June 2017

JUNE 2017 OFFICIAL PUBLICATION OF SDCMS

LEAD MEMBERSHIP MAKES YOU

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MEDICAL PROFESSIONAL LIABILITY INSURANCE

PHYSICIANS DESERVE Offering top-tier educational resources essential to reducing risk, providing versatile coverage solutions to safeguard your practice and serving as a staunch advocate on behalf of the medical community.

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SATURDAY, OCTOBER 7, 3 PM FLETCHER COVE, SOLANA BEACH

SATURDAY, OCTOBER 1 FLETCHER COVE, SOLANA BEACH

Physicians: You are a Health Role Model Model healthy living to patients and staff by inviting them to JOIN YOU at Champions for Health’s Solana Beach Sunset 5K Run/Walk on October 7!

Lead a team of 20 or more patients and staff and receive FREE team t-shirts with your practice/team identification.

Visit www.SB5K.org to sign up.

For more information email Kylene.Cummings@ChampionsFH.org.

Benefiting the Diabetes Prevention Program at

PRESENTED BY:

In Partnership With

THE DOCTORS INSURANCE AGENCY Bob DeSimone

5575 Ruffin Rd., Ste 250, San Diego, CA 92123 www.SB5K.org 858.300.2777

JUNE

CONTENTS

VOLUME 104, NUMBER 6

EDITOR: James Santiago Grisolía, MD EDITORIAL BOARD: James Santiago Grisolía, MD • Mihir Parikh, MD • Robert E. Peters, MD, PhD • J. Steven Poceta, MD MARKETING & PRODUCTION MANAGER: Jennifer Rohr SALES DIRECTOR: Dari Pebdani ART DIRECTOR: Lisa Williams COPY EDITOR: Adam Elder OFFICERS President: Mark W. Sornson, MD, PhD President-elect: David E.J. Bazzo, MD Secretary: James H. Schultz Jr., MD Treasurer: Holly B. Yang, MD Immediate Past President: Mihir Y. Parikh, MD GEOGRAPHIC & GEOGRAPHIC ALTERNATE DIRECTORS East County: Susan Kaweski, MD(Alt); Jane A. Lyons, MD; Rakesh R. Patel, MD; Venu Prabaker, MD Hillcrest: Gregory M. Balourdas, MD; Kyle P. Edmonds, MD(Alt), Thomas C. Lian, MD Kearny Mesa: Sergio R. Flores, MD (Board Representative to Executive Committee); Anthony E. Magit, MD; Alexander K. Quick, MD; Eileen R. Quintela, MD(Alt) La Jolla: Geva E. Mannor, MD, MPH; Marc M. Sedwitz, MD, FACS; Wayne C. Sun, MD(Alt) North County: Christopher M. Bergeron, MD, FACS ; Neelima V. Chu, MD(Alt); Michael A. Lobatz, MD; Patrick A. Tellez, MD South Bay: Maria T. Carriedo, MD; Irineo “Reno” D. Tiangco, MD AT-LARGE & AT-LARGE ALTERNATE DIRECTORS Toluwalase (Lase) A. Ajayi, MD (Board Representative to Executive Committee); Karrar H. Ali, DO, MPH; Steven L-W Chen, MD, FACS, MBA(Alt); Stephen R. Hayden, MD; Preeti Mehta, MD(Alt); Vimal I. Nanavati, MD, FACC, FSCAI(Alt); Alexandra E. Page, MD; Robert E. Peters, MD; Peter O. Raudaskoski, MD(Alt); Al Ray, MD(Alt); Kosala Samarasinghe, MD(Alt); Thomas J. Savides, MD; Karl E. Steinberg, MD(Alt); Erin L. Whitaker, MD(Alt); Marcella (Marci) M. Wilson, MD; Nicholas J. Yphantides, MD ADDITIONAL VOTING DIRECTORS Communications Chair: J. Steven Poceta, MD Young Physician Director: Edwin S. Chen, MD Resident Physician Director: Michael C. Hann, MD Retired Physician Director: Rosemarie M. Johnson, MD Medical Student Director: Meghana Pagadala

features

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14 Membership Makes You Stronger

BY CMA

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18

ill an Exercise Prescription F with Walk with a Doc

Put your SDCMS-CMA Membership to Use

BY NATALIE DIGATE MUTH, MD, MPH,

BY SDCMS

RDN, FAAP

departments 4 Briefly Noted: Calendar • New and Returning Members • Public Heath • Commercial Real Estate Report

7 Practice Management Tip of the Month

BY CMA

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JUNE 2017

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ADDITIONAL NONVOTING MEMBERS Alternate Young Physician Director: Heidi M. Meyer, MD Alternate Resident Physician Director: Zachary T. Berman, MD Alternate Retired Physician Director: Mitsuo Tomita, MD San Diego Physician Editor: James Santiago Grisolia, MD Champions For Health President: Al Ray, MD Delegation Chair: Steven R. Hayden, MD CMA President-elect: Theodore M. Mazer, MD (AMA At Large Delegate, Appointed by CMA) CMA Past Presidents: James T. Hay, MD (AMA Delegate); Robert E. Hertzka, MD (Legislative Committee Chair; AMA At Large Delegate, Appointed

by CMA); Ralph R. Ocampo, MD, FACS CMA Trustees: William T-C Tseng, MD; Robert E. Wailes, MD AMA Alternate Delegate: Lisa S. Miller, MD

It’s Time to Reset the Medical Malpractice Insurance Conversation

BY RICHARD E. ANDERSON, MD, FACP

26 Physician Marketplace: Classifieds 28 Speaking Out to Heal our Divide and Get What We Want

BY HELANE FRONEK, MD, FACP, FACPh

Opinions expressed by authors are their own and not necessarily those of San Diego Physician or SDCMS. San Diego Physician reserves the right to edit all contributions for clarity and length as well as to reject any material submitted.

Not responsible for unsolicited manuscripts. Advertising rates and information sent upon request. Acceptance of advertising in San Diego Physician in no way constitutes approval or endorsement by SDCMS of products or services advertised. San Diego Physician and SDCMS reserve the right to reject any advertising. Address all editorial communications to Editor@SDCMS.org.

All advertising inquiries can be sent to DPebdani@SDCMS.org. San Diego Physician is published monthly on the first of the month. Subscription rates are $35.00 per year. For subscriptions, email Editor@SDCMS.org. [San Diego County Medical Society (SDCMS) Printed in the U.S.A.]

CALIFORNIA MEDICAL ASSOCIATION

EFFECTIVE STRATEGIES FOR REDUCING PATIENTS’

DIABETES RISK HOSTED BY: Champions for Health and the

California Medical Association

DINNER HOSTED BY: Solera Health DATE: Thursday, June 29, 2017 • 6:00 – 8: 00 p.m.

LOCATION:

San Diego County Medical Society 5575 Ruffin Road, Suite 250, San Diego, CA 92123

RSVP TO: LIZ.BRAVE@CHAMPIONSFH.ORG

BY JUNE 27. THE EVENT WILL BE FREE.

PRESENTERS: JAMES DUDL, M.D. Diabetes Lead, Kaiser Permanente Care Management Institute

RODNEY HOOD, M.D. President Multicultural Health Foundation

MARIA CARRIEDOCENICEROS, M.D. Chief Medical Officer San Ysidro Health Center

MARLAYNA BOLLINGER Executive Director The Skinny Gene Project

ABOUT THE EVENT 13 million California adults—nearly half of the state’s adult population—have prediabetes, increasing their risk of developing type 2 diabetes over the next few years. One out of every three Californians between the ages of 18 and 39 is estimated to have prediabetes.

With the clinical burden of diabetes on the rise, physicians should be armed with evidence-based solutions to prevent the onset of diabetes in highrisk patients. Join the California Medical Association and Champions for Health for an educational session on the clinical practice burden and trends in prediabetes and diabetes, the evidence that supports systematically screening patients and establishing a referral process to a community based program, like the NDPP, and outreach strategies employed by clinicians to reach priority, high-risk patient populations.

1 AMA PRA CATEGORY 1 CREDIT™* *The California Medical Association/Institute for Medical Quality (CMA/IMQ) is accredited by the Accreditation Council on Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The California Medical Association/Institute for Medical Quality (CMA/IMQ) designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

SAN DIEGO PHYSICIAN.ORG

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/////////BRIEFLY /////////////////NOTED //////////////////////////////////////////////////////////////////////// MEMBERSHIP

CALENDAR

SDCMS-CMA CALENDAR For further information or to register for the following events, contact Jen at (858) 300-2781 or at JOhmstede@SDCMS.org.

