽƵůĚ ŚĂǀĞ ďĞĞŶ ŐŽŽĚ ƉƌĂĐƟĐĞ ŝŶ ƚŚĞ ZŽŵĂŶ ŵƉŝƌĞ͕ ďƵƚ ŶŽǁͲ ĂͲĚĂLJƐ͍ ^ŝŵŝůĂƌůLJ͕ /͛ǀĞ ƐĞĞŶ Ă ŚĂŶĚĨƵů ŽĨ ƚƵďĞƌĐƵůŽƐŝƐ ĐĂƐĞƐ ŝŶ ĂĚƵůƚƐ ďƵƚ ŶĞǀĞƌ Ă ĐŚŝůĚ͘ ŽƵůĚ ƚŚĞƌĞ ďĞ ďŝŐŐĞƌ ƚŚƌĞĂƚƐ ŽƵƚ ƚŚĞƌĞ ƚŚĂƚ ǁĞ ĂƌĞ ŐůŽƐƐŝŶŐ ŽǀĞƌ͍ dŽĚĂLJ͕ / ĚŝĚ Ă ŶĞǁ ƉĂƟĞŶƚ ƉŚLJƐŝĐĂů ĞdžĂŵ ŽŶ Ă ϯϯͲLJĞĂƌͲŽůĚ ƐŝŶŐůĞ ŵŽƚŚĞƌ ǁŝƚŚ ĨŽƵƌ ĐŚŝůĚƌĞŶ͘ ,Ğƌ ƚŚƌĞĞͲLJĞĂƌͲŽůĚ ĚĂƵŐŚƚĞƌ ĐůƵŶŐ ƚŽ ŚĞƌ ŶĞĐŬ ĨŽƌ ƚŚĞ ĮƌƐƚ ŚĂůĨ ŽĨ ƚŚĞ ǀŝƐŝƚ ƵŶƟů / ƐƚĂƌƚĞĚ ůŝƐƚĞŶŝŶŐ ƚŽ ŵŽŵ͛Ɛ ŚĞĂƌƚ͘ dŚĞ Őŝƌů͛Ɛ ĞLJĞƐ ŐůĞĂŵĞĚ͕ ĂŶĚ ƐŚĞ ĂƐŬĞĚ͕ ͞ ĂŶ / ůŝƐƚĞŶ ƚŽŽ͍͟ &Žƌ ƚŚĞ ŶĞdžƚ ϭϬ ŵŝŶƵƚĞƐ͕ ƐŚĞ ĞdžĂŵŝŶĞĚ ŚĞƌ ŵŽƚŚĞƌ ǁŝƚŚ ŵLJ ƐƚĞƚŚŽƐĐŽƉĞ ǁŚŝůĞ / ĮŶŝƐŚĞĚ ƚŚĞ ƌĞƐƚ ŽĨ ƚŚĞ ĞdžĂŵ͘

ǁŚĞŶ / ŚĂŝů Ă ĐĂď Žƌ ƵƐĞ Ă ƌŝĚĞ ƐŚĂƌŝŶŐ ƐĞƌǀŝĐĞ͘ / ĚŽŶ͛ƚ ǁĂŶƚ ŵĂůů ĐŽƉ ƚLJƉĞ ŐƵLJƐ Ăƚ ŵLJ ŬŝĚ͛Ɛ ƐĐŚŽŽů ƐƵƉƉŽƐĞĚůLJ ĂĐƟŶŐ ĂƐ ĚĞƚĞƌƌĞŶƚƐ͘ /Ĩ ŽƵƌ ĨŽƌĞĨĂƚŚĞƌƐ ǁĂŶƚĞĚ ĞǀĞƌLJ ůĂǁͲĂďŝĚŝŶŐ͕ ƐĂŶĞ ŚŽƵƐĞŚŽůĚ ƚŽ ŚĂǀĞ Ă ŵƵƐŬĞƚ͕ ĮŶĞ͘ Ƶƚ / ĚŽŶ͛ƚ ƚŚŝŶŬ ƚŚĞLJ ŵĞĂŶƚ ĐĂŶŶŽŶƐ͕ <ͲϰϳƐ͕ Ͳϰ͕ Žƌ ǁŚĂƚ ŚĂǀĞ LJŽƵ͘ / ƐƵƉƉŽƐĞ ŝĨ ƚŚĞLJ ĂĐĐŝĚĞŶƚĂůůLJ ƚƌĂŶƐĐƌŝďĞĚ ͞ƚŚĞ ƌŝŐŚƚ ƚŽ Ăƌŵ ďĞĂƌƐ͕͟ ǁĞ͛Ě ŚĂǀĞ ƚŚŽƐĞ ƌŽĂŵŝŶŐ ƚŚĞ ƐƚƌĞĞƚƐ ƚŽŽ͘ dŚĞ ƌĞĐƵƌƌŝŶŐ ĂĚǀŝĐĞ ĨĂŵŝůLJ ĚŽĐƐ ŐŝǀĞ ƚŽ ƚŚĞŝƌ ƉĂƟĞŶƚƐ ŝƐ ĞǀĞƌLJƚŚŝŶŐ ŝŶ ŵŽĚĞƌĂƟŽŶ͘ KĨ ƚŚĞ ƐĂŵĞ ŵĂŐŶŝƚƵĚĞ ĂƐ ĮƌĞĂƌŵ ĚĞĂƚŚƐ ŝŶ ŽƵƌ ĐŽƵŶƚƌLJ ĂƌĞ ĚƌƵŐ ŽǀĞƌĚŽƐĞ ĨĂƚĂůŝƟĞƐ͕ ǁŝƚŚ ƉƌĞƐĐƌŝƉƟŽŶ ŽƉŝŽŝĚƐ ŵĂŬŝŶŐ ƵƉ ĂŶ ĞǀĞƌͲŝŶĐƌĞĂƐŝŶŐ ǁĞĚŐĞ ŽĨ ƚŚĞ ƉŝĞ͘ DLJ ƐĞŶŝŽƌ ĐŽůůĞĂŐƵĞƐ ƌĞŵĞŵďĞƌ Ă ƟŵĞ ǁŚĞŶ ŶŽŶͲ ĐĂŶĐĞƌ͕ ŶŽŶͲƐƵƌŐĞƌLJ ƉĂƟĞŶƚƐ ŚĂĚ ƚŽ ĐŽŵĞ ŝŶ ǁŝƚŚ ŬŶŝǀĞƐ ƐƟĐŬŝŶŐ ŽƵƚ ŽĨ ƚŚĞŝƌ ďĂĐŬƐ ƚŽ ŐĞƚ ŽƉŝŽŝĚƐ͘ dŚĞŶ ŝŶ ƚŚĞ ůĂƚĞ ϭϵϵϬƐ͕ ƵŶĚĞƌͲƚƌĞĂƚŵĞŶƚ ŽĨ ƉĂŝŶ ďĞĐĂŵĞ Ă ĐĂƵƐĞ ĚĞ ƌŝŐƵĞƵƌ ƚĂŬĞŶ ƵƉ ďLJ ƐŽŵĞ ƉŽůŝƟĐŝĂŶƐ ĂŶĚ ĂĚǀŽĐĂƚĞƐ͕ ĂŶĚ͕ ŶŽǁ͕ ŵĂŶLJ ƉĂƟĞŶƚƐ ĂŶĚ ƉŚLJƐŝĐŝĂŶƐ ĐŽŶƐŝĚĞƌ ŝƚ ĐŽŵŵŽŶƉůĂĐĞ ƚŽ ƉƌĞƐĐƌŝďĞ ŽƉŝŽŝĚƐ ĨŽƌ ŶŽŶͲŬŶŝĨĞͲƐƟĐŬŝŶŐͲ ŽƵƚͲŽĨͲƚŚĞͲďĂĐŬ ĐŽŶĚŝƟŽŶƐ͘

ȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ǯȱ ȱ ȱ ȱ ¢ ȱ¢ ȱ ȱ ¢ȱ ȱ ȱ ȱ ȱ ǯȱ ȱ ȱ ȱ ȱ Ȭ ǰȱ ȱ ȱ ȱ ȱ ȱ ǯ

/ƚ ǁĂƐ ŽŶĞ ŽĨ ƚŚŽƐĞ ŝŶĚĞůŝďůĞ ŵŽŵĞŶƚƐ ƚŚĂƚ ƌĞŵŝŶĚ LJŽƵ ŽĨ ǁŚLJ LJŽƵ ĂƌĞ Ă ĨĂŵŝůLJ ĚŽĐƚŽƌ͘ >ĂƚĞƌ͕ ƚŚĞ ŵŽƚŚĞƌ ŵĞŶƟŽŶĞĚ ƐŽŵĞ ƉƌŽďůĞŵƐ ǁŝƚŚ ŚĞƌ ŽůĚĞƌ ŬŝĚƐ͗ ĚƌƵŐ ƵƐĞ͕ ƉƌŽŵŝƐĐƵŝƚLJ͕ ƚƌƵĂŶĐLJ͘ / ƉŝĐƚƵƌĞ ƚŚĂƚ ŝŶŶŽĐĞŶƚ Őŝƌů ǁŝƚŚ ƚŚĞ ƐƚĞƚŚŽƐĐŽƉĞ͘ tŚĂƚ ƌĞĂůůLJ ƚŚƌĞĂƚĞŶƐ ŚĞƌ ĨƵƚƵƌĞ ŝƐ ƉŽǀĞƌƚLJ͕ ƵŶŝŶƚĞŶĚĞĚ ƉƌĞŐŶĂŶĐLJ͕ ũƵŶŬ ĨŽŽĚ͕ ƐƵďƐƚĂŶĐĞ ĂďƵƐĞ͕ ůĂĐŬ ŽĨ ƌŽůĞ ŵŽĚĞůƐͬŵĞŶƚŽƌƐ͕ ĂŶĚ ĞŵŽƟŽŶĂůͬƉŚLJƐŝĐĂů ƚƌĂƵŵĂ͘

tŚĂƚ ƚŚŝŶŐƐ ĂƌĞ LJŽƵ ǁŽƌƌLJŝŶŐ ĂďŽƵƚ ĨŽƌ LJŽƵƌ ƉĞĚŝĂƚƌŝĐ ƉĂƟĞŶƚƐ͍ /Ɛ ŝƚ ůĞĂĚ͕ ƚƵďĞƌĐƵůŽƐŝƐ͕ ďŽůĂ͕ ŝŬĂ ǀŝƌƵƐ͕ ĐůŝŵďŝŶŐ ĞůĞĐƚƌŝĐ ƚŽǁĞƌƐ͕ Žƌ ƉĞƌŚĂƉƐ ďĞŝŶŐ ƐĞŶƚ Žī ŝŶƚŽ ƚŚĞ ĂƚŵŽƐƉŚĞƌĞ ŝŶ ŚĞůŝƵŵ ďĂůůŽŽŶƐ͕ ůŝŬĞ ŝŶ ƚŚĞ ϮϬϬϵ ŽůŽƌĂĚŽ ďĂůůŽŽŶ ďŽLJ ŚŽĂdž͍ tŚŝůĞ Ăůů ƚŚĞƐĞ ƚŚŝŶŐƐ ŐĞƚ ŝŶŽƌĚŝŶĂƚĞ ĂƩĞŶƟŽŶ͕ ǁŚĂƚ ĂďŽƵƚ ƚŚĞ ŽďǀŝŽƵƐ ƚŚƌĞĂƚƐ ƐƵĐŚ ĂƐ ŐƵŶ ǀŝŽůĞŶĐĞ Žƌ ƉƌĞƐĐƌŝƉƟŽŶ ĚƌƵŐ ŽǀĞƌĚŽƐĞ͍ /͛ǀĞ ŐŽŶĞ ƚĂƌŐĞƚ ƐŚŽŽƟŶŐ ďĞĨŽƌĞ͘ &ŝƌŝŶŐ Ă ŐƵŶ ŝƐ ĨƵŶ͘ Ƶƚ / ĚŽŶ͛ƚ ǁĂŶƚ ŵLJ ŵĞŶƚĂůůLJ ƵŶĮƚ ŶĞŝŐŚďŽƌ Ăƚ ƚŚĞ ĞŶĚ ŽĨ ƚŚĞ ďůŽĐŬ ƐƚŽĐŬƉŝůŝŶŐ ƚŚĞŵ͘ / ĚŽŶ͛ƚ ǁĂŶƚ ƚŽ ŚĂǀĞ ƚŽ ƋƵĞƐƟŽŶ ŵLJ ƐĂĨĞƚLJ

6

California Family Physician Spring 2016

/ ƐƚƌƵŐŐůĞ ǁŝƚŚ ƚŚŝƐ ĞǀĞƌLJ ĚĂLJ͘ ^ƵƌĞ͕ ǁĞ ĐĂŶ ƉƌĞƐĐƌŝďĞ ĂŶĚ ƉŽůŝĐĞ ŝƚ͘ ZƵŶŶŝŶŐ ƌĞƉŽƌƚƐ͕ ĐĂůůŝŶŐ ƉŚĂƌŵĂĐŝĞƐ͕ ƋƵĞƐƟŽŶŝŶŐ ĨĂŵŝůLJ ŵĞŵďĞƌƐ͕ ďƵƚ ƚŚĞƌĞ ŝƐ Ă ƌĞĂƐŽŶ / ǁĞŶƚ ŝŶƚŽ ŵĞĚŝĐŝŶĞ ĂŶĚ ŶŽƚ ůĂǁ ĞŶĨŽƌĐĞŵĞŶƚ ;ĂŶĚ ŝƚ͛Ɛ ŵŽƌĞ ƚŚĂŶ ĨŽƌĞŐŽŝŶŐ ƚŚĞ ŵƵƐƚĂĐŚĞͿ͘ ^ƵƉƉŽƌƟŶŐ &W ŝƐ ƚŽ ƐƵƉƉŽƌƚ Ă ǀŽŝĐĞ ŽĨ ƌĞĂƐŽŶ͘ tĞ ĂƌĞ ŶŽƚ ƐĂLJŝŶŐ LJĞĂ Žƌ ŶĂLJ ƚŽ Ăůů ŐƵŶƐ Žƌ ŽƉŝŽŝĚƐ͘ Ƶƚ ǁĞ ĂƌĞ ŝŶƚŽ ĞǀŝĚĞŶĐĞͲďĂƐĞĚ͕ ǁŚŽůĞ ƉĂƟĞŶƚ ĂŶĚ ǁŚŽůĞ ƉŽƉƵůĂƟŽŶ ŚĞĂůƚŚ͘ /Ĩ ƚŚĂƚ ŵĞĂŶƐ ůŽŽŬŝŶŐ Ăƚ ƚŚŝƐ ĐŽƵŶƚƌLJ͛Ɛ ƐĞůĨͲĚĞƐƚƌƵĐƟǀĞ ůŝĨĞƐƚLJůĞ ŚĂďŝƚƐ͕ ƚŚĞŶ ŵĂLJďĞ ŝƚ͛Ɛ ƟŵĞ͘ WůĞĂƐĞ ƐƵƉƉŽƌƚ LJŽƵƌ ƉƌŽĨĞƐƐŝŽŶ ĂŶĚ ĐŽŵŵƵŶŝƚLJ͘ &Žƌ ŶŽǁ͕ ƚŚĂƚ ƚŚƌĞĞͲLJĞĂƌͲŽůĚ Őŝƌů ǁŝƚŚ ƚŚĞ ƐŝŶŐůĞ ŵŽŵ ǁŝƚŚ ƚǁŽ ƉĂƌƚͲƟŵĞ ũŽďƐ ;ǁŝƚŚŽƵƚ ďĞŶĞĮƚƐͿ ŚĂƐ ƚŚĞ ŽĚĚƐ ĂŐĂŝŶƐƚ ŚĞƌ͘ dĞƐƟŶŐ ĨŽƌ ůĞĂĚ ǁŽŶ͛ƚ ŚĞůƉ ŚĞƌ͘ Ƶƚ ŵĂLJďĞ ƚŚĞ ĐĂƌĞ ŽĨ Ă ŐŽŽĚ ĨĂŵŝůLJ ĚŽĐ ĐĂŶ͘

Anaheim Marriott Anaheim, California September 21 - 24, 2016

Identify & eradicate the cause of disease!

We owe it to ourselves and to our patients to learn about and be able to “prescribe” a prevention and treatment protocol with only positive side effects.

We are looked to by our patients for guidance on not only how to treat their conditions, but, more importantly, how to use lifestyle as a therapeutic intervention. And, when it comes to lifestyle, food trumps all.

Educate and inform.

Join the leading names in preventive, nutritional medicine for the 4th Annual International Plant-Based Nutrition Healthcare Conference. Enjoy nine delicious meals, and earn valuable Continuing Medical Education credits: This program is approved for 24 AMA PRA Category 1™ and 24 AAFP Prescribed™ credits.*

24 AAFP Prescribed™ Credits

* AAFP Prescribed Credits were issued in 2015 and are pending approval for this year’s AMA PRA Category 1 accredited event. Please check the CME Accreditation page at pbnhc.com for updates.

Save $100! Register online using discount code: AAFP100 Visit pbnhc.com and register to be part of this medical education event many have described as “life-changing!”

The alarming rise of chronic disease trends, among both adults and children, is sounding the wake-up call in the medical community. It’s critical that preventive, nutritional medicine, which is sorely lacking in our medical schools, become the foundation of our nation’s health care system.

— Scott Stoll, MD, Co-Founder and Board Chairman of The Plantrician Project

©2016 The Plantrician Project. All Rights Reserved.

California Family Physician Spring 2016 pbnhc.com

PRESIDENT’S MESSAGE

¢ȱ ǯȱ ǰȱ ǰȱ

Passing the Gavel /Ŷ ƚŚĞ ŵŝĚͲϭϵϵϬƐ͕ / ǁŽƌŬĞĚ ĂƐ Ă ŵĞĚŝĐĂů ǀŽůƵŶƚĞĞƌ ĨŽƌ Ă ŶŽŶͲ ŐŽǀĞƌŶŵĞŶƚĂů ŽƌŐĂŶŝnjĂƚŝŽŶ ŝŶ ƌƵƌĂů ƉŽƐƚͲǁĂƌ ů ^ĂůǀĂĚŽƌ͘ tŚĂƚ / ǁŝƚŶĞƐƐĞĚ ĨŝƌƐƚŚĂŶĚ ǁĂƐ ƚŚĞ ƌĞůĂƚŝŽŶƐŚŝƉ ďĞƚǁĞĞŶ ƉƌŝŵĂƌLJ ĐĂƌĞ ĂŶĚ ƉƵďůŝĐ ŚĞĂůƚŚ͕ ƉƌŽǀŝĚŝŶŐ ĐůŝŶŝĐĂů ƐƵƉƉŽƌƚ ĨŽƌ ůŽĐĂů ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĂŶĚ ŽƌŐĂŶŝnjŝŶŐ ƉƵďůŝĐ ŚĞĂůƚŚ ƉƌŽũĞĐƚƐ ƐƵĐŚ ĂƐ ĨĂĐŝůŝƚĂƚŝŶŐ ƚŚĞ ĚĞǀĞůŽƉŵĞŶƚ ŽĨ Ă ƉŽƚĂďůĞ ǁĂƚĞƌ ƐLJƐƚĞŵ͘ / ĂůƐŽ ŐƌĞǁ ŵLJ ŚĂŝƌ ůŽŶŐ͘ dŚĂƚ ƐƉŝƌŝƚ ůŝǀĞƐ ŽŶ ŝŶ ŵLJ ůŝĨĞ ĂƐ Ă ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶ ƚŽĚĂLJ͕ ĂŶĚ / ƐƵƐƉĞĐƚ ŝƚ ůŝǀĞƐ ŝŶ LJŽƵƌ ǁŽƌŬ ĂƐ ǁĞůů͘ &ĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ƉůĂLJ Ă ŬĞLJ ƌŽůĞ ŝŶ ďƌŝĚŐŝŶŐ ƚŚĞ ŐĂƉ ďĞƚǁĞĞŶ ĐůŝŶŝĐĂů ŵĞĚŝĐŝŶĞ ĂŶĚ ƉƵďůŝĐ ŚĞĂůƚŚ͘ ǀĞƌLJ ĚĂLJ͕ ǁĞ ǁŝƚŶĞƐƐ ƚŚŝƐ ŝŶƚĞƌĨĂĐĞ͘ ^ŽĐŝĂů ĚĞƚĞƌŵŝŶĂŶƚƐ ŽĨ ŚĞĂůƚŚ ŵĂŶŝĨĞƐƚ ƚŚĞŵƐĞůǀĞƐ ŝŶ ŽƵƌ ŽĨĨŝĐĞƐ ĂƐ ƐLJŵƉƚŽŵƐ ĂŶĚ ƐŽŵĞƚŝŵĞƐ ĂƐ ƐŝŐŶŝĨŝĐĂŶƚ ĚŝƐĞĂƐĞ͘ tĞ ĂƌĞ ĂůƐŽ ƚŚĞ ĨŝƌƐƚ ƉŽŝŶƚ ŽĨ ĂĐĐĞƐƐ ĨŽƌ ŵĂŶLJ ƉĂƚŝĞŶƚƐ ĚƵƌŝŶŐ ŝŶĨůƵĞŶnjĂ ƐĞĂƐŽŶ͘ WĂƚŝĞŶƚƐ ĂƌĞ ǀĂĐĐŝŶĂƚĞĚ ĂŐĂŝŶƐƚ ƉƌĞǀĞŶƚĂďůĞ ĚŝƐĞĂƐĞƐ ŝŶ ŽƵƌ ŽĨĨŝĐĞƐ͘ tĞ ĂůƐŽ ĂƐƐĞƐƐ ĂŶĚ ďĞŐŝŶ ƚƌĞĂƚŵĞŶƚ ĨŽƌ ĚĞƉƌĞƐƐŝŽŶ͘ ŶĚ ǁĞ ŵĂŬĞ ŚĞĂůƚŚ ƉƌŝŵĂƌLJ ǁŚĞŶ ǁĞ ŽĨĨĞƌ ĞǀŝĚĞŶĐĞͲďĂƐĞĚ ĐĂŶĐĞƌ ƐĐƌĞĞŶŝŶŐ͘ /Ŷ ƚŚĞ ƉĂƐƚ ĚĞĐĂĚĞ͕ / ŚĂǀĞ ƐĞĞŶ ŽƵƌ ƌŽůĞ ĂƐ ƉƵďůŝĐ ŚĞĂůƚŚ ĂĚǀŽĐĂƚĞƐ ĞdžƉĂŶĚ͕ ƚŚĞ ŵŽƐƚ ŶŽƚĂďůĞ ƌĞĐĞŶƚ ĞdžĂŵƉůĞ ďĞŝŶŐ ^ Ϯϳϳ͘ Ɛ LJŽƵƌ ƉƌĞƐŝĚĞŶƚ͕ / ŚĂĚ ƚŚĞ ƉƌŝǀŝůĞŐĞ ŽĨ ƐƉĞĂŬŝŶŐ ƚŽ ƚŚĞ ŵĞĚŝĂ ŽŶ ŶƵŵĞƌŽƵƐ ŽĐĐĂƐŝŽŶƐ ŽŶ ƚŚĞ ŝŵƉŽƌƚĂŶĐĞ ŽĨ ƉƌŽƚĞĐƚŝŶŐ ƚŚĞ ƉƵďůŝĐ͛Ɛ ŚĞĂůƚŚ ďLJ ĞůŝŵŝŶĂƚŝŶŐ ƉĞƌƐŽŶĂů ĂŶĚ ƌĞůŝŐŝŽƵƐ ďĞůŝĞĨ ĞdžĞŵƉƚŝŽŶƐ ĨŽƌ ǀĂĐĐŝŶĞƐ͘ KƵƌ ĂĐĂĚĞŵLJ ǁĂƐ Ăƚ ƚŚĞ ƚĂďůĞ ĂŶĚ ůĞǀĞƌĂŐĞĚ ŽƵƌ ĐŽůůĞĐƚŝǀĞ ǀŽŝĐĞ ƚŽ ƌĞƉƌĞƐĞŶƚ ŽƵƌ ŵĞŵďĞƌƐ ŽŶ ƚŚĞ ďĞŶĞĨŝƚƐ ŽĨ ǀĂĐĐŝŶĞƐ ĂŶĚ ĂĐŚŝĞǀŝŶŐ ŚĞƌĚ ŝŵŵƵŶŝƚLJ ĨŽƌ ƚŚĞ ƉƵďůŝĐ ŚĞĂůƚŚ ŽĨ ĂůŝĨŽƌŶŝĂ͘ /ƚ ǁĂƐ ĂŶ ĞƐƉĞĐŝĂůůLJ ƉƌŽƵĚ ŵŽŵĞŶƚ ĨŽƌ Ăůů ŽĨ ƵƐ ǁŚĞŶ ƚŚĞ 'ŽǀĞƌŶŽƌ ƌŽǁŶ ƐŝŐŶĞĚ ^ Ϯϳϳ ŝŶƚŽ ůĂǁ͘ ^ĐŝĞŶĐĞ ĨŽƌ ƚŚĞ ǁŝŶ͊ /Ŷ ƚŚŝƐ ŝƐƐƵĞ ŽĨ California Family Physician͕ LJŽƵ ǁŝůů ƌĞĂĚ ƐƚŽƌŝĞƐ ĂďŽƵƚ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ĂŶĚ ƉƵďůŝĐ ŚĞĂůƚŚ͘ / ďĞůŝĞǀĞ ŝƚ ĐŽŵĞƐ Ăƚ ĂŶ ŽƉƉŽƌƚƵŶĞ ƚŝŵĞ ŝŶ ŽƵƌ ƐƚŽƌLJ ĂƐ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͘ Ɛ ŵŽƌĞ ĂŶĚ ŵŽƌĞ ƉĂLJŵĞŶƚ ƐLJƐƚĞŵƐ ĞǀŽůǀĞ ĨƌŽŵ ǀŽůƵŵĞ ƚŽ ǀĂůƵĞ ǁŝƚŚ ƚŚĞ ƉĂƐƐĂŐĞ ŽĨ ƚŚĞ DĞĚŝĐĂƌĞ ĂŶĚ ,/W ZĞĂƵƚŚŽƌŝnjĂƚŝŽŶ Đƚ ;D Z Ϳ͕ ǁĞ ǁŝůů ƉůĂLJ ĂŶ ŝŶĐƌĞĂƐŝŶŐůLJ ŝŵƉĂĐƚĨƵů ƌŽůĞ ŝŶ ĚĞůŝǀĞƌŝŶŐ ƉŽƉƵůĂƚŝŽŶͲůĞǀĞů ŚĞĂůƚŚ ƚŚƌŽƵŐŚ ŽƵƌ ǁŽƌŬ ŝŶ ƉƌŝŵĂƌLJ ĐĂƌĞ͘ tŚŽ ďĞƚƚĞƌ ƚŚĂŶ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ƚŽ ƉƵƚ ƚŚĞ ŚĞĂůƚŚ ďĂĐŬ ŝŶ ŚĞĂůƚŚ ĐĂƌĞ͍ /Ĩ LJŽƵ͛Ě ůŝŬĞ ƚŽ ƐŚĂƌĞ LJŽƵƌ ƉƵďůŝĐ ŚĞĂůƚŚ ƐƚŽƌLJ͕ ƉůĞĂƐĞ ĐŽŶƚĂĐƚ ƚŚĞ &W ǀŝĂ ĞŵĂŝů ;ĐĂĨƉΛĨĂŵŝůLJĚŽĐ͘ŽƌŐͿ Žƌ ƉŽƐƚ Ă ĐŽŵŵĞŶƚ ŽŶ ŽƵƌ &ĂĐĞŬ ƉĂŐĞ ;ĨĂĐĞŬ͘ĐŽŵͬĨĂŵŝůLJĚŽĐƐͿ͘ Ɛ Ă ĨŝŶĂů ŶŽƚĞ͕ /͛Ě ůŝŬĞ ƚŽ ƚŚĂŶŬ LJŽƵ ĨŽƌ ƚŚĞ ŽƉƉŽƌƚƵŶŝƚLJ ƚŽ

