April 2012

official publication of the san diego county medical society April 2012

Reaching

8,500 Physicians

Every Month

$4,700,000 Project Access San Diego has coordinated

$4.7 million in donated services since 2008! This month, San Diego Physician celebrates physician volunteerism.

“Physicians United For A Healthy San Diego”

NUMBERS THAT WORK AS YOU DO Callers assisted in 2011

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B

S A N D I E G O P HY S I CI A N .or g O c tob e r 2011

Octo ber 2011 SAN DIEGO P HY SIC I A N. o rg

1

this month Volume 99, Number 4

Managing Editor Kyle Lewis Editorial Board Van L. Cheng, MD, Adam F. Dorin, MD, Kimberly M. Lovett, MD, Theodore M. Mazer, MD, Robert E. Peters, PhD, MD, David M. Priver, MD, Roderick C. Rapier, MD Marketing & Production Manager Jennifer Rohr Sales Director Dari Pebdani Art Director Lisa Williams Copy Editor Adam Elder

SDCMS Board of Directors Officers President Robert E. Wailes, MD (CMA Trustee) President-elect Sherry L. Franklin, MD (CMA Trustee) Treasurer Robert E. Peters, PhD, MD Secretary J. Steven Poceta, MD Immediate Past President Susan Kaweski, MD geographic and geographic alternate Directors East County William T-C Tseng, MD, Heywood “Woody” Zeidman,

features PHYSICIAN VOLUNTEERISM 16 SDCMS Foundation: Improving Health, Changing Lives

by Stuart A. Cohen, MD, MPH

In celebration of National Volunteer Month, the San Diego County Medical Society (SDCMS) and San Diego Physician magazine are proud to recognize the passion physicians, physicians-in-training, and our broader volunteer community bring to improving the health and wellbeing of those who may not otherwise have access to our community’s rich healthcare resources.

On the cover, Eileen Natuzzi, MD, SDCMSCMA member since 2010, operates on a patient during Project Access San Diego’s February 2012 Carlsbad Surgery Day, with Christopher Crespo, PA, assisting and medical students Sarah Matrisciano and Daniel Chang observing.

This issue of San Diego Physician highlights the work of the SDCMS Foundation and Project Access San Diego, its flagship program, along with other individuals and organizations in our community whose work has brought the joy of a life free of illness and injury to more than 1,500 people, young and old, in desperate need.

18 Southern California Permanente Medical Group: Innovators and Community Partners

by Lauren Banfe

22 MOST: Mercy Outreach Surgical Team

by Thomas Vecchione, MD

26 Volunteer Medical Students Make Better Practitioners

by Barbara Mandel, MBA

30 Retirement Is Just Another Word for Change

by Rosemarie Marshall Johnson, MD

32 Volunteer Vignettes

At-large and At-large alternate Directors Jeffrey O. Leach, MD, Bing S. Pao, MD, Kosala Samarasinghe, MD, David E.J. Bazzo, MD, Mark W. Sornson, MD, Peter O. Raudaskoski, MD, Mihir Y. Parikh, MD, Suman Sinha, MD (A: Carol L. Young, MD, Thomas V. McAfee, MD, Ben Medina, MD, James E. Bush, MD, Samuel H. Wood, MD, Elaine J. Watkins, DO, Carl A. Powell, DO, Theresa L. Currier, MD) other voting members Communications Chair Theodore M. Mazer, MD (CMA Vice Speaker) Young Physician Director Van L. Cheng, MD Resident Physician Director Steve H. Koh, MD Retired Physician Director Rosemarie M. Johnson, MD Medical Student Director Beth P. Griffiths

OTHER NONVOTING MEMBERS Young Physician Alternate Director Renjit A. Sundharadas, MD Resident Physician Alternate Director Christina Pagano, MD Retired Physician Alternate Director Mitsuo Tomita, MD CMA President James T. Hay, MD

departments 4 Briefly Noted

SDCMS Seminars, Webinars, and Events • CMA Webinars • Community Healthcare Calendar • Upcoming Legislator Birthdays • And More …

CMA Past Presidents Robert E. Hertzka, MD (Legislative Committee Chair), Ralph R. Ocampo, MD CMA Trustee Albert Ray, MD CMA Trustee (OTHER) Catherine D. Moore, MD CMA SSGPF Delegates James W. Ochi, MD, Ritvik Prakash Mehta, MD CMA SSGPF Alternate Delegates Dan I. Giurgiu MD, Ashish K. Wadhwa, MD

8 SDCMS Board of Directors Candidate Statements 12 HEAR at UC San Diego School of Medicine

To learn more about how you can help, please visit the SDCMS Foundation’s website at www.SDCMSF.org.

by Christine Moutier, MD, and William A. Norcross, MD

Cover Photograph by Lauren Radack

Center SDCMS 2011 Annual Report

34 Physician Marketplace

Classifieds

2 SAN DIEGO PHYSICIAN .org apri l 2012

MD, Kimberly M. Lovett, MD (A:Venu Prabaker, MD) Hillcrest Theodore S. Thomas, MD, Steven A. Ornish, MD, Jason P. Lujan, MD (A:Gregory M. Balourdas, MD) Kearny Mesa John G. Lane, MD (A:Marvalyn E. DeCambre, MD, Sergio R. Flores, MD) La Jolla Gregory I. Ostrow, MD, Wynnshang “Wayne” Sun, MD (A: Matt H. Hom, MD) North County James H. Schultz, MD, Douglas Fenton, MD, Niren Angle, MD (A: Steven A. Green, MD) South Bay Vimal I. Nanavati, MD, Mike H. Verdolin, MD (A: Andres Smith, MD)

Opinions expressed by authors are their own and not necessarily those of San Diego Physician or SDCMS. San Diego Physician reserves the right to edit all contributions for clarity and length as well as to reject any material submitted. Not responsible for unsolicited manuscripts. Advertising rates and information sent upon request. Acceptance of advertising in San Diego Physician in no way constitutes approval or endorsement by SDCMS of products or services advertised. San Diego Physician and SDCMS reserve the right to reject any advertising. Address all editorial communications to Editor@SDCMS.org. All advertising inquiries can be sent to DPebdani@SDCMS.org. San Diego Physician is published monthly on the first of the month. Subscription rates are $35.00 per year. For subscriptions, email Editor@SDCMS.org. [San Diego County Medical Society (SDCMS) Printed in the U.S.A.]

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8.4375x11_SMF Physicians AD.indd 1

11/17/11 11:59 AM

brieflynoted calendar SDCMS Seminars, Webinars & Events SDCMS.org/event

For further information or to register for any of the following SDCMS seminars, webinars, and events, visit SDCMS.org/event or contact Serena Sauerheber at (858) 300-2779 or Serena.

Sauerheber@SDCMS.org.

Managing Challenging Patients (seminar/webinar) APR 18 • 6:30pm–7:30pm Managing Challenging Patients (seminar/webinar) APR 19 • 11:30am–12:30pm The Leader’s Toolbox (workshop) APR 20 • 8:00am–4:00pm & APR 21 • 8:00am–12:00pm Subpoenas (seminar/webinar) APR 26 • 11:30am–1:00pm Preparing to Practice (workshop) APR 28 • 8:00am–4:00pm Retirement Seminar (seminar/webinar) MAY 16 • 11:30am–1:00pm Cal-OSHA Certification Training (seminar/webinar) MAY 24 • 11:30am–2:00pm NPs & PAs: Organizational/ Hiring/Management Basics (seminar/webinar) MAY 30 • 11:30am–1:00pm SDCMS White Coat Gala (event) JUN 2 • 6:00pm–11:00pm

Cma Webinars

CMAnet.org/events

Best Practices for Managing Your Accounts Receivable APR 18 • 12:15pm–1:15pm California’s Public Health Insurance Programs APR 23 • 12:15pm–1:15pm

Medicare: Top 10 Claim and Documentation Errors That Cost Your Practice Money MAY 2 • 12:15pm–1:15pm Marketing 101 MAY 9 • 12:15pm–1:15pm Telephone Etiquette for Medical Personnel MAY 16 • 12:15pm–1:15pm Strategic Planning for Solo, Small, and Medium Group Practices MAY 23 • 12:15pm–1:15pm A Manager’s Guide to Lowering Practice Costs JUN 6 • 12:15pm–1:15pm

Community Healthcare Calendar To submit a community healthcare event for possible publication, email KLewis@SDCMS.org. Events should be physician-focused and should take place in or near San Diego County.

Sharon’s Ride Run Walk for Epilepsy 2012!

APR 15 • De Anza Cove, Mission Bay Park • $25 for Adults / $10 for Ages 7–17 / Free for Ages 6 and Under • 7:30am-1:00pm • sharonsride2012.kintera.org Hospital Medicine 2012 APR 1–4 • The Society of Hospital Medicine’s 15th Annual Meeting • San Diego Convention Center • See Page 27 for Details California Orthopaedic Association Annual Meeting APR 19–22 • Park Hyatt Resort, Carlsbad • www.coa.org/coaannual-meeting.html 15th Annual California Health Care Leadership Academy APR 27–29 • Disneyland Hotel, Anaheim • Models of healthcare financing and delivery will change as implementation of federal health reform kicks into high gear.

What are the best options for successful medical practice in the new environment? Hear from the experts and leaders of change, and attend a comprehensive slate of practice management seminars and workshops to position your practice for success. Details coming in January — stay tuned!

Medicare Audits: How and Why APR 25 • 12:15pm–1:15pm

4 SAN DIEGO PHYSICIAN.org apri l 2012

Risk Management

HIPAA Breaches: Are You Overexposed?

Contributed by SDCMS-endorsed The Doctors Company. Members of The Doctors Company are protected from privacy breach liability with CyberGuard.

As wireless devices proliferate, so do the chances of privacy breaches in your office. A recent survey revealed that 91% of healthcare organizations with 250 or fewer employees have experienced a data breach in the past year. Nearly a quarter of these respondents reported that these breaches involved medical identity theft.

Despite growing awareness of privacy issues, medical offices continue to engage in risky behaviors like using unsecured email with patients, speaking to a patient’s family member without appropriate authorization, and “tweeting” about famous patients. All are potential HIPAA breaches.

The convenience of social media and email has made it more difficult to maintain confidentiality of patient information. With reasonable adjustments to your practice, the potential for personal health information (PHI) breaches and subsequent penalties can be reduced.

Tips to Limit Your Exposure: ✓✓ Conduct annual HIPAA training with your staff. ✓✓ Require employees to sign confidentiality agreements. ✓✓ Develop a policy for appropriate use of email. The policy should forbid any mention of these sensitive subject matters in emails: sexually transmitted diseases, treatment for mental health problems, and drug- and alcohol-related disorders. ✓✓ Provide email consent forms as part of the intake, and encourage longtime patients to sign these forms at annual checkups. ✓✓ Encrypt emails containing PHI. ✓✓ Enable password-protection for all computers and mobile devices Sign up to Attend containing PHI. Set these devices the Following to log users off automatically after Webinar Outlining periods of inactivity.

Confidentiality Dangers ✓✓ Encourage patients to identify individuals who may share PHI with HIPAA: Yesterday, Today, and your office staff. Get this permisTomorrow uses sample practice sion in writing. scenarios to illustrate where ✓✓ Obtain records requests in writsystems go wrong and patient ing and ensure that the request confidentiality can be compromised. includes a proper medical records Eligible for 1.0 ACCME CME credits. release.

Register for this and other webinars ✓✓ Make sure all business associates throughout the year at develop and implement privacy www.thedoctors.com/seminars. and security measures for PHI in their possession. ✓✓ Have policies and procedures for identifying PHI breaches — and for a centralized response.

• Thursday, April 26, 9:00am–10:00am • Tuesday, May 22, 12:00pm–1:00pm

you take care of the san diego communit y ’s health. we take care of san diego’s

healthcare communit y.

get in touch

3 income Tax Planning 3 Wealth Management

Your SDCMS and SDCMSF Support Teams Are Here to Help!

