Nov/Dec 2017 | Los Angeles Medicine by Los Angeles County Medical Association

OFFICIAL PUBLICATION OF THE LOS ANGELES COUNTY MEDICAL ASSOCIATION

2017

The LACMA Patient Care Foundation Hosts the

LOS ANGELES HEALTHCARE AWARDS

HEALTHCARE CHAMPION

PAUL S. VIVIANO N O V/ D E C 2 0 1 7

IMPORTANCE OF A BUSINESS PLAN AT ANY STAGE OF YOUR CAREER By: Patrick Nygren, San Fernando Valley Region Banking President, Community Bank, Wells Fargo & Company

You probably created a business plan when you first started your practice. After all, it can be an essential document for communicating your goals, persuading potential lenders to provide financing and recruiting new associates and employees. But did you know a business plan can be an invaluable tool throughout your career? By keeping this document refreshed over the years to accurately reflect your current situation and needs, you can be better prepared to face the many challenges of practice ownership and management. Here are five important ways a regularly updated business plan can serve you: Patrick Nygren

HELPS CONFIRM THE VIABILITY OF YOUR BUSINESS. Let’s say you need financing for an upgrade, redesign or expansion project for your practice. The financials included in your business plan can show that you have met your original targets for your practice and are on track for continued growth.

GUIDES YOUR BUSINESS THROUGH DIFFICULT TIMES. The vision outlined in your business plan can serve as an anchor to help you and your staff stay focused on long-term goals during challenging periods. DEFINES VALUES IN THE WORKPLACE. As you face challenging decisions related to personnel issues or business opportunities, you can look to the values outlined in your business plan as a guidepost for informing those decisions. PROVIDES A BENCHMARK FOR EVALUATING PROGRESS. Your business plan can be a useful management tool for ensuring your practice is staying on track with performance targets. It’s therefore important to update your business plan regularly to ensure that your goals continue to be realistic based on your current operation. PREPARES YOU FOR MARKET CHANGES AND TRENDS. Periodically reassessing the market you work within can better prepare you to react to changes or take advantage of new trends. Your business plan provides the foundation for staying abreast of change so you can respond in a timely fashion.

So don’t just create a business plan at the start of your practice, and then file it away. Think of it as a “living document” that can support your vision and objectives throughout your career.

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EDITOR Sheri Carr | editors@physiciansnewsnetwork.com ADVERTISING SALES Dari Pebdani 858.231.1231 | dpebdani@gmail.com EDITORIAL ADVISORY BOARD David H. Aizuss, MD Troy Elander, MD Thomas Horowitz, DO Robert J. Rogers, MD

VOLUME 148 ISSUE 7 | NOV/DEC 2017

LACMA CEO GUSTAVO FRIEDERICHSEN

Delivering Value to Doctors, Patients & Partners

LACMA BOARD OF DIRECTORS COUNCILORS-AT-LARGE Jerry Abraham, MD (1) Samuel Fink, MD (6) Jeffery Lee, MD (6) Maria Lymberis, MD (5) Nhat Tran, MD (9)

2 4 6

PRESIDENT’S LETTER

William K. Averill, MD

TRUSTEES & CHAIR DELEGATION David Aizuss, MD, CMA Trustee Marvin Kaplan, MD, Chair of the LACMA Delegation Peter Richman, MD, CMA Trustee

-Disaster Healthcare Surge Unit -Homelessness Public Policy Challenge

COUNCILORS Robert Bitonte, MD (D1) Emil Avanes, MD (D2) Stephanie Booth, MD (D3) Troy Elander, MD (D5) Kambiz Kosari, MD (D6) David Hopp, MD (D7) Omer Deen, MD (D9) Christine Phan, MD (D10) Jinha Park, MD (D14) Sidney Gold, MD (D17) Roxana Yoonessi, MD (SCPMG) Heather Silverman, MD (SSGPF) Mitch Katz, MD (LADHS) Albert Young, MD (Allied Pacific) Po-Yin Samuel Huang, MD (1, YP Councilor) Hector Flores, MD (1, EPC Chair) Laura Halpin, MD (Resident Councilor) Erik Berg, MD (Alt. Resident Councilor) Ali Tafreshi (Student, USC) Gwendolyn Lee (Alt. Student, UCLA)

LACMA’s Board of Directors consists of a group of 30 dedicated physicians who are working hard to uphold your rights and the rights of your patients. They always welcome hearing your comments and concerns. You can contact them by emailing or calling Lisa Le, Director of Governance, at lisa@lacmanet.org or 213-226-0304. SUBSCRIPTIONS Members of the Los Angeles County Medical Association: Los Angeles Medicine is a benefit of your membership. Additional copies and back issues: $3 each. Nonmember subscriptions: $39 per year. Single copies: $5. To order or renew a subscription, make your check payable to Los Angeles Medicine, 10755 Scripps Poway Parkway, Suite 615 | San Diego, CA 92131. To inform us of a delivery problem, email editors@physiciansnewsnetwork.com. Acceptance of advertising in Los Angeles Medicine in no way constitutes approval or endorsement by LACMA Services Inc. The Los Angeles County Medical Association reserves the right to reject any advertising. Opinions expressed by authors are their own and not necessarily those of Los Angeles Medicine, LACMA Services Inc. or the Los Angeles County Medical Association. Los Angeles Medicine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. Los Angeles Medicine is not responsible for unsolicited manuscripts.

GET INVOLVED

2017 LOS ANGELES HEALTHCARE AWARDS

DR. PETER KIM, FOUNDER OF CURBSIDE REAL ESTATE

Finding Inspiration as a Social Entrepreneur

Cover photos via newsroom.lmu.edu Los Angeles Medicine (ISSN 1533-9254) is published bimonthly (Jan/Feb, Mar/Apr, May/Jun & Jul/Aug, Sep/Oct & Nov/ Dec) by LACMA Services Inc. (a subsidiary of the Los Angeles County Medical Association) at 801 S. Grand Avenue, Suite 425, Los Angeles, CA 90017. Periodicals Postage Paid at Los Angeles, California, and at additional mailing offices. Volume 143, No. 04 Copyright ©2012 by LACMA Services Inc. All rights reserved. Reproduction in whole or in part without written permission is prohibited. POSTMASTER: Send address changes to Los Angeles Medicine, 801 S. Grand Avenue, Suite 425, Los Angeles, CA 90017. Advertising rates and information sent upon request.