Physician Mixer & Family Pool Party JUN 24: 4pm–8pm Transitioning Your Practice: Retiring, Selling or Buying a Practice (Webinar) JUN 28: 12:15pm-1:15pm SDCMS Physician Social (event) AUG 18: 5:30pm-8pm at Rock Bottom Brewery

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

“POLST: It Starts With a Conversation” Conference JUN 29-30 at the Long Beach Memorial Medical Center 34th Annual Primary Care Summer Conference AUG 4–6 at the Hilton San Diego Resort & Spa Integrative Medicine for Mental Health Conference SEP 28-OCT 1 at the Hyatt Regency Orange County The Future of Medicine: A Conference for Physicians SEP 29 (7:30am–4pm) at Kona Kai Resort & Spa

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JUNE 2017

Welcome New and Returning SDCMS-CMA Members!

OUR NEW MEMBERS Joseph Aquilina, MD, MBA Family Medicine San Diego (619) 843-5319 Jonathan Baker, MD Family Medicine San Diego (619) 279-0925 Ian Diaz, MD Family Medicine Carlsbad (760) 736-6767

Kristen Richards, MD Dermatology La Jolla (858) 362-8800 Shayna Walker, MD Psychiatry San Marcos (760) 471-2100 OUR RETURNING MEMBERS

Edna Flores, MD Medical Oncology La Jolla (858) 552-1410

Julie Block, MD Pediatrics Encinitas (760) 753-7143

Sujana Gunta, MD Pediatrics San Diego (760) 631-5000

Nisha Bunke, MD Family Medicine La Jolla (858) 550-0330

Yewah Jung, DO Family Medicine Ramona (760) 789-1223

Alfonso Camberos, MD Plastic Surgery San Diego (858) 847-0800

Simon Lavotshkin, MD General Surgery La Mesa (619) 797-4049 David Lepez, MD Family Medicine San Diego (619) 662-4100

Andrew Deemer, MD General Surgery Oceanside (760) 724-5352 Marcia Elfenbaum, MD Physical Medicine and Rehabilitation San Diego (858) 514-4116

Corey Marco, MD Family Medicine El Cajon (619) 442-0424

“

Elias Moukarzel, MD, FACP Obstetrics and Gynecology El Centro (760) 352-4103

Kishore Gaddipati, MD Gastroenterology San Diego (619) 291-6064 Fredrick Hanson, MD Pulmonary Disease La Jolla (858) 625-7200 Arturo Leon, MD Urgent Care San Diego (619) 556-8114 Joseph Mann, MD Orthopaedic Surgery Escondido (760) 747-7272 Walter Nahm, MD Dermatology San Diego (858) 278-8835 Minh Nguyen, DO, MBA Occupational Medicine Chula Vista (619) 297-9610 Cesar Pena-Romero, MD Critical Care Medicine Chula Vista (619) 426-9610 Charles Rudolph, MD Sports Medicine San Diego (858) 678-0455 Perry Sexton, MD Family Medicine Encinitas (760) 274-1385 Bernard Urlaub, MD Cardiovascular Surgery San Diego (619) 287-6003

QUOTE OF THE MONTH

”

Individual commitment to a group effort — that is what makes a team work, a company work, a society work, a civilization work.

— Vince Lombardi, NFL Player & Coach (1917-1970)

/////////////////////////////////////////////////////////////////////////////////////////////////// PUBLIC HEALTH

BEHAVIORAL HEALTH CONSULTATION SUPPORT As part of its ongoing initiative to enhance screening and treatment of behavioral health problems in primary care settings, the Behavioral Health Services section of San Diego County’s Health & Human Services Agency has funded an on-demand psychiatric telephone consultation service for primary care providers treating patients of all ages, and a patient call-in center where patients can obtain telephone consultations about their behavioral needs and obtain referrals to appropriate clinical services.

The Vista Hill SmartCare Behavioral Health Consultation Service provides these services free of charge to all primary care clinics within San Diego that serve the Medi-Cal or uninsured populations — consultations and referrals can be requested for any patient seen at these

clinics, regardless of their insurance.

• Provider Line: MD/DO, NP, and PA callers to SmartCare can reach the ondemand psychiatric consultation service by calling the provider line at (858) 880-6405, where they are received by the program’s triage nurse practitioner and board-certified psychiatric consultant for immediate response. Questions regarding psychiatric medications, diagnostic questions, and other behavioral concerns are answered promptly and efficiently to assist in-patient management at the primary care office. As warranted, patient referral or other resource recommendations can also be obtained.

A report with consultative findings and recommendations is provided to the primary care office within 24 hours.

• Patient Line: Patients with behavioral health concerns can be referred to call SmartCare to reach a behavioral health consultant or educator who can dialogue by phone with the patient to better

Behavioral Health Consultation Services SmartCare BHCS provides: • Real time psychiatric consultations • Behavioral Health support and linkage through our “Ready for Health” call line.

• E-Weekly On-line Newsletter

assess the patient’s needs and then to guide the patient to the most appropriate and accessible services. Patients can call SmartCare at (858) 956-5900. Again, a report of findings and recommendations is provided to the primary care office within 24 hours.

• eWeekly Newsletter: SmartCare distributes educational materials on behavioral health issues relevant to primary care practices. These brief articles are accessible at www.pc2education.org.

Write us at BHCS.Provider@vistahill. org to subscribe.

The program funding for SmartCare comes from Mental Health Services Act resources through San Diego County Behavioral Health Services. Both provider and patient calls are accepted weekdays, Monday–Friday, from 8:30 a.m. to 4:30 p.m. In-service and educational visits to your clinic can be arranged by contacting Program Director Deborah Skvarna, MFT, at (858) 444-5503.

Tracy Zweig Associates A A

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INC. INC.

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Physicians

Nurse Nurse Practitioners Practitioners Physician Physician Assistants Assistants

Contact our team directly at: Primary Care Provider Phone Line:

(858) 880-6405 Patient/Parent Phone line:

(858) 956-5900 Monday-Friday 8:30am-4:30pm.

Email: BHCS.Provider@vistahill.org Website: smartcarebhcs.org

“SmartCare – Ready for Health”

SmartCare BHCS services are funded under the County of San Diego Behavioral Services Mental Health Services Act. SmartCare BHCS services are free of cost to providers and patients.

Locum Tenens Tenens Locum Permanent Permanent Placement Placement Voice: Voice: 800-919-9141 800-919-9141 or or 805-641-91 805-641-91 41 41 FAX : 805-641-9143 FAX : 805-641-9143 tt zw zw eig@ eig@ tt rr acyzw acyzw eig.com eig.com w ww w w.t w.t rr acyzw acyzw eig.com eig.com SAN DIEGO PHYSICIAN.ORG

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/////////BRIEFLY /////////////////NOTED //////////////////////////////////////////////////////////////////////// COMMERCIAL REAL ESTATE

San Diego County Medical Office Report, Q1 2017

By Chris Ross

of 4.9 percent for the county overall. The submarket posting the largest year-overyear increase was La Jolla/UTC/Sorrento which increased 14.6 percent and had the highest average asking rental rate in the county at $3.93 per square foot per month, fully serviced.

Tip of the Quarter: With construction costs having gone up significantly over the past 12-18 months, reducing tenants’ out-of-pocket costs by offering increased TI allowances can by a good way to help deals come together. In most cases the increased allowances come with higher rental rates and/or less rent abatement; that being said, allowances in general have risen over the past several years—one trend that is working in tenants’ favor in an environment of rising rents and tightening concessions.

BY THE NUMBERS Market Conditions and Trends San Diego medical office occupancy increased in the first quarter of the year, posting an increase of 28,144 square feet of positive net absorption. The current overall San Diego County direct vacancy rate of 6.6 percent is 51 percent lower than in 2009, when it peaked at 13.6 percent.

Most all of the San Diego medical office submarkets recorded minor movement in their total occupancy in the first quarter, with only two submarkets recording positive or negative movement greater than 10,000 square feet: the Oceanside/Vista submarket increased its occupancy by 32,728 square feet, dropping into singledigit vacancy (9.8%) for the first time since 2008. La Jolla/UTC/Sorrento posted 20,146 square feet of positive net absorption.

The weighted average asking rental rate for medical office space continues to climb, with a current year-over-year increase

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JUNE 2017

6.6% Countywide Direct Vacancy

28,144

Q1 net absorption (s.f.)

4.9%

12-month rent growth $2.81 FS Average Asking

196,432 Total under construction (s.f.)

(3 projects in total)

News, Facts, and Updates Sale Transactions of the Quarter: Sharp Rees-Stealy exercised their option to purchase the 100,000-SF outpatient building at 16899 W. Bernardo Drive, their new Rancho Bernardo location to which they relocated in February. The sales price for the building was $42,662,500 ($426.63 PSF) and included a long-term ground lease.

In South County, Scripps Health purchased 333 H Street at Gateway Chula Vista. The 131,760-SF building sold for $27,825,000 ($211 PSF).