3 employee Benefit Plans

SDCMS Contact Information

3 Profitability Reviews

5575 Ruffin Road, Suite 250, San Diego, CA 92123 T (858) 565-8888 F (858) 569-1334 E SDCMS@SDCMS.org W SDCMS.org • SanDiegoPhysician.org CEO • EXECUTIVE DIRECTOR Tom Gehring at (858) 565-8597 or Gehring@SDCMS.org COO • CFO James Beaubeaux at (858) 300-2788 or James.Beaubeaux@SDCMS.org DATABASE ADMINISTRATOR Janet Lockett at (858) 300-2778 or Janet.Lockett@SDCMS.org DIRECTOR OF MEMBERSHIP SUPPORT • PHYSICIAN ADVOCATE Marisol Gonzalez at (858) 300-2783 or MGonzalez@SDCMS.org DIRECTOR OF ENGAGEMENT Jennipher Ohmstede at (858) 300-2781 or JOhmstede@SDCMS.org DIRECTOR OF BUSINESS DEVELOPMENT Naeiry Vartevan at (858) 300-2782 or at Vartevan@SDCMS.org DIRECTOR OF COMMUNICATIONS AND MARKETING • MANAGING EDITOR Kyle Lewis at (858) 300-2784 or KLewis@SDCMS.org OFFICE MANAGER • DIRECTOR OF FIRST IMPRESSIONS Betty Matthews at (858) 565-8888 or Betty.Matthews@SDCMS.org LETTERS TO THE EDITOR Editor@SDCMS.org GENERAL SUGGESTIONS SuggestionBox@SDCMS.org

3 outsourced Professional services (CFo, Controller) 3 organizational and Compensation structure 3 succession Planning 3 Practice Valuations 3 internal Control Review and Risk Assessment

akt A KT LLP, CPAs and Business Consu LTAnTs CARL SBAD

ESCONDIDO

760-431-8440

SDCMSF Contact Information 5575 Ruffin Road, Suite 250, San Diego, CA 92123 T (858) 300-2777 F (858) 560-0179 (general) W SDCMSF.org EXECUTIVE DIRECTOR Barbara Mandel at (858) 300-2780 or Barbara.Mandel@SDCMS.org project access PROGRAM DIRECTOR Tanya Rovira at (858) 565-8161 or Tanya.Rovira@SDCMS.org RESOURCE DEVELOPMENT DIRECTOR Lauren Banfe at (858) 565-7930 or Lauren.Banfe@SDCMS.org Patient Care Manager Rebecca Valenzuela at (858) 300-2785 or Rebecca.Valenzuela@SDCMS.org Patient Care Manager Elizabeth Terrazas at (858) 565-8156 or Elizabeth.Terrazas@SDCMS.org IT PROJECT MANAGER Rob Yeates at (858) 300-2791 or Rob.Yeates@SDCMS.org

S A N DIEGO

W W W.AKTCPA.COM ron mitchell, cpa director of health services

RMITCHELL@AKTCPA.COM

Give Us 5 Minutes and We’ll Give You a Benefits Check-up!

Call SDCMS at (858) 565-8888 to schedule a time Today!

apri l 2012 SAN DIEGO PHYSICIAN.org 5

brieflynoted Welcome New and Rejoining SDCMS Members!

New Members: Kaveh Bahmanpour, MD Geriatric Medicine San Diego • (619) 528-1245 Faith P. Chisum, MD Family Medicine Imperial Beach • (619) 429-3733 Willard S. Chung, MD Family Medicine Imperial Beach • (619) 429-3733 Damon C. Cobb, DO Obstetrics and Gynecology San Diego • (858) 618-1156

Yaroslav Y. Pogorelov, MD Family Medicine San Diego • (619) 278-3360

Trang D. Thu Le, MD Family Medicine Encinitas • (760) 479-3900

Pam R. Taub, MD Internal Medicine Encinitas • (760) 634-8273

Jose R. Leon, MD Pulmonary Disease Chula Vista • (619) 502-7300

Michael A. Thompson, MD Surgery of the Hand La Jolla • (858) 554-7989

Stacey Lin, MD Family Medicine Encinitas • (760) 479-3900

Robert T. Tran, MD Family Medicine Chula Vista • (619) 502-7300

Gerard A. Lumkong, MD Family Medicine Encinitas • (760) 479-3900

Rejoining Members:

James A. Morgan, MD Internal Medicine San Diego

Ben DuBois, MD Orthopedic Surgery La Mesa • (619) 462-3131

Imran Ahmed, MD Family Medicine Vista • (760) 806-5600

Heidi M. Gilchrist, MD Dermatology Oceanside • (760) 757-7546

Theresa A. Bartolome, MD Family Medicine Carlsbad • (760) 827-7220

Christopher A. Hajnik, MD Orthopedic Surgery Encinitas • (760) 632-4251

Mihaela Beloiu, MD Family Medicine Vista • (760) 806-5500

Nejat A. Jalisi, MD Family Medicine Alpine • (619) 445-1188

Sandhya Desai, MD Family Medicine Carlsbad • (760) 901-5100

Daniel W. Johnson, DO Family Medicine Imperial Beach • (619) 429-3733

Michael C. Devereaux, MD Internal Medicine San Diego • (619) 849-4440

Barrett G. Levesque, MD Gastroenterology La Jolla • (858) 554-8505

Elena A. Dolgonos, MD Family Medicine Oceanside • (760) 901-5020

Amy H. Matayoshi, MD Nephrology Oceanside • (760) 967-9900

Nancy L. Fierro, MD Family Medicine Encinitas • (760) 479-3900

Christine Y. Moutier, MD Psychiatry La Jolla • (619) 246-0398

Sivathilaka S. Ganesh, MD Pediatrics Chula Vista • (619) 502-7300

Jean G. Mullenax, MD Pediatrics Alpine • (619) 445-1188

Vong N. Huynh, MD Family Medicine Carlsbad • (760) 901-5100

Thomas F. Osborne, MD Neuroradiology

David H. Ko, MD Internal Medicine Encinitas • (760) 479-3900

Nayna Patel, MD Physical Medicine and Rehabilitation Escondido • (760) 632-4251

Richard Kornberg, MD Dermatopathology San Diego • (619) 298-7546

6 SAN DIEGO PHYSICIAN.org apri l 2012

Georganne K. Novak, MD Family Medicine Oceanside • (760) 901-5020

legislator birthdays

One way to let your legislators know that you’re paying attention and that you vote is by wishing them a happy birthday!

BIRTHDAY: APRIL 13 U.S. Representative Susan Davis (District 53) E: (via website) house.gov/susandavis Washington, DC, Office: T: (202) 225-2040 • F: (202) 225-2948 San Diego Office: 2700 Adams Ave., Ste. 102, San Diego, CA 92116 T: (619) 280-5353 • F: (619) 280-5311

Irina F. Proshkina, MD Family Medicine Carlsbad • (760) 827-7240 Carlos M. Quiros, MD Family Medicine Chula Vista • (619) 502-7300 Donald D. Stevenson, MD Allergy and Immunology San Diego • (858) 764-9010 Sandra H-C Tan, MD Family Medicine Oceanside • (760) 901-5010 Gay M. Walker, MD Internal Medicine Encinitas • (760) 479-3900 Pamela A. Wells, MD Pediatrics Carlsbad • (760) 827-7450 Anthony M. Whitney, MD Family Medicine Carlsbad • (760) 827-7440 Ronald W. Woerpel, MD Pediatrics Carlsbad • (760) 827-7430

featured member

R. Larry Schmitt, MD Retired SDCMSCMA member who first joined in 1971, Dr. Schmitt is a retired child and adolescent psychiatrist with 36 years of practice in San Diego. Dr. Schmitt has volunteered at the UCSD Student-run Free Clinic for more than seven years, an experience that continues to enrich his life, and has more recently sought out other arenas in which to volunteer.

Thank you for your support of organized medicine, Dr. Schmitt, and for your continued work volunteering in the community!

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Meet this challenge with an MBA from UC San Diego’s Rady School of Management.

Our evening and weekend MBA programs, with specialized healthcare electives, provide the business and technological knowledge necessary to navigate the new frontiers of medicine.

“Developing a basic understanding of how the operational and business world works has been great and it’s all applicable to science and medicine.”

Richard L. Lieber, Ph.D., Rady MBA ‘13 Vice Chair, UC San Diego Department of Orthopaedic Surgery Director, National Center for Skeletal Muscle Rehabilitation Research

www.rady.ucsd.edu/mba

apri l 2012 SAN DIEGO PHYSICIAN.org 7

SDCMS Elections

Candidate Statements 2012–13 SDCMS Board of Directors

Note: Asterisk (*) After Name = Incumbent • Number in Parentheses (#) After Name = Term Length in Years

Candidate for President-elect: Robert E. Peters, PhD, MD (1) I consider it an honor to serve our organization. Our San Diego County Medical Society provides both a critical vehicle and an important opportunity for our physician community to be able to speak as a singular “voice” to the public and to the politicians in the city, county, state, and federal government. We have seen more pressures on, and changes to, the patient-physician-payer relationships in the past 20 years than were seen in the prior 50 years. All signs indicate that the next 20 years will see even greater externally driven pressures on the physician-patient relationship than we have seen in the past 20 years. Given this reality, it will be critical that we as practicing physicians represent, with a unified voice, the medical care interests of our patients. We must represent, in consistent fashion, patient interests, and explain to patients as well as to politicians the economic and the infrastructure requirements of the healthcare “delivery system” necessary for continued optimal patient care.

Candidate for Treasurer: J. Steve Poceta, MD (1) I plan to move from secretary to treasurer of the San Diego County Medical Society for the upcoming year. I have been a member of SDCMS since I came to San Diego in 1987; I have served on the board of directors and, for the past three years, on SDCMS’ Executive Committee. I am dedicated to the pursuit of medicine and to the belief in a pluralistic approach to the practice. All physicians have a role to play in the optimal delivery of healthcare to our fellow community members. The

respect that we receive from our patients is great, and not only serves to enrich our lives, but to indicate our value to the community.

No specific healthcare delivery system is better than another, considering the changes that have occurred since our profession was founded. That is, the practice of medicine has survived since long before the U.S. depression of the 1930s, the creation of Medicare, the HMO, and the current trend toward consolidation. All doctors are needed — from those in academics to those in solo practice — and I support them all. The backbone of the system remains the same: Doctors who study, train, and work hard to take care of people who are sick, and to understand the causes of disease.

We need a system that fosters the most capable young people to go into our profession, rewards them appropriately, and provides career and personal satisfaction.

Candidate for Secretary: William T-C Tseng, MD, MPH (1) Dear Colleagues: I am William Tseng, and I am honored to be a candidate for SDCMS secretary. Thank you for this opportunity to share with you a little bit about what I strongly believe in as your candidate.

I believe in the power of organized medicine. I believe that “Physicians United” is the only way to move forward in order to preserve the profession of medicine. As your candidate, I am committed to addressing physicians’ concerns affected by challenges facing our local and national healthcare policy. With constant political uncertainties and government overregulation threatening the welfare of physicians’ autonomy over medical practices, it is

critical for all area physicians to have a strong focus and a strong voice.

As your candidate, I intend to focus my priorities on protecting and maintaining physician autonomy and independence.

Through community, professional, and political involvement, I hope to assist SDCMS in becoming an even more influential organization. Through SDCMS, we can take the helm in determining the future of our practices — how we care for patients, how we code (prescribe treatment), and how we are reimbursed.

I believe that through SDCMS, we can join our services in the best interest of all physicians, regardless of their modes of practice.

Thank you for supporting my candidacy for SDCMS secretary as we navigate through these difficult economic and political tides.

Candidate for East County Geographic Director #1: Venu Prabaker, MD (1) As a primary care physician practicing in East San Diego County since 1987, I have experienced a dramatic paradigm shift from fee-forservice to managed care. In the near future, we will enter the uncharted territory of healthcare reform, ACOs, and patient-centered medical homes, where the interests of PCPs and the patients we care for risk being undermined by economic and political forces. Now more than ever we need strong leadership to represent us.

I believe that my past leadership experiences and my dedication to our community make me the ideal candidate for East County geographic director. Prior to moving to San Diego, I served as an assistant director of the internal medicine residency program at Cleveland. I have served as voluntary clinical faculty in multiple educational institutions, including UCSD, USD, Western, Stanford, etc.

I have attended three mini-MBA courses (two from UCI and one from UCSD), which have taught me how to effectively assume leadership roles. I was a past president of and actively participate in leadership roles since the inception of the San Diego Association of Physicians of Indian Origin (SAPI).

