Editorial Board: James Santiago Grisolia, MD; David E.J. Bazzo, MD; William T-C Tseng, MD; Holly B. Yang, MD, MSHPEd, HMDC, FACP, FAAHPM
Marketing & Production Manager: Jennifer Rohr
Art Director: Lisa Williams
Copy Editor: Adam Elder
OFFICERS
President: Steve H. Koh, MD
President–Elect: Preeti S. Mehta, MD
Immediate Past President: Nicholas (dr. Nick) J. Yphantides, MD, MPH
Secretary: Maria T. Carriedo-Ceniceros, MD
Treasurer: Karrar H. Ali, DO, MPH
GEOGRAPHIC DIRECTORS
East County #1: Catherine A. Uchino, MD
East County #2: Rachel Van Hollebeke, MD Hillcrest #1: Kyle P. Edmonds, MD
Hillcrest #2: Stephen R. Hayden, MD (Delegation Chair)
Kearny Mesa #1: Anthony E. Magit, MD, MPH
Kearny Mesa #2: Dustin H. Wailes, MD
La Jolla #1: Toluwalasé (Lasé) A. Ajayi, MD
North County #1: Arlene J. Morales, MD (Board Representative to the Executive Committee)
North County #2: Christopher M. Bergeron, MD, FACS
North County #3: Nina Chaya, MD
South Bay #1: Paul J. Manos, DO
South Bay #2: Latisa S. Carson, MD
AT–LARGE DIRECTORS
#1: Rakesh R. Patel, MD, FAAFP, MBA (Board Representative to the Executive Committee)
#2: Kelly C. Motadel, MD, MPH
#3: Irineo (Reno) D. Tiangco, MD #4: Miranda R. Sonneborn, MD #5: Daniel D. Klaristenfeld, MD
#6: Alexander K. Quick, MD
#7: Karl E. Steinberg, MD, FAAFP #8: Alejandra Postlethwaite, MD
ADDITIONAL VOTING DIRECTORS
Young Physician: Emily A. Nagler, MD
Retired Physician: Mitsuo Tomita, MD
Medical Student: Christina Noravian
CMA OFFICERS AND TRUSTEES
Trustee: Holly B. Yang, MD, MSHPEd, HMDC, FACP, FAAHPM
Trustee: Sergio R. Flores, MD
Trustee: Timothy A. Murphy, MD
AMA DELEGATES AND ALTERNATE DELEGATES
District I: Mihir Y. Parikh, MD
District I Alternate: William T–C Tseng, MD, MPH
At–Large: Albert Ray, MD
At–Large: Robert E. Hertzka, MD
At–Large: Theodore M. Mazer, MD
At–Large: Kyle P. Edmonds, MD
At–Large: Holly B. Yang, MD, MSHPEd, HMDC, FACP, FAAHPM
At–Large Alternate: Sergio R. Flores, MD
CMA DELEGATES
District I: Steven L.W. Chen, MD, FACS, MBA
District I: Vikant Gulati, MD
District I: Eric L. Rafla-Yuan, MD
District I: Ran Regev, MD
District I: Quinn Lippmann, MD
District I: Kosala Samarasinghe, MD
District I: Mark W. Sornson, MD
District I: Wynnshang (Wayne) C. Sun, MD
District I: Patrick A. Tellez, MD, MHSA, MPH
District I: Randy J. Young, MD
Opinions expressed by authors are their own and not necessarily those of SanDiegoPhysician or SDCMS. SanDiegoPhysicianreserves 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 SanDiegoPhysicianin no way constitutes approval or endorsement by SDCMS of products or services advertised. SanDiegoPhysicianand 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. SanDiegoPhysicianis 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.]
Candidate Statements SDCMS Board of Directors, 2025-2026
16
California Medical Association Unveils 2025 Sponsored Bill Package By CMA Staff
Briefly Noted: Healthcare Heroes • Healthcare IT
13 SDCMS Board of Directors Holds Annual Retreat in Desert By Paul Hegyi, MBA
14
Dr. ‘Lase’ Ajayi Stars in AD Council Initiative to Reduce Gun Violence Deaths Among America’s Children and Youth By SDCMS Staff 14
18
Some CT Scanners Deliver Too Much Radiation, Researchers Say. Regulators Want to Know More. By Joanne Kenen
20
Advocacy Beyond the Bedside By Christina Noravian
21
Classifieds
Dr. Michael A. Lobatz: A Decade of Service and Leadership Fighting Azheimer’s in San Diego County
Editors’ Note: Dr. Lobatz recently stepped down after a decade of service as chair of the Alzheimer’s Project Clinical Roundtable. We thank Dr. Lobatz for his lengthy term of leadership and sacrifice, and want to share a message he wrote to the physicians of San Diego County upon the conclusion of his chairmanship.
Dear Esteemed Colleagues, Ten years ago, The Alzheimer’s Project was born out of recognition of the growing number of patients and caregivers affected by Alzheimer’s disease and related disorders in our community. In collaboration with then-San Diego Board of Supervisors chairwoman Dianne Jacob and the County Board of Supervisors, multiple system stakeholders and organizations came together to take on measures of standardization of screening and diagnosis of dementia. Neuroscientists and clinicians including neurologists, geriatricians, psychiatrists, neuropsychologists, family practice and internal medicine came together from disparate and often competitive health systems to work collaboratively and establish guidelines for screening, diagnosis, and management of Alzheimer’s disease and related disorders.
A lot has happened over the last 10 years, including the advent of monoclonal antibody therapies (and its attendant controversies), and new, much more precise biomarkers. As such, we have published regularly updated versions of the guidelines, the most recent of which was completed in June 2024. Using these guidelines, several thousand primary care providers have been educated and updated on the guidelines over time. Most recently, this we believe has helped improve the recognition of memory disorders and provide more accurate diagnosis and management in San Diego County. Additionally, we have received grant funding for a research project that is embedding the guidelines in a work-flow-friendly EMR environment involved in a set of primary care clinics at UCSD.
The guidelines have been used across California and in other states in the U.S. A recent study found that San Diego County has one of the highest incidences nationwide of an AD diagnosis that we believe to be due to improved education and recognition of this public health issue in our community.
I cannot say enough about the collaboration from our partners from UCSD, Kaiser, Sharp, Scripps, VA Hospital, and multiple other stakeholders including San Diego State University, Alzheimer’s San Diego, Alzheimer’s Association, Southern Caregivers Resource Center, and many others. It cannot go without mention, appreciation for the tremendous support of the San Diego County Medical Society; the current president, Steve Koh, MD, and many of the past chairs have been intimately involved in this work. Additionally, the administrative leadership of Champions for Health and Barbara Mandel. With Barbara’s support, the work of the various committees, research efforts, and publication of the guidelines in print, electronic, webinars, and more would not have been possible. It has been my distinct honor and privilege to have helped lead this effort over the past 10 years. It is only through collaboration and kindness of all those involved that we have come this far. As the Clinical Roundtable moves forward with its work to strengthen systems of care for those facing Alzheimer’s disease and related dementias, this strong collaboration will continue to reap great benefits for our community.
Sincerely yours,
Michael A. Lobatz, M.D., APC Diplomate, American Board of Psy chiatry and Neurology Chair, Clinical Round Table, San Diego Alzheimer Project Senior Neurologist, The Neurol ogy Center Medical Director Emeritus, Scripps Rehabilitation & Traumat ic Brain Injury Program
HEALTHCARE HEROES
Dr. Jim Schultz Honored
By Paul Hegyi, SDCMS chief executive officer
I HAD THE PLEASURE TO JOIN Neighborhood Healthcare at an intimate event they held March 15, recognizing Dr. Jim Schultz with their Servant Leader of the Year award.
Dr. Schultz embodies the essence of servant leadership through his unwavering dedication to his patients and the medical community. As chief medical officer at Neighborhood Healthcare, he has consistently demonstrated compassion, leadership, and a commitment to whole-person care. In 2016 Dr, Schultz launched Neighborhood’s tattoo removal services for
HEALTHCARE IT
Register Now for HIT Summit in San Diego
on May 6-7
Dr. Schultz receiving the award from Dr. Rakesh Patel, chief executive officer of Neighborhood Healthcare.
gang members and victims of human trafficking, helping them reclaim their identities and move forward with their lives.
Beyond his clinical expertise, Dr. Schultz generously shares his knowledge as a volunteer clinical professor, mentoring future generations of healthcare professionals. His service extends globally, with medical mission treks in the Himalayas and beyond. Additionally, Dr. Schultz has volunteered his time to organizations such as Be There San Diego and Project Access San Diego. His leadership includes his work with the San Diego County Medical Society, where he served as president. His humility, generosity, and dedication to improving lives, both locally and internationally, make him a deserving winner of the Servant Leader Award.
