Soaring
TOWARD A HEALTHIER SAN DIEGO
Champions for Health
2024–2025 Annual Report
Research shows: Physicians want to refer patients to hospice care provided by an independent nonprofit with specialized clinicians who also teach.
Refer your patients to the 1 organization in our area that meets all these criteria: The Elizabeth Hospice.
More than 100 physicians in our area recently participated in research and specified the attributes they value most in hospice care:
The Elizabeth Hospice is the largest, most experienced nonprofit hospice and palliative care provider in San Diego and Riverside Counties, and a proud teaching affiliate of UCSD School of Medicine, UCSD Health, Scripps Health, and other leading medical schools and residency training programs.
Our physicians and nurses, all with subspecialty training, have a close relationship with many physicians in our area and are honored to be their top choice when they refer adult and pediatric patients and their families for comprehensive, compassionate care and grief services.
To recommend truly exceptional hospice care –for a patient, friend, or loved one – refer to the organization trusted for more than 45 years:
Editor: William T–C Tseng, MD, MPH
Editorial Board: James Santiago Grisolia, 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: Preeti S. Mehta, MD
President–Elect: Maria T. Carriedo-Ceniceros, MD
Immediate Past President: Steve H. Koh, MD
Secretary: Karrar H. Ali, DO, MPH
Treasurer: Rakesh R. Patel, MD, FAAFP, MBA
GEOGRAPHIC DIRECTORS
East County #2: Rachel B. Van Hollebeke, MD
Hillcrest #1: Vikant Gulati, 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: Toluwalase (Lase) A. Ajayi, MD
La Jolla #2: Audra R. Meadows, MD
La Jolla #3: Emily A. Nagler, MD
North County #1: Arlene J. Morales, MD (Board Representative to the Executive Committee)
North County #2: Phil E. Yphantides, MD
North County #3: Nina Chaya, MD
South Bay #1: Paul J. Manos, DO
South Bay #2: Latisa S. Carson, MD
AT–LARGE DIRECTORS
#1: Steven L.W. Chen, MD, FACS, MBA (Board Representative to the Executive Committee)
#2: Kelly C. Motadel, MD, MPH
#3: Kyle P. Edmonds, 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: Quinne C. Sember, MD
Retired Physician: Mitsuo Tomita, MD
Medical Student: Adarsh Jagadish
CMA OFFICERS AND TRUSTEES
Trustee: Sergio R. Flores, MD
Trustee: Timothy A. Murphy, MD
Trustee: William T–C Tseng, MD, MPH
Trustee: Holly B. Yang, MD, MSHPEd, HMDC, FACP, FAAHPM
AMA DELEGATES AND ALTERNATE DELEGATES
District I: Mihir Y. Parikh, MD
District I Alternate: William T–C Tseng, MD, MPH
At–Large: Kyle P. Edmonds, MD
At–Large: Sergio R. Flores, MD
At–Large: Robert E. Hertzka, MD
At–Large: Theodore M. Mazer, MD
At–Large: Albert Ray, MD
At–Large: Holly B. Yang, MD, MSHPEd, HMDC, FACP, FAAHPM
CMA DELEGATES
District I: Christopher M. Bergeron, MD, FACS
District I: Corrie D. Broudy, MD
District I: Mojgan Hosseini, MD
District I: Quinn K. Lippmann, MD
District I: Yolanda Marzan, MD
District I: Bijal V. Patel, MD
District I: Eric L. Rafla-Yuan, MD
District I: Ran Regev, MD
District I: Kristen N. Rice, 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
District I: Nicholas (dr. Nick) J. Yphantides, MD, MPH
RFS Delegate: Shawn A. Ali, 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.]
FEATURES
4 California’s Physician Community Loses Beloved Latino Pioneer: Dr. Ralph Ocampo Passes at 93 By Kevin Spillane
7 Champions for Health Annual Report 2024–2025 By Adama Dyoniziak
15
The Waters Rise Unevenly: Flooding, Health, and Who Gets Left Behind By Chioma Ugwonali, Christine James, MD, Angie Neison, MD, and Wael Al-Delaimy, MD, PhD
15
DEPARTMENTS
2 Briefly Noted Advocacy • Practice Management • Physician Workforce
18
Dementia with Lewy Bodies May Be More Common Than We Think By Judy George
20
Classifieds
AMA, CMA and All State Medical Societies Back Legislation to Strengthen No Surprises Act Enforcement
What You Need to Know: CMA joined AMA, every state medical society, and dozens of national healthcare organizations in urging Congress to pass bipartisan legislation aimed at strengthening enforcement of the No Surprises Act after insurers are repeatedly failing to comply with binding IDR payment determinations.
THE
CALIFORNIA MEDICAL ASSOCIATION
(CMA), alongside the American Medical Association (AMA), all 50 state medical societies and 46 national healthcare organizations, is urging Congress to pass bipartisan legislation designed to strengthen enforcement of the federal No Surprises Act.
In a letter sent to congressional leaders, the organizations expressed support for the “No Surprises Act Enforcement Act” (H.R. 4710/S. 2420), which would authorize penalties for parties that fail to comply with statutory payment timelines following a final and binding Independent Dispute Resolution (IDR) determination.
The No Surprises Act, which took effect in 2022, was intended to protect patients from unexpected medical bills for emergency care and certain out-of-network services while establishing an independent process for resolving payment disputes between physicians and health plans.
However, physician organizations say insurers are increasingly failing to comply with the law’s clear payment requirements — even after physicians prevail in the IDR process.
“Physicians continue to report that health plans are failing to make payments within the statutory 30-day timeframe following an IDR determination in the physician’s favor,” the letter states. “In some cases, physicians report receiving no payment at all despite the law’s clear requirement that such determinations ‘shall be binding upon the parties involved.’”
The organizations warned that these practices place significant financial strain on physician practices, particularly smaller and independent practices that have limited ability to challenge insurer noncompliance.
“This means that physician practices are forced to absorb unpaid costs, finance delays, and shoulder uncertainty while insurers retain funds they are legally obligated to pay,” the letter said.
The legislation would provide federal regulators with explicit authority to enforce IDR decisions and impose penalties on parties that fail to comply with final payment determinations.
“Our organizations remain fully committed to the core purpose of the No Surprises Act: protecting patients from surprise medical bills while ensuring physicians and other healthcare providers receive fair and timely payment for the medical services they provide,” the organizations wrote. “We remain deeply invested in this law’s successful implementation and in achieving the balanced framework Congress intended.”
The congressional letter follows a separate letter recently sent by AMA, CMA, and 111 specialty societies and state medical associations to federal administration officials urging stronger oversight and enforcement of the No Surprises Act amid ongoing concerns about insurer compliance.
The latest letter was signed by every state medical society, the Medical Society of the District of Columbia, and dozens of national physician and healthcare organizations, including the American College of Emergency Physicians, American Society of Anesthesiologists, American College of Radiology, and American Academy of Family Physicians.
TRICARE West Now Requiring Availity for Referrals and Authorizations
EFFECTIVE APRIL 30, THE TRICARE West (TriWest Healthcare Alliance) is no longer accepting the Alternative Referral and Authorization form. Physicians will need to submit referrals and authorizations through TRICARE’s online referral management system available via the Availity provider portal. Referrals and authorizations can also still be submitted via fax to (866) 852-1893.
For more information, please see the TriWest Healthcare Alliance Referral and Authorizations User Guide.