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L ACMA PRE S I D E N T

W I L L I AM K . AV E R I L L , MD

Growing Better Together RECENT GROWTH in LACMA’s physician membership has reversed a longstanding secular trend,

challenging much of organized medicine. Some measure of our success have been through the recruitment and re-engagement of some of the finest medical groups in our region. At the same time, one of our challenges is to retain solo and small practices in an environment that is becoming increasingly harsh for this mode of practice. Solo and small group physicians have traditionally been well represented through the geographic “District” model. With the shrinking demographics of some of our Districts, there is likely to be a necessary move towards consolidation of these Districts, and perhaps in the future we will recognize the mode of practice vertically across the organization. In this process, I believe that it is crucial that this practice mode, now under tremendous pressure, be well represented both in the solutions that LACMA presently offers its membership, and in the governance of the organization to assure the developing future. The Saving Private Practice Consortium, held in downtown Los Angeles earlier this year, was a great success ...it is crucial that and introduced our members and potential members to [solo and small LACMA’s Preferred Partners. Are these Partners the answer practices], now under that you need to address the pain points in your practice? tremendous pressure, Make plans now to come to the Saving Private Practice Consortium 2.0 in March and find out! be well represented One of the pain points most commonly noted is in both in the solutions regards to interacting with electronic medical/health that LACMA records. The capabilities that we have with EMR/EHR presently offers its technology promise huge improvements in how we care for membership, and in our patients, including more ways to communicate, more the governance of the portability of health information, more convenience for our organization to assure patients and better ways to detect potential deficiencies care and address population health. At the same time, the developing future. in the technology can often be burdensome in use. There is a burgeoning set of requirements for reporting, from both health plans and government, that disproportionately burdens small practices as we see movement from a traditional fee-for-service model to systems of care that emphasize quality of care and population health measures. MACRA, MIPS and APMs are some of the acronyms that apply, and we have tools that will make the transition less painful. On another note, I would like to remind our physician members/advocates that hospital medical staffs are natural allies with organized medicine through CMA’s Organized Medical Staff Section (OMSS). LACMA members who are active medical staff leaders are urged to get their colleagues involved by scheduling a presentation at a Medical Executive Committee meeting to learn of recent successes in epic battles for medical staff self-governance. Finally, from my friends at the American College of Cardiology, I have once again been reminded how powerful CMA’s stance on healthcare issues can be throughout the legislative process in Sacramento and beyond. If CMA has taken a strong stance, this greatly reinforces the position of specialty societies, and if CMA’s stance does not reflect the serious concerns of a specialty society, the society faces an uphill battle. I encourage my colleagues in all specialties to stay involved with LACMA and with CMA as we strive to represent all physicians in California. Be strong, belong, and join LACMA in our work towards improving patient care and physician well-being. We are better together.

William K. Averill, MD President, Los Angeles County Medical Association 2 LOS ANG ELES MEDI CINE | N OVEMB ER/DECEMB ER 2017

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LACM A CEO

G U STAVO F R I E DE R I C HS EN

Delivering Value for Doctors, Patients & Partners The year 2017 ends with a continued spirit of optimism at LACMA, the optimism reflected in the faces of the scholarship winners at this year’s Patient Care Foundation Los Angeles Healthcare Awards. The Patient Care Foundation was created to address the present-day needs of doctors and their patients in Los Angeles County. The Foundation is specifically designed to support medical school students, encourage community service, and improve patient access to care, treatment and education. The future of medicine is bright as these students continue to grow, contribute and touch all of us with their personal triumphs. Another example of creativity and innovation is Peter Kim, MD, founder of one of LACMA’s preferred partners, Curbside Real Estate. Dr. Kim started the company so he could help physicians get into homes that they wouldn’t have gotten into otherwise. What is equally impressive is Dr. Kim’s mission to “give shelter” because that’s at the heart of what he does. With every home purchase, Curbside donates funds to partners who provide for children in need a rescue home and clean water so they are able to live and be taken care of, breaking the cycle of poverty. Curbside works hand in hand with Angel House Rescue Orphanage, a nonprofit whose mission is to bring abandoned children from the slums to safety and into the loving arms of caretakers who will educate, love and raise them to become future leaders in their generation. Dr. Kim and LACMA members who share his commitment to making a difference are the reason why we will expand our social mission in 2018 to focus in four areas. First, we will partner with the Los Angeles County Department of Health Services to not just educate physicians about oil extraction in Los Angeles, but also to play a role in prohibiting oil drilling and production near homes, schools, parks and businesses. How big is this problem? There are more than 5,000 active oil wells in Los Angeles County. Seventy percent are within 1,500 feet of a home, school or hospital, and most of these areas have been deemed some of the state’s most polluted and socially vulnerable areas. This is a public health crisis. It impacts providers and patients. It impacts the most vulnerable populations such as children and seniors. Regarding the other three areas, we will continue to partner with our physicians on public health issues important to their communities: hepatitis A education and prevention; gun violence (and the public health consequences); and the opioid epidemic, which has destroyed too many lives while wrongfully targeting physicians as the culprits. Oil drilling, hep A, gun violence, opioid abuse. If you want to learn more or get involved, reach out to me. While LACMA stands for physicians every day, it is physicians who stand for patients and communities at risk, and these four issues will be a central part of our social mission in 2018 and beyond. If you are wondering how making a social commitment impacts our mission, vision and values, remember this: Our growth is tied to delivering value to physicians from all walks of life, serving a diversity of patients and becoming a more vibrant brand that makes a difference. At the same time, we deliver tangible value to physicians in solo and small practices as demonstrated through our expanded benefits portfolio; support from the California Medical Association’s Center for Economic Services, which has successfully recouped over $15.5 million from insurance companies on behalf of our physician members; and our Saving Private Practice Consortium, which successfully brings independent physicians and 17 companies together to solve physician problems. We work with large groups as we strive to inspire and share dialogue on issues crippling the practice of medicine in addition to supporting legislative and regulatory relief. What’s next? Continued focus on value, growth, retention, strategic partnerships that yield benefits for our members and their patients and a more aligned organization that might not be everything to everyone, but will always be there for physicians in meaningful, tangible ways. No lip service. No empty promises. Our viability depends on physicians trusting LACMA, seeing value and perhaps most of all witnessing an organization that fights for them each and every day.