During the past few years as alternate East

Left to right, top to bottom:

Bob Peters, MD, Steve Poceta, MD, William Tseng, MD, Venu Prabaker, MD, Alexe Page, MD, Theodore Thomas, MD, Geva Mannor, MD, Jim Schultz, MD, Niren Angle, MD, Michael Verdolin, MD, Gregory Balourdas, MD, Tony Sacks, MD

8 SAN DIEGO PHYSICIAN.org apri l 2012

County geographic director, I witnessed the amazing talents, leadership, and dedication of my colleagues, who work tirelessly on behalf of fellow San Diego County physicians. It would be my proud privilege to join this elite group for another term.

Never before was there a critical need for us to stand steadfast, to speak in one voice, and to safeguard the interests of our patients as well as our colleagues. Organized medicine is the only armor we have to shield ourselves from the political and economic onslaught ahead. I consider the opportunity to serve our esteemed organization, SDCMS, a great honor, and I pledge to be the voice of East County physicians as their geographic director.

Candidate for East County Geographic Director #2: Alexandra (Alexe) E. Page, MD (3) In a rapidly changing world of providing and reimbursing medical care in the United States, alignment of physicians in all specialties becomes increasingly important. Regardless of specialty or practice environment, paradigms of healthcare delivery from patient-centered medical homes, to ACOs, to bundled payments can change the patient-doctor relationship. Physicians can protect the care we give our patients by proactively defining how these new healthcare models will evolve in our community.

My interest and knowledge of health policy and reform has evolved through serving on the American Academy of Orthopaedic Surgeons (AAOS) Healthcare Systems Committee.

But energy spent on specialty-focused battles divides physicians, weakening our ability to maintain the integrity of the profession and care for our patients. SDCMS presents an opportunity to transcend specialty interests and provide a united voice allowing physicians to define how healthcare will evolve.

A cum-laude graduate of Harvard Medical School, after residency in New York I joined Kaiser Permanente in San Diego and have practiced orthopedics here since 1998. As a member of the SDCMS board of directors, I hope to increase membership and encourage communication among physicians of all disciplines to enhance consensus-building and present a stronger front to other stakeholders in the healthcare system.

Candidate for Hillcrest Geographic Director #1: Theodore S. Thomas, MD* (3) Candidate for La Jolla Geographic Director #1: Geva E. Mannor, MD, MPH (3) I am honored to be considered as one of your La Jolla representatives to the San Diego County Medical Society. Since 2002, I have been performing oculoplastic surgery in the ophthalmology division at Scripps Clinic Medical Group. I obtained my MD at North-

western and an MPH at Harvard, followed by a residency in ophthalmology at Mount Sinai Hospital, New York, and a fellowship at Yale.

I have practiced in various types of clinical settings like academic university departments, VA hospitals, British national health service (Moorfields Eye Hospital, London, U.K.), and a U.S. HMO. I am aware of the challenges that today’s physicians face. I have not been involved in organized medicine, but I am motivated to advocate for San Diego physicians.

I plan to represent my colleagues and protect their rights and practices.

Candidate for North County Geographic Director #1: James (Jim) H. Schultz, MD, MBA, FAAFP* (3) Jim Schultz is a family physician who practices at Neighborhood Healthcare, a Federally Qualified Community Health Center serving about 70,000 of the underserved and medically needy. He sees outpatients in Escondido, Pauma Valley, and Temecula, and inpatients as part of the Palomar Medical Center/Neighborhood Healthcare Hospitalist program. He has been chief medical officer of Neighborhood Healthcare since 2001, and is currently the medical director of the Council of Community Clinics and of Project Access San Diego.

Prior to his role at Neighborhood Healthcare, Jim was medical director and practicing physician at Graybill Medical Group in Escondido, where he began his professional career in 1988. His goals in SDCMS include fairly representing the interests of the physicians of North County, and in bringing the voice and perspective of those physicians whose practice is predominantly that of the underserved.

Candidate for North County Geographic Director #3: Niren Angle, MD* (3) Candidate for South Bay Geographic Director #2: Michael H. Verdolin, MD* (3) For the last three years, I have worked as your representative to the San Diego County Medical Society (SDCMS) board of directors.

I would like to continue working on your behalf and on the behalf of your patients.

SDCMS has achieved significant benefits for you and your patients in the last three years.

Some of these tangible results include protection from impending Medi-Cal cuts, as well as perennial defense of MICRA. More specific to the South Bay, I have presented specific needs and had some specific successes that will provide tangible improvements for your practice and your patients.

For example, one of the greatest frustrations I have in treating patients as a specialist is that from month to month patients may switch from one HMO to another. Often, these patients have no understanding of what this will do to their continuity of care.

Even though I may participate in all of these HMOs, it is impossible to follow through on the plan of care without significant interruption. This is even worse for some patients who were not previously on an HMO and didn’t realize that they might not be able to see me anymore. In some cases, for critical specialties such as cardiology, patients have been denied continuity sometimes requiring pacemakers or AICD implants, and have actually died waiting to appeal. To that end, I am proud to have been a co-sponsor of a resolution within the California Medical Association (CMA) House of Delegates that was passed with overwhelming support. Specifically, CMA is directed now to craft legislation that enshrines patient protections when switching to these managed care organization plans to help minimize this interruption in care.

Another example of positive change that I have accomplished includes getting unanimous support of the SDCMS board of directors to support the recently signed Assembly bill that guarantees a response to medication preauthorization within 48 hours on a standardized form. The support of SDCMS was critical in allowing this bill to pass both houses and finally become law upon signature of the governor. This law provides that if the insurance company fails to respond within the 48-hour timeframe on a standardized two-page form, the medication is automatically approved. This is a huge win for our patients and our practices.

We have never been under such threat in our existence as private practices; with impending SGR cuts and a scramble for patients to enter yet unproven ACOs. I pledge to continue to work for all physicians in the South Bay and your patients, and appreciate your continuing support to do so by electing me to another three-year term.

Candidate for Hillcrest Geographic Alternate Director: Gregory M. Balourdas, MD* (3) Candidate for North County Geographic Alternate Director: Anthony (Tony) H. Sacks, MD (3) I am honored to be a candidate to serve as an alternate delegate for SDCMS. I have been practicing family medicine at Sharp Rees-Stealy Medical Group for 30 years, and I have been actively serving in many leadership positions, including having served on the board of directors for 18 years. Previously I was associate medical director for the Mira Mesa site. I also served as chief of family medicine at Sharp Memorial Hospital. I am interested in ensuring that physicians have a voice in the future direction of healthcare and that patients have the ability to access a healthcare system that can effectively meet both their acute and chronic care needs.

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SDCMS Elections Candidate for At-large Director #2: Karrar H. Ali, DO, MPH (3) I am honored to run for the board of the San Diego County Medical Society. As an emergency physician at Sharp Chula Vista Medical Center and full partner with California Emergency Physicians, I am a change agent who seeks to improve medicine at micro and macro levels for our patients, healthcare providers, administrators, and communities. I hold several committee positions at the hospital that focus on efficiency and team-building, as well as being the advocacy lead at Sharp.

During my advocacy work, I have learned that the current state of our healthcare system and its failures stem from apathy on the part of many physicians who share a belief that we could not make a difference in local, state, and federal politics. We have traditionally considered ourselves scientists and healers who were immune to politics, and, in the process, we have let others dictate our practice.

As an emergency physician, I feel the failure of the healthcare system every day. I feel the despair of patients who have nowhere to turn because their primary physician is not accepting their plan. They cannot get a specialist or simply pay for basic medical care.

I feel the frustration of doctors unable to refer their patients or unable to deliver adequate care — with the emergency department being the only hope for helping their patients. The impact of this failure is overcrowded hospitals, stress on healthcare providers, and continued cost-cutting pressures by administrators.

I believe that the only way we can save our healthcare system is for physicians to be informed and involved advocates. My goal as a board member is to advocate our position by educating San Diego physicians. I would specifically like to improve emergency services and advocate access to primary care.

Healthcare is changing rapidly, and our involvement will not only help ameliorate the current crisis, it will also help shape a better future for healthcare providers, patients, and communities.

I thank you for your support.

Candidate for At-large Director #4: David E. Bazzo, MD* (3) I came to you in 2009 asking for the privilege to represent you as member-at-large director, and you placed your trust in me. I am asking you to do so again. During my first term as an SDCMS board member, my notions were validated. The San Diego County Medical Society is second to none when it comes to representing the needs and interests of physicians in advocating to optimize our ability to help our patients. The politics of our state and nation have enormous impact on our capacity to keep our patients healthy. And, as with any process, unless you have a seat at the table, your opinion is not heard. Well, through the work of your county and state medical societies, your voices are heard. Your interests are represented. The members of the board do have influence and work on your behalf to insure that physicians have a say on the future practice of medicine. I am proud of my membership and position on the board, and view it an honor to volunteer to help our organization. I ask that you continue to place your trust in me to serve our organization by supporting my reelection. Thank you.

Candidate for At-large Alternate Director #3: Holly B. Yang, MD (3) I have been a member of the San Diego County Medical Society since I moved here for fellowship training in 2005. I am board-certified both in hospice and palliative medicine and in internal medicine, and I practice at The Institute for Palliative Medicine at San Diego Hospice, seeing patients in homecare, outpatient consultation, and inpatient settings. I am also a voluntary assistant clinical professor at UC San Diego and provide consultations through the Doris A. Howell Service. I am deeply involved in physician and inter-professional education, locally, nationally, and internationally, and currently serve on the Clinical Education Committee for the American Academy of Hospice and Palliative Medicine.

SDCMS is of great value to our community, representing physicians in critical issues,

Left to right, top to bottom:

Karrar Ali, DO, David Bazzo, MD, Holly Yang, MD, Chrissy Pagano, MD, Van Cheng, MD, Renit Sundharadas, MD, Jim Hay, MD, Robert Hertzka, MD

10 SAN DIEGO PHYSICIAN.org apri l 2012

serving physician practices as a resource, providing excellent training and communitybuilding activities, and keeping us “in the know.” I have personally benefitted from the hard work of SDCMS, and I hope to be able to give back for what I have received. I believe we must continue to advocate clearly and with one voice so that our views are brought to bear on the important issues that face us. I am honored to have the opportunity to be a part of that team and that strong voice which speaks out for our profession and our patients.

Candidate for Resident Physician Director: Christina (Chrissy) R. Pagano, MD* Candidate for Young Physician Director: Van L. Cheng, MD* Dr. Van Cheng graduated from Harvard with highest honors, and training in surgery at UCSF. She was then named the first phlebology fellow in the United States, through the UCSD/Scripps fellowship. Dr. Cheng has written a definitive book on foam sclerotherapy that was published in July 2008 (Royal Society Med press). She specializes in treating all vein problems without surgery. Her experienced techniques have proven to be first-rate, even for spider veins, unsightly hand and temple veins, varicose veins, and the most advanced forms of venous insufficiency. Dr. Van Cheng received San Diego’s 2008 Women Who Mean Business Award. In addition, she was awarded the 2009 40 Under 40 Award. Dr. Cheng was also honored with the San Diego Business Journal’s 2009 Health Care Champions Awards.

Candidate for Young Physician Director: Renit A. Sundharadas, MD* Candidate for AMA Delegate: James T. Hay, MD* I have had the privilege of serving you in many capacities over the past 27 years: 2001 president of SDCMS; first president of the SDCMS Foundation; delegate, trustee, speaker, and now president of CMA; and delegate to Our AMA. More important than the titles are the accomplishments of your San Diego AMA team.

The Hertzka, Hay, Ray, and Miller team is a major influence within our California delegation. I wrote and introduced a series of resolutions that resulted in the adoption by the AMA HOD of the “Principles of the Patient-centered Medical Home.” I was part of the campaign to elect Bob Hertzka to the AMA’s Council on Medical Services. I am chair of the finance committee of the delegation and helped to reduce expenses for CMA during these tight budgetary times. I am a recognized consensusbuilding voice in the AMA House. And with the need to redirect AMA at this time in health system reform, strong leaders like San Diego’s are needed at AMA.

Congr at ul ations to the 201 2 Locally, I am proud of the tremendous growth of our Medical Society since we hired CEO Tom Gehring in 2001; of the Foundation, now an important part of the charitable community in San Diego, and of its Project Access; and of the reorganized governance structure of SDCMS, begun during my president year, that, along with a dynamic CEO and current leadership, has made San Diego the premier county medical society in California.