PHYSICIAN WORKFORCE
If physicians have issues submitting referrals and authorizations through the online referral management tool, please contact TriWest via the chat feature in Availity or at 888-TRIWEST (874-9378).
PHC to Convene Statewide GME Summit to Address Physician Workforce Challenges
PHYSICIANS FOR A HEALTHY California (PHC) will host a statewide Graduate Medical Education (GME) Leadership Summit this summer, convening experts and stakeholders to address California’s most pressing physician workforce challenges.
The virtual event, titled “Building California’s GME Ecosystem — Together,” will take place on Tuesday, July 21, 2026, from 9 a.m. to 12 p.m.
The summit will bring together CalMedForce and CalMedForce+ awardees alongside GME thought leaders from across the state, creating space for meaningful dialogue and collaboration across the physician training continuum.
Through a mix of discussion and peer exchange, participants will explore practical solutions to key challenges facing GME, including
long-term funding sustainability, persistent workforce shortages, and the need to recruit and retain physicians in rural and underserved communities.
The summit is designed not only to share ideas, but also to surface strategies that can be implemented and scaled across California.
The event will also mark the launch of a new statewide GME Learning Collaborative. Attendees will play an active role in shaping the initiative by identifying priorities, strengthening partnerships, and helping build a more coordinated, long-term approach to supporting California’s physician workforce.
For more information, visit phcdocs.org/gme-summit. Questions? Contact Kristy MaKieve at kmakieve@phcdocs.org.
California’s Physician Community Loses Beloved Latino Pioneer
Dr. Ralph Ocampo Passes at the Age of 93
By Kevin Spillane
CALIFORNIA’S PHYSICIAN COMMUNITY HAS LOST one of its pioneer medical leaders. The San Diego County Medical Society has only now learned that Ralph R. Ocampo, MD, FACS, passed away at the age of 93 last year. Dr. Ocampo was a very private man who kept his illness secret and sought no attention for his passing.
René Bravo, MD, president of the California Medical Association, declared, “Dr. Ocampo helped pave the way for generations of Latino physicians in organized medicine. His leadership, humility, and lifelong commitment to patients and colleagues left a lasting mark on California’s physician community, and his legacy will continue to inspire those who follow in his footsteps.”
“Dr. Ocampo was deeply respected and loved by his peers,” said Jennipher Ohmstede, senior director of governance and operations for the San Diego County Medical Society. “He was a popular longtime leader in San Diego’s and California’s physician communities. The doctor was especially well known for both his warmth and sense of humor.”
Dr. Ocampo was one of the most prominent and earliest Latino physician leaders in San Diego and California. Dr. Ocampo served as the first Latino President of the San Diego County Medical Society in 1982. A distinguished and highly respected surgeon, he also served as the first Latino president of the California Medical Association (CMA) in 1994 and was a long-term American Medical Association (AMA) delegate member from 1996 to 2002.
As a leader in the California Medical Association, Dr. Ocampo often represented the interests of surgeons and their patients in state-level legislative discussions. During his time as a civic leader, he was a key figure in the 1994 fight against Proposition 188, a tobacco-industry-backed measure. Ironically, he had been a smoker himself but quit when he became a leader in the medical community. He leveraged his public profile to campaign for stricter public smoking bans and health protections.
Dr. Ocampo worked as a janitor when he was an undergrad at USC, where he and his lab partner were the first to document the anatomy of the stingray and give name to its venom. He served as a major and a flight surgeon in the U.S. Air Force, where he was named Physician of the Year during his service.
Dr. Ocampo was named “Physician of the Year” by the U.S. Air Force.
While in the Air Force, he also flew in the back seat of possibly the first remotecontrol-operated jet: the F106 Delta Dart.
Dr. Ocampo graduated from the Loma Linda University School of Medicine in 1958. Following his medical degree, he completed an internship at Cook County Hospital in Chicago in 1959, which is where he met his beloved and equally charming late wife, Bonnie, who passed
in December 2019. The couple were married for more than 60 years and raised their family, which included sons Ernie and Joe, in San Diego.
In the early 1950s, Dr. Ocampo was involved with the School of Tropical and Preventive Medicine and the department of anatomy at Loma Linda University.
Dr. Ocampo’s career in general and vascular surgery spanned nearly four decades, where he practiced
primarily at Scripps Mercy Hospital. He achieved the distinction of being a fellow of the American College of Surgeons (FACS), a credential signifying that a surgeon’s education, training, and professional qualifications have passed a rigorous evaluation.
Ocampo was also a clinical professor at the UCSD School of Medicine, where he first met Dr. Ira D. Levine, who was an intern training in the department of surgery in 1967. “Ralph Ocampo was an excellent teacher, mentor, friend, and a terrible punster. He had a collection of several hundred puns. Punning was a high form of his humor even though most people considered it the lowest form of humor. He was an excellent surgeon,
having a way of setting up and approaching a case that was methodical and well thought-out. Above all else, Ralph was a humble man despite his many achievements,” is how Levine described his friend and colleague.
Dr. Sergio Flores, a former SDCMS president and current chair of the California Medical Association Board of Trustees, said, “Ralph Ocampo, MD was a very kind and great surgeon who took me under his wing when I started my gastroenterology practice in 1997 at Mercy Hospital. He was always available for any surgical service, whether a middle of the night emergency or a routine surgical consultation. He also introduced me to the San Diego County Medical Society after I moved back home from practicing in Humboldt County. I would also always look forward to seeing him at the CMA HOD, proudly being called up for the past president’s celebration. He will truly be missed.”
Dr. Ted Mazer, also a former SDCMS president and former CMA president,
stated, “I could only describe Dr. Ocampo as a gentleman, professional, mentor, and role model. Hard to believe that Ralph was actually SDCMS president before I even arrived in San Diego, but became one of the key figures in my professional life, particularly in community service and leadership in organized medicine. He was also an amazing role model in his love and caring for Bonnie over the years as she needed him more and more. His efforts helped change San Diego medicine in many ways, for which we all owe him a debt of gratitude. I am proud to have followed in his footsteps at SDCMS and CMA, but even prouder to have been a friend and to have Ralph gift me some of his CMA mementos.”
In the early 1990s, Ocampo served as the medical director for Hispanocare, a program designed to bridge the gap between healthcare providers and the Latino community in San Diego. While medical in nature, the role was deeply civic, focused on improving social equity and healthcare access for underrepresented groups in the region.
Outside of his medical practice, Dr. Ocampo held significant roles in corporate governance and local community leadership, often connecting professional expertise and civic responsibility. One of his most prominent nonmedical roles was serving on the board of directors for Sempra Energy, the Fortune 500 parent company of San Diego Gas & Electric. He served as an independent director, contributing to oversight during a period of significant growth for the energy giant. Ocampo was also appointed by San Diego Police Chief William Kollender to serve on the Community Relations Committee to evaluate and bridge relations between city police and minority communities after a tragic event.
Dr. Ocampo’s son Joe said, “Dad loved the simple things in life and helping others. He was wearing an AC/DC shirt at age 92 and I asked him why. He said it was $5 at Walmart. Dad loved classical music and playing the piano. He never knew who AC/DC was. Doctors and friends loved his humor.”
Joe concluded, “He was a man who always preferred a hot dog over a steak.”
In his later years, Dr. Ocampo remained active in the medical community through the Retired Old Doctors Eat Out (RODEO) group, where he used his videography skills to record an oral history of surgical specialties in San Diego County. In addition, he and Dr. Levine interviewed Dr. Marshall Orloff, professor and chair of the department of surgery at UC San Diego about the establishment of the medical school and its relationship to San Diego’s medical community, ensuring the legacy and history of local medical institutions was documented for future generations.
