The Message December 2010

THE

message A MON T HLY N E WS M AG A Z IN E OF SCMS – DECE M BER 2010

2010 The Year In Review SPOKANE COUNTY M EDICAL SOCIETY

November SCMS Message Open2

2010 Board of Trustees Gary Knox, MD President Brad Pope, MD President-Elect Terri Oskin, MD Vice President Anne Oakley, MD Secretary-Treasurer J. Courtney Clyde, MD Immediate Past President Louis Koncz, PA-C Position 1 Keith Kadel, MD Position 2 Michael Cunningham, MD Position 3 David McClellan, MD Position 4 Paul Lin, MD Position 5 Michael Metcalf, MD Position 6 Gary Newkirk, MD Position 7 Carla Smith, MD Position 8 Vacant Position 9 David Bare, MD Position 10 Keith Baldwin, MHA Chief Executive Officer

TA B L E O F C O N T E N T S

President’s Message: 2010 – The Year in Review. . . . . . . . . . . . . . . . . . . . . . . . . . 1 Project Access – Provider Appreciation Day Breakfast. . . . . . . . . . . . . . . . . . . . . . . 2 Expanding the Interprofessional Approach of Learning . . . . . . . . . . . . . . . . . . . . . . 3 Fighting Fraud with Knowledge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Spokane Regional 4-Year Medical School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Psychiatry Residency to Lose Three Training Slots in Spokane — The Reality of the Present. . . 8 Graduate Medical Education Summit —The Vision for the Future . . . . . . . . . . . . . . . . 9 Health care in 2010: A wrap-up from the perspective of organized medicine . . . . . . . . . . 11 Spokane County Medical Society: 2010 Priorities and Focus Goals . . . . . . . . . . . . . . . . 13 Beacon Community of the Inland Northwest and Meaningful Use . . . . . . . . . . . . . . . . 14 Membership Recognition for December 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Medical Referral Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 An interview with Deb Harper, MD - WSMA Past President . . . . . . . . . . . . . . . . . . . . 15 FYI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 The Drama of Health Insurance Equals Trauma to Your Bottom Line . . . . . . . . . . . . . . . 17 In the News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Meetings and Conferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Classified Ads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Spokane County Medical Society Message Brad Pope, MD, Editor A monthly newsletter published by the Spokane County Medical Society.

The annual subscription rate is $21.74 (this includes the 8.7% tax rate).

Advertising Correspondence Quisenberry Marketing & Design Attn: Jeff Akiyama 518 S. Maple Spokane, WA 99204 509-325-0701 Fax 509-325-3889 jeff@quisenberry.net

Editorial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Congratulations to IMRS Residents and Faculty . . . . . . . . . . . . . . . . . . . . . . . . . . 23 New Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Positions Available . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 St. Luke’s Community Grand Opening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

"LEADERSHIP IS THE ART OF ACCOMPLISHING MORE THAN THE SCIENCE OF MANAGEMENT SAYS IS POSSIBLE." – COLIN POWELL

All rights reserved. This publication, or any part thereof, may not be reproduced without the express written permission of the Spokane County Medical Society. Authors’ opinions do not necessarily reflect the official policies of SCMS nor the Editor or publisher. The Editor reserves the right to edit all contributions for clarity and length, as well as the right not to publish submitted articles and advertisements, for any reason. Acceptance of advertising for this publication in no way constitutes Society approval or endorsement of products or services advertised herein.

November SCMS Message Open3

President’s Message: 2010 – The Year in Review Gary Knox, MD SCMS President As I write my final column for the Message as president of the Spokane County Medical Society, I would like to use two quotes.

The first is by Albert Einstein who said, “We can’t solve problems using the same kind of thinking we used when we created them.”

Or, as he more colorfully put it, the definition of insanity is “doing the same thing over and over again and expecting different results.” We are confronted with this reality in medicine in various ways, spanning the continuum, from our patients who have selfdestructive behavior such as smoking or other abuses, to the current state of our runaway medical expenditures. Einstein was a genius at being able to think creatively about objective sciences.