We need leaders who build consensus and can get things done. Certainly as we face the challenges of healthcare reform and the system reorganization proposals of the administration in Washington, we want people who understand the policy and the politics. I am very grateful that you have believed that I do, and I ask for your support to continue as your delegate to the AMA House of Delegates.

Candidate for AMA Delegate: Robert Hertzka, MD* I ask for your support for reelection as one of your AMA delegates.

The changes in medicine over the past decade or two have been profound, and, to many of us, the future appears ominous. That said, amid all the dubiously funded expansions of healthcare coverage and the steady stream of new regulations being thrust upon us, AMA remains not only our best line of defense, but also our only chance to go on offense.

Over the past 15 years, I have been honored to be one of the few physicians who have served two senior positions within AMA. The first was eight years of service on its political action committee board (AMPAC), where we zealously supported those in Congress who stood up for physicians and opposed those who did not.

Following that, I was elected four years ago to what is called the Council on Medical Service, a 10-member group of physicians who develop most of the AMA position papers on healthcare access, cost, and quality. Presently, we are working to develop a pro-physician position for AMA in what seems certain to be a serious debate on Medicare reform next year. Unlike health reform, for which some would argue that AMA was not fully prepared, the same cannot and will not happen with Medicare.

Between these two roles and my experience as your California Medical Association president in 2004, I have been able to build relationships with dozens of representatives and senators, and have used those relationships to promote the preservation of the core values that I believe we all share: a health system with the physician-patient relationship as its core, in an environment where physicians can not just survive, but thrive.

I thank the many among you who have, over the years, brought your concerns — and your criticisms — to me. It would be an honor to continue to represent you for another term as one of your delegates. I ask for your vote.

Combined HealtH agenCies

HealtH Heroes The 18th annual Health Hero Awards honored individuals and companies selected by each of the members of Combined Health Agencies. The heroes have given freely of their time, talent and resources to improve the health and well-being of our community.

Sponsored in part by:

Dr. Ramón Valle • Alzheimer’s Association Profil Institute for Clinical Research, Inc. • American Diabetes Association Dr. Rohit Loomba • American Liver Foundation Paul Manasjan • American Lung Association in California Valerie Guild • American Melanoma Foundation Dr. William Mobley • Amyotrophic Lateral Sclerosis Association Camp Marston, YMCA of San Diego County • Arthritis Foundation Dr. Parvathi Pokala • Autism Society of San Diego San Diego County Firefighters Pipes & Drums • Burn Institute Dr. Paul A. Negulescu • Cystic Fibrosis Foundation Dr. Howard Taras • Epilepsy Foundation Dr. Salvator Pacella • Fresh Start Surgical Gifts Cebix, Inc. • Juvenile Diabetes Research Foundation Celgene Corporation • The Leukemia & Lymphoma Society In Motion, Inc. • Lupus Foundation of Southern California The Xceptional Music Company • Mental Health America Diane Carlson • Muscular Dystrophy Association Kaiser Permanente • National Multiple Sclerosis Society Dr. David Barba • Parkinson’s Association of San Diego Ruth Westreich • San Diego Hospice and The Institute for Palliative Medicine Brian M. Culley • Sickle Cell Disease Association Willis Allen Jr. • Stepping Stone of San Diego

More information at combinedhealth.org

“think SDCMS FIRST!”

Start by contacting SDCMS at (858) 565-8888 or at SDCMS@SDCMS.org.

apri l 2012 SAN DIEGO PHYSICIAN.org 11

Physician Wellbeing

While the suicide rate for male physicians is about 70% higher than among men in general, the suicide rate for female physicians is a staggering 250% to 400% higher than among women in the general population.

HEAR at UC San Diego School of Medicine

The Healer Education Assessment and Referral Program

By Christine Moutier, MD, and William A. Norcross, MD

Each year, 300 to 400 physicians take their own lives. The leading cause of suicide is untreated depression, yet many physicians and medical students fail to recognize depression in themselves or their colleagues, and often delay or refuse to seek mental health treatment until it is too late. Citing barriers such as time, cost, stigma, lack of confidentiality, or fears of sanction or 12 SAN DIEGO PHYSICIAN.org apri l 2012

discrimination, those of us in the medical profession often fail to seek treatment for depression or suicidal impulses.

Female physicians are at particularly high risk for suicide. While the suicide rate for male physicians is about 70% higher than among men in general, the suicide rate for female physicians is a staggering 250% to 400% higher than among women in the general population. The heightened suicide rate appears to begin as early as medical school. The rates of depression among medical students are significantly higher than in the age-matched population.

Unfortunately, the physicians and medical students at UC San Diego are not immune to these issues, and we have lost several irreplaceable members of the medical community to suicide in the past decade.

The UC San Diego HEAR committee was established to address these important issues within the medical community.

With the full support of the UC San Diego School of Medicine and the UC San Diego Health System, the committee launched an outreach campaign in 2009 to provide education about depression and suicide prevention and to promote the identification and treatment of depression and other related issues that could potentially increase the risk for suicide.

The committee decided on a twopronged approach to suicide prevention that includes a web-based screening assessment that is completely anonymous (unless the participant chooses to reveal his or her identity) and a referral program based on one developed by the American Foundation for Suicide Prevention; as well as face-to-face education to medical students, residents, fellows, and faculty about physician burnout, depression, and suicide.

We raise awareness about suicide and depression by lecturing at department meetings and grand rounds, and by encouraging discussion about these issues within the departments and learning environments of the community. Screening efforts begin with an email invitation from the dean of the School of Medicine inviting members of the School of Medicine community to complete a brief and confidential online screening questionnaire. Next, a personalized assessment is provided by a trained mental health counselor, and, when appropriate, the counselor makes recommendations for further evaluation and/or treatment.

Individuals who indicate suicidal thoughts, mild to severe depressive symptoms, or other significant problems, such as anxiety, substance abuse, or eating disorders, are urged to come in for a face-to-face meeting with the counselor for a more thorough evaluation and referral if warranted.

From its inception in May 2009 through August 2010, the program invited a total of 2,850 students, residents, fellows, and faculty physicians to complete the online screening. Of these, nearly 500 were medical students, another 240 were pharmacy students, 822 were residents or fellows, and the remaining 1,300 were faculty members. Overall, 374 individuals completed the screening.

Very few of the respondents met the criteria for no to very mild risk of suicide, and the majority (67%) met the criteria for mild risk of suicide. More than a quarter, however, were considered at moderate to severe risk, and 10 individuals in the highest risk groups had attempted suicide in the past. Although all respondents in the top two tiers reported meaningful levels of psychological distress, less than a fifth were receiving psychotherapy or taking medication for symptoms of depression, anxiety, or stress. In a more recent review of medical student participant screenings, 68% of those who reported suicidal ideation were not receiving any form of mental health treatment (therapy or medications.)

These concerning results are consistent with the literature on physician trainee distress and therefore are likely not unique to UC San Diego, but rather reflective of the medical profession as a whole. Since a major barrier to getting help is the perceived stigma, depression might not only lead to personal suffering, but also to a sense of

1899

shame and distorted negative thoughts of self. Depression may thereby contribute to the problem of stigmatization by setting the stage for a person’s downward spiral of suffering in silence — perpetuating a hidden message to “tough it out” instead of getting help.

Early in the process of the HEAR program, we observed similarities between the medical and military professionals and learned from the successful suicide prevention program of the U.S. Air Force. Both military and medical personnel are driven to excellence and hold high expectations for themselves and other members of their profession. The Air Force’s approach is one we embraced, that there must be a strong message from senior leadership in support of the program.

Both our dean and the CEO of the UC San Diego Health System have enthusiastically supported and funded the HEAR program, emphasizing that no stigma should be attached to mental illness, and encouraging everyone — sick or well — to

participate.

The results thus far have been a source of immense satisfaction and pride. We are optimistic that HEAR’s education and screening efforts will help physicians and students identify depression in themselves, colleagues, and patients; reduce the stigma associated with depression and mental illness; and empower physicians and students to practice self-care. We are confident these efforts will not only improve personal wellness, but also gradually address the “hidden curriculum” of suffering in silence; enhance quality of patient care; and, ultimately, prevent suicide within the UCSD medical community.

Dr. Moutier, SDCMS-CMA member since 2012, is associate clinical professor of psychiatry and assistant dean for student affairs at the UC San Diego School of Medicine. Dr. Norcross, SDCMS-CMA member since 1999, is clinical professor of family medicine, UC San Diego School of Medicine, and director of the UC San Diego PACE Program.

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apri l 2012 SAN DIEGO PHYSICIAN.org 13

Phys i c i an Vo

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San Diego County Medical Society Foundation Improving Health, Changing Lives

By Stuart A. Cohen, MD, MPH

Incoming SDCMS president, Robert Hertzka, MD, and SDCMS’ board of directors identify a need to reach out into the community, and begin discussions on how to expand SDCMS’ impact and reach. A charitable arm of SDCMS is created to recognize efforts of area physicians. The seeds of the SDCMS Foundation are planted.

SDCMS Foundation Timeline

Improving community health, access to care for all, and wellness for patients and physicians through engaged volunteerism.

That’s the mission of the San Diego County Medical Society (SDCMS) Foundation, founded by SDCMS as a sister organization in 1968. Originally known as San Diego Association for Medical and Paramedical Education and Research (AMPER), the organization provided loans, grants, and scholarships to medical students. Over the years, through the leadership of numerous physician volunteers serving on the board of directors and committees, the scope of services and the number of community members benefitting from these efforts have increased exponentially.

“There is so much more that physicians and SDCMS have done and continue to do than advocate for legal and legislative changes,” says current California Medical Association (CMA) president James T. Hay, MD. As past president of SDCMS and the SDCMS Foundation, Dr. Hay has been instrumental in the development of both organizations. “The establishment of the Foundation was a way of helping docs do what they often do anyway: provide pro bono care to those in need. We knew they could do it better with a more coordinated way to volunteer.”

James T. Hay, MD, serves as president of SDCMS and begins the planning process, hiring a consultant to develop a framework based on learning from Project Access Dallas, one of the first coordinated volunteer programs in the country.

Reach Out San Diego, established in 2001 by local physicians to provide referrals to low-cost specialty healthcare services, is folded into the SDCMS Foundation after its initial grant funding expires.

2002

1999

2000

2001 A major goal for the new organization is to connect physicians to coordinated volunteer medical service, recognizing physicians have been providing volunteer care in the community throughout their careers.

16 SAN DIEGO PHYSICIAN.org apri l 2012

2003

//////////////////////////////////////////////// Project Access San Diego has been just one of the projects that the Foundation has established and nurtured since its beginnings. “We went from a shoestring organization to a viable foundation that has many projects that are helping the community,” continues Dr. Hay. “Credit goes to the SDCMS CEO Tom Gehring, Foundation staff, and board leadership for their commitment to growing the organization. Most Foundation board members are former SDCMS presidents, and we are delighted that community members are part of the effort now, too.”

Dr. Hay noted that many times, a program of the Foundation is attributed to SDCMS and vice versa. While each organization has a unique mission, both have access to care as a core value. “It is a huge benefit for SDCMS that the good work of the Foundation is blurred with its work, and a huge benefit for the Foundation that the close connection with SDCMS facilitates volunteerism.”

Tax-exempt 501c3 status is issued

by IRS. Robert Hertzka, MD, is honored at a roast event to raise funds for medical student support, including loans and advocacy education. The History of Medicine in San Diego project with retired physicians is launched. The California Endowment and Sharp Health Plan provide first grant funding. San Diego physicians donate their RICO settlement checks to the SDCMS Foundation to support its programs.

The first executive director is hired.

“We are not done yet,” Dr. Hay says emphatically. “Doctors volunteer in many places, both in our community and around the world. Very few physicians say no when asked to help. Our hope is that other care providers will be as positive when asked to help improve the lives of our most vulnerable community residents.”

Dr. Cohen, SDCMS-CMA member since 1988, is a pediatrician with Rady Children’s Primary Medical Group, vice chair (California District) of the American Academy of Pediatrics, former SDCMS president, and current board president of the SDCMS Foundation.

