BULLET N PIERCE COUNTY MEDICAL SOCIETY | May 2026
Serving our members and community since 1888 www.PCMSWA.org
The Bulletin is a publication of: Pierce County Medical Society 1019 Regents Blvd Ste 202 Fircrest WA 98466 253.572.3667 www.pcmswa.org
PCMS Officers President Blair Campbell, MD President Elect TBD Secretary/Treasurer Courtney Kennel, DO Immediate Past President Neil Batta, MD PCMS Directors Nicole Cassler, MD, FAAD Erin Kallock, MD H. Matt Davis, MD Kenneth Foerster, MD, MBA JT (John) Heffernan, MD James “Jay” Miller, MD ex-officio, TPCHD Health Officer Nicholas Rajacich, MD Camille Samujh, DO, MPH Jeffrey Wesolowski, MD Staff Linda Krause - Executive Director Tanya McClain - Office Coordinator
Cover photo credit: Nev Lewis, MD Taken at Asahel Nature Trail 10/27/2020 Nikon D850 24mm f/22 6 seconds ISO 100
CONTENT ________________ May 2026
3 President's Message Blair Campbell, MD 4-5 Tacoma-Pierce County Department of Health From the desk of Jay Miller, MD 6 March Madness Recap Thank you for joining us at TRA’s Crescent Lounge 7 Save the Date for Upcoming PCMS Events Residents’ Social at Cheney Stadium 3rd Annual Meet your District Representative 2026 Annual Holiday Event 8-9 Supporting Healthcare Access in Pierce County John Van Buskirk, DO 10 Pierce County Medical Society Delegates Needed Represent your colleagues at the WSMA Annual Meeting 11 Washington State Medical Association 2026 Legislative Report 12 In Memoriam 13 A Call for Nominations! 14
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President's Message
Here we are, heading into summer already! We have plans for more collegial events and opportunities to enjoy the sunshine! Thank you to all those who were able to make it our March Madness event on March 17 at TRA. It was great to connect with both physicians who have been dedicated to Pierce County patients for decades, and also to meet some who are new to PCMS. Our goal is continuing to create a greater sense of community and connection, so please don't hesitate to share information and invites for our events with colleagues who might be interested. One of my favorite events of the year is coming up this weekend (May 17) with our annual Rainiers Game with our local residents. Attendance is free to all resident physicians and their families. I hope those of us who have made meaningful connections and careers here in the county are attending and encourage our residents in training to put down roots in this wonderful community. The Health Care Access Workgroup continues to meet. We have more information about the issues at hand in a separate portion of this newsletter (see article on page 8 & 9), but I want to encourage anyone with questions or an interest to feel welcome. We are stronger together, and I personally appreciate all the high-quality patient care each of you is providing every day. Each patient encounter matters, and is helping our community. Sincerely, Blair Campbell, MD
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James “Jay” Miller, MD Health Officer
Immunization Guidance, Opioids, Medetomidine & Buprenorphine Governor Ferguson recently signed House Bill 2242, which allows Washington State Department of Health (DOH) to determine the most appropriate sources of immunization guidance, rather than requiring alignment with Advisory Committee on Immunization Practices (ACIP) guidance. DOH is currently recommending that physicians use the American Academy of Pediatrics and American Academy of Family Physicians immunizations schedules. This change maintains evidence-based immunization guidance and associated insurance coverage for Washingtonians. It also addresses the uncertainty over the current federal guidance, since the latest federal immunization guidance was issued by Health and Human Services without input from ACIP and is now temporarily blocked by judicial decision. You can find more information from DOH at its new immunization guidance webpage. I also want to share some updates on opioids and opioid use disorder treatment in our community. Tacoma-Pierce County Health Department (TPCHD) recently issued a health advisory on the presence of medetomidine in the illegal fentanyl supply. Up to now, this issue has occurred primarily in the eastern United States; however, we are seeing some evidence of medetomidine appearing in Washington as well. Medetomidine is a sedative approved for veterinary use but not for use in humans. A related drug, dexmedetomidine (Precedex), is approved for use in humans. Medetomidine use can cause extreme sedation, bradycardia, and hypotension. People who use it regularly and then stop can experience severe withdrawal symptoms, such as severe hypertension, anxiety, nausea, vomiting, and confusion. Overdose and withdrawal can be serious enough to require emergency department care and sometimes intensive care admission.