CMA’S HIT SUMMIT WILL TAKE PLACE MAY 6–7 IN SAN DIEGO. California’s premier health IT event will bring together thought leaders, innovators, and healthcare professionals to explore the intersection of healthcare technology under the theme “Building the Future.” As healthcare continues to evolve through digital innovation and the rise of artificial intelligence, the HIT Summit will offer a deep dive into the tools, strategies, and partnerships shaping the industry. Attendees can expect engaging sessions on AI, health information exchange and QHIOs, and the evolving role of technology in patient care. Use the code “SDCMS” for a $50 discount for registration. Learn more and register at cmadocs.org/HealthIT
Candidate Statements
OF DIRECTORS
Note:
• (inc.) After Name = Incumbent
• Number in Parentheses (#) After Name = Term Length in Years
OFFICERS
Candidate for PresidentElect: Maria T. CarriedoCeniceros, MD (1)
I am grateful to be considered for the post of president-elect of the San Diego County Medical Society. I have had the privilege to serve on the SDCMS board of directors for the past nine years and have seen firsthand the valuable role advocacy plays in meeting the needs of our patients and our physicians. While serving on the board, I have watched physicians from all specialties, modes of practices, and regions come together for the betterment of the diverse communities and patients of San Diego County. During the past three years serving on the executive committee, I have gained further knowledge about the work and responsibilities of SDCMS in ensuring the voices of our patients and physicians are heard and honored. Through my various leadership roles, I have continued to appreciate the value of collaboration and unity among our fellow colleagues. I have been the VP and chief medical officer for San Ysidro Health Center since 2012. Serving the underserved and addressing health disparities has been my passion throughout my career. Ensuring continued access to high quality of care for all our communities has made workforce development an additional priority and led to my work in graduate medical education. It will be an honor and a privilege to serve as your SDCMS president-elect and I ask for your continued trust and support. Thank you.
Candidate for Secretary: Karrar H. Ali, DO, MPH (1) It is a privilege and honor to be a candidate for secretary. As part of the executive committee for the San Diego County Medical Society, my goal is to promote our physicians to thrive.
I am an emergency medicine physician and have been in practice for almost 20 years. Educated and trained in Chicago, I moved to San Diego in 2007 and started working at Sharp Chula Vista Medical Center. I am a senior partner with Vituity, a multi-specialty, national physician group that staffs the Sharp Chula Vista emergency department. In my career, I have been fortunate to have been involved with both my ED group and Sharp Chula Vista and Sharp Coronado. During my tenure at Sharp, I have been on the hospital throughput committee and the medical executive committee. Additionally, I am on faculty with the University of Rochester Mindfulness in Medicine program, leading sessions on mindfulness and wellness to healthcare providers.
I have been involved with the San Diego County Medical Society board of directors for more than a decade. The advocacy we do at the county and state level and the education we provide throughout the county has benefitted physicians in all specialties. SDCMS and CMA have been instrumental in advocating for physicians for MICRA, during the pandemic, and when there were threats to Medi-Cal and access to care.
My hope is to continue to advocate for my colleagues throughout the county so that we may be able to take care of our patients and help them navigate through our healthcare system.
On a personal level, I live with my wife, Shahrzad Nooravi, a business psychologist, and my nephew, a UCSD student who aspires to become a physician. And two years ago, I started a concierge medical service, La Jolla Concierge MD, that is a membership-based medical practice serving La Jolla and the surrounding area. Thank you for your support.
Candidate for Treasurer:
Rakesh R. Patel, MD, FAAFP, MBA (1)
I am honored to be nominated for the position of treasurer of the San Diego County Medical Society. I am a family physician and the CEO of Neighborhood Healthcare, a Federally Qualified Health Center and PACE organization, serving more than 100,000 patients who are underserved and medically needy. I am also a CMA delegate
representing the Medium Size Group Practice Forum as well as serve on the Council of Legislation. My background in family medicine allows me to speak of the various challenges of primary care: access, reimbursement, administrative burdens, staffing, etc. I also understand the many challenges of running a healthcare organization. My overarching goals are to improve the health of our community, while continuing to advocate for the under- and uninsured.
GEOGRAPHIC DIRECTORS
Candidate for Hillcrest Director #1: Vikant Gulati, MD (3)
It is a privilege to be considered for a position representing the physicians of San Diego County, along with the patients and broader community we serve. Healthcare advocacy has been a passion of mine since 2010, when I was invited during residency to meet with national House
and Senate leaders. Coming from a smaller state at the time, direct access to policymakers was common. However, it was eye-opening to realize that many of those shaping healthcare policies lacked the medical expertise we, as physicians, bring to the table. That moment solidified my commitment to advocacy, ensuring that sound medical knowledge informs decisions affecting our practice and our patients.
Since then, healthcare advocacy has remained my passion and professional focus. Upon moving to California in 2012, I was honored to be selected as the Healthcare and Advocacy Fellow for the California Chapter of the American College of Physicians. Under the mentorship of exceptional leaders, I learned how to drive meaningful change in both emergency medicine and healthcare at large. Some of my proudest achievements include contributing to the redesign of CURES 2.0, advocating for legislation enabling emergency consent for research in critical patients, and serving as a chapter president during the height of the COVID-19 pandemic. During that time, we tackled critical issues including securing PPE, ventilator support, and ensuring safe living conditions for providers and their families. All the while working collaboratively with the broader medical community to navigate the crisis.
Over the past two years, I have been privileged to witness and contribute to the exemplary work of San Diego County Medical Society. The collaborative spirit among specialties and physicians has been inspiring, as we collectively strive to protect and strengthen medical practice in San Diego County. I am equally impressed by the dedication of our membership in supporting the initiatives of our medical society, making us leaders in innovative, practicechanging care not just in California, but across the nation.
I am deeply grateful for the opportunity to serve as a steward of this esteemed organization. My goal is to uphold and protect our achievements while driving continued progress. I am committed to listening, advocating, and working tirelessly on behalf of those I represent. I look forward to collaborating with you to transform ideas into impactful realities that benefit our patients, our colleagues, and the future of medicine in San Diego County.
Candidate for Hillcrest Director #2: Stephen R. Hayden, MD (inc.) (3)
For most of my career in the fields of emergency medicine and hyperbaric medicine at UC San Diego, I have been involved in national specialty societies and have advocated for the practicing emergency physician in various capacities. Ultimately, I decided to focus more on local San Diego and California issues and so, in addition to serving on the medical society’s board of directors, I have the privilege of being the District 1 delegation chair to the CMA. It has been a great experience to participate in the annual House of Delegates, and to help determine the major topics the CMA will address each year. There are many challenges currently facing California physicians, and I believe it is as important as ever for community physicians and academic physicians to partner and face these together. For over 20 years, I have been directly involved with the American Board of Emergency Medicine as an item writer oral examiner, and technical editor for the MOC program. I have also served on the board of directors for the American Academy of Emergency Medicine in my capacity as the editor-in-chief of the Journal of Emergency Medicine These experiences will allow me to contribute to SDCMS’s advocacy efforts.
After a tour of duty as senior flight surgeon for the Naval Strike Warfare Center NAS Fallon, Nevada, I completed my emergency medicine residency at the University Medical Center at Stony Brook, New York. I am the previous associate dean for Graduate Medical Education at UC San Diego, after serving as the program director of the Emergency Medicine Residency. I am a past president of the national Council of Emergency Medicine Residency Directors and currently serve as the associate program director for the EM residency based at Temecula Valley Hospital. I have endeavored to use this experience to represent all physicians in San Diego with both the SDCMS and the CMA. I am passionate about teaching, assisting the underserved in our community every shift I work, healthcare advocacy, and advancing clinical research. If reelected, I would consider it a privilege to continue to serve the San Diego County Medical Society and its members.
Candidate for La Jolla Director #1: Toluwalase (Lase) A.
Ajayi, MD (inc.) (3)
It has been an honor to serve on the San Diego County Medical Society (SDCMS) board of directors for the past 10 years and on the executive committee for the past seven. I am privileged to once again ask for your support as I seek election as a director for La Jolla.
Throughout my time with SDCMS, I have been dedicated to ensuring that the voices of physicians and the patients we serve are heard at every level of policy and advocacy. I previously served as an atlarge director before joining the executive committee in 2017, holding leadership roles as treasurer (2018–2019), secretary (2019–2020), president-elect (2020–2021), and president during the critical post-COVID era (2021–2022).
Beyond SDCMS, I have actively represented San Diego physicians at the California Medical
Association (CMA), serving on the Council on Legislation, the Ethnic Minority Section, and as past chair of the Council on Medical Services. These roles have allowed me to advocate for meaningful policy changes that support both physicians and our patients.
Physicians today are burdened by mounting challenges — burnout, workforce shortages, unsustainable Medicare and Medicaid cuts, and increasing government interference in the physician-patient relationship. These issues threaten not only the viability of our practices but also the quality of care we provide. Now, more than ever, we need strong physician advocates to ensure our collective voice is heard and that we push back against policies that undermine our profession and patient care.
I remain committed to this fight and to working alongside my colleagues to protect the future of medicine in San Diego. I would be honored to have your support as I seek election as a La Jolla director on the SDCMS board.
Candidate for La Jolla Director #2: Audra R. Meadows, MD, MPH, FACOG (1) I am honored to be considered for a position on the San Diego County Medical Society (SDCMS) board of directors.
As a board-certified OB/GYN, professor, and vice chair at UC San Diego, I have dedicated my career to strengthening physician leadership, transforming health systems, and advancing policies that promote equitable, excellent care for all.