The first Saturday Surgery Day in partnership with Kaiser Permanente and Southern California Permanente Medical Group is held; 19 patients are served with $180,000 in donated services. More than 50 physicians attend each of the four Retired Physicians Society meetings.

Blue Shield supports the SDCMS Foundation’s new Emergency Department Medical Home Project program, developed with the help of Steve Carson, MD, to find medical homes for uninsured and underinsured patients utilizing the emergency rooms for primary care.

A diabetes and obesity health education program is launched, later transitioned to the Hospital Association of San Diego and Imperial County’s Community Health Improvement Project (CHIP).

Rosemarie Marshall Johnson, MD, SDCMS Foundation medical community liaison, receives the 10News 2011 Leadership Award for her work with Project Access.

The SDCMS Foundation is honored with the prestigious 2011 Adarsh S. Mahal, MD, Access to Health Care and Disparities Award by the CMA Foundation. 616 physicians volunteer for PASD, serving 673 patients with 1,863 specialty healthcare appointments and 121 donated surgeries. Kaiser Permanente continues to partner with the SDCMS Foundation to provide two Super Saturday Surgery Days. Surgery One and its Carlsbad Surgery Center join with its first Saturday Surgery Day. A new SDCMS Foundation website is launched at the end of the year, and the Retired Physicians Society is relaunched to support the connection of retired physicians to the medical community. The total donated services since PASD inception exceeds $4.5 million.

Project Access San Diego is officially launched. The SDCMS Foundation recruits private practice specialty physicians, anesthesiologists, and radiologists willing to provide pro bono medical services in their offices; 164 patients are served with 295 specialty care appointments. Three Saturday Surgery Days in partnership with KP provide 119 patients with general surgeries and colonoscopies. The total donated healthcare services since PASD’s inception reaches $980,000. The Specialty Care Access Initiative, in partnership with the Council of Community Clinics, is launched to increase access to specialty care at the community health centers.

2007

2004 2005

The San Diego Association for Medical and Paramedical Education and Research (AMPER) is changed to the San Diego County Medical Society Foundation; new corporate papers are filed with the Department of Corporations. James T. Hay, MD, is appointed first SDCMS Foundation president.

2006

2010 2008

James Hay, MD, and the SDCMS Foundation board of directors create a vision for access to specialty care program in response to needs identified in the 2006 San Diego County Healthcare Safety Net Study, founding Project Access San Diego. PASD is designed to fill gaps left by Reach Out San Diego and a lack of resources for the uninsured. Seed funding for Project Access is received from the Alliance Healthcare Foundation, County of San Diego, Kaiser Permanente, and The California Endowment. Carol Young, MD, serves as president.

2009

2011

523 specialty care and ancillary physicians volunteer with Project Access; 524 patients receive care and 249 are assisted to receive public benefits. Donated healthcare services reach $2.5 million. Text4baby, a mobile health program, is launched nationally and in San Diego by the SDCMS Foundation. eConsultSD, increasing the capacity of primary care physicians to receive electronic consultations with specialty care physicians, is launched.

The San Diego Business Journal recognizes the SDCMS Foundation with its Health Care Champions Award.

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//////////////////////////////////////////////// Southern California Permanente Medical Group Innovators and Community Partners

By Lauren Banfe Southern California Permanente Medical Group (SCPMG) physicians are recognized throughout California as innovators in increasing access to care for the uninsured and underinsured. That is exemplified in the partnerships that SCPMG physicians and the Kaiser Permanente system have nurtured throughout the San Diego community. Among the programs launched thanks to the support of Kaiser Permanente physician leadership are the Community Health Needs Assessment, conducted semiannually by Community Health Improvement Partners (CHIP); the development of a formal training program for community health workers; support for numerous programs at the area community clinics, including Project Dulce, addressing diabetes prevention and treatment; the statewide Specialty Care Access Initiative; and Project ALL Heart, improving outcomes for those at risk for cardiovascular disease.

However, many do not know of the tremendous volunteer efforts SCPMG physicians contribute to the community. Twice each year, several SCPMG physicians along with over 100 Kaiser Permanente staff give a Saturday to improve the health and lives of some of the most vulnerable San Diego County residents at a Kaiser Permanente outpatient surgery center. The partnership between the volunteer physicians, Kaiser Permanente, and the SDCMS Foundation since 2008 has resulted in improved health for 313 patients, including three lives saved.

Leading the effort to launch Project Access San Diego in late 2008, Daniel “Stony” Anderson, MD (SDCMS-CMA member since

1989), Sandra Freiwald, MD (SDCMS-CMA member since 2010), Deepak Sonthalia, MD (SDCMS-CMA member since 2006), and Paul Bernstein, MD (SDCMS-CMA member since 2000), have recruited other SCPMG physicians to volunteer for what is affectionately known as Super Saturday Surgery Days. Averaging 19 outpatient surgeries each time, and as many colonoscopies and flexible sigmoidoscopies as there is need, SCPMG physicians and Kaiser staff are engaged volunteers, resulting in more than $1.7 million in contributed medical services over the four years.

The latest Super Saturday Surgery Day was March 24. From the surgeons and anesthesiologists, to the nurses, techs, and environmental services team, the group gathered at 6:30 a.m. for a bite of breakfast and an inspirational kick-off to a heartwarming day. Albert Ray, MD (SDCMSCMA member since 1993), SCPMG and SDCMS Foundation board member, welcomed the volunteers and highlighted a few of the patients who have had their lives changed for the better from past Surgery Days.

Dr. Freiwald has participated in all nine Surgery Days since 2008. “I was involved in international aide work, and I wanted to do the same thing in my own community,” Dr. Friewald says. “It’s a great way to give back to the community, and it is really gratifying to see patients return for their post-op visit and see that they are feeling better, that they have been able to resume their regular activities, go back to work, or take care of their kids again.”

SCPMG physicians also volunteer

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Twice each year, several SCPMG physicians along with over 100 Kaiser Permanente staff give a Saturday to improve the health and lives of some of the most vulnerable San Diego County residents at a Kaiser Permanente outpatient surgery center.

20 SAN DIEGO PHYSICIAN.org apri l 2012

throughout the community as part of their Martin Luther King Day of Service.

When many San Diegans use this day off to sleep in or catch a sale, SCPMG physicians and Kaiser Permanente teams are making the community a better place. This past January, volunteers painted, deep cleaned, organized, and landscaped Hidden Valley House, a domestic violence shelter in North County; sorted through 56,475 pounds of food at the Jacobs and Cushman San Diego Food Bank; and landscaped the grounds of South Bay Community Service’s Trolley Trestle, a residential complex for foster youth. “Healthy communities and a healthy environment go hand in hand with individual health and wellness. MLK Day of Service is a great opportunity to meet the critical needs of San Diego and advance Dr. King’s dream of opportunity for everyone,” said Dr. Bernstein, area medical director and chief of staff for Kaiser Permanente’s SCPMG in San Diego.

SCPMG physicians volunteer in the community throughout the year, providing free physicals for student athletes in underserved communities where lack of a physical examination would prevent participation in sports. Building on their commitment to the safety net, Kaiser specialists provide training to community clinic primary care physicians. On a recent Saturday morning, Kaiser physicians trained more than 25 community clinic

PCPs on joint injections to increase their capacity to provide care for their patients.

Mitsuo “Mits” Tomita, MD (retired SDCMSCMA member), and Alexandra Page, MD (SDCMS-CMA member since 2009), led the training at SDCMS’ offices.

SCPMG volunteers also provide training and technical assistance to primary care providers at community clinics on improving health outcomes among patients at high risk for cardiovascular disease through the Community Clinics Health Network’s ALL HEART program. In addition, these dedicated physicians expand the capacity of community clinic PCPs to care for their patients through their volunteer participation in eConsultSD, a HIPAA-compliant electronic consultation program between specialists and community clinic primary care providers, launched in 2011.

It is without a doubt that SCPMG physicians hold closely to the Kaiser Permanente social mission of building healthier communities. SCPMG physicians innovate and participate in volunteerism throughout San Diego to make our community a better and healthier place to live.

Ms. Banfe is the resource development director for the San Diego County Medical Society Foundation. She recruits specialty care physicians, hospitals, and surgery centers as volunteers for Project Access San Diego. Ms. Banfe also works in fundraising and grant-writing for the SDCMS Foundation.

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MOST

Mercy Outreach Surgical Team

By Thomas Vecchione, MD

22 SAN DIEGO PHYSICIAN.org apri l 2012

//////////////////////////////////////////////// The Mercy Outreach Surgical Team (MOST) has been going to Mexico to repair congenital anomalies and acquired or traumatic injuries in indigent children since 1988. A team of doctors, nurses, technicians, and logistical personnel from San Diego functioning as an all-volunteer organization, MOST works out of Scripps Mercy Hospital and is dedicated to serving poor people who have limited access to surgical treatment.

MOST used to bring 100 patients to Scripps Mercy for a “Mercy Day” of surgery on the third Saturday in September.

This unfortunately ended Sept. 11, 2001, with the attack on the United States. The borders became a barrier interfering with bringing these children to us for surgical care. This, along with the dangers of drug traffickers, has made the team very cautious about planning our trips to certain parts of Mexico.

Six months before each mission, the team sends a scouting group to the next venue. They work with local officials, doctors, clergy, and Rotary to find the people who need our help. The arrangements for their surgeries are begun at this time. In the past 23 years, MOST has performed surgical corrections on more than 10,000 patients. This requires a great deal of planning and working with the government, the Rotary Clubs, the Desarrollo Integral de la Familia, and local hospitals, doctors, and nurses.

The team tries to involve as many caregivers in the community as possible so that the experience can educate them and enable them to develop their own program. MOST is a nonprofit organization that depends on support from the Rotary Clubs, individual and corporate donations, and hospital support. All of the volunteers pay their own way and donate many hours of service, both on the trip and in preparation. It is indeed a labor of love.

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//////////////////////////////////////////////// Phys i c i an V o l untee r i sm

When each of us looks at what we have done with our lives, it’s the missions like these that can give the greatest personal satisfaction.

MOST has conducted more than 42 week-long missions deep into Mexico and more than 36 weekend missions to Tijuana. In 2010, we traveled to Pachuca, Huejutla, and Tijuana. In 2011, we visited Aguascalientes and Tijuana. In April 2012 MOST will travel to Tehuacán, Mexico for a one-week surgical mission. During this time we expect to perform 250–300 surgical procedures.

MOST started when two nurses in the late ’80s, Judy Haimes and Pat Robinson, saw a need to help poor children in Mexico. At first they brought many patients to Mercy Hospital, but they soon realized we could reach more children by going into Mexico as an organized team.

This effort has blossomed into a great team of like-minded people who want to help these children get back to a more level playing field. The Rotary Clubs in Mexico and Rotary Club #33 in San Diego have been invaluable in helping with the logistics of moving the team in Mexico

and meeting the complex international rules and regulations of going into Mexico to perform surgery.

The team relates that the greatest satisfaction is seeing the children in the recovery room with their mothers. The tears of joy and relief and hope all come showering down on their families. This surgery helps the children, families, and their communities realize that these children can have a new opportunity to lead a more fulfilling and normal life. When each of us looks at what we have done with our lives, it is the missions like these that can give the greatest personal satisfaction.

Dr. Vecchione, SDCMS-CMA member since 1974 and associate clinical professor of plastic surgery at UCSD (voluntary), is a San Diego plastic surgeon who performs cosmetic as well as reconstructive repair to congenital anomalies and traumatic deformities. Dr. Vecchione is one of the founding members of the Mercy Outreach Surgical Team.

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//////////////////////////////////////////////// Phys i c i an V o l untee r i sm

Dr. Sunny Smith (left) and Dr. Michelle Johnson, Co-medical Directors of the UC San Diego Student-run Free Clinic Project

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//////////////////////////////////////////////// Volunteer Medical Students Make Better Practitioners

By Barbara Mandel, MBA Each year, UC San Diego medical students gain invaluable insight and skills in providing medical care while serving the community as volunteers. It is an experience few will forget.

Sunny Smith, MD, co-medical director for the UC San Diego Student-run Free Clinic (SRFC) Project, started working with the clinic as a first-year medical student.

“I learned so much during my medical student experience,” says Dr. Smith. “I learned leadership, community empowerment, and how to take on the challenges of working with underserved people. There is nothing more rewarding than getting a hug from a grateful patient, and seeing we can make a big difference in people’s lives.