Our growth is tied to delivering value to physicians from all walks of life, serving a diversity of patients and becoming a more vibrant brand that makes a difference.

Gustavo Friederichsen CEO, Los Angeles County Medical Association 4 LOS ANG ELES MEDI CINE | N OVEMB ER/DECEMB ER 2017

Are You Navigating Your 2018 Health Insurance Benefits Alone? • Are you spending too much time getting small group health insurance quotes? • Want to sign up for individual and family coverage but you’re just not sure where to turn? • Wondering what ACA benefits may have changed? The Los Angeles County Medical Association has a resource to help you: Call Mercer! Mercer is sponsored by LACMA and the CMA and is the largest insurance brokerage firm in the world. They have resources to help you navigate the health insurance marketplace and provide you with the options you’re looking for at no additional cost to your premiums.

If you are an individual/family: you need to get coverage, or make any changes to your current coverage, during the open enrollment period from November 1st to December 15th. If you don’t qualify for the Covered California healthcare exchange visit www.CMACountyHealth.com to see the plans available in your area in the tiers that you prefer. You can enroll online through the site with the carrier you choose. If you have small group coverage: Mercer can help you find the coverage you want based on your preferences. Or you can keep your current plan and assign it to Mercer, so you can support your association and call on Mercer’s team of Client Advisors, available to you when you need help. What are you waiting for? Join the LACMA/CMA-sponsored health insurance programs right now! Call a Client Advisor at 800-842-3761, email CMACounty.Insurance.service@mercer.com, or visit www.CountyCMAMemberInsurance.com for more information.

Sponsored by:

Administered by:

Programs Administered by Mercer Health & Benefits Insurance Services LLC • CA Insurance License #0G39709

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777 South Figueroa Street, Los Angeles, CA 90017 • 800-842-3761 • CMACounty.Insurance.service@mercer.com • www.CountyCMAMemberInsurance.com 79184 (11/17) Copyright 2017 Mercer LLC. All rights reserved.

O P P ORT UN I TI E S

G E T I N VOLV E D

JOIN THE DISASTER HEALTHCARE SURGE UNIT!

HOMELESSNESS PUBLIC POLICY CHALLENGE Homelessness is a serious health problem throughout the United States, and has been shown to disproportionately affect Los Angeles County. Since taking office, Mayor Eric Garcetti has made it his priority to address the homelessness crisis. The administration has a three pillar approach: • Housing those who are homeless, • Preventing people at risk for homelessness from landing on the streets, • Balancing health and safety concerns with the rights and needs of people who are living in unacceptable conditions.

LACMA is working with the LA County Department of Health Services on a Disaster Healthcare Volunteer Project. We have been given a grant to help with the recruitment and training of 200 physician volunteers from LA County. This project is aimed at improving the county’s public health and medical preparedness and response capabilities for emergencies, whether deliberate, accidental or naturally occurring. Physicians are being recruited to provide critical health services following a terrorist attack, disaster or other public health emergency. There are three ways you can participate: 1) SERVE ON THE COMMITTEE | Quarterly meetings at LACMA. Members must represent various medical specialties to include but not limited to emergency medicine, trauma surgery, pediatrics, psychiatry, infectious disease, anesthesiology and orthopedics. You will be compensated for your time. 2) BECOME A TRAINER | Give quarterly training presentations. Compensation is available for trainers as well. 3) SIGN UP AS A VOLUNTEER | Visit healthcarevolunteers.ca.gov to sign up. If you’d like the guide to registration, please contact Deborah at 310.930.4127 More information about the Surge Unit can be found at www.lacountydhv.org/surgeunit/. For quick registration, go to healthcarevolunteers.ca.gov. (It’s a fast and super easy way to get started!) If you have any questions, please email Deborah at deborah@lacmanet.org or call 310.930.4127.

6 LOS ANG ELES MEDI CINE | N OVEMB ER/DECEMB ER 2017

However, over the past year, homelessness rates have grown by over 23% within the county. According to the city’s annual report, conducted in early January, rising rates were largest in the Antelope Valley and eastern Los Angeles County and lowest in the South Bay and San Fernando Valley. The drastic increase to nearly 58,000 homeless individuals suggests that the pathway into homelessness continues to outpace intensifying efforts made by Los Angeles’ homelessness officials and political leaders. The report also indicated that the substantial shift in homelessness affected nearly every significant demographic group within the county— children, families, veterans and the chronically homeless. In response to this public health issue and in order to work towards prevention of displacement and homelessness, LACMA has launched a challenge for medical students from Charles R. Drew University of Medicine and Science, David Geffen School of Medicine at UCLA, Keck School of Medicine of USC and Western University of Health Sciences to propose legislation for adoption by the County of Los Angeles in order to reduce the onset of increasing homelessness throughout the county.