While there is no reporting requirement, we encourage you to report possible cases of medetomidine overdose or withdrawal to TPCHD. Additionally, DOH and UW Medicine have launched a statewide tele-buprenorphine hotline, where anyone 13 and older can receive a same-day telehealth visit and, if indicated, a prescription for buprenorphine. Please help spread the word about this lifesaving resource. Finally, whether you work in primary care, psychiatry, emergency medicine, or inpatient medicine, I hope you’ll consider prescribing buprenorphine as part of your clinical practice if you are not already doing so. While we have made strides as a community in improving access to buprenorphine in Pierce County, we still have room to improve. My goal – and I think our shared goal across governmental agencies in Pierce County – is to have no wrong door to accessing buprenorphine, such that people who need it can access it through primary care, in psychiatry clinics, in emergency departments, in inpatient settings, through TPCHD’s Street Medicine team, and even when being treated by Emergency Medical Services (EMS) in the field. I know that some of you already prescribe buprenorphine for patients with opioid use disorder. For those who are interested in doing so but have not yet started, please feel free to reach out to me about any barriers you face so that we can try to find a solution together. A Healthcare Authority-funded initiative called Scala Northwest also provides guidance on initiation and dosing of buprenorphine in different settings. Providing opioid use disorder care with buprenorphine meets a major need in our community and has been a rewarding part of my clinical practice over the years. I hope you will find the same meaning in this work.
MARCH MADNESS & ST. PADDY’S DAY CELEBRATION Thank you for joining us this year! This year’s high scorers were 1st place: Dr. Julian Arroyo 2nd Place: Dr. Victor Liu 3rd Place: Dr. Daniel Guerra
See you next year!
Pierce County Medical Society Upcoming Events May 17, 2026 Annual Resident Event at Cheney Stadium - Free for residents! 1:35 pm game Registration ends Friday at 5pm. Click on the baseball to join us! PCMS members receive a discounted rate of $20, which includes food, beverages, a ticket in our private section, and snacks. September 22, 2026 (New Date) PCMS 3rd Annual Meet your District Representative Event with TRA Meet your Disctrict Representatives - Q&A to follow With a special guest! 5:30 pm: Drinks and Snacks 6:00 pm: Start December 8, 2026 PCMS Annual Holiday Event 5:00 pm: Drinks and Appetizers 5:30 pm: Start
Supporting Healthcare Access in Pierce County The Medical Community has the opportunity to demonstrate our compassion, generosity, and advocacy. Submitted by John Van Buskirk, DO PCMS Member
The medical community has a vital opportunity to demonstrate compassion, generosity, and advocacy during a time of significant change. On July 4, 2025, the Big Beautiful Bill was signed into law. This complex legislation includes provisions that may directly affect access to healthcare for many individuals in Pierce County. In response, representatives from local medical and community organizations began meeting on November 13, 2025. Since then, the group—now known as the Pierce County Healthcare Access Workgroup—has convened regularly, both in person at Elevate Health and via Zoom, to better understand and address these changes. Workgroup Focus The Pierce County Healthcare Access Workgroup is committed to: Understanding changes to Medicaid and Health Benefit Exchange subsidies Estimating how many residents may lose coverage and when Identifying strategies to minimize disruptions in care Supporting healthcare systems in preparing for increased numbers of uninsured patients Developing practical solutions to help individuals retain or obtain coverage Key Policy Changes Several upcoming changes are expected to significantly impact coverage: January 2026 - Loss of federal subsidies for Health Benefit Exchange (Marketplace) plans, effectively increasing premium costs for many patients October 2026 - Medicaid eligibility changes affecting refugee, asylee, and certain noncitizen adults (estimated 20,000 individuals in Pierce County) January 2027 - Introduction of work and six-month registration requirements; Additional eligibility changes; Reduction in retroactive Medicaid coverage (from three months to one)
