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Utah Physician magazine is published 6 times per year for Utah Medical Association (UMA) members. All advertising, articles and editorials represent the views of the advertisers and authors and do not necessarily reflect the official policy of UMA. Copyright 2026.
BY LANE CHILDS, MD, FACS, UMA PRESIDENT
As far as I am concerned, you may step onto your pedestal. You deserve to be there. In my activities and travels to discuss the state of medicine with doctors in Utah, I am continually reminded of the dedication and sacrifice each of you made to reach this point in your careers as physicians. For many of us, taking the extra class, completing an additional project, pursuing a research year, or committing
to volunteer service wasn’t optional—it was simply part of the path. Those added efforts shaped us, prepared us, and ultimately opened the door to medical school. That diligence led to more years of hard work, schooling, residency training, sleep deprivation, examinations, pressure, and learning how to maintain a sense of humanity and caring, the reason why many of us started this journey.
Along this pathway of becoming physicians we have been asked why we wanted to become doctors? And the answers likely included the idea of helping others, bettering humanity, easing suffering, etc. As you know, the practice of medicine is associated with regulations, bureaucracy, politics, and social factors which can obscure the core desire and joy we reap from helping our patients. We will not be able to eliminate bureaucracy from the practice of medicine, but how we handle challenges can have a huge impact on improving the quality of care we deliver and the quality of the life that we live as physicians.
Several priorities that came out of the House of Delegates 2025 meeting are actively being worked on by UMA with the current Utah legislature. Some of those priorities included elimination of restrictive noncompete clauses, the maintenance of funding for Primary Care residency programs, and improvement to the currently oppressive system of insurance prior authorization. This last item alone regarding prior authorization deserves special mention. I do not know a single physician who does not have a strong opinion about this topic. It has undoubtedly cost each of us not only time but countless resources negotiating the insurance quagmire to accomplish justified patient care. The resources and efforts put in by the Utah Medical Association to improve this issue for physicians and patients alike are an excellent example of the importance of UMA in each of our lives. This cannot be understated. Accomplishing these kinds of changes are next to impossible on an individual basis. But just as the tide causes all boats to rise, together we can make an impact and make a difference. This translates into better care for our patients, and a better quality of life for ourselves.
Some physicians have expressed concern about the rise of Artificial Intelligence and its impact on their practice of medicine. There is no doubt AI will have a profound effect on our practice careers but let me reassure you that you cannot be replaced by AI. Just this week in the prestigious Nature magazine published a review of the ability of the AI program ChatGPT Health to correctly triage medical emergency conditions1 . Experts concluded that 52% of gold standard emergencies such
as DKA and respiratory failure were incorrectly assessed, AI recommending observation rather than emergency room care. Again, AI will be a helpful tool, but it cannot replace you. I know the fire from which you have come. Your training and your expertise allow you to correct and oversee AI.
We prescribe. We document. We operate. We meet. We advocate. We suture. We scope. We Research. We do so many things that are the nuts and bolts of the practice of medicine. But in the process, we also love, we care, and we listen. I hope
that as we go forward with our many mechanical duties, that our compassion will prevail along the way. I was reminded of this by a wonderful article in JAMA2 of a young man with advanced incurable cancer who showed up as a 3 PM “New Patient” on the surgeon’s schedule. Through the visit, the surgeon’s initial feelings of “Why see me, I have nothing to help this person with, he should be seeing someone else” were soon replaced with honesty, a discussion of God, and caring. The surgeon ultimately realized he had done as much good for that terminal patient as he had for those able to have a possible cure with surgery.
I know what you went through to become physicians. Your human ability to connect with your patients helps you to negotiate the mechanics of the practice of medicine and still provide care for those in need. I will keep looking up to you on your well-deserved pedestal.
Citations:
1. Ramaswamy, A., Tyagi, A., Hugo, H. et al. ChatGPT Health performance in a structured test of triage recommendations. Nat Med (2026). https://doi. org/10.1038/s41591-026-04297-7, Received 15 January 2026
Accepted 20 February 2026, Published 23 February 2026, DOI
2. JAMA Feb 3, 2026 Vol 335 Number 5, p401-2
BY ANGELA C. DUNN, MD MPH; FORMER UTAH STATE EPIDEMIOLOGIST, SALT LAKE COUNTY HEALTH DEPARTMENT EXECUTIVE DIRECTOR & HEALTH OFFICER
In early 2015, Utah’s last major measles response began with a familiar story: an unvaccinated family trip and a teen returning home with fever and rash. Two unvaccinated siblings became suspect cases with likely exposure linked to the Disneyland outbreak. Public health did not wait. Contact tracing started immediately, before lab confirmation, mapping everywhere those teens had been: movie theaters, grocery stores, private gatherings, and multiple healthcare settings. When PCR confirmed measles two days later, the response escalated
quickly—a press release, an online public self-assessment tool, and an incident command structure. Exposed individuals without evidence of immunity were actively monitored by public health for 21 days with daily calls. This required working nights, weekends, and “all hands on deck” staffing.
That intensive approach worked. Investigators identified 388 total contacts, and 149 susceptible contacts were placed on 21day quarantine and active monitoring. Nearly half of susceptible
Continued on page 8…
exposures were tied to pediatric office encounters, an early warning of how quickly measles exposure can amplify in waiting rooms. After all that effort, only one secondary case occurred (an unvaccinated sibling), and there were no additional exposures.
Fast forward to 2026. In the first 54 days of the year (as of February 24, 2026), Utah had already identified 123 measles cases, and as of March 24, a total of 289 cases. That is a fundamentally different scale, and it forces a fundamentally different response. Many local and state public health teams no longer have the staffing capacity to immediately contact trace every individual exposed to measles. Investigation and contact tracing may start after lab results return, except in the highest risk scenarios (for example, an unvaccinated individual clearly linked to a confirmed case).