Kevin Spillane serves as communications consultant for the San Diego County Medical Society.
Dr. Ocampo and his wife, Bonnie, at the San Diego County Medical Society’s annual gala.
Dr. Ocampo at his medical office.
Myths and Facts About Electroconvulsive Therapy
Dramatic depictions of electroconvulsive therapy (ECT) in movies and TV shows have contributed to significant stigma around the treatment. However, modern ECT — which utilizes anesthesia and other medications to ensure patient comfort throughout the procedure — is a safe, highly effective treatment for severe depression. Here are 7 myths and facts about ECT that all health care providers should know.
Myth 1: ECT is painful.
Fact: ECT is painless and administered only under supervision by a team of specialists, including anesthesiologists, nurses and psychiatrists. The patient is under general anesthesia and asleep during the procedure. Electrodes are used to induce a short, painless seizure in the brain, which causes brain chemistry changes that can help relieve symptoms of severe depression.
Myth 2: ECT is dangerous.
Fact: When a patient receives ECT, they are monitored closely for side effects and to evaluate the treatment’s effectiveness. The most common side effects of ECT are headaches, nausea and muscle aches, all of which can be treated with medication. Some patients may experience temporary short-term memory loss that usually goes away within two weeks to six months after the treatments end.
Myth 3: Patients don’t get a say with ECT.
Fact: At Sharp Mesa Vista Hospital, a patient is very involved in the ECT process. The process includes the patient receiving a referral from a psychiatrist to receive ECT as well as undergoing a physical examination. The care team answers any questions and asks the patient for consent before starting treatment. The team also works with each patient to ensure the treatments are reducing their symptoms.
Myth 4: ECT is not effective.
Fact: ECT is highly effective and has been shown to relieve symptoms in approximately 80% of patients. It is most effective for treating severe depression, and less so for mild depression. It can also be used for severe cases of bipolar disorder and schizophrenia. Patients typically start to feel better after three or more ECT treatments. Usually, loved ones are the first to notice an improvement in the patient.
Myth 5: ECT is a complicated procedure.
Fact: Each ECT treatment takes only a few minutes. Once the patient wakes up from anesthesia, their vital signs are monitored as they rest for 30 minutes. The patient can go home the same day.
Myth 6: ECT can be administered anywhere.
Fact: Only a few hospitals in San Diego offer ECT, including Sharp Mesa Vista Hospital. At Sharp Mesa Vista, the ECT process begins with a referral from a patient’s psychiatrist. The medical staff will perform an evaluation and discuss symptoms with the patient, who will have a medical exam to ensure they are healthy enough to receive ECT.
Myth 7: It is hard to refer a patient to receive ECT.
Fact: Physicians and other providers can easily refer patients to receive ECT at Sharp Mesa Vista. If you or a colleague know a patient who may benefit from ECT or other behavioral health services, call 858-836-8390 or visit sharp.com/ectform to refer them. Patients may also call the same number to self-refer.
To learn more about ECT and other treatment programs at Sharp Mesa Vista Hospital, visit sharp.com/ect
ANNUAL REPORT
2024–2025
Dear
friends,
“You cannot get through a single day without having an impact on the world around you. What you do makes a difference, and you have to decide what kind of difference you want to make” — Jane
Goodall
Join us by creating a healthier and happier life for each Project Access patient. Volunteer like our physician specialists and the hospitals and surgery centers who provide pro bono space, time, and talent. Contribute your treasure and donate to Champions for Health to continue the good work started by the physician leadership of the San Diego County Medical Society. Happiness is a direction we head toward, not a destination. It’s built over time through choices that favor purpose, service, and connection. We invite you to join us at the intersection where community, compassion, and impact take flight. Together, we can soar toward a healthier San Diego!
With much appreciation,
Adama Dyoniziak, Executive Director, Champions for Health, Board of Directors and Staff
Champions for Health is dedicated to providing access to critically needed healthcare for uninsured, low-income residents of San Diego County who would otherwise face insurmountable barriers to care. We recruit, mobilize, and support hundreds of volunteer physicians and other professionals to provide free preventive and specialty healthcare.
190 Specialty care physicians
34 Specialty areas
10 Hospitals and outpatient surgery centers
20 Referral clinics
68 Specialty and medical partners
Volunteers
“Once you choose hope, anything is possible.” Christopher Reeve was describing what can be achieved because of our amazing volunteers. Our medical and healthcare professionals are a vital part of our network of commitment to providing primary and specialty care services, and administering vaccines and health screenings. Our physician and nurse volunteers contribute to the health and wellness of every patient. In turn, each patient and their family experience hope for a future full of possibility.
“Volunteering for Project Access San Diego has been such a wonderful opportunity to help the community. I am thankful to be part of such a great organization and how kind, caring, and supportive the staff is. It is so fulfilling to see the joy and relief in patients’ faces to have someone at their appointments to interpret for them. Truly priceless.”
— MARGARITA P., VOLUNTEER MEDICAL INTERPRETER
Community Wellness
With our amazing health equity partners, our wellness initiatives are place-based programs that improve health and wellbeing. Think health, but where people actually live. Champions for Health removes barriers to prevention services such as language, needing to make appointments, lack of technology, and transportation by providing opportunities for immunizations, health screenings, and education sessions in communities of need. We shift demand by preventing problems, or by catching issues early, where the return on effort is biggest. The immunization team administered vaccinations to skilled nursing facilities, senior and low-income housing, K–18 schools, farms, faith-based organizations, free clinics, shelters, libraries, parks, and community centers. These programs make health feel local, doable, and shared.
342 Immunization field clinics
6,539 COVID and flu doses
Youth Emotional Wellness and
Family Communication Program
Project Access Care Managers noted an increased need for emotional support for the children of clients who were impacted by their parent’s long-term medical conditions. These youth took on parental roles such as cooking, cleaning, caring for younger siblings, and going to jobs with parents to help them when they are unable to complete due to physical limitations.
Funded by the Conrad Prebys Foundation, 47 overburdened youth (ages 6-26) within 24 families were connected to an innovative home-based emotional wellness support program developed and facilitated by an occupational therapist. The ninesession program improved the youth’s understanding of the impact of chronic medical conditions on their family members, communication among family members, and the youth’s sense of personal cultural identity. Families received local community resources and much needed grocery store gift cards.
47 Youth educated 24 Families served
“Being together — doing exercises to calm ourselves down and playing loteria — reconnected us just like we were before [my mom was sick].” —
A 15-YEAR-OLD YOUTH
Project Access San Diego
Physician volunteers are the true champions at the heart of Project Access. They step in during some of the most difficult moments in a patient’s life and guide them with care and expertise through the resolution of their health challenges. Their dedication and compassion make a lasting impact, offering not only treatment, but hope and reassurance when it is needed most. Uninsured adults between 139% and 322% of federal poverty level receive referrals from partner clinics to Project Access. We then arrange elective, medically necessary specialty care appointments and outpatient procedures by leveraging donated care.