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Supporting Healthcare Access in Pierce County cont. Participating Organizations The workgroup includes leadership and representatives from a broad range of organizations, including: Pierce County Medical Society (PCMS) Elevate Health (Accountable Care Organization) Washington Academy of Family Physicians – Pierce County Chapter Federally Qualified Health Centers (including Sea Mar and Community Health Care) Medicaid Managed Care Organizations (including Molina and Community Health Plan of Washington) Local free clinics (Trinity Clinic, Neighborhood Clinic, Blessed Hope Health Center, Nativity House Clinic) Tacoma-Pierce County Health Department Regional health systems (Virginia Mason Franciscan Health, MultiCare, Kaiser Permanente) Project Access Key Findings to Date Workgroup discussions have highlighted several critical concerns: An estimated 50,000 Pierce County residents were already uninsured prior to these changes The region faces a significant shortage of primary care and specialty providers, limiting access to care Free clinics are currently operating at full capacity Many organizations employ Navigators who assist individuals in enrolling in or maintaining Medicaid coverage Project Access provides premium assistance but may see capacity reduced from 1,400 to approximately 700 individuals annually due to rising costs There is a widespread need for public education about these changes A substantial increase in uninsured individuals (potentially 35,000 or more) may lead to delayed care, increased emergency department utilization, and preventable hospitalizations. How You Can Help? Stay informed about changes to Medicaid and Health Benefit Exchange plans Share accurate, up-to-date information with patients and community members Support public education efforts through posters, social media, and community outreach Consider ways you can help expand access to care. This could include volunteering at a free clinic or in your own office, through Pierce County Project Access, or engaging with your employer to bridge care for underserved patients. Please contact Linda Krause at PCMS linda@pcmswa.org or John Van Buskirk at kajajv@harbornet.com if you have questions or ideas on how to help. Contact us: Admin@pcmswa.org
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WSMA Annual Meeting/House of Delegates
Would you like to represent your colleagues in Pierce County September 26-27 in Spokane Washington? Represent Pierce County Medical Society at the WSMA Annual Meeting and House of Delegates Meeting. September 26-27, 2026 at the Historic Davenport Hotel Join your colleagues at the WSMA House of Delegates Meeting this Fall. Limited stipends are available from PCMS. Alert your colleagues that you are a delegate for Pierce County and ask for comments and recommendations on WSMA programs and policies. Collaborate with the PCMS Delegation to review and discuss proposed resolutions while networking with peers from across the state. The PCMS Resolution Review Meeting will take place on September 15, 2026. RSVP to confirm your attendance. Participation is exclusive to active PCMS members. Date: September 26-27, 2026 Location: Historic Davenport Hotel, Spokane, WA To be part of the PCMS Delegation, please contact Linda Krause, PCMS Exec. Director at: linda@pcmswa.org by August 14, 2026. Thank you.