This shift has real clinical consequences. Post exposure prophylaxis, or PEP, is time sensitive. If you are using MMR vaccine as PEP, it must be administered within 72 hours of exposure. If immune globulin (IG) is needed, it must be given within 6 days. In practice, that timeline is hard to meet. Confirmatory PCR testing often takes 24 to 48 hours, and additional time is lost while the case is recognized, tested, and reported. By the time results are back and contacts are identified, there may be little or no time left to find exposed, susceptible people (unvaccinated or under vaccinated) and provide PEP.
As a result, clinics and health systems will increasingly be asked to help quickly identify who was exposed and who is susceptible to measles (unvaccinated or under-vaccinated), and to provide PEP. These requests may come after hours and on weekends to meet the narrow time window for effective PEP.
What does preparedness for physicians look like now?
1. Keep measles out of the waiting room. Screen before arrival whenever possible, especially for unvaccinated or under-vaccinated patients. If symptoms are compatible with measles (fever with cough, coryza, conjunctivitis, and or rash), do not place them in a shared waiting area. Use alternate workflows: curbside intake,
masked direct to room placement, or telehealth triage with planned entry.
2. Plan for “breakthrough” and “unexpected” cases. Even vaccinated patients can develop measles, though still rare. In the current outbreak, a notable minority of cases are breakthrough infections (8.5% statewide as of February 24, 2025), so symptom screening matters regardless of vaccine status.
3. Know your exposure playbook.
If a patient seen in your clinic tests positive for measles, how will you quickly produce an exposure list (waiting room, lab, checkout, shared exam room)? Who can pull immunization status quickly? Who calls your local health department? Who calls families?
4. Build a weekend and after-hours bridge to your local health department (LHD).
Public health has on call staff 24/7, but they may need rapid help from clinics to locate exposed patients and deliver PEP in time. Identify a point person and backup now.
5. Use every visit to strengthen immunity.
When appropriate, recommend vaccination in a direct, clear way. For many families, their clinician remains the most trusted source of vaccine information, and that trust is especially important right now.
Because of the ongoing statewide measles outbreak, the Utah Department of Health and Human Services recommends an early, extra MMR dose for infants 6 to 11 months of age. This early dose is safe and can provide added protection during the outbreak, but it does not replace the routine schedule. Children who receive the early dose should still receive the standard two dose series, starting with the first official dose at 12 to 15 months.
Measles is the canary in the coal mine: extremely contagious and quick to exploit immunity gaps. As vaccine rates fall, the rules of outbreak response are being rewritten in real time. Utah physicians are not just downstream recipients of public health guidance. You are part of the public health ecosystem. Your preparedness, health department partnership, and practical clinic workflow changes are key tools to keep our communities safe.
BY DR. ERIC ZACHARIAS, COPIC CHIEF MEDICAL OFFICER
A physician in the emergency department went into a room to assess a 63-year-old female with concerns about diffuse abdominal pain. The patient had a history of smoking, coronary disease, and intermittent claudication. On exam, vitals were normal and the abdomen was diffusely tender with mild guarding and no rebound. On workup, the patient’s labs were unremarkable except for a white blood cell count of 13,000 with a normal differentiation. An abdominal CT scan was read as normal.
The physician recommended that she be admitted for observation since her pain was not improving during the ER stay. The patient declined admission, citing the concern of having to care for her pets and her high-deductible insurance plan. After a long discussion, the patient signed an “against medical advice” form and left the ER. Two days later, the physician was informed that the patient had been admitted the following night at another hospital with acute ischemic colitis and infarction requiring emergency surgery.
Against medical advice discharges are when the patient chooses to leave the hospital or clinic even when the physician suggests against it. Medical providers may feel distressed when the patient makes this type of decision,
both because of the health risks to the patient and the liability risks to the provider.
Patients who present with actual or potentially high-risk clinical conditions pose the greatest safety risk. Providers should be vigilant around patients who want to leave against medical advice who have complaints such as non-specific chest pain, abdominal pain, potential stroke symptoms, or evidence of systemic infection, among other issues.
In the case study, there is risk for a lawsuit due to a poor outcome. However, good contemporaneous documentation of the physician’s communication with the patient about his concerns around the patient’s desire to refuse admission (as we will outline later) ultimately make this situation very defensible in the event of a lawsuit.
• Addressing addiction—In many cases, the patient’s real concern is fear of withdrawal from alcohol, benzodiazepines, or opioids.
Recognition of these as common issues, skill at discussing the problem in a non-accusatory fashion, and an honest attempt to alleviate concern for withdrawal can be very helpful.
• Psychiatric issues—Patients may have underlying psychiatric issues such as anxiety surrounding the loss of control that being a patient can represent. Sick patients may make instinctual decisions that are not in their best interest, and empathic and nonjudgmental communication may help alleviate the impact of psychiatric issues.
• Motivational interviewing—Approaching patients with open questions and reflective responses helps the clinician understand their thought process. Restating what you’ve heard may help patients understand their own ambivalence and the risk of their decision. Additionally, patients commonly leave the hospital for personal or financial reasons and the clearer these are to the physician, the more chance there is of a successful interaction, including bringing in appropriate support services.
A signed informed consent or informed refusal form is the cornerstone of provider protection for a situation such as the one illustrated in the case study. Informed decision making means the patient has arrived at their decision with a thorough discussion, no coercion, and full understanding of the risks and benefits.
Important areas to address and document include:
• Is the patient competent? Do they have capacity to make such a decision? Although courts have found that intoxication can impair a patient’s competence and ability to refuse medical treatment, a patient who is intoxicated does not automatically lack the competence or capacity to make medical decisions. Similarly, patients with psychiatric complaints can also be difficult to assess but do not necessarily lack capacity to make an informed decision.
• Do they have the health literacy to understand their decision?
• Does the patient understand the diagnosis and the reason for treatment?