Throughout my career, I have served in key leadership roles within organized medicine, including the American College of Obstetricians and Gynecologists (ACOG) Massachusetts Section and the Massachusetts Medical Society, where I worked to shape maternal health policies and statewide quality initiatives. As a founding director of the Perinatal-Neonatal Quality Improvement Network of Massachusetts (PNQIN) and lead for the state’s AIM Initiative and Maternal Equity Bundle, I collaborated with hospitals, policymakers, and clinicians to drive measurable improvements in maternal outcomes across more than 30 hospitals.
At UC San Diego, my work continues this
mission through NIH-funded research, health systems science education, equity-focused perinatal quality improvement, and leadership in the Center for Learning Health Systems. SDCMS plays a vital role in advocating for physicians, strengthening professional wellbeing, and ensuring healthcare policies reflect the needs of both providers and patients.
As a strong advocate for physicians at every stage of their careers, I am committed to bringing my expertise in policy, quality improvement, and health system leadership to the board. I look forward to the opportunity to collaborate with my colleagues, advocate for our profession, and strengthen the future of medicine in San Diego.
It would be an honor to contribute my experience to the important work of SDCMS.
Candidate for La Jolla Director #3: Emily A. Nagler, MD (3)
I have had the immense privilege of serving on the board of directors as the Young Physician Section director. As I have progressed in my career, I have found that the San Diego County Medical Society has transformed this large city into a close-knit community. Knowing that I have a fantastic group of doctors I know and trust to send patients and family members to, while working together to create a greater good for physicians in our city, has been such a comfort. My goal is to continue to provide that same service to my colleagues all over the county. Living and working in La Jolla as well as having clinics in Hillcrest and Oceanside allows me to see the unique variety in patient and physician needs throughout San Diego County. I would be honored to be a La Jolla director in SDCMS, and appreciate the opportunity to continue to serve on the board of directors in this role.
Candidate for North County Director #2:
Theophilos (Phil) E. Yphantides, MD (3)
I am truly honored to be nominated for the San Diego County Medical
Society North County director position. I am blessed with a 28year marriage to the love of my life and have three wonderful adult children. Since graduating from UCSD School of Medicine in 1997 and completing my family medicine residency at UCSD in 2000, I have spent my entire career serving the San Diego community.
From 2000 to 2006, I worked in full-time patient care at Neighborhood Healthcare and Palomar Hospital, serving as outpatient medical director.
From 2006 to 2022, I worked with Sharp Rees-Stealy Medical Group in family medicine and urgent care, collaborating with teams on quality, value, and patient experience initiatives. I also served on the board of directors and as medical director for the group’s urgent cares.
Since 2022, I have been privileged to serve as the chief medical officer of Palomar Health Medical Group, where I continue to support and empower our practicing physicians. In addition to my clinical and administrative roles, I serve on the board
of directors for TrueCare, helping to guide the critical work of our local community health center safety-net providers.
As physicians and community leaders, we must continue to collaborate to improve the patient experience, quality of care, value, and clinician wellbeing amid the growing complexity of modern healthcare. I am excited about the opportunity to work alongside physician leaders across the county to champion these priorities and ensure that all our patients receive exceptional care, regardless of where they seek it. Thank you for considering me for this role on the SDCMS board.
AT-LARGE DIRECTORS
Candidate for At-large Director #3: Kyle P. Edmonds, MD (3)
I am a clinical professor of medicine and a palliative medicine specialist at UC San Diego where I have held multiple leadership roles over the past 13 years. At the CMA, I am the vice chair of the Council on Membership, Governance, and Bylaws, represent the University of California at the Council on Legislation, and serve as a member of the Governance Reform Technical Advisory Committee. I am also a delegate from California to the American Medical Association and an active member of the policy work of the PacWest Caucus. I have been involved in organized medicine and health policy since I was a first-year medical student and am grateful to be considered for another term on the board of directors.
Candidate for At-large Director #5: Daniel D. Klaristenfeld, MD, FACS (inc.) (3)
It is an honor to be considered for a position on the San Diego County Medical Society board of directors. As a general and colorectal surgeon at Kaiser Permanente in San Diego, it is my privilege to bring the view of a subspecialist working in a community setting to SDCMS. Thank you for your support and encouragement.
YPS DIRECTOR
Candidate for YPS
Director: Quinne C.
Sember, MD (1)
I completed my fellowship in hematology/ oncology at Scripps in June 2024 and now work as a breast medical oncologist at UCSD. Given this recent transition, I am acutely aware of the issues faced by physicians early in their careers. I recognize the important role that SDCMS can play in improving these issues and hope to broaden its influence among my peers. I first joined SDCMS while in fellowship and have been impressed by my experiences with it thus far. I have prior experience in organized medicine, including serving as a district delegate in the Resident and Fellow Section of CMA during my time in fellowship and experience with the Texas Medical Association and physician advocacy groups working to improve healthcare for patients in Houston during my internal medicine residency. I hope to expand my experience in organized medicine through SDCMS as I appreciate the important role organizations such as these can play in ensuring the future of medicine is bright for all of those involved. I am honored to be considered for this role.
AMA DISTRICT I DELEGATE
Candidate for AMA District I Alternate
Delegate: William T-C
Tseng, MD, MPH (inc.) (3)
It is an honor to be your AMA candidate. For over two decades, I have practiced in San Diego and witnessed firsthand the impact of numerous policy decisions on patient care. I believe that active participation in the AMA House of Delegates is critical to advocating for meaningful and lasting improvements in healthcare.
I have had the privilege of serving as your past president and as your representative at the CMA board of trustees. These experiences have given me deep insight into the challenges physicians face and the leadership necessary to drive meaningful change.
I am passionate about advancing policies that address social determinants of health, reduce health disparities, and promote health equity. These are issues where the AMA has a vital role to play. At the same time, I am committed to fostering physician leadership among our next generation, particularly among medical students and residents. The AMA serves as a powerful platform for mentorship and professional growth, and I am eager to work alongside my colleagues to drive progress while empowering the next generation of physician leaders.
As we confront the challenges ahead, it is more important than ever that we raise our voices at the national level to ensure that fact, not fiction, prevails; that misinformation is challenged and dispelled; and that the voices of those who provide care from the first lines are not silenced remotely by distant policymakers who dictate from the social media channels of DC. Physicians must be the ones to shape the future of healthcare.
As medicine enters a new era, we must
take an active role in the integration of artificial intelligence — guiding the technology rather than being guided by it. We have all seen the consequences of relinquishing control, as electronic medical records remind us daily of what happens when external forces dictate how we practice. We cannot let industry interests alone shape the future of our profession.
For over two years, I have worked to understand the role of AI in healthcare and have been fortunate to contribute to these discussions while assisting in teaching a course on its applications. This journey has deepened my appreciation for both the potential and the challenges of AI in medicine. By standing together, physicians can ensure that technology enhances patient care rather than undermines it, keeping the focus where it truly belongs, on our patients.
Thank you for considering my candidacy for AMA alternate delegate. I am committed to serving as a strong and effective advocate for San Diego and look forward to working with my colleagues to help align and advance the mission of the AMA.
CMA DISTRICT I DELEGATES
Candidate for CMA District I Delegate: Christopher Mark Bergeron, MD,FACS (3) I am honored to be considered for reelection to the board of directors of the San Diego County Medical Society. As a surgeon in our community, I have seen firsthand the incredible impact that a strong, unified medical society can have on advocating for both patients and healthcare professionals. I once again ask for your support to be able to continue to contribute my experience, vision, and commitment to improving the healthcare landscape in San Diego.
With 20-plus years of experience in organized medicine, I understand the challenges that physicians face in providing the highest quality care while navigating an increasingly complex healthcare system. Through my head and neck surgery practice, I have witnessed the evolving needs of our patients and the pressures placed on medical professionals; from administrative burdens to financial constraints to the grow-
ing demand for equity in healthcare access. As a member of the SDCMS board, my goals have, and will continue to be, to help shape policy that fosters better work-life balance for physicians, promotes innovative patient care solutions, and ensures the sustainability of our healthcare system.
I am passionate about advocacy and collaboration, and I believe in the power of the collective voice. Together, we can create a stronger, more supportive environment for physicians and the patients we serve. I look forward to bringing my leadership skills, problem-solving abilities, and deep dedication to the board, where I will continue to work to ensure that our organization remains a powerful advocate for patients and medical professionals in San Diego.
Candidate for CMA District I Delegate:
Corrie D. Broudy, MD (3)
I am a rheumatologist at Sharp Rees Stealy and have the good fortune to be challenged by complicated patients and do what I love. Also, I have had the honor to serve as the division chief since 2020 and as a member of the SRS Well Being Committee and the Sharp Metro Campus Well Being Committee since 2014. I have worked tirelessly to improve physician satisfaction and prevent burnout. This was challenging when I first started working on the Well Being Committee and has proven to be a bigger test since the COVID pandemic.