Lease Transaction of the Quarter: Cosmetic Laser Dermatology finalized a blend-and-extend at Genesee Plaza to increase its offices from 13,154 SF to 21,367 SF. Mr. Ross is senior vice president of healthcare solutions for Jones Lang LaSalle. He is a commercial real estate broker specializing exclusively in medical office and healthcare properties in San Diego County. To receive the complete Q1 2017 report, call Mr. Ross at (858) 410-6377 or email him at chris.ross@ am.jll.com.

///////////////////////CALIFORNIA /////////////////////////MEDICAL /////////////////// //////////////////////////////// ASSOCIATION PRACTICE MANAGEMENT:

TIP OF THE MONTH

JUNE

Know when you can, and cannot, charge a payor for copying medical records. Most managed care contracts include language that require practices to generally comply with medical records requests at no additional cost. However, if neither the contract, nor payor policies or procedures require you to bear the cost of those copies, there is no law to prevent you from billing the payor for reasonable copying expenses. For more information, see http://cal.md/may-2017-tip.

Through its robust webinar series, CMA gives you the opportunity to watch live presentations on important topics from the comfort • SEMINARS • PODCASTS • AND of yourWEBINARS home or office.

Webinars are free to members andMORE their staff and provide timely information to help you run a successful medical DID YOU KNOW? practice.

Check out the current webinar schedule at www.cmanet.org/webinars.

TROUBLE GETTING PAID? WE CAN HELP! CMA’s team of practice management experts has a combined experience of over 125 years in medical practice operations. Our goal is to empower physician practices by providing resources and guidance to improve the success of your practice.

Access to CMA experts is a FREE, members-only benefit.

Call (800) 786-4262 or email memberservice@cmanet.org.

Meet Your Advocate: Kris Marck

Kris is Associate Director in CMA’s Center for Economic Services. Before joining CMA in 2011, she spent 23 years working on the payor side of the health care industry. This previous experience makes her a very effective and approachable advocate for physicians in need of reimbursement and contracting assistance.

Working with payors is challenging and the reimbursement process is complex.

Don’t hesitate to call us. It’s easy to give the easy answer, but it’s difficult to go and find the right answer. We’ll get you the right answer.”

Kris Marck, Associate Director, CMA Center for Economic Services TO OPT OUT OF FUTURE NOTICES, EMAIL MEMBERSERVICE@CMANET.ORG OR FAX (916) 551-2036. BE SURE TO INCLUDE THE FAX NUMBER YOU WANT REMOVED. SAN DIEGO PHYSICIAN.ORG

7

EXERCISE

FILL AN EXERCISE PRESCRIPTION WITH WALK WITH A DOC

by Natalie Digate Muth, MD, MPH, RDN, FAAP

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JUNE 2017

DR. DAVID SABGIR was a frustrated cardiologist, repeatedly giving his patients the same advice (“move more”) but seeing little change. Instead of sitting around being upset, he decided to make a difference.

He rallied a few patients on a Saturday morning to walk together, branding it Walk with a Doc. Walk with a Doc evolved into a movement in Columbus, Ohio, his hometown, and then to hundreds of communities across the country—including right here in San Diego County.

As physicians, we know that physical activity is an effective treatment for myriad conditions, including weight concerns, depression and anxiety, dyslipidemia, prediabetes and diabetes, and attention problems, among others. A recent Health Affairs study projected that if all 8- to 11-year-olds engaged in exercise for

WILL YOU JOIN ME? walkwithadoc.org/Carlsbad 25 minutes three times per week, it would prevent $62.3 billion in healthcare costs over their lifetimes, and prevent 1.2 million cases of overweight and obesity. Not to mention, physical activity helps all of us to be happier and feel better. It is a potent “medication” that is rarely prescribed and too infrequently filled. Knowing this, I often asked myself: What could I do differently to change that for my patients?

That’s how Walk with a Doc Carlsbad was born. Children’s Primary Care Medical Group, Carlsbad Parks and Recreation, and national Walk with a Doc came together to launch the first civilian Walk with a Doc in San Diego County. Walk with a Doc Carlsbad is open to everyone—with a particular focus on families and children—

every Thursday at 4 p.m. at Stagecoach Park in Carlsbad. Each week we start with a nutrition or healthy living demo and skill-building activity, followed by a walk in the park. While I realize we cannot reach everyone with this program, it is a start.

And it is a turnkey program that I hope will catch on throughout San Diego.

Walk with a Doc is one way, but, of course, not the only way that we can do more to help our patients increase activity.

Healthcare leaders, and even the Surgeon General, are calling on physicians to routinely prescribe exercise—and walking in particular. For example, authors in The Journal of the American Medical Association recommend that clinicians do the following to integrate physical activity counseling into their practices: • Make physical activity a vital sign at each clinic visit.

• Ask if the patient exercises regularly or engages in physical activity.

• Associate physical activity with reduced risk of heart disease, stroke,

diabetes, and many cancers.

• Write a prescription for an agreed-upon daily physical activity.

• Encourage use of a pedometer and advise record keeping.

• Recognize success and encourage reluctant adopters.

Clearly there is a need for opportunities and programs to help both patients and providers to increase physical activity and enjoy it at the same time. Walk with a Doc is one such program that is growing throughout the country. It’s to get started, and provides a tangible way for us to all get moving and provide a concrete way to Walk the Talk.

Dr. Muth is a pediatrician and lead of the W.E.L.L. healthy weight clinic and Carlsbad Walk with a Doc at Children’s Primary Care Medical Group-La Costa. She is also involved in the healthcare domain of the National Physical Activity Plan and is senior adviser for healthcare solutions at the American Council on Exercise.

Transforming the Health Care Experience The physicians at Sharp bring the most advanced clinical care to those they serve each day. And as San Diego’s health care leader, we’re proud to touch the lives of more individuals in our community than any other health care provider.

CORP766A ©2017 SHC

From how we greet each person with a smile to the way we explain a procedure — we go beyond caring for people to caring about people. This is the extraordinary level of care called The Sharp Experience.

Learn more at sharp.com.

SAN DIEGO PHYSICIAN.ORG

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R I S K M A N AG E M E N T

IT’S TIME TO RESET THE MEDICAL MALPRACTICE INSURANCE CONVERSATION

by Richard E. Anderson, MD, FACP

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JUNE 2017

IN THE MID-1970S, malpractice lawsuits and skyrocketing jury awards caused commercial insurance companies to raise physicians’ malpractice rates by as much as 400 percent. The practice of medicine was deemed to be “uninsurable.” Thousands of physicians faced cancellation of their policies. As a result, doctors came together to form their own companies to provide affordable and sustainable coverage. However, today’s physicians need more.

We spoke with more than 800 doctors, practice managers, and group administrators across the country last year. The message was clear: In addition to requiring strong professional liability protection, practices of all sizes also need their insurer to be a proactive partner to help them navigate the challenges ahead.

It is time for our industry to reset the conversation around medical malpractice

The industry needs to focus on the positive aspects of what we do for physicians by taking the “mal” out of malpractice.

insurance. We believe we should serve the medical profession by partnering with those who provide care — so that doctors can focus on making decisions based on the best outcomes for patients, rather than on threats of litigation, invasive regulation, or financial loss.

The industry needs to focus on the positive aspects of what we do for physicians by taking the “mal” out of malpractice. We will do this by collaborating with practices and systems to reduce the likelihood of lawsuits, by defending doctors inside and outside the courtroom, and by helping them navigate today’s healthcare landscape.

Evolving to meet changing needs As healthcare continues to undergo unprecedented change, practicing medicine has become increasingly complex. Faced with a tangle of contradictory regulations,

rapidly changing system and reporting mandates, the disruptions of digitization and consolidation, and ever-present cyber threats, those who practice medicine have never been under greater pressure.

In this environment, medical malpractice insurers must evolve to meet the changing needs of the profession. Practitioners struggling to heal patients and stay in business need more than an insurer that simply reacts to claims.

We should offer tools and services that provide guidance. For example, we have created an extensive library of articles and resources openly available to all healthcare providers to help them understand and comply with electronic health record requirements, become familiar with the risks of telemedicine, and stay informed about drug safety laws. We share these articles and resources with healthcare providers worldwide in a number of ways, including social media.

We have also initiated online conversations about medicine in the changing healthcare environment through our hashtag #advancegoodmedicine.

Every piece of information that supports practicing medicine safely and effectively in this changing environment has special value. Practices and systems are looking for insurer-led participatory education and coaching, like rare-event simulation, to improve patient safety and reduce the threat of litigation. Our foundation recently provided grants for hands-on medical simulations, institutional- and physician-level process improvements in healthcare delivery, and improved safety systems as a core part of medical education.