Ellen Beck, MD, SDCMS-CMA member since 2004 and clinical professor in the Department of Family and Preventive Medicine at the UC San Diego School of Medicine, launched the clinics in 1997 to provide humanistic learning environments for both patients and students. “We want to reach the people who have fallen through the cracks, who have no access to care,” she explains. “And we want to teach students how to be respectful, empathetic, and self-aware in their practices.” Dr. Beck continues to serve as executive director for the SRFC Project.

Medical students and more than 150 volunteer physicians over the past 15 years have provided free medical and preventive care, dental care, health education, and access to social services at three locations throughout San Diego. The SRFC has received numerous awards and honors,

including most recently the 2011 WebMD Magazine Health Hero Award, the 2010 James Irvine Foundation California Leadership Award to Dr. Ellen Beck, and the 2010 KPBS Local Hero Diversity award.

The first clinic location was at the Pacific Beach United Methodist Church, started partly with funds raised from bake sales.

When certain patients didn’t show up there, Dr. Beck and her students tracked them down — at shelters, under bridges, in parks — to make sure they received the care they needed. The clinic sites now also include First Lutheran Church in downtown San Diego and Baker Elementary School in Mountain View. In all, they run five half-day sessions per week. The clinics offer treatment in nearly all fields of medicine, from asthma and cancer to kidney and liver disease, and partner with other organizations to offer legal assistance, acupuncture treatments, dental care, psychiatric help, and social-services support.

“Medical students devote hours and hours, a significant part of their medical school life, as volunteers at the Free Clinic,” says Dr. Beck. “These are remarkable medical students passionate about making a difference and wanting to serve. They get involved with the Free Clinic, learn the skills to do that, and our hope is that they take those skills out into the world and make a difference.”

The program is very popular. More than 1,000 UC San Diego medical students have taken free clinic electives that teach the program’s philosophy of providing accessible, quality healthcare for the underserved

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//////////////////////////////////////////////// Phys i c i an V o l untee r i sm

in a respectful environment in which students, health professionals, patients, and community members learn from one another. The skills the medical students learn help them provide high-quality care to people who might otherwise go without it. “Our medical students arrive with passion, compassion, and a desire to make a difference for patients,” says Dr. Beck. “But the medical system often beats it out of them. Our program keeps those dreams alive and gives them the tools to provide that kind of humanitarian care in their own practices.”

The Student-run Free Clinic is not just a name. “It is a reality,” says Dr. Beck. She says the students do everything at the clinic, and learn to manage and run the clinic while under the guidance of faculty and other volunteer physicians. Since 1997, the students of SRFC have helped more than 7,500 underserved and uninsured patients in San Diego.

“I remember the first night I showed up at the Pacific Beach clinic,” remembers Scott Auerbach, MD, former medical student volunteer. “I learned more about diabetes that night, caring for a patient under the guidance of a fourth-year student, than I had at numerous lectures.” Medical students often have little interaction with patients in the first two years of medical school, which is why volunteer participation with SRFC Project is a coveted assignment. Most of the 550 UC San Diego medical students elect to serve during their

Medical students and more than 150 volunteer physicians over the past 15 years have provided free medical and preventive care, dental care, health education, and access to social services at three locations throughout San Diego.

28 SAN DIEGO PHYSICIAN.org apri l 2012

first two years, and many vie to stay with the program throughout their education.

Senior students shepherd junior students to learn to care for patients, often people presenting with more significant health issues than the general population.

“Our patients often have more complicated health issues than a private practice physician would see,” says Michelle Johnson, MD, co-medical director of SRFC with Dr. Smith. “We want to make sure our patients have all the information they need to make informed decisions about their options. The medical students provide patients with the highest medical care, and really take the time to explain and educate patients about their conditions.”

Patients requiring specialty care for services not available through the SRFC’s network of volunteers, or requiring surgery, are referred to Project Access. One SRFC volunteer, Eileen Natuzzi, MD, a general surgeon and SDCMS-CMA member since 2010, is also a PASD volunteer. She recently participated at a PASD Saturday Surgery Day at Carlsbad Surgery Center, and provided four pro bono hernia surgeries to needy patients, many of whom were her patients from the Free Clinic. “We are

appreciative of partnering with Project Access San Diego,” says Sunny Smith, MD, co-medical director of the SRFC. “There were many times we did not have the resources to serve our patients needs. We had a long list of unmet needs, and now, through our partnership, we don’t have a list any more.”

“I want to see a time when free clinics are not needed because universal health access has been achieved,” concludes Dr. Beck. “But until then, we encourage and mentor those students passionate about making a difference to get involved with the Free Clinic.”

Ms. Mandel is the executive director of the San Diego County Medical Society Foundation.

SDCMSF’s mission is to improve community health, access to care for all, and wellness for patients and physicians through engaged volunteerism.

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Retirement Is Just Another Word for Change Dr. Ira Levine, Volunteer

By Rosemarie Marshall Johnson, MD Retired SDCMS-CMA member, Ira Levine, MD, who originally joined in 1976, started a new chapter in his life, but retirement is not the word one would use to describe it. Dr. Levine, a surgeon at Scripps Mercy Hospital since 1975, has been a volunteer for Project Access since the program’s beginnings in 2009. “It’s important to give back to the community,” recognizes Dr. Levine.

“And it’s important to acknowledge all the volunteer physicians who give their time and deserve credit. The patient may not know the anesthesiologist who allows the surgeon to operate, or the pathologist who is responsible for diagnosis of a biopsy, but we are all a team.”

Dr. Levine recalls with a chuckle a conversation with a patient’s wife, when he reported to her that her husband had done well with the surgery and would have a full recovery. “And how did you do?” asked the wife. As he’d not been asked that question before, he reflected before responding, “I did well too.” Surgeons get few compliments, Levine noted, but many Project Access patients are so grateful for the care they have received that they bring him gifts and homemade food, which he recognizes they can often hardly afford. “It makes physicians feel good knowing we are doing something for someone who has nowhere else to turn.”

Claudia Ramos is one of the people whose life was changed by Dr. Levine in his role as a volunteer for Project Access

30 SAN DIEGO PHYSICIAN.org apri l 2012

San Diego. Claudia experienced pain and difficulty with eating, drinking, and even swallowing. The 32-year-old was diagnosed with a multinodular goiter and an enlarged thyroid nodule, but, as an uninsured San Diego resident, did not have the resources for follow-up care. Dr. Levine performed a thyroid lobectomy/ isthmusectomy, and, fortunately, the nodules were benign. The mother of three young children has regained her health and peace of mind now that her medical needs have been addressed. She expressed her immense gratitude to Dr. Levine. “He is my angel!” she says.

Thyroid maladies, including cancer, are issues that can be cured through surgery, adds Dr. Levine. What is difficult for physicians, particularly Project Access volunteers who know that resources are extremely limited, is treating a patient with cancer that requires significant postsurgical care. “Hormone therapy, radiation, or chemotherapy can cost hundreds of thousands of dollars that uninsured patients cannot afford,” he says. “A common theme discussed at the Scripps Mercy Hospital tumor board meetings is the unavailability of resources for underfunded patients. It is heart-wrenching.”

Dr. Levine admires his colleagues’ work with the Mercy physicians’ outreach program Mercy Outreach Surgical Team

(MOST) in Mexico, performing hernia, cleft palate, and club feet surgeries before the launch of Project Access. “I wanted to do this kind of volunteer healthcare work in America; that’s what I think is great about Project Access,” he says.

What’s in store for Dr. Levine since his official retirement from private practice?

He’s taken on the role of assistant medical director for Mercy Physicians Medical Group, with a focus on caring for our aging population. And he plans to take better care of his own health and wellness — including long walks with his wife, Ellen, improving his putting and chipping, and reading a book for pleasure each month.

He’s also interested in assisting the SDCMS Foundation in addressing patient pre-op education needs so that patients are best prepared for a successful recovery. We are most appreciative of Dr. Levine’s heroic volunteer efforts on behalf of those who most need his help.

Dr. Johnson, retired SDCMS-CMA member and former SDCMS president, is the medical community liaison for the SDCMS Foundation’s Project Access San Diego.

////////////////////////////////////////////////

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Six Vignettes Jeffrey L. Marxen, MD: In Memorium The recent passing of Jeffrey Marxen, MD, SDCMS-CMA member since 1981, has left a huge void in the medical community, and one in particular for Project Access, where he served as a dedicated volunteer. Dr. Marxen regularly saw Project Access patients needing a consult or procedure for orthopedic problems.

One of the last patients Dr. Marxen saw was Monica, a baby boomer who had fractured her hip 17 years ago and whose injuries never healed properly due to her lack of insurance and access to care. Monica saw Dr. Marxen on Feb. 22, just hours before his tragic accident. “Dr. Marxen told me that his daughter teased him about his Spanish.

The fact that he shared something personal with me about his family made me feel that he saw me like an equal, not someone who is less than him.”

Upon hearing of his death, Claudia added, “I feel as if one of my family members has died. I wish I could let his family know how sorry I am for their loss. I know that someone like him, a kind-hearted humanitarian, can only be in a good place. I will never forget Dr. Marxen.”

County Public Health Hero Daniel “Stony” Anderson, MD, SDCMS-CMA member since 1989, a gastroenterologist with Southern California Permanente Medical Group, was recently honored by the County of San Diego as the 2012 Public Health Hero for his work with Project Access and colorectal cancer screening. Dr. Anderson also serves as chair of the California Colorectal Cancer Coalition and has been a long-time champion of reducing colorectal cancer through screening and diagnostics.

Daniel “Stony” Anderson, MD, was recently honored by the County of San Diego as the 2012 Public Health Hero.

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Providing More Than Physical Changes Susan Kaweski, MD, has been a dedicated volunteer in so many arenas. SDCMS-CMA member since 1991, Dr. Kaweski served as SDCMS president in 2010–11 and is currently finishing her term as immediate past president. Dr. Kaweski has also served as a longtime Project Access volunteer, changing the lives of the many patients to whom she provides pro bono care.

One such patient is Jose, who suffered with a large lipoma on the back of his head for more than seven years. As the lipoma grew, so did his anxiety. Without the possibility of health insurance, Jose, 39, was uncertain about his future. Could the lump result in his death? Would he be able to care for his family? Dr. Kaweski improved Jose’s health and changed his life with the removal of the benign lipoma. “I am so grateful for the care Dr. Kaweski gave me,” Jose says. “I am living a normal life again.”

Many patients Dr. Kaweski has helped suffered from a physical disfigurement or issue that prevented them from attaining a job, or perhaps even leaving their home.

Carmen suffered from a rare sweat gland disorder that was so intense she could not go out in public, even to walk her child to school, without others noticing the odor of her condition. Requiring more than a dozen intensive, painful, and arduous procedures, Carmen is now able to join the world and has gained employment. She credits Dr. Kaweski for profoundly changing her life. (continued on page 36)

//////////////////////////////////////////////// Looking for a way to give back to the community?

The San Diego County Medical Society Foundation’s (SDCMSF) mission is to address the unmet San Diego healthcare needs of all patients and physicians through innovation, education, and service. SDCMSF is proud to partner with volunteer specialty physicians and nearly 100 community clinics in the county who provide primary care services for the medically uninsured and underserved. These clinics have little to no access to specialty care for their patients and need your help!

Opportunities for Physicians 1

Volunteer for Project Access San Diego:

If you are a specialist in private practice in San Diego, please consider joining more than 180 specialists in the county by seeing a limited number of uninsured adult community clinic patients in your office for free. Project Access coordinates all aspects of care so your volunteerism is hassle-free for you and your office staff.

2

Volunteer for eConsultSD:

eConsultSD allows primary care physicians from the community clinics in San Diego to articulate a clinical question to a specialist and receive a timely response in a HIPAA-compliant, web-based portal. eConsultSD is an easy way for busy specialist physicians to give back to the community who are not able to provide direct patient care.

3

Obtain a Volunteer or Paid Position at a Local Community Clinic: SDCMSF is happy to connect specialist physicians with a community clinic that needs your services on site. This opportunity involves traveling to a clinic within San Diego County as your schedule permits.

4

Make a Contribution:

SDCMSF needs your support to care for the medically underserved in our community. Please consider making a contribution of any size to support the Foundation’s efforts.