Project Access patients 32 procedures/ surgeries 237 specialty appointments $411,307 in donated specialty care 45 interpretation services
transportation services 31% reported improved health status 100% reduction in missed workdays 100% reduction in emergency department visits
Since 2008: 9,882 PASD patients 2,242 procedures/ surgeries 31,086 specialty appointments 2,781 transportation services
$28,492,831 in donated specialty care 70 lives saved REFERRING
3,580 interpretation services
Our Project Access Partners
Alcon Cares
Alliance Retina Consultants
Anesthesia Consultants of California Medical Group
Anesthesia Service Medical Group
Arch Health Partners
Arthritis Care and Research Center
Arthritis Care Specialist of North County
Balboa Nephrology
California Center for Neurointerventional Surgery
California Eye Prosthesis
cCare California Cancer Associates
ChEARS Hearing Center
Coast Surgical Group
Coastal Gastroenterology
Coastal Pain & Spinal Diagnostics Medical Group
Coastal Skin & Eye Institute
Core Orthopaedic Medical Group
Davies Eye Center
Diabetes & Endocrine Treatment Specialists
Eye & Retina Institute of San Diego
Eye Care of La Jolla
Eye Care of San Diego
Fallbrook Family Health Center
Family Allergy, Asthma, Immunology & Sinus Center
Genentech Foundation
Genesis Healthcare Partners
Gordon Schanzlin New Vision Institute
Greider Eye Associates
IGO Medical Group
Imaging Healthcare Specialists
Kaiser Permanente
Kaska Orthopedics
La Jolla Endoscopy Center
La Jolla Neurosurgical Associates
La Jolla Vein and Vascular
La Mesa Cardiac Center
Medacta USA
Minimally Invasive Surgeons of North County
North Coast Surgery Center
North County ENT, H&N Surgery
Northern Litho
Olde Del Mar Surgical
Outpatient Surgery Center of La Jolla
Pacific Coast Surgical Group
Pacific ENT Medical Group
Palomar Health Medical Center
PCND Neurology
Regents Pharmacy
Retina Consultants of San Diego
San Diego Cardiac Center
San Diego Cardiovascular Associates
San Diego Endoscopy Center
San Diego ENT
San Diego Family Dermatology
San Diego Hand Specialists
San Diego Neurosurgery
San Diego Podiatry Group
Scripps Health Chula Vista
Scripps Health Encinitas
Scripps Memorial La Jolla
Scripps Mercy Surgery Pavilion
Skin Surgery Medical Group
South Coast Gynecologic Oncology
Spine and Sport Physical Therapy
Stryker Corporation
Surgical Associates of La Jolla
Synergy Orthopedics
The Endoscopy Center
Vision Care & Correction of San Diego
Ximed Medical Center
Physician Support
The Alzheimer’s Clinical Roundtable has brought to light the effects of 10 years of collaborative, countywide efforts to improve provider competence and confidence in caring for individuals with dementia and their care partners, and significantly increase screening rates around the county. While the Fourth Edition of the Physician Guidelines for Screening, Evaluating and Managing Symptoms of Dementia was published in June 2024, a significant amount of training on these guidelines and best practices occurred during the past fiscal year. More than 15,000 educational encounters addressed the needs most often faced by primary care providers in their practices with older adult patients. This included a panel on dementia updates at the Sharp Community Medical Group annual conference.
The Clinical Roundtable continues to bring together dementia specialists at all health systems in the region, with greater engagement among primary care providers in leadership roles. Ian Neel, MD, geriatrician at UC San Diego, and Peter Kim, MD, CMO Sharp Community Medical Group, serve as co-chairs, joined by many other system leaders. Through funding from the County of San Diego Department of Aging and Independence Services, five health systems adopted system guideline pathways and enabled their electronic medical record systems with tools to assist providers with more efficient care. The conclusions of a two-year research study have shown that a systematic approach to training and EMR tools have significantly increased screening rates, and have improved provider performance and confidence, leading to enhanced patient experiences.
Participation in the Geriatric Workforce Enhancement Program and its funding through UC San Diego allowed for the development of numerous patient/ caregiver resources to assist providers, as well as new on-demand webinars on important topics. Additionally, the California Association of Physician Associates partnered to provide both publication and on-demand webinars to their membership.
Physician Guidelines for the Screening, Evaluation, and Management of Alzheimer’s Disease and Related Dementias
Lauren Kearny
Lisa Keeley
Daniel Klaristenfeld, MD
KMG Psychiatry
Monique Knight
Steve Koh, MD
La Jolla Concierge MD
Anita Lalani
Latina Giving Circle
Eva Pei-Srbich Leonard, MD
Shelly Lilly Maarten Lippmann Quinn Lippmann, MD
Tina McMahon
Medical Oncology Associates of San Diego
Preeti Mehta, MD
Molina Healthcare
Jennifer Montanez
Eimaneh Mostofian, MD
Kelly Motadel, MD
Tim Murphy, MD
Emily Nagler, MD
David Najafi, MD
Neighborhood Healthcare
OM&E Partners
Orange County Medical Association
Christine de Pagter
Parker Foundation
Rakesh Patel, MD
Pacific ENT Medical Group
Anushree Parashar
Anjou Parekh
Malika Pasha
Point Loma Nazarene University
Druv Puri
Quest Diagnostics
Nousha Rafii
Kristin Rice, MD
Carey Riccitelli
Jeff Sachs
San Diego Association of Physicians of Indian Origin
San Diego Cardiovascular Associates
San Diego County Medical Society
James Schultz, MD
Kendra Scott
Scripps Health
Seaport Scripps Home Health
Sharp Community Medical Group
Kelsey Sly
Mona Sondhi, MD
Southwest Strategies Group
Kevin Spillane
Karl Steinberg, MD
Wayne Chen Sun, MD
Carol & Patrick Tellez, MD
The Doctors Company
Sayone Thihalolipavan, MD
Tri City Medical Center
TrueCare
UCSD Health System
UCSD Preventive Medicine Residency
Devesh Vashista
Dustin Wailes, MD
Robert Wailes, MD
Mike Weathers
Holly Yang, MD
Thank You to Our Health Equity Partners!
Active Care Rolling Hills Ranch
Albert Einstein Academy
Alpha Project Shelters
Alpine View Lodge
Always Ready Care
Arc of San Diego
Borrego Springs Library
Boulder Creek Post Acute Care
Cajon Valley Middle School
Catholic Charities of San Diego
Cherokee Point Elementary School
Chicano Federation
Child Development Associates
Christ the King Catholic Church
Chula Vista Fire Dept
Church Of Resurrection
City
City
Community Harm Reduction Shelter
Community Housing Works
County
Crawford High School
Creative Performing Media Arts Middle School
Cross Border Xpress
Cuyamaca College
Del Cerro Manor Assisted Living
Dramm Etcher Farms
Dreams for Change
EJE Academies Charter School
Cajon Valley High School
Employee Rights Center Episcopal Community Services
Fallbrook Union Elementary & High School
Family Health Centers of San Diego Father Joe’s Villages Fay Village
First Presbyterian Church of El Cajon
Fresh Origins Nursery
Friendship Manor Nursing &
Fulton K-8 School
Garfield High School
Gary & Mary West Senior Center
Grandon Village Apartments
Grossmont College
Grossmont Healthcare District
Grossmont Health Occupations Center
Grow Lead Motivate House Inc.
Guajome Park Academy
Hancock Elementary School
Hawthorne CAT
Mesa Convalescent &
Home
Kent Bromeliad Nursery
La Mesa First United Methodist Church
Kurdish Community Islamic Center
Leukemia Lymphoma Society
Steps
Lily’s Villa Lincoln High School
Live Well San Diego Advance
Living Water Church of Nazarene Magnolia Post Acute Care
Manchester Grand Hyatt
Prep Academy
New Life Baptist Church
North County Lifeline
Northgate Markets
Oak Park Elementary School
O’Farrell Charter School
Otay Ranch High School
Our Lady of Angels Church
Our Lady of Guadalupe Church
Pacific Beach United Methodist Church
Pacific Housing Inc.