I am grateful and honored to be nominated to serve on the SDCMS board. I have had the pleasure to represent SDCMS at the CMA House of Delegates in 2024. I look forward to greater participation and opportunities to work with the physicians in San Diego to make our voices heard so that we can continue to provide the best medical care to our patients. I look forward to collaboration with other physicians in San Diego to address the challenges we face in this rapidly changing environment. I look forward to working with you to advocate to improve access to care and services, and bring back the joy into our medical practices.
Candidate for CMA District I Delegate: Edward (Lalo) R. Cachay, MD (3) It is both a privilege and an honor to be considered as your District I delegate. As your representative, I am committed to ensuring that our physicians not only survive but thrive in today’s challenging healthcare environment.
Since joining UC San Diego in 2001, I have dedicated my career to clinical care, teaching, and research, with a focus on infectious diseases and HIV. My personal journey, academic career, and leadership roles have deeply shaped my understanding of the challenges we face. Over the past decade, serving in various leadership positions, including on the UCSD board of governors, I have learned to navigate the complexities of productivity-based models and reimbursement systems while advocating for access to quality care for all patients.
None of this is
possible without prioritizing our physicians’ and clinical staff’s wellbeing and satisfaction. If elected, I will bring an attentive ear and a strong voice to the SDCMS board, representing your interests, enhancing our profession’s mission, and improving patient care. Together, we can create a fulfilling and sustainable future for all physicians.
I humbly ask for your support and the opportunity to serve you. Thank you for your consideration.
Candidate for CMA District I Delegate:
Steven L. Chen, MD, FACS, MBA (inc.) (3)
It is an honor to be considered for reelection to a position as a delegate for SDCMS. As a surgical oncologist in independent practice with offices in Mira Mesa and Encinitas, I hold privileges in the Scripps, Sharp, and Palomar systems, allowing me to get a broad overview of county issues. Prior to my current practice, I have been an academic physician at UC Davis while serving as chief of breast surgery and an employed physician at City of Hope in Los Angeles. Through these different places, I have developed experience in multiple practice modes and will ensure that our policies and positions take all modes of practice into account. My experience in organized medicine has spanned serving on the board of the Los Angeles County Medical Association and the Sierra Sacramento Valley Medical Society, as well as nationally including being a past president of the American Society of Breast Surgeons, as well as prior service on the governing councils of the Young Physicians Section of the AMA and the Young Fellows Association of the American College of Surgeons. I continue to serve on committees of the AMA, American College of Surgeons, Society of Surgical Oncology, and the American Society of Breast Surgeons and thus stay up to date on the issues facing the professional practice of surgery and medicine, while also serving as a delegate in the AMA House of Delegates, giving me a broader view of the needs of other specialties. I continue to believe that if we do not defend our profession and our ability to act as professionals in the best interests of our patients, we will lose the right to be a profession. SDCMS
and organized medicine are key links to ensuring that being a physician continues to mean being a professional. I ask for your support to allow me to help represent you and your concerns.
Candidate for CMA
District I Delegate:
Mojgan Hosseini, MD (3)
I am honored to be considered for the board of the San Diego County Medical Society. As a physician deeply committed to our medical community, I believe SDCMS provides an essential platform where physicians can unite their voices to advocate for excellence in patient care and physician wellbeing.
I am a pathologist and chair of physician board of governors at UCSD Health. I have been a practicing physician in San Diego County for the last decade. Throughout my career, I have gained valuable leadership experiences across healthcare systems and have actively participated in various healthcare initiatives.
As healthcare continues to evolve, physicians face unprecedented challenges. SDCMS plays a crucial role in addressing these challenges by providing a unified voice for physicians at local, state, and federal levels. My vision for SDCMS centers on a few key priorities: strengthening physician wellness, environment of practice, and professional relationships, advancing health equity and access to care, and mentoring the next generation of medical professionals. I believe that by fostering stronger connections within our physician community, we can better serve our patients and address the evolving challenges in healthcare delivery.
I am committed to working collaboratively with our members to address these issues while preserving the fundamental values of our profession. I thank you for your support and I look forward to the opportunity to serve our medical community and advance the mission of SDCMS.
San Diego County Medical Society board. I have served in this role on the board for the past year, and it is a privilege to work with physicians across many specialties and practice types to unify our voices and work toward improving healthcare for our patients and quality of life for our members. I am a member of the CMA Council on Medical Services, helping to identify issues most relevant to our state medical community and craft resolutions that guide our legislative priorities. I am also the current vice chair of the District 1 delegation to the House of Delegates.
new physicians and medical students and showing them that while this work is serious, it is also fun and invigorating!
With the tumultuous political landscape, coming together as physicians is more vital than ever, and I would be honored to continue my work with the SDCMS board. Sincerely, Quinn Lippmann, MD, MPH
Candidate for CMA
District I Delegate: Yolanda Marzan, MD (3)
Candidate for CMA District I Delegate:
Quinn K. Lippman, MD, FACOG, MPH (inc.) (3)
I am honored to be considered for a District 1 delegate position on the
As a urogynecologist with the Permanente group, I bring the perspective of a large group physician. Prior to moving to California in 2023, I was a partner in a 30-physician private practice in Virginia. Working in two very different practice models has given me varying perspectives that allow me to see different sides of the patient and physician experience, and I bring this broad view to the board. I am passionate about organized medicine and love engaging
It is an honor to serve and be considered for a term as an SDCMS District 1 delegate. I am a physician anesthesiologist at Anesthesia Services Medical Group (ASMG), practicing predominantly in the South Bay for the past nine years. I have served as chairperson of the department of anesthesia at Sharp Chula Vista Medical Center for four years, have been a board member in ASMG for three years, and currently serve as vice president/president-elect of ASMG. It is a privilege to advocate for patient care, in particular access to patient care services in underserved communities. I also look forward to promoting the value and importance of physician anesthesiologist presence in all surgeries and combating physician impersonation by allied health providers in all fields of practice, in particular anesthesiology. Our collective voice through the CMA is extremely important if we wish to truly be heard and make a change. It is a privilege to be chosen to be a part of this group, and I look forward to contributing and maintaining the highest level of patient care for all our communities. Thank you for the opportunity.
Candidate for CMA District I Delegate: Bijal V. Patel, MD, MBA(3)
I am honored to seek a position on the board of directors of the San Diego County Medical Society. As a dedicated physician, leader, and advocate, my mission is simple: Care for the people who care for people.
Physicians are the backbone of our healthcare system, yet we face increasing pressures — administrative burdens, declining autonomy,
and systemic inefficiencies that take us away from what we do best: caring for our patients. If elected, I will champion physician-first policies that restore joy to medicine, protect our professional integrity, and amplify our collective voice in shaping the future of healthcare.
As president of Balboa Nephrology, we work with our 50-plus physicians to serve all of San Diego and Imperial Valley counties. We drive patient-centered, value-based care, integrating innovative models to enhance physician autonomy, and ensuring our voices are central in healthcare decision-making. We strive for negotiating partnerships that are physicianled and pursue implementing stainable care models. I am committed to doing the right thing and empowering physicians.
With my background as an MBA graduate and fellow at the Center for Innovative Leadership at Johns Hopkins, I hope to bring strategic leadership to SDCMS, ensuring that we advocate for doctors, by doctors.
My priorities include advocating for physician autonomy, fighting for policies that put decision-making back in the hands of doctors, reducing burnout by cutting bureaucracy and improving work-life balance, and supporting financial and contracting strategies that help physicians navigate the business side of medicine. I will work to strengthen advocacy efforts at the local and state levels, ensuring our voices are heard and respected. By fostering collaborative innovation, we can drive physician-led solutions that shape the future of healthcare.
Together, we can strengthen, protect, and uplift the medical community in San Diego. I would be honored to serve you and advocate for our profession, our future, and our patients. I respectfully ask for your support and your vote.
Candidate for CMA District I Delegate:
Kristen N. Rice, MD (3)
Thank you for considering me for the position of District I delegate. I was active in the student section of the Colorado Medical Society and AMA during medical school, and have recently felt a pull to return to this important work. I am a hematologist/oncologist in a midsized private practice. Like many of you, I have noticed my daily work
and the care of my patients becoming ever more difficult. It feels as though every day brings a new hoop we must jump through to get our patients the tests and treatments they need to be healthy. The insurance and pharmaceutical companies have powerful lobbyists to shape healthcare legislation so that it works for them, and if physicians are not at the table advocating for ourselves and our patients, they will define the future of healthcare. We can’t allow that to happen. Becoming active in the medical society makes me feel like I am doing my part to change medicine for the better.
I attended the recent California Medical Association House of Delegates meeting as a temporary delegate. It was exciting to again be in a room full of physicians focused on the same goal: deciding how best to use our energy and influence as a medical society. I also observed that District I is an exceptionally strong, informed, and passionate group of physician leaders. I am looking forward to working with them and learning from them for the next 3 years and beyond.
Candidate for CMA District I Delegate:
Mark W. Sornson, MD, PhD (inc.) (3)
It has been my privilege to have served as a pastpresident of SDCMS, and multiple other roles within SDCMS and CMA, representing the physicians of San Diego. Taking part in the presidency, executive committee, board, and finance and legislative committees has reinforced my conviction that when we speak with a unified voice and build relationships, we can make a difference.