• Are they aware of alternatives?
• Can they communicate their choices?
• Is there an understanding of the effects of their refusal?
Note: Copic is the preferred, endorsed medical professional liability insurance provider for UMA members. For more information, please visit www.UtahMed.org Member Benefits
The information provided herein does not, and is not intended to constitute legal, medical, or other professional advice; instead, this information is for general informational purposes only. The specifics of each state’s laws and the specifics of each circumstance may impact its accuracy and applicability; therefore, the information should not be relied upon for medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation.
BY JEFFREY D. ZESIGERMS, CFP®, PRESIDENT, WEALTH ADVISOR
WHY IT’S NOT ABOUT SPENDING MORE, IT’S ABOUT LOCKING YOURSELF IN
For many physicians, lifestyle inflation is treated as a moral failing: “If I were more disciplined, I wouldn’t feel financially stressed.” But for most doctors, the real issue isn’t overspending. It’s something far more subtle and far more dangerous.
The hidden cost of lifestyle inflation in medicine isn’t buying nicer things. It’s building a life with too many fixed, illiquid commitments.
This distinction matters, especially in a profession where income is high, but time, energy, and flexibility are limited.
Traditional financial advice warns against lifestyle inflation, the gradual increase in spending as income rises. Yet for physicians, discretionary spending (travel, dining, hobbies) is rarely the source of financial strain.
Instead, stress usually comes from commitments that are difficult or impossible to unwind:
• Large mortgages in high-cost neighborhoods
• Private school tuition for multiple children
• Practice buy-ins or ownership obligations
• Car leases, boat loans, or vacation property expenses
• Family obligations that assume continued peak income
These aren’t inherently bad decisions. Many are thoughtful, values-driven choices. The problem arises when too many of them stack together, quietly turning a high income into a fragile financial structure.
Medicine has several characteristics that make lifestyle lock-in more likely.
1. Income Arrives Late
Physicians spend their 20s and early 30s earning little while accumulating debt. When income finally rises, there’s pressure to “catch up” on housing, family life, and quality of living.
2. Income Feels Stable—Until It Isn’t
Physician income is often perceived as guaranteed. But call coverage changes, burnout, health issues, reimbursement shifts, and employer consolidation can disrupt earnings more than many expect.
3. Utah-Specific Dynamics
In Utah, physicians often face:
• Rapidly rising home prices along the Wasatch Front
• Larger average family sizes
• Strong cultural emphasis on home ownership and stability
• Fewer perceived “exit options” once rooted in a community
These factors encourage long-term commitments early and make reversing your course harder.
For physicians in their 30s, lifestyle inflation often shows up as front-loading permanence.
A common scenario:
A new attending purchases a home near the top of their comfort range, enrolls children in private school, leases multiple vehicles, and structures life around the assumption that income will only rise.
None of these choices are reckless. The risk lies in how little margin remains afterward.
Early-career physicians benefit enormously from preserving optionality:
• Buying a home that works even if income dips
• Avoiding fixed expenses that require uninterrupted high earnings
• Keeping savings flexible and accessible
The first five years as an attending sets the tone. This is not typically due to spending, but because of what becomes non-negotiable.
Physicians in their 40s and early 50s are often earning the most and feeling the most constrained.
At this stage, lifestyle lock-in typically looks like:
• Peak mortgage + peak tuition + peak lifestyle costs
• College funding colliding with retirement savings
• Less willingness (or ability) to change jobs or schedules
• Increasing awareness of burnout, but fewer exits
Ironically, financial stress at this stage is rarely about not making enough money. It’s about having too little flexibility relative to obligations.
This is where physicians often realize that a high net worth on paper doesn’t equal peace of mind - especially if much of that net worth is tied up in home equity or illiquid assets.
For physicians approaching retirement, lifestyle inflation shows up as postponed freedom.
Common patterns include:
• Working longer than desired to sustain a fixed lifestyle
• Delaying retirement because housing or family obligations remain high
• Fear of stepping away due to income replacement concerns
• Difficulty downsizing emotionally or logistically
This is often described as “golden handcuffs,” but the issue isn’t compensation, it’s structure. The lifestyle itself requires continued work.
The true danger of lifestyle inflation isn’t extravagance, it’s financial vulnerability.
A vulnerable financial life:
• Depends on uninterrupted peak income
• Has little room for health changes or career pivots
• Converts success into obligation
• Creates stress even at high income levels
By contrast, resilient finances prioritize:
• Flexibility over maximal lifestyle
• Liquidity alongside net worth
• The ability to say “no” without panic
Rather than asking, “Can I afford this?” a better question is: “What happens if my income changes?”
Here are some practical guidelines to consider:
• Keep core living expenses well below peak earning capacity
• Avoid stacking multiple large, fixed obligations simultaneously
• Stress-test your household on reduced income or fewer work hours
• Value liquidity as much as long-term returns
• Revisit commitments every 3 - 5 years as life evolves
These aren’t about denial; they’re about preserving choice.
For physicians, true financial success isn’t about the size of the home, the car, or even the net worth statement.
It’s about:
• Sleeping well despite uncertainty
• Having the freedom to reduce hours
• Saying yes to family and no to burnout
• Knowing that success didn’t trap you
Remember, lifestyle inflation isn’t the enemy, but lifestyle lockin is. Awareness, early and often, is the most powerful antidote. If you would like to see how Physician Wealth Advisors can help you improve your financial picture, please contact us at questions@pwa.org or at 801-747-0800.
The CALL-UP program was developed by the Huntsman Mental Health Institute at University of Utah Health as a free statewide resource to support you and your team in caring for patients with mental health needs.
Through CALL-UP, you can access timely consultations with experienced psychiatrists for help with:
• Diagnostic clarification
• Medication guidance
• Treatment planning
• Local mental health resources and more
Our dedicated care coordinator works directly with your office to help patients connect with social services and other local supports—so you can feel confident they’re getting the care they need beyond the exam room.