Today’s medical malpractice insurance buyers also expect a comprehensive array of tools to help them stay current with emerging best practices in patient care. For example, we analyze data captured from our claims experience with more than 78,000 members and translate it into actionable reports that are shared free of charge with all healthcare providers. We have published

reports on cardiology, anesthesiology, emergency medicine, orthopedics, obstetrics, hospital medicine, internal medicine, plastic surgery, and electronic health record claims. In upcoming reports, we will focus on opioid prescription, psychiatry, advanced practice provider, pediatrics, and hospitalbased claims. These studies are designed to promote patient safety and minimize liability exposure. The analysis uncovers the newest plaintiff allegations, reveals the most important factors that potentially lead to patient injury, and discusses — in detail — the shared aspects of claims. Physicians nationwide have already begun using the data in these studies to make changes in their practices that benefit patients and reduce the risk of adverse events.

Starting a new conversation Another reason to reframe the conversation about medical malpractice is that the term “malpractice” is a misnomer. Over 80 percent of our claims are closed with no indemnity payment. It’s time to stop focusing on the inaccurate term “malpractice” and instead emphasize the positive measures insurers take to help doctors, practices, and systems reduce claims. The industry can join in this effort by sharing data and by engaging in collaborative patient safety and risk management programs.

Changing the way we talk about malpractice insurance is the first step in demonstrating our understanding of the contemporary experience of medical practice and becoming a proactive partner that meets rapidly evolving needs.

Richard E. Anderson, MD, FACP, is chairman and chief executive officer of The Doctors Company (thedoctors.com), the nation’s largest physician-owned medical malpractice insurer.

He also chairs the board of directors of PIAA, the leading international association representing the medical and healthcare professional liability insurance community.

SAN DIEGO PHYSICIAN.ORG

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We understand that one size does not fit all.

With location, accessibility, size, office layout and specific medical requirements to consider, we will find the right fit for you. Have you seen what is available in the medical office market lately?

Village North at Pacific Highlands Ranch 6155 Carmel Valley Road Carmel Valley up to 10,000 s.f. available For Lease

Genesee Plaza 9333-9339 Genesee Avenue UTC up to 17,060 s.f. available For Lease

Nordahl Medical Centre 838 Nordahl Road San Marcos up to 14,920 s.f. available For Lease or Sale

Sorrento Medical Plaza 9200 Scranton Road Sorrento Valley 1,514 s.f. available For Lease

CreekView Medical Park 1968 Via Centre Vista up to 5,000 s.f. available For Lease

Carlsbad Medical Dental Plaza 3144 El Camino Real Carlsbad 1,797 s.f. available For Lease

Ruffin Surgical & Medical Center 3939 Ruffin Road Kearny Mesa up to 30,600 s.f. available Surgery Center & office space

Torrey Hills Medical Plaza 4765 Carmel Mountain Road Carmel Valley up to 3,714 s.f. available For Lease

1940 5th Avenue Bankers Hill 11,108 s.f. available For Sale with income

Garden View Professional Center 499 N El Camino Real Encinitas 4,910 – 8,306 s.f. available For Lease

8901 Activity Road Mira Mesa 1,725 & 3,670 s.f. available For Lease

Ryan Plaza 11943 El Camino Real Del Mar Heights up to 7,152 s.f. available For Lease

JLL Healthcare Practice Group 8910 University Center Lane Suite 100 San Diego, CA 92122 sdmedicalrealestate.com

Paul Braun Managing Director 858.410.6388 paul.braun@am.jll.com

Chris Ross Senior Vice President 858.410.6377 chris.ross@am.jll.com

Kelly Moriarty Associate 858.410.6359 kelly.moriarty@am.jll.com

HOW TO GET INVOLVED WITH CMA

MEMBERSHIP MAKES YOU

STRONGER

BY THE CALIFORNIA MEDICAL ASSOCIATION

14

JUNE 2017

Together we are stronger. It’s a catchphrase you’ve heard before. And it’s true.

When physicians come together through organized medicine, we have the power to make a big impact on the health of California. ¶ Getting involved in organized medicine — through the California Medical Association (CMA) and your local county medical society — is also an investment in yourself: in your career, in your wellbeing and in your profession.

SUCCEED Get paid. Highly trained economic advocates with expertise in physician reimbursement and medical business issues are available to provide one-on-one help to improve your bottom line.

Earn free CME. CMA’s robust webinar series gives physicians and their staff the opportunity to watch live presentations on important topics of interest from the comfort of their homes or offices. Many of these FREE webinars also offer CME! Receive FREE legal help and information. CMA’s legal help line provides immediate assistance to members with questions on human resources, medical, regulatory, or legal issues. Members also have free access to CMA’s comprehensive legal library for information on hundreds of healthcare topics.

Attend timely seminars.

CMA’s experts travel around the state, giving live presentations on current healthcare topics.

Stay on top of critical healthcare news by signing up for custom content alerts on your interest areas.

Follow cutting-edge healthcare trends. CMA members save $300 on registration to the annual Western Health Care Leadership Academy. The Academy is the state’s premier opportunity for physicians and medical practice managers to learn trends and developments in our rapidly changing healthcare marketplace.

Stay in the know. CMA and your local county medical society produce a number of publications to keep members up to date on the latest healthcare news and information affecting the practice of medicine in California.

“I would not consider myself a complete physician in California without being a CMA member.”

Albert Ray, M.D., Family Physician CMA MEMBER SINCE 1994

SAN DIEGO PHYSICIAN.ORG

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Membership is easier than ever with new MONTHLY payment plan

CONNECT Get empowered. Many issues feel overwhelming in the isolation of your office — but you don’t have to face the challenges alone. Getting involved with CMA or your county medical society will help you feel empowered to make a difference.

Network with colleagues at hosted events throughout the year.

Improve your community with volunteer opportunities at health fairs and community clinics.

Champion community health through the CMA Foundation. Innovative partnerships with physicians and community leaders provide CMA members the training and tools to make a difference.

Get help. If you or a family member need confidential help with problems of alcoholism, drug dependence or mental illness, the Physicians’ and Dentists’ Confidential Assistance Line is a 24-hour service that provides completely confidential doctor-to-doctor assistance. Call (650) 7567787 (Northern California) or (213) 383-2691 (Southern California).

Earn FREE membership!

CMA members who sign up three to four new members will get a 50 percent discount on their dues the following year. Recruit five or more and get free membership.

LEAD Influence CMA’s advocacy agenda by serving in the House of Delegates or on councils and committees.

Help establish CMA policies on major issues that affect the practice of medicine.

Join CMA’s sections and forums based on your career phase and mode of practice.

Positions are available for physicians, students, and residents to serve as officers, trustees, or CMA delegates.

Run for office within your county medical society and/ or CMA. There are many leadership positions for physicians who want to get involved — including Boards of Directors and Executive Committees.

Get elected to the State Legislature or Congress.

The CMA Political Action Committee (CALPAC) helps physicians get involved in the state legislature and Congress, as well as supports candidates and legislators who understand and embrace the profession. Even if you don’t intend to run for office, you can join the fight to keep medical decisions where they belong: in your well-trained hands.

“It’s critical for medical students to understand and appreciate the complexities our future patients are experiencing in the ever-changing healthcare landscape.”

Abhishek Kumar, Medical Student CMA MEMBER SINCE 2016

16

JUNE 2017

Membership in the California Medical Association (CMA) and your local county medical society is easy to maintain and hassle-free with automatically recurring monthly payments at an affordable monthly price. If you’re not already a member, enroll today at www.cmanet. org/monthly to start receiving your benefits! If you’re a current member, keep an eye out for your renewal invoices this fall and choose the monthly payment plan.

Questions? Contact CMA’s Member Service Center at (800) 786-4262 or memberservice@cmanet.org.

IMPACT Influence elected officials and policymakers. CMA’s Legislative Key Contacts build relationships, receive action alerts, and educate lawmakers to ensure decisions are guided by medical experts.

Help shape CMA policy.

Not enough time to serve on a council or committee?

Members can still participate in the development of CMA policy by testifying quarterly on resolutions and reports.

Author a resolution.

Members are encouraged to submit policy ideas for consideration by CMA councils and committees.

Advocate for your patients and your profession. CMA gives members the tools, training, and opportunities to make an impact on proposed laws and regulations.

Improve quality of care. Serve as a surveyor, committee member, or educator for the Institute for Medical Quality’s (IMQ) accreditation programs.

Be the voice of medicine.

CMA Media Ambassadors are trained to play a critical role in making sure that physicians have a strong voice in the public sphere.

Influence the debate on social media. Engage with CMA, your local medical society, and colleagues on social media — share, retweet, and tag! Follow CMA at @ cmaphysicians across all social platforms.

Learn more at www.cmanet.org/ get-involved.

“Working with CMA has been the perfect addition to my medical training.

It has made me appreciate the role of physicians as champions for health and the importance of making our voices heard to help patients across the world.”

Meghana Pagadala, SDCMS Medical Student Liaison and UCSD CMA Alternate Delegate

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MEMBER BENEFITS

PUT YOUR SDCMS-CMA MEMBERSHIP TO WORK! DID YOU KNOW? When you join SDCMS you join CMA as well, and together we are stronger.