Learn more about how to get involved in this challenge at LOSANGELESMEDICINE.ORG

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Los Angeles Healthcare Awards 2017 AWARDEES (Left to right) Paul S. Viviano, Shlomo Melmed, MD, MB, ChB, MACP, FRCP Gary K. Michelson, MD David Aizuss, MD, FACS (2nd row) David N. Alexander, MD Daniel J. Wallace, MD, FACP, MACR Neal Baer, MD

017

COPE Health Solutions CEO Allen Miller

On November 3, the Los Angeles County Medical Association, through its Patient Care Foundation, recognized individuals and institutions for increasing access to quality healthcare in Los Angeles County through leadership, innovation, education, and service, at the sixth annual Los Angeles Healthcare Awards. Troy Elander, MD, chairman of the Patient Care Foundation, opened the event with a warm welcome: “Your presence here tonight and your participation in LACMA is a confirmation of both your dedication to the art of medicine and your commitment to the belief that our self-interest is closely tied to the interests of our patients.” LACMA President William K. Averill, MD, then took the stage to introduce the honorees. “The caliber of medical talent and commitment in this room is unequaled. Our members personify ‘care’ in all its many meanings. It is my honor to do all I can to keep LACMA at the cutting edge of serving your needs so you can serve the medical needs of the people in and around Los Angeles. “Never has healthcare faced so many challenges coming from so many disparate sources. Which is why our collective voice has never been so badly needed. We are able to succeed because we — over 6,500 physicians covering every specialty and practice — stand together. We also stand proudly in our determination to nurture the next generation of great LA physicians and surgeons. I know you will share my pride when you meet this year’s scholarship students.” Congratulations to all of this year’s honorees. You exemplify our mission and you make life in Los Angeles both happier and healthier!

LOS ANGEL ES

CHAMPION

PAUL S. VIVIANO | Healthcare Champion of the Year

HEALT HCARE AWARDS

Paul S. Viviano is a healthcare leader who has directed academic, nonprofit and for-profit healthcare organizations that deliver excellence in clinical care, research and diagnostics for three decades. Paul joined Children’s Hospital Los Angeles as president and chief executive officer in 2015 and serves as a member of the institution’s Board of Trustees. Previous to serving as president and chief executive of CHLA, Paul served as the CEO and associate vice chancellor for the UC San Diego Health System, an institution noted for its leadership in medical research and patient care. He has also served as the president and chief executive officer of USC University Hospital and USC/Norris Cancer Hospital and held various chief executive roles within the St. Joseph Health System, ultimately serving as the president and chief operating officer for the system. He served as chairman of the board and CEO of Alliance HealthCare Services, the nation’s largest provider of outpatient diagnostic imaging services and radiation oncology services, for 10 years. Paul currently serves on the boards of several organizations, including Loyola Marymount University, where he now serves as the chair of the Board of Trustees and Alliance HealthCare Services. In addition, he was recently appointed to the Board of Directors of the Hospital Association of Southern California (HASC), and serves as the chair of HASC’s Los Angeles Central Area. “For more than three decades, our 2017 honoree has been a role model of excellence as a leader in the healthcare care field,” Dr. Elander stated as he introduced Mr. Viviano. “He has garnered the respect and admiration of colleagues and staffs for his expertise in directing academic, nonprofit and for-profit Awarded to a physician, healthcare organizations that deliver excellence in both clinical care and research. researcher, policymaker, advocate, philanthropist or other He selflessly shares his time and experience with such healthcare organizations who has led initiatives to improve as the Hospital Association of Southern California; Loyola Marymount University; healthcare in Los Angeles County through increased patient the Hospital Association of San Diego and Imperial Counties; and the California access to care and treatment, Hospital Association,” Dr. Elander continued. “Since joining Children’s Hospital Los advanced public health Angeles, his visionary leadership has made a profound impact. He chose CHLA education, emboldened physician engagement in underserved because of its commitment to patient care, education and research, as well as its communities, promoted the investment in technology, service to its community and longstanding mission to furtherance of professional development for current and improve the healthcare of children around the world. Under his stewardship, the future physicians, and whose children and families of Los Angeles are in great hands. We are honored to present contributions have shaped the the 2017 Healthcare Champion of the Year Award to Paul S. Viviano.” future of healthcare.

PHOTOS: 1. Healthcare Champion Paul S. Viviano with chairman of the Patient Care Foundation, Troy Elander, MD. 2. Honorees (left to right) Daniel J. Wallace, MD, Paul S. Viviano, David N. Alexander, MD, Shlomo Melmed, MD, and David Aizuss, MD. 3. The room was filled with LACMA physicians and guests celebrating the accomplishments of the honorees. 4. Scholarship recipients (left to right) Jessica Osorio, Bria Pettway, Eutiquio Gutierrez, Pamela Vila and Stacy Songco.

NNOVATIO

DANIEL J. WALLACE, MD, FACP, MACR | Innovation Award for Community Service Dr. Averill introduced Dr. Wallace as “one of today’s leading experts in rheumatology and for close to 40 years has been our city’s go-to man for those seeking help in the fight against lupus, fibromyalgia, osteoarthritis and other central pain syndromes.” He continued: “His work as chair of the Lupus Foundation is known far and wide, and his compassion for his patients Awarded in recognition is legendary. He also serves on the Research and Education Foundation of the American College of of facilitating access to health services, Rheumatology, the Board of the United Scleroderma Foundation and the American Society for Apheresis, education and information just to name a few of the many organizations to which he gives so much of his time. Town and Country at a community or neighborhood level Magazine named him one of the nation’s 200 best doctors, and LA Magazine agreed. His expertise is that eliminates barriers unquestioned, and his patients have been known to speak publicly of his thorough and compassionate to transportation, language or health care. He’s also published eight medical textbooks, authored 25 book chapters and had work published insurance with a focus on in more than 340 medical publications. For his superior care, his compassionate heart and his charivulnerable populations in underserved communities. table works that have raised more than $20 million for various rheumatic disease organizations.”