Serving as a San Diego delegate to the House of Delegates, I will continue to bring the perspective of our local physicians to the matters raised at the House. We in San Diego have a voice at CMA beyond our numbers due to the strength of our advocacy and the strong local support of our members. Decisions made today on our key issues will greatly affect our futures. I am honored to ask for your vote to continue my service as a Delegate.
Candidate for CMA District I Delegate: Nicholas “dr. Nick” J. Yphantides, MD (3)
I am so grateful for the opportunity I had to serve as the president of our medical society last year and for my current role on the board as the immediate past-president. These are very dynamic times in healthcare and I am committed to continuing to advocate for our regional physician family and the precious patients that we all so diligently serve. My professional passion has been to be a catalyst to improve the health and wellbeing of our local population with a primary focus on those who need it the most.
Currently, I am serving in a tapestry of strategic yet part-time roles, including as the clinical adviser for the San Diego Wellness Collaborative, which is a regional nonprofit organization that improves health equity and population health in San Diego County through multistakeholder collaborative initiatives. Up until recently, I was supporting Palomar Health and Palomar Health Medical Group as a part-time executive clinical consultant, and I continue to
serve as a volunteer board member for a variety of charity and local service-based organizations. For 12 years, I was so blessed with the strategic and impactful opportunity to be the first ever chief medical officer of the County of San Diego’s Health and Human Services Agency. During that time, I helped lead the regional COVID response, and provided leadership in response to the county’s hepatitis-A outbreak and the migrant caravan crisis. My role also included oversight over the regional emergency medical system, leadership of Medi-Cal’s Healthy San Diego, and as a public advocate for Live Well San Diego. Prior to my service with the county, I served as the CMO of one of the largest regional Federally Qualified Health Centers called Neighborhood Health Care, was the publicly elected board chair of Palomar Health, and was the first CMO of the Council of Community Clinics.
As a candidate for the District I delegate position, I look forward to my ongoing involvement on our board and advocating for our noble profession locally while working to strengthening our regional collective impact even further. Together we must continue to strive to improve the health and wellness of our patients and their families. My greatest
life joy is as the fulltime single father for my two daughters and being an actively engaged resident of my Escondido community. Your support is sincerely appreciated.
CMA RFS DELEGATE
Candidate for CMA District I RFS Delegate: Shawn A. Ali, MD (1) I am privileged to be considered for the 2025–2026 RFS Delegate of the San Diego County Medical Society. I began my medical training here in San Diego and returned to complete my hematology/oncology fellowship. I am passionate about addressing critical issues in healthcare, including access to quality care, physician wellbeing, and advancing medical education. I aim to bring the voices of residents and fellows to the forefront, ensuring our perspectives shape policy and drive meaningful change. With a collaborative spirit and commitment to equity, I will work tirelessly to represent our community’s interests and uphold the values of excellence and compassion in medicine.
SDCMS Board of Directors Holds Annual Retreat in Desert
By Paul Hegyi, MBA
UNDER THE LEADERSHIP OF DR. Preeti S. Mehta, president-elect of SDCMS, your physician leaders gathered together in early February for our annual board retreat at the Omni Rancho Las Palmas Resort in Rancho Mirage. Special thanks to Jennipher Ohmstede, SDCMS’s senior director of governance and operations, for all her hard work in organizing this intensive event. Along with the trust falls and human knots (kidding), we had a jam-packed schedule focused on leadership development and planning for the year.
SDCMS was honored to welcome Bobby Mukkamala, MD, president-elect of the American Medical Association, who spoke with the group and participated in all of the activities. Dr. Mukkamala was introduced by his college roommate, Dr. Mihir Parikh, his college roommate and SDCMS board member. Dr. Mukkamala’s speech was particularly dramatic given that he had successful brain surgery just a few months earlier.
The California Medical Association’s (CMA) general counsel Jamie Ostroff conducted a seminar on board responsibilities, conflict of interest, and antitrust compliance, and former CMA vice president Molly Weedn conducted a media engagement seminar.
Dr. Robert Hertzka made a presentation on the political activities of SDCMS and what are anticipated to be the most competitive local campaigns of 2026. Dr. Holly Yang, CMA trustee, updated the board members on CMA governance while Dr. Stephen Hayden led a session on the processes involved in composing and passing policy resolutions for the California Medical Association.
While we are likely to face many serious challenges related to healthcare policy at the state and federal level this year, your SDCMS board is well positioned to work together and advocate on behalf of your patients and the physicians of San Diego.
Dr. ‘Lasé’ Ajayi Stars in Ad Council Initiative to Reduce Gun Violence Deaths Among America’s Children and Youth
By SDCMS Staff
SAN DIEGO’S OWN TOLÚWALÀSÉ
“Lasé” Ajayi, MD, FAAP, is starring in a public service announcement (PSA) that’s part of an extensive new campaign by the Ad Council to reduce gun violence deaths among children and teens. The effort, dubbed “Agree to Agree” focuses on a nonpartisan and positive message of family safety and protecting children from gun deaths, which is now the leading cause of death for children and teens.
“Gun violence in America impacts us all and, tragically, it is the leading cause of death for children and teens in the United States,” said Michelle Hillman, chief campaign development officer for the Ad Council. “It is time we change the belief that conversations about gun violence always end in a heated debate or impasse. This powerful new work shows that we all have a role in creating positive change, starting from the common ground we share.”
In announcing its anti-gun violence initiative, the Ad Council stated, “The campaign is releasing two distinct efforts today, reaching two unique audiences. The first speaks to parents and those with youth in their lives — relatives, caregivers, and neighbors — and the second reaches healthcare professionals who are on the front lines and are trusted messengers for patients’ health and safety. Both components of the “Agree to Agree” effort are based in
common ground. They raise awareness of the fact that everyone — including gun owners and non-gun owners — can agree that firearms shouldn’t be the leading cause of death for children and teens in this country and that we can take action to protect these vulnerable communities.”
The Ad Council adds further, “As firearm injuries and deaths have risen over the last several decades, hospitals
and healthcare systems and clinicians have been on the front lines of this crisis, treating tens of thousands of firearm injuries annually. As trusted pillars within their communities, healthcare professionals are pivotal in keeping the country’s children healthy and are uniquely equipped to engage with their patients about proven public health practices that can keep young people safe.”
The Ad Council continues, “The second content series launching … features healthcare professionals speaking directly to other healthcare professionals on the responsibility and unique role they hold to help prevent firearm injuries through supportive conversations with their patients. The video series directs audiences to AgreeToAgree.org/ HealthCare to learn more.”
As Dr. Ajayi points out in the extend-
of parents support healthcare systems playing a role in preventing and reducing gun violence
Source:
Northwest Health Gun Violence Prevention Issues
& Creative Testing, July 2022
“
ed two-minute-and-20-second version of her PSA, a major public education campaign was successfully conducted 20 years ago to reduce what was then the number-one cause of death for children and teens: automobile vehicle accidents.
Dr. Ajayi’s video is complemented by videos by Dr. Chethen Sathya, pediatric surgeon and trauma director at Cohen Children’s Hospital; Kurt Michael, PhD, senior clinical director of the Jed Foundation, which tackles suicide prevention; and Zac Shepherd, RN.
As Michael points out in his PSA video, 80% of firearm suicides by youths are committed with household guns, and safe storage of guns in the home is critical to suicide prevention among young people.
Dr. Ajayi, a pediatrician and palliative care physician, offers her experience and approach on how to most effectively discuss firearm safety for children in the home with patients.
“Let’s agree to agree that we can all make a difference.”
In pediatrics, talking about firearms and safe storage, things like that is just part of the medicine that we give. It’s not about judging you or trying to change your lifestyle. It’s about how do we partner with you so that your family has the best outcome so everybody is safe and healthy and growing really well.”
–DR. “LASÉ” AJAYI
California Medical Association Unveils 2025 Sponsored Bill Package
By CMA Staff
THE CALIFORNIA MEDICAL Association (CMA) released its sponsored bill package for the 2025 legislative session. The seven-bill package tackles issues relating to bureaucratic delays in providing care, private equity’s influence on medicine, the use of artificial intelligence in healthcare, and increasing the physician workforce.
“CMA is advancing bold solutions that protect patients and prioritize their care,” said CMA President Shannon Udovic-Constant, MD. “We are taking a strong stand against private
equity’s profit-driven interference in medicine and pushing to end bureaucratic delays that harm patients. Our proactive approach to regulating artificial intelligence ensures that technology supports, rather than replaces, physician decision making. We are driving change to ensure that patients always come first in our healthcare system.”
The bills in CMA’s sponsored bill package include:
SB 351 by Senator Christopher Cabaldon (SD 3): Private equity firms
are gaining influence in our healthcare system, leading to rising costs and undermining the quality of care. SB 351 empowers the attorney general to hold private equity groups accountable for interfering with the practice of medicine, allowing the attorney general to investigate and take action against private equity firms that unlawfully interfere in the patient-physician relationship. The goal is to restore trust in the healthcare system, ensuring that medical decisions are made in the best interest of patients, not financial shareholders.