It is going to take some new thinking about our current medical model to solve the problems we find facing us. Problems like the work force shortage of physicians in primary care, access to care for those without insurance, aligning incentives with quality rather than quantity of services provided, shifting focus more toward prevention rather than recovery from devastating disease and addressing liability reform and still being able to compensate the harmed.

Over the past year the SCMS has focused attention on some of those problems. We have dedicated two issues of the Message to medical education. One of the long-term problems of work force and access to primary care will be at least partially addressed by training more doctors. The SCMS has been very involved in advocating and planning for the expansion of the WWAMI program in Spokane into a complete four-year medical school as an extension of the University of Washington School of Medicine, and the expansion of graduate medical education in our region.

This has been covered extensively in this newsletter. The SCMS helped fund an economic impact study of a complete medical school here, and I sat on a panel discussing some of the impacts and necessary next steps in bringing the school to fruition.

Keith Baldwin and I met with Dr. Paul Ramsey, Dean of the U of W School of Medicine to discuss what it will take to bring more residency slots to our area. We also participated in a Graduate Medical Education Summit that brought together residency leaders and other stakeholders from medical facilities from the entire five state WWAMI region to discuss and plan for the future of GME here. The reality is that GME is very expensive, both in dollars in the ballpark of about $150,000 per year per resident, and in time and commitment by practicing physicians. I am more confident we have the latter than the former. Even so, there will need to be some creative thinking to develop a culture of teaching in our community, let alone to come up with the funding considering the current status of the state budget.

My second quote is from Max DePree, a leadership author

and owner of Herman Miller Office Equipment Company - “The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.” There are many other ways the SCMS has been providing leadership over the past year, primarily focusing on serving the membership.

Those activities have been reported throughout the year, such as our advocating for physicians at the state and national level with our legislators, providing CME programs, bringing together leadership of hospitals and groups in a collegial way to discuss common concerns, and helping to bring forward some practice management education. We are also bringing together stakeholders to begin to address the huge problem of pain medication use and abuse in our community. This problem affects nearly all segments of our society and can only be solved by the medical profession working with the many stakeholders.

I am the first to admit that physicians helped to create the problem and new ways of thinking will be required to solve it. The reality of this problem needs to be clearly stated as a first step.

The two quotations of Einstein and DePree fit nicely together. Before a difficult problem can be solved or even addressed, the reality must first be defined and acknowledged. It has been shown that victims of disasters have a better chance of survival if they accept the reality of their dire situation, so they can appropriately take action. One of the realities of our time is that things are changing. This organization will need to be light on its feet, flexible in the future, and will most likely have to keep re-defining itself according to how healthcare reform plays out. The needs of physicians and the ways physicians interact professionally are going to change as market and legislated forces get more definition. It is an exciting, if not unsettling, time to be in medicine.

In closing I would like to acknowledge the CEO of the SCMS, Keith Baldwin, and his staff. Their hard work has certainly made my job easier and more fun. Also, my thanks go out to the members of the Board of Trustees, and all the committee members who give their time to serving the community and the Society. Thank you for allowing me the opportunity to serve this organization and the Spokane medical community.

December SCMS Message 1

…the definition of insanity is “doing the same thing over and over again

and expecting different results.”

Project Access – Provider Appreciation Day Breakfast John Driscoll Project Access Executive Director On November 17, the 1st Annual Provider Appreciation Day was celebrated. The day’s events began with a community breakfast to recognize the immense impact that physicians, hospitals and the entire health care community, make to underserved people in Spokane County. Each year, hundreds of low-income, uninsured people receive millions of dollars in donated medical care from volunteer healthcare professionals.

To begin the day’s events, Dr. Courtney Clyde welcomed the audience of over 100 community members, physicians, hospital representatives and event sponsors. City of Spokane Mayor Mary Verner issued an official City proclamation that November 17, 2010 has been recognized as Project Access Provider Appreciation Day, and encouraged citizens to “join me in this special observance”. In her subsequent remarks, the Mayor recalled the beginning of Project Access, and the access it has created for people who otherwise would not receive the care they need. Without volunteer physicians, and the support of the Spokane County Medical Society, low-income uninsured citizens would not have access to care. The community has benefited because Project Access, as a physician-led comprehensive community healthcare system for the uninsured, has improved the health and well being for thousands of individuals since it began in 2003.