COPE HEALTH SOLUTIONS, ALLEN MILLER, CEO | Innovation Award for Public Education

“Twenty-two years ago, right here in Westwood, a group of caring UCLA student volunteers looked at the shameful lack of healthcare options in our most underserved communities and decided something needed to be done,” Dr. Elander said as he announced the award. “Together they formed Community Outreach Prevention and Education (COPE), today known as COPE Health Solutions. Their singular goal was to provide health education to the underprivileged and uninsured in the LA community. Their first major push was to fund a course at UCLA to train students and supervise interns while working at outreach sites to provide health education and enrichment activities to at-risk youth in the LA area. That alone was a terrific start, but in subsequent years they’ve evolved into a leader in healthcare that provides business, clinical integration and health workforce solutions, while continuing to focus on improving the health of the community, now through the redefinition of healthcare systems. They are highly skilled educators who offer needed assistance to those patients who invariably have the fewest resources to allow them to get the best posAwarded in recognition sible care. When a family member is in need of care, information is power, and COPE Health Solutions of health education programs that empower works with health scholars and students to inform patients and their families of their best possible patients to make decisions options at every level of care. Over the years they’ve worked with more than 4,500 students, and their about their health to minimize illness and training has turned each of them into a qualified care ambassador in their community. And to be clear, improve quality of life they not only help the patients, they help the staff in a number of ways, both technical and practical, and that make medical including something as simple as sitting with a single patient facing care alone. At the same time, they information accessible and usable, and advance help implement long-term strategic initiatives able to manage health across the continuum of care.” the physician/patient Accepting on behalf of CEO Allen Miller was COPE Vice President Carla D’Angelo. relationship.

GARY K. MICHELSON, MD | Innovation Award for Technology

“With every passing day, technology becomes a more important part of medical care. From robot surgeons to minuscule fiber optic cameras inserted into a patient’s body to a host of other options, what was once science-fiction is now medical fact. Nowhere is this more prevalent than in the work being pioneered by our next honoree,” Dr. Elander began. “At the Michelson Medical Research Foundation, they are breaking barriers and providing treatment options that can touch the lives and expedite healing to billions of people on the planet. Their team pools their expertise to develop innovative techniques in Awarded in recognition a fraction of the time typical just a decade ago. They quickly and brilliantly move medical expansion of technology that facilitates access to from the lab to the specific physician’s office or operating room. Just some of their leading initiatives healthcare information, include the Michelson Center for Convergent Bioscience at USC, where they work to fast-track detecimproves the gathering and dissemination of tion and cure of diseases by turning biological sciences into a quantitative and predictive science. information that will Their Institute for Protein Design at the University of Washington works to design synthetic proteins help physicians and/ or patients make better that can tackle today’s medical problems, and their Michelson Entrepreneurship Award at Wharton decisions about medical supports and encourages the next best generation of healthcare professionals by driving technologitreatment, and/or is used cal innovations into our nation’s top universities. These are just a few of the ways they are revolutionto administer treatment. izing the practice of medicine.”

CALIFORNIA REHABILITATION INSTITUTE | Innovation Award for Healthcare Facilities

“The best possible option for a patient is, of course, the most caring and qualified staff. But no matter how expert their knowledge or how compassionate their intent, no patient can get the care he or she requires if a facility falls short. That is why our next category is so vital – and why this year’s recipient is a clear leader in the category of Innovation for Healthcare Facilities,” past LACMA President Howard Krauss, MD, said as he announced the Innovation in Healthcare Facilities awardee. “Together our next honorees have harnessed and combined the collective strengths found at both Cedars-Sinai and UCLA to create one of the world’s best rehabilitation centers for recovering patients. Their partnership began almost four years ago, when Pennsylvania’s Select Medical announced their alliance with Cedars-Sinai and UCLA Health to open a new facility in Century City, designed to service inpatient rehabilitation and serve as a center for treating more complex rehab cases from across the United States. They work tirelessly to Awarded in recognition serve the needs of people recovering from illness, physical injury, the debilitating effects of stroke, spinal of innovative design, cord injury, brain injury or orthopedic recovery. They bring compassion, respect, excellence, integrity and operation or maintenance of health facilities that teamwork to the goal of improving patients’ quality of life. I have never seen patients facing the oftenpromote and facilitate grueling task of rehabilitation served as well or as carefully as by their dedicated team.” Accepting the patient care resulting in high patient satisfaction, award was California Rehabilitation Institute leader David Alexander, MD. Dr. Alexander is the medical health improvement, and director of UCLA-Ronald Reagan’s Neurological Rehabilitation and Research Unit as well as a professor in operational cost savings. the Department of Neurology at UCLA’s David Geffen School of Medicine.

PATIENT CARE FOUNDATION LACMA leads a unified healthcare front by fostering optimal collaborations among physicians, patients, and the community. To this end, LACMA established the Patient Care Foundation of Los Angeles County in June 2008. The Foundation is the charitable arm of LACMA that serves as a link between physicians and the community. It champions community opportunities and has a tremendous commitment to impact the quality of life of all patients in Los Angeles County by expanding the pool of medical professionals who attend to underserved populations. “Our primary goal is to improve and impact quality of life for all Angelenos by expanding its pool of medical professionals, especially those who care for our most underserved citizens,” said Dr. Elander in his opening remarks at the Healthcare Awards. “The relationships LACMA has fostered with like-minded companies and organizations help every physician in LA fight for legislation that proves beneficial to the practice of medicine in the 21st century. Membership in LACMA allows us to collectively rise up against policies and regulations that hinder us in our attempt to give our patients the best quality care. And as a collective we help physicians’ individual needs – such as helping them to define their own brand identity.” During these turbulent times, when access to healthcare is of great concern to citizens, having more doctors in these disadvantaged communities is of priority. The Patient Care Foundation (PCF) of Los Angeles County has made great strides over the past few years, providing scholarships to medical students who come from underserved areas of Los Angeles County. Additionally, PCF works with LACMA in an effort to encourage, inspire and mentor a new cadre of community-based physicians poised to deliver highquality healthcare in areas with significant gaps in access and services.