We also offer free CME-accredited webinars through our Project ECHO series so you can stay current on evidencebased approaches in mental health care with practical tools, real-time learning, and peer support networks.
We’re here for you Monday–Friday, 9 a.m.–5 p.m. (excluding holidays).
Request a consultation online at uofuhealth.org/call-up or call 801.587.3636
Questions? Email us at Callup@hsc.utah.edu
BY CHRIS ESSELTINE, UMA GENERAL COUNSEL, DEPUTY DIRECTOR
Practicing medicine is difficult enough without all the other considerations and distractions involved in running your own practice. From managing staff to paying vendors to marketing, the administrative side of practice ownership is a necessary hassle. And one of the most important aspects a practice needs to be considered is legal compliance and protection. It’s the issue most doctors want to avoid but also the one that can either protect or ruin any healthcare business. Most practices pay for prewritten forms. This is fine so long as the forms contain everything, they need to ensure the maximum protection possible. But how do you know whether they contain what you need? The following are some essentials you want to make sure you have in your consent and waiver forms.
Informed consent is an indispensable part of patient care. Ensuring patients understand everything they need to to agree to a treatment or procedure is not only the kind and fair way to practice medicine, it is the only ethical and legally binding way.
Explanation of the Procedure. The most important part of any consent form is actual consent. But patients can’t truly consent to what they don’t really understand. The form needs to briefly explain what the procedure is and what will take place before, during, and after. This does not need to get into the minutia.
For example, the law does not require a step-by-step guide that includes things such as “…then you’ll put a gown on, and then the medical assistant will take your vitals.” It does, however, need to give the patient a reasonable expectation of what will happen so the patient cannot claim they didn’t understand what they were getting into. This is one of the hallmarks of a personal injury or malpractice complaint. “I never would have agreed to this if I had known beforehand” is an all-too-common battle cry of the patientplaintiff. Providing a clear road map of treatment or procedure is the surest way to avoid this complaint.
Identifying Potential Risks / Outcomes. On that same note, you MUST have a section in the forms that clearly communicates the potential risks, side effects, and negative outcomes associated with the procedure. The forms need to have major and common risks and possible negative outcomes. And to ensure as much legal protection as possible, forms should include minor ones as well. The good news is that you don’t need to list rare side effects. It’s fine to do, but it’s not necessary.
Properly informing patients about treatments and procedures is not only the kind and ethical thing to do, but a truly informed patient cannot call foul after the fact and have a legal leg to stand on.
2. Comprehension.
Another indispensable element of patient consent is that the
person actually understands what the consent and waiver forms say. Therefore, the forms need some kind of indication that the patient comprehends both the words in the document and what the physician explains verbally.
Signatory. One of the ways a consent and waiver form can be rendered void due to a patient’s lack of comprehension is if the patient is a minor, mentally challenged, or otherwise in need of a guardian to help make decisions. In this case, a sentence needs to be added just before the signature section that indicates 1) the person signing for the patient understands the forms and everything the doctor explained, 2) the signatory has explained this information clearly to the person they are signing for, and 3) the signatory is authorized to sign for the patient.
Understanding English. Another example of lack of sufficient comprehension about a procedure occurs when the patient doesn’t speak English well enough. So, the forms need to have a sentence near the signature section that indicates the patient or their signatory speaks English well enough to understand all the information presented.
3. Alternative Treatments
A sneaky strategy used by malpractice attorneys is to argue that a doctor should have provided a patient with alternative choices for a treatment or procedure. They contend that doing so may
have allowed the patient to choose a less risky option that would not have led to harm. So, doctors should fight fire with fire and not only discuss alternative options, but they should include a statement in the consent and waiver forms that they did exactly this. Obviously, most physicians do discuss alternatives with patients as standard practice. But having this recorded and acknowledged by the patient negates any claim to the contrary.
Like discussing alternative treatments with patients, doctors should purposely and conspicuously give patients the opportunity to say no to treatments and procedures – even if they have been scheduled. Again, this should be in the written forms, acknowledged and signed by the patient.
Because every person’s body is different and reacts differently to treatments and procedures, medicine can never guarantee any outcome. Your forms need to clearly state these so patients have no assumptions or false expectations. You can verbally explain to a patient about statistical likelihoods of success, etc. But every patient must reconcile themselves to the absolute reality that they will never have a guarantee of success. Stating this clearly and upfront provides an invaluable layer of legal protection.
Waivers—in whatever form they may take—are necessary to ensure
legal protection for a practice. These basically say that because all the requisite information was given to a patient, they cannot sue for damages if something goes wrong or fails to meet the patient’s expectations. However, this is never entirely true. There is a famous saying in the legal profession that “you can’t contract away your rights.” Every state in the country acknowledges this principle to one extent or another. In medicine, this applies to waivers for treatment.
A patient can waive the right to sue a doctor in connection with some unforeseen negative outcome. But that waiver does not apply if the doctor has acted intentionally, recklessly, or with negligence. In short, if it rises to the level of malpractice, waivers aren’t going to save you. You still need to put them in your forms. Just be aware that they never provide blanket protection.
The elements discussed in this article represent only the most misunderstood or deficient things about consent and waiver forms. Several other elements also need to be included, but these are usually in any set of boilerplate forms you can find. Also, keep in mind that detailing specific procedures and their potential risks are mostly reserved for specialty treatments, not so much for common procedures. For example, you don’t need to have a patient sign a separate consent and waiver form to prescribe antibiotics or lance a boil. But for more specialized and potentially risky treatments and procedures, the right forms give you and your practice the greatest legal protection available. As the saying goes: “An ounce of prevention is worth a pound of legal bills.”
PRESS RELEASE, MARCH 26, 2026
The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) announced the members of the Healthcare Advisory Committee, a new federal advisory body comprised of leaders from across the healthcare system to provide expert advice on improving, strengthening and modernizing U.S. healthcare.