Contributions can be made online at SDCMSF.org or sent to the San Diego County Medical Society Foundation at 5575 Ruffin Road, Suite 250, San Diego, CA 92123.

Thank you for your support!

Thank you for your dedication to the medically underserved. If you are interested in any of the opportunities above, please contact Lauren Banfe, resource development director, at (858) 565-7930 or at Lauren.Banfe@SDCMS.org.

The San Diego County Medical Society Foundation is a 501(c)3 organization (Tax ID # 95-2568714).

Please visit SDCMSF.org for more information. Telephone: (858) 300-2777 or Fax: (858) 569-1334

SDCMSF was formed as a separate 501(c)3 in 2004 by the San Diego County Medical Society.

33

S AN D I E G O P HY S I CI A N. or g A u gust 2011

apri l 2012 SAN DIEGO PHYSICIAN.org 33

classifieds PRACTICE ANNOUNCEMENTS JENNIFER EASTLACK, MD, JOINS DEL MAR MED: Dr. Jennifer Eastlack, a board-certified dermatologist specializing in medical, surgical, and cosmetic disorders of the skin, hair, and nails, has joined a new practice. She is now seeing pediatric and adult patients with partners Dina Massry, MD, and Jeffrey Eaton, MD, at Del Mar MED in Carmel Valley. Her address is 12395 El Camino Real, #200, San Diego, CA 92130. (858) 481-3376. [020] PHYSICIAN POSITIONS AVAILABLE BOARD-CERTIFIED FAMILY PRACTICE PHYSICIAN NEEDED: To cover hours at busy urgent care/family practice office in Carlsbad. Nights and weekend coverage needed. Same-day coverage available. Please Fax CV to (760) 603-7719 or email CV to gcwakeman@sbcglobal.net. [031] PSYCHIATRIST-INDEPENDENT CONTRACTOR, PART TIME: Facility/Location: Douglas Young BPSR Center, San Diego, CA 92126. Douglas Young BPSR Center is an adult outpatient mental health clinic. DYC provides initial psychosocial assessments, psychiatric evaluations, medication support services, individual and group counseling, crisis intervention, and psychosocial rehabilitation activities.

Qualifications/Skills Requirements: Must be a CA-licensed psychiatrist / MD. Preferred Applicants: Board-certified psychiatrist, experience working withclients who have serious and persistent mental illness. Basic computer skills are required. Please forward resume to Jennifer Whelan, MFT, by fax at (858) 695-3521 or email at jwhelan@comresearch.org. Please see our website for further information at www.comresearch.org. [030] PHYSICIAN Wanted to assume a part-time practice by Paradise Valley Hospital from retiring physician who has been in the area for 35 years. Please email me at bpmedina@msn.com if you are interested. [029] PHYSICIANS: Retired with license? Want to cut back to one or two days a week? Alternative care office in Carlsbad looking for California licensed MD for consultativework. Part time, excellent compensation. Contact James at (760) 703-3767 or at knewidea@gmail.com. [028] NEEDED: Physician with urgent care / primary care experience needed for a well-established urgent care. Excellent starting and upward pay. Call (858) 488-9126. [027] GENERAL SURGEONS NEEDED IN SAN DIEGO: Sharp Rees-Stealy Medical Group, a 400+ physician multi-specialty group in San Diego, is seeking two well-rounded general surgeons to join our group. Competitive firstyear compensation guarantee, excellent benefits and shareholder eligibility after two years. Please send CV and letter of interest to: Lori Miller, 2001 4th Ave., San Diego, CA 92101. Fax: (619) 233-4730. Email: lori.miller@ sharp.com. [023] MEDICAL DIRECTOR — SUNNY SAN DIEGO: County Psychiatric Hospital needs a full-time medical director.

This is a key leadership role in our very physician-friendly, dynamic behavioral health system. Facility includes an inpatient unit and a very busy psychiatric emergency unit.

County has partnered with UCSD to develop a community psychiatry fellowship, and teaching opportunities will be available, though the facility does not do research. Medical director does limited direct clinical care. Required: Proven administrative, leadership, and supervisory skills, and a “big-picture” orientation to help us evolve our entire system. Salary competitive and excellent County employee benefit package. San Diego combines the lifestyle of a resort community and the amenities of a big city. Hospital centrally located, minutes from many recreational opportunities and great residential communities. Wonderful year-round weather, of course! CV and letter of interest can be submitted online at www.sdcounty.ca.gov/hr. For questions, please contact Gloria Brown, human resources analyst, at (858) 505-6525 or at gloria.brown@sdcounty. ca.gov, or Darah Frondarina, human resources specialist, at (858) 505-6534 or at darah.frondarina@sdcounty.

ca.gov. Questions and interest can also be directed to Marshall Lewis, MD, Behavioral Health Clinical Director, Health & Human Services Agency, at marshall.lewis@sdcounty.ca.gov. [021] MEDICAL CONSULTANT — COUNTY OF SAN DIEGO: BC/BE internist/family practice physician sought for fulltime employment with the County of San Diego, Edgemoor in long-term care at the 192-bed Santee facility.

Compensation includes salary, bonuses for certifications, and on-call reimbursement, as well as medical, dental, vision, and retirement benefits. Seeking physician with superior interpersonal and clinical skills, attention to detail, comfortable working in teams to serve patients ages 18 and up with mental and physical disabilities. CV can be submitted online at www.sdcounty.ca.gov/hr. [015] CHIEF MEDICAL OFFICER: San Ysidro Health Center, a Federally Qualified Health Center with nine medical clinics serving southern San Diego, is recruiting for a chief medical officer. Reports to the president/CEO. Partners with the board of directors, senior leadership, and all healthcare providers to ensure the highest quality of healthcare for patients. Provides clinical supervision of provider staff.

Provides some direct patient care (80% administrative / 20% direct patient care). Qualifications: MD valid / current / unrestricted California medical license and BC; minimum 10 years professional experience in primary care setting; 10 years administrative and patient care management.

Send resume to jobs@syhc.org. [012] ASSOCIATE MEDICAL DIRECTOR: San Ysidro Health Center, a federally qualified health center with nine medical clinics serving southern San Diego, is recruiting for an associate medical director. Will report to the chief medical officer with a dotted line relationship to the CEO. Works collaboratively to ensure SYHC continues to provide high quality, cost-effective healthcare. Leads efforts to increase healthcare access and enhance the patient experience. Provides some direct patient care (80% administrative, 20% direct patient care). Qualifications: Doctorate degree in Medicine (MD or DO) from accredited school of medicine; valid, current, unrestricted California medical license; BC in primary care specialty; minimum five years clinical/administrative practice in primary care setting; minimum five years as an associate medical director or clinical lead physician. Send resume to jobs@syhc.org. [005] GERIATRICIAN: Full-time position available at Neighborhood Healthcare in North San Diego County. This position provides comprehensive medical services for geriatric patients on continuing basis. Candidates must have current California medical license, DEA, and CPR certification.

Please send CVs to Dr. Jim Schultz via email at JimS@ nhcare.org or fax to (760) 796-4021 — “Attn: Geriatrician” must be included in the subject of your email or fax for your application to be considered. [010] CONTRACT PHYSICIAN: Profil Institute for Clinical Research is in need of three contract physicians for primarily weekend shifts. Requirements: One year of clinical experience in adult medicine and/or equivalent experience.

License to practice medicine in California. Responsibilities: Perform medical histories, physical exams, and protocol-based assessments for qualification of subjects for studies. Admit, discharge, and monitor subjects including reviewing labs results, EKGs, and telemetry. Assess and manage adverse events and medical emergencies. Participate in safety and dosing assessments. Interested parties please email resumes to hrpicr@profilinstitute.com. If you have further questions, please contact Robyn Nielsen, recruitment manager, at (619) 419-2048. [007] SEEKING BOARD-CERTIFIED PEDIATRICIAN FOR PERMANENT FOUR-DAYS-PER-WEEK POSITION: Private practice in La Mesa seeks pediatrician four days per week on partnership track. Modern office setting with a reputation for outstanding patient satisfaction and retention for over 15 years. A dedicated triage and education nurse takes routine patient calls off your hands, and team of eight staff provides attentive support allowing you to focus on direct, quality patient care. Clinic is 24–28

patients per eight-hour day, 1-in-3 call is minimal, rounding on newborns, and occasional admission, NO delivery standby or rushing out in the night. Benefits include tailcovered liability insurance, paid holidays/vacation/sick time, professional dues, health and dental insurance, uniforms, CME, budgets, disability and life insurance. Please contact Venk at (619) 504-5830 or at venk@gpeds. sdcoxmail.com. Salary $ 102–108,000 annually (equal to $130–135,000 full-time). [778] PRACTICE WANTED WE BUY URGENT CARE OR READY MED-CLINIC: We are interested in purchasing a preexisting urgent care or ready med-clinic anywhere in San Diego County. Please contact Lyda at (619) 417-9766. [008] OFFICE SPACE / REAL ESTATE LA JOLLA OFFICE SPACE: Share reception, waiting area, and exam/consultations rooms in brand new office. Four exam rooms. Office is close to Scripps Memorial Hospital. In Golden Triangle between 805 and 5 freeways.

Terms negotiable. Please contact Kathy Koppinger at (858) 678-0455. [025] TURN-KEY MEDICAL OFFICE IN EASTLAKE — FOR SALE OR LEASE: Suite 205 at 890 Eastlake Parkway in Chula Vista is available for Sale OR Lease. Asking only $1.75 NNN for 2,900 Rentable SF med ofc condo in Eastlake’s premier medical office building: Village Walk Medical Arts Center. Ample parking, beautiful state-of-the-art improvements completed in ’07, 2nd floor corner, excellent views to adjacent, walkable retail amenities, just a few blocks from SR-125. Contact Nic Lyon at (760) 230-4811 or at NLyon@AcreCommercial.com. [024] 1450 SQ. FT. OFFICE SPACE FOR LEASE IN LA MESA, NEW BUILDING, NEAR GROSSMONT HOSPITAL: Beautiful building recently completed at 5980 Severin Dr. in La Mesa. Off highways 8 and 125. Space includes handicap bathroom, new HVAC, upgraded electrical panel, tall ceilings, plenty of parking, very functional design and layout. Price is $1.50 per sq. ft., a very good rate for new construction. Call Nathan at (619) 787-3422 or email at hythams@att.net for further information or a private showing. [022] SPACE AVAILABLE FOR SUBLEASE IN A 1,850 SQFT FAMILY PRACTICE OFFICE IN ENCINITAS: Two furnished exam rooms. One doctor’s office furnished with computer — EMR available. One lab/procedure room to share. Please contact Jaleh Brunst at (858) 756-2340 or at jalehbrunst@mac.com. [019] 2,142 SQ-FT OFFICE AVAILABLE FOR SHARING/ SUBLEASE: Currently occupied by cardiothoracic and vascular surgeons. Share partially furnished reception and waiting area. Three exam rooms furnished. One doctor office available. Terms negotiable. Please call Sonia at (619) 287-6003. [018] POWAY OFFICE SPACE AVAILABLE IN GATEWAY MEDICAL BUILDING, NEXT TO POMERADO HOSPITAL: Close to the 15 and 56. Large (18 ft. x 10.5 ft.) consult room with large windows, lots of natural light. Ample free parking. Rooms are soundproofed. Separate exit. Secure waiting room with large, comfortable seating. Kitchen with refrigerator, microwave, coffee maker, and toaster.

Bathroom in suite. Utilities, high-speed internet included.

Suite has new carpet, paint, and waiting room furniture upholstery. Days, evenings, and weekends available.

Please email lisa@thinnertimes.com with inquiries. [013] LOOKING FOR SPACE TO SUBLET: Please contact if you have office space available to sublet. Would specifically be interested in Poway, Escondido, Vista, North County, San Marcos, Sorrento Valley, Del Mar, etc. Prefer situation where we can use existing office staff. Contact sundhmail@yahoo.com. [011] LUXURIOUS / BEAUTIFULLY DECORATED DOCTOR’S OFFICE NEXT TO SHARP HOSPITAL FOR SUB-LEASE

To submit a classified ad, email Kyle Lewis at KLewis@SDCMS.org. SDCMS members place classified ads free of charge (excepting “Services Offered” ads). Nonmembers pay $150 (100-word limit) per ad per month of insertion.