Both SDCMS and CMA are aggressively defending the practice of medicine, but the benefits of organized medicine extend well beyond these universal protections. Members can offset the price of their annual dues when using SDCMS and CMA membership services and discounts. Thanks to our group buying power, members receive deep discounts on everything from magazines to office supplies to insurance products. From physician practice websites to waste management, our discount programs will save you time and money.

Many SDCMS-CMA members save more than their annual dues!

Suggest a member benefit — email Membership@SDCMS.org!

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JUNE 2017

BENEFIT

CONTACT

AUTO/HOMEOWNERS INSURANCE

Save up to 8%.

Mercury Insurance Group (888) 637-2431 www.mercuryinsurance.com/cma

CAR RENTALS

Save up to 25%.

Avis or Hertz (800) 786-4262 www.cmanet.org/groupdiscounts

Free classified ads in San Diego Physician magazine and online at SDCMS.org.

SDCMS (858) 565-8888 Editor@SDCMS.org

Discounted CME certification for credentialing purposes with the MBC, as well as hospitals, health plans, specialty societies, and others.

Institute for Medical Quality (IMQ) (415) 882-5151 www.imq.org

Join an SDCMS committee or commission: San Diego Physician Editorial Board, Bioethics Commission, Emergency Medicine Oversight Commission (EMOC), Group to Eradicate Resistant Microorganisms (GERM) Commission, Legislative Committee, Professional Conduct Committee.

SDCMS (858) 565-8888 Membership@SDCMS.org

CONFIDENTIAL HOTLINE

For physicians who have substance abuse, or psychological or emotional problems to help them help themselves before their lives and livelihood are put in jeopardy.

CMA (213) 383-2691 www.cmanet.org/resources/confidentialassistance

DISPLAY ADS

Substantial discounts on display advertising in San Diego Physician magazine, at SDCMS.org, and in SDCMS’s e-newsletters.

Dari Pebdani (858) 231-1231 DPebdani@SDCMS.org

Free emergency situation driving emblem.

SDCMS (858) 565-8888 Membership@SDCMS.org

Various compliance toolkit discounts.

PrivaPlan Associates, Inc. (877) 218-7707 www.privaplan.com

CLASSIFIED ADS CME CERTIFICATION AND TRACKING

COMMITTEES AND COMMISSIONS

EMERGENCY DRIVING EMBLEM HIPAA ICD-10-CM

Tools and resources, including a transition guide, one-on-one assistance, discounted education and training, and news alerts.

CMA www.cmanet.org/icd10

Join SDCMS-CMA on Oct. 1 and receive 15 months of membership for the price of 12!

SAN DIEGO PHYSICIAN.ORG

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MEMBER BENEFITS

INSURANCE SERVICES IT

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BENEFIT

CONTACT

Save up to 25% on workers’ compensation insurance, and receive special pricing and/or enhanced coverage for life, disability, long-term care, medical, dental, and more.

Mercer Health & Benefits Insurance Services LLC (800) 842-3761

Free site inspection and subsequent infrastructure recommendations, free inventory and assessment of network and hardware computing assets, and free analysis of Internet/telco/data activity and subsequent ROI recommendations.

SOUNDOFF Computing (858) 569-0300 www.soundoffcomputing.com

LABORATORY ACCREDITATION

15% discount on lab accreditation programs and services.

COLA (800) 786-4262 www.cmanet.org/cola

LEGAL SERVICES

Need to know how to terminate a physicianpatient relationship? How to challenge your quality rating in a pay-for-performance program?

How long to retain medical records? What you can do regarding a negative online review? What restrictions apply to e-prescribing of controlled substances? Whether there are laws that govern physician advertising? CMA is your best source of knowledge to effectively answer difficult questions about practicing medicine in California.

Members have free access to CMA ON-CALL (CMA’s online health law library with nearly 5,000 pages of documents and valuable information for physicians and their staffs), access to CMA legal staff through the legal information line, and more.

CMA’s Center for Legal Affairs (800) 786-4262 legalinfo@cmanet.org www.cmanet.org/legal

MAGAZINE SUBSCRIPTIONS

Save up to 50% on all subscriptions.

Subscription Services, Inc. (800) 289-6247 www.cmanet.org/magazines

MEDICAL IDs

Discounts on 24-hour emergency identification and family notification services.

MedicAlert (800) 253-7880 www.cmanet.org/medicalert

MEDICAL MALPRACTICE INSURANCE

5% discount for qualified members with a favorable claims history, additional claims-free credit of up to 25% for eligible members, free retirement tail coverage for qualified members, and free web-based and live CME.

The Doctors Company www.thedoctors.com/sdcms

MEDICAL WASTE MANAGEMENT

Save 30% or more on medical waste management and regulatory compliance services and 50% on the Compliance Portal.

EnviroMerica (650) 655-2045 www.cmanet.org/enviromerica

MESSAGING APP

Free, secure messaging app.

DocbookMD www.cmanet.org/docbookmd

JUNE 2017

BENEFIT

CONTACT

MEMBER HELP LINE

Highly trained economic advocates with expertise in physician reimbursement and medical business issues are available to provide one-on-one help to improve your bottom line. Whatever you need — be it legal information, help with a problematic payer, or details about your member discounts and services — just call the member help line.

CMA (800) 786-4262

NEWS, INFORMATION, AND UPDATES

CMA’s website lets you customize your website content and receive personalized updates on the issues that matter most to you and your practice.

First, activate your web account. Then sign up for custom content alerts on the topics that are of interest to you (e.g., public health, practice management, breaking healthcare news). You will then be notified anytime there is new content posted in one of your interest areas. You can also sign up for “content update” alerts on any webpage to be notified anytime the content on that page is updated.

CMA www.cmanet.org/activate

This conference will give practitioners a whole body approach to successfully diagnose and treat underlying issues contributing to the manifestations of neurological, social, and behavioral disorders.

Research has revealed that many disorders such as depression, bipolar disorder, anxiety, OCD, eating disorders, and autism spectrum disorders often have biomedical causes that contribute to symptoms, from nutritional deficiencies to chronic infections. Patients have better outcomes when these causes are addressed and treated through a combination of specialized testing and nutritional therapies.

VENUE: HYATT REGENCY ORANGE COUNTY CME AND CE AVAILABLE!

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Register by july 31 and save $100!

SAN DIEGO PHYSICIAN.ORG

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MEMBER BENEFITS

BENEFIT

CONTACT

OFFICE MANAGER FORUM

Access a private e-forum for office managers and practice administrators.

SDCMS (858) 565-8888 Membership@SDCMS.org

OFFICE SUPPLIES

Save up to 80%.

Staples Advantage (800) 786-4262 www.cmanet.org/staples

PHYSICIAN MAILING LISTS

Free San Diego County physician mailing list and label service.

SDCMS Membership@SDCMS.org

PHYSICIAN PROFILES

Free physician profile at SDCMS.org, on SDCMS’s San Diego County all physician directory app, and at sandiegomagazine.com/findadoctor, and a free listing in San Diego Magazine’s annual health annex.

SDCMS (858) 565-8888 Membership@SDCMS.org

Seeking Family Medicine Physicians in San Diego and Orange Counties Position: Full-time and part-time. Full benefits package and malpractice coverage is provided by clinic.

Requirements: California license, DEA license, CPR certification and board certified in family medicine. Bilingual English/Spanish preferred.

Send resume to: hr@vistacommunityclinic.org or fax to 760-414-3702

Vista Community Clinic is a private, nonprofit outpatient community serving people who experience social, cultural or economic barriers to health care in a comprehensive, high quality setting.

www.vistacommunityclinic.org EEO/AA/M/F/Vet/Disabled

22

JUNE 2017

BENEFIT

CONTACT

PRACTICE RESOURCES

CMA produces a number of resources to help practices of all sizes run smoothly. These resources include legal handbooks, HIPAA compliance toolkits, practice management guides, patient forms, and patient education materials. Many of these are free or deeply discounted for members. Visit the resource library for more details.

CMA www.cmanet.org/resource-library

PUBLICATIONS

CMA produces a number of publications to keep members up to date on the latest healthcare news and information affecting the practice of medicine in California: CMA Alert, CMA Capitol Insight, CMA Practice Resources, CMA Press Clips, Legal Case List, Legislative Hot List.

CMA (800) 786-4262 memberservice@cmanet.org www.cmanet.org/newsletters

REIMBURSEMENT ASSISTANCE

Questions about Covered California? Claims not being paid in a timely manner? Not being paid according to your contract? Receiving unreasonable requests for medical records? Receiving untimely requests for refunds or is a payer recouping money from your check without first notifying you in writing of a refund request? Need help with Medicare related issues? Claims being denied after obtaining prior authorization? Been presented with a managed care contract and you’re not sure if the terms are consistent with California law?