Palomar Community College
Perkins K-8 School
Pioneer Ocean View United Church of Christ
Porter Elementary School
Potiker City Heights Square Senior Apartments
Rachel’s Promise
Rancho Monsarte Senior Apartments
Reo Vista Healthcare Center
Rolando Park Elementary School
Roosevelt International Middle School
Salvation Army
San Diego City College
San Diego County Libraries
San Diego Mesa College
San Diego Miramar College
San Diego Pride
San Ysidro Transit Center
Santee School District
Second Chance Employment Services
Serving Seniors
Sherman Elementary
Sherman Heights Community Center
Sorrento Tower Senior Apartments
South Region Public Health Center
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Stand Down
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Stronger Together Community Services
Sun Coast Farmer’s Market
Survivors of Torture
Sweetwater Spring Elementary School
Teledyne Impulse
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The Chrysalis
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The Rail Bar
Thrive Lemon Grove
Transgender Health & Wellness Center
Trauma 2 Resilience
UEI College
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University of San Diego
USS Midway Museum
Villa de Vida
Villa Escondido
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Vituity Cares Foundation
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West Coast Tomato Growers
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YMCA – Copley-Price Family, Jackie Robinson
The Waters Rise Unevenly: Flooding, Health, and Who Gets Left Behind
By Chioma Ugwonali, Christine James, MD, Angie Neison, MD, and
Wael Al-Delaimy, MD, PhD
FOR TOO LONG, CLIMATE AND ENVIRONMENTAL disasters have been treated as issues belonging to scientists and policymakers, not physicians. But these crises cross every boundary we draw between fields, and they manifest in the bodies of our patients. Every year brings record-breaking heat waves, earlier and more intense hurricanes, extreme flooding followed by prolonged drought, and extended wildfire seasons. Other environmental disasters unfold more quietly but with equal devastation: microplastics accumulating in our oceans, soils, and bodies; collapsing pollinator populations threatening food security; and deteriorating air quality that triggers asthma attacks, imperils fetal development, and poisons waterways. These disasters continue long after the news cycle moves on, shaping the lives of those caught within them for years — often generations.
The health of our ecosystems is inseparable from human health. This is not theoretical, nor is it someone else’s problem. These are problems impacting your patients in your exam rooms here in San Diego.
A Storm That Swept Away 40 Years in 40 Minutes
In one of the dozens of community meetings held after the flooding that swept through parts of Southeast San Diego in January 2024, one woman quietly shared that within 40 minutes, 40 years of her life was washed away. Photo albums, recipes, books, clothes, medications, baby food: gone. Many residents had to abandon what remained of their homes, unable to afford repairs. Others cycled through hotels before returning to waterlogged structures that were shells of what had once been refuge.
Judi Banks, a longtime Southeast San Diego resident and flood survivor, tearfully shared: “In my golden years I lost everything! It brings tears to my eyes because it was things that can’t be replaced! I have lived here in this house for 30 years plus, so I’m talking about pictures, old school albums, pillows that my great grandkids played and jumped on, my pots and pans — and that’s what messes with my mind. Here today, gone tomorrow. But God is good. I could go on and on but I won’t.”
This flooding was not inevitable. It resulted from increased rainfall converging with a cluttered Chollas Creek and an obstructed neighborhood drain — an infrastructure failure that community members had flagged for years. Climate change and chronic neglect interacted to create the perfect storm. And the disaster nearly repeated itself earlier this year until a community member donned a scuba suit and unclogged the drain himself. What systemic changes have been made since January 2024? The honest answer is: not enough.
Floods Don’t Just Drown — They Poison, Infect, and Traumatize
As physicians, we understand acute flood injuries: trauma, drowning, hypothermia. The less visible sequelae are where our clinical attention often falls short.
Floodwaters are not clean water. They carry sewage, agricultural runoff, heavy metals, pesticides, and industrial chemicals that contaminate drinking water and indoor surfaces for weeks, linked to birth defects, neurodevelopmental harm in children, and long-term cardiovascular disease.6,9 Floodwaters expand mosquito breeding habitats and raise rates of diarrheal illness.3,8 Skin and wound infections — increasingly with drugresistant organisms — become more common.
Flooding also disrupts the basic infrastructure of daily life and daily survival. Community members from Southeast San Diego have described children missing weeks of school, households unable to pay rent, difficulty accessing or storing life-saving medications, and widespread food insecurity. These disruptions compound existing health vulnerabilities in ways that may not manifest in the exam room for months.
Then there is the psychological toll. Elevated rates of PTSD, major depression, and complicated grief are welldocumented in communities following flood events — particularly among renters, low-income households, and those without insurance coverage. 4,10 Displacement is a profound
Neighborhood flooding in Southeast San Diego in January 2024. Credit: Judi Banks.
stressor. Patients lose connection to care teams, medication routines, and the social support networks that buffer adversity. For children, flood-related displacement is an adverse childhood experience with significant effects on neurodevelopment and behavioral health.1
A flood that damages a home, contaminates a well, introduces mold, displaces a family, and disrupts a child’s schooling is not one health event. It is many, unfolding over months and years. When we treat these as separate problems, we miss the underlying diagnosis: heightened exposure to climate change and environmental degradation.
When Disasters Strike, Inequity Deepens
The impacts of climate and environmental disasters are not equally distributed. People who are unhoused, who have limited English proficiency, and/or who live in underresourced communities are the most exposed and least equipped to recover. They are the same patients already navigating the most barriers to care. With every disaster, the gap widens.
Mold is among the most insidious lingering threats after a flood. It begins colonizing walls and insulation within 24 to 48 hours of water intrusion, growing silently — often invisible behind drywall and beneath flooring. Its health effects peak weeks to months after the flood and include cough, wheezing, new-onset asthma, allergic rhinitis, hypersensitivity pneumonitis, and a range of other upper and lower respiratory conditions, especially among children and seniors.5 Banks echoed the sentiments of other residents when she described how her health changed after the flood: “I have allergies I wasn’t bothered with before.” In South Chollas Valley, a community that already ranks above the 90th percentile for asthma rates statewide according to the Office of Environmental Health Hazard Assessment, mold exposure compounds an already precarious respiratory burden.
Yet many families have little power to address it. In the immediate aftermath of the January 2024 floods, homeowners faced steep repair costs and bureaucratic barriers to aid. Renters had even less recourse, dependent on landlords who were slow to act or unresponsive altogether. With the steep cost of living and limited financial resources, some families had no choice but to abandon their homes entirely. Those who stayed lived for weeks or months in damp, contaminated spaces — not by choice, but by circumstance.
Mold exposure is also associated with increased healthcare utilization — an added strain on a community already facing significant barriers to care.5 Transportation, cost, language, institutional mistrust, and fear of seeking services all limit healthcare access. For patients navigating illness in this environment, a mold-related asthma exacerbation is not just a medical event. It is one more crisis layered on top of many.
Southeast San Diego is not an anomaly. It is an example of what happens when environmental neglect meets social vulnerability. Our coastal geography, aging stormwater infrastructure, and increasingly volatile precipitation patterns —
climatologists project more “weather whiplash” for California, with longer dry spells punctuated by intense atmospheric rivers — mean that what happened in January 2024 will happen again.9 The question is what we do before it does.