DAVID AIZUSS, MD, FACS | Independent Physician Leadership Award

EADERSHI

“David Aizuss could not be a better candidate,” Dr. Elander began. “He began his career in Northwestern’s prestigious ‘six-yearMed’ program that accepts a tiny number of medical students of the very highest caliber right out of high school. Today he runs a small private group ophthalmology practice in Encino and West Hills. He served as chief of surgery at Encino Hospital, vice chief of staff at Encino Hospital and Providence Tarzana Regional Medical Center, and chaired the Bioethics Committee, Quality Assurance Committee, and Utilization Review Committee at Encino Hospital as well as chairing the Quality Management Council at Providence Tarzana Hospital. His long list of credits and honors includes his membership in the California Medical Association and the Los Angeles County Medical Association since 1981. He is a past president of the Los Angeles County Medical Association, past president of the Los Angeles Society of Ophthalmology, past president of the California Academy of Eye Physicians and Surgeons, and he chaired the Bylaws Committee of the American Academy of Ophthalmology from 2003 to 2008. He serves on the CMA Council on Legislation and chaired the Membership Technical Advisory Committee (TAC) and was a member of the Governance TAC and the County Medical Society Alignment TAC. Dr. Aizuss has been a member of the CMA Board of Trustees since 2010 and was elected vice chair of the Board in 2011 and chair of the Board in 2014. Dr. Aizuss also represents the CMA on the Awarded in recognition of Board of the Institute for Medical Quality. At the AMA, Dr. Aizuss has been a vital advocate for more exemplary contributions than three decades. I know David well. We went to Cornell together, and when I came to LA I did to the medical profession through active leadership in a month rotation at Stein Eye Institute at UCLA. Having watched him up close, I can vouch for his professional organizations, passionate support for our causes. He is constantly going to D.C. and Sacramento on our behalf. He dedicated service to patients, fostering healthy gives so much of his time to help other physicians, and we couldn’t have a better person on our communities, and performing side. His service to the art of medicine while offering superior care to his patients is why we are a medical specialty in a honored to present the 2017 Independent Physician Award to Dr. David Aizuss.” successful practice.

SHLOMO MELMED, MD, MB, CHB, MACP, FRCP | Hospital Physician Leadership Award

Dr. Krauss introduced the next award. “We have an especially worthy honoree this year. He is the executive vice president of academic affairs and dean of the medical faculty at Cedars-Sinai, and holds the Helene A. and Philip E. Hixon Distinguished Chair in Investigative Medicine at the hospital. He is also professor and associate dean of the UCLA School of Medicine, and director of the Research Institute at Cedars-Sinai Medical Center. His laboratory has been consistently funded by the National Institutes of Health from 1980-2016, and he has trained more than 60 physicians, scientists and graduate students who occupy leading positions in academic endocrinology worldwide. His research is devoted to molecular pathogenesis and treatment of pituitary tumors and growth factor regulation of anterior pituitary function. He has pioneered the discovery and application of novel treatments for endocrine tumors and is a recognized international authority on pituitary medicine. He is acknowledged as a plenary speaker at multiple national and international meetings and is the author of over 300 peer-reviewed articles in prestigious publications. At Cedars, he has spearheaded major academic growth and development by leading building efforts, recruiting talented nationally recognized faculty leadership, establishing new programs and maintaining standards of excellence for educational programs. His Awarded in recognition of executive leadership continues to maintain Cedars-Sinai as a top-tier academic medical center. exemplary contributions to the medical profession Once you absorb all of those laudatory titles it’s important to add what an incredible person he is. through active leadership in He has all the attributes desirable in a healthcare professional. He’s a doctor, a scientist actively professional organizations, researching the mechanisms of pituitary tumor and treatment. He’s written definitive books on his dedicated service to patients, fostering healthy course of pituitary research, and he is a leading editor on relevant medical journals. He is adored by communities, and performing his patients. His leadership helped make Cedars-Sinai the world-class institution it is, and doctors a medical specialty or research in hospital. coming up in his field compete to spend time with him. What more could any physician wish for?”

NEAL BAER, MD | Shine the Light Media Award

Dr. Averill introduced the next award: “This year’s outstanding honoree has a history of winning awards for his great work beginning with the Jerry L. Pettis Memorial Scholarship, presented to an “outstanding medical student who has contributed to promoting a better understanding of medicine in the media. His devotion to pediatric and adolescent medicine is well Awarded to recognize and honor branches of the known. His volunteer work is vast and diverse; he lends his talents to such organizations as Venice media for their outstanding Family Clinic, RAND HEALTH, Physicians for Social Responsibility, and Children’s Hospital LA. He is a representations of physicians and healthcare providers. champion of social justice, public health, women’s rights and advocacy for children. For more than In addition to film and 30 years, his writing has helped millions learn about medical topics of the day – including teen television, the Award also pregnancy, AIDS, nutrition and drug abuse. He’s written for a number of shows including “ER,” “Law considers achievements in other branches of the & Order: SVU,” “China Beach” and even the beloved “ABC Afterschool Specials.” This is a man who media and arts, including went to medical school so he could become a better writer. It’s why his writing resonates on both a theater, music, books, print media, digital media, and dramatic and a medical level. It’s why we need his work and why it has helped so many.” advertising.

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CHOLARSHIP

BRIA PETTWAY | A native of La Pu-

ente, California, Bria saw serious gaps in healthcare in her community, even for those lucky enough to have insurance. Through her church and volunteer work, she discovered her vocation was working on health advocacy for and with underserved patients. She is a busy and active medical student at Charles Drew/UCLA Medical Education Program while volunteering in a number of mentor and volunteer capacities.

President of the LACMA Alliance, Elizabeth Kurihara joined Dr. Elander in introducing the 2017 LOS ANGELES COUNTY MEDICAL STUDENT SCHOLARSHIP PROGRAM RECIPIENTS

the field of internal medicine-pediatrics, with a focus on the immigrant and underserved population.

“The LACMA Alliance is the largest support network for physicians and their families in LA County. The Alliance works with LACMA to build healthy communities, support quality medicine and offer support to the next great generation of caring physicians. When you meet our 2017 Scholarship honorees, I know you’ll agree the future is in great hands.”

EUTIQUIO GUTIERREZ | Eutiquio was motivated by the breast cancerrelated death of a loved one who had been denied healthcare due to lack of insurance. Five years ago he began volunteering at Share Our Selves, a clinic that provides low-cost healthcare, financial counseling, food and clothing to the homeless in Orange County. He chose to study at the Western University of Health Sciences in order to stay close to his home community of Pomona. While in school, he also serves as chair of P-CHAT – the Pomona Community Health Action Team. He also mentors disenfranchised youth.