Following Mayor Verner’s proclamation, Dr. Val Logsdon, Project Access Medical Director, spoke briefly about what it means as a physician to participate in charity care.

“Major illness affects the entire family, so the impact of donated medical care goes way beyond just treating the condition. Often, our volunteers don’t get to hear the end of the story – the difference they made that changed the life trajectory of one of our patients.” She then introduced two patients, and their treating physicians. Each patient spoke about the impact that Project Access, and the physicians who cared for them, made in their lives.

The Appreciation Day sponsors, Physician Insurance, First Choice Health Plan, WSMA, Providence - Sacred Heart Medical Center and Holy Family, Deaconess Medical Center, Valley Hospital and Medical Center and St. Luke’s Rehabilitation Institute, wanted to host this event to make sure that the entire community knows of the tremendous impact the Project Access network of dedicated volunteers has on the lives of people in Spokane.

In addition to the breakfast, Deaconess, Sacred Heart, Holy Family and Valley hospitals had Project Access informational booths during the day, manned by Project Access and hospital staff. With a theme of “Thank a Doctor Today”, each hospital contributed staff and resources to make this day a big success.

Cycrest Systems Inc., the Medical Society’s IT support company, arranged for the donation of seven billboards by Lamar Outdoor Advertising. To further recognize our providers, print advertisements thanking volunteers were placed in the Inland NW Health magazine and Journal of Business.

We would like to give special thanks to Ann Bryant, Physicians Insurance; Christine Varela, DeSautel-Hege Communications; and Jonathan Feriuolo, Cycrest Systems for their help with sponsors and media coverage that allowed us to say a big THANK YOU to the volunteers that make Project Access possible.

Please see the Project Access Provider list for the names of those who have dedicated their time and services to Project Access patients.

Valerie Logsdon, MD Project Access Medical Director and Samuel Selinger, MD

Dale Lauber, Project Access Patient and Michael Ryan, MD

City of Spokane Mayor Mary Verner

December SCMS Message 2

Expanding the Interprofessional Approach of Learning Barb Chamberlain Washington State University Director of Communications & Public Affairs It’s a November afternoon and 23 medical and dental students file into Dr. Eva Szentirmai’s histology class. Today, she’ll give the first of two lectures about the endocrine system.

As the professor connects the computer that contains her PowerPoint presentation, students check their e-mail or surf the Web on their laptops. A few joke about the mustaches that some of the male students are growing. “How long are you going to wear them?” asks Professor Katerine Roberge, who’s sitting nearby, pulling up the PowerPoint on her own laptop. “The end of November,” says one student, “unless I can’t stand it anymore and shave it off before then.”

Three months into their inaugural semester, the doctors-to-be in Spokane’s third group of first-year medical students seem to be in good spirits, despite the fact their next round of tests is only a few days away. Roberge credits WWAMI Spokane’s new testing system. Every other Monday is test day. “Some classes used to have midterms, others didn’t,” says Roberge. “This way, every class is on the same test schedule.” She says some students used to fall behind in classes, while they studied for tests in others.

“Now they’re tested more, but it helps them stay caught up.”

That’s one of the changes the Spokane medical school has made this fall. One benefit of clustering the tests, says WWAMI Spokane Director and WSU Medical Sciences associate professor Ken Roberts, is that it has freed up time for service learning projects. Some of the first year students volunteer a few hours a week doing checkups on homeless men at the House of Charity.

Others do sexually transmitted disease screening at Family Medicine Spokane. Some help immigrants in Spokane get to their doctors’ appointments. “We want to get students feeling like they’re getting into the role of a doctor right away,” Roberts says.

In addition to helping implement changes in Spokane, Roberts is part of a committee that’s beginning to examine the doctor education curriculum throughout the whole WWAMI system. He says the last review was done nearly 10 years ago.

“We want to encourage more active learning, more peer learning,” Roberts says.

That includes mixing students in different disciplines. There are examples of that on the Spokane campus. Medical and dental students already share many of the same first-year courses; Eva Szentirmai’s histology class is one of them. That blending of students doesn’t take place in WWAMI’s Seattle classes.