8

California Family Physician Spring 2016

ȱ ȱ ȱ ȱCalifornia Family Physicianǰȱ¢ ȱ ȱ ȱ ȱ ȱ ¢ȱ ȱ ȱ ȱ ǯȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ¢ȱ ȱ ¢ȱ ¢ ǯ ƐĞƌǀĞ LJŽƵ ĂƐ ĐŚĂƉƚĞƌ ƉƌĞƐŝĚĞŶƚ ƚŚŝƐ ƉĂƐƚ LJĞĂƌ͘ ^ĞǀĞƌĂů ŬĞLJ ƚŚĞŵĞƐ ĞŵĞƌŐĞĚ ĂƐ / ǀŝƐŝƚĞĚ ǁŝƚŚ LJŽƵ ŝŶ LJŽƵƌ ĐŽŵŵƵŶŝƚŝĞƐ ĨƌŽŵ ƵƌĞŬĂ ƚŽ ^ĂŶ ŝĞŐŽ͗ ϭ͘ dƌĂŶƐĨŽƌŵŝŶŐ ŚĞĂůƚŚ ĐĂƌĞ ƚŽ ĚĞůŝǀĞƌ ŽŶ ƚŚĞ dƌŝƉůĞ ŝŵ ŽĨ ďĞƚƚĞƌ ĞdžƉĞƌŝĞŶĐĞ͕ ďĞƚƚĞƌ ǀĂůƵĞ͕ ĂŶĚ ďĞƚƚĞƌ ŚĞĂůƚŚ ŝƐ ŚĂƌĚ ǁŽƌŬ͕ ĂŶĚ ŽƵƌ ƐƵĐĐĞƐƐ ĚĞƉĞŶĚƐ ŽŶ ƚŚĞ ƐƚƌŽŶŐ ƌŽŽƚƐ ŽĨ ƉƌŝŵĂƌLJ ĐĂƌĞ ďĞĐĂƵƐĞ ǁĞ ŵĂŬĞ ŚĞĂůƚŚ ƉƌŝŵĂƌLJ͖ Ϯ͘ dƌŝƉůĞ ŝŵ ŵĞĂŶƐ ŶŽƚŚŝŶŐ ŝĨ ǁĞ ĚŽ ŶŽƚ ƌĞƐƚŽƌĞ ũŽLJ ƚŽ ŽƵƌ ƉƌĂĐƚŝĐĞ ŽĨ ŵĞĚŝĐŝŶĞ͘ EŽďŽĚLJ ǁƌŽƚĞ ŝŶ ƚŚĞŝƌ ƉĞƌƐŽŶĂů ƐƚĂƚĞŵĞŶƚ͗ ͞/ ǁĂŶƚ ƚŽ ĐůŝĐŬ Ă ďƵƚƚŽŶ ϰ͕ϬϬϬ ƚŝŵĞƐ Ă ĚĂLJ ǁŚĞŶ / ŐƌŽǁ ƵƉ ƚŽ ďĞ Ă ƉŚLJƐŝĐŝĂŶ͘͟ /ŶǀĂƌŝĂďůLJ͕ ǁŚĂƚ ǁĞ Ăůů ǁĂŶƚ ŝƐ ƚŚĞ ĂďŝůŝƚLJ ƚŽ ƉƌŽǀŝĚĞ ƐŽŵĞ ĨŽƌŵ ŽĨ ůŽŶŐŝƚƵĚŝŶĂů͕ ƌĞůĂƚŝŽŶƐŚŝƉͲďĂƐĞĚ ŚƵŵĂŶͲ ĐĞŶƚĞƌĞĚ ƉƌŝŵĂƌLJ ĐĂƌĞ͖ ϯ͘ WŚLJƐŝĐŝĂŶ ďƵƌŶŽƵƚ ŝƐ ƌĞĂů͘ tĞ ŵƵƐƚ ƐƚŽƉ ƚŚĞ ŵĞĂŶŝŶŐůĞƐƐ ĂďƵƐĞ ƚŚĂƚ ŚĂƐ ĐŽŵĞ ǁŝƚŚ ƚŚĞ ŝŶĐƌĞĂƐŝŶŐ ĐŽŵƉůĞdžŝƚLJ ĂŶĚ ǀŽůƵŵĞͲďĂƐĞĚ ĚĞŵĂŶĚƐ ŽĨ ŵŽĚĞƌŶ ŚĞĂůƚŚ ĐĂƌĞ͘ ŶĚ ǁĞ ŵƵƐƚ ůĞĂƌŶ ƚŽ ĐĂƌĞ ĨŽƌ ĞĂĐŚ ŽƚŚĞƌ ĂƐ ǁĞ ĐĂƌĞ ĨŽƌ ŽƵƌ ƉĂƚŝĞŶƚƐ͘ Ɛ / ƉĂƐƐ ƚŚĞ ŐĂǀĞů ƚŽ ƌ͘ ZĂůƉŚ ŝŶ ^ĂŶ &ƌĂŶĐŝƐĐŽ͕ / ůŽŽŬ ĨŽƌǁĂƌĚ ƚŽ ƚŚĞ ŽƉƉŽƌƚƵŶŝƚLJ ƚŽ ĐŽŶƚŝŶƵĞ ƐĞƌǀŝŶŐ ƚŚĞ ĨĂŵŝůLJ ŽĨ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ĂŶĚ ĂŶƚŝĐŝƉĂƚĞ ǁĞ ǁŝůů ŵŽǀĞ ƚŚĞ ŚĞĂůƚŚ ĐĂƌĞ ǀĞĐƚŽƌ ĞǀĞŶ ŵŽƌĞ ƚŽǁĂƌĚ ƉƌŝŵĂƌLJ ĐĂƌĞ͘ sŝǀĂ ƚŚĞ &ĂŵŝůLJ DĞĚŝĐŝŶĞ ZĞǀŽůƵƚŝŽŶ͊

PCMH CORNER

ȱ ȱ

PCPCC Reviews Annual PCMH Evidence dŚĞ WĂƟĞŶƚͲ ĞŶƚĞƌĞĚ WƌŝŵĂƌLJ ĂƌĞ ŽůůĂďŽƌĂƟǀĞ ;W W Ϳ ƉƵďůŝƐŚĞĚ ŝƚƐ ĂŶŶƵĂů ƌĞǀŝĞǁ ŽĨ WĂƟĞŶƚ ĞŶƚĞƌĞĚ DĞĚŝĐĂů ,ŽŵĞ ;W D,Ϳ ƌĞƐĞĂƌĐŚ ŝŶ &ĞďƌƵĂƌLJ ŽĨ ϮϬϭϲ͘ dŚĞ ƌĞƉŽƌƚ͕ WĂƟĞŶƚͲ ĞŶƚĞƌĞĚ DĞĚŝĐĂů ,ŽŵĞ͛Ɛ /ŵƉĂĐƚ ŽŶ ŽƐƚ Θ YƵĂůŝƚLJ͗ ŶŶƵĂů ZĞǀŝĞǁ ŽĨ ǀŝĚĞŶĐĞ ϮϬϭϰͲϮϬϭϱ͕ ĞǀĂůƵĂƚĞƐ ϯϬ ƐƚƵĚŝĞƐ ŽĨ ĂĚǀĂŶĐĞĚ ƉƌŝŵĂƌLJ ĐĂƌĞ Žƌ W D, ŝŶŝƟĂƟǀĞƐ ƉƵďůŝƐŚĞĚ ŝŶ ƚŚĞ ůĂƐƚ ĐŽƵƉůĞ ŽĨ LJĞĂƌƐ͘ ^ĞǀĞŶƚĞĞŶ ŽĨ ƚŚĞƐĞ ƐƚƵĚŝĞƐ ǁĞƌĞ ƉĞĞƌͲƌĞǀŝĞǁĞĚ͖ ĨŽƵƌ ǁĞƌĞ ƐƚĂƚĞ ŐŽǀĞƌŶŵĞŶƚ ĞǀĂůƵĂƟŽŶƐ͖ Ɛŝdž ǁĞƌĞ ŝŶĚƵƐƚƌLJ ƌĞƉŽƌƚƐ ĂŶĚ ƚŚƌĞĞ ǁĞƌĞ ŝŶĚĞƉĞŶĚĞŶƚ ĞǀĂůƵĂƟŽŶƐ ŽĨ ĨĞĚĞƌĂů ŝŶŝƟĂƟǀĞƐ͘ KŶĐĞ ĂŐĂŝŶ͕ W W ĨŽƵŶĚ ƚŚĂƚ W D, ĚƌŝǀĞƐ ƌĞĚƵĐƟŽŶƐ ŝŶ ŚĞĂůƚŚ ĐĂƌĞ ĐŽƐƚƐ ĂŶĚͬŽƌ ƵŶŶĞĐĞƐƐĂƌLJ ƵƟůŝnjĂƟŽŶ͕ ƐƵĐŚ ĂƐ ĞŵĞƌŐĞŶĐLJ ĚĞƉĂƌƚŵĞŶƚ ǀŝƐŝƚƐ͕ ŝŶƉĂƟĞŶƚ ŚŽƐƉŝƚĂůŝnjĂƟŽŶƐ ĂŶĚ ŚŽƐƉŝƚĂů ƌĞĂĚŵŝƐƐŝŽŶƐ ĂŶĚ ƌĞƐƵůƚƐ ŝŶ ƋƵĂůŝƚLJ ĂŶĚ ƉĂƟĞŶƚ ŚĞĂůƚŚ ŝŵƉƌŽǀĞŵĞŶƚƐ͘ &W ǁŝůů ƉƵďůŝĐŝnjĞ ƚŚĞƐĞ ƌĞƐƵůƚƐ ǁŝĚĞůLJ ǁŝƚŚ ĂůŝĨŽƌŶŝĂ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͕ ŚĞĂůƚŚ ĐĂƌĞ ƐƚĂŬĞŚŽůĚĞƌƐ ĂŶĚ ůĞŐŝƐůĂƚŽƌƐ͘ tĞ ĂůƐŽ ǁĂŶƚ ƚŽ ĂĐŬŶŽǁůĞĚŐĞ Ă ŶĞǁ ĂƉƉĞĂů͕ ŝŶ W W ͛Ɛ ƌĞƉŽƌƚ ĂŶĚ ĞůƐĞǁŚĞƌĞ͕ ĨŽƌ ĂůŝŐŶŵĞŶƚ ŝŶ W D, ĚĞĮŶŝƟŽŶ͕ ƋƵĂůŝƚLJ ŵĞĂƐƵƌĞƐ ĂŶĚ ƉĂLJŵĞŶƚ ŵŽĚĞůƐ ĂŶĚ ƐŽŵĞ ŝŶĚŝĐĂƟŽŶƐ ƚŚĂƚ ƚŚĂƚ ĂůŝŐŶŵĞŶƚ ŝƐ ĐŽŵŝŶŐ͘ dŚĞ W W ƌĞƉŽƌƚ ƌĞĐŽŐŶŝnjĞƐ ƚŚĞ ŐƌĞĂƚ ǀĂƌŝĞƚLJ ŽĨ W D, ŝŶŝƟĂƟǀĞƐ ĂŶĚ ĐĂůůƐ ĨŽƌ Ă ƵŶŝĮĞĚ ĚĞĮŶŝƟŽŶ ŽĨ W D, ŐƌŽƵŶĚĞĚ ŝŶ ƌĞƐĞĂƌĐŚ ƚŚĂƚ ŝĚĞŶƟĮĞƐ ǁŚŝĐŚ ŽĨ ŝƚƐ ĐŽŵƉŽŶĞŶƚƐ ŚĂǀĞ ƚŚĞ ŐƌĞĂƚĞƐƚ ĞīĞĐƚƐ͘ dŚĞ ĂƵƚŚŽƌƐ ŶŽƚĞ ƚŚĂƚ ƚŚĞ ĞŶƚĞƌƐ ĨŽƌ DĞĚŝĐĂƌĞ ĂŶĚ DĞĚŝĐĂŝĚ ^ĞƌǀŝĐĞƐ ; D^Ϳ ǁŝůů ĚĞĮŶĞ W D, ĐĞƌƟĮĐĂƟŽŶ ĨŽƌ ƚŚĞ ƉƵƌƉŽƐĞ ŽĨ ƉĂLJŵĞŶƚ ŝŶĐĞŶƟǀĞƐ ƵŶĚĞƌ ƚŚĞ DĞĚŝĐĂƌĞ ĐĐĞƐƐ ĂŶĚ ,/W ZĞĂƵƚŚŽƌŝnjĂƟŽŶ Đƚ ;D Z Ϳ ŝŶ ϮϬϭϲ ĂŶĚ ƚŚĂƚ ƚŚŝƐ ƉƌŽǀŝĚĞƐ ĂŶ ŝŵƉŽƌƚĂŶƚ ŽƉƉŽƌƚƵŶŝƚLJ ƚŽ ƵŶŝĨLJ ĂƌŽƵŶĚ Ă ĐůĞĂƌ W D, ĚĞĮŶŝƟŽŶ ĂŶĚ ƌĞĐŽŐŶŝƟŽŶ ƉƌŽĐĞƐƐ͘ ůŽŶŐ ƚŚĞ ƐĂŵĞ ůŝŶĞƐ͕ W W ƌĞĐŽŐŶŝnjĞƐ ƉƌŽǀŝĚĞƌ ͞ŵĞĂƐƵƌĞŵĞŶƚ ĨĂƟŐƵĞ͟ ŝŶ ŝƚƐ ƌĞƉŽƌƚ ĂŶĚ ĐĂůůƐ ĨŽƌ ƚŚĞ ĂůŝŐŶŵĞŶƚ ŽĨ ďŽƚŚ ƉĂLJŵĞŶƚ ĂŶĚ ƉĞƌĨŽƌŵĂŶĐĞ ŵĞĂƐƵƌĞŵĞŶƚ ĂĐƌŽƐƐ ƉƵďůŝĐ ĂŶĚ ƉƌŝǀĂƚĞ ƉĂLJĞƌƐ ƚŽ ŐĂƌŶĞƌ ƐƵƉƉŽƌƚ ĨƌŽŵ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉƌĂĐƟĐĞƐ͘ dŚĞ ǀĂƌŝĂƟŽŶ ŝŶ ƚŚĞ ĚĞƐŝŐŶ ŽĨ ŝŶŝƟĂƟǀĞƐ ŝƐ ĂůƐŽ ĞǀŝĚĞŶƚ ŝŶ ƉĂLJŵĞŶƚ ŵŽĚĞůƐ͘ ^ŽŵĞ ƉƌĂĐƟĐĞƐ ƌĞĐĞŝǀĞ ƉĞƌ ŵĞŵďĞƌ ƉĞƌ ŵŽŶƚŚ ƉĂLJŵĞŶƚƐ ;WDWDͿ͖ ŽƚŚĞƌƐ ƌĞĐĞŝǀĞ ƉĂLJŵĞŶƚ ŝŶĐĞŶƟǀĞƐ ƟĞĚ ƚŽ ƋƵĂůŝƚLJ͕ ĐŽƐƚ Žƌ ƉĂƟĞŶƚ ĞŶŐĂŐĞŵĞŶƚ ŵĞƚƌŝĐƐ ĂŶĚ ƐƟůů ŽƚŚĞƌƐ ƌĞĐĞŝǀĞ ƐŚĂƌĞĚ ƐĂǀŝŶŐƐ͘ ^ŝŐŶŝĮĐĂŶƚ ĞdžƉĞƌŝŵĞŶƚĂƟŽŶ ǁŝƚŚ ƉĂLJŵĞŶƚ ŵŽĚĞůƐ ŝƐ ƵŶĚĞƌǁĂLJ͕ ĂŶĚ ƌĞƐĞĂƌĐŚĞƌƐ ŚŽƉĞ ƚŽ ůĞĂƌŶ ŵŽƌĞ ĂďŽƵƚ ƚŚĞ ďĞƐƚ ĂƉƉƌŽĂĐŚ͘ dŚĞ W W ĂƵƚŚŽƌƐ ĚƌĂǁ ƐĞǀĞƌĂů ĐŽŶĐůƵƐŝŽŶƐ͗ ϭ͘

Ϯ͘

/ŶŝƟĂƟǀĞƐ ǁŝƚŚ ƚŚĞ ŐƌĞĂƚĞƐƚ ŝŵƉĂĐƚ ǁĞƌĞ ŐĞŶĞƌĂůůLJ ƚŚŽƐĞ ƚŚĂƚ ŝŶǀŽůǀĞĚ ŵƵůƟͲƉĂLJĞƌ ĐŽůůĂďŽƌĂƟǀĞƐ ǁŝƚŚ ƐƉĞĐŝĮĐ ŝŶĐĞŶƟǀĞƐ Žƌ ƉĞƌĨŽƌŵĂŶĐĞ ŵĞĂƐƵƌĞƐ ůŝŶŬĞĚ ƚŽ ƋƵĂůŝƚLJ͕ ƵƟůŝnjĂƟŽŶ͕ ƉĂƟĞŶƚ ĞŶŐĂŐĞŵĞŶƚ Žƌ ĐŽƐƚ ƐĂǀŝŶŐƐ͖ sĂůƵĞͲďĂƐĞĚ ƉĂLJŵĞŶƚ ƐŚŽƵůĚ ďĞ ĂƉƉƌŽƉƌŝĂƚĞůLJ ƉŚĂƐĞĚ

ϯ͘

ŝŶ͗ ĮƌƐƚ͕ ƚŽ ƐƵƉƉŽƌƚ ƚŚĞ ƉƌĂĐƟĐĞ ŝŶ ĂĚŽƉƟŶŐ ƐƚƌƵĐƚƵƌĂů ĂŶĚ ŽƌŐĂŶŝnjĂƟŽŶĂů ůĞĂĚĞƌƐŚŝƉ ĐŚĂŶŐĞƐ͕ ƚŚĞŶ͕ ƚŽ ĂĚŽƉƚ ǁŽƌŬŇŽǁͬƉƌŽĐĞƐƐ ŵŽĚŝĮĐĂƟŽŶ ĂŶĚ ĮŶĂůůLJ ƚŽ ĨŽĐƵƐ ŽŶ ƉƌŽĐĞƐƐ ĂŶĚ ŽƵƚĐŽŵĞ ŝŵƉƌŽǀĞŵĞŶƚƐ͖ WƌŽǀŝĚĞƌƐ ŶĞĞĚ ĂĚĞƋƵĂƚĞ ƉĂLJŵĞŶƚ ƚŽ ĐŽŵƉĞŶƐĂƚĞ ĨŽƌ ƚŚĞ ĮŶĂŶĐŝĂů ƌŝƐŬ ĂŶĚ ĂĐĐŽƵŶƚĂďŝůŝƚLJ ŽĨ Ă W D,͘ ϮϬϭϱ ƐƚƵĚLJ ďLJ DĂŐŝůů ĂŶĚ ŚƌĞŶďĞƌŐĞƌ ĨŽƵŶĚ ƚŚĂƚ ƚŚĞ ĐŽƐƚ ŽĨ ƐƵƐƚĂŝŶŝŶŐ Ă W D, ǁĂƐ ŵŽƌĞ ƚŚĂŶ ΨϭϬϬ͕ϬϬϬ ƉĞƌ ĨƵůůͲ ƟŵĞ ƉŚLJƐŝĐŝĂŶ ĂŶŶƵĂůůLJ͘

ŐĂŝŶ͕ ĂƐ ƚŚĞ W D, ŵŽǀĞŵĞŶƚ ŵĂƚƵƌĞƐ͕ W W ͕ &W ĂŶĚ ŽƚŚĞƌƐ ƐĞĞŬ ďĞƐƚ ƉƌĂĐƟĐĞƐ ŝŶ ƚĞƌŵƐ ŽĨ ƉĂLJŵĞŶƚ ŵŽĚĞůƐ͘ tĞ ĂƌĞ ĂůƐŽ ƐĞĞŝŶŐ ĨƌŽŵ ĂĐĐƵŵƵůĂƚĞĚ ƌĞƐĞĂƌĐŚ ƚŚĂƚ ƚŚĞ ůŽŶŐĞƌ Ă W D, ŝŶŝƟĂƟǀĞ ŚĂƐ ďĞĞŶ ŝŶ ƉůĂĐĞ͕ ƚŚĞ ďĞƩĞƌ ƚŚĞ ƌĞƐƵůƚƐ͘ &Žƌ ĞdžĂŵƉůĞ͕ ƚŚĞ WĞŶŶƐLJůǀĂŶŝĂ ŚƌŽŶŝĐ ĂƌĞ /ŶŝƟĂƟǀĞ ĚĞŵŽŶƐƚƌĂƚĞĚ ƉŽƐŝƟǀĞ ƌĞƐƵůƚƐ ŝŶ LJĞĂƌƐ ĨŽƵƌ ĂŶĚ ĮǀĞ͕ ǁŚŝĐŚ ĐŽŶƚƌĂƐƚƐ ǁŝƚŚ ĞĂƌůŝĞƌ ƌĞƐƵůƚƐ ĨĞĂƚƵƌĞĚ ŝŶ Ă ǁŝĚĞůLJ ĐŝƚĞĚ :ŽƵƌŶĂů ŽĨ ƚŚĞ ŵĞƌŝĐĂŶ DĞĚŝĐĂů ƐƐŽĐŝĂƟŽŶ ƐƚƵĚLJ ƚŚĂƚ ƐŚŽǁĞĚ ŶŽ ĐŽƐƚ ƐĂǀŝŶŐƐ ĂŶĚ ůŝŵŝƚĞĚ ƋƵĂůŝƚLJ ŝŵƉƌŽǀĞŵĞŶƚ͘ dŚĞƐĞ ŽůĚĞƌ W D, ŝŶŝƟĂƟǀĞƐ ĂůƐŽ ŝŶĐůƵĚĞ ƐƚĂƚĞ ŐŽǀĞƌŶŵĞŶƚ ŝŶŝƟĂƟǀĞƐ ƐƵĐŚ ĂƐ ŽŵŵƵŶŝƚLJ ĂƌĞ ŽĨ EŽƌƚŚ ĂƌŽůŝŶĂ͕ ǁŚŝĐŚ ǁĂƐ ĞǀĂůƵĂƚĞĚ ďLJ ĂŶ ŝŶĚĞƉĞŶĚĞŶƚ ƐƚĂƚĞ ĂƵĚŝƚŽƌ ŽǀĞƌ Ă ŶŝŶĞͲ LJĞĂƌ ƉĞƌŝŽĚ ĂŶĚ ĨŽƵŶĚ ƚŽ ƐĂǀĞ ƚŚĞ ƐƚĂƚĞ ĂƉƉƌŽdžŝŵĂƚĞůLJ Ψϭϯϰ ŵŝůůŝŽŶ͘ dŚĞ ůĞƐƐŽŶ ůĞĂƌŶĞĚ ŝƐ ƚŚĂƚ ƐŽŵĞ W D, ƉƌŽũĞĐƚƐ ŵĂLJ ƚĂŬĞ ƐŽŵĞ ƟŵĞ ƚŽ ƐŚŽǁ ƌĞƐƵůƚƐ͘ W W ͛Ɛ ƌĞƉŽƌƚ ĂůƐŽ ĞǀĂůƵĂƚĞƐ ƚŚĞ ƉƌĞůŝŵŝŶĂƌLJ ƌĞƐƵůƚƐ ĨƌŽŵ ƚŚƌĞĞ ŵĂũŽƌ ĨĞĚĞƌĂů ƉƌŝŵĂƌLJ ĐĂƌĞ ƚƌĂŶƐĨŽƌŵĂƟŽŶ ƉƌŽŐƌĂŵƐ͗ dŚĞ DƵůƟͲ ƉĂLJĞƌ ĚǀĂŶĐĞĚ WƌŝŵĂƌLJ ĂƌĞ WƌĂĐƟĐĞ ;D W WͿ ĞŵŽŶƐƚƌĂƟŽŶ͕ ƚŚĞ ŽŵƉƌĞŚĞŶƐŝǀĞ WƌŝŵĂƌLJ ĂƌĞ ; W Ϳ /ŶŝƟĂƟǀĞ ĂŶĚ Ă &ĞĚĞƌĂůůLJ YƵĂůŝĮĞĚ ,ĞĂůƚŚ ĞŶƚĞƌ ;&Y, Ϳ ĚĞŵŽŶƐƚƌĂƟŽŶ͘ ĂƌůLJ ƌĞƐƵůƚƐ ĨŽƌ D W W ĂŶĚ W ĂƌĞ ƉŽƐŝƟǀĞ͕ ĂůƚŚŽƵŐŚ ŶŽƚ ĂƐ ƉŽƐŝƟǀĞ ĂƐ ŵĂŶLJ ŚĂĚ ŚŽƉĞĚ ƚŽ ƐĞĞ͘ dŚĞ &Y, ƐŚŽǁĞĚ ůĞƐƐ ĨĂǀŽƌĂďůĞ ƌĞƐƵůƚƐ͘ tĞ ĂǁĂŝƚ Ă ďĞƩĞƌ ĞǀĂůƵĂƟŽŶ ŽĨ ƚŚĞƐĞ ůĂƌŐĞͲƐĐĂůĞ ƉƌŽũĞĐƚƐ ƚŚĂƚ ŝŶ ƚŚĞ ůŽŶŐͲƚĞƌŵ ŚĂǀĞ ƚŚĞ ƉŽƚĞŶƟĂů ƚŽ ƐŚŽǁ ƵƐ Ă ŐƌĞĂƚ ĚĞĂů ĂďŽƵƚ ǁŚĂƚ ǁŽƌŬƐ ĂŶĚ ǁŚĂƚ ĚŽĞƐ ŶŽƚ ŝŶ W D, ƉƌŽŐƌĂŵƐ͘ ZĞĨĞƌĞŶĐĞƐ͗ ͻ DĂŐŝůů͕ D͘<͕͘ ŚƌĞŶďĞƌŐĞƌ͕ ͕͘ ^ĐĂŵŵŽŶ͕ ͘>͕͘ ĂLJ͕ :͕͘ ůůĞŶ͕ d͕͘ ZĞĂůů͕ ͘:͕͘ <ŝŵ͕ :͘ ;ϮϬϭϱͿ͘ dŚĞ ĐŽƐƚ ŽĨ ƐƵƐƚĂŝŶŝŶŐ Ă ƉĂƟĞŶƚͲĐĞŶƚĞƌĞĚ ŵĞĚŝĐĂů ŚŽŵĞ͗ ĞdžƉĞƌŝĞŶĐĞ ĨƌŽŵ ƚǁŽ ƐƚĂƚĞƐ͘ ŶŶĂůƐ ŽĨ &ĂŵŝůLJ DĞĚŝĐŝŶĞ͕ ϭϯ;ϱͿ͕ ϰϮϵͲϯϱ͘ ͻ &ƌŝĞĚďĞƌŐ͕ D͘t͕͘ ^ĐŚŶĞŝĚĞƌ͕ ͘ ͕͘ ZŽƐĞŶƚŚĂů͕ D͘ ͕͘ sŽůƉƉ͕ <͘'͘ Θ tĞƌŶĞƌ͕ Z͘D͘ ;ϮϬϭϰͿ͘ ƐƐŽĐŝĂƟŽŶ ďĞƚǁĞĞŶ ƉĂƌƟĐŝƉĂƟŽŶ ŝŶ Ă ŵƵůƟƉĂLJĞƌ ŵĞĚŝĐĂů ŚŽŵĞ ŝŶƚĞƌǀĞŶƟŽŶ ĂŶĚ ĐŚĂŶŐĞƐ ŝŶ ƋƵĂůŝƚLJ͕ ƵƟůŝnjĂƟŽŶ͕ ĂŶĚ ĐŽƐƚƐ ŽĨ ĐĂƌĞ͘ : D ͕ ϯϭϭ;ϴͿ͕ ϴϭϱͲϴϮϱ͘

Leah Newkirk is CAFP’s Vice President of Health Policy.

