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T h e N e w O f f i c i a l P u b l i c at i on o f t h e Lo s An g e l e s Co u nt y M e d i c a l A s s o c i at i on


A PUBLICATION OF PNN www.PhysiciansNewsNetwork.com

LACMA Welcomes New President


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JULY 2013


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Volume 144 Issue 07



Marketing your practice

Valuable insight for taking an organized, proactive approach to marketing—both internally and externally—that can lead to strategic decisions that affect the future of your practice.



DR. Marshall Morgan

LACMA is excited to welcome its new president, Dr. Marshall Morgan, who was named LACMA’s 142nd president during a special installation dinner ceremony on June 20. Here is a look at what to expect under Dr. Morgan’s leadership.

14 DEPARTMENTS 6 Front Office | Practice Management

Tips, hints, advice and resources 10 Balance | Lifestyle & Wellness


News, studies, tips and opportunities to help physicians maintain a balanced lifestyle 12 PNN | NEWS IN REVIEW

The latest headlines impacting the economics of healthcare delivery in Southern California 22 United We Stand | AT WORK FOR YOU

LACMA and CMA membership at work for you

From Your Association 4

President’s Letter | Samuel Fink, MD

24 LACMA News | Association Happenings 28 CEO’s Letter | Rocky Delgadillo

24 Physician Magazine (ISSN 1533-9254) is published monthly by LACMA Services Inc. (a subsidiary of the Los Angeles County Medical Association) at 707 Wilshire Boulevard, Suite 3800, 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 Physician Magazine, 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 9001 7. Advertising rates and information sent upon request.

J ULY 2013 | w w w. p h y s i c i a n s n e w s n e t w o r k .c o m 1


Sheri Carr 559-250-5942 | sheri@physiciansnewsnetwork.com ADVERTISING SALES

display ad sales / director of sales CLASSIFIED ad sales editorial advIsory board

The Los Angeles County Medi-

Christina Correia 213-226-0325 | christinac@lacmanet.org Dari Pebdani 858-231-1231 | dpebdani@gmail.com David H. Aizuss, MD Troy Elander, MD Thomas Horowitz, DO Robert J. Rogers, MD Headquarters

cal Association is a profes-

Physicians News Network Los Angeles County Medical Association 707 Wilshire Boulevard, Suite 3800 Los Angeles, CA 90017 Tel 213-683-9900 | Fax 213-226-0350 www.physiciansnewsnetwork.com

sional association representing physicians from every medical specialty and practice setting

LACMA Officers

as well as medical students, interns and residents. For more than 100 years, LACMA has

President President-elect Treasurer Secretary Immediate Past President

been at the forefront of current medicine, ensuring that its members are represented in the areas of public policy, government relations and community relations. Through its advocacy

LACMA BOARD OF DIRECTORS CMA Trustee Councilor - District 9 Councilor - District 2 med student Councilor/usc keck Councilor-at-large young physician councilor cma trustee Councilor - District 5 ethnic physicians commitee representative Councilor - District 1 Councilor - District 17

efforts in both Los Angeles

Councilor - District 14

County and with the statewide

Chair of LACMA Delegation

California Medical Association,

Councilor - District 6

your physician leaders and staff


strive toward a common goal–

Councilor - District 10

that you might spend more time

Alternate med student Councilor/ucla

Councilor - District 7 Councilor-at-large Councilor - SSGPF Councilor - District 3

treating your patients and less time worrying about the challenges of managing a practice.

Marshall Morgan, MD Pedram Salimpour, MD Peter Richman, MD Vito Imbasciani, MD Samuel I. Fink, MD

Councilor - SCPMG RESIDENT/FELLOW Councilor cma trustee alternate RESIDENT/officer Councilor Councilor-at-large Councilor-at-large cma trustee (resident)

David Aizuss, MD William Averill, MD Boris Bagdasarian, DO Erik Berg Stephanie Booth, MD Steven Chen, MD Jack Chou, MD Troy Elander, MD Hector Flores, MD Carlotta Freeman, MD Sidney Gold, MD William Hale, MD David Hopp, MD Paul Kirz, MD Lawrence Kneisley Kambiz Kosari, MD Howard Krauss, MD Maria Lymberis, MD Carlos E. Martinez, MD Nassim Moradi, MD Ashish Parekh, MD Jennifer Phan Heidi Reich, MD Peter Richman, MD Sion Roy, MD Michael Sanchez, MD Nhat Tran, MD Erin Wilkes, MD

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, Executive Assistant, at lisa@lacmanet.org or 213-226-0304.

Subscriptions Members of the Los Angeles County Medical Association: Physician Magazine 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 Physician Magazine, 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 90017. To inform us of a delivery problem, call 213-683-9900. Acceptance of advertising in Physician Magazine 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 Physician Magazine, LACMA Services Inc. or the Los Angeles County Medical Association. Physician Magazine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. PM is not responsible for unsolicited manuscripts.

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T h i s i s i t! My last column that I will write as your President. It has been an honor to serve as the 141st President of LACMA, and I’ll discuss that a bit more later on. But first, I want to update you on a few legislative issues that are very important! The trial lawyers are going all out to defeat MICRA. Based on the amount of money they are spending, it is clear that they are “all in.” Why now? Because there are a supermajority of Democrats in both the California Assembly and Senate, along with a Democratic governor. Republicans have always been solid MICRA supporters, so this is the trial lawyers’ best chance to get a bill to the governor’s desk. Failing that...and we will do everything in our power to make sure that their legislative attempts are unsuccessful...we expect that the lawyers will spend an additional two million dollars to get the signatures needed to get an initiative on the November ballot that overturns MICRA. We anticipate that it will cost LACMA, the CMA, and our allies 60 million dollars (!) to defend MICRA, but that is where we are headed! I’m asking you to go to the CMA website at www.cmanet.org and click on the “Donate Now” button to contribute to this fight. Medical staffs up and down our state will be asked to donate as well, and the California Hospital Association has agreed to not only match, but to double any medical staff contribution that is made...we are in this fight together! As I have written each month, we continue to obstruct in any way that we can the forced transition of California’s Medi-Medi dual eligibles to managed care. As of right now, the program is scheduled to start on January 1, 2014 with a 12 month phase in. But, there are no signed contracts in place, no doctors to see these patients, and no developed infrastructure to carry out the State’s wishes. To say that the program is in “disarray” puts it mildly. I would be shocked to see even one patient enrolled on January 1! Senate Bills 491, 492 and 493, which make pharmacists, optometrists and nurse practitioners primary care doctors by legislative fiat have passed out of the Senate, and will now be heard in the Assembly Business and Professions Committee in early July... please contact your legislators and ask them to vote NO on these bills! Serving as your President over the past year has been one of the most challenging and rewarding experiences that I have had in my 25 years of practice. It required significant personal growth, and the development of a new set of skills. I had to learn how to write, speak, and argue passionately on your behalf...sometimes at a moment’s notice, and often with a great deal riding on the outcome 4 PHYSICIAN MA G A Z INE | J ULY 2013