The Committee will advise HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz on ways to improve how care is financed and delivered across Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace.
“This Administration is bringing leaders together to tackle the challenges facing American patients and the health care system, putting prevention front and center,” said HHS Secretary Robert F. Kennedy, Jr. “This committee will help us shift from a sick care system to a true health care system by delivering practical solutions that drive real change.”
“We received an overwhelming response from highly qualified candidates across the country,” said CMS Administrator Dr. Mehmet Oz. “These members bring deep expertise across care delivery, financing, innovation, and patient engagement. Their insights will help us advance higherquality care, reduce administrative burden, and strengthen the sustainability of our programs, while supporting efforts
to transform our healthcare system and restore a stronger focus on patients.”
The following individuals will serve on the Healthcare Advisory Committee:
• Robert Bessler, MD
• Kimberly Brandt, JD (ex officio)
• Sebastian Caliri
• Stephanie Carlton (ex officio)
• David Carmouche, MD
• Elizabeth M. Fago
• Clive K. Fields, MD
• William J. Gassen, JD
• Jenni Gudapati, PhD
• Valerie D. Huhn
• Dennis Laraway
• Dan Liljenquist, JD (Intermountain Health)
• Andrew Lynch, PhD
• Ursel J. McElroy
• Kyu Rhee, MD
• Tony Robbins
• Russ Thomas, JD
• Linda Thomas-Hemak, MD
Members were selected through a competitive review process that drew more than 400 nominations nationwide.
The Committee will provide nonbinding recommendations to inform federal healthcare policy and program administration.
Over its term, the Committee will focus on:
• Developing actionable policy solutions to prevent and better manage chronic disease;
• Advancing accountability for safety and outcomes while reducing unnecessary administrative burden;
• Expanding the use of real-time data to support a higher quality of care, speed up claims processing, and improve quality measurement;
• Enhancing care for vulnerable populations, including those served by Medicaid; and
• Strengthening Medicare Advantage sustainability, including modernizing risk adjustment and quality measurement.
Members will serve two-year terms and will meet regularly throughout the year, with meetings open to the public consistent with federal transparency requirements. The Committee is authorized under the Public Health Service Act and operates in accordance with the Federal Advisory Committee Act.
The Committee will hold its first meeting later this year. Additional information, including meeting notices and opportunities for public engagement, will be published in the Federal Register and on the CMS website.
For more information, visit: www.cms. gov/priorities/healthcare-advisorycommittee/overview
FROM BONNIE CHAR HENNEFER-DEA, CANYONS REGION, INTERMOUNTAIN HEALTH
Beginning June 1, physicians and patients will have new, essential referral options in the Salt Lake Valley as Intermountain Health opens the expanded Behavioral Health Center at Alta View Hospital. This major investment brings together crisis care, inpatient behavioral health, specialized withdrawal management, and dedicated maternal mental health support—all designed to improve access, coordination, and outcomes for patients who need timely, compassionate behavioral health care.
The need for expanded services has never been greater. Utah continues to face rising mental health concerns, increasing substance use disorders, and growing demand for comprehensive maternal mental health support. The new Alta View facility responds directly to these needs by creating focused, standalone units staffed by expert caregivers in an environment built for healing.
The new walkin Behavioral Health Access Center will provide sameday crisis assessment, observation, and rapid connection to appropriate treatment for adults 18 and older. This option gives physicians a reliable, immediate resource for patients in acute distress who may not require an ED visit but still need urgent support.
Alta View’s expanded inpatient unit offers a safe, therapeutic setting for adults experiencing a mental health emergency. More beds mean more timely access to care when patients need stabilization and structured treatment.
Two of the most impactful additions are the Medical Withdrawal Management Unit and the Maternal Mental Health Unit—each designed as a separate, dedicated space to ensure focused expertise and supportive environments.
Led by Medical Director Spencer Hansen, MD, FASAM, the withdrawal management unit provides medically managed detox services for patients withdrawing from alcohol, opioids, and other substances. The team delivers evidencebased, clinically supervised care to support a safe transition into recovery.
Dr. Hansen emphasizes how critical this service is for community physicians:
“Withdrawal is often the barrier that keeps people from getting help. Having a dedicated, medically supervised unit means we can safely guide patients through the most difficult step and connect them to ongoing treatment with dignity and hope.”
The Maternal Mental Health Unit is one of the few dedicated inpatient programs of its kind in the region. Serving individuals during pregnancy and up to one year postpartum, this separate unit provides compassionate, specialized care in an environment tailored to the unique needs of birthing people and their families.
For referring providers, these expanded services offer:
• More timely access to crisis care and inpatient treatment
• Specialty pathways for substance withdrawal and perinatal mental health
• Closertohome options for patients
• Streamlined coordination with Intermountain Behavioral Health Teams
Alta View’s expanded Behavioral Health Center represents innovation, compassion, and a commitment to meeting the mental health needs of our communities—together.
For more information about Withdrawal Management at Alta View Hospital please email Spencer.Hansen@imail.org. To learn more about the Alta View Hospital Behavioral Health expansion visit: https://intermountainhealthcare.org/ locations/alta-view-hospital/about/altaview-behavioral-health-center
BY DR. SPENCER HANSEN, MEDICAL DIRECTOR, WITHDRAWAL UNIT ALTA VIEW HOSPITAL
Our purpose at Alta View Hospital is to provide a welcoming, judgment-free environment where patients are met with compassion and discharged with dignity to an aftercare program personally tailored for optimal success in their life-long journey.
We understand that substance use disorders are medical conditions, not moral failings. Our team creates a safe, trauma-informed space where you can stabilize physically and emotionally without shame or pressure.
We keep intake simple and supportive. Our goal is to help patients feel comfortable enough to stay—and to come back if you need to.