California Family Physician Spring 2016

9

POLITICAL PULSE

ȱ ǰȱ ȱ

Family Medicine Residency Programs Facing $40 Million Fiscal Cliff ϮϬϭϲ ǁŝůů ďĞ Ă ĐƌƵĐŝĂů LJĞĂƌ ĨŽƌ ĨĂŵŝ ŵŝůůLJ ůLJ ŵĞĚ ĞĚŝŝĐŝŶ ŝĐŝŶĞĞ ĂĚ Ğ ĂĚ ĂĚǀŽ ǀŽĐĂ ǀŽ ĐĂĐLJ ĐĂ ĐLJ ĞīŽ Žƌƚ ƌƚƐ͘ Ɛ͘ ĞƐƉ Ğ ƐƉŝƚ ŝƚĞĞ ƚǁ ƚǁŽ Ž ĐŽ ĐŽŶƐ ŶƐĞĐ ĞĐƵƟ ƵƟǀĞ ǀĞ LJĞĂ ĞĂƌƐ ƌƐ ŽĨ Ĩ &W ƐƵĐ ƵĐĐĞ ĐĞƐƐ ƐƐƐ ŝŶ ŐĞ ŐĞŶĞ ŶĞƌĂ ŶĞ ƌĂƟŶ ƌĂ Ɵ Ő ƟŶ ƌĞƐŝĚĞŶĐLJ ĨƵŶĚŝŶŐ Ăƚ ďŽƚŚ ƚŚ ƚŚĞĞ Ɛƚ ƐƚĂƚ ĂƚĞĞ ĂŶ ĂŶĚ Ě ŶĂ ŶĂƟŽ ƟŽŶĂ ŶĂůů ůĞ ůĞǀĞ ǀĞůů͕ ƐĞǀĞƌ ĞƌĂů Ă ƐŽƵƌĐĞƐ ŽĨ ĨƵŶĚŝŶŐ ǁŝůů ĞǀĂƉŽƌĂƚĞ ďLJ ƚŚĞ ĞŶĚ ŽĨ ƚŚĞ LJĞĂƌ͘ dŚŝƐ ǁŝůů ĐƌĞĂƚĞ Ă ΨϰϬ ŵŝůůŝŽŶ ƐŚŽƌƞĂůů ŝŶ ĨƵŶĚŝŶŐ ĂŶĚ ĐŽƵůĚ ŵĞĂŶ the loss of more than 150 family medicine residency slots ŝŶ ĂůŝĨŽƌŶŝĂ͘ ƚ Ă ƟŵĞ ǁŚĞŶ ŶĞĂƌůLJ ĮǀĞ ŵŝůůŝŽŶ ƉĞŽƉůĞ ŚĂǀĞ ŐĂŝŶĞĚ ŚĞĂůƚŚ ŝŶƐƵƌĂŶĐĞ͕ ƚŚŝƐ ƉůĂĐĞƐ ĂŶ ĞŶŽƌŵŽƵƐ ƐƚƌĂŝŶ ŽŶ Ă ƉƌŝŵĂƌLJ ĐĂƌĞ ǁŽƌŬĨŽƌĐĞ ƚŚĂƚ ŝƐ ĂůƌĞĂĚLJ ĨĂĐŝŶŐ ĐƌŝƟĐĂů ƐŚŽƌƚĂŐĞƐ ĂĐƌŽƐƐ ƚŚĞ ƐƚĂƚĞ͘ dǁĞŶƚLJͲƚŚƌĞĞ ŽĨ ĂůŝĨŽƌŶŝĂ͛Ɛ ϱϴ ĐŽƵŶƟĞƐ ĨĂůů ďĞůŽǁ ƚŚĞ ŵŝŶŝŵƵŵ ƌĞƋƵŝƌĞĚ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶ ƚŽ ƉŽƉƵůĂƟŽŶ ƌĂƟŽ ĂŶĚ ŵŽƌĞ ƚŚĂŶ ϯϮ ƉĞƌĐĞŶƚ ŽĨ ĂůŝĨŽƌŶŝĂ͛Ɛ ƉƌĂĐƟĐŝŶŐ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶƐ ĂƌĞ ĂŐĞ ϲϬ Žƌ ŽůĚĞƌ͘ KŶůLJ ĨŽƵƌ ŽƚŚĞƌ ƐƚĂƚĞƐ ŚĂǀĞ Ă ůĂƌŐĞƌ ƉĞƌĐĞŶƚĂŐĞ ŽĨ ƉŚLJƐŝĐŝĂŶƐ ǁŚŽ ĂƌĞ ůŝŬĞůLJ ƚŽ ƌĞƟƌĞ ƐŽŽŶ͘

t ƌŬĨŽ tŽ ƌŬŬĨŽ ĨŽƌĐ ƌĐĞĞ dƌ dƌĂŝ ĂŝŶŝ ŶŝŶŐ ŶŐ WƌŽ ƌŽŐƌ Ő Ăŵ Őƌ Ăŵ͘​͘ ZĞ ZĞƐŝ Ɛ ĚĞ ĚĞŶĐ ŶĐLJLJ Ɖ ƉƌŽŐ ƉƌŽŐ ŽŐƌĂ ŐƌĂ ƌĂŵƐ ŵ ƚŚĂ ŵƐ Ś ƚ ƌĞ ƌ ĐĞĞŝǀ ƌĞ ŝ ǀĞ ^ŽŶŐ ŶŐͲ Ͳ ƌŽ ƌŽǁŶ ǁŶ ĨƵŶ ŶĚŝ ĚŝŶŐ Ŷ ŚĂǀǀĞ Ğ Ă Ă Ɖƌ ƉƌŽǀ Ɖƌ ŽǀĞŶ Žǀ ĞŶ ƌĞĐ Ğ ŽƌĚ ŽĨĨ ƚƌĂŝŶ ƌĂŝŶŝŶ ŝŝŶ ŶŐ Ő ŚĞ ŚĞĂů ŚĞ ĂĂůůƚŚ ĐĂĂƌĞ ƉƌŽ ƌŽĨĞ ĨĞƐƐ ƐƐŝŽ ŝŽŶĂ ŶĂůƐ ǁŚŽ ĐĂƌĞĞ ĨŽ ĨŽƌ ƌ ƵŶĚĞƌƐĞƌǀĞĚ ƉŽ ŽƉƵůĂƟŽ ƟŽŶƐ ŶƐ ŝŶ ƵŶĚĞƌƐĞƌǀĞĚ Ě ĂƌĞĂƐ ĂŶĚ Ě ĞdžƉĂŶĚ ƚŚĞ Ś ĞƚŚ ŚŶŝĐ Ěŝ ŝ ĚŝǀĞƌƐŝƚLJ ŽĨĨ ƚŚĞ ŚĞĂůƚŚ ĐĂƌĞ ǁŽƌŬĨŽƌĐĞ͘ LJ ŝŶǀĞƐƟŶŐ ŝŶ ^ŽŶŐͲ ƌŽǁŶ͕ ĂůŝĨŽƌŶŝĂ ǁŝůů ƌĞĂůŝnjĞ ĂŶ ŝŵŵĞĚŝĂƚĞ ƌĞƚƵƌŶ ŽŶ ŝŶǀĞƐƚŵĞŶƚ ĂƐ ĞĂĐŚ ƉƌŝŵĂƌLJ ĐĂƌĞ ƌĞƐŝĚĞŶƚ ƉƌŽǀŝĚĞƐ ĂŶ ĂǀĞƌĂŐĞ ŽĨ ϲϬϬ ĂĚĚŝƟŽŶĂů ƉĂƟĞŶƚ ǀŝƐŝƚƐ ƉĞƌ ƉŚLJƐŝĐŝĂŶ ƉĞƌ LJĞĂƌ ĚƵƌŝŶŐ ƚƌĂŝŶŝŶŐ ĂůŽŶĞ͘ KƵƌ ůŽŶŐͲƚĞƌŵ ǁŽƌŬĨŽƌĐĞ ĂůƐŽ ǁŽƵůĚ ŐƌŽǁ ƐŝŐŶŝĮĐĂŶƚůLJ ĂƐ ƚŚĞ ǀĂƐƚ ŵĂũŽƌŝƚLJ ŽĨ ƉŚLJƐŝĐŝĂŶƐ ǁŚŽ ƚƌĂŝŶ ŝŶ Ă ƌĞŐŝŽŶ ƐƚĂLJ ƚŚĞƌĞ ƚŽ ƉƌĂĐƟĐĞ͘ ĂůŝĨŽƌŶŝĂ ůĞĂĚƐ Ăůů ϱϬ ƐƚĂƚĞƐ ŝŶ ƚŚĞ ƉĞƌĐĞŶƚĂŐĞ ŽĨ ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵ ŐƌĂĚƵĂƚĞƐ ǁŚŽ ƐƚĂLJ ŝŶ ƚŚĞ ƐƚĂƚĞ ŝŶ ǁŚŝĐŚ ƚŚĞLJ ƚƌĂŝŶĞĚ͘ EĞĂƌůLJ ϳϬ ƉĞƌĐĞŶƚ ŽĨ ŵĞĚŝĐĂů ƌĞƐŝĚĞŶƚƐ ǁŚŽ ƚƌĂŝŶ ŝŶ ĂůŝĨŽƌŶŝĂ ƉƌĂĐƟĐĞ ŚĞƌĞ ĂŌĞƌ ŐƌĂĚƵĂƟŽŶ͘

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tŚLJ ĂƌĞ ǁĞ ĨĂĐŝŶŐ Ă ΨϰϬ ŵŝůůŝŽŶ ĮƐĐĂů Đůŝī͍ dŚĞ ĂŶƐǁĞƌ ŝƐ ƚŚĂƚ ĨƵŶĚŝŶŐ ƐƚƌĞĂŵƐ͕ ĨŽƌ ǁŚŝĐŚ ǁĞ ĨŽƵŐŚƚ ŚĂƌĚ͕ ŶĞĞĚ ƚŽ ďĞ ƌĞƉůĂĐĞĚ Žƌ ƌĞŶĞǁĞĚ͗ ͻ ƚŚƌĞĞͲLJĞĂƌ͕ ΨϮϭ ŵŝůůŝŽŶ ĂůŝĨŽƌŶŝĂ ŶĚŽǁŵĞŶƚ ŐƌĂŶƚ ĞdžƉŝƌĞƐ ŝŶ ϮϬϭϲ͘ ͻ /Ŷ ϮϬϭϰ͕ ƚŚĞ >ĞŐŝƐůĂƚƵƌĞ ĂƉƉƌŽƉƌŝĂƚĞĚ Ψϰ ŵŝůůŝŽŶ ƚŽ ŚĞůƉ ŵĞĞƚ ƚŚĞ ĚĞŵĂŶĚ ĨŽƌ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶƐ ŝŶ ĂƌĞĂƐ ŽĨ ƵŶŵĞƚ ŶĞĞĚ͕ ďƵƚ ƚŚĂƚ ĨƵŶĚŝŶŐ ǁĂƐ ŶŽƚ ƌĞŶĞǁĞĚ͘ ͻ dŚĞ ĨĞĚĞƌĂů WƌŝŵĂƌLJ ĂƌĞ ZĞƐŝĚĞŶĐLJ džƉĂŶƐŝŽŶ ƉƌŽŐƌĂŵ͕ ǁŚŝĐŚ ĂǁĂƌĚĞĚ ŵŽƌĞ ƚŚĂŶ Ψϭϴ ŵŝůůŝŽŶ ŝŶ ŐƌĂŶƚƐ ƚŽ ĂůŝĨŽƌŶŝĂ ƚŽ ĐƌĞĂƚĞ ŶĞǁ ƉƌŝŵĂƌLJ ĐĂƌĞ ƌĞƐŝĚĞŶƚ ƉŽƐŝƟŽŶƐ͕ ĞŶĚĞĚ ŝŶ ϮϬϭϱ͘ tŚŝůĞ Ă ƐĞĐƵƌĞ ĂŶĚ ƐƚĂďůĞ ĨƵŶĚŝŶŐ ƐŽƵƌĐĞ ŝƐ &W͛Ɛ ƵůƟŵĂƚĞ ŐŽĂů͕ 'ŽǀĞƌŶŽƌ :ĞƌƌLJ ƌŽǁŶ ŚĂƐ ƐŝŐŶĂůĞĚ ƟŵĞ ĂŶĚ ĂŐĂŝŶ ƚŚĂƚ ŚĞ ŽƉƉŽƐĞƐ ĂŶ ŽŶŐŽŝŶŐ ĮƐĐĂů ĐŽŵŵŝƚŵĞŶƚ͘ dŚĂƚ ŝƐ ǁŚLJ &W ŝƐ ƉƵƐŚŝŶŐ ŚĂƌĚ ĨŽƌ Ă ŽŶĞͲƟŵĞ ΨϰϬ ŵŝůůŝŽŶ ^ƚĂƚĞ ƵĚŐĞƚ ĂƉƉƌŽƉƌŝĂƟŽŶ ƚŽ ƐƵƉƉŽƌƚ ƚŚĞ ^ŽŶŐͲ ƌŽǁŶ ,ĞĂůƚŚ ĂƌĞ 10

California Family Physician Spring 2016

&W͛Ɛ ĂĚǀŽĐĂĐLJ ĞīŽƌƚƐ ĂƌĞ ĂůƌĞĂĚLJ ƵŶĚĞƌ ǁĂLJ͘ tĞ ŚĂǀĞ ƌĞĂĐŚĞĚ ŽƵƚ ƚŽ ŬĞLJ ůĞŐŝƐůĂƚŽƌƐ ĂŶĚ ŝŶǀŝƚĞĚ ƚŚĞŵ ƚŽ ƚŽƵƌ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵƐ ŝŶ ƚŚĞŝƌ ĚŝƐƚƌŝĐƚƐ͘ &Žƌ ůĞŐŝƐůĂƚŽƌƐ ǁŝƚŚŽƵƚ ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵƐ͕ ǁĞ ĂƌĞ ĂƌƌĂŶŐŝŶŐ Ă ďƵƐ ƚŽƵƌ ŽĨ ƚŚƌĞĞ ŐƌĞĂƚ ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵƐ ŶĞĂƌ ^ĂĐƌĂŵĞŶƚŽ͗ h ĂǀŝƐ &ĂŵŝůLJ DĞĚŝĐŝŶĞ ZĞƐŝĚĞŶĐLJ WƌŽŐƌĂŵ͕ ^ƵƩĞƌ ,ĞĂůƚŚ &ĂŵŝůLJ DĞĚŝĐŝŶĞ ZĞƐŝĚĞŶĐLJ WƌŽŐƌĂŵ ĂŶĚ DĞƌĐLJͬDĞƚŚŽĚŝƐƚƐ &ĂŵŝůLJ DĞĚŝĐŝŶĞ ZĞƐŝĚĞŶĐLJ WƌŽŐƌĂŵ͘ /Ĩ LJŽƵ ǁŽƵůĚ ůŝŬĞ ƚŽ ŚĞůƉ ŽƵƌ ĞīŽƌƚƐ͕ ƉůĞĂƐĞ ůŽŽŬ ƵƉ LJŽƵƌ ůĞŐŝƐůĂƚŽƌƐ͛ ĐŽŶƚĂĐƚ ŝŶĨŽƌŵĂƟŽŶ ;ŚƩƉ͗ͬ​ͬĮŶĚLJŽƵƌƌĞƉ͘ůĞŐŝƐůĂƚƵƌĞ͘ ĐĂ͘ŐŽǀͬͿ ĂŶĚ ůĞƚ ƚŚĞŵ ŬŶŽǁ ŚŽǁ ĚĞǀĂƐƚĂƟŶŐ ŝƚ ǁŽƵůĚ ďĞ ƚŽ LJŽƵƌ ĐŽŵŵƵŶŝƚLJ ƚŽ ůŽƐĞ ŶĞĂƌůLJ ŚĂůĨ ŽĨ ƚŚĞ ĨƵƚƵƌĞ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ǁŽƌŬĨŽƌĐĞ͘ /Ĩ LJŽƵ ŚĂǀĞ ĂŶLJ ƋƵĞƐƟŽŶƐ ĂďŽƵƚ ǁŚĂƚ ƚŽ ƐĂLJ͕ ƉůĞĂƐĞ ĞŵĂŝů &W ŝƌĞĐƚŽƌ ŽĨ 'ŽǀĞƌŶŵĞŶƚ ZĞůĂƟŽŶƐ ĚĂŵ &ƌĂŶĐŝƐ ;ĂĨƌĂŶĐŝƐΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐͿ͘ dŚĂŶŬ LJŽƵ ĨŽƌ LJŽƵƌ ƐƵƉƉŽƌƚ͊ Dr. <akutani is Chair, CAFP LegislaƟve Aīairs CommiƩee.

HUNGER KEEPS UP ON CURRENT EVENTS, TOO.

1 IN 6 AMERICANS STRUGGLES WITH HUNGER.

Physician – Full-time position for the Clovis facility. Current CA MD or DO license required; Board Certified/Board Eligible Family Practice or Internal Medicine; Current DEA; ACLS required; EMR exp. pref.; Excellent benefits package; Hiring in accord. with Indian Pref. Act. Please send CV to CVIH HR, 2740 Herndon Ave., Clovis, CA 93611 or email to hr@cvih.org Central Valley Indian Health, Inc.

UCSF FRESNO CHIEF/VICE CHAIR OF FAMILY MEDICINE The UCSF Fresno Medical Education Program and the Central California Faculty Medical Group (CCFMG) are currently recruiting for an experienced academic physician at the Associate or Full Professor level to lead its Family and Community Medicine program and serve as Vice-Chair in the UCSF Department of Family and Community Medicine. Responsibilities include department leadership, teaching residents and students, clinical research and participation in community practice. The program is based at Community Regional Medical Center including a new ambulatory facility with a Family Health Center. Other rural hospital and FQHC sites also participate in the program. Applicants must be board certified in Family Medicine and should have an established record of teaching and clinical excellence. Research experience is desirable.

Faculty appointment with UCSF will be commensurate with the applicant’s background and accomplishments.

PLEASE APPLY ONLINE AT: https://aprecruit.ucsf.edu/apply/JPF00778

TOGETHER WE’RE

Hunger is closer than you think. Reach out to your local food bank for ways to do your part.

Visit FeedingAmerica.org today.

Visit our websites: www.fresno.ucsf.edu and www.communitymedical.com 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 Spring 2016

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They May Not Listen, But Take Your Best Shot tŚĂƚ Ă LJĞĂƌ ĨŽƌ ǀĂĐĐŝŶĞƐ͘ /Ŷ ƚŚĞ ŵŽŶƚŚƐ ƐŝŶĐĞ Ă ƉĞƌĨĞĐƚ ƐƚŽƌŵ ŽĨ ƌƵďĞŽůĂ ǀŝƐŝƚĞĚ ƚŚĞ DĂŐŝĐ <ŝŶŐĚŽŵ͕ ǁĞ͛ǀĞ ƐĞĞŶ ƚŚĞ ĨƵƌŽƌ ŽǀĞƌ ǀĂĐĐŝŶĞ ŚĞƐŝƚĂŶĐLJ ;ƚŚĞ ŶƵĂŶĐĞĚ ĂůƚĞƌŶĂƟǀĞ ƚŽ ůĂďĞůƐ ƐƵĐŚ ĂƐ ͞ĂŶƟͲǀĂdždžĞƌƐ͟Ϳ Śŝƚ ƚŚĞ ŵĂŝŶƐƚƌĞĂŵ ŵĞĚŝĂ ůŝŬĞ ŶĞǀĞƌ ďĞĨŽƌĞ͘ /Ŷ :ƵŶĞ ϮϬϭϱ͕ 'ŽǀĞƌŶŽƌ ƌŽǁŶ ƐŝŐŶĞĚ ^ Ϯϳϳ͕ ŵĂŬŝŶŐ ĂůŝĨŽƌŶŝĂ ũƵƐƚ ƚŚĞ ƚŚŝƌĚ ƐƚĂƚĞ ŝŶ ƚŚĞ ƵŶŝŽŶ ƚŽ ĞůŝŵŝŶĂƚĞ Ăůů ďƵƚ ƚƌƵĞ ŵĞĚŝĐĂů ĞdžĞŵƉƟŽŶƐ ƚŽ ŵĂŶĚĂƚŽƌLJ ŝŵŵƵŶŝnjĂƟŽŶ͘ ŶĚ ƉĞƌŚĂƉƐ ŵŽƐƚ ŝŶƚĞƌĞƐƟŶŐůLJ͕ ĂůƚŚŽƵŐŚ ƚŚĞ ŶĞǁ ǀĂĐĐŝŶĞ ůĂǁ ĚŽĞƐŶ͛ƚ ƚĂŬĞ ĞīĞĐƚ ƵŶƟů :ƵůLJ͕ ǁĞ͛ǀĞ ƐĞĞŶ ƚŚĞ ƉĞƌĐĞŶƚĂŐĞ ŽĨ ĨƵůůLJ ǀĂĐĐŝŶĂƚĞĚ ŬŝŶĚĞƌŐĂƌƚŶĞƌƐ ŝŶ ƚŚĞ ƐƚĂƚĞ ƌĞĂĐŚ ŝƚƐ ŚŝŐŚĞƐƚ ůĞǀĞů ŝŶ Ă ĚĞĐĂĚĞ͕ ƵƉ Ϯ͘ϱ ƉĞƌĐĞŶƚ ĨƌŽŵ Ă LJĞĂƌ ĂŐŽ͘ ^Ɵůů͕ ŵƵĐŚ ǁŽƌŬ ƌĞŵĂŝŶƐ ƚŽ ďĞ ĚŽŶĞ͘ dŚĞ ƉƵďůŝĐ ŚĞĂůƚŚ ĐŚĂůůĞŶŐĞ ƚŚĂƚ ǀĂĐĐŝŶĞ ŚĞƐŝƚĂŶĐLJ ƉƌĞƐĞŶƚƐ ŝƐ ǀĞƌLJ ŵƵĐŚ Ă ƐŽĐŝŽůŽŐŝĐĂů ŽŶĞ͕ ĂƐ ŝƚ ĂƐƐĞƌƚƐ ƚŚĞ ƌŝŐŚƚƐ ŽĨ ƚŚĞ ŝŶĚŝǀŝĚƵĂů ŝŶ ĐŝƌĐƵŵƐƚĂŶĐĞƐ ŝŶ ǁŚŝĐŚ ŽŶĞ͛Ɛ ĚĞĐŝƐŝŽŶ ĐĂŶ ĚŝƌĞĐƚůLJ ĂīĞĐƚ ƚŚĞ ŚĞĂůƚŚ ŽĨ ŽƚŚĞƌƐ͘ Ŷ ƵƉƐǁŝŶŐ ŝŶ ĚŝƐƚƌƵƐƚ ŽĨ ďŽƚŚ ƐĐŝĞŶĐĞ ĂŶĚ ŐŽǀĞƌŶŵĞŶƚ ƉƌŽŵŝƐĞƐ ƚŽ ŵĂŬĞ ĂŶLJ ĐŽŶǀĞƌƐĂƟŽŶ ĂďŽƵƚ ǀĂĐĐŝŶĞƐ ĂŶ ĞŵŽƟŽŶĂů ĂŶĚ ƵŶƐĐŝĞŶƟĮĐ ĚĞďĂƚĞ͘ ŶĚ Ăƚ Ă ƟŵĞ ǁŚĞŶ͕ ĚĞƐƉŝƚĞ ŝŶƌŽĂĚƐ͕ ƚŚĞ ƉĞƌĐĞŶƚĂŐĞ ŽĨ ƵŶŝŵŵƵŶŝnjĞĚ ƐƚƵĚĞŶƚƐ Ăƚ ƐŽŵĞ ƐĐŚŽŽůƐ ĞdžĐĞĞĚƐ Ϯϱ ƉĞƌĐĞŶƚ͕ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͕ ƚŚĂŶŬƐ ƚŽ ŽƵƌ ƌĞůĂƟŽŶƐŚŝƉƐ ǁŝƚŚ ƉĂƌĞŶƚƐ ĂƐ ǁĞůů ĂƐ ĐŚŝůĚƌĞŶ͕ ĂƌĞ ƵŶŝƋƵĞůLJ ƐŝƚƵĂƚĞĚ ƚŽ ĂĚĚƌĞƐƐ ƚŚŝƐ͘ tŚŽŵ ĂƌĞ ǁĞ ƚĂƌŐĞƟŶŐ͍ dŚĞ ǀĂĐĐŝŶĞͲŚĞƐŝƚĂŶƚ ĐĂŶ ďĞ ƐĞĞŶ ĂƐ ďĞůŽŶŐŝŶŐ ƚŽ ŽŶĞ ŽĨ ƚŚƌĞĞ ĐĂŵƉƐ͘ &ŝƌƐƚ ĂƌĞ ƚŚĞ ǁĞůůͲŝŶƚĞŶƟŽŶĞĚ͕ ǁŚŽ ĨĞĞů Ă ĚƵƚLJ ƚŽ ĞdžĞƌĐŝƐĞ ĚƵĞ ĚŝůŝŐĞŶĐĞ ŝŶ ƐĂĨĞŐƵĂƌĚŝŶŐ ƚŚĞŝƌ ĐŚŝůĚƌĞŶ͛Ɛ ĂŶĚ ƚŚĞŝƌ ŽǁŶ ŚĞĂůƚŚ͘ ^ĞĐŽŶĚ ĂƌĞ ƚŚŽƐĞ ǁŝƚŚ ƐƉĞĐŝĮĐ ĨĞĂƌƐ ĂďŽƵƚ ǀĂĐĐŝŶĞƐ ďĂƐĞĚ ŽŶ ŵLJƚŚƐ ĨƌŽŵ ƚŚĞ ŵĞĚŝĂ Žƌ ĨƌŽŵ ĨƌŝĞŶĚƐ͘ &ŝŶĂůůLJ͕ ƚŚĞƌĞ ŝƐ Ă ƐŵĂůů ŵŝŶŽƌŝƚLJ ;Εϱ ƉĞƌĐĞŶƚ ŽĨ ƚŚĞ ǀĂĐĐŝŶĞͲŚĞƐŝƚĂŶƚͿ ǁŚŽ ŚĂƌďŽƌ Ă ŵŽƌĞ ŐůŽďĂů͕ ĐŽŶƐƉŝƌĂĐLJͲŵŝŶĚĞĚ ƐƵƐƉŝĐŝŽŶ ŽĨ ŝŵŵƵŶŝnjĂƟŽŶ ƉƌĂĐƟĐĞƐ͘ dŚŝƐ ůĂƐƚ ŐƌŽƵƉ ŝƐ ůĞĂƐƚ ůŝŬĞůLJ ƚŽ ƌĞƐƉŽŶĚ ƚŽ ĂŶLJ ĞīŽƌƚƐ ƚŽ ƉĞƌƐƵĂĚĞ͕ ďƵƚ ƚŚĞ ĮƌƐƚ͕ ŐŝǀĞŶ ƚŚĞ ŽƉƉŽƌƚƵŶŝƚLJ ƚŽ ĂƐŬ ƋƵĞƐƟŽŶƐ ĂŶĚ ďĞ ŐƵŝĚĞĚ͕ ŽīĞƌƐ ŽƵƌ ďĞƐƚ ŚŽƉĞ ĨŽƌ ďĞŶĚŝŶŐ ƚŚŝƐ ŝŵŵƵŶŝnjĂƟŽŶ ĐƵƌǀĞ͘ dŚĞ ŶĂƚƵƌĞ ŽĨ ĨĞĂƌƐ ƐƵƌƌŽƵŶĚŝŶŐ ǀĂĐĐŝŶĞƐ ŝƐ ǁĞůů ĚŽĐƵŵĞŶƚĞĚ͘ /ƚ ŝŶĐůƵĚĞƐ ĐŽŶĐĞƌŶƐ ƌĞŐĂƌĚŝŶŐ ƚŚĞŝƌ ŝŶŐƌĞĚŝĞŶƚƐ ĂŶĚ ƐĂĨĞƚLJ͕ ƚŚĞ ƌŝƐŬ ŽĨ ĂƵƟƐŵ Žƌ ƐĞŝnjƵƌĞƐ͕ ĂŶĚ ĞǀĞŶ ƚŚĞ ŶĞĐĞƐƐŝƚLJ ŽĨ ŝŵŵƵŶŝnjĂƟŽŶ Ăƚ Ă ƟŵĞ ǁŚĞŶ ĨĞǁ ĂĚƵůƚƐ ;ĂŶĚ ĞǀĞŶ ĚŽĐƚŽƌƐͿ ŚĂǀĞ ƐĞĞŶ ƐŽŵĞ ǀĂĐĐŝŶĞͲƉƌĞǀĞŶƚĂďůĞ ĚŝƐĞĂƐĞƐ ŝŶ ƚŚĞ ǁŝůĚ͘ Ƶƚ ŚĞƌĞ͛Ɛ ǁŚĂƚ ǁĞ ŬŶŽǁ͗ ƚŚĞ ŵŽƐƚ ĞǀŝĚĞŶĐĞͲďĂƐĞĚ ĂŶĚ ƌĂƟŽŶĂů ĂƌŐƵŵĞŶƚƐ ĨŽƌ ŝŵŵƵŶŝnjĂƟŽŶ ĂƌĞ ĂŵŽŶŐ ƚŚĞ ůĞĂƐƚ ůŝŬĞůLJ ƚŽ ƉĞƌƐƵĂĚĞ͘ ŵŽƟŽŶĂů ĂŶĚ ĂŶĞĐĚŽƚĂů ĂƌŐƵŵĞŶƚƐ ĂŐĂŝŶƐƚ ǀĂĐĐŝŶĞƐ ĂƌĞ ĨĂƌ ŵŽƌĞ ĞŶĚƵƌŝŶŐ ĂŶĚ ĂīĞĐƟŶŐ ƚŚĂŶ ŽƵƌ ďĞƐƚ ƐĐŝĞŶƟĮĐ ĚĂƚĂ͕ ĂŶĚ ǁĞ ŶĞĞĚ ƚŽ ƚĂŬĞ Žī ŽƵƌ ǁŚŝƚĞ ĐŽĂƚƐ ĂŶĚ ĂĚŽƉƚ Ă ĚŝīĞƌĞŶƚ ĂƉƉƌŽĂĐŚ ŝĨ ǁĞ ŚŽƉĞ ƚŽ ŵĂŬĞ Ă ĚŝīĞƌĞŶĐĞ͘