of my efforts. Along the way I had strong support from many of LACMA’s Past Presidents, my fellow Executive Officers and board members, as well as LACMA’s hardworking and loyal staff. And you know what? I think we have turned this ship around! I have never seen the New LACMA fight so hard on behalf of its member physicians or develop the media presence that we have established this year. Additionally, through the Physician’s News Network we are communicating with you weekly about the news stories that will most affect your practice. Joining our new group purchasing programs with Medline and Provista should easily save you the cost of your entire LACMA membership, if not much more! I am also proud of our philanthropic work in raising scholarship money for disadvantaged medical students. LACMA’s successful efforts on behalf of its doctors have resulted in 350 new members this year alone! The most important thing I have learned as your President is that practicing medicine in Southern California in 2013 is not a spectator sport. It is no longer enough to go into your office and do a great job taking care of your patients, while being oblivious to the storm warnings around us. Every payor wants to interfere with your practice...they want to second guess what you do, how you do it, and what you are paid for it. I’ve done my best over the past year to keep you informed...but that won’t be enough. What’s required is for YOU personally to get involved and take action. Call your legislators, educate your patients on the issues, and join a district board or committee. LACMA can easily get you involved....this is your opportunity to shape your own future! I want to express my sincere appreciation to LACMA’s CEO, Rocky Delgadillo. He has been a terrific quarterback for our organization, and represents you with commitment and enthusiasm! Alberto Tovar, our COO, manages our day to day operations, overseeing an outstanding and dedicated staff: Carol, Eva, Lisa, Luis, Carolina, Christina, Margaret, Rosario, Priscilla, Michelle, Ann and Fred...I couldn’t have been successful without you! Thanks to Reo and Sheri as well...who never complained when I pushed my column’s monthly deadline from the 15th to the 22nd! My office staff....Arlene, Edith, Lindy and Krystie kept my office running smoothly and my patients happy, continually shuffling my schedule when I was required to be in two places at once...thanks so much! And my biggest thanks goes to my wife, Beloria, and my kids...Jonathan, Zachary, Sarrica and Benji who sometimes didn’t see me during the week until very late at night, but supported my work nonetheless. I now leave you in the good hands of Dr. Marshall Morgan, our 142nd President. We have worked closely together for the past three years, and I know that he will serve you well! Thanks for all of your support! Samuel Fink, MD, is an internist in private practice in Tarzana. He is the 141st president of the Los Angeles County Medical Association.

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Preventing Physician Turnover by marion webb

W ith m e di c a l grou p physician turnover rates at its highest level since 2005 at a time when

millions of people will become newly insured and physicians are in short supply, practices need to rethink their efforts in recruiting and retaining doctors. According to the 2012 Physician Retention Survey from physician recruiting organization Cejka Search and the American Medical Group Association, the average physician turnover rate in 2012 was 6.7%, the highest since the first year data was collected in 2005 and also exceeding prerecession levels. The findings suggest that an improved housing market and a recovery in stock prices boosted physicians’ financial security levels, making them more apt to consider new job opportunities and also to relocate. As more physicians move into the employment ranks, the competition for hiring and retaining physicians is expected to intensify. According to the survey, more than three quarters of respondents said they plan to hire more primary care doctors in the next 12 months and 22% said they plan to hire “significantly more” new doctors. With this in mind, experts suggest that medical groups who are looking to hire or have vacant positions consider tracking their recruiting, hiring and retaining metrics. Many may not realize the real costs. For example, if a lost revenue for one full-time equivalent (FTE) is $990,034, recruitment costs are $61,200 and annual start-up costs are $211,063, that means replacing one physician leaving and getting another on board will cost the organization more than $1 million ($1,262,297), according to Cejka Search. The study has shown that turnover is particularly high among doctors who have recently joined a practice, peaking between two and three years. When doctors stay for five years, they are more likely to stay for the long haul. Hiring the right person that fits in with the culture


of the practice and offering new hires the resources they need to become successful will be even more critical in the changing healthcare environment.

7 Tips on Physician Retention That Every Practice Should Know: 1. Have a solid on-boarding strategy: This should encompass orientation, meetings with staff members, touring the building, getting business cards, reviewing OR schedules (if applicable) and introducing the new electronic health system. 2. Offer flexible scheduling: Some doctors may frown on offering their doctors part-time work, but not being flexible could mean losing out on a very attractive younger candidate or experienced doctor. 3. Partner with nurse practitioners and physician assistants: In the increasingly team-based working environment, creating partnerships with nurse practitioners and physician assistants can help doctors relieve some of the work burden. 4. Implement a physician mentoring program: Although three-quarters (74%) of respondents say they believe mentoring helped reduce turnover, only about half assign a mentor to a new physician. Finding the right mentor is key. 5. Screening: To ensure that a new hire is compatible, using behavioral interviewing to gauge whether a candidate’s motivations, values and past actions are compatible with the organization’s mission and goals is critical. 6. Professional Growth: Offering doctors a long-term vision of their career in your practice is as critical as the onboarding process. 7. Recognize Doctors: Recognizing physicians at an annual party and “thank you” can go a long way toward making your physicians feel welcomed and wanting to do the best job they can.

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Frequent Malpractice Risks Faced by Office Practices Revealed in Survey Th e mo s t fr e qu e nt malpractice risks medical office practices face are related to lab tests/referrals

and scheduling/follow-up, according to a nationwide survey of practice environments conducted by The Doctors Company. The survey found that medical record documentation, medication management, and communication are other top areas of risk. Your office practice can follow these steps to lessen risks:

Lab Tests/ Referrals and Scheduling/ Follow-Up

• Ensure that the office staff knows how to reconcile tests, referrals, and consult orders with the results when received, and have a process in place in case of discrepancy. • Communicate all test results to patients. • Don’t rely on a return appointment or a “hold” on a medical record as a reminder that a test was not performed or the patient was not contacted about results. • Tell patients to contact your office if they have not received test results by a specified date. • Send letters to patients who fail to follow up and cannot be reached by phone; file all documentation in the medical record. • If using an electronic medical record, utilize the test-tracking capability.

Medical Record Documentation

• Document allergy information in the same place on all medical records. • Keep a current list of all medications. • Maintain a current problem list with dates of problem identification, reviews, and resolutions. • Use the patient’s own words when documenting. • Indicate in writing or electronically that all results of tests, consultants, and referrals were reviewed. • Document all after-hours patient calls.

Medication Management

Communication Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www. thedoctors.com/patientsafety.


• Ensure that the patient understands the reason for the medication, how to take it, and when to contact your office about side effects. • Store medication samples, syringes, and prescription pads securely. • Label syringes and administer medications immediately—don’t leave them unattended. • If you prepare medications to be used later, sign or initial the label and include the name of the medication, dosage, and date. • Maintain refrigerated medications at the correct temperature and keep a record of who performs the checks and what was discarded. • Ask verbal orders to be repeated back. • Identify all high-alert medications and follow guidelines to ensure they are ordered, stored, dispensed, and administered correctly. • Refer to your state law to determine which staff can call in new prescriptions and refills.

• Document all advice in the patient’s record. • Ensure that a licensed provider responds when the patient’s question is outside the scope of office staff knowledge. • Document the level of understanding during the informed consent process. • Use open-ended questions. • Incorporate a standard communication protocol to enhance the handoff process and reduce errors of omission.

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balance | li festyle & wellness

When Life Impacts Work by Liz Ferron

W h e n d o c tor s h av e personal problems—from marital or relationship issues, to children in crisis

or elderly parents in need of care, to financial investments gone bad—it often has an impact on the quality and quantity of patient care that physicians are able to offer. Physicians tend to believe that they can compartmentalize different aspects of their lives. The reality is that personal stress is often taking a costly toll on themselves and their work. • An agreement that his cell phone wouldn’t be taken into the exam room • A temporary reduction in administrative duties and clinical load, giving him time to catch up on his cases and medical records • A therapist to help the physician work through his marital and parenting issues • A Physician Peer Coach to work with the physician on more effective ways to balance his work and life issues • An evaluation and coordination of the family counseling and behavioral health resources being provided to the physician’s family (at the request of the physician and with full permission).

A Case in Point A family practice physician going through a difficult divorce was also struggling with an adolescent daughter who’d been in and out of treatment for a variety of behavioral health issues. He was so concerned that he dropped everything to accept cell phone calls from her and her siblings, no matter what he was doing. Negative patient feedback was reaching his colleagues and also the organization’s CEO. The physician had also fallen deeply behind in case management and charting. The organization wanted to retain the physician, whose highly valued contributions and performance had, until recently, been above reproach. A performance improvement plan for the doctor was developed that included:


The physician, who was unaware of how his behavior was affecting patients, colleagues and staff, was grateful for the heads-up and appreciated the support the organization was willing to extend. His colleagues were able to see immediate and noticeable improvement.