Our medical team provides 24/7
monitoring and evidence-based addiction treatment to ease symptoms and develop a long-term safety plan. Treatment goals on the unit include improved health, better sleep, reconnecting with family, learning stress-relief tools, returning to work, or simply getting through the day more safely. Function and quality of life matter. Addiction deprives patients of the healthy, daily biorhythms of life. We will help patients restore these rhythms as they begin to learn to eat, sleep, smile and pay attention to their bodies again.
Education, overdose prevention strategies, and practical tools are part of our approach. Supporting harm reduction reflects our belief that the patient’s life has value—always.
Strong therapeutic relationships improve outcomes. Our nurses, physicians, therapists, and support staff are committed to respect, shared decisionmaking, and collaboration. We listen. We partner with you. We help build next steps—whether that’s residential treatment, outpatient care, medication treatment, or community support.
Help your patients know about Alta View Hospital as a place to start their detox journey from alcohol, sedative/hypnotics, opioids (including Kratom), or other difficult-to-treat substances that require inpatient care as a starting point.
If you have questions, you can always consult with our medical director, Spencer Hansen. He’d love to hear from you: 228-343-8901.
BY KATIE MATISOHN, DIRECTOR OF MARKETING & COMMUNICATIONS, UTAH MEDICAL ASSOCIATION
In the 2025 Legislative Session HB81 passed, prohibiting adding fluoride to public water systems in Utah. It allows a pharmacist to prescribe fluoride and directs the Division of Professional Licensing to establish guidelines for prescribing fluoride. After the bill was passed, a resolution was passed in the 2025 UMA House of Delegates to educate members on steps to educate patients and families to prevent tooth decay.
The Utah Dental Association (UDA) and UMA strongly opposed the bill as “fluoridation in water plays a protective role against dental decay throughout our life, benefiting both children and adults. It is the most efficient way to prevent tooth decay”, Rodney Thornell, D.D.S., President Utah Dental Association.
Research shows fluoride is safe, beneficial, and saves money. When young children swallow fluoride it enters the bloodstream, the fluoride then combines with calcium and phosphate as the tooth is formed under the gums, making the tooth stronger and more resistant to decay throughout childhood and teenage
years1. For others, fluoride in drinks and food mixes with saliva, neutralizing acid produced by bacteria on the teeth. The fluoride heals the tooth and protects it from further decay2
In November 2025, DOPL came out with guidelines for licensed pharmacists to dispense fluoride. The guidelines direct pharmacists to educate the patient or caregiver on the adverse effects of fluoride and who to contact in case a toxic amount is taken. It warns of long-term ingestion of excess fluoride in infancy and childhood, when teeth are being formed, that can lead to dental fluorosis which can lead to pitting in tooth enamel. It talks of proper storage and disposal upon expiration3.
The clinician must consider all sources of fluoride intake from bottled water, local, county, or state fluoride content vs. caries prevention and risk assessment using tools available to dentists and physicians. It is important for the patient to use fluoride as directed to maximize the caries prevention benefit4
To get the complete DOPL guidelines on Fluoride, scan this QR code.
For additional resources from the UDA fluoride toolkit, scan this QR code.
Endnotes
1,2. uda.org/government-affairs/fluoride
3. Utah Guidance for Fluoride, Pursuant to the authority in UCA § 58-17b-627
4. https://www.mchoralhealth.org/pocket/index.phpw
BY KATIE MATISOHN, DIRECTOR OF MARKETING & COMMUNICATIONS, UTAH MEDICAL ASSOCIATION
PrEP is a highly effective method for preventing HIV. It involves taking antiretroviral medication consistently before potential exposure to significantly reduce the risk of infection1 .
As part of comprehensive sexual health and HIV prevention strategies, discussions about PrEP are a crucial part of comprehensive sexual health, along with using condoms and regular testing2
HIV remains an important aspect of public health; PrEP can help individuals stay HIV negative.3
When taken as prescribed, PrEP is ~99% effective at preventing HIV through sex.2
The CDC recommends that all sexually active adults and adolescents consider discussing PrEP as a strategy to prevent HIV, emphasizing that its use is appropriate regardless of gender identity, sexual orientation, relationship status, or race2
Practitioners should use the CDC’s 5 Ps framework—Partners, Practices, Protection, Past STI history, and Pregnancy intentions to guide conversations. Providers should approach with sensitivity, avoid assumptions, and emphasize sexual health as part of routine care, empowering individuals to actively participate in HIV prevention strategies2
Patients using PrEP should be seen and reevaluated approximately every 3 months.
For more detailed information for physicians on PrEP scan the QR codes.
talk-prep.com
Endnotes
1. https://www.talk-prep.com
2. Centers for Disease Control and Prevention. HIV Nexus: CDC resources for clinicians. Updated August 20, 2024. Accessed September 4, 2024. https://www.cdc.gov/hivnexus/hcp/ prep/index.html
3. Bosh KA, Hall HI, Eastham L, Daskalakis DC, Mermin HJ. Morbidity and Mortality Weekly Report (MMWR): Estimated annual number of HIV infections—United States, 1981-2019. Centers for Disease Control and Prevention. Published June 4, 2021. Accessed September 12, 2024. https://www.cdc.gov/mmwr/volumes/70/ wr/pdfs/mm7022a1-H.pdf
cdc.gov/hivnexus/hcp/prep
BY KATIE MATISOHN, DIRECTOR OF MARKETING & COMMUNICATIONS, UTAH MEDICAL ASSOCIATION
Each fall, physicians from across the state come together to shape the future of organized medicine in Utah at the House of Delegates (HOD). As the legislative and policy-making body of the Utah Medical Association (UMA), the HOD plays a vital role in setting the association’s priorities and advocacy agenda.