What Physicians Can Do
We are not asking every physician to become an environmental advocate, though the case for that is strong. We are asking for heightened clinical attentiveness and a willingness to see the socioenvironmental context surrounding your patients.
Ask about the home environment. After flood events or prolonged rain, ask patients with asthma, COPD, allergies, or immune compromise about water intrusion and mold. The question takes 30 seconds and can change your clinical approach significantly.
Recognize delayed presentations. Mold-related illness and mental health sequelae may not surface until weeks or months after a flood. Maintain an index of suspicion in patients from affected neighborhoods.
Screen for displacement and social disruption. Use your practice’s existing screening tools to identify patients who have lost housing or are living in substandard post-flood conditions. Connect them with resources and when those resources are inadequate, say so.
Our Patients Need Us to Speak Up
Individual clinical vigilance is necessary but not sufficient. The San Diego County Medical Society has both the standing and the responsibility to act as a collective voice on the conditions that shape our patients’ health.
Flooding and climate-related extreme weather events are public health emergencies that demand immediate action. We must advocate for accelerated investment in stormwater infrastructure, especially in communities of concern like those along Chollas Creek that bear a disproportionate burden of cli-
Neighborhood flooding in Southeast San Diego in January 2024. Credit: Judi Banks.
mate impacts. We need stronger mold remediation standards in rental housing with meaningful enforcement mechanisms. And we need flood-specific health surveillance protocols, developed in partnership with county public health officials, that can detect and respond to disease surges in real time.
Equally important is recognizing and supporting the organizations that are already doing this work. When the January 2024 floods struck Southeast San Diego, community-based organizations mobilized quickly to provide food distribution, emergency housing navigation, and social support. These organizations have established trust that institutions cannot replicate on short notice. They deserve not just acknowledgment, but institutional and sustained financial partnership. Their networks are critical infrastructure for disaster response and community health, and we must fund them accordingly.
Physicians carry unique credibility in the public square. When you speak about health consequences in clinical, evidence-based terms, policymakers listen. You have earned that credibility through your training and direct witness to human suffering. We urge you to use it.
References
1. Ahdoot, S., Baum, C. R., Cataletto, M. B., Hogan, P., Wu, C. B., & Bernstein, A. (2024). Climate change and children’s health: Building a healthy future for every child. Pediatrics, 153(3), e2023065505. https://doi.org/10.1542/peds.2023-065505
2. California Office of Environmental Health Hazard Assessment. (2021). CalEnviroScreen 4.0. California Environmental Protection Agency. https://oehha.ca.gov/calenviroscreen/report/calenviroscreen-40
3. Dimitrova A, et al. Precipitation variability and risk of infectious disease in children under 5 for 32 countries. Lancet Planet Health 2022; 6: e147–55.
4. Fernandez, A., Black, J., Jones, M., Wilson, L., SalvadorCarulla, L., Astell-Burt, T., & Black, D. (2015). Flooding and mental health: A systematic mapping review. PLOS ONE, 10 (4), e0119929. https://doi.org/10.1371/journal.pone.0119929
5. Grant, T. L., Wood, R. A., & Chapman, M. D. (2023). Indoor environmental exposures and their relationship to allergic diseases. The Journal of Allergy and Clinical Immunology: In Practice, 11(10). https://doi.org/10.1016/j.jaip.2023.08.037
6. Kahn, L. G., Philippat, C., Nakayama, S. F., Slama, R., & Trasande, L. (2020). Endocrine-disrupting chemicals: Implications for human health. The Lancet Diabetes & Endocrinology, 8(8), 703–718. https://doi.org/10.1016/S22138587(20)30129-7
7. Mendell, M. J., Mirer, A. G., Cheung, K., Tong, M., & Douwes, J. (2011). Respiratory and allergic health effects of dampness, mold, and dampness-related agents: a review of the epidemiologic evidence. Environmental Health Perspectives, 119(6), 748–756. https://doi.org/10.1289/ehp.1002410
8. Myers, S. S., Masztalerz, O., Ahdoot, S., Gabrysch, S., Gupta, J., Haines, A., Kleineberg-Massuthe, H., Lambrecht, N. J., Landrigan, P. J., Mahmood, J., Pörtner, L. M., Rohr, J.,
Traidl-Hoffmann, C., Wendt, A. S., Wray, B., & Rockström, J. (2025). Connecting planetary boundaries and planetary health: A resilient and stable Earth system is crucial for human health. The Lancet. https://doi.org/10.1016/S01406736(25)01256-5
9. Swain, D.L., Langenbrunner, B., Neelin, J.D. et al. Increasing precipitation volatility in twenty-first-century California. Nature Climate Change 8, 427–433 (2018). https://doi. org/10.1038/s41558-018-0140-y
10. Woodruff TJ. Health Effects of Fossil Fuel-Derived Endocrine Disruptors. N Engl J Med 2024; 390: 922–33. Kahn LG, et al. Endocrine-disrupting chemicals: implications for human health. Lancet Diabetes Endocrinol 2020; 8: 703–18.
11. Grant, T. L., Wood, R. A., & Chapman, M. D. (2023). Indoor environmental exposures and their relationship to allergic diseases. The Journal of Allergy and Clinical Immunology: In Practice, 11(10). https://doi.org/10.1016/j.jaip.2023.08.037
Chioma Ugwonali is a second-year medical student at UC San Diego School of Medicine with a degree in ecology and evolutionary biology, and a minor in environmental studies from Princeton University. She is passionate about the ways climate and the environment shape human health, and works to raise awareness through community organizing, wellness events, and building connections between community members, clinicians, scholars, and policymakers.
Dr. James is an assistant professor of medicine in the division of allergy and immunology at UC San Diego. Her work focuses on the intersection of climate change and health, and how physicians can address the health impacts of environmental crises on their patients.
Dr. Neison is a family, obesity, lifestyle, and culinary medicine physician who practices through the lens of planetary health equity. She is on San Diego’s Public Health Advisory Council for Climate Action Campaign, where she’s continually using her expertise to advocate for clean air, water, access to nutrient-dense food, and renewable energy for optimal health.
Dr. Al-Delaimy is a professor at the UC San Diego Herbert Wertheim School of Public Health and a principal investigator of research projects involving climate change and health impacts among vulnerable populations. He is an epidemiologist who uses mixed methods in data collection and analyses. He is a national and international authority in community engagement and public health within the areas of environmental health, including climate change.
Dementia With Lewy Bodies May Be More Common Than We Think
Diagnosis
is Difficult, and Many Cases Are Missed in Everyday
Practice
By Judy George
DEMENTIA WITH LEWY BODIES — A DISEASE characterized by faster progression and greater functional decline than Alzheimer’s disease — was confirmed as a predominantly late-onset dementia with incidence rising sharply with age, a systematic review and meta-analysis showed.
Across 12 population-based studies, the pooled incidence was 46.85 per 100,000 person-years (95% CI 23.78-92.30) for people ages 65 and older, and the pooled prevalence was 352.26 per 100,000 population (95% CI 112.25-1,099.79), reported Daniele Urso, MD, MPH, of the University of Bari Aldo Moro in Italy, and co-authors in JAMA Neurology
In people younger than 65, the pooled incidence was 0.34
per 100,000 person-years (95% CI 0.14-0.83) and the prevalence was 2.52 per 100,000 population (95% CI 1.43-4.44).
Pooled crude incidence across all ages was 4.79 (95% CI 3.90-5.88). Incidence was higher in men (5.45) than in women (4.32).