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California Family Physician Spring 2016

ȱ ȱ DZ Ȋȱ ȱǻ ǯ £ ǯ Ǽ Ȋȱ ȱǻ ǯ ǯ ǯ Ǽ Ȋȱ ȱǻ ǯ £ ǯ Ǽ Ȋȱ Ȧ ȱǻ ǯ ǯ ǯ Ǽ Ȋȱ ȱǻ ǯ ǯ Ǽ Ȋȱ ȱǻ ǯ ǯ Ǽ Ȋȱ ȱǻ ǯ ¢ǯ Ǽ Ȋȱ ȱ ȱǻ ǯ ǯ Ǽ Ȋȱ ¢ȱ ȱ ¢ȱ ȱǻ ǯ ǯ Ǽ &ŝƌƐƚ͕ ǁĞ ŚĂǀĞ ƚŽ ƐƚŽƉ ĂŶĚ ƚĂŬĞ ŽƵƌ ŽǁŶ ƉƵůƐĞ͘ ,ĂǀŝŶŐ ŽƵƌ ĞdžƉĞƌƚ ĂĚǀŝĐĞ ŝƌƌĂƟŽŶĂůůLJ ƌĞũĞĐƚĞĚ ŝƐ ĨƌƵƐƚƌĂƟŶŐ Ăƚ ďĞƐƚ ĂŶĚ ŽīĞŶƐŝǀĞ ƚŽ ƐŽŵĞ͕ ďƵƚ Ă ƐŶĂƉƉŝƐŚ Žƌ ĚŝƐƌĞƐƉĞĐƞƵů ƌĞƐƉŽŶƐĞ ǁŽŶ͛ƚ ŚĞůƉ͘ /ŶƐƚĞĂĚ ǁĞ ŵƵƐƚ ĚŽ ǁŚĂƚ ǁĞ ĚŽ ďĞƐƚ͗ ǁŽƌŬ ƚŽ ďƵŝůĚ ƚƌƵƐƚ ĂŶĚ ƚŽ ĞĚƵĐĂƚĞ͘ ƐƐĞƐƐŝŶŐ ƚŚĞ ĚĞƉƚŚ ŽĨ Ă ƉĂƌĞŶƚ͛Ɛ ĐŽŶĐĞƌŶ ĂŶĚ ƌĞƐƉŽŶĚŝŶŐ ƚŚŽƵŐŚƞƵůůLJ ŝƐ ƌĞĂůůLJ ŵŽƌĞ ŽƵƌ ƐƚLJůĞ ĂŶLJǁĂLJ͘ ƌŵĞĚ ǁŝƚŚ Ă ĨĞǁ ŐĞŶĞƌĂů ƌĞĂƐƐƵƌĂŶĐĞƐ ;͞ Ž LJŽƵ ƌĞĂůůLJ ƚŚŝŶŬ /͛Ě ƌĞĐŽŵŵĞŶĚ ƐŽŵĞƚŚŝŶŐ ƚŚĂƚ / ĚŝĚŶ͛ƚ ƚŚŝŶŬ ǁĂƐ ďĞƐƚ ĨŽƌ LJŽƵƌ ĐŚŝůĚ͍͟ Kƌ ƉĞƌŚĂƉƐ͕ ͞,ĂǀĞ LJŽƵ ĐŽŶƐŝĚĞƌĞĚ ǁŚLJ LJŽƵ ǁŽƵůĚ ƚĂŬĞ ĂĚǀŝĐĞ ĨƌŽŵ Ă ĐĞůĞďƌŝƚLJ ďƵƚ ŶŽƚ ĨƌŽŵ LJŽƵƌ ĐŚŝůĚ͛Ɛ ĚŽĐƚŽƌ͍͟Ϳ͕ ŽŶĞ ĐĂŶ ŵŽǀĞ ŽŶ ƚŽ ĂůůĂLJ ƐƉĞĐŝĮĐ ĨĞĂƌƐ ƵƐŝŶŐ Ă ĐŽŵďŝŶĂƟŽŶ ŽĨ ĨĂĐƚ ĂŶĚ ĐŽŵŵŽŶ ƐĞŶƐĞ͘ hƐĞĨƵů ƌĞƐƉŽŶƐĞƐ ƚŽ ŵĂŶLJ ŽĨ ƚŚĞ ĐŽŵŵŽŶ ĐŽŶĐĞƌŶƐ ĂƌĞ ĨŽƵŶĚ ŝŶ ŶƵŵĞƌŽƵƐ ƉƌŝŶƚ ĂŶĚ ŽŶůŝŶĞ ƌĞƐŽƵƌĐĞƐ͕ ĂŶĚ ŝƚ͛Ɛ ƵƐĞĨƵů ƚŽ ŚĂǀĞ ŽŶĞ Žƌ ƚǁŽ Ăƚ ƚŚĞ ƌĞĂĚLJ ĨŽƌ ĂŶLJ ŐŝǀĞŶ ŵLJƚŚ Žƌ ĨĞĂƌ͘ KŶ ƚŚĞ ƐƵďũĞĐƚ ŽĨ ŽŶůŝŶĞ ƌĞƐŽƵƌĐĞƐ͕ Ă ůŝƐƚ ŽĨ ƚŚĞ ŵŽƌĞ ĐƌĞĚŝďůĞ tĞď ƐŝƚĞƐ ĨŽƌ ǀĂĐĐŝŶĞ ŝŶĨŽƌŵĂƟŽŶ ;ƐĞĞ ĂďŽǀĞͿ ŵĂŬĞƐ Ă ŐƌĞĂƚ ŚĂŶĚŽƵƚ ĨŽƌ ĐŽŶĐĞƌŶĞĚ ƉĂƌĞŶƚƐ͘ /Ŷ ƉĂƌƟĐƵůĂƌ͕ ƚŚĞ EĂƟŽŶĂů EĞƚǁŽƌŬ ĨŽƌ /ŵŵƵŶŝnjĂƟŽŶ /ŶĨŽƌŵĂƟŽŶ ƐŝƚĞ ĐŽŶƚĂŝŶƐ Ă ƉĂƌĞŶƚ͛Ɛ ŐƵŝĚĞ ƚŽ ǀĂĐĐŝŶĞ ŝŶĨŽ ŽŶ ƚŚĞ tĞď ƚŚĂƚ͛Ɛ ƋƵŝƚĞ ŚĞůƉĨƵů͘ &Žƌ ƚŚĞ ƉŚLJƐŝĐŝĂŶ ǁŚŽ ǁĂŶƚƐ Ă ĚĞĞƉĞƌ ĂŶĂůLJƐŝƐ ŽĨ ƚŚĞ ŝƐƐƵĞ͕ ƚŚĞƌĞ ŝƐ KŶ /ŵŵƵŶŝƚLJ ʹ Ŷ /ŶŽĐƵůĂƟŽŶ͕ Ă ďĞĂƵƟĨƵů ĂŶĚ ďĂůĂŶĐĞĚ ǁŽƌŬ ďLJ ƵůĂ ŝƐƐ͘ ŶĚ ǁŚĞŶ ĨĞĞůŝŶŐ ĞƐƉĞĐŝĂůůLJ ƉƵƚͲƵƉŽŶ͕ ůĂƐƚ LJĞĂƌ͛Ɛ :ŝŵŵLJ <ŝŵŵĞů >ŝǀĞ ƐĞŐŵĞŶƚ ŽŶ ǀĂĐĐŝŶĞ ĚĞŶŝĂů ;ƐĞĞ zŽƵdƵďĞͿ ŝƐ Ă ŐƌĞĂƚ ǁĂLJ ƚŽ ǀĞŶƚ ŽŶĞ͛Ɛ ĨƌƵƐƚƌĂƟŽŶ ƚŚƌŽƵŐŚ ůĂƵŐŚƚĞƌ͘ dŚĞŶ ŐŽ ďĂĐŬ ƚŽ ƚŚĞ ĞdžĂŵ ƌŽŽŵ ĂŶĚ ďĞ ƚŚĂƚ ĞŵƉĂƚŚŝĐ ĂŶĚ ƚƌƵƐƚǁŽƌƚŚLJ ĞdžƉĞƌƚ LJŽƵƌ ƉĂƟĞŶƚƐ ĚĞƐĞƌǀĞ͘ Dr. :eīrey Luther is the current program director for the Memorial Family Medicine Residency Program in Long Beach, CA.

TM

Do you know What, When and How to Report Child Abuse?

ACHIEVE extraordinary outcomes When you're part of Dignity Health, you'll be able to do more than just care for your patients. You’ll have the opportunity to develop and participate in health, education

FREE ON-LINE COURSE!

and wellness programs that will help improve the lives of people throughout your community...and beyond. If you want to achieve extraordinary outcomes, join us today.

OUTPATIENT FAMILY MEDICINE PHYSICIANS

Northern and Southern California (Grass Valley, Inland Empire, Merced, Redding, Sacramento, Santa Cruz, Stockton, Ventura & Woodland)

Practice Highlights: • Autonomy with administrative and clinical support • An established, growing medical group OR an independent single specialty group practice • Full-time and part-time practice options • A Medical Foundation aligned with one of the largest health systems in the nation and the largest hospital system in California • Salary guarantee period and excellent earning potential based on productivity model

Course developed by the Child Abuse Prevention Center 

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Approved for 1.25 AMA PRA Category 1 Credits™ 

• Attractive bonus structure • Sunny California locations with easy access to San Francisco, Napa, Lake Tahoe, Los Angeles and San Diego

Please contact/send your CV to: Physician Recruitment providers@dignityhealth.org 888-599-7787 www.dignityhealth.org/physician-careers

Approved for 1.25 CE credits 

Course available 24/7

Pre-register at: http://www.imq.org/education/caprrc.aspx California Family Physician Spring 2016

13

Meet Your Incoming President: Lee Ralph, MD

ƌ͘ >ĞĞ ƉƌĞƐĞŶƚŝŶŐ Ă ƐĞƐƐŝŽŶ Ăƚ ƚŚĞ ϮϬϭϱ &ĂŵŝůLJ DĞĚŝĐŝŶĞ ůŝŶŝĐĂů &ŽƌƵŵ ŝŶ ^ĂŶ &ƌĂŶĐŝƐĐŽ͘

Meet Your Incoming President: Lee Ralph, MD &W ŝŶƚĞƌǀŝĞǁĞĚ >ĞĞ ZĂůƉŚ͕ D ͕ ϮϬϭϲͲϭϳ WƌĞƐŝĚĞŶƚ͕ ǁŚŽ ǁĂƐ ƐǁŽƌŶ ŝŶƚŽ ŽĨĨŝĐĞ Ăƚ ƚŚĞ &ĂŵŝůLJ DĞĚŝĐŝŶĞ ůŝŶŝĐĂů &ŽƌƵŵ ŝŶ Ɖƌŝů ŝŶ ^ĂŶ &ƌĂŶĐŝƐĐŽ͘ ƌ͘ ZĂůƉŚ ŝƐ Ă ŵĂŶĂŐŝŶŐ ƉĂƌƚŶĞƌ ĂŶĚ ŚŝĞĨ &ŝŶĂŶĐŝĂů KĨĨŝĐĞƌ ĨŽƌ ^ĂŶ ŝĞŐŽ ^ƉŽƌƚƐ DĞĚŝĐŝŶĞ͕ Ă ƐŵĂůů ŐƌŽƵƉ ƉƌĂĐƚŝĐĞ͕ ĂŶĚ DĞĚŝĐĂů ŝƌĞĐƚŽƌ ŽĨ ĂŶ /ŶĚĞƉĞŶĚĞŶƚ WƌĂĐƚŝĐĞ ƐƐŽĐŝĂƚŝŽŶ͘ ,Ğ ůŝǀĞƐ ŝŶ ^ĂŶ ŝĞŐŽ ǁŝƚŚ ǁŝĨĞ ^ƚĂĐLJ ĂŶĚ ĐŚŝůĚƌĞŶ :ƵůŝĂ͕ ĂůŵŽƐƚ ϭϳ͕ KůŝǀŝĂ͕ ϭϱ ĂŶĚ ^ƉĞŶĐĞƌ͕ ϭϬ ĂŶĚ >ĂďƌĂĚŽŽĚůĞ 'ĞŽƌŐŝĂ͕ ĂŶĚ ĂƚƚĞŶĚƐ ĂƐ ŵĂŶLJ ŽĨ ŚŝƐ ŬŝĚƐ͛ ƐŽĐĐĞƌ ŐĂŵĞƐ ĂƐ ƉŽƐƐŝďůĞ͘ CFP /ŶƚĞƌǀŝĞǁĞĚ ƌ͘ ZĂůƉŚ ƌĞĐĞŶƚůLJ͗ Why family medicine for you? &ĂŵŝůLJ ŵĞĚŝĐŝŶĞ ƌĞƉƌĞƐĞŶƚƐ ƚŚĞ ƌĞŶĂŝƐƐĂŶĐĞ ŽĨ Ăůů ƐƉĞĐŝĂůƚŝĞƐ͘ /ƚ ƌĞƋƵŝƌĞƐ ĞdžĐĞƉƚŝŽŶĂů ĐŽŵŵƵŶŝĐĂƚŝŽŶ ƐŬŝůůƐ ĐŽƵƉůĞĚ ǁŝƚŚ ĞdžƋƵŝƐŝƚĞ ŝŶƚĞůůĞĐƚƵĂů ĐƵƌŝŽƐŝƚLJ͕ ĚĞĚƵĐƚŝǀĞ ƌĞĂƐŽŶŝŶŐ ĂŶĚ ƌĞůĂƚŝŽŶƐŚŝƉͲďƵŝůĚŝŶŐ ĂďŝůŝƚŝĞƐ͘ ǀĞƌLJ ĞŶĐŽƵŶƚĞƌ ŝƐ Ă ƵŶŝƋƵĞ ĞdžƉĞƌŝĞŶĐĞ͕ ŵĂŬŝŶŐ ŝƚ ĞŶũŽLJĂďůĞ ƚŽ ƉĂƌƚŝĐŝƉĂƚĞ͘ ŶĚ ǁĞ ĂƌĞ ƉĂŝĚ ĨŽƌ ĚŽŝŶŐ ƚŚŝƐ͊ Why did you focus on sports medicine? >ŝŬĞ ŵŽƐƚ ŽĨ ŵLJ ƐƉŽƌƚƐ ŵĞĚŝĐŝŶĞ ďƌĞƚŚƌĞŶ͕ / ĂůǁĂLJƐ ĐŽŶƐŝĚĞƌĞĚ ŵLJƐĞůĨ Ă ƐĐŚŽůĂƌͲĂƚŚůĞƚĞ͘ / ůŽǀĞĚ ƚĞŶŶŝƐ ĂŶĚ 14

California Family Physician Spring 2016

ďĂƐŬĞƚďĂůů ĂŶĚ ĐŽŵƉĞƚĞĚ ŝŶƚŽ ĐŽůůĞŐĞ͘ EŽƚ ƐƵƌƉƌŝƐŝŶŐůLJ͕ / ŚĂĚ ŵLJ ƐŚĂƌĞ ŽĨ ŝŶũƵƌŝĞƐ ƚŚĂƚ ŬĞƉƚ ŵĞ ŽĨĨ ƚŚĞ ĐŽƵƌƚ ĂŶĚ / ŐŽƚ ƚŽ ŬŶŽǁ ƚŚĞ ĂƚŚůĞƚŝĐ ƚƌĂŝŶĞƌƐ ƚŽŽ ǁĞůů͘ /ŶƚĞƌĂĐƚŝŶŐ ǁŝƚŚ ŵŽƚŝǀĂƚĞĚ ŝŶĚŝǀŝĚƵĂůƐ ǁŚŽ ĚĞƐƉĞƌĂƚĞůLJ ǁĂŶƚ ƚŽ ŐĞƚ ďĞƚƚĞƌ ƋƵŝĐŬůLJ ĂƉƉĞĂůĞĚ ƚŽ ŵĞ ƚŚƌŽƵŐŚŽƵƚ ŵLJ ŵĞĚŝĐĂů ƚƌĂŝŶŝŶŐ͘ / ĚĞǀĞůŽƉĞĚ Ă ĚĞƐŝƌĞ ƚŽ ŚĂǀĞ Ă ƐƉĞĐŝĨŝĐ ĨŽĐƵƐ ǁŝƚŚŝŶ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ŽŶ ǁŚŝĐŚ / ĐŽƵůĚ ĐŽŶƐŝĚĞƌ ŵLJƐĞůĨ ĂŶ ĞdžƉĞƌƚ͘ ŽŵďŝŶŝŶŐ ƐƉŽƌƚƐ ŵĞĚŝĐŝŶĞ ǁŝƚŚ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ůĞƚ ŵĞ ŚĂǀĞ Ă ŚŝŐŚĞƌ ƉĞƌĐĞŶƚĂŐĞ ŽĨ ƉĂƚŝĞŶƚƐ ǁŚŽ ƐƵĨĨĞƌĞĚ ŵĞĚŝĐĂů ƉƌŽďůĞŵƐ ƚŚĂƚ ĐŽƵůĚ ŵŽƌĞ ĞĂƐŝůLJ ďĞ ͞ĨŝdžĞĚ͟ Žƌ ͞ĐƵƌĞĚ͕͟ ǁŚŝĐŚ ǁĂƐ Ă ŐƌĞĂƚ ĐŽŵƉůĞŵĞŶƚ ƚŽ ŵƵĐŚ ŽĨ ƚŚĞ ĐŚƌŽŶŝĐ ĚŝƐĞĂƐĞ ŵĂŶĂŐĞŵĞŶƚ ǁŝƚŚ ǁŚŝĐŚ ǁĞ ĐŽŵŵŽŶůLJ ĚĞĂů͘ Is noǁ the best time eǀer to be a family physician, in your estimation? dŚĂƚ͛Ɛ Ă ůŽƚ ůŝŬĞ ĂƐŬŝŶŐ ǁŚŝĐŚ ǁĂƐ ƚŚĞ ďĞƐƚ ĚĞĐĂĚĞ ŽĨ LJŽƵƌ ůŝĨĞ͘ ^ŽŵĞ ƚƌƵůLJ ĂŵĂnjŝŶŐ ƚŚŝŶŐƐ ŚĂǀĞ ƚƌĂŶƐƉŝƌĞĚ ƌĞĐĞŶƚůLJ ƚŚĂƚ ŚĂǀĞ ŵĂĚĞ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ƐŽ ĂƉƉĞĂůŝŶŐ͘ tĞ͛ǀĞ ŵĂĚĞ ŐƌĞĂƚ ƐƚƌŝĚĞƐ Ăƚ ĞŶŚĂŶĐŝŶŐ ƚŚĞ ƌĞƉƵƚĂƚŝŽŶ ĂŶĚ ƉĞƌĐĞŝǀĞĚ ǀĂůƵĞ ŽĨ ŽƵƌ ƐƉĞĐŝĂůƚLJ͖ Ăƚ ƚŚĞ ƐĂŵĞ ƚŝŵĞ͕ ƐŽŵĞ ƚƌĞŵĞŶĚŽƵƐ ŚƵƌĚůĞƐ ŵƵƐƚ ďĞ ŽǀĞƌĐŽŵĞ͘ DĞĚŝĐĂů ƐƚƵĚĞŶƚ ĚĞďƚ ŝƐ ĂŶ ĞǀĞƌͲŐƌŽǁŝŶŐ ĚŝůĞŵŵĂ ĂĨĨĞĐƚŝŶŐ ƐƉĞĐŝĂůƚLJ ĚĞĐŝƐŝŽŶƐ ĂŵŽŶŐ ƐƚƵĚĞŶƚƐ͘ ůĞĐƚƌŽŶŝĐ ,ĞĂůƚŚ ZĞĐŽƌĚƐ ; ,ZƐͿ ĂŶĚ ŶƵŵĞƌŽƵƐ ŽƚŚĞƌ ĂĚŵŝŶŝƐƚƌĂƚŝǀĞ ŚĂƐƐůĞƐ ĐŽŶƚŝŶƵĞ ƚŽ ĚĞŵŽƌĂůŝnjĞ LJŽƵŶŐ

ĂŶĚ ŽůĚ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͘ dŚĞ ŐƌŽǁŝŶŐ ŶĞĞĚ ĨŽƌ ĞdžĐĞƉƚŝŽŶĂů ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶƐ ŚĂƐ ŶĞǀĞƌ ďĞĞŶ ŚŝŐŚĞƌ͕ ŚŽǁĞǀĞƌ͘ &ĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĂƌĞ d, ĂŶƐǁĞƌ ƚŽ ŵŽƐƚ ŽĨ ƚŚĞ ƉƌŽďůĞŵƐ ƉůĂŐƵŝŶŐ ŚĞĂůƚŚ ĐĂƌĞ ƚŽĚĂLJ͘ tĞ ŚŽůĚ ƚŚĞ ŬĞLJ ƚŽ ƉƌŽǀŝĚŝŶŐ ĞdžĐĞƉƚŝŽŶĂů͕ ĐŽƐƚͲ ĞĨĨĞĐƚŝǀĞ͕ ĞǀŝĚĞŶĐĞͲďĂƐĞĚ ŵĞĚŝĐĂů ĐĂƌĞ ĨŽƌ ƚŚŝƐ ĐŽƵŶƚƌLJ͘ What’s your role in running the business end of your practice and how has that experience influenced your work with CAFP? /Ŷ ĐŽůůĞŐĞ͕ / ŵĂũŽƌĞĚ ŝŶ ĞĐŽŶŽŵŝĐƐ ĂŶĚ ďŝŽůŽŐLJ͘ / ǁĂƐ ƚŽƌŶ ďĞƚǁĞĞŶ tĂůů ^ƚƌĞĞƚ ĂŶĚ ŵĞĚŝĐĂů ƐĐŚŽŽů ĂŶĚ͕ ƚŚĂŶŬĨƵůůLJ͕ ŵĂĚĞ ƚŚĞ ƌŝŐŚƚ ĐŚŽŝĐĞ͘ EĞǀĞƌƚŚĞůĞƐƐ͕ / ǁĂƐ ĂůǁĂLJƐ ŝŶƚĞƌĞƐƚĞĚ ŝŶ ĞĐŽŶŽŵŝĐƐ ĂŶĚ ďƵƐŝŶĞƐƐ ĂŶĚ ǁĂƐ ƉƌĞƚƚLJ ŐŽŽĚ ǁŝƚŚ ŶƵŵďĞƌƐ͘ ĨƚĞƌ ŐŽŝŶŐ ŝŶƚŽ ƉƌŝǀĂƚĞ ƉƌĂĐƚŝĐĞ͕ / ŐƌĂǀŝƚĂƚĞĚ ƚŽǁĂƌĚ ƚŚĞ ƌ͘ ZĂůƉŚ ;ƌŝŐŚƚͿ ĚƌĞƐƐĞƐ ƵƉ ĨŽƌ ƚŚĞ ͞&D ǀŽůƵƟŽŶ͟ Ăƚ &W͛Ɛ ϮϬϭϱ ƐƚƌĂƚĞŐŝĐ ƉůĂŶŶŝŶŐ ŵĞĞƟŶŐ ǁŝƚŚ &W WƌĞƐŝĚĞŶƚ͕ ƌ͘ :ĂLJ t͘ >ĞĞ ;ůĞŌͿ ĂŶĚ ĨŽƌŵĞƌ &W ^ƚĂīĞƌ ŽŶŶĂ sĂůƉŽŶŝ ;ŵŝĚĚůĞͿ͘ ŚŝĞĨ &ŝŶĂŶĐŝĂů KĨĨŝĐĞƌ ƌŽůĞ͕ ŵŽƐƚůLJ ƚŚƌŽƵŐŚ ƚŚĞ ƐĐŚŽŽů ŽĨ ŚĂƌĚ ŬŶŽĐŬƐ͘ / ĨŽƵŶĚ / ĞŶũŽLJĞĚ ƚŚĞ ďƵƐŝŶĞƐƐ ƐŝĚĞ ŽĨ ŵĞĚŝĐŝŶĞ ĂŶĚ ĂĐƚƵĂůůLJ ŚĞůƉĞĚ ŵĞ ĂƐ ĂŶ ŽĨĨŝĐĞƌ ĂŶĚ ŽĂƌĚ ŵĞŵďĞƌ ƚŽ ďĞƚƚĞƌ ĞŶũŽLJĞĚ ĞƐƚĂďůŝƐŚŝŶŐ ďƵƐŝŶĞƐƐ ƉƌŽ ĨŽƌŵĂƐ ĂŶĚ ƌĞĂĚŝŶŐ ƉƌŽĨŝƚ ƵŶĚĞƌƐƚĂŶĚ ƚŚĞ ĨŝĚƵĐŝĂƌLJ ĚƵƚŝĞƐ ŝŶ Ă ŶŽŶͲƉƌŽĨŝƚ ŽƌŐĂŶŝnjĂƚŝŽŶ ĂŶĚ ůŽƐƐ ƐƚĂƚĞŵĞŶƚƐ͘ / ƚŚŝŶŬ ƚŚŝƐ ŝŶƚĞƌĞƐƚ ĂŶĚ ĞdžƉĞƌŝĞŶĐĞ ƐƵĐŚ ĂƐ &W͘