Restoring Work/Life Balance A 2010 article in American Medical News stated, “An unmanageable work schedule and outof-control home life can lead to depression, poor performance at work, conflict with family and a feeling of burnout that can lead physicians to question whether to stay in medicine at all.” While balancing work and life isn’t a challenge for all physicians, a 2009 article in Medical Care noted that 31% of participants in a recent survey reported it as a moderate or serious challenge. And, a 2008 study for The Physician’s Foundation found that 63% of physicians found long hours and lack of personal time as one of the least satisfying aspects of being in medical practice.

Organizations can provide • More flexible hours and reduced call • More part-time opportunities • Hospitalists to reduce call schedules and hospital responsibilities • Resources: exercise facilities, coaching, daily living support (e.g., concierge, EAP)

Physicians can • Practice better time management around clinical and administrative duties • Practice better self-care: small breaks during the day for meals, short walks, mindfulness • Schedule “appointments” for family and life pursuits—and don’t cancel • Acknowledge what you can’t do yourself—and get and accept help, whether at work or at home.

Liz Ferron, MSW, LICSW, Senior Consultant and Manager of Clinical Services, Physician Wellness Services

Business & Medical Practice Loans Loans for: • Office Remodels • Practice Acquisition • Partner Buyout • Purchase of Existing Practice • Office Expansion

Call me now to discuss your needs!

(310) 963-0749 Mark Magna | Mark@ZumaCap.com J ULY 2013 | w w w. p h y s i c i a n s n e w s n e t w o r k .c o m 11

l i festyle & wellness | balance

Here are just a few strategies to increase work/life balance. Even seemingly small steps can make a difference, but physicians need to make balance a priority—and occasionally ask their organizations for help:

phys i c i ansnewsnetwo r k . co m | NEWS i n r ev i ew

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The LOS ANGELES County Medical Association

PNN | LOCAL • TIMELY • RELEVANT reporting on the economics of healthcare delivery

Key Changes Dealing with Transparency Are Coming for LA Doctors The president of the American Medical Association recently spelled out key changes to the Physician Payment Sunshine Act that every Los Angeles County physician needs to understand. The new Sunshine Act, created by Congress, ensures transparency in physicians’ interactions with the pharmaceutical, biologic and medical device industries and group purchasing organizations. Covered CA Selects Insurance Plans; Loophole Spells Trouble for Physicians Covered California, the state agency implementing the Affordable Care Act (ACA), has selected 13 health plans for the new state-run insurance marketplace, starting January 2014. According to the Covered California website, 80% of practicing physicians and 80% of acute care hospitals will be seeing new patients coming on the exchange through 13 commercial health plans. In Los Angeles County, the following six companies will represent the northern and southern regions: Anthem Blue Cross, Blue Shield of California, Health Net Inc., Kaiser Permanente, L.A. Care, and Molina Healthcare. Payers Must Offer Electronic Funds Transfers Starting January 2014, all payers will be required to offer electronic funds transfers (EFTs) under health reform, and Medicare will only reimburse healthcare providers via EFTs, according to the Healthcare Billing & Management Association (HBMA) based in Laguna Beach, CA. HBMA recently said it supports the new EFT tool by the Council for Affordable Quality Healthcare (CAQH) as a way to save time and money for everyone involved in the medical billing process. CHA Says Legislation Negatively Affects LA Communities The California Hospital Association (CHA) recently released an online video of a mobile clinic program serving underinsured and uninsured Los 1 2 PHYSICIAN MA G A Z INE | J ULY 2013

Angelenos, which it says would be jeopardized by proposed legislation seeking to rewrite the state’s community benefit requirements for nonprofit hospitals. The proposed bill, AB 975, authored by Assembly member Robert Wieckowski, D-Fremont, would impose “vague and unrealistic standards on nonprofit hospitals, and would compromise their ability to meet local healthcare needs,” the CHA said in a May 21 press release. AltaMed Expands Services in LA To meet the growing medical needs of the underserved community, AltaMed Health Services says it plans to add 12 new healthcare providers and 69 support staffers for its Los Angeles and Orange County community centers. LA Native Americans Could Lose Health Coverage Many members of Los Angeles County’s large Native American community could lose free health coverage under the Affordable Care Act, which limits the definition of American or Alaskan Indians to those who can document membership in 566 tribes recognized by the Bureau of Indian Affairs. Health Plan Targets Latinos, Offers Access to LA Doctors and Clinics Woodland Hillsbased Anthem Blue Cross and AltaMed Health Services recently announced they have joined forces to develop an HMO health plan targeting Latinos. The health plan will give future members exclusive access to the AltaMed network of doctors and primary care clinics in Los Angeles County. LA Healthcare Professionals Join Protest A spokeswoman for the California Medical Association said the recent protest against cuts to Medi-Cal, which drew thousands of doctors, nurses and unionized healthcare workers from Los Angeles County and elsewhere to the state’s capital, was highly successful.

Glendale Group Plans Own Information Exchange Glendale Healthier Community Coalition has announced it plans to establish a health information exchange in Glendale to share patients’ medical records and other information with health providers. The effort aims to cut costs by improving and streamlining medical care among three hospitals—Glendale Memorial Hospital, Glendale Adventist Medical Center and Verdugo Hills Hospital—with a planned expansion to other community health providers, such as the American Diabetes Association, Ascencia homeless services and Glendale Healthy Kids. L.A. Care Health Plan to Expand Provider-Clinic Connections Since the start of the project 18 months ago, L.A. Care Health Plan, the nation’s largest public health plan, has counted 15,000 electronic consultations between primary care doctors and specialists, connecting 1,300 providers in 108 community clinics and health centers across the county. The web-based system allows primary care doctors and specialists to share health information and discuss patient care. This reduces patient treatment times, improves clinical quality and lowers costs. This year, the program will be expanded to 76 additional sites to serve one million low-income Los Angelenos. Apollo Medical’s CEO Announces New Physician Association Dr. Warren Hosseinion, CEO of Apollo Medical Holdings, which contracts with health plans through its network of more than 150 primary care doctors and specialists, said its newly formed independent physician association (IPA), Maverick Medical Corp., serves Medicare, dual eligible, commercial and Medi-Cal patients residing in the greater Los Angeles area. The organization is looking to expand both its IPA and existing accountable care organization (ACO) into other geographic areas, he said. This means they’ll be looking to add primary care and specialists in Los Angeles County to serve its growing network of patients.

reporting on the technology of healthcare delivery

Read Full Stories and Subscribe to the PNN eNews Bulletins at www.PhysiciansNewsNetwork.com/iPNN

UCLA Birth Control App Saves Physicians Time, Empowers Patients A new free iPad application designed to educate women on birth control choices could soon be coming to a kiosk’s physician’s waiting room near you. The application already is saving doctors valuable time. The iPad called Plan A Birth Control or Plan ABC, developed by Dr. Aparna Sridhar, a clinical fellow in family planning in the UCLA Department of Obstetrics and Gynecology, is now available on iTunes. UCI Uses New Device to Fight Breast Cancer Surgeons at UC Irvine Medical Center are the first in the country to use a device that reduces by half the need to reoperate and cut out breast cancer cells missed during an initial lumpectomy. The MarginProbe System lets the surgeon immediately assess whether cancer cells remain on the margins of excised tissue. Currently, patients have to wait days for a pathologist to determine this. Specialists Use New Technology to Implant Mini Telescopes in Eyes A team of specialists in Kaiser Permanente San Diego’s (KPSD) Ophthamology department is the first of all Kaiser Permanente facilities to offer Implantable Miniature Telescopes (IMT) that are surgically placed in the eye during an outpatient visit to improve vision. Under the direction of Dr. Peter Custis, chief of ophthalmology for KPSD, and Drs. Leslie Purcell and Tim Yee, VE, who are the only two certified low-vision specialists at KPSD, the technology offers invaluable benefits for the right candidate.