34 SAN DIEGO PHYSICIAN.org apri l 2012

OR FULL LEASE: The office is conveniently located just at the opening of Highway 163 and Genesee Avenue.

Lease price if very reasonable and appropriate for ENT, plastic surgeons, OB/GYN, psychologists, research laboratories, etc. Please contact Mia at (858) 279-8111 or at (619) 823-8111. Thank you. [836] NEW — EXTREMELY LOW RENTAL RATE INCENTIVE — EASTLAKE/RANCHO DEL REY: Two office/medical spaces for lease. From 1,004 to 1,381 SF available. (Adjacent to shared X-ray room.) This building’s rental rate is marketed at $1.70/SF + NNN; however, landlord now offering first-year incentive of $0.50/SF + NNN for qualified tenants and five-year term. $2.00/SF tenant improvement allowance available. Well parked and well kept garden courtyard professional building with lush landscaping.

Desirable location near major thoroughfares and walkable retail amenities. Please contact listing agents Joshua Smith / Steve Dok, Grubb & Ellis, at (858) 875-3600. [006] POWAY / RANCHO BERNARDO — OFFICE FOR SUBLEASE: Spacious, beautiful, newly renovated, 1,467 sqft furnished suite, on the ground floor, next to main entrance, in a busy class A medical building (Gateway), next to Pomerado Hospital, with three exam rooms, fourth large doctor’s office. Ample parking. Lab and radiology onsite. Ideal sublease/satellite location, flexible days of the week. Contact Nerin at the office at (858) 521-0806 or at mzarei@cox.net. [873] TWO MONTHS FREE RENT: 1,215 SQ FT MEDICAL OFFICE NEXT TO POMERADO HOSPITAL: Office has furnished waiting area, front and back stations for four staff members, two exam rooms, a break room, private bathroom, and doctors’ office. Office is updated and ready for move in. Located in a great medical/dental complex in Poway, close to Pomerado Hospital, on the border with Rancho Bernardo. Second floor. Elevator/stair access. Large, free patient parking area. Ideal for medical, complementary/alternative medicine, physical therapy, chiropractic, acupuncture, massage/body work, etc. Patients from Poway, Rancho Bernardo, Carmel Mountain, 4-S Ranch, Scripps Ranch, Escondido, Ramona, and surrounding areas. Negotiable rent. Please contact Olga at (858) 485-8022. [980] OFFICE SPACE TO SHARE: Currently occupied by orthopedic surgeon. Great location close to Scripps/Mercy and UCSD Hospital. Looking to share with part-time or fulltime physician. Fully furnished, fully equipped with fluoro machine and four exam rooms, and staff. (NEGOTIABLE) Please contact Rowena at (619) 299-3950. [804] FULL-AND PART-TIME OFFICE SPACE IN UTC with 8th floor view in suite with established psychologists and psychiatrists in Class A office building. Features include private entrance, staff room with kitchen facilities, active professional collegiality and informal consultation, private restroom, spacious penthouse exercise gym, storage closet with private lock in each office, soundproofing, common waiting room, and abundant parking. Contact Christine Saroian, MD, at (619) 6826912. [862] 3998 VISTA WAY, IN OCEANSIDE: Two medical office spaces approximately 2,000 sq. ft. available for lease. Close proximity to Tri-City Hospital with pedestrian walkway connected to parking lot of hospital, and ground floor access. Lease price: $1.75 +NNN. Tenant improvement allowance. For further information, please contact Lucia Shamshoian at (760) 931-1134 or at shamshoian@coveycommercial.com. [965] SHARE OFFICE SPACE IN LA MESA: Available immediately. 1,400 square feet available to an additional doctor on Grossmont Hospital Campus. Separate receptionist area, physician’s own private office, three exam rooms, and administrative area. Ideal for a practice compatible with OB/GYN. Call (619) 463-7775 or fax letter of interest to La Mesa OB/GYN at (619) 463-4181. [648] BUILD TO SUIT: Up to 1,900ft2 office space on University Avenue in vibrant La Mesa/East San Diego, across from the Joan Kroc Center. Next door to busy pediatrics practice, ideal for medical, dental, optometry, lab, radiology, or ancillary services. Comes with 12 assigned, gated parking spaces, dual restrooms, server room, lighted tower sign. Build-out allowance to $20,000 for 4–5 year

lease. $3,700 per month gross (no extras), negotiable.

Contact venk@cox.net or (619) 504-5830. [835] SHARE OFFICE SPACE IN LA MESA JUST OFF OF LA MESA BLVD: 2 exam rooms and one minor OR room with potential to share other exam rooms in building.

Medicare certified ambulatory surgery center next door.

Minutes from Sharp Grossmont Hospital. Very reasonable rent. Please email KLewis@SDCMS.org for more information. [867] NONPHYSICIAN POSITIONS AVAILABLE NURSE PRACTITIONER, Float — San Diego North County Coastal: North County Health Services (NCHS) is looking for highly competent family practice nurse practitioners. Job Qualifications / Skills: Highly effective communication skills; desire and ability to work autonomously; enjoys the variety of working at NCHS’ multiple health centers; flexible (must be available to work during peak periods of the year); ability to relate to and work with people of all ages; ability to work independently and as a part of a team; comfortable treating patients of all ages. Experience: Minimum 3–5 years clinical experience preferred. Contact Araceli Mercado at fax (760) 7368740 or at araceli.mercado@nchs-health.org. [032] FAMILY NURSE PRACTITIONER: Full-time position (40 hours per week) available in North San Diego County.

The FNP provides healthcare services to patients under direction and responsibility of physician. Candidates must have a current FNP license, DEA and CPR certifications. Candidates must also specialize in geriatrics.

Please send CVs to Dr. Jim Schultz via email at JimS@ nhcare.org or fax to (760) 796-4021 — “Attn: FNP-North” must be included in the subject line of your fax or email for your application to be considered. [009]

PA/NP NEEDED IN VERY ACTIVE NEUROSURGERY PRACTICE: Candidate needs to be highly interested and motivated, as well as caring and flexible. Will be asked to conduct patient clinics, hospital rounds, and assist in surgeries. Motivated, as well as caring candidates, please send email with CV and references to armonia01@me.com. [977] MEDICAL EQUIPMENT ALMOST NEW X-RAY PROCESSOR: The Hope Micro-Max processor is value-priced to ideally serve the moderate film developing needs of the private practice market, including medical clinics and diagnostic and chiropractic care centers, as well as mobile diagnostic applications. The back-to-basics features of the Hope Micro-Max processor are designed to deliver high output for its compact size. 110V, 60Hz, 14amp. Includes stand, hoses, and refill tanks. Works great and 1/3 the price of a new processor. Processing Capacity: 135 seconds equals 68 (10” x 12”) films/hour; 45 (14” x 17”) films/hour; 113 seconds equals 89 (10” x 12”) films/hour; 57 (14” x 17”) films/hour; 90 seconds equals 110 (10” x 12”) films/hour; 70 (14” x 17”) films/hour. Contact kathy. koppinger@bonebuilders.com or (858) 354-5549.

[016] SERVICES OFFERED RADIOLOGY GROUP AVAILABLE TO READ YOUR STUDIES: We have three different teleradiology programs so we can read your studies over the internet. We are set up for digital. We can arrange courier for films.

We will read your X-rays, ultrasounds, echocardiograms, CT, and MRI. Board-certified radiologists. Reasonable pricing. We read overflow for San Diego Kaiser.

Call Alan White, MD, at (949) 922-1321. [026]

Increase Your Referral Business San Diego Physician is the only publication that is distributed to all 8,500 practicing physicians in San Diego County. Advertising is a cost-effective and profitable way to increase your referral business.

Contact Dari Pebdani at 858-231-1231 or at DPebdani@sdcms.org

apri l 2012 SAN DIEGO PHYSICIAN.org 35

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Improving an Entire Family’s Wellbeing Michael Muldoon, MD, SDCMS-CMA member since 2005, has assisted people throughout the community to increase their mobility and regain their lives through his orthopedic expertise. Perhaps no one is as grateful as L. Aguilar, a patient referred to Dr. Muldoon through the SDCMS Foundation’s Project Access late last year. By providing a pro bono knee scope on March 5, Dr. Muldoon is assisting Aguilar to return to his employment, assuring that daycare centers are clean for the community’s young children.

Dr. Muldoon has been a Project Access volunteer for the past two years, assisting 11 patients and providing surgeries at PASD partner La Jolla Orthopedic, as well as at Sharp Memorial Hospital. Aguilar had been waiting for his surgery since June 2011. His recent post-op visit showed good recovery, and he will be able to return to work this spring without the former debilitating pain. Aguilar expressed his gratitude to Dr. Muldoon, as he would have never been able to afford the simple outpatient procedure he needed to work and live comfortably. His granddaughter wrote Dr. Muldoon a thank-you card to let him know that his volunteerism changes not only the patient’s life, but improves also an entire family’s wellbeing.

Addressing Women’s Urgent Health Issues Scripps Health physician Elizabeth Silverman, MD, SDCMS-CMA member since 2008 who is specializes in obstetrics and gynecology, is a health hero to Project Access and a lifesaver to Monica H., who had been suffering with profuse bleeding, significant enough to require transfusions, since 2009. Dr. Silverman donated her services to provide Monica with a hysterectomy last December, solving her health issues and allowing her to launch a cake-making business to support her children.

As a PASD volunteer over the past two years, Dr. Silverman has addressed the healthcare needs of several low-income, uninsured women who lacked the resources to address urgent health issues. Her patients echo Monica’s words, “I am very grateful to Dr. Silverman for the gift of health and for the gift of a normal life.”

36 SAN DIEGO PHYSICIAN.org apri l 2012

Dr. Silverman has addressed the healthcare needs of several lowincome, uninsured women who lacked the resources to address urgent health issues.

The Gift of Sight “Thank you Dr. Cooper, you have changed my life!” That’s a call familiar to Lawrence Cooper, MD, SDCMS-CMA member since 1978 and an ophthalmologist volunteer for Project Access San Diego. A volunteer throughout his career in both the United States and abroad, Dr. Cooper has long been empathetic to the needs of others.

Before Felipe’s cataract surgery in December 2011, he could not leave the house alone due to his blindness. “Now I can read the Bible and see even the smallest things,” he exclaims. “I could not see for almost three years, and I was unable to work. I am hoping to return to my job at the tire store soon.”

Speaking to his patients in Spanish and patiently explaining the procedure that will improve their eyesight, Dr. Cooper affectionately hugs those expressing their gratitude. A humble and gracious man, he sees a need and works to fill it. Through his efforts, Mercy Outpatient Surgical Center has joined the team of PASD surgical centers and now provides pro bono care for uninsured patients. Dr. Cooper performed five cataract surgeries there in one day last December, restoring sight and lives.

“La luz es la vida,” says patient Teodoro Medrano. “The light is the life; now I have my life back. Dr. Cooper is my angel, mi milagroso.” The beloved physician turns the tables and credits Project Access for changing lives. “What you do is a great thing,” says Dr. Cooper.

Without physicians like Lawrence Cooper, Project Access would not be able to help so many. We thank the more than 616 volunteer physicians, hospitals, ambulatory surgery centers, and ancillary health providers for their support and dedication to the uninsured and underserved in our community.

//////////////////////////////////////////////// We Celebrate Excellence – James Strebig, MD CAP member, internal medicine physician, and former President of the Orange County Medical Association.

800-252-7706 www.CAPphysicians.com San Diego orange LoS angeLeS PaLo aLTo SacramenTo

For 35 years, the Cooperative of American Physicians, Inc. (CAP) has provided California’s finest physicians, like Irvine internal medicine specialist James Strebig, MD, with superior medical professional liability protection through its Mutual Protection Trust (MPT).

Physician owned and physician governed, CAP rewards excellence with remarkably low rates on medical professional liability coverage – up to 40 percent less than our competitors.

CAP members also enjoy a number of other valuable benefits, including comprehensive risk management programs, best-in-class legal defense, and a 24-hour CAP Cares physician hotline. And MPT is the nation’s only physician-owned medical professional liability provider rated A+ (Superior) by A.M. Best.

We invite you to join the more than 11,500 preferred California physicians already enjoying the benefits of CAP membership.

Superior Physicians. Superior Protection.

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