ŽŶƟŶƵĞĚ ŽŶ ƉĂŐĞ ϭϲ х

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www.MedLion.com California Family Physician Spring 2016

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How do you balance your family of three kids, a wife, a fulltime practice, and your ǀolunteer work with CAFP and your county chapter? / Ăŵ ŐůĂĚ LJŽƵ ĂƐŬĞĚ ŵĞ ƚŚŝƐ ƋƵĞƐƚŝŽŶ ĂŶĚ ŶŽƚ ŵLJ ǁŝĨĞ͕ ƐŝŶĐĞ ƐŚĞ ǁŽƵůĚ ƉƌŽďĂďůLJ ŚĂǀĞ Ă ƐůŝŐŚƚůLJ ĚŝĨĨĞƌĞŶƚ ƉĞƌƐƉĞĐƚŝǀĞ ŽŶ ƚŚŝŶŐƐ͊ ůů ŽĨ ƵƐ ŝŶ ŵĞĚŝĐŝŶĞ ŚĂǀĞ ŚĂĚ ƚŽ ĨŝŐƵƌĞ ŽƵƚ ŚŽǁ ƚŽ ŵƵůƚŝͲƚĂƐŬ ƚŚƌŽƵŐŚŽƵƚ ŽƵƌ ĐĂƌĞĞƌƐ ĂŶĚ ĞǀĞŶ ƚŚŽƵŐŚ ǁĞ ĚŽŶ͛ƚ ĞǀĞƌ ĚŽ ĞǀĞƌLJƚŚŝŶŐ ƉĞƌĨĞĐƚůLJ͕ ǁĞ ĐŽŵĞ ƚŽ Ă ŚĂƌŵŽŶŝŽƵƐ ďĂůĂŶĐĞ͘ / Ăŵ ďůĞƐƐĞĚ ƚŽ ŚĂǀĞ Ă ƐƵƉƉŽƌƚŝǀĞ ĨĂŵŝůLJ͕ ƉĂƌƚŝĐƵůĂƌůLJ ŵLJ ǁŝĨĞ͕ ^ƚĂĐLJ͕ ǁŚŽ ƌĞĐŽŐŶŝnjĞƐ ƚŚĞ ǀĂůƵĞ / ƉůĂĐĞ ŽŶ ďĞŝŶŐ Ă ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶ͘ / Ăŵ ĂůƐŽ ďůĞƐƐĞĚ ǁŝƚŚ ĂŶ ĞdžĐĞƉƚŝŽŶĂů ŐƌŽƵƉ ŽĨ ƉƌĂĐƚŝĐĞ ƉĂƌƚŶĞƌƐ ǁŚŽ ƐƵƉƉŽƌƚ ŵĞ ŝŶ ŵLJ ŽƌŐĂŶŝnjĞĚ ŵĞĚŝĐŝŶĞ ĞŶĚĞĂǀŽƌƐ͘ KŶĞ ŽĨ ƚŚĞ ďĞŶĞĨŝƚƐ ŽĨ ďĞŝŶŐ ŝŶ Ă ƐŵĂůů ŐƌŽƵƉ ƉƌŝǀĂƚĞ ƉƌĂĐƚŝĐĞ ŝƐ ƚŚĞ ĨůĞdžŝďŝůŝƚLJ ŽĨ ƐĐŚĞĚƵůĞƐ͘ / ŚĂǀĞ ŵĂĚĞ ŝƚ Ă ƉŽŝŶƚ ƚŽ ƚƌLJ ƚŽ ĂƚƚĞŶĚ ĂƐ ŵĂŶLJ ŽĨ ŵLJ ĐŚŝůĚƌĞŶ͛Ɛ ƐĐŚŽŽů ĂŶĚ ƐƉŽƌƚŝŶŐ ĞǀĞŶƚƐ ĂƐ / ĐĂŶ͕ ƌĞŐĂƌĚůĞƐƐ ŽĨ ǁŚĞŶ ƚŚĞLJ ŽĐĐƵƌ͕ ƐŝŶĐĞ / ƌĞĂůŝnjĞ ƚŚĂƚ ƚŚĞLJ ĂƌĞ ŝŶ ŵLJ ůŝĨĞ Ă ĨŝŶŝƚĞ ĂŵŽƵŶƚ ŽĨ ƚŝŵĞ͘ tĞ ƚƌĞĂƐƵƌĞ ĨĂŵŝůLJ ǀĂĐĂƚŝŽŶƐ ĂŶĚ ƚƌLJ ƚŽ ƐĐŚĞĚƵůĞ ĨĂŵŝůLJ ĂĐƚŝǀŝƚŝĞƐ͕ ǁŚŝĐŚ ďĞĐŽŵĞƐ ĐŚĂůůĞŶŐŝŶŐ ǁŝƚŚ ŽůĚĞƌ ĂĚŽůĞƐĐĞŶƚ ĐŚŝůĚƌĞŶ͊ dŚĞ ŵŽƐƚ ĚŝĨĨŝĐƵůƚ ďĂůĂŶĐĞ ŝŶǀŽůǀĞƐ ŵĂŝŶƚĂŝŶŝŶŐ ŝŶĚŝǀŝĚƵĂů ƚŝŵĞ ǁŝƚŚ ŵLJ ǁŝĨĞ͘ tĞ ĂƌĞ ĐŽŶƐƚĂŶƚůLJ ƐĞĂƌĐŚŝŶŐ ĨŽƌ ƚŚĞ ƌŝŐŚƚ ďĂůĂŶĐĞ ĂŶĚ ŚĂǀĞ ŵĂĚĞ Ă ƉůĞĚŐĞ ƚŽ ĐŽŶƚŝŶƵĞ ŵŽƌĞ

ĂĚƵůƚ ĂĚǀĞŶƚƵƌĞƐ ƚŚƌŽƵŐŚŽƵƚ ƚŚĞ LJĞĂƌ͘ /Ŷ ƚŚĞ ƉĂƐƚ͕ ǁĞ ŚĂǀĞ ĐůŝŵďĞĚ DŽƵŶƚ tŚŝƚŶĞLJ ƚŽŐĞƚŚĞƌ ĂŶĚ ƚƌĂǀĞƌƐĞĚ dŚĞ EĂƌƌŽǁƐ ŝŶ ŝŽŶ WĂƌŬ͊ /Ŷ ƚĂůŬŝŶŐ ƚŽ ŶƵŵĞƌŽƵƐ ƉĞŽƉůĞ Ăƚ ƚŚĞ ƐĂŵĞ ƐƚĂŐĞƐ ŽĨ ůŝĨĞ͕ / ŬŶŽǁ / Ăŵ ŶŽƚ ĂůŽŶĞ ŝŶ ƚŚŝƐ ƐƚƌƵŐŐůĞ ƚŽ ĨŝŶĚ ĂĚĚŝƚŝŽŶĂů ƚŝŵĞ͘ What’s your message to the next generation of FP’s – what will sustain them? / ƚŚŝŶŬ ƚŚĞ ĨƵƚƵƌĞ ŝƐ ǀĞƌLJ ďƌŝŐŚƚ ĨŽƌ LJŽƵŶŐĞƌ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͘ dŚĞLJ ĂƌĞ ǁĞůů ƉŽƐŝƚŝŽŶĞĚ ǁŝƚŚ ƚŚĞŝƌ ƚƌĂŝŶŝŶŐ ĂŶĚ ƐŬŝůů ƐĞƚ ĂůŽŶŐ ǁŝƚŚ Ă ŐƌŽǁŝŶŐ ƉŽůŝƚŝĐĂů ƵŶĚĞƌƐƚĂŶĚŝŶŐ ŽĨ ƚŚĞ ŝŵƉŽƌƚĂŶĐĞ ŽĨ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ĂƐ ƚŚĞ ďĂĐŬďŽŶĞ ŽĨ Ă ƐƵĐĐĞƐƐĨƵů ŚĞĂůƚŚ ĐĂƌĞ ĚĞůŝǀĞƌLJ ƐLJƐƚĞŵ͘ dŚĞ ǀĂůƵĞ ƚŚĞLJ ǁŝůů ƉƌŽǀŝĚĞ ǁŝůů ŝŶĞǀŝƚĂďůLJ ŬĞĞƉ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ŝŶ ƚŚĞ ĨŽƌĞĨƌŽŶƚ ŽĨ ĂŶLJ ŚĞĂůƚŚ ĐĂƌĞ ŵŽĚĞů ĂŶĚ ůĞƚ ƚŚĞŵ ŶĞŐŽƚŝĂƚĞ ĞƋƵŝƚĂďůĞ ƉĂLJŵĞŶƚ ĂŶĚ ŵŽƌĞ ĞĨĨŝĐŝĞŶƚ ǁĂLJƐ ƚŽ ƉƌŽǀŝĚĞ ĐĂƌĞ ĨŽƌ ŽƵƌ ƉĂƚŝĞŶƚƐ͘ ŵƉŽǁĞƌŝŶŐ LJŽƵŶŐ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͕ ŵƵĐŚ ĂůŽŶŐ ƚŚĞ ůŝŶĞƐ ƚŚĂƚ :ĂLJ >ĞĞ ŚĂƐ ďĞĞŶ ĂĚǀŽĐĂƚŝŶŐ ĨŽƌ LJĞĂƌƐ ŶŽǁ ǁŝƚŚ ƚŚĞ &D ZĞǀŽůƵƚŝŽŶ͕ ǁŝůů ůĞƚ ƚŚĞŵ ĐƌĞĂƚĞ ƚŚĞŝƌ ŽǁŶ ĚĞƐƚŝŶŝĞƐ͘ dŚŝƐ ǁŝůů ĂůůŽǁ ƚŚĞŵ ƚŽ ĐŽŶƚŝŶƵĞ ƚŽ ĨŝŶĚ ͞ƚŚĞ ũŽLJ͟ ŝŶ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ƚŽ ǁŚŝĐŚ ǁĞ ŬĞĞƉ ƌĞĨĞƌƌŝŶŐ͘ Please check out Dr. Ralph’s full interview on familydocs.org.

Northern, Central, Southern California, and the Pacific Northwest

West Coast Family F il Medicine Opportunities 2XWSDWLHQW 7UDGLWLRQDO )DPLO\ 0HGLFLQH RSWLRQV DYDLODEOH 0XOWLSOH HPSOR\PHQW PRGHOV ZLWK )XOO 3DUW WLPH SRVVLELOLWLHV

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California Family Physician Spring 2016

InnovAge congratulates

DR. MARY FAIRBANKS 2016 CAFP Family Physician of the Year Dr. Fa D Fairrba b nks is one e of th t e he heal a th thca ca are e exp xperrts wit ith h Inno In n vA no vAge ge PAC CEâ&#x20AC;&#x201D;Prog ogra ram m of Alll-inc nc clusive ve Carre for th he El E de derl rllyâ&#x20AC;&#x201D; yâ&#x20AC;&#x201D;wh ho pr prov ovid id dess inter e diiscip sc cip iplililna nary ary and coor o di d nate ed me medi diica c l ca c re re. Inno novAge vA Age PAC CE can be ca be an excellent o op pti tion on for ind ndiv ivid iv id dua alss witth lilimi miite ed ďŹ n ďŹ nan ancial res esou ourc rces rc es or de es decl c in cl inin ing in ga ab bililitty to o per erfo form fo rm acttiv ivit itie ie es of dai aily ly y liv ivin in ng.

Lear Le arn ar n mo more re e at MyInnovAge.org or 888.992.4464

Mountain Valleys Health Centers, Inc. is a great place to work and rural north eastern California is a great place to live. Whether raising a family, relaxing in seclusion or working your own ranch the communities we live in and serve are a great place to enjoy a little slower pace and a much higher quality of life.

Mountain Valleys Health Centers offer numerous attractive employment opportunities for health care professionals. If you are a dedicated, mission driven health care professional or want to be part of the staff of a mission driven corporation, please consider joining our team. MVHC is currently recruiting for a full scope Family Practice physician which includes being on staff at the local rural hospital and, preferably, performing OB.

We offer generous compensation packages including: Â&#x2021; )XOO 0HGLFDO %HQHILWV 3DFNDJH Â&#x2021; 5HWLUHPHQW 3ODQ Â&#x2021; &RQWLQXLQJ (GXFDWLRQ Â&#x2021; 372 +ROLGD\V Â&#x2021; 1+6& /RDQ 5HSD\PHQW Â&#x2021; )7&$ 0DOSUDFWLFH ,QVXUDQFH

Interested Candidates Please Contact: Mountain Valleys Health Centers 'DYH -RQHV &(2 530-294-5114 djones@mtnvalleyhc.org California Family Physician Spring 2016

17

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Are Opioid Overdoses the New Vietnam War? / ƌĞŵĞŵďĞƌ ďĞŝŶŐ ŝŶ ŵLJ ĚŽƌŵ ŽŶ ƚŚĞ ŶŝŐŚƚ ŽĨ ƚŚĞ ĚƌĂĨƚ ůŽƚƚĞƌLJ ŝŶ &ĞďƌƵĂƌLJ ϭϵϳϮ ʹ ƚŚĞ ŶŝŐŚƚ Ăůů ŵĞƌŝĐĂŶ ŵĂůĞƐ ďŽƌŶ ŝŶ ϭϵϱϯ ǁŽƵůĚ ůĞĂƌŶ ƚŚĞŝƌ ƌŝƐŬ ŽĨ ďĞŝŶŐ ĚƌĂĨƚĞĚ ĨŽƌ ƚŚĞ sŝĞƚŶĂŵ tĂƌ͘ dŚĞ ůŽƚƚĞƌLJ ǁĂƐ ŶŽ ƌĞƐƉĞĐƚĞƌ ŽĨ ƌĂĐĞ͕ ĞƚŚŶŝĐŝƚLJ͕ ƐŽĐŝŽĞĐŽŶŽŵŝĐ ƐƚĂƚƵƐ͕ ĞƚĐ͘ /ƚ ǁĂƐ Ă ƌĂŶĚŽŵ ŵĂƚĐŚŝŶŐ ŽĨ ďŝƌƚŚ ĚĂƚĞ ƚŽ ůŽƚƚĞƌLJ ŶƵŵďĞƌ ʹ ƚŚĞ ůŽǁĞƌ LJŽƵƌ ŶƵŵďĞƌ͕ ƚŚĞ ŐƌĞĂƚĞƌ LJŽƵƌ ĐŚĂŶĐĞ ŽĨ ďĞŝŶŐ ĚƌĂĨƚĞĚ͘ ŶĚ ǁŚŝůĞ ƚŚĞ ĂďŽǀĞ ĐŚĂƌĂĐƚĞƌŝƐƚŝĐƐ ƉƌŽďĂďůLJ ĂĨĨĞĐƚĞĚ ƚŚĞ ĞǀĞŶƚƵĂů ŽƵƚĐŽŵĞ ŽĨ ǁŚĞƚŚĞƌ Žƌ ŚŽǁ LJŽƵ ƐĞƌǀĞĚ͕ ŝƚ ǁĂƐ Ă ƚŝŵĞ ŽĨ ŚŝŐŚ ĂŶdžŝĞƚLJ ĨŽƌ ŵĞŶ ďŽƌŶ ŝŶ ϭϵϱϯ ĂŶĚ ƚŚŽƐĞ ǁŚŽ ůŽǀĞĚ ƚŚĞŵ͘ ,ĂĚ / ďĞĞŶ ďŽƌŶ ŵĂůĞ͕ / ǁŽƵůĚ ŚĂǀĞ ďĞĞŶ Ăƚ ƌŝƐŬ͗ ƚŚĂƚ LJĞĂƌ ƚŚĞLJ ĚƌĂĨƚĞĚ ƚŽ ŶƵŵďĞƌ ϵϱ͕ ĂŶĚ ŵLJ ďŝƌƚŚ ĚĂƚĞ ǁĂƐ ϴϱ͘ EŽǁ ǁĞ ĂƌĞ ĨĂĐŝŶŐ Ă ƚŚƌĞĂƚ ƚŽ ƚŚĂƚ ƐĂŵĞ ŐĞŶĞƌĂů ĂŐĞ ĐŽŚŽƌƚ ĂƐ ǁĞ ĚŝĚ ƚŚĞŶ͕ ƚŚĂƚ ŽĨ ĚĞĂƚŚ ĨƌŽŵ ĚƌƵŐ ŽǀĞƌĚŽƐĞ͕ ƉƌŝŵĂƌŝůLJ ŽƉŝŽŝĚƐ͘ &Žƌ ƚŚĞ ĨŝƌƐƚ ƚŝŵĞ ƐŝŶĐĞ ƚŚĞ sŝĞƚŶĂŵ tĂƌ͕ ƚŚĞ ĚĞĂƚŚ ƌĂƚĞ ĨŽƌ ĂĚƵůƚƐ ĂŐĞĚ ϮϱͲϯϰ ŝƐ ŚŝŐŚĞƌ ƚŚĂŶ ƚŚĞ ƉƌĞǀŝŽƵƐ ŐĞŶĞƌĂƚŝŽŶ͘ h^ ĚĞĂƚŚƐ ĚƵƌŝŶŐ ƚŚĞ sŝĞƚŶĂŵ tĂƌ ;ϭϵϱϱͲϭϵϳϱͿ ƌĞĂĐŚĞĚ ϱϴ͕ϮϬϵ͘ dŚĞ ŶƵŵďĞƌ ŽĨ ĚƌƵŐ ƌĞůĂƚĞĚ ĚĞĂƚŚƐ ŝŶ ƚŚĞ h^ ŝŶ ƚŚĞ ůĂƐƚ d,Z LJĞĂƌƐ ƌĞĂĐŚĞĚ ϲϬ͕ϵϯϴ͘ >ŝŬĞ ƚŚĞ ĚƌĂĨƚ ůŽƚƚĞƌLJ͕ ĞǀĞƌLJŽŶĞ ŝƐ Ăƚ ƌŝƐŬ͕ ďƵƚ ĚĞĂƚŚƐ ĨĂůů ĚŝƐƉƌŽƉŽƌƚŝŽŶĂůůLJ ŝŶƚŽ ŽŶĞ ŐƌŽƵƉ͘ Ƶƚ ƚŚŝƐ ƚŝŵĞ͕ ŝƚ͛Ɛ ǁŚŝƚĞ ŵĂůĞƐ ǁŚŽ ĂƌĞ ĚLJŝŶŐ Ăƚ Ă ŚŝŐŚĞƌ ƌĂƚĞ͘ /ƚ Ɛƚŝůů ŝƐ ŵƵĐŚ ŵŽƌĞ ůŝŬĞůLJ ĂŵŽŶŐ ƚŚĞ ůĞƐƐ ĞĚƵĐĂƚĞĚ ;Ă ŶĞǁ ƚLJƉĞ ŽĨ ͞ĐŽůůĞŐĞ ĚĞĨĞƌŵĞŶƚ͍͟Ϳ͘ dŚĞ ŽǀĞƌĚŽƐĞ ĚĞĂƚŚ ƌĂƚĞ ĨŽƌ ǁŚŝƚĞ ŵĂůĞƐ ĂŐĞĚ ϮϱͲϯϰ ŝŶ ϮϬϭϰ ǁĂƐ ĨŝǀĞ ƚŝŵĞƐ ŐƌĞĂƚĞƌ ƚŚĂŶ ŝŶ ϭϵϵϵ͘

ĂĚĚŝĐƚĞĚ͘ ǀŝĚĞŶĐĞ ƐŚŽǁƐ ƚŚĂƚ ŵŝŶŽƌŝƚLJ ƉĂƚŝĞŶƚƐ ĂƌĞ ůĞƐƐ ůŝŬĞůLJ ƚŽ ďĞ ƉƌĞƐĐƌŝďĞĚ ŽƉŝŽŝĚƐ ĨŽƌ ĂĐƵƚĞ ƉĂŝŶ͘ ůƚŚŽƵŐŚ ƚŚŝƐ ŵĂLJ ƌĞĨůĞĐƚ ƵŶĐŽŶƐĐŝŽƵƐ ďŝĂƐ͕ ŝƚ ŚĂƐ ƚƵƌŶĞĚ ŽƵƚ ƚŽ ďĞ ƉƌŽƚĞĐƚŝǀĞ ĨŽƌ ƚŚĞŵ͕ ĂƐ ƚŚĞŝƌ ĚĞĂƚŚ ƌĂƚĞƐ ŚĂǀĞ ƐƚĂďŝůŝnjĞĚ Žƌ ŝŶĐƌĞĂƐĞĚ ŽŶůLJ ƐůŝŐŚƚůLJ ĨƌŽŵ ƚŚŝƐ ĐĂƵƐĞ͘ ĚŽůĞƐĐĞŶƚƐ͛ ƵƐĞ ŽĨƚĞŶ ƐƚĂƌƚƐ ĨƌŽŵ ĞdžƉĞƌŝŵĞŶƚĂƚŝŽŶ͕ ĂŶĚ͕ ĨŽƌ ƚŚĞ ƐĂŵĞ ƌĞĂƐŽŶƐ͕ ƐƉŝƌĂůƐ ŽƵƚ ŽĨ ĐŽŶƚƌŽů͘ ĚŽůĞƐĐĞŶƚƐ ĂƌĞ Ă ǀƵůŶĞƌĂďůĞ ƉŽƉƵůĂƚŝŽŶ͖ ƚŚĞŝƌ ďƌĂŝŶƐ ĂƌĞ ŶŽƚ ĨƵůůLJ ĚĞǀĞůŽƉĞĚ ĂŶĚ ƚŚĞLJ ŚĂǀĞ ŶŽƚ ĚĞǀĞůŽƉĞĚ ĐŽŶƐĐŝŽƵƐ ĐŽƉŝŶŐ ŵĞĐŚĂŶŝƐŵƐ ƚŽ ŵĂŬĞ ďĞƚƚĞƌ ĚĞĐŝƐŝŽŶƐ͘ hŶůŝŬĞ ĂĚƵůƚƐ͕ ƚŚĞLJ ĂƌĞ ůĞƐƐ ůŝŬĞůLJ ƚŽ ƐƚĂƌƚ ƵƐŝŶŐ ĂĨƚĞƌ ŐĞƚƚŝŶŐ Ă ƉƌĞƐĐƌŝƉƚŝŽŶ ĨŽƌ ĂĐƵƚĞ ƉĂŝŶ͘ ^Ž ǁŚĞƌĞ ĂƌĞ ƚŚĞLJ ŐĞƚƚŝŶŐ ƚŚĞ ĚƌƵŐƐ͍ &ƌŽŵ ƚŚĞŝƌ ƉĂƌĞŶƚƐ͕ ŐƌĂŶĚƉĂƌĞŶƚƐ͕ ƐŝďůŝŶŐƐ͕ ĨƌŝĞŶĚƐ ʹ ŶŽƚ ĨƌŽŵ ĚƌƵŐ ĚĞĂůĞƌƐ͘ dŚĞLJ ĂƌĞ ŐŝǀĞŶ ƚŚĞŵ ďLJ ǁĞůůͲŵĞĂŶŝŶŐ ƌĞůĂƚŝǀĞƐ͕ Žƌ ƚŚĞLJ ƚĂŬĞ ƚŚĞŵ ĨƌŽŵ ŵĞĚŝĐŝŶĞ ĐŚĞƐƚƐ͘

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zŽƵ ŵĂLJ ďĞ ƚŚŝŶŬŝŶŐ͕ ͞ďƵƚ ƚŚŝƐ ŝƐ ĚŝĨĨĞƌĞŶƚ͖ ŶŽ ŽŶĞ ĐŚŽƐĞ ƚŽ ŚĂǀĞ Ă ůŽǁ ůŽƚƚĞƌLJ ŶƵŵďĞƌ͕ ďƵƚ ƉĞŽƉůĞ ĂƌĞ ĐŚŽŽƐŝŶŐ ƚŽ ĂďƵƐĞ ĚƌƵŐƐ͘͟ tĞ ĐŽƵůĚ ŚĂǀĞ Ă ůŝǀĞůLJ ĚĞďĂƚĞ ĂďŽƵƚ ƚŚĞ ƉĂƌƚ ͞ĐŚŽŝĐĞ͟ ƉůĂLJƐ ŝŶ ƚŚŝƐ͕ ďƵƚ / ŚĂǀĞ ǁŽƌŬĞĚ ǁŝƚŚ ŵĂŶLJ ƉĞŽƉůĞ ĂĚĚŝĐƚĞĚ ƚŽ ĚƌƵŐƐ͕ ĂŶĚ ŶŽŶĞ ŽĨ ƚŚĞŵ ͞ĐŚŽƐĞ͟ ŝƚ͘ &Žƌ ŵĂŶLJ ĂĚƵůƚƐ͕ ŝƚ ƐƚĂƌƚĞĚ ďLJ ƚĂŬŝŶŐ ŽƉŝŽŝĚƐ ĨŽƌ ĂŶ ĂĐƵƚĞ ƉĂŝŶ ĐŽŶĚŝƚŝŽŶ͕ ĂŶĚ ƚŚĂƚ ƚƌŝŐŐĞƌĞĚ Ă ƉŚLJƐŝŽůŽŐŝĐ ƌĞƐƉŽŶƐĞ ƚŚĂƚ ůĞĚ ƚŽ ĞƐĐĂůĂƚŝŶŐ ƵƐĞ ĂŶĚ ĂĚĚŝĐƚŝŽŶ͘ dŚĞ ƚƌŝŐŐĞƌ ŵĂLJ ďĞ ŐĞŶĞƚŝĐ͕ Žƌ ĨƌŽŵ ĂŵĞůŝŽƌĂƚŝŶŐ ĂŶ ƵŶƚƌĞĂƚĞĚ ŵĞŶƚĂů ŚĞĂůƚŚ ŝƐƐƵĞ͕ Žƌ Ă ƉŚLJƐŝĐĂů ŝƐƐƵĞ ƌĞůĂƚĞĚ ƚŽ ƉĂŝŶ͕ Žƌ ĨƌŽŵ ƐŽŵĞ ĐŽŵďŝŶĂƚŝŽŶ ŽĨ ƚŚĞ ĂďŽǀĞ Žƌ ŽƚŚĞƌ ĨĂĐƚŽƌƐ͘ /ƚ ŵĂLJ ŚĂǀĞ ďĞĞŶ ƚŚĞŝƌ ĐŚŽŝĐĞ ƚŽ ĐŽŶƚŝŶƵĞ ƚŽ ƚƌĞĂƚ ƚŚĞ ƉƌĞǀŝŽƵƐůLJ ƵŶƚƌĞĂƚĞĚ͕ ďƵƚ ŝƚ ǁĂƐ ŶŽƚ ƚŚĞŝƌ ŝŶƚĞŶƚ ƚŽ ďĞĐŽŵĞ 18