J ULY 2013 | w w w. p h y s i c i a n s n e w s n e t w o r k .c o m 1 3

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“The day was an enormous success, with about 8,000 people in attendance from all across the state,” said Molly Weedn, spokeswoman for the CMA.

Consider the long-term stability of your practice, the changes coming with healthcare reform and the fact that patients are online sharing their thoughts with potential new patients and creating your online reputation. And what about the threat of ‘minute clinics’ popping up everywhere, offering quick, inexpensive primary care? And insurance companies are paying closer attention to patient satisfaction ratings, which in some cases are linked to reimbursements. Another consideration is the cost of attrition. It’s often underestimated, especially when considerBy: Cheryl Bisera ing one’s reputation and the hit to potential new growth when an unhappy patient leaves your practice. At minimum, you’re down one patient and your ex-patient is no longer a potential referral source. At worst, they become a source of de-marketing your practice as they tell others about their dissatisfaction. The process of taking on a new patient is costly as well; profits often don’t begin to add up until a patient is seen at least twice in order to recoup initial costs. Internal marketing is marketing to your existing patient base. You may ask, “Why would I need to do that, they are already sold?” This kind of patient-centered activity is exactly what keeps your bottom line growing, putting you in the driver’s seat by building a panel of desirable patients that remain loyal and become your community referral sources as they tell their friends and family about you, drawing more of these like-patients to your practice. Taking an organized, proactive approach to marketing—both internally and externally—leads to strategic decisions that affect the future of your practice, thus strengthening your position and increasing your ability to withstand the winds of change in healthcare and your community.



You’ve got more patients than you can spend a reasonable amount of time seeing, you’re hearing about a physician shortage in the U.S., and you may be thinking, “The last thing I need to do is think about marketing or catering to patients to improve my ‘reputation.’ ” You may want to think twice.

your medical practice consider these benefits (the five whys) 1. Marketing will attract patients from better performing payers, allowing you to strengthen your practice’s financial position, possibly allowing you to let go of less-attractive, high-maintenance insurance plans that keep reducing reimbursements. 2. Marketing to existing or desirable patients will give you the opportunity to consider adding revenue-boosting services that appeal to them. 3. Satisfied patients will tell referring physicians, online review sites, friends and family about their experience with your practice, boosting your reputation in the community, online and among physician-referrals. This positions you for growth and greater control. 4. Marketing will help you showcase added services and new providers or allied professionals – growing these new modes of revenue quicker, reducing a costly lull before these services or providers are well known. 5. An important part of marketing is understanding your competition – keeping your hand on the pulse of the market and adjusting the practice accordingly, in order to maintain your competitive edge and high patient satisfaction.

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These are just five of the many benefits of taking a proactive approach to marketing your practice and boosting patient satisfaction through improved customer service and marketing. However, the full payoff is often not realized until much later as positive change snowballs and leads to more positive changes, both sharpening and strengthening your practice. Properly marketing your practice can reap benefits for years to come by making your practice more visible and opening doors of opportunity you may not yet know exist. Strengthening your position can help you make welcome changes, rather than changes forced on the practice by external forces. So, now you’re asking, “Where do I begin?” Like most anything else, by making small positive changes and tackling different areas needing attention or change as time, money and energy allows. Below are five categories to consider, simplified so that any practice can begin to understand the basics of successfully marketing a medical practice.

consider these strategies (the five hows)

Taking an organized, proactive approach to marketing leads to strategic decisions that affect the future of your practice

1. Social Media Before you panic because you haven’t started a Facebook page and don’t have time to blog, consider how you might take the reins of your online reputation in a few simple steps. The first step in developing an online presence is making sure you are listed correctly on the most popular review sites. Some sites will list all physicians they can find a record of; however, the information could include your residence before establishing your private practice or joining an existing practice. It is confusing and can create uncertainty among potential patients when they view an address that is not your current location. Some review sites will allow you to list your board certifications, languages you speak and even a photo – all of this is “free” marketing and gives patients who are searching online more confidence in choosing you. Begin by “claiming your space.” Go to these sites and log on as the provider. Look for something like,“Is this you?” or “Doctor Resource: Update your profile.” After providing proof that you are this provider, you can update the contact information, making sure all the fields are filled out accurately while providing confident, positive information. Some of the most influential sites include Avvo.com, Vitals.com and Healthgrades.com. 2. Internal Marketing As referenced earlier in this article, internal marketing is focused on your existing patients. One way to do this is with outstanding customer service. This in itself is deserving of its own article because I can’t stress enough that no matter how competent the clinical skills of a physician are, the staff


m ar k eti ng your pr act i ce | FEAT UR E

Properly marketing your practice can reap benefits for years to come by making your practice more visible and opening doors of opportunity you may not yet know exist

whom your patients encounter influence their visit and how they feel about your practice at least as much, and usually more. A strong office manager with this priority is key. Surveying patients is a great way to get feedback – so long as patients feel the feedback is truly anonymous, so that ratings will always be honest and do not compromise integrity. Another internal marketing strategy is hiring a professional mystery patient service to have an anonymous patient rate your practice. This can be an eye-opening catalyst for changes you may have never guessed were needed. Email marketing is a great way to stay in touch with patients, letting them know about changes and improvements to your practice, but remember it needs to be short, sweet and useful. Give them timely advice and tips, announce how a new change in your practice is going to benefit them. Don’t send too often – about once a month or less is recommended – and always secure permission to email them, a simple check-box on your new patient form should suffice. Competitive forces don’t let up, and neither should you in showing your patients that you are their best choice. 3. Media Every business wants it -- but few get it. So how do they get it? Start by sending short, to-the-point and very factual press releases to your local media outlets, including Physicians News Network/Physician Magazine, when you have business changes: you’re adding a provider (be sure to brag on them a bit – schooling, special focus, services they will add to your practice), you’ve moved offices, or even if a provider attends a conference that can be viewed as positively impacting patient care. When your practice is frequently in print, it positively affects your reputation; it’s a relatively inexpensive way of reminding patients and potential patients that you exist and are the best choice. For greater exposure, such as a feature article, you will need to think about what a publication deems interesting and relevant in the eyes of their readers. Local papers love local news. However, no media wants to market your practice for you, and trust me, they are used to getting a lot of ego-driven “story” pitches. Is there something going on in your community that

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you – because of your specialty – can speak to? Can you weigh in on a current event in a valuable way? For instance, a whitefly epidemic in my community years ago led to increased crop-dusting, which brought on all kinds of issues for patients of a local allergist. His insight, opinion and unique ability to comment on and treat related issues made him the perfect interviewee. Calling the local papers right at the onset of such an event gives you a far greater chance of getting in a story. If you have a unique patient case – and the patient has agreed to talk to the media – by all means, call them up and see if they are interested. Though it’s usually not going to be “all about you,” there are occasions where your personal story or life journey is unique enough and local (because you are local) enough to be considered valid by the media, for instance, a recent client of mine who came from a third-world country with fifty dollars in his pocket and went on to obtain a medical degree at a prestigious university, overcoming unusually difficult obstacles. My first call to a less experienced reporter resulted in nothing, but when I persisted and spoke with a more experienced reporter, the interview was scheduled and my client’s story was on the front page with full color photos two weeks later. 4. Community Your most powerful realm of influence is closest to you, your very own community. So before you go advertising across your state, consider the importance of establishing a strong reputation and brand in your own community first. Is there a non-profit whose mission you can really get behind – either your personal passion or its significance to your specialty? Consider sitting on their board or contributing to their fund-raisers and supporting their events as a practice or as an individual. If you are an oncology practice, perhaps your staff can sign up for a local cancer research fundraising walk – get matching T-shirts with your practice logo on them and get out there and rub shoulders with your community. A family practice might want to get involved with a local YMCA, these often have health-related events and welcome the support of their local medical community! This kind of community involvement says a lot to your patients, potential patients and your staff. It’s 100% positive and a win-win! 5. Referral Sources It’s easy to forget to say thank you when you feel like you’re the one serving others all day long, but it’s vitally important to keep in mind where your patients come from. Are primary care physicians sending you referrals, other specialists, the dentist in the office downstairs, your current patients? Track where patients are coming from and make it a priority to thank these sources. Some practices “get” the impact of this small act so much, they personally write and mail a thank you note to the referring patient with a nominal gift card enclosed. Do you think that patient is impacted and encouraged