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2026 Session Recap: Key Policy Wins for Physicians, Patients The 2026 Washington legislative session concluded March 12 with several major wins for the Washington State Medical Association (WSMA) and the physician community. Key legislation passed this year will improve access to vaccines and preventive care, reform prior authorization requirements, and require insurers to pay claims more promptly. WSMA also successfully opposed all bills it identified as harmful to patient care or physician practice. Lawmakers faced a difficult budget environment driven by rising Medicaid costs and increasing state tort claims. Despite fiscal pressures, WSMA secured funding to preserve Apple Health Expansion coverage for immigrants, maintain insurance affordability subsidies through the Washington Health Benefit Exchange, and fully fund Foundational Public Health Services. Advocacy efforts also helped restore proposed cuts to Medicaid therapy services in the final budget. Much of the session focused on Senate Bill 6346, the new “millionaires tax,” which establishes a state income tax on individuals earning more than $1 million annually. WSMA advocated for portions of the revenue to support Medicaid reimbursement increases and reduce business and occupation taxes for physician practices. The final bill included a WSMA-supported amendment eliminating a 0.5% B&O tax surcharge on large medical groups one year earlier than previously scheduled, saving physician organizations an estimated $22 million. Gov. Bob Ferguson signed the bill into law March 30, though legal and voter challenges are expected before implementation in 2029. Among WSMA’s top policy victories were Senate Bill 5395 reforming prior authorization, Senate Bill 5845 requiring timely insurance payments, House Bill 2242 protecting access to vaccines and preventive services, and House Bill 2385 preserving the Medicaid Access Program. WSMA also supported legislation updating the definition of fetal death, prohibiting noncompetition agreements, funding abortion clinical care services, regulating AI chatbots, and banning the manufacture of 3D-printed firearms. Scope-of-practice legislation remained a major issue. WSMA successfully opposed proposals expanding prescribing authority for psychologists, naturopaths, and pharmacists without sufficient education and training standards. The association also negotiated a compromise on Senate Bill 5185, creating a pilot pathway for certain international medical graduates to pursue licensure as primary care physicians in Washington. In total, WSMA tracked more than 600 bills during the session and partnered with physician groups, hospitals, public health organizations, and patient advocates to advance policies supporting patient access, affordability, and physician practice sustainability. This article is a summarized adaptation of original legislative session reporting and is reprinted with permission from the Washington State Medical Association (WSMA). 8
In Memoriam We lost our wonderful father, grandfather, and great grandfather Walter Arthur on July 31, 2025, who lived a life dedicated to healing others and spreading joy to all who knew him. Walter Martin Arthur was born on July 17, 1931, in Spokane, Washington, to Ernest and Grace Arthur. Walt was the middle child, between sister Earline and brother Don. Walt attended Libby Junior High, then graduated from Lewis & Clark High School with the class of 1949. Walt attended Gonzaga University for one year and then transferred to Whitworth College and graduated in 1953. Read Dr. Arthur’s full obituary HERE
John Daniel Wanwig MD, age 80, passed away April 30, 2026, in Tacoma, WA, surrounded by his family. "Dan" was born July 8, 1945 in Seattle, WA. He attended the University of Washington and graduated from medical school there in 1971. Dan was a prominent member of the medical community. He specialized in Psychiatry and Internal Medicine, working in both public and private practice. Dan served patients in the Puget Sound region for nearly 50 years. Read Dr. Wanwig’s full obituary HERE
Jim Wilson passed away on March 4, 2026, after fifteen years of living with Parkinson's Disease. He met every step of that journey with quiet courage and grace. Born in Warsaw, New York, Jim devoted his life to caring for others. As an internal medicine and geriatric physician, he offered steady compassion to countless patients. He trained at the University of Rochester School of Medicine, served in the U.S. Army Medical Corps, and completed his residency at Madigan Army Hospital beginning a lifetime of service that helped shape the Tacoma medical community. Over his thirty-five year... Read Dr. Wilson’s full obituary HERE 9
CALL FOR NOMINATIONS
CONTACT US Tel: 253-572-3667 Email: admin@pcmswa.org
Call for Nominations: Community Service Award We are currently accepting nominations for this year’s Community Service Award. Nominate a deserving colleague—or yourself—who demonstrates outstanding commitment to the community.
Know a Community Champion? Help us recognize individuals making a meaningful impact in Pierce County.