Done everything you can to resolve an issue with a payer, but have hit a brick wall? CMA’s Center for Economic Services (CES) is staffed by practice management experts with a combined experience of more than 125 years in medical practice operations. Our goal is to empower physician practices by providing resources and guidance to improve the success of your practice. Assistance ranges from coaching and education to direct intervention with payers or regulators. SDCMS-CMA members receive free assistance with payment, billing, and contracting issues.

CMA’s Center for Economic Services (800) 401-5911 economicservices@cmanet.org www.cmanet.org/ces

Free subscription.

SDCMS (858) 565-8888 Membership@SDCMS.org

SBA loan guarantee fee discounts.

San Diego Private Bank Michael T. Valenti, SVP SBA Division Manager (760) 759-1709 mvalenti@sandiegoprivatebank.net

15% discount on tamper-resistant security prescription pads.

RxSecurity (800) 667-9723 www.cmanet.org/rxsecurity

SAN DIEGO MAGAZINE NEW MEMBER BENEFIT

SBA LOANS

SECURITY PRESCRIPTION PADS AND FORMS

Join SDCMS-CMA at SDCMS.org — it takes 5 minutes

SAN DIEGO PHYSICIAN.ORG

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MEMBER BENEFITS

BENEFIT

CONTACT

SOCIALS

Free attendance at SDCMS’s many physician networking opportunities and mixers held throughout the year (next social: Aug. 18 at Rock Bottom Brewery in La Jolla, 5–8 p.m.).

Jennipher Ohmstede (858) 300-2781 JOhmstede@SDCMS.org

WEBINARS AND SEMINARS

SDCMS and CMA provide timely, high-quality educational programs for physician members and their staffs. From highly interactive, in-person seminars to live and on-demand webinars, SDCMS and CMA provide you with the information you need to run a successful medical practice.

WEBSITES

Save up to $1,000 on unique website packages.

GRAND OPENING

Urogynecology & GYN Practice in Carlsbad

Dr. Elias Moukarzel, FACOG, FPMRS is double board certified in OBGYN and Female Pelvic Medicine & Reconstructive Surgery.

6125 Paseo Del Norte, Suite 140 Carlsbad, CA 92011

760.585.2380 feminacareouro-gyn.com

24

JUNE 2017

Evaluation and management for all female pelvic disorders, pelvic pain, pelvic organ prolapse and incontinence.

SDCMS www.sdcms.org CMA www.cmanet.org/events

MAYACO Marketing & Internet (209) 957-8629 www.cmanet.org/mayaco

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Activ. Fee: Up to $30/line. Credit approval req. $400 SDP Visa Prepaid Card Offer: Offer ends 6/30/17. Sel. SDP with qualifying corp. id.

While supplies last. Limit 1 per new acct. New acct. must remain active & in good standing for 31 days to receive Visa Prepaid Card. Allow 10-12 wks. for delivery. Excl. CL, select SDP, add-a-line, tablet activ. upgrades, replacements, and ports made between Sprint entities or providers associated with Sprint (i.e., Virgin Mobile USA, Boost Mobile, and Assurance). May not be combinable with other offers. See store or sprint.com for details. Visa Prepaid Card: is issued by MetaBank®, Member FDIC, pursuant to a license from Visa U.S.A. Inc. No cash access or recurring payments. Can be used everywhere Visa debit cards are accepted. Card and funds expires after 6 months.

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Incl. unlimited domestic Long Distance calling, texting & data & 10GB of high-speed Mobile Hotspot, VPN & P2P. Third-party content/ downloads are add’l. charge. Sel. int’l. svc. incl. see sprint.com/globalroaming. Plan not avail. for tablets/MBB devices. AutoPay: To receive $5/mo. discount you must remain enrolled in AutoPay. Quality of Service (QoS): Customers who use more than 23GB of data during a billing cycle will be deprioritized during times & places where the Sprint network is constrained. See sprint.com/networkmanagement for details. Usage Limitations: To improve data experience for the majority of users, throughput may be limited, varied or reduced on the network. Sprint may terminate service if off-network roaming usage in a month exceeds: (1) 800 min. or a majority of min.; or (2) 100MB or a majority of KB. Prohibited use rules apply — see sprint.com/termsandconditions. SDP Offers: Sel. SDP only. Offers avail. for eligible company/agency employees or org. members (ongoing verification). Subject to change according to the company’s/agency’s/org’s agreement with Sprint. Offers are avail. upon request. Other Terms: Offers/coverage not avail. everywhere or for all phones/networks.

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Be it legal information, help with a problematic payor, or details about your member benefits, call CMA’s Member Help Line: (800) 786-4262

SAN DIEGO PHYSICIAN.ORG

25

CLASSIFIEDS CLINICAL TRIALS WE ARE LOOKING FOR VOLUNTEERS TO PARTICIPATE IN CLINICAL TRIALS: Currently enrolling volunteers who suffer from rheumatoid arthritis, lupus, psoriasis, and psoriatic arthritis.

Qualified volunteers may receive: no-cost investigational study medication, no-cost study-related care from a study doctor. There is compensation available for time and travel.

All study-related care will be at no cost, and volunteers can continue seeing their primary care doctor during the study. Health insurance and doctor referrals are not required to participate.

Please email Joy at joy@rheumSD.com for more information. [607] PHYSICIAN POSITIONS AVAILABLE DERMATOLOGIST NEEDED: Premier dermatology practice in La Jolla seeking a fulltime/part-time BC- or BE-eligible dermatologist.

Existing practice taking over another busy practice and looking to add dermatologist. This is a significant opportunity for a motivated physician to take over a thriving patient base. Work with two energetic dermatologists and a highly trained staff in a positive environment. We care about our patients and treat our staff like family.

Opportunity to do medical, cosmetic, and surgical dermatology. May 2017 start preferred. Please call practice administrator at (858) 761-7362 or email jmaas12@hotmail.com for more information. [612] PRIVATE PRACTICE INTERNAL MEDICINE OPPORTUNITY IN BEAUTIFUL NORTH SAN DIEGO COUNTY: Unique opportunity to practice outpatient internal medicine in a private practice setting. Practice is part of a well-established internal medicine group with a 30+ year history of outstanding care in the community, seeking physician who enjoys providing thoughtful, personalized patient care. Exceptional office staff, flexible scheduling options, small group environment, autonomy, and very high quality patient care are among the many benefits of this opportunity. Office is easily accessible from all parts of San Diego County, as well as Orange County. Seeking BC/BE applicants. Please send CV to portofino3@aol.com or call (619) 248-2324. [611] FULL-TIME PRIMARY CARE PEDIATRIC POSITION AVAILABLE in beautiful San Diego, California, to provide coverage for newborn care in Maternal Child Health Unit and community outpatient pediatric clinic. Job duty includes supervision and teaching of residents and medical students. Average 20–25 patients daily.

No evening or weekend calls or attendance of deliveries. Centrally located in San Diego with easy access to gorgeous beaches, parks, hiking trails, San Diego Zoo, and fine dining. Opening available now. Must be certified for PALS and NRP. BC or BE. Must have a valid California medical license. An additional part-time position is also available. Please submit inquiry and CV to Garcia.Leanne-Sarah@scrippshealth.org. [610] FAMILY PRACTICE MD/DO WANTED for urgent care and family practice office in Carlsbad.

Flexible morning, afternoon, evening, and weekend shifts available for family practice physician. Exceptional office staff and flexible scheduling options at this busy, well-established private practice. Please fax or email CV to (760) 603-7719 or gcwakeman@sbcglobal.net. [609]

LOOKING FOR A FAMILY PRACTITIONER: Well-established solo family practitioner located in suburban San Diego wishing to transition into retirement and looking for a fellow family practitioner to assume fully operational practice.

This practice is part of a 15-member incorporated family practice medical group with lab, X-ray, and MRI facilities. All interested candidates will be considered. Please email CV with contact information to Editor@SDCMS.org. [607] SEEKING PART-TIME PHYSICIAN: Anderson Medical Center is a busy primary care, sports, and occupational medicine practice housed in a stateof-the-art urgent care facility in Pacific Beach.

We’re seeking a part-time physician. Experience in a busy practice, emergency department, or urgent care; with musculoskeletal medicine, X-ray, and sutures/wound care required; and ability to provide compassionate care in a fast-paced environment necessary. We seek someone who values: integrity and quality medical care; with impeccable bedside manner, emotional / professional maturity, ability to work well with patients / team members, easily manages multiple priorities / patients; detail-oriented and teamfocused. We’re open 8:00am–8:00pm, Monday– Friday, 8:00am–4:00pm weekends. Providers share day, night, and weekend coverage.