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Competitive forces don’t let up, and neither should you in showing your patients that you are their best choice to “keep‘em coming”? You bet. You can have a note of thanks delivered along with a fruit tray, high-end bakery goodies or some other creative gift to offices that refer – something the entire staff can enjoy while being sure the referring physician is personally thanked. When physicians or patients trust you to care for others, it’s no small thing. If you want to nurture that referral source, begin by thanking them, then ask them how you’re doing and how you might improve service. Surveying referring physicians and informing them of any changes or improvements in your office and services is a smart strategy to building a strong referral network. Always remember to return patients to the referring physician, communicating both findings and recommendations. It is simply good business! In the end, there’s much to be said about marketing and how it helps improve the overall patient and referring physician’s experience. Taking these positive steps will portray the practice in a way that reflects your culture and mission, build desirable relationships with new and existing patients, improve patient compliance rates, facilitate better patient-doctor communication, improve the employee environment and boost job-satisfaction for everyone—including physicians! All of this while contributing to increased satisfaction of patients and physicians who become loyal referral sources. Isn’t it time you consider marketing as a key strategy to protecting the future of your practice? Cheryl Bisera is a healthcare marketing and image development consultant based in Newbury Park, California. Her passion is finding the unique strengths of a practice and bringing them to the forefront in marketing while developing a practice image befitting the target market. By improving the overall patient experience her clients gain a leading edge among their competitors. Contact Cheryl from her website: www. CherylBiseraConsulting.com.

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SOCIAL MEDIA In this changing healthcare environment, many physician practices will need to rethink their marketing strategies and find new ways to connect with patients. With millions of Americans using social networking sites like Facebook, Twitter and Google Places to connect with each other, social media is the new virtual waiting room for doctors to tap into. In this article, you’ll find seven expert tips on how to successfully market your medical practice even after the Affordable Care Act takes hold. You’ll also find critical answers on “dos and don’ts” when it comes to social media marketing.

With millions of Americans using social networking sites like Facebook, Twitter and Google Places to connect with each other, social media is the new virtual waiting room for doctors to tap into.

1. Develop a Social Media Plan – According to the experts, physicians who focus on one or two social media platforms and try to create a streamlined process have a higher chance of success than those trying to be everywhere at once. “Make sure the ‘social media path’ you choose is a sustainable one, said John Lynn, founder of Healthcare Scene blog network and co-founder of Influential Networks, in an article in HealthCare Finance News. “Those who try to sprint with social media marketing usually end up with poor results, unless your name is Justin Bieber.”

2. Understand Your Community – As part of developing your social media plan, you want to learn first where your target audience communicates. Do your patients prefer Facebook, Twitter or Pinterest? If you don’t know the answer, it’s a good idea to research which social networking site your clients actually prefer before reaching out to them. When using these channels, be sure to learn about the boundaries of communication and patient privacy issues first—as well as educating your staff—to see what forms of communication are acceptable and which ones are absolutely not acceptable. 3. Start a Blog – Starting a blog is a great way to let future patients know what to expect from you, learn about your services, background and philosophy and office culture.


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This will not only give patients a good understanding about you and your office team before they even set foot inside your practice, but can give you a competitive edge. You want to update your blog regularly—at least once a week—to keep the pages fresh and searchable. Also, it’s best to avoid heavy medical jargon and get to the point fast rather than writing long. Most people won’t take the time to read through multiple pages online. 4. Hire a Marketing Expert – If you don’t feel comfortable with your marketing efforts or want to take it to the next level, consider hiring an expert. “They are somewhat hard to find and in high demand, but a good one is worth the cost,” Lynn said in the article. He advises physicians to set clear expectations and an understanding in the partnership to reap the best results. 5. Don’t be Afraid to Make Mistakes – There are plenty of free ways to market your practice online, Lynn said. For some doctors, social media marketing opens up a new chapter of learning. The good news is that people tend to be forgiving when it comes to others making mistakes online. Hence, the expert advises doctors to not be afraid to try a new approach and see where it goes. Moreover, he said, social marketing takes time, so physicians can’t expect miracles when it comes to reaching new clients. 6. Create a Following on Twitter – Oftentimes, it’s having an online presence that will bring patients in the door in the long run. Twitter, for instance, allows users to send “tweets,” which are text-based posts, up to 140 characters long, to a Twitter Website via a short message service or instant messaging from a computer or through a third-party application. But it’s also a search engine, which makes it extremely valuable for physicians to gain a following. When potential patients subscribe to different feeds, they can gain insight about your practice. Twitter has a greater clickthrough rate than Facebook, which makes it a great advertising tool for your business. However, you want to make sure that Twitter users are your target audience. 7. Pros and Cons of Using Facebook – Facebook is the world’s largest social network with more than 350 million active users, which makes it a great platform to raise your brand awareness and drive traffic to your medical website. There are several ways doctors can use Facebook to

market their clinic: Understand the difference between a Facebook Fan Page (public access) and a Profile Page (for people where you control the information that is accessible and must be accepted by Facebook users) and the Facebook Group (where users with profiles can create groups that attract other members with common interests to join). Some experts tout Facebook as the perfect venue to announce promotions, news, and promote pages on your practice or healthcare website. A great headline and some “free medical information” can catch people’s attention and draw eyeballs to your medical site. That said, you want to make sure that you don’t violate patient’s privacy laws and stay HIPPA compliant.

Also, since others can post on your Facebook page (provided you allow it), it requires that pages are monitored and managed to keep your good reputation in tact and avoid misinformation from being spread. Once information is out in cyberspace, it’s very hard to take it back.

patient privacy—what every doctor needs to know before marketing online Patient privacy is probably the most significant consideration when mixing medicine with social media, according to the experts. Because doctors can never really know who is blogging or commenting on the other end, it is important to maintain boundaries and respect patient confidentiality when promoting a practice. Never Post About Patients

Keep Personal and Business Accounts Separate

Maintain a High Level of Security

Do Not Provide Medical Advice

Implement a Media Policy

When using social media, it’s not enough to simply eliminate patientspecific data such as name, birth date and place. Physicians have been disciplined for blogging or commenting about patients online. If there is a third party that can identify the information, it should not be posted. When in doubt, don’t post.

Business pages should provide practice information only, such as business hours, new additions to the practice and upcoming events. These pages do not include “friends” or allow comments by non-approved administrators.

Routinely check the settings on your accounts to ensure that the privacy and security settings are constantly updated, since many social sites, especially Facebook, have been known to change their security settings on a regular basis. Experts recommend to disallow comments from outsiders on your Facebook page as well as post tags or photos.

Doctors should also stay away from providing medical advice whether solicited or not on blogs or social media posts. Even innocent comments should be avoided, such as giving advice to a friend, because it could potentially impact that individual’s treatment decision.