Submit to the PCMS Newsletter We welcome article submissions from our members. (Subject to board approval)
Calling All Photographers Have a passion for photography? We’re seeking images for our newsletter covers—submit your work today!
Welcome New Pierce County Clinicians Mudassar Ahmad, MD Rami Alhakim, MD Eloy Alibin, MD Kathryn Annand, MD Abdullah Arjomand, MD Ankush Asija, MD Micah Atwood, DO Ran Baik, MD Mengistu Balcha, MD Megan Barnes, MD Ian Bastian, MD Ayele Belachew, MD Hailey Benesch, MD Nick Bennett, DO Joel Bervell, MD Allegra Blomenberg, PA-C Audra Boehm, MD, DDS Sophia Bostwick, DO Alexandra Brennan, MD Christine Broniak, DO Campbell Brown, MD Brent Bubany, MD Elaine Jayne Buckley, MD Vivian Chiang, MD Paul Cho, DO, MHA
Emmiline Chou, PA-C Karen Chung, MD Michael-Flynn Cullen, MD Michael Cusack, DO Yinager Dagnaw, MD Frezer Degefa, MD Nicole Delos Santos, MD Ryne Deyoe, DO Dung Do, DO Kara Ellingson, MD Joshua Genstler, MD James Gilbert, PA-C Arne Gratias, DO Shawna Greenleaf, MD Scott Grogan, DO Daniel Guillory, MD Kimber Guinn Chadwick, PA-C Beth Hapke, MD Jeanette Helgerson, DO Sarah Herwald, PA-C Yeun Hiroi, PA-C Gabrielle Hodgins, MD Elizabeth Horenkamp, MD Jacob Howard, MD Alexandra Howells, DO
Amanda Humphrey, MD Kag Iglinski-Benjamin, MD Nwamaka Iloani, DO Kasey Jackson, MD Sean Jarboe, PA-C Alexander Jonson, DO Varun Kasula, DO Jacob Keith, MD Ardeshir Kianercy, DO Michael Kim, MD Teja Kirby, PA-C Britta Kumley, MD Cassandra LaMarche, MD Tessa Lamberton, MD Michael Leisle, MD Charles Llewellyn, MD Zachary Long, MD Nihar Mahajan, MD Mitchell Maisel, MD Rabia Malik, DO Julianne Meany, MD Blaine Menon, MD Kunal Mishra, DO Lincoln Mitchell, MD Kawthar Mohamed, MD
Rubin Moore, MD Suraj Muddasani, MD Alexander Mundell, MD Krystal Nguyen, DO Jimmy Nguyen, MD, MS Gregory O'Connor, MD Justin Pavlovich, MD Sindhu Pokhriyal, MD Shwetha Prabakar, MD Josie Prado, MD Anne Recker, MD Benjamin Roberts, DO Jorge Salazar, MD Jaime Salazar, PA-C Hembashima Sambe, MD Luke Sampson, MD Ivy Sandquist, MD Nikole Shaham, DO Elena Sharma, MD Joseph Shen, MD, MPH Matiyas Shiferaw, MD Ransherjit Singh, MD Jovanpreet Singh, MD Michelle Skoretz, MD Mosope Soda, MD
Rachel Straughn, MD Mehreen Tajammul, MD Bryce Templeman, PA-C Sam Thao, MD Kisha Thayapran, MD John Tomkinson, MD Sean Turner, MD Gemechis Wacho, MD Malsha Walgamage, MD Thilini Walgamage, MD Sukhcharan Walia, MD Lillian Wang, MD Chayce Weaver, MD Christopher Weissman, MD Isaiah Williams, PA-C Bradley Wine, MD Katherine Wingo, MD Matthew Wolf, MD Shannon Wood, MD Jennie Yang, MD Priscilla Yong, MD Sunyoung Yoon, MD Yuki Yoshiyasu, MD Kara Zada, PA-C Elizabeth Zinn, MD Molly Zivkovic, DO
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