Contact Anderson Medical Center at (858) 224-7977. CVs may be emailed to jhardyman@andersonmedicalcenter.com. [606] SEEKING PART-TIME CARDIOLOGIST: Seeking a cardiologist to work part-time in an outpatient cardiology practice in North San Diego County.

Practice opportunities from Monday through Saturday. Hours are from 8am to 5pm. There is no night call or holiday workdays. The contracted cardiologists would decide from the days available which days to work. Please fax resume to (760) 510-1811 or email to evelynochoa2013@yahoo.com.

[596] SHARPCARE MEDICAL FOUNDATION CHIEF MEDICAL OFFICER: Full-time CMO for new primary care Foundation model. Adult primary care physician, 80% clinical / 20% administrative with practice in La Mesa area: Current unrestricted license to practice medicine in the State of California; board certified in primary care or related sub-specialty area; minimum five years of medical administration experience; excellent communication skills; demonstrated clinical practice leadership experience; knowledge of managed healthcare systems, medical quality assurance, quality improvement and risk management; demonstrated leadership, management, organizational, and interpersonal skills; ability to work collaboratively internally and externally; demonstrated ability to assess business needs, design and implement programs, and evaluate results; demonstrated commitment to group practice and healthcare system values.

Job type: Full-time. Contact Glenn Chong at glenn.chong@sharp.com or call (858) 499-4557.

[594] SEEKING FAMILY MEDICINE AND INTERNAL MEDICINE PHYSICIANS: SHARP Rees-Stealy Medical Group is seeking full-time or half time (job share) BC/BE family medicine and internal medicine physicians to join our staff. We offer a first-year competitive compensation guarantee and an excellent benefits package. Please send CV to SRSMG, Physician Services, 300 Fir Street, San Diego, CA 92101. Fax: (619) 233-4730. Email: lori. miller@sharp.com. [590]

TO SUBMIT A CLASSIFIED AD, email Editor@SDCMS.org. SDCMS members place classified ads free of charge (excepting “Services Offered” ads). Nonmembers pay $150 (100-word limit) per ad per month of insertion.

26

JUNE 2017

SEEKING EMERGENCY MEDICINE PHYSICIANS: SHARP Rees-Stealy Medical Group is seeking full-time BC/BE emergency medicine physicians to join our urgent care department. We offer a first-year competitive compensation and an excellent benefits package. Please send CV to SRSMG, Physician Services, 300 Fir Street, San Diego, CA 92101. Fax: (619) 233-4730. Email: lori.miller@sharp.com. [591] FAMILY MEDICINE / INTERNAL MEDICINE PHYSICIANS NEEDED: Graybill Medical Group is one of North San Diego County’s largest independent multi-specialty groups with over 80+ physicians and midlevel practitioners.

We currently have full-time openings in our San Marcos, Ramona (solo practice), and Temecula locations. Current CA and DEA licenses required. Must be BC/BE. We offer a competitive compensation and benefit package, including malpractice coverage and shareholder opportunity. Check out a full list of our benefits under Careers at www.graybill.org. Send CVs to ssnodgrass@graybill.org, apply online, or fax (760) 738-7101. [592] GENERAL, FAMILY, OR INTERNAL MEDICINE PHYSICIAN NEEDED IMMEDIATELY: This opening is an independent contractor position. We are a house-call practice located in beautiful North San Diego County. We will also provide paid training on our EMR. 8–5, Monday–Friday, 10–12 patients per day, and on-call pager one week every three weeks, telephone call only. No rounds or hospital duties.

If interested, please email your CV to julie@sandiegomobiledoctor.com. We are very anxious to fill this position, and we look forward to hearing from YOU! No agencies please. [584] FAMILY MEDICINE / PEDIATRIC PHYSICIANS NEEDED: Family medicine and pediatric physician positions currently available. Vista Community Clinic is a private nonprofit outpatient clinic serving the communities of North San Diego County, Riverside County, and Orange County.

We have openings for full-time and part-time physicians. Current CA and DEA licenses required.

Malpractice coverage provided. Full benefits packet. Email resume to hr@vistacommuntyclinic. org or fax to (760) 414 3702. Visit our website at www.vistacommuntyclinic.org. EEO Employer/ Vet/Disabled/AA [566] PRIMARY CARE JOB OPPORTUNITY: Home Physicians (www.thehousecalldocs.com) is a fast-growing group of house-call doctors. Great pay ($200–$250+K), flexible hours, choose your own days (full or part time). No ER call or inpatient duties required. Transportation and personal assistant provided. Call Chris Hunt, MD, at (619) 992-5330 or email CV to drhunt@thehousecalldocs.com. Visit www.thehousecalldocs.com. [037] OFFICE SPACE AVAILABLE / REAL ESTATE MEDICAL OFFICE IN SOUTH BAY AVAILABLE TO SUBLEASE: Located next to Paradise Valley Hospital, this large, recently renovated office consists of six exam rooms and one procedure room. The office is currently utilized by orthopedic surgeons, and a med-legal specialist, but can accommodate any practice. Facility provides easy access the PVH operating room, physical therapist, imaging center, laboratory, and wound care center, and has easy freeway access.

Opportunity for orthopedic ER call at Paradise Valley Hospital and patient referrals. For more information, please contact Jeff Craven at jeff@sdmiortho.com or at (858) 245-9109. [613] OPPORTUNITY TO OWN A MEDICAL OFFICE BUILDING IN BEAUTIFUL ESCONDIDO: Why rent when you can own and have other medical

professionals (building tenants) help pay your mortgage?! For about the price of a nice southern California home, you can own a seven-tenant office building. For more information, call or text Ralph Hemphill (CA BRE licensee 01238305) at (760) 613-9791. [608]

KEARNY MESA MEDICAL OFFICE - FOR LEASE 7910 Frost Street. Class A medical office building adjacent to Sharp & Rady Children’s. Ready-to-occupy suites ranging from 1,300-5,000 SF with mix of exam rooms and offices. Will consider short-term & long-term leases.

For details, floor plans and photos contact David DeRoche (858) 966-8061 | dderoche@rchsd.org NORTH COUNTY MEDICAL SPACE AVAILABLE: 2023 W. Vista Way, Suite C, Vista 92083. Large office space is located in an upscale medical office. Finishings, décor, and atmosphere are upscale and inviting, a great place to build your business and clientele following.

Few blocks from Tri-City Medical Center. X-ray suite is included. Included with multiple exam rooms, procedure / dressing room, is access to a kitchenette / break room, two bathrooms, and spacious reception areas all located on the property. Wifi is included as well. Ample free parking. Contact Harish Hosalkar, MD, at hhorthomd@gmail.com or on cell at (858) 2436883. [605] SOUTH COUNTY MEDICAL SPACE AVAILABLE: 2323 E. 8th St., Wellness Center Suite 103, National City 91950. Large office space available for lease/rent. Finishings, décor, and atmosphere are upscale and inviting, a great place to build your business and clientele following. X-ray suite is included. Lots of free parking space. Included with multiple exam rooms, procedure / dressing room, is access to a kitchenette / break room, two bathrooms and spacious reception areas all located on the property. Wifi is included as well. Contact Harish Hosalkar, MD, at hhorthomd@gmail.com or on cell at (858) 243-6883. [604] OPEN TO ALL MEDICAL PROFESSIONALS: Lease an office from San Diego Psychological Center in Poway or work as a licensed contractor.

First floor, bathroom, receptionist area, waiting room, playroom, kitchen, handicap access, separate entrance / exit. By Pomerado Hospital.

Contact Sam at (760) 607-6463. [603] MEDICAL OFFICE SPACE AVAILABLE FOR SUBLEASE / SHARE IN UTC / LA JOLLA AREA: Established orthopedic surgeon seeks tenant to share office space. 4675ft2 in Chancellor Park, near Scripps Memorial Hospital.

Completely rebuilt in 2009. Six exam rooms, digital X-ray onsite. Beautiful finishings, spacious waiting room, conference room, break room.

Ample space for support staff and a private office for physician. Available immediately, full or part time. Ideal for primary or satellite office. Excellent freeway access (1-5 and 805), first-floor suite located off lobby near main building entrance. For further information, please contact Georgana Bradley at (858) 457-0050 or at gbradley@jpbamc.com. [602] MEDICAL OFFICE BUILDING FOR SALE OR LEASE: 1729 Palm Avenue is an approximately 2,433ft2, freestanding, professional medical

office building conveniently located in San Diego.

The property offers excellent exposure and visibility along Palm Avenue with approximately 38,000 ADT (Costar) and is minutes away from Imperial Beach and the Pacific Ocean. Sale Price: $519,000. Lease Rate: $1.35/sf + Utilities.