AB 489 by Assemblymember Mia Bonta (AD 18): While AI can be a useful tool in healthcare, it should not replace physician decision making. This bill would ban companies from marketing
artificial intelligence (AI) chatbots as licensed medical professionals.
AB 967 by Assemblymember Avelino Valencia (AD 68): California is facing a physician shortage, leaving millions of residents waiting weeks and months to get critical care. This bill will streamline the process for licensing out-ofstate physicians looking to practice in California.
Additionally, CMA is sponsoring a bill package titled “Prioritizing Patients, Empowering Physicians” to cut bureaucracy in the health system that harms patients and delays the ability to provide care. The red tape, called prior authorization, has been shown to unnecessarily delay care and lead to serious adverse events such as hospitalizations, permanent bodily damage, and even death. The Prioritizing Patients, Empowering Physicians package includes:
AB 510 by Assemblymember Dawn Addis (AD 30): Requires that appeals of prior authorization denials be performed by a provider of the same or similar specialty. This will help ensure that providers can discuss prior authorization denials with a professional peer who understands the recommended treatment and underlying condition.
AB 539 by Assemblymember Pilar Schiavo (AD 40): Extends the validity of an approved prior authorization to one year (current industry standard is 60 to 90 days). This will provide patients with a longer window of time to receive medically necessary care and avoid the cumbersome prior authorization review and appeal processes.
AB 512 by Assemblymember John Harabedian (AD 41): Requires health plans to respond to urgent prior authorization requests within 24 hours and respond to nonurgent requests within 48 hours. Currently, health plans have 72 hours for urgent requests and five days for nonurgent requests. This change will ensure more patients can receive care or appeal denials in a timely fashion.
SB 306 Senator Josh Becker (SD 13): Requires health plans to remove the requirement for prior authorization from any service that they approve more than 90% of the time. This will reduce the overall volume of prior authorization requests and ensure that patients can receive the care they need with minimal delay and physicians can spend more time focusing on patient care.
CMA thanks our partners in the assembly and senate for championing legislation to improve the quality, integrity, and accessibility of our healthcare system.
Some CT Scans Deliver Too Much Radiation, Researchers Say. Regulators Want to Know More.
By Joanne Kenen
REBECCA SMITH-BINDMAN, MD, a professor at the University of California-San Francisco medical school, has spent well over a decade researching the disquieting risk that one of modern medicine’s most valuable tools, computerized tomography scans, can sometimes cause cancer.
Dr. Smith-Bindman and like-minded colleagues have long pushed for federal policies aimed at improving safety for patients undergoing CT scans. Under new Medicare regulations effective this year, hospitals and imaging centers must start collecting and sharing more information about the radiation their scanners emit.
About 93 million CT scans are performed every year in the United States, according to IMV, a medical market research company that tracks imaging. More than half of those scans are for people 60 and older. Yet there is scant regulation of radiation levels as the machines scan organs and structures inside bodies. Dosages are erratic, varying widely from one clinic to another, and are too often unnecessarily high, Dr. Smith-Bindman and other critics say.
“It’s unfathomable,” Dr. Smith-Bindman said. “We keep doing more and more CTs, and the doses keep going up.”
One CT scan can expose a patient to
10 or 15 times as much radiation as another, Dr. Smith-Bindman said. “There is very large variation,” she said, “and the doses vary by an order of magnitude — tenfold, not 10% different — for patients seen for the same clinical problem.” In outlier institutions, the variation is even higher, according to research she and a team of international collaborators have published.
She and other researchers estimated in 2009 that high doses could be responsible for 2% of cancers. Ongoing research shows it’s probably higher, since far more scans are performed today.
The cancer risk from CT scans for any individual patient is very low,
although it rises for patients who have numerous scans throughout their lives. Radiologists don’t want to scare off patients who can benefit from imaging, which plays a crucial role in identifying life-threatening conditions like cancers and aneurysms and guides doctors through complicated procedures.
But the new data collection rules from the Centers for Medicare & Medicaid Services issued in the closing months of the Biden administration are aimed at making imaging safer. They also require a more careful assessment of the dosing, quality, and necessity of CT scans.
The requirements, rolled out in January, are being phased in over about three years for hospitals, outpatient settings, and physicians. Under the complicated reporting system, not every radiologist or healthcare setting is required to comply immediately. Providers could face financial penalties under Medicare if they don’t comply, though those will be phased in, too, starting in 2027.
When the Biden administration issued the new guidelines, a CMS spokesperson said in an email that excessive and unnecessary radiation exposure was a health risk that could be addressed through measurement and feedback to hospitals and physicians. The agency at the time declined to make an official available for an interview. The Trump administration did not respond to a request for comment for this article.
The Leapfrog Group, an organization that tracks hospital safety, welcomed the new rules. “Radiation exposure is a very serious patient safety issue, so we commend CMS for focusing on CT scans,” said Leah Binder, the group’s president and CEO. Leapfrog has set standards for pediatric exposure to imaging radiation, “and we find significant variation among hospitals,” Binder added.
CMS contracted with UCSF in 2019 to research solutions aimed at encouraging better measurement and assessment of CTs, leading to the develop-
ment of the agency’s new approach.
The American College of Radiology and three other associations involved in medical imaging, however, objected to the draft CMS rules when they were under review, arguing in written comments in 2023 that they were excessively cumbersome, would burden providers, and could add to the cost of scans. The group was also concerned, at that time, that health providers would have to use a single, proprietary tech tool for gathering the dosing and any related scan data.
The single company in question, Alara Imaging, supplies free software that radiologists and radiology programs need to comply with the new regulations. The promise to keep it free is included in the company’s copyright. Dr. Smith-Bindman is a co-founder of Alara Imaging, and UCSF also has a stake in the company, which is developing other health tech products unrelated to the CMS imaging rule that it does plan to commercialize.
But the landscape has recently changed. ACR said in a statement from Judy Burleson, ACR vice president for quality management programs, that CMS is allowing in other vendors — and that ACR itself is “in discussion with Alara” on the data collection and submission. In addition, a company called Medisolv, which works on healthcare quality, said at least one client is working with another vendor, Imalogix, on the CT dose data.
Several dozen health quality and safety organizations — including some national leaders in patient safety, like the Institute of Healthcare Improvement — have supported CMS’s efforts.
Concerns about CT dosing are longstanding. A landmark study published in JAMA Internal Medicine in 2009 by a research team that included experts from the National Cancer Institute, the
Department of Veterans Affairs, and universities estimated that CT scans were responsible for 29,000 excess cancer cases a year in the United States, about 2% of all cases diagnosed annually.
But the number of CT scans kept climbing. By 2016, it was estimated at 74 million, up 20% in a decade, though radiologists say dosages of radiation per scan have declined. Some researchers have noted that U.S. doctors order far more imaging than physicians in other developed countries, arguing some of it is wasteful and dangerous.
More recent studies, some looking at pediatric patients and some drawing on radiation exposure data from survivors of the atomic bomb attacks on Hiroshima and Nagasaki in Japan, have also identified CT scan risk.
Older people may face greater cancer risks because of imaging they had earlier in life. And scientists have emphasized the need to be particularly careful with children, who may be more vulnerable to radiation exposure while young and face the consequences of cumulative exposure as they age.
Max Wintermark, MD, MS, MBA, a neuroradiologist at the MD Anderson Cancer Center in Houston, who has been involved in the field’s work on appropriate utilization of imaging, said doctors generally follow dosing protocols for CT scans. In addition, the technology is improving; he expects artificial intelligence to soon help doctors determine optimal imaging use and dosing, delivering “the minimum amount of radiation dose to get us to the diagnosis that we’re trying to reach.”
But he said he welcomes the new CMS regulations.
“I think the measures will help accelerate the transition toward always lower and lower doses,” Dr. Wintermark said. “They are helpful.”
Joanne Kenen is a journalist for KFF Health News, where this article first appeared. KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling, and journalism.
Advocacy Beyond the Bedside
Reflections on Health Policy and Medical Student Leadership
By Christina Noravian
I ENTERED MEDICAL SCHOOL WITH a simple yet sincere goal: to help people. Like many of my peers, I aspired to become a physician to provide compassionate, clinically informed care that met the full spectrum of my patients’ needs. Included in these needs were the social determinants of health, like food security and environmental justice, which I was equally as emboldened to advocate for. Despite recognizing the importance of advocacy, however, I initially saw medicine and politics as two separate worlds. My job is to treat patients, not to be a politician, I thought. As I have progressed through my MS1 year at UC San Diego School of Medicine, I am often confronted by the question of what it means to be a “good doctor” in a healthcare system that fails to provide equitable care. How do we, as medical students and future physicians, confront the systemic barriers that undermine patient health?
This question led me to Dr. Robert Hertzka’s “Fundamentals of Healthcare Policy, Advocacy, and Leadership” course this winter. There I learned that physician advocacy and lobbying are just as important to patient outcomes as reaching a diagnosis or crafting a treatment plan. In a nation where health policy has historically been
shaped without physician input, the personal becomes political.