Implement a social media policy for your practice and ensure your office staff is familiar with the policy. It’s a good idea to have your employees sign a social media agreement and maintain that in their personnel file. Employees should not be allowed to “friend” patients or communicate with patients through social media sites to avoid privacy issues.

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Despite Surplus, State Budget Slashes Medi-Cal Rates Th e C a li f or nia Le gi s l atur e has pssed a $234-billion budget that will cut Medi-Cal payments

to physicians and other providers by 10%. The cuts were originally passed as part of the 2011-2012 budget, but were held up in court as the California Medical Association (CMA) and other plaintiffs filed suit to stop the draconian cuts. In January of this year, a three-judge panel of the 9th Circuit Court ruled that the state could move forward with the rate cuts, despite an earlier district court ruling that found that the cuts would irreparably harm the millions of patients who rely on Medi-Cal for healthcare. CMA and the other plaintiffs in the case had requested a rehearing from the full 9th Circuit Court of Appeals, which was denied. Although the state is in a much better financial situation than it was in 2011 when the cuts were first passed, the 2013-2014 budget includes roughly $1 billion in Medi-Cal provider rate cuts annually. Recently, the California Legislature passed legislation (AB X1-1) that would expand Medi-Cal to more than 1.4 million state residents under the Affordable Care Act. The irony of slashing rates while promising coverage to more than a million new patients has not gone unnoticed. If the state moves forward with the cuts, particularly at a time when millions of new patients will be eligible for the program, access to care will be decimated in our state, undermining the success of federal health reform. The budget does restore dental and mental health benefits under the Medi-Cal program. The final agreement includes $206 million to improve mental health services, including $142 million in one-time general fund money; $51 million in nongeneral fund money in the coming fiscal year and


about $150 million the following fiscal year to boost grants for CalWORKS, California’s welfare-to-work program; and $16.9 million in general fund money in the coming fiscal year and $77 million the following fiscal year to help partially restore Denti-Cal benefits for adults. Denti-Cal is the Medi-Cal dental program. Even before the cuts, California’s Medi-Cal provider payment rates are some of the lowest in the nation. Low reimbursement rates have driven many of California’s providers from the program. As a result, 56% of Medi-Cal patients report difficulty finding a doctor. If these cuts are not stopped, Medi-Cal will become nothing more than a broken promise of access to care. “What good does it do our communities if they have healthcare coverage, but cannot get in to see a doctor?” said Senator Ricardo Lara, author of SB 640, one of two CMA-sponsored bills (along with AB 900, authored by Assemblyman Luis Alejo) that will stop the Medi-Cal cuts. “If we want healthy communities we need to provide access to quality and preventative care.” CMA has joined an unprecedented coalition of physicians, dentists, healthcare workers and hospitals that will continue working to stop the cuts. The coalition, called “We Care for California,” includes the largest statewide organizations representing physicians, dentists, hospitals and healthcare workers, as well as health plans, first responders, caregivers and other health providers. CMA and the We Care for California coalition will aggressively push for a solution to the provider cut before the end of session. “Every provider in California’s vast healthcare delivery system unequivocally agrees with the simple notion that more Californians must have access to quality healthcare – when and where they need it – but that quality care is going to be less available and affordable in California if we continue to cut our system to the bone,” said Paul R. Phinney, MD, CMA President.

Court Decision Gives Physicians Extra Leverage The decision by the Supreme Court upheld the rights of physicians to arbitrate their claims against Oxford Health Plans, one of the largest health insurers in the country, on a class-wide basis. According to Steve Coopersmith, the managing attorney at The Coopersmith Law Firm, a business litigation law firm in San Diego, the Oxford Health case has important points to consider, and several that have implications in the healthcare industry. In 2012, a class action against Oxford Health Plans, LLC was filed on behalf of Dr. John Sutter, a pediatrician in Clifton, NJ, for improper claims processing by Oxford Health. Mazie Katz, Sutter’s attorney, said in the news reports, Sutter suffered an annual loss of about $1,000 a year over 10 years. Katz pointed out that the cost of a lawsuit would have been too high for an individual physician, but 20,000 doctors suffering the same loss, $20 million over 10 years, more than war-

ranted the class action arbitration. Oxford Health tried to get the “class action” dismissed – to limit the case to only Dr. Sutter’s claim. The Supreme Court, in a 9-0 unanimous opinion, upheld the arbitrator’s decision to allow the class claims to proceed in arbitration. The case, according to Coopersmith, has many nuances, and the court decision does not mean that physicians can now file class action lawsuits. The decision has to do with arbitration. However, the implications according to Coopersmith are still very important because arbitration is often used as a tool by large companies to limit claims. Dr. Jeffrey Nordella, a primary care physician in Los Angeles, who earlier this year won a victory against Anthem Blue Cross for improper network exclusion, said that cases like this are important as they serve as precedents to help other doctors fight insurance companies to restore a doctor-patient relationship.


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LACMA welcomes New President

Dr. Marshall Morgan LACM A is e xcited to welcome its new president, Dr. Marshall Morgan, who was

named LACMA’s 142nd president during a special installation dinner on June 20. Here is a look at what to expect under Dr. Morgan’s leadership. The new president, who is also professor and chief of emergency medicine at the Ronald Reagan UCLA Medical Center and director of the emergency medicine center at the David Geffen School of Medicine at UCLA, recently outlined his plans and vision for LACMA. Here are his five priorities: reimbursement, Medical Injury Compensation Reform Act (MICRA), scope of practice, public health and safety issues, and LACMA’s membership expansion.

Reimbursement As president, Dr. Morgan plans to promote the well-being of doctors by protecting them from inappropriate cuts in reimbursements. “One of the purposes of a medical association is to promote the well-being of doctors and protect them from inappropriate cuts in reimbursements,” Dr. Morgan said. This summer, when California makes a controversial cut to Medi-Cal rates, it will reduce the future payments to physicians over the next four years by about 15%. The reductions will also make it tough for patients to get medical care and comes at a time when millions are preparing to join the healthcare system under the Affordable Care Act. As of April 1, Medicare payments to physicians for services performed shrank by 2% under the automatic, across-the-board sequestration cuts. Together with the Medicare cuts that went into effect on Jan. 1., physicians who treat Medicare patients will be faced with tough decisions as operating margins continue to shrink.

MICRA Another goal is to fight for the preservation of MICRA. A coalition, including the Consumer Attorneys of California and a trial-lawyer-funded Consumer Watchdog Group, recently announced intentions to overturn MICRA through a ballot initiative, according to CMA. The group has until September to submit a proposed initiative to qualify for the November 2014 general election ballot. (continued) 2 4 PHYSICIAN MA G A Z INE | J ULY 2013

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If successful, according to CMA, the efforts would cause malpractice rates to skyrocket and create the same conditions that threatened to throw California’s healthcare system into crisis during the early 1970s. Prior to MICRA, out-of-control medical liability costs were forcing community clinics, health centers, physicians and other healthcare providers out of practice. MICRA has stabilized liability costs. The initiative comes at a time when millions of new patients will be entering the healthcare system and reimbursements for Medicare, Medi-Cal, and Denti-Cal are being cut. If MICRA were changed, it would exacerbate the situation.

practitioners (registered nurses), and pharmacists to offer more primary care medical care independent of doctors. “We need to preserve the quality of care to patients by protecting them against the inappropriate expansion,” he said.

Scope of Practice

LACMA’s Membership Expansion

Dr. Morgan said he’ll fight the inappropriate proposed expansion of medical services to providers who aren’t specifically trained like doctors to provide these services. Proposed legislation by state Sen. Ed Hernandez (D-West Covina) would allow optometrists, nurse

Finally, he’ll join LACMA’s on-going effort to unite doctors in Los Angeles. “The percentage of doctors who belong to the medical association is not as great as it should be,” Dr. Morgan said. ‘I will persuade doctors to join the medical association to help us preserve the critical issues.”