The 131st UMA House of Delegates will take place September 18–19, bringing together physician leaders representing county and regional medical societies, specialty societies, hospitals, medical groups, residents, and medical students. During this annual meeting, delegates discuss the issues affecting physicians and patients across Utah and establish policies that guide UMA’s work in the year ahead.
Every UMA physician member can be represented or participate in the House
of Delegates through their county or regional medical society, a chartered specialty society, or their mode of practice. County societies form the foundation of representation, with each society sending at least one delegate and additional delegates based on membership, one delegate for every 30 UMA members.
Chartered state specialty societies and large group practices may also send delegates if the majority of their members belong to UMA and they meet chartering requirements. Physicians who are not part of a large practice group are represented by solo and small-group practice delegates designated by their county medical society.
Delegates serve as a critical link between UMA leadership and physicians throughout the state. They help share information
about UMA initiatives while also bringing forward the perspectives, concerns, and ideas of the physicians they represent.
Through their participation, delegates help shape policy positions, influence advocacy priorities, and strengthen the voice of physicians in Utah.
Interested in serving as a delegate? UMA welcomes physician members who want to engage in leadership and advocacy.
For more information about becoming a delegate, contact Paige De Mille at paige@UtahMed.org or (801) 747-3500 x228.
CONTRIBUTOR AND INTERVIEW FACILITATED BY BENNION D. BUCHANAN, MD, MBA, FACEP
Exercise offers countless benefits, but fitting it into a packed schedule can be tough. Fit.Doc highlights physicians who make it work—whether they’re casual exercisers or elite athletes. If you want to share your fitness story or suggest a colleague, contact Ben Buchanan at bdb3@comcast.net
I grew up in Richfield where my dad was the town doctor. My aspiration was always to go to medical school and join him in
practice. I trained at George Washington University and the University of Utah. I then joined my father in practice with the Intermountain Medical Group in Richfield where we were partners for 15 years. Richfield is the perfect Family Medicine town. I loved my Richfield practice and patients.
I am by no means a gym rat, but I have learned the power of healthy lifestyle, primarily regular exercise and healthy
diet. From my standpoint there is dedicated exercise as well as healthy recreation. My wife and I walk for an hour most mornings at 6am. This is good for the body, the mind, and the marriage! One or two mornings per week I run 2-3 miles rather than walk. My favorite exercises are recreation: snow skiing, water skiing, bike riding, hiking, or playing tennis.
Following residency, I allowed the pressures of life and practice to take priority of wellness. I ate poorly, did not exercise, and became overweight. At age 40 I realized I was on track to be like my sick patients and not like my healthy patients. I joined Weight Watchers and learned how to eat less, eat better, and exercise regularly. I lost about 50 pounds, the majority of which I have kept off, and the subsequent years have been the healthiest and happiest years of my life.
The low point was the 15 years of physical neglect, obesity, and apathy. Some of the high points include running the Richfield 4th of July 5K every summer and backpacking to Havasupai Falls with my son. Walking an hour with my wife is my favorite part of every day.
My goals currently are to maintain healthy habits so I can keep skiing into my 60’s and 70’s. Funny how that also serves to prevent most major physical and mental illness as well.
I always told my patients that it didn’t matter much which type of exercise they chose, rather that they chose something and made their body move on a daily or regular basis. The worst thing for our bodies is sitting and doing nothing.
I enjoy watching tennis and appreciate Novak Djokovic. His skill and dedication have allowed him to remain at the top of the game at age 38. As a Dodger fan I also love the once in a generation talent Shohei Ohtani.
We all have 24 hours every day and we fill them with what we perceive to be of the utmost importance. You must decide it is a priority and then make it part of your routine. I find it works best to make it the first thing every morning, then it doesn’t get crowded out by other priorities.
It has improved and likely prolonged my life.
It matters less what you do, it matters that you do it. Get your body moving every day!
Bennion D. Buchanan, MD MBA FACEP, is a retired Emergency Medicine physician and UMA member since 1979, a past president of the Utah Chapter of ACEP and board member since 1995. During the last seven years of his career, he was a medical director for the Medical Review Institute of America. He currently serves on UMA’s Editorial Board and CME Accreditation Committee, has held multiple leadership positions within several organizations, including UMA Treasurer from 2000 to 2004, an invited guest to the Board of Trustees representing Utah ACEP from 1996 to 2005, and creator and Chair of the UMA Fitness Committee from 1995 to 2005.
UMA Event Center gives you a professional, wellequipped space that’s easy to plan, easy to access, and easy to run, so you (and your team) can focus on outcomes, not logistics.
Schedule Your Tour
Discover how easy it is to plan your next training or corporate event at the UMA Event Center located at 6820 South 900 East Midvale, UT 84047-1765.
Schedule online at UMAEventCenter.com, call (801) 747-3500 x221, or email kelly@utahmed.org.
131st UMA House of Delegates & Annual Meeting
Friday & Saturday, September 18–19, 2026
UMA Event Center in Midvale, Utah
CME Resources
Available CME Credits may vary. Please contact organizers for more information.
April 2026
2 Innovations in Obesity Treatment, Juliana Simonetti, MD, 6 pm via zoom. Please sign up by emailing Jackie Smith-Gibbs at jackie@utahmed.org
9–11 Revitalize Renewal Retreat for Physicians and Healthcare Professionals. Black Desert Resort, 1500 E. Black Desert Drive, Ivins, UT 84738.
10 Rimrock Trauma Conference No virtual Option. AMA PRA Category 1 Credit(s)™ from Intermountain IPCE.
16 2nd Annual Pediatric APP Symposium: AMA PRA Category 1 Credit(s)™ from Intermountain IPCE.
16–17 9th Annual Wound Care Conference AMA PRA Category 1 Credit(s)™ from Intermountain IPCE.