Dr. Hertzka’s course led us through the history of Medicare and Medicaid in the U.S. to contextualize the health policies that exist today. We discussed pharmaceutical development and drug costs, debated the feasibility of singlepayer healthcare, and learned the realities of advocacy through a local physician panel. With each class, my sense of disillusionment with the U.S. healthcare system shifted, as Dr. Hertzka reframed our sense of powerlessness into a striking call to action. I soon came to view my frustrations as fertile ground for growth through advocacy.
Throughout our course, we were introduced to examples of successful, physician-led advocacy and taught the skills to replicate such efforts ourselves. We learned from the California Medical Association’s Dustin Corcoran about the creation of Prop 35, and from Supervisor Monica Montgomery Steppe about public health
initiatives at the county level. These speakers illustrated the importance of community partnerships, stakeholder involvement, and respect for dissenting opinions. It was clear that centering patients ultimately led to frameworks that unify resources and streamline health policies. Even more apparent was an understanding that change happens slowly, and that people will inevitably disagree along the way. Anchoring in a bipartisan, patient-centered approach seemed key to the coalition-building and relationships needed to sustain substantive progress.
Dr. Hertzka’s emphasis on advocacy as a learned skill further helped bring these teachings into a more attainable view. With hands-on media training and grassroots lobbying exercises, we were able to repeatedly put theory into practice. We discovered firsthand that advocacy is harder than it looks — but also, that we are more capable than we know.
I am deeply grateful to Dr. Hertzka and all our guest speakers for not only introducing us to this world of health policy, but also for equipping us with the tools to succeed in it. Advocacy, I’ve learned, is a form of wellness and community-building in times of chaos. In just three months, my classmates and I explored the complex realities of health policy — spanning healthcare spending, Prop 35, and the debate around universal healthcare. It would be easy to walk away from these discussions feeling overwhelmed or disheartened, yet the course left us with a critical takeaway: Hopelessness serves no one. Together, we must be able to confront the challenges in our healthcare system and still believe in our ability to transform them.
Christina Noravian is an MD candidate in the class of 2028 at UC San Diego School of Medicine. She is also the medical student representative on the San Diego County Medical Society’s board of directors.
PRACTICE ANNOUNCEMENTS
VIRTUAL SPEECH THERAPY AVAILABLE: Accepting new pediatrics and adult patients. We accept FSA/HSA, Private pay, Medicare, Medi-Cal, and several commercial insurance plans pending credentialing. Visit virtualspeechtherapyllc.org or call 888-855-1309.
PSYCHIATRIST AVAILABLE: Accepting new patients for medication management, crisis visits, ADHD, cognitive testing, and psychotherapy. Out of network physician servicing La Jolla & San Diego. Visit hylermed.com or call 619-707-1554.
PHYSICIAN OPPORTUNITIES
CLINICAL DIRECTOR | BEHAVIORAL HEALTH SCIENCES | FAMILY MEDICINE/INTERNAL MEDICINE PHYSICIAN | PHMG
RAMONA: Palomar Health Medical Group is seeking a Family Medicine or Internal Medicine Physician (MD/DO) to join our multi-specialty practice at our Ramona clinic location. Experienced physicians and new graduates are encouraged to apply. Clinic schedule is Mon – Fri, outpatient only, no weekends or holidays. We offer competitive salary of $300k/year or more depending on experience. In addition, we offer productivity and other bonuses, PTO, CME reimbursement, health, dental, vision insurance, participation in 401K with partial employer match, short and long-term disability, and life insurance. Student loan repayment assistance is also available. Join Palomar Health Medical Group, where we’re reimagining healthcare with compassion, excellence, and integrity. Please email CV to clayton.trosclair@ palomarhealth.org or phil.yphantides@phmg.org.
COUNTY OF SAN DIEGO: The County of San Diego is seeking a dynamic physician with a passion for building healthy communities. This is an exceptional opportunity for a California licensed, Board–certified, Physician to help transform the local behavioral health continuum of care and lead important work within the Health and Human Services Agency’s Behavioral Health Services department. Visit the county website to view a detailed brochure outlining the duties and responsibilities of the position and file your application. Anticipated Hiring Range: $310,000 to $320,000 annually. In addition to the base salary, the incumbent may receive a 10 % premium for Board Certification or a 15 % premium for Board Certification and Sub–specialty. [2877-0225]
VENOUS DISEASE SPECIALIST | NORTH COUNTY: La Jolla Vein & Vascular, the premier vein care provider in San Diego, is seeking a highly skilled and experienced Venous Disease Specialist to join our team at our newest location in Vista, CA, nestled in the stunning coastal region of North County San Diego. This full-time position offers competitive salary and benefits, including profit-sharing and a 401(k). Our state-of-the-art facility operates Monday through Friday, with no weekend or night shifts, promoting an excellent work-life balance. Ideal candidates may also consider a locum or locum-to-hire arrangement. Join us in making a difference in our patients’ lives while enjoying your dream location! Email cv to jobs@ljvascular.com. [2875-1030]
PART–TIME PRIMARY CARE PHYSICIAN: Primary Care Clinic in San Diego searching for part-time physician for 1 to 2 days a week, no afterhours calls. Please send CV to medclinic1@yahoo.com. [2872-0909]
OB/GYN POSITION AVAILABE | EL CENTRO: A successful Private OBGYN practice in El Centro, CA seeking a board eligible/ certified OB/GYN. Competitive salary and benefits package is available with a tract of partnership. J-1 Visa applicants are welcome. Send CV to feminacareo@gmail.com or call Katia M. at 760-352-4103 for more information. [2865-0809]
COUNTY OF SAN DIEGO PROBATION DEPT. MEDICAL DIRECTOR: The County of San Diego is seeking dynamic physician leaders with a passion for building healthy communities. This is an exceptional opportunity for a California licensed, Board-certified, physician to help transform our continuum of care and lead essential medical initiatives within the County’s Probation Department. Anticipated Hiring Range: Depends on Qualifications Full Salary Range: $181,417.60 - $297,960.00 annually. As part of the Probation Administrative team, the Medical Director is responsible for the clinical oversight and leadership of daily operations amongst Probation facilities’ correctional healthcare programs and services. As the Medical Director, you will have significant responsibilities for formulating and implementing medical policies, protocols, and procedures for the Probation Department.
PART–TIME CARDIOLOGIST POSITION AVAILABLE: Cardiology office in San Marcos seeking part–time cardiologist. Please send resume to Dr. Keith Brady at uabresearchdoc@yahoo.com. [2873-0713]
INTERNAL MEDICINE PHYSICIAN: Federally Qualified Health Center located in San Diego County has an opening for an Internal Medicine Physician. This position reports to the chief medical officer and provides the full scope of primary care services, including diagnosis, treatment, and coordination of care to its patients. The candidate should be board eligible and working toward certification in Internal Medicine. Competitive base salary, CME education, Four weeks paid vacation, year one, 401K plan, No evenings and weekends, Monday through Friday 8:00am to 5:00pm. For more information or to apply, please contact Dr. Keith Brady at: uabresearchdoc@yahoo. com. [2874-0713]
FAMILY MEDICINE/INTERNAL MEDICINE PHYSICIAN: San Diego Family Care is seeking a Family Medicine/Internal Medicine Physician (MD/DO) at its Linda Vista location to provide outpatient care for acute and chronic conditions to a diverse adult population. San Diego Family Care is a federally qualified, culturally competent and affordable health center in San Diego, CA. Job duties include providing
complete, high quality primary care and participating in supporting quality assurance programs. Benefits include flexible schedules, no call requirements, a robust benefits package, and competitive salary. If interested, please email CV to sdfcinfo@sdfamilycare.org or call us at (858) 810-8700.
PHYSICIAN POSITIONS WANTED
PART–TIME CARDIOLOGIST AVAILABLE: Dr. Durgadas Narla, MD, FACC is a noninvasive cardiologist looking to work 1-2 days/week or cover an office during vacation coverage in the metro San Diego area. He retired from private practice in Michigan in 2016 and has worked in a San Marcos cardiologist office for the last 5 years, through March 2023. Board certified in cardiology and internal medicine. Active CA license with DEA, ACLS, and BCLS certification. If interested, please call (586) 206-0988 or email dasnarla@gmail.com.
OFFICE SPACE / REAL ESTATE AVAILABLE
MEDICAL OFFICE FOR SUBLEASE OR SHARE: A newly remodeled and fully built–out medical clinic in Torrey Hills. The office is approximately 2,700 sq ft with 5 fully equipped exam rooms, 1 lab, 1 office, spacious and welcoming waiting room, spacious reception area, large breakroom, and ADA–accessible restroom. All the furniture and equipment are new and modern design. Ample parking. Perfect for primary care or any specialty clinic. Please get in touch with Charlie at (714) 271-0476 or cmescher1@gmail.com. Available immediately. [2871-0906]
LA JOLLA/XIMED OFFICE TO SUBLEASE: Modern upscale office on the campus of Scripps Hospital — part or full time. Can accommodate any specialty. Multiple days per week and full use of the office is available. If interested please email kochariann@yahoo.com or call (818) 319-5139. [2866-0904]
SUBLEASE AVAILABLE: Sublease available in modern, upscale Medical Office Building equidistant from Scripps and Sharp CV. Ample free parking. Class A+ office space/medical use with high-end updates. A unique opportunity for Specialist to expand reach into the South Bay area without breaking the bank. Specialists can be accommodated in this first floor high-end turnkey office consisting of 1670 sq ft. Located in South Bay near Interstate 805. Half day or full day/week available. South Bay is the fastest growing area of San Diego. Successful sublease candidates will qualify to participate in ongoing exclusive quarterly networking events in the area. Call Alicia, 619-585-0476.