Public Health and Safety Issues Dr. Morgan said he will also put a renewed emphasis on the medical association’s long-standing commitment to public health issues, including firearm injuries.


George Mason, MD In addition to Dr. Morgan’s installation, Dr. George Mason, was honored at the event with the LACMA Lifetime Achievement Award, for his longtime service, advocacy and countless contributions to the organization. Dr. Mason has advocated on behalf of LACMA members and their patients for more than six decades. He is also a well-known and highly respected

obstetrician and gynecologist in Santa Monica. Those who have worked side-by-side with Dr. Mason at LACMA say he continues to be committed to the medical association’s causes and still travels to Sacramento to lobby on behalf of doctors’ and patients’ rights, despite his own failing health. Dr. Troy Elander, a former LACMA president who has known Dr. Mason for more than 10 years, described him as an “amazing parliamentarian.” “He makes sure that meetings follow a certain structure and is better than anybody I know to keep everybody on track and following the proper order,” Dr. Elander said. Dr. Howard Krauss, also a former LACMA president, agreed with Dr. Elander. “I came to know him in his leadership at LACMA and the California Medical Association,” Krauss said. “He’s been a stickler for detail, especially with respect to bylaws, proper conduct of a meeting and parliamentary procedures.” He added, “When I first observed this, I thought he was holding all of us back, but as time went on, I realized the value he brought in taking all of us to task and insisting and honoring the bylaws.” Both men describe Dr. Mason as a rare straight-shooter who is dependable, committed, and never afraid to express his opinion. “He strongly believes in the interests of the medical bylaws and is never shy in expressing it to others,” Dr. Krauss said. He also applauded the lifetime honoree for being a lifelong mentor. “He (Dr. Mason) always took medical students and residents under his arm,” Dr. Krauss said. “He took it as his personal mission to have medical students and residents become acquainted with lobbying and advocating on behalf of physicians. The medical students loved him.” Moreover, “He’s never afraid to say it as he sees it,” Dr. Elander said. “In a world of ‘yes men,’ he’s somebody who will tell you how he sees it.” In his role as obstetrician and gynecologist, Dr. Mason has delivered more than 10,000 babies. “He was delivering the grandchildren of the babies he’s delivered,” Dr. Krauss noted. “He’s a well-respected obstetrician and well-liked physician by his colleagues and his patients.”

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associ at i on ha ppen i ngs | lacm a news

ceo’s letter

Legacies and New Beginnings A f t e r a y e a r o f many successful battles and new beginnings, the Los Angeles County Medical Association welcomes a new incoming president, Dr. Marshall Morgan. We are excited about opening this new chapter under Dr. Morgan’s leadership and welcome his readiness to lift our organization to even greater heights. The “New LACMA,” however, also has much to be thankful for. I want to take this opportunity to recognize LACMA’s outgoing president, Dr. Samuel Fink, for his tireless devotion and hard work in furthering LACMA’s initiatives and causes. For his legacy will be one of championing new beginnings and standing up for doctors’ and patients’ rights, all the way into the courtroom. Within two days after becoming LACMA’s president and much preparation by the previous leadership team, Dr. Fink joined their efforts on July 3, 2012, in filing a lawsuit against health insurance giant Aetna. The lawsuit charged that the insurer often refuses to reimburse policyholders who go out of their networks when medically necessary, even though they have bought policies that allow them to do so. Three months later, LACMA filed legal action against another major insurer, Health Net, for illegally denying patients’ claims to sometimes lifesaving medical treatments. These weren’t the only battles fought under Dr. Fink’s watch. In our effort to protect the rights of patients to see the doctors of their choice, LACMA successfully delayed the implementation of the dual eligible demonstration project as well as achieved a reduction of this unfair and potentially dangerous undertaking. Dr. Fink’s tenure was also marked by several exciting firsts: Among them ranks LACMA’s Healthcare Awards, benefitting the Patient Care Foundation of Los Angeles. He also coined the term “New LACMA” and with it, our revamped Physician Magazine, the Physicians News Network newsletter offering Los Angeles physicians weekly breaking news on critical healthcare issues, and our brand-new technology section dubbed iPNN. He also helped create the Group Purchasing Program, offering members steep savings, and paved the way to LACMA’s embracing diversity by initiating the new physician advisory and action committees. The early successes of the new committees are already visible. The most recent African-American Physician Advisory Committee kick-off dinner was expected to draw 65 people—80 people showed. Most recently, LACMA’s political action committee for the first time in its history endorsed a mayoral candidate for Los Angeles County. On May 22, LACMA’s chosen candidate, Eric Garcetti, won. LACMA’s 142nd incoming president, Dr. Marshall Morgan, vowed to help LACMA continue its presence of being a moral voice in Los Angeles County and we are excited about addressing the critical issues with him. Dr. Morgan currently is professor and chief of emergency medicine at the Ronald Reagan UCLA Medical Center and Director of the Emergency Medicine Center at the David Geffen School of Medicine at UCLA. As LACMA’s president, Dr. Morgan will devote his efforts to increasing membership advocacy as well as the bottom line for physicians. He will also encourage policy makers to think about public maladies through the prism of doctors and try to find innovative ways to address them. Stay tuned. As we open up this next chapter in our organization, LACMA’s leadership will continue to work hard on the many challenges ahead and renew our call for all physicians in Los Angeles County to join us.

Rocky Delgadillo

Rocky Delgadillo Chief Executive Officer


LACMA NOW GUARANTEES SAVINGS Preferred Partner Program The Preferred Partner program marks LACMA’s first-ever initiative designed to provide exclusive discounts on products and services that physicians in private practice rely on to run a successful and sustainable business.

Clinic Supply Program Medline manufactures and distributes more than 350,000 medical and surgical products to health care institutions and retail markets. Medline’s market advantage ranks #1 across healthcare categories, including exam gloves, OR kits, and textiles. Members are guaranteed a minimum savings of 10%, and up to 47% on clinical supplies.

Insurance Services As the world leader in delivering risk and insurance services and solutions to its clients, Marsh designs, develops, and implements insurance plans available only to members – with discounted pricing, enhanced coverage or both. Marsh assists members and their office managers by providing information, programs, and guidance to assist with insurance buying decisions.

Secure Texting for Healthcare TigerText is the leader in secure real-time messaging for healthcare. TigerText allows healthcare providers to create a private and secure mobile messaging network with their own smartphone. This controlled platform is HIPAA compliant and replaces the unsecured SMS text message that leaves protected health information and other confidential data at risk. Members receive a free subscription to the TigerText application on their mobile device.

Shipping UPS is the world's largest package delivery company and a leading global provider of specialized transportation and logistics services. Members can save up to 37% on shipping through UPS.

Prescription Savings For Patients GoodRx works to save your patients up to 80% on their prescriptions. Every time your patient uses GoodRx, they donate a portion of the revenue to LACMA’s Medical School scholarships & loan debt relief program to increase the number of physicians serving patients in Los Angeles. The Preferred Partner Program consists of carefully vetted, industry leading vendors who share LACMA’s goal to advocate quality health care for all patients and serve the professional needs of its members.


