President
Julian S. Arroyo, MD
President Elect
Neil Batta, MD
Secretary/Treasurer
Courtney Kennel, DO
Immediate Past President
C. Blake Perry, MD PCMS Officers
PCMS Directors
C. Blair Campbell, MD
H. Matt Davis, MD
JT (John) Heffernan, MD
James (Jay) Miller, MD
Nicholas Rajacich, MD
Camille Samujh, DO
Yancey Sloane, MD
Executive Director
Krause
Office Coordinator
Tanya McClain
PCMS Member Colleagues,
Summer has finally arrived in full force. I hope everyone is getting out and enjoying the PNW while staying hydrated and using plenty of sunscreen. Speaking of hydration, it was good to see so many PCMS members at the wine tasting event in June at Tacoma Wine Merchants in Old Town. They did a wonderful job picking and serving wines from Spain. All registration fees were donated to the Healthcare Careers Academy to support high school students We are planning another similar event for the fall so be on the lookout.
Other upcoming events will be the Rainiers’ Game sponsoring the residents and their families on August 25, 2024, 1pm game. On September 17th we will be hosting a number of our local state representatives with TRA at our “Meet your District Representative Event” and it should be a good opportunity to put a face to names and let them know what is important in our medical lives. It will be a good chance to discuss Medicaid and L&I reimbursements, patient access and administrative burdens that we are all facing
The WSMA Annual Meeting is September 28-29 in Spokane. This is the meeting that gives WSMA their marching orders from the counties’ delegates for the upcoming legislature session. They then lobby in Olympia to promote our agenda. Last year WSMA worked hard to increase Medicaid payments and set the stage for this upcoming session They were also able to support the legislation on state funding for physician residencies through the Family Medicine Residency Network. Scope of practice is always an area of focus to ensure appropriate delivery of care by appropriately trained providers
If anyone is interested in attending the meeting in Spokane, PCMS still has open delegate spots as well a stipend to attend and represent Pierce County Medical Society. If interested, please reach out to Linda Krause at linda@pcmswa.org
Enjoy the rest of your summer and make the most of it.
Julian Arroyo, MD
President, Pierce County Medical Society
Tacoma-Pierce County Health Department News
James (Jay) Miller, MD, MPH
Dear Colleagues,
As you might know, Dr. Anthony Chen has retired from his role as Director and Health Officer for TacomaPierce County Health Department (TPCHD) The Board of Health decided to create separate Director and Health Officer roles (as do most local health departments in Washington), so Chantell Reed now serves as Director, and I serve as Health Officer I’m excited to be in this role and look forward to partnering with physicians and healthcare organizations throughout Pierce County.
As a brief introduction, I’m an internist by training, and worked as Regional Medical Officer at the Washington State Department of Health before coming to TPCHD So, while I’m new to local public health, I’m familiar with the public health system in Washington I also previously served as a CDC Epidemic Intelligence Service Officer, based here in Washington In addition to my domestic public health experience, I have substantial experience in global health, including several years living and working full-time in Uganda. Much of my global health work was focused on community health worker programs, so I hope to bring that expertise to our work together in Pierce County as well. In addition to my TPCHD role, I also work part-time at the After Care Clinic at Harborview Medical Center
I would like to share some of my priorities for our work as a health department as well as areas where I hope to collaborate with physicians and healthcare organizations. We currently face a challenging syphilis epidemic. We have seen substantial increases in syphilis in heterosexual populations, with people who use drugs and people experiencing homelessness particularly affected, along with substantial increases in congenital syphilis While men who have sex with men are still disproportionately affected, approximately 77% of early syphilis cases in Pierce County now occur in heterosexual people (up from approximately 28% in in 2019) Additionally, 19% of early syphilis cases in Pierce County now occur in people experiencing homelessness.
We greatly appreciate your efforts to increase syphilis screening! As a reminder, we recommend testing for anyone who is sexually active and under 45 years of age, as well as testing based on risk factors for people over 45; all pregnant people should be tested three times during pregnancy (more details here and here) If in doubt, send the test! Please feel free to reach out to me or my team with questions about syphilis testing and treatment. Additionally, one of my priorities as Health Officer is to increase collaboration across the health department and around the county on the linked issues of syphilis, hepatitis C, substance use, and homelessness. I would love to support you in expanding access to hepatitis C treatment as well.
Another area of focus is tuberculosis Incidence of active TB has been rising in recent years It’s important to remember that the most significant risk factor for tuberculosis is having been born in or lived in a highly endemic setting.
In Pierce County, Marshallese communities have been particularly affected by tuberculosis. One of my goals as Health Officer is to strengthen relationships and expand services for Marshallese communities. Our tuberculosis team works incredibly hard on detailed investigations for active tuberculosis cases. However, I don’t think we’ll be able to address this issue fully without also addressing latent tuberculosis infection. As a reminder, we recommend tuberculosis screening testing for anyone who was born in or lived in a highly endemic setting, as well as people who have lived or worked in a correctional facility or homeless shelter. We would greatly appreciate your partnership in increasing tuberculosis screening in Pierce County. And again, please feel free to reach out to me or my team with questions about tuberculosis testing and treatment!
I also want to share some information about emerging concerns with avian influenza. As you have likely heard, there is an ongoing worldwide avian influenza epidemic among wild birds, with spillover into some mammals and domestic birds. More recently, the U.S. has faced an unexpected situation involving transmission of avian influenza among dairy cattle, with transmission to several farm workers as well. The route(s) of transmission are not yet fully understood, but we do know that high levels of virus can be found in raw/unpasteurized milk.
While avian influenza has had substantial animal health impacts, from a human health standpoint our biggest concern is that the virus could evolve to transmit efficiently between humans. Influenza virus evolution can occur through the familiar process of natural selection, or through reassortment in which viruses swap genetic material. Because pigs and of course humans are susceptible to seasonal influenza viruses, we are particularly concerned about the possibility of co-occurring avian influenza and seasonal influenza infections in pigs and humans during the coming respiratory season. And while consumption of raw milk is always risky, it is even riskier given the current situation with dairy cattle.
Our communicable disease staff, along with state and federal partners, are leaning into preparations for avian influenza. Given limitations in our current surveillance testing approaches, we very much rely on astute clinicians as the eyes and ears of public health. Please contact the health department immediately if you suspect avian influenza based on a patient’s exposure history.
While I’ve focused mostly on communicable disease today, I do want to emphasize that another key priority for me is expanding TPCHD’s work on chronic/noncommunicable diseases. I’ll save the details for another time but am looking forward to collaboration in this area as well. And finally, I would be remiss if I didn’t mention the upcoming respiratory virus season. As you all likely experienced, the COVID-19 vaccine commercialization process last fall led to challenges with access and uptake. We look forward to partnering with you on a smoother process this fall – and hopefully increasing uptake of COVID-19, influenza, and RSV vaccines. The fall is also a great opportunity to make sure children are up to date on childhood vaccines and to offer other important adult vaccines such as pneumococcal vaccination – especially now that we have the one-and-done PCV-20 option! Clear clinician recommendation is one of the best ways of raising immunization coverage.
I’ll end by emphasizing again that I’m so looking forward to working with you and meeting with you in the coming months! I’ve already had the chance to connect with the Pierce County Medical Society Board and with leaders for several of the healthcare organizations that serve Pierce County and look forward to connecting more in the future. We at TPCHD so value your partnership and want to be a resource for you!