The findings show that clinically diagnosed
Key Takeaways
Dementia with Lewy bodies is the second most common form of degenerative dementia after Alzheimer’s disease.
Diagnosing it can be difficult due to substantial overlap with other neurodegenerative disorders.
A meta-analysis showed that clinically diagnosed dementia with Lewy bodies was uncommon, likely reflecting underdiagnosis.
dementia with Lewy bodies was uncommon, likely reflecting underdiagnosis and diagnostic insensitivity, the researchers observed.
“Dementia with Lewy bodies is considered the second most common form of degenerative dementia in older adults after Alzheimer’s disease, but we still know surprisingly little about how common it is at the population level,” Dr. Urso said.
“Our study represents one of the first attempts to systematically metaanalyze population-based estimates of the incidence and prevalence of dementia with Lewy bodies,” he told MedPage Today.
Population-based studies provide the most reliable evidence to help understand the real-world burden of the disease, Dr. Urso noted. “Reliable estimates are also essential for healthcare planning,” he said. “Dementia with Lewy bodies often requires a different clinical approach compared with other dementias, because patients may present with a complex combination of cognitive, motor, psychiatric, sleep, and autonomic symptoms.”
Dementia with Lewy bodies is characterized by abnormal accumulation of alpha-synuclein into Lewy bodies and Lewy neurites that involve both cortical and subcortical regions. It is marked by progressive cognitive decline along with fluctuating cognition, recurrent visual hallucinations, REM sleep behavior disorder, and spontaneous parkinsonism, frequently accompanied by psychiatric symptoms and autonomic dysfunction.
Diagnosing dementia with Lewy bodies can be difficult because of its substantial overlap with other neurodegenerative disorders. That uncertainty can be particularly distressing for patients and families as Susan Schneider Williams described in an essay in Neurology about the experience of her husband, actor and comedian Robin Williams, who developed Lewy body disease and subsequently died by suicide.
“Lewy body dementia is more common than many people realize; however, it is often overlooked or mistaken for Alzheimer’s or Parkinson’s disease,” noted Michael Okun, MD, of the University of Florida Fixel Institute in Gainesville, who wasn’t involved with the study. “Awareness matters because recognizing the diagnosis early can change care, safety, and quality of life for families,” he told MedPage Today
“This study reminds us that Lewy body dementia is not rare in older adults, and the numbers likely underestimate the true burden because many cases are missed in everyday practice,” Dr. Okun added. “We need better recognition, better tools, and more conversations about symptoms like hallucinations, dream enactment, and fluctuating thinking.”
Dr. Urso and co-authors systematically searched PubMed, Embase, and Scopus from inception to October 2024 for population-based studies that reported the incidence or prevalence of dementia with Lewy bodies based on validated diagnostic criteria.
They identified 16 studies and used 12 in the meta-analysis. The studies had considerable heterogeneity (between-study I2 was 85% or higher), which may partly reflect inherent diagnostic challenges, Dr. Urso and colleagues noted.
“Notably, the pooled incidence of dementia with Lewy bodies was higher than population-based incidence estimates reported for other uncommon neurodegenerative disorders such as frontotemporal dementia (2.28 per 100,000 personyears), amyotrophic lateral sclerosis (1.59 per 100,000 personyears), and atypical parkinsonian syndromes, including progressive supranuclear palsy (0.81 per 100,000 person-years) and corticobasal syndrome (0.28 per 100,000 person-years),” they wrote.
The meta-analysis was limited by the small number of studies and high heterogeneity, the researchers acknowledged. Changes in diagnostic criteria over time may have influenced results, they added.
“Our findings also show that the current evidence base remains limited,” Dr. Urso said. “There are relatively few population-based studies, and most come from high-income countries. This means that we need more studies from different regions of the world, especially in underrepresented populations, to understand the true global burden of dementia with Lewy bodies.”
Judy George covers neurology and neuroscience news for MedPage Today, where this article first appeared. She writes about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more.
CLASSIFIEDS
PRACTICE ANNOUNCEMENTS
CRANIO/MAXILLOFACIAL AND HEAD & NECK
SURGERY: Accepting new adolescent and adult patients seeking evaluation and management of head and neck masses, multidisciplinary assessment of oral/ facial cancers and reconstruction, nasal airway assessment and functional rhinoplasty, corrective jaw surgery including jaw advancement for obstructive sleep apnea, cleft and craniofacial reconstruction, maxillofacial fracture management and secondary facial and jaw reconstruction. We work with Medicare, Tricare, most PPO insurance plans, and some HMO plans. Referrals may be called in to (619) 452-7332, or emailed to jaw@ scrippshealth.org. [2887-0808]
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
MEDICAL CONSULTANT (MD/DO): SD County Epidemiology and Immunization Services Branch is hiring a Medical Consultant! We seek a California–licensed physician with strong clinical, public health, and medical administration expertise who communicates effectively, collaborates with multidisciplinary teams, and provides clinical consultation on sensitive issues across diverse audiences. The ideal candidate is committed to underserved communities, builds community partnerships, and is board certified or board eligible in a relevant specialty; infection–prevention experience is preferred. The Medical Consultant leads mandated public health surveillance, investigation, and response activities; oversees case investigation, contact tracing, surveillance, and public education; and coordinates with healthcare partners to implement response strategies. Responsibilities include 24/7 on–call physician coverage for emerging infectious diseases, bioterrorism, and complex cases; clinical consultation and prescription oversight for reportable diseases; and physician coverage for programs such as HAI/MDRO, overdose surveillance, BioWatch/bioterrorism, and tribal, rural, military, and base liaison work. The role also includes representing the branch and serving as media spokesperson. CLICK HERE to file your application. [2901-0429]
PER DIEM ANESTHESIOLOGIST – NORTH COUNTY (92127) Facial plastics practice seeking anesthesiologist for elective cases in AAAHC-accredited, private, single-OR setting. Healthy patients, no emergencies, tight-knit team, smooth workflow. Typical 1–3 cases/day, 6AM-5PM depending on case load. Flexible per diem role. Compensation structured per case with strong effective hourly rates. Located in 92127. Looking for a reliable, long-term fit. SKY Facial Plastic Surgery | (858) 381-4801 | hello@skyfps.com .