California Family Physician Spring 2016

,Žǁ ĚŽĞƐ Ăůů ƚŚŝƐ ĂĨĨĞĐƚ ƵƐ͍ KŶ Ă ƉĞƌƐŽŶĂů ůĞǀĞů͕ ĨŽƌ ƚŚŽƐĞ ŽĨ LJŽƵ ǁŚŽ ůŽǀĞ ĂŶ ĂĚŽůĞƐĐĞŶƚ͕ ƌĞĂůŝnjĞ ƚŚĞLJ ĂƌĞ Ăůů Ăƚ ƌŝƐŬ͘ dĂůŬ ƚŽ ƚŚĞŵ͕ ŵŽŶŝƚŽƌ ƚŚĞŵ͕ ƚĂůŬ ƚŽ ƚŚĞŝƌ ĐůŝŶŝĐŝĂŶƐ ĂďŽƵƚ ĂůƚĞƌŶĂƚŝǀĞƐ ƚŽ ŽƉŝŽŝĚƐ ŝĨ ƚŚĞLJ ŚĂǀĞ Ă ƉĂŝŶĨƵů͕ ĂĐƵƚĞ ĐŽŶĚŝƚŝŽŶ͘ WƌŽĨĞƐƐŝŽŶĂůůLJ͕ ƚŚŝŶŬ ǀĞƌLJ ĐĂƌĞĨƵůůLJ ĂďŽƵƚ ƉƌĞƐĐƌŝďŝŶŐ ƚŽ ĂŶ ĂĚŽůĞƐĐĞŶƚ͘ &Žƌ Ăůů ƉĂƚŝĞŶƚƐ͕ ŐŝǀĞ ŽŶůLJ ƚŚĞ ŽƉŝŽŝĚƐ LJŽƵ ƚŚŝŶŬ ƚŚĞLJ ǁŝůů ĂĐƚƵĂůůLJ ŶĞĞĚ ĨŽƌ ƚŚĞ ĐŽŶĚŝƚŝŽŶ͕ ƌĂƚŚĞƌ ƚŚĂŶ ĚĞĨĂƵůƚ ƚŽ ƚŚĞ ƵƐƵĂů ϯϬ Žƌ ϱϬ ʹ Žƌ ϭϬϬ ƚĂďůĞƚƐ͘ ĚƵĐĂƚĞ LJŽƵƌ ƉĂƚŝĞŶƚƐ ĂďŽƵƚ ƚŚĞ ƌŝƐŬ ƚŽ ŽƚŚĞƌƐ ĨƌŽŵ ƐŚĂƌŝŶŐ ƚŚĞŝƌ ŵĞĚƐ͕ ĞǀĞŶ ƚŚŽƵŐŚ ƚŚĞLJ ĂƌĞ ǁĞůů ŵĞĂŶŝŶŐ͘ ĂƵƚŝŽŶ ƚŚĞŵ ĂďŽƵƚ ƚŚĞ ƌŝƐŬ ŽĨ ŽƚŚĞƌƐ ƚĂŬŝŶŐ ƚŚĞŝƌ ŵĞĚƐ ʹ ĂĚǀŝƐĞ ƚŚĞŵ ƚŽ ŬĞĞƉ ƚŚĞŵ ŽƵƚ ŽĨ ƌĞĂĐŚ ĨƌŽŵ ĐŚŝůĚƌĞŶ ;ĂŶĚ ĂŶŝŵĂůƐ͊Ϳ͖ ŬĞĞƉ ƚŚĞŵ ŚŝĚĚĞŶ ĨƌŽŵ ŽůĚĞƌ ƌĞůĂƚŝǀĞƐ͘ / ĐĞƌƚĂŝŶůLJ ĚŽŶ͛ƚ ǁĂŶƚ ƚŽ ƌĞƚƵƌŶ ƚŽ ƚŚĞ ĂŶdžŝĞƚLJ ŽĨ ƚŚĞ ĚƌĂĨƚ͕ ďƵƚ ǁĞ ŵƵƐƚ ƐƚŽƉ ďĞŝŶŐ ĐŽŵƉůĂĐĞŶƚ ĂďŽƵƚ ƚŚŝƐ ŶĞǁ ŬŝůůĞƌ͘ dŚĞ ĂĐƚŝǀŝƐŵ ŽĨ ƚŚĞ sŝĞƚŶĂŵ tĂƌ͕ ŝĨ ƚƵƌŶĞĚ ŶŽǁ ƚŽ ƚŚŝƐ ŶĞǁ ƚŚƌĞĂƚ͕ ĐŽƵůĚ ŚĞůƉ ƐĂǀĞ ůŝǀĞƐ͘ Carol Havens, MD is currently the director of clinical education, northern California region, at Kaiser Permanente.

The Core Content Review of Family Medicine Why Choose Core Content ontent Revie Review? t Online and Flash Drive Versions available ble t Cost Effective CME t For Family Physicians by Family Physician cians t Print Subscription also available North h Americaâ&#x20AC;&#x2122;s most widely-recognize widely-recognized program for Family y Medicine CME and ABFM Board Preparation.

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Primary Care Physicians San Francisco Veterans Aff ffairs Healthcare System is seeking full-time primary care physicians at our Santa Rosa, Ukiah, Eureka and Clearlake clinics. Clinics operate under a medical home model. Together with his or her teamlet, comprised of a PCP, RN, LVN, and a clerk, the PCP cares for a panel of approximately 1,000 patients. Work Schedule: typically Monday through Friday: 8:00am - 4:30pm, excluding paid Federal Government holidays; flexible tours of duty may be negotiated. Competitive salary, retirement benefits, healthcare insurance, paid vacation and sick time off ffered. Recruitment bonus and education debt reduction program negotiable. Current, full and unrestricted license to practice medicine in a State, Territory, or Commonwealth of the United States, or in the District of Columbia is required. Must be proficient in spoken and written English.

Board certified or eligible family or internal medicine physicians preferred.

If interested in applying, email our resume to: Amy Noack at amy.noack@va.gov or Sue Bringel at susan.bringel@va.gov

The VA is an EOE. Minority applicants encouraged to apply.

MED7 has been providing urgent care services in the Greater Sacramento area since 1987 Urgent care clinics are located in Roseville, Carmichael, Folsom & North Sacramento.

All shifts 9am to 9pm. Full time is 13 shifts per month. We offer our full time physicians the following: full malpractice coverage, medical & dental coverage at no cost for the physician & any dependents, disability policy & we have a simple IRA you can contribute to with 3% matching. Part time is 6 to 8 shifts per month. There is no call. There is no tail coverage that needs to be purchased should you leave our employment. We have a single policy that continues on after you leave.

If something were to arise here after you left our employment, you would be covered.

For more information about MED7 and our clinics please visit our website: www.med7.com We offer an attractive compensation package.

Contact Merl Oâ&#x20AC;&#x2122;Brien,MD, at: (916) 791-1300, ext.111; or email CV to: sherry@med7atwork.com.

California Family Physician Spring 2016

19

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SEEKING EXPERIENCED, HIGHLY MOTIVATED FAMILY PHYSICIAN Federally qualified health center clinic in central San Diego seeks a highly motivated family or int med MD with a vision for the future of community medicine. San Diego Family Care operates 8 clinic sites in San Diego, with a PCMH model & EHR system in place. NCQA recognized. Visit website at sdfamilycare.org. CA lic required. Competitive salary/benefits with retirement match. Looking for a special doctor, committed to our mission!

Send CV to Arthur â&#x20AC;&#x153;Tonyâ&#x20AC;? Blain, MD, MBA, FAAFP, Medical Director, at aablain@lvhcc.com or call (858) 248-1509.

Academic FP Program Director â&#x20AC;&#x201C; Las Vegas, NV HCA MountainView Hospital is seeking qualified candidates for our new Family Medicine Residency Program. The Program Director provides leadership and general administration and establishes the strategic direction of the program and is responsible for the standards, quality and reputation of the Family Medicine Residency Program. The Program Director is expected to integrate the Family Medicine Residency Program with physician practices and hospital clinical services in a manner that enhances value and quality, and that promotes an optimal environment for professional practice and graduate medical education.

QUALIFICATIONS t 3FRVJTJUF TQFDJBMUZ FYQFSUJTF BOE EPDVNFOUFE FEVDBUJPOBM BOE administrative expertise acceptable to the review committee. t $VSSFOU DFSUJGJDBUJPO JO UIF TQFDJBMUZ CZ UIF "NFSJDBO #PBSE PG Family Medicine. t $VSSFOU NFEJDBM MJDFOTVSF BOE BQQSPQSJBUF NFEJDBM TUBGG appointment. t "DUJWF JOWPMWFNFOU JO UIF DBSF PG QBUJFOUT 1SJPS UP BTTVNJOH UIJT position, a minimum of two years full-time professional activity in family medicine, as well as teaching experience in a family medicine residency is required.

For more information, please forward your cover letter and CV. Randy Mitchell HCA Physician Services Group 615.943.7854 Randall.Mitchell@HCAHealthcare.com

For Advertising CONTACT

Michelle Gilbert

6$9( $ /,)( '21¡7 '5,9( +20( %8==(' %8==(' '5,9,1* ,6 '581. '5,9,1*

mgilbert@pcipublishing.com

1-800-561-4686 ext. 120 California Family Physician Spring 2016

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ŚŽƌƌŝĮĐĂůůLJ ĚŝƐƉůĂLJĞĚ͘ dǁŽ ƐŚŽŽƚĞƌƐ ƵƐĞĚ ĂƐƐĂƵůƚ ƌŝŇĞƐ ƉƵƌĐŚĂƐĞĚ ďLJ ĂŶŽƚŚĞƌ ƉĞƌƐŽŶ ƚŽ ĐŽŵŵŝƚ ƚŚĞ ƚĞƌƌŽƌŝƐƚ ĂƩĂĐŬƐ Ăƚ ƚŚĞ /ŶůĂŶĚ ZĞŐŝŽŶĂů ĞŶƚĞƌ͕ ŬŝůůŝŶŐ ϭϰ ƉĞŽƉůĞ͕ ůĞĂǀŝŶŐ ϮϮ ŽƚŚĞƌƐ ǁŽƵŶĚĞĚ ĂŶĚ ĐŽŵŵƵŶŝƟĞƐ ŝŶ ƐŚŽĐŬ͘ &ŝƌĞĂƌŵ ŚŽŵŝĐŝĚĞƐ͕ ƐƵŝĐŝĚĞƐ ĂŶĚ ŽƚŚĞƌ ŐƵŶ ǀŝŽůĞŶĐĞ ŝŶĐŝĚĞŶƚƐ ĂƌĞ Ă ůĂƌŐĞ ƉƵďůŝĐ ŚĞĂůƚŚ ĐŽŶĐĞƌŶ ŝŶ ƚŚĞ hŶŝƚĞĚ ^ƚĂƚĞƐ͘ ĐĐŽƌĚŝŶŐ ƚŽ ƚŚĞ ĞŶƚĞƌƐ ĨŽƌ ŝƐĞĂƐĞ ŽŶƚƌŽů ĂŶĚ WƌĞǀĞŶƟŽŶ ; Ϳ ĂŶĚ EĂƟŽŶĂů sŝƚĂů ^ƚĂƟƐƟĐƐ ^LJƐƚĞŵ ;Es^^Ϳ͕ ĨƌŽŵ ϮϬϬϵͲϮϬϭϬ ŚŽŵŝĐŝĚĞƐ ĂŶĚ ƐƵŝĐŝĚĞƐ ƚŽƚĂůĞĚ ϮϮ͕ϱϳϭ ĮƌĞĂƌŵ ŚŽŵŝĐŝĚĞƐ ĂŶĚ ϯϴ͕ϭϮϲ ĮƌĞĂƌŵ ƐƵŝĐŝĚĞƐ͘ dŚĞ ĮƌĞĂƌŵ ŚŽŵŝĐŝĚĞ ƌĂƚĞ ĂŵŽŶŐ ƉĞƌƐŽŶƐ ĂŐĞĚ ϭϬͲϭϵ LJĞĂƌƐ ǁĂƐ ĂďŽǀĞ ƚŚĞ ĂůůͲĂŐĞƐ ƌĂƚĞ͘ ,ŽŵŝĐŝĚĞ ǁĂƐ ƚŚĞ ĮŌĞĞŶƚŚ ůĞĂĚŝŶŐ ĐĂƵƐĞ ŽĨ ĚĞĂƚŚ ŝŶ Ăůů ĂŐĞƐ ŝŶ ƚŚĞ hŶŝƚĞĚ ^ƚĂƚĞƐ ĂŶĚ ƐĞĐŽŶĚ ůĞĂĚŝŶŐ ĐĂƵƐĞ ŽĨ ĚĞĂƚŚ ŝŶ ĂŐĞƐ ϭϬͲϭϵ͕ ǁŝƚŚ ĮƌĞĂƌŵƐ ĂĐĐŽƵŶƟŶŐ ĨŽƌ ϲϴ ƉĞƌĐĞŶƚ ŽĨ Ăůů ŚŽŵŝĐŝĚĞƐ ĂŶĚ ϴϯ͘ϱ ƉĞƌĐĞŶƚ ŽĨ LJŽƵƚŚ ŚŽŵŝĐŝĚĞƐ͘ ^ƵŝĐŝĚĞ ǁĂƐ ƚŚĞ ƚĞŶƚŚ ůĞĂĚŝŶŐ ĐĂƵƐĞ ŽĨ ĚĞĂƚŚ ĂŵŽŶŐ Ăůů ĂŐĞƐ ĂŶĚ ƚŚŝƌĚ ůĞĂĚŝŶŐ ĐĂƵƐĞ ŽĨ ĚĞĂƚŚ ŝŶ ĂŐĞƐ ϭϬͲϭϵ͘ ĐĐŽƌĚŝŶŐ ƚŽ ƚŚĞ ͞^ƚĂƚĞ ŽĨ ƚŚĞ ^ƚĂƚĞ͞ ĚĂƚĂ ĨƌŽŵ ƚŚĞ ͕ ŝŶ ϮϬϭϰ ĂůŝĨŽƌŶŝĂ ŚĂĚ Ă ĮƌĞĂƌŵ ĚĞĂƚŚ ƌĂƚĞ ŽĨ ϳ͘ϰ͕ ĂĐĐŽƵŶƟŶŐ ĨŽƌ Ϯ͕ϵϯϱ ĚĞĂƚŚƐ ŽƵƚ ŽĨ ƚŚĞ ƚŽƚĂů h͘^͘ ϯϯ͕ϯϵϬ ĮƌĞĂƌŵ ĚĞĂƚŚƐ͘ dŚĞƐĞ ƐƚĂƟƐƟĐƐ ĚŽ ŶŽƚ ŝŶĐůƵĚĞ ƚŚĞ ůĂƌŐĞ ŶƵŵďĞƌƐ ŽĨ ƉĞƌƐŽŶƐ

ĨƚĞƌ ƚŚĞ ^ĂŶ ĞƌŶĂƌĚŝŶŽ ƐŚŽŽƚŝŶŐ͕ ƚŚĞ ĐŽŵŵƵŶŝƚLJ ůĂŝĚ ĨůŽǁĞƌƐ ĂŶĚ ĨůĂŐƐ ĂůŽŶŐ ƚŚĞ ĨĞŶĐĞ ŽĨ ƚŚĞ /ŶůĂŶĚ ZĞŐŝŽŶĂů ĞŶƚĞƌ͘ WŚŽƚŽ ƌĞĚŝƚ͗ dǁŝƚƚĞƌ &ĞĞĚ 22

California Family Physician Spring 2016

ŽŶƟŶƵĞĚ ŽŶ ƉĂŐĞ Ϯϰ х

CAPG Annual Conference 2016 Sharing The Lessons of Innovative Payment Models June 16-19, 2016 • Manchester Grand Hyatt, San Diego, CA Taking risk is no longer just an option. The Medicare Access and CHIP Reauthorization Act of 2015—MACRA—is effectively making risk mandatory for physician organizations that want to stay in the game. And where Medicare goes, commercial payers will follow.

At our Annual Conference, you’ll gain hands-on knowledge and best practices from physician organizations who are thriving in both government and commercial risk arrangements, along with high-level insights on the political and legislative forecast for value-based care.

Don’t get left behind.

Register today! capg.org/conference2016 California Family Physician Spring 2016

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ŝŶũƵƌĞĚ ďƵƚ ŶŽƚ ŵŽƌƚĂůůLJ ǁŽƵŶĚĞĚ ďLJ ĮƌĞĂƌŵƐ͕ ŶŽƌ ĚŽ ƚŚĞLJ ŝŶĐůƵĚĞ ƚŚĞ ƚƌĂƵŵĂ ƚŽ ƚŚŽƐĞ ĞdžƉŽƐĞĚ ƚŽ ǀŝŽůĞŶĐĞ͘ dŚĞ EĂƟŽŶĂů ^ƵƌǀĞLJ ŽĨ ŚŝůĚƌĞŶ͛Ɛ džƉŽƐƵƌĞ ƚŽ sŝŽůĞŶĐĞ ;EĂƚ^ sͿ͕ ƐƵƉƉŽƌƚĞĚ ďLJ ƚŚĞ ͕ ŝƐ Ă ĐŽŵƉƌĞŚĞŶƐŝǀĞ ƐƵƌǀĞLJ ŽĨ ŝŶĐŝĚĞŶĐĞ ĂŶĚ ƉƌĞǀĂůĞŶĐĞ ŽĨ ĐŚŝůĚƌĞŶ͛Ɛ ĞdžƉŽƐƵƌĞ ƚŽ ǀŝŽůĞŶĐĞ ĂĐƌŽƐƐ ŵĂũŽƌ ĚŽŵĂŝŶƐ͕ ƐŽŵĞ ŽĨ ǁŚŝĐŚ ŝŶĐůƵĚĞ ĐŽŶǀĞŶƟŽŶĂů ĐƌŝŵĞ ĂŶĚ ĞdžƉŽƐƵƌĞ ƚŽ ĐŽŵŵƵŶŝƚLJ ĂŶĚ ĨĂŵŝůLJ ǀŝŽůĞŶĐĞ͕ ŝŶĐůƵĚŝŶŐ ƐĞĞŝŶŐ ƐŽŵĞŽŶĞ ŚĂƌŵĞĚ Žƌ ďĞŝŶŐ ƚŚĞ ǀŝĐƟŵ ŽĨ ĂŶ ĂƩĂĐŬ ǁŝƚŚ Ă ǁĞĂƉŽŶ͘ /Ŷ ϮϬϬϴ͕ ƚŚĞ ƐƵƌǀĞLJ ĨŽƵŶĚ ƚŚĂƚ ŵŽƌĞ ƚŚĂŶ ϲϬ ƉĞƌĐĞŶƚ ŽĨ ĐŚŝůĚƌĞŶ ŝŶ ƚŚĞ hŶŝƚĞĚ ^ƚĂƚĞƐ ǁĞƌĞ ĞdžƉŽƐĞĚ ƚŽ ǀŝŽůĞŶĐĞ ǁŝƚŚŝŶ ƚŚĞ ƉƌŝŽƌ LJĞĂƌ͘ ŚŝůĚƌĞŶ ĞdžƉŽƐĞĚ ƚŽ ǀŝŽůĞŶĐĞ ŵĂLJ ƐƵīĞƌ ůĂƐƟŶŐ ƉŚLJƐŝĐĂů͕ ŵĞŶƚĂů ĂŶĚ ĞŵŽƟŽŶĂů ŚĂƌŵ͘ Ɛ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͕ ǁĞ ŵĂLJ ĞŶĐŽƵŶƚĞƌ ƉĂƟĞŶƚƐ Ăƚ ƌŝƐŬ ƚŽ ďĞ ƉĞƌƉĞƚƌĂƚŽƌƐ ŽĨ ǀŝŽůĞŶĐĞ͕ ĂŶĚ ǁĞ ŵƵƐƚ ďĞ ĂůĞƌƚ ĨŽƌ ƐŝŐŶƐ ƐƵĐŚ ĂƐ ĐŚĂŶŐĞƐ ŝŶ ƉĂƟĞŶƚ ďĞŚĂǀŝŽƌ͕ ĚĞƉƌĞƐƐŝŽŶ͕ ǁŝƚŚĚƌĂǁĂů͕ ƐƵďƐƚĂŶĐĞ ĂďƵƐĞ ĂŶĚ ƵŶƐŽůŝĐŝƚĞĚ ĐŽŵŵĞŶƚƐ ĂďŽƵƚ ǀŝŽůĞŶĐĞ͘ tŚŝůĞ ŵĂŶLJ ƉĞƌƐŽŶƐ ǁŚŽ ŽǁŶ Žƌ ƵƐĞ ŐƵŶƐ ĚŽ ƐŽ ƐĂĨĞůLJ͕ ĮƌĞĂƌŵͲƌĞůĂƚĞĚ ǀŝŽůĞŶĐĞ ŽŌĞŶ ŽĐĐƵƌƐ ǁŚĞŶ ƉĞƌƐŽŶƐ Ăƚ ƌŝƐŬ ĨŽƌ ƐĞůĨͲŚĂƌŵ Žƌ ŚĂƌŵŝŶŐ ŽƚŚĞƌƐ ŚĂǀĞ ĂĐĐĞƐƐ ƚŽ ĮƌĞĂƌŵƐ͘ ŶĂƚƵƌĂů ƉůĂĐĞ ƚŽ ĚŝƐĐƵƐƐ ǁŚĞƚŚĞƌ Ă ƉĂƟĞŶƚ ŚĂƐ ĂĐĐĞƐƐ ƚŽ ŐƵŶƐ ĂŶĚ ƉƌŽŵŽƚĞ ƐĂĨĞƚLJ ŝƐ ǁŚĞŶ ĞĚƵĐĂƟŶŐ ƉĂƟĞŶƚƐ ĂďŽƵƚ ŚĞĂůƚŚ ƉƌŽŵŽƟŽŶ ƚĞĐŚŶŝƋƵĞƐ͘ WƌŽŵŽƟŶŐ ĞīĞĐƟǀĞ ĐŽŵŵƵŶŝĐĂƟŽŶ͕ ƉŽƐŝƟǀĞ ƌĞůĂƟŽŶƐŚŝƉƐ ĂŶĚ ƐƵƉƉŽƌƟŶŐ ĞīŽƌƚƐ ƚŽ ŝŵƉƌŽǀĞ ĐŽŵŵƵŶŝƚLJ ĞŶǀŝƌŽŶŵĞŶƚƐ ƚŽ ƌĞĚƵĐĞ ƚŚĞ ůŝŬĞůŝŚŽŽĚ ŽĨ ǀŝŽůĞŶĐĞ ĂƌĞ ŝŵƉŽƌƚĂŶƚ ĂĐƌŽƐƐ ƚŚĞ ĂŐĞ ƐƉĞĐƚƌƵŵ͕ ďƵƚ ĞƐƉĞĐŝĂůůLJ ǁŚĞŶ ƚƌĞĂƟŶŐ LJŽƵŶŐ ƉĂƟĞŶƚƐ͘ ǀĞŶ ǁŝƚŚ ŽƵƌ ĞīŽƌƚƐ Ăƚ ŐƵŶ ǀŝŽůĞŶĐĞ ƉƌĞǀĞŶƟŽŶ͕ ĂĐƟǀĞ ƐŚŽŽƚĞƌ ƐŝƚƵĂƟŽŶƐ ƐƟůů ŽĐĐƵƌ͘ /ƚ ŝƐ ĞdžƚƌĞŵĞůLJ ŝŵƉŽƌƚĂŶƚ ƚŽ ďĞ ƉƌĞƉĂƌĞĚ ĂŶĚ ƉƌĂĐƟĐĞ ĞŵĞƌŐĞŶĐLJ ƉůĂŶƐ ƚŽ ŝŵƉƌŽǀĞ ƚŚĞ ĐŚĂŶĐĞ ĨŽƌ Ă ƐĂĨĞ ŽƵƚĐŽŵĞ͘ KƵƌ ƚƌĂŝŶŝŶŐ ŽŶ ŚŽǁ ƚŽ ƌĞƐƉŽŶĚ ǁŚĞŶ ĂŶ ĂĐƟǀĞ ƐŚŽŽƚĞƌ ŝƐ ŝŶ ƚŚĞ ǀŝĐŝŶŝƚLJ ǁĂƐ ĞdžƚƌĞŵĞůLJ ƵƐĞĨƵů ǁŚĞŶ ƚŚĞ ƚĞƌƌŽƌŝƐƚƐ ǁĞƌĞ ƉĞƌƉĞƚƌĂƟŶŐ ƚŚĞŝƌ ŚĞŝŶŽƵƐ ǀŝŽůĞŶĐĞ Ă ĨĞǁ ďůŽĐŬƐ ĨƌŽŵ ŽƵƌ ƌĞƐŝĚĞŶĐLJ ĐůŝŶŝĐ Ăƚ Ă &ĞĚĞƌĂůůLJ YƵĂůŝĮĞĚ ,ĞĂůƚŚ ĞŶƚĞƌ͘ dŚĞ ĮƌƐƚ ƌĞĂĐƟŽŶ ƚŽ ƚŚĞ ŽĚĞ ^/>s Z ǁĂƐ ĨĞĂƌ͗ ĨĞĂƌ ĨŽƌ ŽƵƌ ƌĞƐŝĚĞŶƚƐ͕ ƐƚĂī͕ ƉĂƟĞŶƚƐ͕ ĨĂŵŝůŝĞƐ͕ ƐĞůĨ ĂŶĚ ĐŽŵŵƵŶŝƚLJ͘ dŚĞ ƌĞƐŝĚĞŶĐLJ ĐůŝŶŝĐ ƐĞĐƵƌŝƚLJ ŽĸĐĞƌƐ ǁĞƌĞ ŝŶĨŽƌŵĞĚ ŽĨ ƚŚĞ ƵŶĨŽůĚŝŶŐ ƐŝƚƵĂƟŽŶ͕ ĂŶĚ ƚŚĞ ĐůŝŶŝĐ ĚŽŽƌƐ ǁĞƌĞ ůŽĐŬĞĚ ĚŽǁŶ ďĞĨŽƌĞ ƚŚĞ ůĂǁ ĞŶĨŽƌĐĞŵĞŶƚ ĐŚĂƐĞ ƐƉĞĚ ďLJ ĂŶĚ ŐƵŶƐŚŽƚƐ ǁĞƌĞ ŚĞĂƌĚ͘ dŚĞ ƌĞƐŝĚĞŶƚƐ͕ ĨĂĐƵůƚLJ ĂŶĚ ƐƚĂī ŐĂǀĞ ĞŵŽƟŽŶĂů ƐƵƉƉŽƌƚ ƚŽ ƚŚĞ ƉĂƟĞŶƚƐ ;ǁŚŽ ǁĞƌĞ ƉĞƌŵŝƩĞĚ ƚŽ ůĞĂǀĞ Ăƚ ƚŚĞŝƌ ƌĞƋƵĞƐƚͿ ĂŶĚ ƉƌŽǀŝĚĞĚ ƐƵƐƚĞŶĂŶĐĞ ĚƵƌŝŶŐ ƚŚĞ ůŽŶŐ ŚŽƵƌƐ ƚŚĂƚ ĨŽůůŽǁĞĚ͘ ĨĞǁ ŵŝůĞƐ ĂǁĂLJ Ăƚ ŽƵƌ ƌĞƐŝĚĞŶĐLJ ĂŶĚ ĨĂĐƵůƚLJ ŽĸĐĞƐ ŝŶ >ŽŵĂ >ŝŶĚĂ͕ ŶŽ ůŽĐŬ ĚŽǁŶ ǁĂƐ ƌĞƋƵŝƌĞĚ͘ KƵƌ ƌĞƐŝĚĞŶĐLJ ĂĚŵŝŶŝƐƚƌĂƚŽƌƐ ĂĐĐŽƵŶƚĞĚ ĨŽƌ ƚŚĞ ůŽĐĂƟŽŶ ŽĨ ĞĂĐŚ ŽĨ ŽƵƌ ƌĞƐŝĚĞŶƚƐ ĂŶĚ ĂƐĐĞƌƚĂŝŶĞĚ ǁŚŝĐŚ ƌĞƐŝĚĞŶƚƐ ŚĂĚ ƌĞĐĞŶƚůLJ ďĞĞŶ ŽŶ ŽƵƌ ƐƚĂŶĚĂƌĚ ƌŽƚĂƟŽŶ Ăƚ /ŶůĂŶĚ ZĞŐŝŽŶĂů ĞŶƚĞƌ͘ ŌĞƌ ƚŚĞ ƐŚŽŽƚĞƌƐ ǁĞƌĞ ŝĚĞŶƟĮĞĚ͕ ǁĞ ŝĚĞŶƟĮĞĚ ĂŶĚ ƐƵƉƉŽƌƚĞĚ 24