24 2026 Desert Region APP CME Summit: Advancing Outpatient Care, Friday, April 24, 2026, 7 pm–5 pm, UNLV Student Union, 4505 S. Maryland Pkwy, Las Vegas, NV 89154. Registration Link Event Flyer
30–May 1 Excellence in Trauma Care Conference: Pharmacy, Trauma Services, Advanced Practice Provider, Emergency Medical Technician., Registration Link
There are a number of health observances that raise awareness for a variety of conditions and remind patients to be proactive about their health. Here are a few to celebrate:
April
Medicaid Awareness Month
Parkinson’s Awareness Month
Oral Cancer Awareness Month
Title: Controlled Substances: Education for the Prescriber
When: On-demand Webinar
Where: Online at utahmed.inreachce.com
Provider: UMA Foundation, cme.UtahMed.org
CME: 4 AMA PRA Category 1 Credits™
This education is specifically designed to comply with the Utah State Law, Utah Code Section 58--37-6.5, which requires healthcare providers licensed to prescribe controlled substances to complete DOPL-approved continuing education on Schedule II and III controlled substances that are applicable to opioid narcotics, hypnotic depressants, or psychostimulants.
Following this activity, learners should be able to:
• Know existing laws and rules pertaining to prescribing controlled substances;
• Provide patients the care they need to restore and maintain their health;
• Mitigate the burdens of illness, injury and aging, including appropriate prescriptions for controlled substances when indicated;
• Minimize adverse effects of controlled substance use and reduce risks to the public health.
• Know Utah requirements and limitations in recommending medical cannabis.
September 18 - 19, 2026
Recurring activities are scheduled at St. Mark’s Hospital, Intermountain Hospitals, Primary Children’s Medical Center, and the University of Utah School of Medicine. Contact the sponsor for specific information. For more information on the above listings, please call the provider at the phone number listed below.
American College of Obstetrics and Gynecology, UT Chapter, SLC, (801) 747-3500
American College of Physicians, UT Chapter, SLC, (801) 582-1565 x2441
American College of Surgeons, utahATLS@gmail.com
Association for Utah Community Health, SLC, (801) 924-2848
Collegium Aesculapium, Orem, (801) 802-0449
Clark County Medical Society, Las Vegas NV, (702) 739-9989
HCA Continental Division, (303) 575-0055
ESI Management Group, SLC, (801) 501-9446
Intermountain Health CME, SLC, (801) 507-8470
Ogden Surgical-Medical Society, Ogden, (801) 564-5585
Primary Children’s Hospital, SLC, (800) 910-7262
Project ECHO, Salt Lake City, (801) 585-3090
Steward Health Care Utah, South Jordan, (801) 984-2384
Timpanogos Regional Hospital, Orem, (801) 714-6505
Utah Academy of Family Physicians, SLC, (801) 587-3285
Utah Dermatology Society, SLC, utahdermsociety@gmail.com
Utah Medical Association Foundation, SLC, (801) 747-3500
Utah Ophthalmology Society, SLC, (801) 747-3500
University of Utah CME, SLC, (801) 581-6978, cme.office@hsc.utah.edu
VA Center for Learning, SLC, (801) 584-2586
Counseling on Access to Lethal Means (CALM) to Prevent Suicide, (1.0 AMA/PRA Category 1 Credits™). Conversations about suicide can be uncomfortable. When the stakes are high, effectively engaging with a patient to encourage safety can be difficult. Counseling on Access to Lethal Means (CALM) will teach how to ask a suicidal client or patient about their access to lethal means while working with the patient and families to reduce their access. CALM provides education on effectively communicating about means reduction in a supportive and engaging method. This allows the patient and family to engage in personal problem-solving and set acceptable goals to reduce access to lethal means while in a crisis. CALM gives the provider concrete tools and sample language to support this process and follow-up care. https://intermountainhealthcare.org/ ihcu/public/bh/CounselingOnAccessToLethalMeansCALMToPreventSuicide/Primary/story.html
cme.utahmed.org ama-assn.org/ edhub.ama-assn.org medicine.utah.edu/cme physicians.utah.edu/echo
BCM.edu cmelist.com emedevents.com freecme.com medscape.org nejm.org/ continuing-medical-education osteopathic.org pri-med.com/pmo/OnlineCME primarycarenetwork.org
psnet.ahrq.gov/ continuing-education reachmd.com/cme thedoctorschannel.com/cme www.vlh.com
ama-assn.org eMedEvents.com
Utah.gov DHHS Provider Medical Education, Qualified medical providers must participate in at least 4 hours of medical cannabis-specific continuing education. As of January 2020, the Department of Health and Human Services (DHHS) has approved courses that meet the four-hour CE requirement. https://medicalcannabis.utah.gov/providers/ continuing-education/
The Virtual Curbside Podcast, Colorado Medical Society and Utah Chapter of AAP (Contact Organizer for AMA/PRA Category 1 Credits™) https://vcurb.com/
BMW X3.
When you pair “adventure ready” with “city savvy,” you’ll find a vehicle that lives at the intersection of downtown avenues and mountain roads: the BMW X3.
With a reimagined design and sporty handling, the latest iteration of this icon doesn’t just tackle any journey with ease; it draws attention while doing it.
And it wouldn’t earn the X3 name without versatility at its heart and a premium interior that makes it unmistakably BMW.
Visit BMW of Murray or BMW of Pleasant Grove for exceptional offers on the BMW X3.
BMW of Murray
4735 S. State Street
Murray, Utah
801-262-2479
bmwofmurray.com
BMW of Pleasant Grove 2111 West Grove Parkway
Pleasant Grove, Utah 801-443-2000
bmwofpg.com
For over 85 years, Ray Quinney & Nebeker has provided sophisticated and comprehensive legal services both nationally and across the Intermountain West. Our collective expertise and collaborative approach assure our capacity to grow with changing legal markets. We solve problems the right way — with expertise, responsiveness, and integrity. In the end, we not only solve our clients’ problems, we build relationships to help prevent problems in the future.