OFFICE SPACE FOR SUBLEASE | SOUTHEAST SAN DIEGO: 3 patient exam rooms, nurse’s station, large reception area and waiting room. Large parking lot with valet on-site, and nearby bus stop. 286 Euclid Ave - Suite 205, San Diego, CA 92104. Please contact Dr. Kofi D. Sefa-Boakye’s office manager: Agnes Loonie at (619) 435-0041 or ams66000@aol.com. [2869-0801]
MEDICAL OFFICE FOR SALE OR SUBLEASE: A newly remodeled and fully built-out primary care clinic in a highly visible Medical Mall on Mira Mesa Blvd. at corner of Camino Ruiz. The office is approximately 1000 sq ft with 2 fully equipped exam rooms, 1 office, 1 nurse station, spacious and welcoming waiting room, spacious reception area, and ADA accessible restroom. All the furniture and equipment are new and modern design. Ample parking. Perfect for primary care or any specialty clinic. Please contact Nox at 619-776-5295 or noxwins@ hotmail.com. Available immediately.
RENOVATED MEDICAL OFFICE AVAILABLE | EL CAJON: Recently renovated, turn-key medical office in freestanding single-story unit available in El Cajon. Seven exam rooms, spacious waiting area with floor-to-ceiling windows, staff break room, doctor’s private office, multiple admin areas, manager’s office all in lovely, drought-resistant garden setting. Ample free patient parking with close access to freeways and Sharp Grossmont and Alvarado Hospitals. Safe and secure with round-the-clock monitored property, patrol, and cameras. Available March 1st. Call 24/7 on-call property manager Michelle at the Avocado Professional Center (619) 916-8393 or email help@ avocadoprofessionalcenter.com.
OPERATING ROOM FOR RENT: State of the Art AAAASF Certified Operating Rooms for Rent at Outpatient Surgery of Sorrento. 5445 Oberlin Drive, San Diego 92121. Ideally located and newly built 5 star facility located with easy freeway access in the heart of San Diego in Sorrento Mesa. Facility includes two operating rooms and two recovery bays, waiting area, State of the Art UPC02 Laser, Endoscopic Equipment with easy parking. Ideal for cosmetic surgery. Competitive Rates. Call Cyndy for more information 858.658.0595 or email Cyndy@ roydavidmd.com.
PRIME LOCATION | MEDICAL BUILDING LEASE OR OWN OPPORTUNITY IN LA MESA: Extraordinary opportunity to lease or lease-to-own a highly visible, freeway-oriented medical building in La Mesa, on Interstate 8 at the 70th Street on-ramp. Immaculate 2-story, 7.5k square foot property with elevator and ample free on-site parking (45 spaces). Already built out and equipped with MRI/CAT machine. Easy access to both Alvarado and Sharp Grossmont Hospitals, SDSU, restaurants, and walking distance to 70th St Trolley Station. Perfect for owner-user or investor. Please contact Tracy Giordano [Coldwell Banker West, DRE# 02052571] for more information at (619) 987-5498.
KEARNY MESA OFFICE TO SUBLEASE/SHARE: 5643 Copley Dr., Suite 300, San Diego, CA 92111. Perfectly centrally situated within San Diego County. Equidistant to flagship hospitals of Sharp and Scripps healthcare systems. Ample free parking. Newly constructed Class A+ medical office space/medical use building. 12 exam rooms per half day available for use at fair market value rates. Basic communal medical
supplies available for use (including splint/cast materials). Injectable medications and durable medical equipment (DME) and all staff to be supplied by individual physicians’ practices. 1 large exam room doubles as a minor procedure room. Ample waiting room area. In office x-ray with additional waiting area outside of the x-ray room. Orthopedic surgery centric office space. Includes access to a kitchenette/indoor break room, exterior break room and private physician workspace. Open to other MSK physician specialties and subspecialties. Building occupancy includes specialty physicians, physical therapy/occupational therapy (2nd floor), urgent care, and 5 OR ambulatory surgery center (1st floor). For inquiries contact kdowning79@gmail.com and scurry@ ortho1.com for more information. Available for immediate occupancy.
LA JOLLA/UTC OFFICE TO SUBLEASE OR SHARE: Modern upscale office near Scripps Memorial, UCSD hospital, and the UTC mall. One large exam/procedure room and one regular-sized exam room. Large physician office for consults as well. Ample waiting room area. Can accommodate any specialty or Internal Medicine. Multiple days per week and full use of the office is available. If interested please email drphilipw@gmail.com.
ENCINITAS MEDICAL SPACE AVAILABLE: Newly updated office space located in a medical office building. Two large exam rooms are available M-F and suitable for all types of practice, including subspecialties needing equipment space. Building consists of primary and specialist physicians, great for networking and referrals. Includes access to the break room, bathroom and reception. Large parking lot with free parking for patients. Possibility to share receptionist or bring your own. Please contact coastdocgroup@gmail.com for more information.
NORTH COUNTY MEDICAL SPACE AVAILABLE: 2023 W. Vista Way, Suite C, Vista CA 92082. Newly renovated, large office space located in an upscale medical office with ample free parking. Furnishings, decor, and atmosphere are upscale and inviting. It is a great place to build your practice, network and clientele. Just a few blocks from TriCity Medical Center and across from the urgent care. Includes: multiple exam rooms, access to a kitchenette/break room, two bathrooms, and spacious reception area all located on the property. Wi-Fi is not included. For inquiries contact hosalkarofficeassist@gmail.com or call/ text(858)740-1928.
MEDICAL EQUIPMENT / FURNITURE FOR SALE
UROLOGY OFFICE CLOSING 6/2023 | EQUIPMENT AVAIL-
ABLE: Six fully furnished exam rooms including tables (2 bench, 3 power chair/table, 1 knee stirrup), rolling stools, lights, step stools, patient chairs. Waiting room chairs, tables, magazine rack. Specialty items—Shimadzu ultrasound, SciCan sterilizer, Dyonics camera with Sharp monitor, Medtronic Duet urodynamics with T-DOC catheters, Bard prostate biopsy gun with needles, Cooper Surgical urodynamics, Elmed ESU cautery, AO 4 lens microscope. RICOH MP-3054 printer with low print count. For more information contact: r.pua@cox.net.
NON–PHYSICIAN POSITIONS AVAILABLE
NURSE PRACTITIONER | PHYSICIAN ASSISTANT: Open position for Nurse Practitioner/Physician Assistant for an outpatient adult medicine clinic in Chula Vista. Low volume of patients. No call or weekends. Please send resumes to medclinic1@yahoo.com. [2876-1121]
POSTDOCTORAL SCHOLARS: The Office of Research Affairs, at the University of California, San Diego, in support of the campus, multidisciplinary Organized Research Units (ORUs) https://research.ucsd. edu/ORU/index.html is conducting an open search for Postdoctoral Scholars in various academic disciplines. View this position online: https://apol-recruit.ucsd.edu/JPF03803. The postdoctoral experience emphasizes scholarship and continued research training. UC’s postdoctoral scholars bring expertise and creativity that enrich the research environment for all members of the UC community, including graduate and undergraduate students. Postdocs are often expected to complete research objectives, publishing results, and may support and/or contribute expertise to writing grant applications https://apol-recruit. ucsd.edu/JPF03803/apply. [2864-0808]
RESEARCH SCIENTISTS (NON–TENURED, ASSISTANT, ASSOCIATE OR FULL LEVEL): The University of California, San Diego campus multidisciplinary Organized Research Units (ORUs) https://research.ucsd.edu/ORU/index.html is conducting an open search for Research Scientists (non–tenured, assistant, associate or full level). Research Scientists are extramurally funded, academic researchers who develop and lead independent research and creative programs similar to Ladder Rank Professors. They are expected to serve as Principal Investigators on extramural grants, generate high caliber publications and research products, engage in university and public service, continuously demonstrate independent, high quality, significant research activity and scholarly reputation. Appointments and duration vary depending on the length of the research project and availability of funding. Apply now at https://apol-recruit.ucsd.edu/ JPF04188/apply. [2867-0904]
PROJECT SCIENTISTS: Project Scientists (non-tenured, Assistant, Associate or Full level): The University of California, San Diego, Office of Research and Innovation https://research.ucsd.edu/, in support of the Campus multidisciplinary Organized Research Units (ORUs) https://research.ucsd.edu/ORU/index.html is conducting an open search. Project Scientists are academic researchers who are expected to make significant and creative contributions to a research team, are not required to carry out independent research but will publish and carry out research or creative programs with supervision. Appointments and duration vary depending on the length of the research project and availability of funding: https://apol-recruit.ucsd.edu/ JPF04189/apply. [2868-0904]