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To place a classified ad visit www.physiciansnewsnetwork.com or contact Dari Pebdani at dpebdani@gmail.com or 858-231-1231.


consulting & services

Physicians: Internal Medicine BE-BC

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legal services


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office for lease/ sublease/share


1,800 or 3,600 SF Medical Office Space for Lease

Build your dream in this new medical office space. Located in Granada Hills, near the 405 Freeway and the 118. This beautiful free standing building is located on a high traffic corner, with great visibility and secured free parking. Contact Linda Brown, 818-4660221, lindab@told.com, TOLD Partners, CA.RE#01465757 520


TRACY ZWEIG ASSOCIATES • Physicians • Nurse Practitioners • Physician Assistants LOCUM TENENS PERMANENT PLACEMENT 800-919-9141 • 805-641-9141 FAX: 805-641-9143 email: tzweig@tracyzweig.com www.tracyzweig.com


Salary: $79.75 PER HOUR

DUTIES A Per Diem (relief) Physician provides medical care to arrestees in three City of Los Angeles correctional care facilities. Medical care providers includes obtaining a focused history and examination to diagnose and treat patients who may require medications, minor suturing, or referral for care. A Per Diem Physician is responsible for the provision of medical services at City correctional care facilities that operate 24 hours each day, seven days a week, and may be required to work varied shifts and weekends. REQUIREMENTS • Current license as a physician in the State of California; • Current valid American Heart Association Healthcare Provider CPR card; • At least one year of clinical experience as a licensed physician in the area of Family Medicine, Internal Medicine or Emergency Medicine; and • Boards in the area of specialty. HOW TO APPLY Submit your City application and direct any questions to: MSD c/o Physician Recruiter City of Los Angeles, Personnel Department Medical Services Division 520 E. Temple Street, Los Angeles, CA 90012 (213) 473-7033 (213) 473-3776 Fax PLEASE APPLY IMMEDIATELY. DOWNLOAD A CITY APPLICATION AT:


APPLICATIONS WILL BE ACCEPTED UNTIL THE POSITIONS ARE FILLED An Equal Employment Opportunity Employer As a covered entity under Title II of the American with Disabilities Act, the City of Los Angeles does not discriminate on the basis of disability and, upon request, will provide reasonable accommodation to ensure equal access to its programs, services, and activities.


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Carl H. Boatright, MD, DABR, 30 years’ experience, rapid turn-around. We are now accepting Teleradiographs for General X-ray and General Ultrasound examinations. 866-723-2081.


Board certified. Have own malpractice insurance. Available for part-time position or film reading. Call 310-477-4257. 540

locum tenens available

TRACY ZWEIG ASSOCIATES • Physicians • Nurse Practitioners • Physician Assistants LOCUM TENENS PERMANENT PLACEMENT 800-919-9141 • 805-641-9141 FAX: 805-641-9143 email: tzweig@tracyzweig.com www.tracyzweig.com

or contact Dari Pebdani at dpebdani@gmail.com or 858-231-1231.

Mid-Level Provider Nurse Practitioner/Physician Assistant (Civil Service Title: Advance Practice Provider Correctional Care) Per Diem-As Needed, Exempt Position Salary: $40.45 - up to $50.25 per hour

A 5.5% bonus may be paid upon proof of certification by a recognized national professional organization in a nurse practitioner specialty that is relevant and applicable to the duties performed. Some positions require night work, for which a 5.5% bonus is paid. DUTIES: A Mid-Level Provider/Nurse Practitioner/Physician Assistant is responsible for obtaining medical histories, performing physical examinations, ordering and interpreting diagnostic tests, assessing medical conditions, providing medical care and treatment, and performing related duties as required under standardized procedures and/or protocols established by the department in one of the City of Los Angeles’ correctional care facilities. An Equal Employment Opportunity Employer

REQUIREMENTS 1. Must be licensed as a: a. Registered Nurse and certified as a Nurse Practitioner by the California Board of Registered Nursing with documentation of education and training as a Nurse Practitioner in family practice, adult, or emergency medicine, and possess a current license and Furnishing Number which provides the ability to provide drug/medication orders in the State of California; or b. b. Physician Assistant with documentation of education and training as a Physician Assistant in family practice, adult, or emergency medicine, and possess a current license and Furnishing Number which provides the ability to provide drug/medication orders in the State of California; and 2. Must have a current, valid American Heart Association Healthcare Provider CPR card. HOW TO APPLY Submit your City application and direct any questions to: MSD c/o APPCC Recruiter City of Los Angeles, Personnel Department Medical Services Division 520 E. Temple Street, Los Angeles, CA 90012 (213) 473-7033 (213) 473-3776 Fax PLEASE APPLY IMMEDIATELY. DOWNLOAD A CITY APPLICATION AT:

PM Marketplace Surgeons Needed for Expanding Nationwide Surgical Practice • Full or part-time positions • Competitive Pay • Add revenue to your current practice

• Flexible schedule, complete autonomy • No Call

Please contact us for more information: Phone: 1-877-878-3289 Fax: 1-877-817-3227 or email CV to: Jobs@AdvantageWoundCare.org


CME City of Hope’s 13th Annual Women’s Cancer Conference: Progress in Women’s Cancers from Treatment to Survivorship November 8 to 10, 2013 The Venetian/Palazzo Resort Hotel, Las Vegas, NV

REGISTER NOW for this exciting conference featuring prominent oncology experts who will address clinical and translational research, prevention, practical issues, current standards of care, controversies and evolving new treatment recommendations for women’s cancers. Attendees will learn new tools to optimize decision making to help improve patient outcomes. To learn more and to register, visit www.cityofhope.org/womensconference2013


APPLICATIONS WILL BE ACCEPTED UNTIL THE POSITIONS ARE FILLED. An Equal Employment Opportunity Employer. As a covered entity under Title II of the American with Disabilities Act, the City of Los Angeles does not discriminate on the basis of disability and, upon request, will provide reasonable accommodation to ensure equal access to its programs, services, and activities.

CME City of Hope’s 6th Annual How the Experts Treat Hematologic Malignancies September 18 to 20, 2013 Casa Del Mar Hotel, Santa Monica, CA JOIN US for this two-and-a-half-day conference for the opportunity to learn about the most recent advances in the treatment of multiple myeloma, lymphoma and leukemia. Updates on improved curative and palliative treatments, evolving molecular and immunologicallybased systemic therapies and clinical trials, will be profiled and discussed. To learn more and to register, visit www.cityofhope.org/hematologicconference2013

Advertiser Index Athena Health..............................................5 BBVA.........................................................25 Cooperative of American Physicians .......... 16 The Doctors Company ............................ C4 Fenton Nelson .......................................... 19 Los Angeles County Sheriff ’s Department.....7 Marsh...........................................................3 NORCAL ................................................C2 Office Ally ............................................... C3 Summit Lending.........................................27 UC Irvine..................................................23 Wells Fargo...................................................9 Zuma Capital.............................................11

J ULY 2013 | w w w. p h y s i c i a n s n e w s n e t w o r k .c o m 3 1

class i fi ed | job boar d

To place a classified ad visit www.physiciansnewsnetworK.com

Internet users have performed a health-related search query.


age range of people most likely to search online for health information

4 out of five

by t he nu m be r s | m a r k et i ng your pr act i ce

% of Internet users look online for information about doctors or other health professionals.


forty seven

of adults age 18-24 trust medical information shared by others in their social media networks. [PwC Health Research Institute]

10=27 If you question the value of a marketing investment, consider this:

% increase in volume of patients

% growth in profit

44% FIFTY of patients fifty years old and younger use online tools to choose a doctor, while 72% search the Internet for general medical information.



% of smartphone owners use their phone to look up health or medical information

physician’s office, a malfunctioning thermostat ruined $51,000 in refrigerated vaccine. Make sure you’re covered.

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Medical Malpractice Workers’ Compensation Health and Disability Property and General Liability

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Employment Practices Liability Directors and Officers/Management Liability Errors and Omissions Liability Billing Errors and Omissions Liability


Profile for RGOC

July 2013  

The official publication of the Los Angeles Medical Association, reporting on the economics of healthcare delivery. www.physiciansnewsnetwor...

July 2013  

The official publication of the Los Angeles Medical Association, reporting on the economics of healthcare delivery. www.physiciansnewsnetwor...