GABRIEL MENDOZA | Raised in Long Beach, Gabriel graduated from UCLA with a major in Neuroscience and a minor in Spanish Linguistics. He is working on his medical degree at the David Geffin School at Charles Drew/UCLA Medical Education Program. He also works as a research assistant in neuropeptides and studies social behavior under Naomi Eisenberger, PhD, at UCLA, as a teacher at Jordan High School and as a member of AmeriCorps. He has volunteered with a number of programs including the UCLA Mobile Clinic Project and the Latino Medical Student Association at the Lennox Health Fair. JESSICA BODDEN | Born and raised in Watts, Jessica learned early

about the disparity of care in South LA and made a commitment to help. From an early age she knew her destiny was to be a physicianadvocate. Currently in her third year at Charles Drew/UCLA Medical Education Program, she is strengthening the tools for that vocation. She works with students at the Sunday Science Academy, served two years as a mentor to South LA High School students with Partnerships for Progress, and her ultimate plan is to open a women’s health clinic in South LA. SUNG HYUN (ANGIE) LIM | Sung moved to LA with her family from South Korea, when she was 10. Her parents worked six days a week to keep them housed and fed. Health insurance was an unaffordable luxury, and any healthcare needs were dealt with at a community health clinic. Seeing the need for improved care in underserved communities, she volunteered at the Glendale Community Free Health Clinic throughout high school and college. She earned a Master of Public Health Degree at UCLA before she began study at the David Geffen School of Medicine at UCLA. She plans to work in

OSOSE OBOH | Osose loves photography and sees her medical goals as a series of snapshots that led her to dedicate her life to underserved patients. As an undergrad at the David Geffen School of Medicine at UCLA she volunteered throughout LA to provide free blood pressure screenings and health education workshops to people in South LA, Compton and Inglewood. While pursuing her MPH at USC she served as a public health intern at a family clinic in Calcutta and later at a clinic closer to home in the San Fernando Valley. She is determined to advocate and care for underserved patients and work to bridge the gap in their care through mentorships, the creation of pipeline programs and fighting for policy change. PAMELA VILA | As a high school student, Pamela earned a paid summer research internship at City of Hope Medical Center. Hoping to study treatment for breast cancer, she was placed in the Department of Population Science to research health disparities. That experience laid the foundation for her decision to dedicate her career to practicing medicine with an intense focus on community health. While an undergrad at UCLA she coordinated health fairs in local underserved communities and volunteered at the Venice Family Clinic. Currently a student at Pomona’s Western University of Health Sciences, she has already received such honors as the Dr. Lawrence F. Gosenfeld Scholarship for Academic Excellence and Service to the Community and has been published in medical journals. STACY SONGCO | Stacy came to the David Geffen School of Medicine at UCLA by way of UC Berkeley, where she majored in molecular and cell biology and sociology. She is impassioned, tenacious and synergistic and wants to be a catalyst for positive change in underserved communities, specifically working to take a population management approach to improve chronic health outcomes with a focus on mental as well as physical well-being. JESSICA OSORIO | Jessica grew up in a working-class Latino and African-American neighborhood in Mid-City LA, the child of immigrant parents from Guatemala and El Salvador. Her parents went out of their way to provide their children with the best possible healthcare options, but she soon realized the options for those in her community were, at best, lacking. As an undergrad at Loyola Marymount, she volunteered at a Dolores Mission Parish in Boyle Heights, and as part of her thesis project she did research in a rural clinic in Guatemala. At the David Geffen School of Medicine at UCLA she co-chairs Students for a National Health Program and serves as Community Representative for the Latino Medical Student Association.

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DR. PETER KIM, FOUNDER OF CURBSIDE REAL ESTATE:

Finding Inspiration as a

Social Entrepreneur

Growing up in the comfortable suburbs of Baltimore, Maryland, Peter Kim, MD, was no stranger to community service or the value of volunteerism. With a physician father deeply focused on his patients and a mother who regularly volunteered her time and energy to social causes, Dr. Kim understood at a young age that actions can be meaningful. “When I see a need, I find opportunities,” he explains. Throughout his teens, he was able to find opportunities to provide service both at his school and his church, and he continued this volunteerism as an undergraduate student at Johns Hopkins University, where he founded a mentoring organization pairing fellow students with Baltimore inner-city youth. Driven by this same passion to serve, Dr. Kim, a full-time anesthesiologist, founded Curbside Real Estate (CurbsideRealEstate.com) three years ago after finding a need he knew he could fill. In the fall of 2011, only months out of his fellowship, Dr. Kim struggled to track down information and resources to finance his new home. He was successful, and friends and colleagues came to him for years seeking advice and direction. Taking the hard-won information he had learned on home-buying options for physicians, Dr. Kim created a company he hoped would provide his fellow doctors simple and free real estate guidance and solutions. Curbside Real Estate took off from there with dozens of new clients added every month. As Curbside continued to grow, Dr. Kim found himself reading Blake Mycoskie’s “Start Something That Matters” and was reminded of his community volunteerism roots that he had put on hold

while completing his medical education and training. Much like Mycoskie, who founded TOMS shoes, Dr. Kim was in a situation where his growing business could be used to fund a corresponding social mission for which he had always felt great passion. For Dr. Kim, that mission was giving shelter where needed. After some research and recommendations, Dr. Kim connected with Angel House Rescue Orphanage (angelhouse. me), a global organization that builds and maintains orphanages for children in some of the poorest regions of the world. The nonprofit uses the full contribution raised by individuals and groups such as Curbside Real Estate to finance the land, materials and labor needed to build new structures. By finding homes for fellow doctors, Curbside has funded a 25-orphan home in India and is in the process of building another. Curbside has also partnered with ZOE (wearezoe.org), an international youth empowerment program that provides education

“Part of the DNA of being a physician is helping people.”