Please contact Chris Baumgart with Cushman & Wakefield for more information at (760) 431-3847 or at chris.baumgart@cushwake.com. [600] EAST COUNTY SINGLE-STORY HOME FOR SALE: East county single-story home on cul-desac, 4,800+ square feet, Hidden Mesa Estates, custom built 1990, on 0.8 acres, 5 bedrooms, 3.5 baths, 2 family rooms, plus den, pool, spa, deck with cabana, original owner. To contact agent, email ranchhouse21@gmail.com. [597] HILLCREST OFFICE TO SHARE: Fourth floor suite at 4033 Third Avenue, a short walk to Mercy Hospital. Two exam rooms, private office, and break room. All days available. Please call Jack Yang at (619) 548 0450. [585] EL CAJON OFFICE SPACE FOR RENT: Centrally located in East County in El Cajon. Rent by the hour, day, week, or month. Reasonable rates.

Free parking. Quiet office building. Free Wi-Fi. Kitchen available. Central workroom. Wheelchair accessible. Perfect for therapists, consultants, etc.

Call Marlene at (619) 401-1430 or email saben615@sbcglobal.net. [582] LA JOLLA (NEAR UTC) OFFICE FOR SUBLEASE OR TO SHARE: Scripps Memorial medical office building, 9834 Genesee Ave. — great location by the front of the main entrance of the hospital between I-5 and I-805.

Multidisciplinary group. Excellent referral base in the office and on the hospital campus. Please call (858) 455-7535 or (858) 320-0525 and ask for the secretary, Sandy. [127] POWAY OFFICE SPACE FOR SUBLEASE: Private exam room or rooms available for one day a week or more. Ideal for physician, chiropractor, massage therapist. Low rates. Email inquiries to kathysutton41@yahoo.com. [173] BUILD TO SUIT: 950SF office space on University Avenue in vibrant La Mesa / East San Diego, across from the Joan Kroc Center. Next door to busy pediatrics practice, ideal for medical, dental, optometry, lab, radiology, or ancillary services.

Comes with six gated parking spaces, two entryways, restrooms, lighted tower sign space.

Build-out allowance to $5,000 for 4–5 year lease, rent $1,800 per month net ($400 NNN). Contact venk@cox.net or (619) 504-5830. [835] SHARE OFFICE SPACE IN LA MESA JUST OFF OF LA MESA BLVD: Two exam rooms and one minor OR room with potential to share other exam rooms in building. Medicare certified ambulatory surgery center next door. Minutes from Sharp Grossmont Hospital. Very reasonable rent. Please email Editor@SDCMS.org for more information.

[867] NONPHYSICIAN POSITIONS AVAILABLE FAMILY MEDICINE NURSE PRACTITIONER: Needed at the Sycuan Medical Dental Center, a tribal health center on the Sycuan Reservation in El Cajon. Full-time position includes part-time patient care / part-time administrative duties.

Mon.–Fri., 8am–4pm. Apply online at www.sycuan.com. [595] SEEKING PER DIEM PHYSICIAN ASSISTANT OR NURSE PRACTITIONER: Graybill Medical Group is one of North San Diego County’s largest independent multi-specialty groups with over 80+ physicians and midlevel practitioners. We

are currently looking for a per diem PA or NP to provide direct patient care in an urgent care / extended family practice setting in Escondido; to work three weekend shifts per month (8am–4pm) with a possibility of additional shifts as needed.

Must have a current CA (PA or NP) license, and be ACLS and CPR certified. Two years’ prior experience in an urgent care or ER required.

Bilingual in English/Spanish helpful. Send CV to ssnodgrass@graybill.org, apply at www.graybill.org, or fax to (760) 738-7101. [593] NURSE PRACTITIONER: Needed for house-call physician in San Diego. Full-time, competitive benefits package and salary. Call (619) 992-5330 or email drhunt@thehousecalldocs.com. Visit www.thehousecalldocs.com. [152] PHYSICIAN ASSISTANT OR NURSE PRACTITIONER: Needed for house-call physician San Diego. Part-time, flexible days / hours.

Competitive compensation. Call (619) 992-5330 or email drhunt@thehousecalldocs.com. Visit www.thehousecalldocs.com. [038] MEDICAL EQUIPMENT WAITING ROOM KIOSK WITH TABLETOP STAND: (eClinicalWorks Compatible) Decrease wait times, increase collections, and improve financial performance. 17-inch touchscreen with swipe magnetic credit card reader. Copays and accounts receivable payable upon check-in. Software included. Original cost new $5,199. Sell for only $1,299. Email docpaul7@sdmedgroup.com. [587] FREE MEDICAL EXAM TABLE: Good condition.

Free for the taking. Email Editor@SDCMS.org.

[586] SERVICES OFFERED PHYSICIAN OFFICES IN NEED OF ASSISTANCE FOR MEANINGFUL USE ATTESTATION of their electronic health records can avail themselves of technical assistance from Champions for Health, the sister organization to SDCMS. Practices attesting on the Medi-Cal Incentive Program with at least 30% of patients billed to Medi-Cal can receive free assistance thanks to a federal funding source. Medicare practices can receive the same great service at a very reasonable rate, and SDCMS-CMA members receive a discount. For more information, email Barbara.Mandel@ChampionsFH.org or call (858) 300-2780. [559] OTHER

DOCTOR/NURSE OR OTHER EXPERIENCED PROFESSIONAL NEEDED FOR SIMPLE COSMETIC PROCEDURE Multiple decade wearer of hair piece seeking southern CA area provider to place approximately 1” long sutures with 2-0 prolene into scalp to be semipermanent anchors. Wearer has had excellent success with this procedure for over 30 years. Wearer has relocated here from east coast. Please reply to 516-317-8788. Dermatologists, cosmetologists, nurses, nurse practitioners, registered nurses, surgeons, cosmetic surgeons, Tijuana doctoras.

SAN DIEGO PHYSICIAN.ORG

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P E R S O N A L & P R O F E S S I O N A L D E V E LO P M E N T

Exposed to difficult feelings throughout training, physicians learn to ignore them as a defense against feeling overwhelmed and being unable to act appropriately.

With practice, we can become adept at understanding our emotional state.

SPEAKING OUT TO HEAL OUR DIVIDE AND GET WHAT WE WANT

by Helane Fronek, MD, FACP, FACPh

PHYSICIANS REPORT increased anxiety among patients, who cite the political climate as a major source of distress. “Our country is divided,” we often hear. Preferring not to consider others’ opinions, we remain in the echo chambers of shows that feature only our views.

While few enjoy the tachycardia, tight muscles, and flushing that accompany confrontation, another reason we avoid potentially antagonistic conversations is that we don’t have the skills. We’re afraid to share our opinions, lest others become angry and say hurtful things or we direct those damaging outbursts toward others.

This simple, three-step process has the potential to open up productive dialogue and heal the divide we are feeling.

When we feel a confrontation coming, the first step is to recognize our emotion.

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JUNE 2017

Is it anger? Frustration? Fear? Sadness?

Exposed to difficult feelings throughout training, physicians learn to ignore them as a defense against feeling overwhelmed and being unable to act appropriately.

With practice, we can become adept at understanding our emotional state. We feel a strong emotion when an issue we care about is at stake, so the second step is to identify the issue. If we’re cut off during a discussion, are we angry because we feel disrespected, because it’s important to hear all viewpoints, or because the information we’re sharing may prevent something untoward from happening? Once we understand the issue, we can speak calmly and directly about that.

Let’s say you are assigned a different MA from the float pool each day of your assistant’s vacation. You are frustrated

explaining your protocols to a new person every morning; any experience she gains that day is lost when she doesn’t return.

You have run an hour late each day, lab results have slipped through the cracks, and you are worried that a serious issue might occur. You feel disrespected because another colleague was assigned one person for the entire duration of her assistant’s vacation. You feel your jaw clench and your fists tighten as another new MA walks into your office in the morning. You want to explode.

Instead, you recognize you are angry.

The issues are patient safety, the efficiency of your practice, and the unfairness and disrespect you perceive. With that understanding, you call the administrator and say, “I’m unhappy I’ve been assigned a new assistant each day. Things have slipped through the cracks and I’m worried there may be a serious patient safety issue if this continues. In addition, the situation is unfair and disrespectful to me, as my colleague was assigned the same MA for the entire duration of her assistant’s vacation.

I request that I be given the same respect and that the MA in my office today remain with me for the duration of the week.”

Using this simple three-step approach can help us speak plainly and powerfully without risk of damaging relationships, and greater understanding between people can occur. Only then can we heal the divide we are experiencing.

Dr. Fronek, SDCMS-CMA member since 2010, is assistant clinical professor of medicine at UC San Diego School of Medicine and a certified physician development coach who works with physicians to gain more power in their lives and create lives of greater joy. Read her blog at helanefronekmd.com.

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At CAP, we salute your dedication and support you in every way we can — with protection to reduce the worry of professional liability lawsuits, but also with a host of value-added services to help manage your practice so you can focus on the highest quality professional care. Ask for a no-obligation quote and more information on CAP membership.

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