California Family Physician Spring 2016

ŽƵƌ ƌĞƐŝĚĞŶƚƐ ǁŝƚŚ ƐƉĞĐŝĂů ĨŽĐƵƐ ŽŶ ƚŚŽƐĞ ǁŚŽ ŚĂĚ ƉĞƌĨŽƌŵĞĚ ĞŶǀŝƌŽŶŵĞŶƚĂů ƐĂĨĞƚLJ ǀŝƐŝƚƐ ǁŝƚŚ ƚŚĞ ƐŚŽŽƚĞƌ͘ KƵƌ ŚŽƐƉŝƚĂů͕ >ŽŵĂ >ŝŶĚĂ hŶŝǀĞƌƐŝƚLJ DĞĚŝĐĂů ĞŶƚĞƌ͕ ŝƐ Ă >ĞǀĞů ϭ dƌĂƵŵĂ ĞŶƚĞƌ ǁŚĞƌĞ ǁĞ ƌĞŐƵůĂƌůLJ ŚĂǀĞ ĚŝƐĂƐƚĞƌ ƉƌĞƉĂƌĞĚŶĞƐƐ͕ ĂĐƟǀĞ ƐŚŽŽƚĞƌ ĂŶĚ ŵƵůƟͲĐĂƐƵĂůƚLJ ĚƌŝůůƐ͕ ĂŵŽŶŐ ŽƚŚĞƌƐ͘ tŚĞŶ ƐĞĐƵƌŝƚLJ ǁĂƐ ŝŶĨŽƌŵĞĚ ŽĨ ƚŚĞ ƐŚŽŽƟŶŐƐ͕ ŚŽƐƉŝƚĂů ĂĚŵŝŶŝƐƚƌĂƟŽŶ ĞŶĂĐƚĞĚ ƉƌŽƚŽĐŽůƐ ĨŽƌ Ă ͞ŵƵůƟͲĐĂƐƵĂůƚLJ ŝŶĐŝĚĞŶƚ͕͟ ĂŶĚ Ă ƐĞƌŝĞƐ ŽĨ ǁĞůůͲŽƌĐŚĞƐƚƌĂƚĞĚ ĞǀĞŶƚƐ ŽĐĐƵƌƌĞĚ͕ ƉƌĞƉĂƌŝŶŐ ƚŚĞ ĞŵĞƌŐĞŶĐLJ ƌŽŽŵ ĂŶĚ ƚŚĞ ƌĞƐƚ ŽĨ ƚŚĞ ŚŽƐƉŝƚĂů ĂŶĚ ƐƚĂī ƚŽ ĐĂƌĞ ĨŽƌ ƚŚĞ ǁŽƵŶĚĞĚ͘ /ŶůĂŶĚ ŽƵŶƟĞƐ ŵĞƌŐĞŶĐLJ DĞĚŝĐĂů ŐĞŶĐLJ ;/ D Ϳ ĐŽŵŵĂŶĚ ĐĞŶƚĞƌ ĚŝƐƚƌŝďƵƚĞĚ ƚŚĞ ǀŝĐƟŵƐ ƚŽ ƐĞǀĞƌĂů ĂƌĞĂ ŚŽƐƉŝƚĂůƐ͘ ^ĂĚůLJ͕ ŵĂŶLJ ŽĨ ƚŚĞ ǀŝĐƟŵƐ ĚŝĞĚ Ăƚ ƚŚĞ ƐĐĞŶĞ ŽĨ ƚŚĞ ƐŚŽŽƟŶŐƐ͘ dŚĞ ŝŵƉĂĐƚ ŽĨ ƚŚĞ ƚĞƌƌŽƌŝƐŵ ĞdžƚĞŶĚƐ ĨĂƌ ďĞLJŽŶĚ ƚŚĞ ďŽƵŶĚĂƌŝĞƐ ŽĨ ^ĂŶ ĞƌŶĂƌĚŝŶŽ ĂŶĚ ƚŚĞ ĂĚũĂĐĞŶƚ ŝƚLJ ŽĨ ZĞĚůĂŶĚƐ ǁŚĞƌĞ ƚŚĞ ƐŚŽŽƚĞƌƐ ůŝǀĞĚ ĂŶĚ ŚĂĚ ŵŽƌĞ ǁĞĂƉŽŶƐ ƐƚŽƌĞĚ͘ /Ŷ ĂĚĚŝƟŽŶ ƚŽ ƚŚĞ ǀŝĐƟŵƐ͕ ƚŚĞŝƌ ĨĂŵŝůŝĞƐ ĂŶĚ ĐŽǁŽƌŬĞƌƐ͕ ƚŚĞ ŚĞĂůƚŚ ĐĂƌĞ ƚĞĂŵ ŵĞŵďĞƌƐ͕ ĮƌƐƚ ƌĞƐƉŽŶĚĞƌƐ͕ ƚŚĞ ƐĐŚŽŽů ĐŚŝůĚƌĞŶ ĂŶĚ ƐŽ ŵĂŶLJ ŽƚŚĞƌ ŵĞŵďĞƌƐ ŽĨ ŽƵƌ ĐŽŵŵƵŶŝƟĞƐ ĂŶĚ ĐŽƵŶƚƌLJ ǁĞƌĞ ĚĞĞƉůLJ ĂīĞĐƚĞĚ ďLJ ƚŚŝƐ ƚƌĂŐĞĚLJ͘ Ɛ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͕ ǁĞ ĂƌĞ ƐĞĞŝŶŐ ƚŚĞ ƐĞƋƵĞůĂĞ ŽĨ ƚŚĞ ĨĞĂƌ ĂŶĚ ŐƌŝĞĨ ƚƌŝŐŐĞƌĞĚ ďLJ ƚŚĞ ƐŚŽŽƟŶŐƐ͘ dŚĞ ƐƵƌǀŝǀĂů ƐƚŽƌŝĞƐ͕ ƐĞůĨͲƐĂĐƌŝĮĐĞ ďLJ ƐŽŵĞ ŽĨ ƚŚĞ ǀŝĐƟŵƐ͕ ďƌĂǀĞƌLJ ŽĨ ƚŚĞ ĮƌƐƚ ƌĞƐƉŽŶĚĞƌƐ ĂŶĚ ƚŚĞ ĂŵĂnjŝŶŐ ĐŽŵŵƵŶŝƚLJ ŽƵƚƌĞĂĐŚ ƐƉĞĂŬ ƚŽ ƚŚĞ ƌĞƐŝůŝĞŶĐLJ ŽĨ ƚŚĞ ŚƵŵĂŶ ƐƉŝƌŝƚ͕ ŚŽǁĞǀĞƌ͕ ĂŶĚ ŝŶĐƌĞĂƐĞ ŽƵƌ ĚĞƚĞƌŵŝŶĂƟŽŶ ƚŽ ƌĞĚƵĐĞ ǀŝŽůĞŶĐĞ ŝŶ ŽƵƌ ĐŽŵŵƵŶŝƟĞƐ͘ KŶ ĞĐĞŵďĞƌ ϱ͕ ϮϬϭϱ͕ ƚŚƌĞĞ ĚĂLJƐ ĂŌĞƌ ƚŚĞ ^ĂŶ ĞƌŶĂƌĚŝŶŽ ƐŚŽŽƟŶŐƐ͕ ǁŚŝůĞ LJĞůůŽǁ ĐĂƵƟŽŶ ƚĂƉĞ ƐƟůů ďůŽĐŬĞĚ Žī ƚŚĞ ƉĂƌƚ ŽĨ ZĞĚůĂŶĚƐ ǁŚĞƌĞ ƚŚĞ ĚĞĐĞĂƐĞĚ ƚĞƌƌŽƌŝƐƚƐ ŚĂĚ ůŝǀĞĚ͕ ŽƵƌ ĐŽŵŵƵŶŝƚLJ ĂŶĚ ŽƵƌ ĞůĞĐƚĞĚ ŽĸĐŝĂůƐ ďƌĂǀĞůLJ ĨŽƌŐĞĚ ŽŶ ĂŶĚ ĐĂŵĞ ƚŽŐĞƚŚĞƌ ĨŽƌ ƚŚĞ ĂŶŶƵĂů ,ŽůŝĚĂLJ WĂƌĂĚĞ ŝŶ ĚŽǁŶƚŽǁŶ ZĞĚůĂŶĚƐ͘ Ɛ / ƐĂƚ ŽŶ ƚŚĞ ĞĚŐĞ ŽĨ ƚŚĞ ƉĂƌĂĚĞ ƌŽƵƚĞ ǁĂƚĐŚŝŶŐ ŽƵƌ ĐŚŝůĚƌĞŶ ŝŶ ƚŚĞ ůŽĐĂů ƐĐŚŽŽů ďĂŶĚƐ ŵĂƌĐŚ ďLJ͕ ƐŵŝůŝŶŐ ǁŚŝůĞ ƉůĂLJŝŶŐ ďƌŝŐŚƚůLJ ĚĞĐŽƌĂƚĞĚ ŝŶƐƚƌƵŵĞŶƚƐ͕ / ǁĂƐ ƐƚƌƵĐŬ ďLJ ƚŚĞ ƐŽƵŶĚ ŽĨ Ă ĚŝīĞƌĞŶƚ ƚLJƉĞ ŽĨ ƐŝůǀĞƌ͕ ŶŽ ŵŽƌĞ ͞ ŽĚĞ ^/>s Z͟ ƉĂŐĞƐ͖ ƌĂƚŚĞƌ͕ ƚŚŝƐ ƟŵĞ͕ ŝƚ ǁĂƐ ƚŚĞ ůŝǀĞůLJ Ɖ ŵƵƐŝĐ ŽĨ ͞^/>s Z >>^͘͟ Dr. Simon is the Assistant Director of the Family Medicine Residency Program at Loma Linda University.

FAMILY MEDICINE/PEDIATRIC MEDICINE

Vista Community Clinic With locations in Vista/No San Diego County, Lake Elsinore/So Riverside County and La Habra/Orange County Seeking: Full-time, part-time and per diem Family Medicine Physicians and Pediatricians.

Requirements: California license, DEA license, CPR certification and board certified in family medicine.

Bilingual English/Spanish preferred.

Contact c Us: Visitt our website at a ww www.vistacommunityclinic.org r Forward resume to hr@vistacommunityc t linic.org r or fax resume to 760-414-3702

Leading the future of health care.

FAMILY MEDICINE PHYSICIAN OPPORTUNITIES Northern & Central California Many organizations have a mission statement; we have a calling: to lead the way to a better future for health care. Through our leadership in the use of advanced technology, our creation of innovative solutions and our influence on health policy and reform efforts, we are shaping the future of health care in the nation. Currently, we have opportunities available for Family Medicine Physicians in Northern and Central California.

FORGIVABLE LOAN PROGRAM - $150,000-$200,000 (based on experience) To demonstrate how much we value the role our Primary Care Physicians play, we’ve created a special incentive just for you. Available exclusively to Internal Medicine and Family Medicine Physicians, the Forgivable Loan Program is just one of many incentives we offer in exchange for your dedication and expertise.

LA SALUD PERMANENTE At The Permanente Medical Group, Inc. (TPMG), we practice a multi-lingual, culturally inclusive approach to care that celebrates the diversity of our patients and physicians.

By developing medical programs that are in tune with every aspect of our patients’ lives—from the language they speak to the heritage they embrace—we are actively investing in initiatives and services that reflect the diversity of our member community.

Here, our bilingual physicians can act as true advocates for their patients, delivering care that’s as medically advanced as it is culturally sensitive. Si su vocación y avocación son una y la misma, please join us today.

TPMG is the largest multi-specialty group practice in the nation with over 9,000 physicians and an over 65-year tradition of providing quality medical care. We offer competitive salaries and a generous benefits package. For further details, please contact Gretchen Miles at Gretchen.H.Miles@kp.org or Aileen Ludlow at Aileen.M.Ludlow@kp.org. You may also call (800) 777-4912. Please visit our website at: http://physiciancareers-ncal.kp.org. We are an EOE/AA/M/F/D/V Employer.

VEVRAA Federal Contractor.

http://physiciancareers-ncal.kp.org California Family Physician Spring 2016

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Pesky Mosquitos: Causing More than the Summer Itch /Ŷ ƚŝŵĞƐ ƉĂƐƚ͕ ŵLJ ƐƵŵŵĞƌ ǁĂƐ ŵĂƌŬĞĚ ďLJ ƚŚĞ ŶƵŵďĞƌ ŽĨ ŵŽƐƋƵŝƚŽ ďŝƚĞƐ / ŐŽƚ Ăƚ ŽƵƌ ĨĂŵŝůLJ ůĂŬĞ ƌĞƚƌĞĂƚ ŝŶ ŶŽƌƚŚĞƌŶ DŝŶŶĞƐŽƚĂ͘ dŽĚĂLJ͕ / Ɛƚŝůů ƵƐĞ ďƵŐ ƐƉƌĂLJ ĂŶĚ ŚŽƉĞ ƚŚĞ ƉĞƐŬLJ ďƵŐƐ ǁŽŶ͛ƚ ĂƚƚĂĐŬ ĚƵƌŝŶŐ ĚŝŶŶĞƌƐ ŝŶ ŽƵƌ ďĞĂĐŚƐŝĚĞ ŚŽƵƐĞ ŝŶ ƚŚĞ zƵĐĂƚĂŶ͘ /͛ǀĞ ĂůǁĂLJƐ ŬŶŽǁŶ ŵŽƐƋƵŝƚŽƐ ĐĂƌƌLJ ƚĞƌƌŝďůĞ ŝůůŶĞƐƐĞƐ ĂŶĚ ǁĂƐ ĞǀĞŶ ĐĂƵƚŝŽŶĞĚ ĂďŽƵƚ ďŝƚĞƐ ĂŶĚ ĚĞŶŐƵĞ ǁŚĞŶ ŽŶ ƚƌŝƉƐ ƚŽ ƵďĂ ŝŶ ϮϬϬϰ ĂŶĚ ϮϬϬϲ͘ Ƶƚ͕ ƵŶƚŝů ƌĞĐĞŶƚůLJ͕ / ŶĞǀĞƌ ƚŚŽƵŐŚƚ ƚŽŽ ŵƵĐŚ ĂďŽƵƚ ƚŚĞ ďŝƚĞƐ ƉĂƐƚ ƚŚĞ ͞ĚĂƌŶ͕ ŚĞ ŐŽƚ ŵĞ ĂŐĂŝŶ͕͟ Žƌ ͞ƐƚŽƉ ďƵnjnjŝŶŐ ŵLJ ĞĂƌ͘͟ hŶƚŝů ƌĞĐĞŶƚůLJ͘ ŶĚ ŶŽǁ͕ / ƌĞĂĚ ƚŚĞ ƉĂƉĞƌƐ͕ ǁĂƚĐŚ ƚŚĞ ŶĞǁƐ͕ ƐĞĞ ƌĞƉŽƌƚƐ ŽŶ ƐŽĐŝĂů ŵĞĚŝĂ ĂŶĚ ŐĞƚ ĐĂůůƐ Ăƚ &W ŽĨĨŝĐĞƐ ĂďŽƵƚ ƚŚĞ ƚŚĞ ŝŶĐŝĚĞŶĐĞƐ ŽĨ tĞƐƚ EŝůĞ͕ ŝŬĂ ĂŶĚ ĐŚŝŬƵŶŐƵŶLJĂ͘ EĞĂƌůLJ ϳϬϬ ŵŝůůŝŽŶ ƉĞŽƉůĞ ǁŽƌůĚǁŝĚĞ ŐĞƚ Ă ŵŽƐƋƵŝƚŽͲďŽƌŶĞ ŝůůŶĞƐƐ ĞĂĐŚ LJĞĂƌ͕ ƌĞƐƵůƚŝŶŐ ŝŶ ŵŽƌĞ ƚŚĂŶ ŽŶĞ ŵŝůůŝŽŶ ĚĞĂƚŚƐ ;ƚŚĞ ŵĂũŽƌŝƚLJ ĂƌĞ Ɛƚŝůů ĐĂƵƐĞĚ ďLJ ŵĂůĂƌŝĂͿ͘ /Ŷ ƚŚĞ h^͕ ĨŽƌƚƵŶĂƚĞůLJ ƚŚĞ ŶƵŵďĞƌƐ ĂƌĞ ĞdžƚƌĞŵĞůLJ ůŽǁ ĨŽƌ ďŽƚŚ ŝůůŶĞƐƐ ĂŶĚ ĚĞĂƚŚƐ͘ ^Ž͕ ƚŽ Ăƌŵ ŵLJƐĞůĨ ĂŶĚ ĂŶƐǁĞƌ ƋƵĞƐƚŝŽŶƐ ŬŶŽǁůĞĚŐĂďůLJ͕ / ƚŚŽƵŐŚƚ Ă ďŝƚ ŽĨ ƌĞƐĞĂƌĐŚ ǁŽƵůĚ ďĞ ďĞŶĞĨŝĐŝĂů͘ ,ĞƌĞ ŐŽĞƐ͕ ĂŶĚ ƉůĞĂƐĞ ĨĞĞů ĨƌĞĞ ƚŽ ƐŚĂƌĞ ƚŚŝƐ ǁŝƚŚ ƚŚŽƐĞ ǁŚŽ ƋƵĞƐƚŝŽŶ LJŽƵƌ ŶĞdžƚ ĨŝƐŚŝŶŐ ƚƌŝƉ ƚŽ ƚŚĞ <ĞLJƐ Žƌ ƐƵŵŵĞƌ ďŝŬĞ ƌŝĚĞ ŝŶ <ĂŶƐĂƐ ŝƚLJ͘ West Nile Virus DŽƐƚ ƉĞŽƉůĞ ǁŚŽ ŐĞƚ tĞƐƚ EŝůĞ ǀŝƌƵƐ ĚŽŶ͛ƚ ŚĂǀĞ ĂŶLJ ƐLJŵƉƚŽŵƐ͘ ďŽƵƚ ŽŶĞ ŝŶ ĨŝǀĞ ǁŝůů ŚĂǀĞ Ă ĨĞǀĞƌ ĂŶĚ ŽƚŚĞƌ ĨůƵͲ ůŝŬĞ ƐLJŵƉƚŽŵƐ͘ dŚĞ ǁŽƌŶͲŽƵƚ ĨĞĞůŝŶŐ ĐĂŶ ƚĂŬĞ ŵŽŶƚŚƐ ƚŽ ŐŽ ĂǁĂLJ ĐŽŵƉůĞƚĞůLJ͘ ĨĞǁ ƉĞŽƉůĞ ŐĞƚ Ă ŵŽƌĞ ƐĞƌŝŽƵƐ ŝŶĨĞĐƚŝŽŶ

ƚŚĂƚ ŵĂLJ ĐĂƵƐĞ ďƌĂŝŶ ƐǁĞůůŝŶŐ Žƌ ŵĞŶŝŶŐŝƚŝƐ͕ ďƵƚ ŽŶůLJ Ă ǀĞƌLJ ƐŵĂůů ŶƵŵďĞƌ ŽĨ ƉĞŽƉůĞ ĚŝĞ ĨƌŽŵ tĞƐƚ EŝůĞ͘ WĞŽƉůĞ ŝŶ ϰϴ ŽĨ ƚŚĞ ϱϬ h^ ƐƚĂƚĞƐ͕ ĨƌŝĐĂ͕ ƵƌŽƉĞ͕ ƚŚĞ DŝĚĚůĞ ĂƐƚ͕ ĂŶĚ tĞƐƚ ĂŶĚ ĞŶƚƌĂů ƐŝĂ ŚĂǀĞ ŚĂĚ tĞƐƚ EŝůĞ͘ Zika Virus dŚĞ :ĂŶƵĂƌLJ ϮϬϭϲ D ^ƉŽƚůŝŐŚƚ ŚŝŐŚůŝŐŚƚĞĚ ƚŚĞ ŝŬĂ ǀŝƌƵƐ ĂƐ ŝƚ ŚĂƐ ďĞĞŶ ŵĂŬŝŶŐ Ă ůŽƚ ŽĨ ŚĞĂĚůŝŶĞƐ ƌĞĐĞŶƚůLJ͘ dŚĞ ǀŝƌƵƐ ǁĂƐ ĨŝƌƐƚ ĨŽƵŶĚ ŝŶ ĨƌŝĐĂ ŝŶ ƚŚĞ ϭϵϰϬƐ ĂŶĚ ŚĂƐ ƐƉƌĞĂĚ ƚŽ ^ŽƵƚŚ ĂŶĚ ĞŶƚƌĂů ŵĞƌŝĐĂ͕ DĞdžŝĐŽ͕ ƚŚĞ ĂƌŝďďĞĂŶ͕ ^ŽƵƚŚĞĂƐƚ ƐŝĂ͕ ƚŚĞ WĂĐŝĨŝĐ /ƐůĂŶĚƐ ĂŶĚ ƚŚĞ h^͘ ĞĐĂƵƐĞ ŝŬĂ ƐLJŵƉƚŽŵƐ ĂƌĞ ŵŝůĚ ĂŶĚ ƵƐƵĂůůLJ ƌƵŶ ƚŚĞŝƌ ĐŽƵƌƐĞ ŝŶ ůĞƐƐ ƚŚĂŶ Ă ǁĞĞŬ͕ ŵŽƐƚ ƉĞŽƉůĞ ĂƌĞ ƵŶĂǁĂƌĞ ƚŚĞLJ ĞǀĞŶ ŚĂǀĞ ƚŚĞ ǀŝƌƵƐ͘ sŝƌƵƐ ƐLJŵƉƚŽŵƐ ŝŶĐůƵĚĞ ĨĞǀĞƌ͕ ũŽŝŶƚ Žƌ ŵƵƐĐůĞ ƉĂŝŶ͕ ƉŝŶŬĞLJĞ͕ Žƌ Ă ƌĂƐŚ͘ dŚĞ ǀŝƌƵƐ ŚĂƐ ĂůƐŽ ďĞĞŶ ůŝŶŬĞĚ ƚŽ ŵŽƌĞ ƐĞƌŝŽƵƐ ƉƌŽďůĞŵƐ͗ ĐĂƐĞƐ ŽĨ 'ƵŝůůĂŝŶͲ ĂƌƌĞ ƐLJŶĚƌŽŵĞ ĂŶĚ Ă ďŝƌƚŚ ĚĞĨĞĐƚ ĐĂůůĞĚ ŵŝĐƌŽĐĞƉŚĂůLJ͘ 'ƵŝůůĂŝŶͲ ĂƌƌĞ ŝƐ Ă ŶĞƌǀŽƵƐ ƐLJƐƚĞŵ ĚŝƐŽƌĚĞƌ ƚŚĂƚ ĐĂŶ ĐĂƵƐĞ ǁĞĂŬŶĞƐƐ ĂŶĚ ƉĂƌĂůLJƐŝƐ͘ DŽƐƚ ƉĞŽƉůĞ ƌĞĐŽǀĞƌ ŽǀĞƌ ƚŝŵĞ͘ DŝĐƌŽĐĞƉŚĂůLJ͕ ŽŶ ƚŚĞ ŽƚŚĞƌ ŚĂŶĚ͕ ĐĂƵƐĞƐ Ă ďĂďLJ͛Ɛ ŚĞĂĚ ƚŽ ďĞ ƐŵĂůů ĂŶĚ ŶŽƚ ĨƵůůLJ ĚĞǀĞůŽƉĞĚ͘ ĂďŝĞƐ ǁŝƚŚ ƚŚŝƐ ĐŽŶĚŝƚŝŽŶ ŵĂLJ ŚĂǀĞ ĚĞǀĞůŽƉŵĞŶƚĂů ĂŶĚ ŝŶƚĞůůĞĐƚƵĂů ĚĞůĂLJƐ ĂŶĚ ŽƚŚĞƌ ƉƌŽďůĞŵƐ͘ dŚĞ ƌĞĐĞŶƚ ŽĐĐƵƌƌĞŶĐĞƐ ŽĨ ŵŝĐƌŽĐĞƉŚĂůLJ ŝŶ ƌĂnjŝů ĂŶĚ ŽƚŚĞƌ ^ŽƵƚŚ ŵĞƌŝĐĂŶ ĐŽƵŶƚƌŝĞƐ ŚĂƐ ďƌŽƵŐŚƚ ŝŬĂ ƚŽ ƚŚĞ ĨƌŽŶƚ ƉĂŐĞƐ͖ ƚŚĞ ĞŶƚĞƌƐ ĨŽƌ ŝƐĞĂƐĞ ŽŶƚƌŽů ĂŶĚ ŵĂŶLJ ƐƉĞĐŝĂůƚLJ ŽƌŐĂŶŝnjĂƚŝŽŶƐ ;ŝŶĐůƵĚŝŶŐ &W ĂŶĚ &WͿ ŚĂǀĞ ŝƐƐƵĞĚ ŐƵŝĚĂŶĐĞ ĨŽƌ ƉĂƚŝĞŶƚƐ͕ ƉĂƌƚŝĐƵůĂƌůLJ ǁŽŵĞŶ ǁŚŽ ƉůĂŶ

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California Family Physician Spring 2016

THE STRENGTH TO HEAL and stand by those who stand up for me.

Learn n the latest treatments and play an impo mportant role in the care of Sold mp oldiers ol and th heir famil ilies. As a physician on the U.S. Army Reserve health care team, you’ll continue to practtice in yourr comm munity and serve when ne eeded. You’ll work with the most advanced techn nollogy and disting guish you urse rself while rs e wo orking g with dedicated proffessio onalss. You’lll make a difference.

To learn more about the U.S. Army health care team, call 310-216-4433 or visit healthcare.goarmy.com/eb19.

©2013. Paid aid d for o by the h Uni Unitted St S ate es Army. All A rights reserved.

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ƚŽ ďĞĐŽŵĞ ƉƌĞŐŶĂŶƚ Žƌ ĂƌĞ ƉƌĞŐŶĂŶƚ͕ ĨŽƌ ĐĂƵƚŝŽŶ ǁŚĞŶ ƚƌĂǀĞůŝŶŐ͘ EŽ ǀĂĐĐŝŶĞ ĂƐ LJĞƚ ŚĂƐ ďĞĞŶ ĚĞǀĞůŽƉĞĚ ƚŽ ƉƌĞǀĞŶƚ ƚŚĞ ǀŝƌƵƐ͘

The Petaluma Health Center (PHC) has opportunities for experienced, innovative physicians to join a dynamic team of over forty providers in Southern Sonoma County.