16 LOS ANG ELES MEDI CINE | N OVEMB ER/DECEMB ER 2017

and skills-training to children living in extreme poverty around the world, and has been able to fund an 85-student academy in Kenya. Needless to say, Curbside clients are thrilled their home purchases have made, and will continue to make, a global impact. Despite the success of Curbside Real Estate, Dr. Kim continues to work full time as a physician and is mindful of the importance of his role as a doctor. “Part of the DNA of being a physician is helping people,” he says. “I love being a physician, but I could see myself overlooking the impact my work makes if I wasn’t able to view myself from different perspectives.” Helping other physicians in their homebuying process makes him grateful to have the knowledge and connections to improve the experience of his colleagues. Additionally, being able to take that positive transaction and translate it to homes and education for less-fortunate children reminds him of how fortunate he has been in his life to have a supportive family, ample opportunities, a beautiful home, and now a young family of his own. It is this gratitude that compels him to continue to work hard for other people, whether it be his patients at the hospital, his doctor clients in their home buying, or the underprivileged children in need of homes and education. Dr. Kim encourages physicians considering volunteerism or social entrepreneurial ventures to pursue the challenge if possible. He recommends reflecting on what you are passionate about, what you have to offer — be it time, skills or money — and how that can translate into your local or

global community in a way that is meaningful to you. “Working on Curbside has given me an opportunity to reclaim some of the social activism I was passionate about in my earlier years while also allowing me a chance to help colleagues in my physician community.” And, if you find that you don’t have the resources to volunteer, Dr. Kim reminds us that “choosing to become a physician is a special and hard-earned calling in which you make an impact every day.” Making a difference is always within your reach.

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Doctors Examine Injury Risks with Malpractice Closed Claims Robin Diamond, senior vice president of patient safety and risk management, The Doctors Company

Physicians are always seeking ways to enhance patient safety. Taking a close look at research into real-life malpractice claims and incorporating some of the findings into their practices is one way physicians are reducing risks of adverse events. Studies provided by The Doctors Company provide insight into thousands of closed claims and shine a light on preventive actions. The following are examples of doctors who learned from these malpractice closed claims studies and, as a result, took patient safety in their practices and hospitals to the next level. CARDIOLOGY

EMERGENCY MEDICINE

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• DOCTOR SPOTLIGHT: Sandeep S.

• DOCTOR SPOTLIGHT: Roneet Lev,

• DOCTOR SPOTLIGHT: John D. Nelson,

Mangalmurti, MD, JD, cardiologist at the Bassett Healthcare Network in Cooperstown, New York.

• RISK TREND: The Cardiology Closed

Claims Study outlines liability pitfalls of improper medication management. Cardiovascular medications have inherent risks even when used correctly.

• SOLUTION: This risk led Dr.

Mangalmurti to change his daily practice when managing certain high-risk medications such as anticoagulants. “Coumadin, in particular, is associated with highliability risk because of the risk of bleeding and its narrow therapeutic window,” said Dr. Mangalmurti. To avoid medication mishaps or breakdowns in communication, he makes a point to be very clear about whether the general practitioner or cardiologist will manage the anticoagulant medication.

INTERNAL MEDICINE • DOCTOR SPOTLIGHT: Howard Marcus,

MD, internal medicine physician in Austin, Texas.

• RISK TREND: The Internal Medicine

Closed Claims Study found that 39% of claims resulted from a diagnosisrelated allegation (failure, delay, or wrong).

• SOLUTION: Dr. Marcus has conducted

small group discussions with physicians in his multispecialty medical group of over 300 doctors to improve understanding of the underlying methodological reasons leading to cognitive error. “Diagnosis in medicine is often challenging. There are more than 8,000 diagnostic entities listed by the National Library of Medicine and every patient is unique. It is helpful to understand the effect that psychological biases such as ‘overconfidence bias’ or ‘anchoring bias’ may play in medical decision making,” said Dr. Marcus.

MD, FACEP, chief of the emergency medicine department at Scripps Mercy Hospital in San Diego, California.

• RISK TREND: The Emergency Medicine

Closed Claims Study identified the need for rapid recognition of stroke patients and treatment for tissue plasminogen activator (tPA).

• SOLUTION: Across the entire hospital

system, Scripps Mercy Hospital now initiates its emergency protocol for potential strokes when the call is placed to 911. The patient is taken straight to the CT scan without stopping at an emergency department bed. This expedites patient care as they activate the stroke team.

PLASTIC SURGERY • DOCTOR SPOTLIGHT: Phillip Haeck, MD,

a plastic surgeon at The Polyclinic in Seattle, Washington.

• RISK TREND: The Plastic Surgery

Closed Claims Study notes that 10% of claims against plastic surgeons involved miscommunication between the patient or family members and the doctor.

• SOLUTION: Dr. Haeck presented the

study to his six partners and 35 staff members where they reviewed communication practices. As a result, the practice administered changes to communication protocols among physicians, staff, and patients. It now has clear guidelines to identify each communication, when it took place, and what resulted. All communications— including social media exchanges between patient and staff—are now entered into the EHR to alert the surgeon of new communication.

20 LOS ANG ELES MEDI CINE | N OVEMB ER/DECEMB ER 2017

MD, internal medicine hospitalist at Overlake Medical Center in Bellevue, Washington.

• RISK TREND: The Hospitalist Closed

Claims Study reveals spinal epidural abscess—a disease relatively uncommon in the general population—is appearing in medical malpractice claims more frequently. A diagnosis-related error involving spinal epidural abscess can lead to dire consequences, including paralysis.

• SOLUTION: “This study should serve

as a strong reminder for hospitalists of the importance of maintaining a very high index of suspicion for spinal epidural abscess,” said Dr. Nelson. Problems with back pain, leukocytosis, and fever are red flags, but Dr. Nelson states the literature isn’t so simple. These symptoms alone do not equate with epidural abscess. It requires a great deal of judgment to decide which cases are deemed appropriate for this diagnosis. “If you think a patient could have it, and it’s worth pursuing, you should pursue it now rather than later. So, for example, get an MRI tonight rather than tomorrow.”

By leveraging technology, implementing new protocols, and being better equipped to address scenarios that could negatively impact patient safety, these practices and hospitals are taking steps in advancing patient care. Further insights from doctors who are learning from malpractice claims are available in The Doctors Company’s Innovations in Patient Safety video playlist.

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