PULMONOLOGY PHYSICIAN | PHMG NORTH COUNTY: Palomar Health Medical Group is seeking a board-certified Pulmonology/Critical Care Physician to join our multi-specialty, not-for-profit practice in North San Diego County. The ideal candidate will offer expert pulmonary care in a comprehensive outpatient and inpatient setting, supported by advanced facilities at Palomar Medical Center Escondido and Poway. Responsibilities include diagnosing and treating a wide range of pulmonary conditions, performing both inpatient and outpatient procedures, and collaborating with specialists across the Palomar Health network. Candidates must hold a valid California medical license, be board-certified in Pulmonology, and preferably have at least two years of clinical experience. Per diem roles are also available, offering competitive pay and flexible scheduling. Join us in reimagining healthcare with compassion and excellence. To apply, send your application and CV to clayton. trosclair@palomarhealth.org. [2893-1015]
UCSD DEPARTMENT OF FAMILY MEDICINE | FACULTY POSITIONS AVAILABLE: UCSD Department of Family Medicine seeks motivated faculty to join our team in clinical, teaching, and scholarly roles. Faculty participate in comprehensive patient care, resident and fellow education, and research or quality improvement initiatives. We welcome candidates with diverse experiences and a passion for family medicine, community engagement, and academic medicine. Opportunities are available at various academic ranks, with salary commensurate with experience, rank, and step. Join a collaborative, supportive environment committed to excellence in primary care and education. Apply here: https://apol-recruit.ucsd.edu/JPF04341. [2889-0822]
OB/GYN PHYSICIAN | PHMG ESCONDIDO: Palomar Health Medical Group is seeking a full-time, board-certified/eligible Obstetrics and Gynecology Physician to deliver comprehensive reproductive care, including labor and delivery management, gynecologic surgeries, and OB call rotations. The ideal candidate will possess strong surgical skills, California licensure, and a commitment to maternal health. We offer competitive compensation, performance-based incentives, and a collaborative team environment. Please email CV to clayton.trosclair@palomarhealth.org or phil.yphantides@phmg.org. [2882-0626]
FAMILY
MEDICINE/INTERNAL MEDICINE PHYSICIAN | PHMG RANCHO PENASQUITOS: Palomar Health Medical Group is seeking a Family Medicine or Internal Medicine Physician (MD/DO) to join our multi–specialty practice at our Rancho Penasquitos 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. [2881-0626]
FAMILY PRACTICE | INTERNAL MEDICINE
PHYSICIAN: La Jolla Village Family Medical Group is seeking a PT/FT primary care physician to join our wellestablished private practice. We’ve been caring for our La Jolla/UTC area neighbors for 35+ years providing comprehensive, longitudinal care to patients of all ages. Call responsibilities are minor; hours consistent with a healthy work/life balance. Our office is new, clean, modern, and well-appointed. Our clinical team is collegial, passionate, and close-knit, with a supportive, cohesive support staff. A true private practice where physicians practice artfully and build enduring relationships with patients and colleagues. Seeking a Board-certified, California-licensed MD/DO physician, passionate about medicine and looking to establish roots in a practice dedicated to the art of good medicine. Competitive salary and excellent benefits including medical, dental, vision, and retirement. Send a cover letter and CV to jcataluna@lajollafamilymedical.com. [2880-0520]
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]
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 SPACE FOR SUBLEASE | ENCINITAS: Beautiful, modern medical office space available for sublease in Encinitas, conveniently located just minutes from Interstate 5 with ample on–site parking for patients and staff. At approximately 2,000 sq ft it includes six spacious exam rooms to accommodate both clinic visits and minor procedures. Every room features stunning ocean views, creating a bright and welcoming environment. Additional amenities include a dedicated lab area, small break room, modern security system, and keyless entry. The entire office was fully renovated in 2023 and offers a fresh, contemporary design throughout. Flexible leasing options are available, including the opportunity to sublease a portion of the suite or the entire space. The sublease term is flexible, with the current lease running through July 2028, offering the possibility to assume or negotiate a longer–term lease directly with the landlord thereafter. Contact (760) 783-5502 for pricing and availability. [2902-0512]
MEDICAL OFFICE FOR LEASE | CHULA VISTA: Former pediatric clinic which closed due to retirement of owner. Can be used for any medical specialty, podiatry, chiropractor, optometry or medical spa office. Located at 890 Eastlake Parkway in Eastlake Chula Vista, 1163 square feet. With waiting room and exam room chairs, exam tables, some basic medical instruments, credit card and telephone units. Free to use or all can be removed to suit your needs and preferences. Contact (619) 274-9904 or fbarbadillo@cox.net. [2899-0323]
MEDICAL OFFICE SPACE TO SUBLEASE IN VISTA: Recently updated and well–appointed medical office space for partial or full sublease in Vista, CA. This approximately 6,000 square foot clinic is located at 2067 West Vista Way, within a prime medical office building. The space is equipped with 16 exam rooms, 3 restrooms, and ample dedicated office and lab space. The building itself is ADA compliant and offers several amenities, including ample parking, an outdoor atrium, elevators, and public restrooms on all floors. For more information or to discuss sublease terms, please contact Denise at dporter@tpirc.org. [2896-0309]
MEDICAL OFFICE AVAILABLE TO RENT | MID–
CITY: Practice for sale, medical office available for rent. Centrally located in San Diego’s Mid–City community at 3250 El Cajon Blvd, San Diego, CA 92104. Contact Miguel Losada, MD at (619) 282-2178 or by fax at (619) 282-2179. [2894-1215]
AVAILABILITY OF UTC MEDICAL OFFICE: Office in UTC area. 2–3 exam rooms, ample waiting room, 2 private offices. Ground floor location. Just one block from 805 exit. Close to Genesee Ave, all major shopping and restaurants in UTC. Parking available. Ground floor office, handicapped accessible. Six month–one year lease available with possibility to renew. Call (619) 5850476. Ask for Alisha. [2890-0825]
OFFICE SPACE FOR LEASE | AESTHETIC SET-
TING: Take your practice to the next level with this beautifully appointed office space available in a modern, fully equipped clinical environment. Whether you’re already in aesthetics or starting an aesthetic practice, we offer flexible, high–end rental options. Rentals include use of PicoSure Pro Laser and Potenza Microneedling with Radiofrequency, two private treatment rooms and staff breakroom in a professional, clean and serene setting. Available Mondays, Tuesdays, Thursdays & Fridays at $1,000/day between the hours of 8:30am–5:00pm. Ideal for dermatologists/plastic surgeons, cosmetic physicians, nurse injectors or other licensed professionals in the aesthetic field. Must see to appreciate the quality and atmosphere. Contact us today at Vivian@ sandiegomobiledoctor.com to schedule an in–person tour of this great opportunity. [2886-0804]
OFFICE SPACE FOR LEASE | MEDICAL SETTING:
Take your practice to the next level with this beautifully appointed office space available in a modern, fully equipped clinical environment. Whether you’re in primary care or specialty medicine, we offer flexible, high–end rental options. Rentals include use of two medical exam rooms and waiting (lobby) area in a clean, professional setting. Available Mondays, Tuesdays, Thursdays and Fridays at $350/half day or $600/day between the hours of 8:30am–5:00pm. Ideal for primary care physicians and specialists seeking flexible space. Must see to appreciate the quality and atmosphere. Contact us today at Vivian@sandiegomobiledoctor.com to schedule an in–person tour of this great opportunity. [2885-0804]
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.
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 Tri-City 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
FRIDGE & FREEZER EQUIPMENT AVAILABLE |
MINT CONDITION: Pristine medical cold storage refrigeration equipment available for purchase by Champions for Health, SDCMS’ philanthropic 501(c)3. Used to store vaccines. Includes 2 (two) commercial–grade Accucold ARG49ML 49 cu ft upright pharmacy refrigerators each with two glass doors, automatic defrost, digital thermostat and stainless steel cabinets (83.75” H x 55.25” W x 31.0” D), plus 1 (one) pharmaceutical–grade TempArmour BFFV15 compact freezer built to ensure stable temperatures and virtually eliminate supply losses (26.5” H x 25.0” W x 31.0” D). All units were acquired new, in use between 2-4 years and in very gently used condition. Units meet all CDC guidelines for vaccine storage. Asking price for each fridge is $4,000 OBO and $2,500 OBO for the freezer. Purchase individually or as a set. Contact Adama at (858) 300–2780 or adama.dyoniziak@championsfh. org. [2879-0502]
NON–PHYSICIAN POSITIONS AVAILABLE
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]
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]
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/JPF04449/apply. [2867-0904]
PROJECT SCIENTISTS: Project Scientists (nontenured, 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/ JPF04450/apply. [2868-0904]
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