PHC is a Federally Qualified Health Center (FQHC) located in Petaluma and Rohnert Park, CA and provides full spectrum comprehensive primary care including obstetrical care and mental health services to over 20,000 patients. Our health center is a leading innovator in integrative medicine, team based care, and technology. We are seeking bilingual English/Spanish physicians with a minimum of three years’ experience to provide care to a panel of patients. These positions allow for ample growth and leadership in a multitude of areas related to improvement of the patient care experience. Options for combined hospital medicine and obstetric call are available, as is the option of outpatient call (telephone call) only.

Chikungunya Virus dŚĞ ĨŝƌƐƚ ůŽĐĂůůLJ ĂĐƋƵŝƌĞĚ ĐĂƐĞƐ ŽĨ ĐŚŝŬƵŶŐƵŶLJĂ ǁĞƌĞ ƌĞƉŽƌƚĞĚ ŝŶ &ůŽƌŝĚĂ ŽŶ :ƵůLJ ϭϳ͕ ϮϬϭϰ͘ dŚĞƐĞ ĐĂƐĞƐ ƌĞƉƌĞƐĞŶƚ ƚŚĞ ĨŝƌƐƚ ƚŝŵĞ ƚŚĂƚ ŵŽƐƋƵŝƚŽĞƐ ŝŶ ƚŚĞ ĐŽŶƚŝŶĞŶƚĂů hŶŝƚĞĚ ^ƚĂƚĞƐ ĂƌĞ ƚŚŽƵŐŚƚ ƚŽ ŚĂǀĞ ƐƉƌĞĂĚ ƚŚĞ ǀŝƌƵƐ ƚŽ ŶŽŶͲƚƌĂǀĞůĞƌƐ͘ ŚŝŬƵŶŐƵŶLJĂ ŝƐ Ă ǀŝƌĂů ĚŝƐĞĂƐĞ ƐƉƌĞĂĚ ƚŽ ƉĞŽƉůĞ ďLJ ƚŚĞ ďŝƚĞ ŽĨ ŝŶĨĞĐƚĞĚ ŵŽƐƋƵŝƚŽĞƐ͘ dŚĞ ŵŽƐƚ ĐŽŵŵŽŶ ƐLJŵƉƚŽŵƐ ŽĨ ĐŚŝŬƵŶŐƵŶLJĂ ǀŝƌƵƐ ŝŶĨĞĐƚŝŽŶ ĂƌĞ ĨĞǀĞƌ ĂŶĚ ũŽŝŶƚ ƉĂŝŶ͘ KƚŚĞƌ ƐLJŵƉƚŽŵƐ ŵĂLJ ŝŶĐůƵĚĞ ŚĞĂĚĂĐŚĞ͕ ŵƵƐĐůĞ ƉĂŝŶ͕ ũŽŝŶƚ ƐǁĞůůŝŶŐ Žƌ ƌĂƐŚ͘ dŚŽƵŐŚ ĚŽĞƐ ŶŽƚ ĞdžƉĞĐƚ ǁŝĚĞƐƉƌĞĂĚ ĐĂƐĞƐ͕ ŵĞƌŝĐĂŶƐ ŝŶĨĞĐƚĞĚ ǁŚĞŶ ƚƌĂǀĞůŝŶŐ ƚŽ ƚŚĞ ĂƌŝďďĞĂŶ͕ ^ŽƵƚŚ ŵĞƌŝĐĂ͕ Žƌ ƚŚĞ WĂĐŝĨŝĐ /ƐůĂŶĚƐ ĂƌĞ ůŝŬĞůLJ ƚŽ ďƌŝŶŐ ƚŚĞ ǀŝƌƵƐ ǁŝƚŚ ƚŚĞŵ ǁŚĞŶ ƚŚĞLJ ƌĞƚƵƌŶ ƚŽ ƚŚĞ h^͘ &Žƌ ƵƉĚĂƚĞƐ ŽŶ ůŽĐĂůůLJͲĂĐƋƵŝƌĞĚ ĂŶĚ ƚƌĂǀĞůͲĂƐƐŽĐŝĂƚĞĚ ĐŚŝŬƵŶŐƵŶLJĂ ĐĂƐĞƐ͕ ǀŝƐŝƚ ͛Ɛ ĐŚŝŬƵŶŐƵŶLJĂ ǁĞďƐŝƚĞ͘ Battle the Bite DĂŶLJ ŵŽƐƋƵŝƚŽĞƐ ůŝǀĞ ĨŽƌ ƚǁŽ ƚŽ ƚŚƌĞĞ ŵŽŶƚŚƐ͘ DŽƐƚ ǁŝůů ĚŝĞ Žƌ ŚŝďĞƌŶĂƚĞ ǁŚĞŶ ƚŚĞ ƚĞŵƉĞƌĂƚƵƌĞ ĚƌŽƉƐ ďĞůŽǁ ϱϬ ĚĞŐƌĞĞƐ͘ /Ŷ ƚŚĞ h^͕ ŵŽƐƋƵŝƚŽ ƐĞĂƐŽŶ ďĞŐŝŶƐ ŝŶ ĞĂƌůLJ ƐƉƌŝŶŐ͕ ƉĞĂŬƐ ŝŶ ƚŚĞ ƐƵŵŵĞƌ ĂŶĚ ĞŶĚƐ ǁŝƚŚ ƚŚĞ ĨŝƌƐƚ ĨƌĞĞnjĞ͘ /Ŷ ƉĂƌƚƐ ŽĨ ƚŚĞ ǁŽƌůĚ ǁŝƚŚ ǁĂƌŵĞƌ ǁĞĂƚŚĞƌ͕ ƚŚĞ ƉĞƐŬLJ ďƵŐƐ ŵĂLJ ďĞ ĂĐƚŝǀĞ LJĞĂƌͲƌŽƵŶĚ͘ dŚĞ ďĞƐƚ ǁĂLJ ƚŽ ƉƌĞǀĞŶƚ ƚŚĞ ŝůůŶĞƐƐĞƐ ƚŚĞLJ ƐƉƌĞĂĚ ŝƐ ƚŽ ĂǀŽŝĚ ƚŚĞŝƌ ďŝƚĞƐ͘ ͻ tĞĂƌ ůŝŐŚƚͲĐŽůŽƌĞĚ ĐůŽƚŚŝŶŐ ƚŽ ĐŽǀĞƌ ƵƉ͘ ͻ WƵƚ ŵŽƐƋƵŝƚŽ ƌĞƉĞůůĞŶƚ ;͞ďƵŐ ƐƉƌĂLJ͟Ϳ ŽŶ LJŽƵƌ ďĂƌĞ ƐŬŝŶ͘ ͻ 'Ğƚ ƌŝĚ ŽĨ ƉůĂĐĞƐ ǁŚĞƌĞ ǁĂƚĞƌ ĐĂŶ ĐŽůůĞĐƚ ĂƌŽƵŶĚ LJŽƵƌ ŚŽŵĞ͘ <ĞĞƉ ǁĂƚĞƌ ŝŶ ƉŽŽůƐ ĂŶĚ ůĂŶĚƐĐĂƉŝŶŐ ŵŽǀŝŶŐ͘ ͻ hƐĞ ƐĐƌĞĞŶƐ ŽŶ LJŽƵƌ ǁŝŶĚŽǁƐ Žƌ ƵƐĞ Ă ŵŽƐƋƵŝƚŽ ŶĞƚ ǁŚĞŶ ƐůĞĞƉŝŶŐ ŽƵƚĚŽŽƌƐ͘ &Žƌ ƚŚĞ ůĂƚĞƐƚ ŝŶĨŽƌŵĂƚŝŽŶ ŽŶ Ăůů ŵŽƐƋƵŝƚŽͲ ďŽƌŶĞ ŝůůŶĞƐƐĞƐ ĐŽŶƐƵůƚ ǁǁǁ͘ĐĚĐ͘ŐŽǀ͘ Shelly Rodrigues, CAE, CHPH, FACEHP is CAFP’s Deputy Executive Vice President.

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California Family Physician Spring 2016

Hilton San Francisco Union Square

May 13 - 15, 2016

San Francisco, CA

Physicians, nurses, medical practice managers and all other health care industry professionals—Join us in the heart of San Francisco to prepare for changes affecting your profession, your practice and your economic future.

Health care power players will share strategies and resources for accelerating the shift to a more integrated, high performing and sustainable health care system. Speakers include Dr. Atul Gawande, distinguished surgeon, teacher and writer – named one of TIME magazine’s 100 most influential thinkers; Karl Rove, former Deputy Chief of Staff and Senior Advisor to President George W. Bush; and Donna Brazile, Al Gore campaign manager and Democratic National Committee Vice Chair.

800.795.2262 www.westernleadershipacademy.com California Family Physician Spring 2016

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EXECUTIVE VICE PRESIDENT’S FORUM

Public Health Continues to be a Priority for Your Academy ŝŬĂ͕ ĐŚŝŬƵŶŐƵŶLJĂ͕ ĚĞŶŐƵĞ ĂŶĚ tĞƐƚ EŝůĞ ǀŝƌƵƐĞƐ͕ ŚĞƉĂƟƟƐ ͕ ,/s͕ ŽƵƚďƌĞĂŬƐ ŽĨ ƉĞƌƚƵƐƐŝƐ ĂŶĚ ŵĞĂƐůĞƐ͕ ǁĂƚĞƌ ƋƵĂůŝƚLJ ʹ ƚŚĞ ĞŶŐĂŐĞŵĞŶƚ ŽĨ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ŽŶ ŝƐƐƵĞƐ ĐŽŶĐĞƌŶŝŶŐ ƉƵďůŝĐ ŚĞĂůƚŚ ŝƐ ĞƐƐĞŶƟĂů͕ ĂŶĚ LJŽƵƌ ĐĂĚĞŵLJ ŚĂƐ ďĞĞŶ ĚŽŝŶŐ͕ ĂŶĚ ŝŶƚĞŶĚƐ ƚŽ ŬĞĞƉ ŽŶ ĚŽŝŶŐ͕ ũƵƐƚ ƚŚĂƚ͘ tĞ ŚĂǀĞ ǁƌŝƩĞŶ ŵĂŶLJ ƟŵĞƐ ƉƌĞǀŝŽƵƐůLJ ŝŶ Ăůů ĐĂĚĞŵLJ ƉƵďůŝĐĂƟŽŶƐ ʹ ĞůĞĐƚƌŽŶŝĐ ĂŶĚ ƉƌŝŶƚ ʹ ĂďŽƵƚ ŽƵƌ ƌŽůĞ ŝŶ ƉĂƐƐĂŐĞ ŽĨ ^ Ϯϳϳ͕ ůĞŐŝƐůĂƟŽŶ ďLJ ^ĞŶĂƚŽƌ ZŝĐŚĂƌĚ WĂŶ ƚŽ ĞůŝŵŝŶĂƚĞ ƚŚĞ ƉĞƌƐŽŶĂů ĂŶĚ ƌĞůŝŐŝŽƵƐ ďĞůŝĞĨ ĞdžĞŵƉƟŽŶƐ ĨŽƌ ƌĞƋƵŝƌĞĚ ĐŚŝůĚŚŽŽĚ ǀĂĐĐŝŶĞƐ͕ ƐŽ / ǁŽŶ͛ƚ ďĞůĂďŽƌ ƚŚĂƚ ĞdžĐĞƉƚ ƚŽ ƐĂLJ ǁĞ ĚŝĚ ƚŚĞ ƌŝŐŚƚ ƚŚŝŶŐ ĂŶĚ ƚŽŽŬ ƚŚĞ ŚĞĂƚ ĨŽƌ ŝƚ ĨƌŽŵ ƚŚĞ ĂŶƟͲǀĂĐĐŝŶĞ ĨĂĐƟŽŶƐ͘

ƚŚĞƌĞ ƚŽ ĚŝĞ ŽĨ ƚŚĞŝƌ ĚŝƐĞĂƐĞ ʹ ŵŽƐƚůLJ ƵŶƚƌĞĂƚĞĚ ʹ ƚŽ ƚŚĞ ĚĞŐƌĞĞ ƚŚĂƚ ƚƌĞĂƚŵĞŶƚ Ăƚ ƚŚĞ ƟŵĞ ŚĞůƉĞĚ͘ dŚĞ ĐĂƐĞ ĨŽƌ ǀĂĐĐŝŶĂƟŽŶ ŝƐ ƉƌĞƩLJ ĐůĞĂƌ ŶŽǁ͕ ŚŽǁĞǀĞƌ͕ ďƵƚ ƚŚŽƐĞ ŽƉƉŽƐĞĚ ĚŽŶ͛ƚ ůĞƚ ƚŚĞ ĨĂĐƚƐ ĐŽŶĨƵƐĞ ƚŚĞŵ͖ ƚŚĞLJ ĚŽ ůĞƚ ƚŚĞ ͞ĨĂĐƚƐ͟ ƚŚĞLJ ĮŶĚ ŽŶ ƚŚĞ /ŶƚĞƌŶĞƚ ĐŽŶĨƵƐĞ ƚŚĞŵ͘ :ƵƐƚ ĂƐ ŵŽǀŝĞ ĂŶĚ ds ƌĞĂůŝƚLJ ƐƚĂƌƐ ĂƌĞ ŝŵďƵĞĚ ďLJ ŵĂŶLJ ǁŝƚŚ ƉŽůŝƟĐĂů ĂŶĚ ůĞĂĚĞƌƐŚŝƉ ƚĂůĞŶƚƐ ƚŚĞLJ ŵĂLJ ŶŽƚ ƉŽƐƐĞƐƐ ŝŶ ĂĐƚƵĂůŝƚLJ͕ ƐŽ ƚŚĞLJ ĂůƐŽ ĂƌĞ ŝŵďƵĞĚ ǁŝƚŚ ƐĐŝĞŶƟĮĐ ƐŬŝůůƐ ƚŚĞLJ ĚĞĮŶŝƚĞůLJ ĚŽ ŶŽƚ ƉŽƐƐĞƐƐ ŝŶ ĂĐƚƵĂůŝƚLJ͘ /Ĩ ZŽď ^ŶLJĚĞƌ ƐĂLJƐ ǀĂĐĐŝŶĞƐ ĐĂƵƐĞ ĂƵƟƐŵ͕ ŝƚ ŵƵƐƚ ďĞ ƐŽ͍

Ȭ ȱ ȱ ȱ ȱ ȱ ¢ȱ ȱ ȱ Dzȱ ȱ ȱ ȱ ȱ ȱ ę ǰȱ ȱ ȱ ȱ ȱ ¡ȱ ȱ ȱ ȱ ȱ ¢ȱ ¢ ȱ ȱ ¢ ȱ ȱ ȱ ȱ ǯ

Ɛ ƌĞƉŽƌƚĞĚ ŝŶ &W͛Ɛ :ĂŶƵĂƌLJ Ϯϵ >ĞŐŝƐůĂƟǀĞ hƉĚĂƚĞ͕ ŚŽǁĞǀĞƌ͕ ƚŚĞ ĂůŝĨŽƌŶŝĂ ĞƉĂƌƚŵĞŶƚ ŽĨ WƵďůŝĐ ,ĞĂůƚŚ ƌĞĐĞŶƚůLJ ĂŶŶŽƵŶĐĞĚ ƚŚĂƚ ĂŶ ĞƐƟŵĂƚĞĚ ϵϯ ƉĞƌĐĞŶƚ ŽĨ ĂůŝĨŽƌŶŝĂ ŬŝŶĚĞƌŐĂƌƚŶĞƌƐ ƌĞĐĞŝǀĞĚ Ăůů ŽĨ ƚŚĞŝƌ ƌĞƋƵŝƌĞĚ ŝŵŵƵŶŝnjĂƟŽŶƐ ďLJ ĞĐĞŵďĞƌ ϮϬϭϱ͕ ĂŶ ŝŶĐƌĞĂƐĞ ŽĨ Ϯ͘ϱ ƉĞƌĐĞŶƚ ĐŽŵƉĂƌĞĚ ƚŽ ϮϬϭϰ͘ /Ɛ ^ Ϯϳϳ ƌĞƐƉŽŶƐŝďůĞ͍ tĞ ƚŚŝŶŬ ŝƚ ŝƐ ŽŶĞ ŽĨ ƚŚĞ ĨĂĐƚŽƌƐ͘ EŽŶĞƚŚĞůĞƐƐ͕ ǁĞ ŚĂǀĞ Ă ůŽŶŐ ǁĂLJ ƚŽ ŐŽ ŝŶ ƚŚĞ ƚǁĞŶƚLJ ŽĨ ϱϴ ĐŽƵŶƟĞƐ ŝŶ ŽƵƌ ƐƚĂƚĞ ƚŚĂƚ ƐƟůů ĨĂůů ďĞůŽǁ ƚŚĞ ƉĞƌĐĞŶƚĂŐĞ ŶĞĐĞƐƐĂƌLJ ƚŽ ƐƚŽƉ ƚŚĞ ƐƉƌĞĂĚ ŽĨ ǀĂĐĐŝŶĞͲ ƉƌĞǀĞŶƚĂďůĞ ĚŝƐĞĂƐĞ ʹ ƐŽͲĐĂůůĞĚ ŚĞƌĚ ŝŵŵƵŶŝƚLJ ůĞǀĞůƐ͘ ŶƟͲǀĂĐĐŝŶĂƟŽŶ ĨĂĐƟŽŶƐ ŚĂǀĞ Ă ůŽŶŐ ŚŝƐƚŽƌLJ ŝŶ ŽƵƌ ŶĂƟŽŶ͖ ƐŽŵĞƟŵĞƐ ŽƉƉŽƐŝƟŽŶ ƚŽ ǀĂĐĐŝŶĂƟŽŶ ǁĂƐ ũƵƐƟĮĞĚ͕ ƐƵĐŚ ĂƐ ǁŚĞŶ ƚŚĞ ƐŵĂůůƉŽdž ǀĂĐĐŝŶĞ ĐŽƵůĚ ďĞ ƉƌŽĚƵĐĞĚ ďLJ ĂŶLJŽŶĞ ĂŶĚ ĞǀĞƌLJŽŶĞ ĂŶĚ ŝŶ ƵŶƐƚĞƌŝůĞ ĐŽŶĚŝƟŽŶƐ͘ ƉŝĚĞŵŝĐƐ ŽĨ ƚĞƚĂŶƵƐ ƐŽŵĞƟŵĞƐ ƌĞƐƵůƚĞĚ ŝŶ ƚŚĞ ĚĞĂƚŚƐ ŽĨ ŚƵŶĚƌĞĚƐ ŽĨ ĐŚŝůĚƌĞŶ͕ ĂŶĚ ĐŽŵŵƵŶŝĐĂďůĞ ĚŝƐĞĂƐĞƐ ƐƵĐŚ ĂƐ ƐLJƉŚŝůŝƐ ǁĞƌĞ ƚƌĂŶƐŵŝƩĞĚ ǁŚĞŶ ǀĂĐĐŝŶĞƐ ǁĞƌĞ ŵĂĚĞ ĨƌŽŵ ƚŚĞ ƐĐĂďƐ ŽĨ ƐŵĂůůƉŽdž ŝŶŽĐƵůĂƟŽŶƐ ƚĂŬĞŶ ĨƌŽŵ ŝŶĨĞĐƚĞĚ ŝŶĚŝǀŝĚƵĂůƐ͘ dŚĂƚ ŝƐ ƐŽŵĞ ƐĐĂƌLJ ƐƚƵī͕ ĞƐƉĞĐŝĂůůLJ ǁŚĞŶ ƚŚĞ ǀĂĐĐŝŶĂƟŽŶ ĨŽƌ ƐŵĂůůƉŽdž ǁĂƐ ŵĂŶĚĂƚŽƌLJ ĂŶĚ ƉĞŽƉůĞ͕ ĞƐƉĞĐŝĂůůLJ ŵŝŐƌĂŶƚ ǁŽƌŬĞƌƐ ŽĨ ĐŽůŽƌ ĂŶĚ ƚŚĞ ƉŽŽƌ͕ ǁĞƌĞ ŚƵŶƚĞĚ ĚŽǁŶ ĂŶĚ ĨŽƌĐŝďůLJ ǀĂĐĐŝŶĂƚĞĚ͖ ƚŚŽƐĞ ǁŚŽ ǁĞƌĞ ĂůƌĞĂĚLJ ŝŶĨĞĐƚĞĚ ĂůƐŽ ǁĞƌĞ ŚƵŶƚĞĚ ĚŽǁŶ ĂŶĚ ŵŽƌĞ Žƌ ůĞƐƐ ŝŶĐĂƌĐĞƌĂƚĞĚ ŝŶ ĨĂƌ ůĞƐƐ ƚŚĂŶ ŽƉƟŵĂů ĐŽŶĚŝƟŽŶƐ͕

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California Family Physician Physician Spring Spring 2016 2016

&Žƌ ƚŚĞ ƟŵĞ ďĞŝŶŐ͕ ĂůŝĨŽƌŶŝĂ ĂŶĚ ŵŽƐƚ ŽĨ ƚŚĞ hŶŝƚĞĚ ^ƚĂƚĞƐ ŚĂǀĞ ďĞĞŶ ƐƉĂƌĞĚ ƚŚĞ ƌĂǀĂŐĞƐ ŽĨ ƐŽŵĞ ŽĨ ƚŚĞ ǁŽƌƐƚ ƚŚŝƌĚͲǁŽƌůĚ ĚŝƐĞĂƐĞƐ͕ ƐƵĐŚ ĂƐ ŵĂůĂƌŝĂ ĂŶĚ ďŽůĂ ;ǁŝƚŚ ĞdžĐĞƉƟŽŶƐͿ͘ Ƶƚ ǁŚĞƚŚĞƌ ƚŚĞ ĐĂƵƐĞ ŝƐ ĐůŝŵĂƚĞ ĐŚĂŶŐĞ Žƌ ŶŽƚ͕ Žƌ ƚŚĞ ĞĂƐĞ ŽĨ ǁŽƌůĚǁŝĚĞ ƚƌĂǀĞů ĂŶĚ ƉŽƌŽƵƐ ďŽƌĚĞƌƐ͕ ƐŽŵĞ ƉƌĞƩLJ ǁĞŝƌĚ ƐƚƵī ŝƐ ŚĂƉƉĞŶŝŶŐ ŝŶ ƚŚĞ ŝŶĨĞĐƟŽƵƐ ĚŝƐĞĂƐĞ ĂƌĞŶĂ ʹ ŵŽƐƋƵŝƚŽͲ ďŽƌŶĞ ŝůůŶĞƐƐĞƐ ƐƵĐŚ ĂƐ ƚŚĞ ĂďŽǀĞͲŵĞŶƟŽŶĞĚ ŝŬĂ ǀŝƌƵƐ͕ ŚŝŬƵŶŐƵŶLJĂ͕ ĚĞŶŐƵĞ ĨĞǀĞƌ ĂŶĚ ŽƚŚĞƌƐ ƐƵĐŚ ĂƐ ĚƌƵŐ ƌĞƐŝƐƚĂŶƚ ƚƵďĞƌĐƵůŽƐŝƐ ŵĂŬĞ ƉƌĂĐƟĐŝŶŐ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ Ă ŚĞĂĚƐͲƵƉ ĞdžƉĞƌŝĞŶĐĞ ʹ LJŽƵ ŵĂLJ ďĞ ĐŽŶĨƌŽŶƚĞĚ ǁŝƚŚ ĚŝƐĞĂƐĞƐ ŽĨ ǁŚŝĐŚ LJŽƵ ŵĂLJ ŶĞǀĞƌ ŚĂǀĞ ŚĞĂƌĚ͕ ŵƵĐŚ ůĞƐƐ ƚƌĞĂƚĞĚ͘ ^Ž͕ ĂƐ / ƐĞĞ ŝƚ͕ &W͛Ɛ ĐŚĂůůĞŶŐĞ ŝƐ ƚǁŽͲĨŽůĚ͗ ϭͿ ĐŽŶƟŶƵĞ ƚŽ ĮŐŚƚ ŝŶ ŽƵƌ ƐƚĂƚĞ ůĞŐŝƐůĂƚƵƌĞ ĂŶĚ ǁŽƌŬ ǁŝƚŚ ŽƵƌ ǀĞƌLJ ƌĞƐƉŽŶƐŝǀĞ ^ƚĂƚĞ ĞƉĂƌƚŵĞŶƚ ŽĨ WƵďůŝĐ ,ĞĂůƚŚ ƚŽ ĞŶƐƵƌĞ ƚŚĂƚ ƐĞŶƐŝďůĞ͕ ĞǀŝĚĞŶĐĞͲďĂƐĞĚ ĂƉƉƌŽĂĐŚĞƐ ƚŽ ƉƵďůŝĐ ŚĞĂůƚŚ ŝƐƐƵĞƐ ƉƌĞǀĂŝů͖ ĂŶĚ ϮͿ ĞŶƐƵƌĞ ƚŚĂƚ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ŚĂǀĞ ĂĐĐĞƐƐ ƚŽ ĐŽŶƟŶƵŝŶŐ ƉƌŽĨĞƐƐŝŽŶĂů ĚĞǀĞůŽƉŵĞŶƚ ƉƌŽŐƌĂŵŵŝŶŐ ĂŶĚ ŵĂƚĞƌŝĂůƐ ƚŽ ŚĞůƉ ƚŚĞŵ ƌĞĐŽŐŶŝnjĞ͕ ƌĞƉŽƌƚ ĂŶĚ ĞŝƚŚĞƌ ƚƌĞĂƚ Žƌ ƌĞĨĞƌ ƉĂƟĞŶƚƐ ƉƌĞƐĞŶƟŶŐ ǁŝƚŚ ƐŽŵĞ ŽĨ ƚŚĞ ĞdžŽƟĐ ĚŝƐĞĂƐĞƐ ĐŽŵŝŶŐ ŽƵƌ ǁĂLJ͘ tŝƚŚ ƚŚĞ ŚĞůƉ ŽĨ ƚŚĞ ĮŶĞ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ŽŶ ŽƵƌ >ĞŐŝƐůĂƟǀĞ īĂŝƌƐ ŽŵŵŝƩĞĞ͕ ĂŶĚ ƚŚĞ ŝŶĐƌĞĚŝďůĞ ĞĚƵĐĂƚŽƌƐ ŽŶ ŽƵƌ ŽŵŵŝƩĞĞ ŽŶ ŽŶƟŶƵŝŶŐ WƌŽĨĞƐƐŝŽŶĂů ĞǀĞůŽƉŵĞŶƚ͕ ĂŶĚ ŽƵƌ ƐƚĂī͕ ǁĞ͛ůů ŐĞƚ ŝƚ ĚŽŶĞ͘

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CALIFORNIA ACADEMY OF FAMILY PHYSICIANS FOUNDATION 1520 PACIFIC AVE SAN FRANCISCO, CA 94109 -2627

Presorted Standard U.S. POSTAGE PAID

Little Rock, AR Permit No. 2437

MIEC Belongs to Our Policyholders!

Toni Brayer, MD Board of Governors

Philosophy is Important In 2016 MIEC will be the only MPLI carrier distributing dividends in California. It’s time to join the company whose philosophy puts policyholder-owners first.

MIEC has never lost sight of its original mission, always putting policyholders (doctors like you) first. For 40 years, MIEC has been steadfast in our protection of California physicians with conscientious Underwriting, excellent Claims management and hands-on Loss Prevention services; we’ve partnered with policyholders to keep premiums low.

Added value: profit motive and low overhead Q Dividends for a TEN year average savings of 31.4%* Q No

For more information or to apply: Q www.miec.com Q Call

800.227.4527 questions to underwriting@miec.com

Q Email

* On premiums at $1/3 million limits. Future dividends cannot be guaranteed.

MIEC 6250 Claremont Avenue, Oakland, California 94618 s 800-227-4527 s www.miec.com CalFamPhy_ad_12.21.15

MIEC Owned by the policyholders we protect.