Roberts says expanding that interprofessional approach will be a challenge for medicine. “We’re struggling with how to do that.” WSU’s nursing and pharmacy colleges have led the way in using human simulation technology to practice patient scenarios.

Sometimes they include physician’s assistant students from the

UW MEDEX program, who are also on campus; M.D. students are not yet in the mix.

In the long run, Roberts says, teaching students in different medical fields to work together is important. “In a traditional operating room model,” he says, “there’s the surgeon and everyone does what he says. But now we’re thinking about surgical teams, where there’s also an O.R. nurse, an anesthesiologist, maybe a resident and a pharmacist. They need to know who’s doing what and what are the expectations. We don’t teach that now.”

But the medical school should, says Dennis Barts, the CEO of Spokane’s Valley Hospital and Medical Center. “If our physicians are learning how to take care of patients in that multidisciplinary, cooperative environment,” he says, “I think that’s going to be a great advantage to them as they move into this new paradigm that we’re all looking at.”

The Riverpoint Interprofessional Education and Research Committee led by Barb Richardson, RN, PhD, is meeting regularly to talk about how to bring interprofessional experiences into curricula across the health professions.

The rationale behind it is simple: compared to the traditional, topdown approach of healthcare, a teambased approach has been shown to increase patient safety, patient satisfaction and quality of care, says Richardson.

The interprofessional approach is just one potential change to the WWAMI curriculum. Roberts says any tweaking of what’s taught would be done under the assumption that WSU Spokane will someday take over the education of second-year medical students. Currently, WSU educates first-year doctors-to-be. Second-year students attend class in Seattle. Students may then return to Spokane and other sites for their third and fourth years; many of those who had their first year in Spokane are choosing to return here for clerkships. Having the full four years in Spokane “will happen,” says Roberts, “it’s just a matter of when.”

WSU Spokane employs 27 on-campus faculty members in its medical education program. Up to 40 Spokane doctors also act as preceptors for students. In addition to their teaching duties, WSU medical sciences professors are also busy with research.

Focus areas include sleep and performance, cellular biology, reproductive physiology, cancer research and more, with several federally funded projects under way and others in development.

December SCMS Message 3

“We want to get students

feeling like they’re getting into the role of a doctor right away,”

73%

Fighting Fraud with Knowledge Shawn D. Swartout, VP Corporate Security Director Sterling Savings Bank The Association for Financial Professionals Payments Fraud and Control Survey found that 73 percent of organizations experienced attempted or actual fraud in 2009. Over 90 percent of the incidents involved some form of check fraud with typical losses ranging in excess of $17,000. Check fraud clearly isn’t new to the industry; it continues to be a burden that all medical practices must face.

Today’s turbulent economy, along with warnings of emerging payment fraud threats, can create unique challenges for any organization. In an environment where profit margins are under a tremendous amount of pressure, an effective fraud/lossprevention program is key to achieving organizational business goals.

The financial services industry and its customers are also facing an emerging fraud threat that has received quite a bit of publicity. The FBI and FDIC recently warned of online business banking fraud threats that specifically target small- to midsized businesses. The threats involve the use of a compromised computer and stolen online banking credentials that have resulted in devastating losses reported in excess of $1,000,000. There are mitigating strategies that can be adopted to reduce exposure to loss while still taking full advantage of the benefits that online banking products provide.

The following recommendations may serve as great topics to discuss with your financial and treasury management services provider: Tips for reducing exposure to check fraud in your practice Use products specifically designed to reduce the likelihood of unauthorized items clearing your account Positive Pay is a product offered by many financial institutions that gives businesses the option to submit an electronic file of checks authorized to clear your account. Checks not authorized are rejected. This greatly reduces exposure to fraud.

Review your bank statement immediately upon receipt or availability We recommend you review your bank statement immediately as it ensures that any suspicious check activity is reported in a timely manner. Review your bank’s account agreement to learn the reporting requirements. Failure to report in the specified time may result in relinquishing your right to dispute an item. You may also opt to leverage the benefits of online banking to monitor your accounts on a more regular basis.

Tips for reducing exposure to online business banking fraud Dual-control authorization for ACH or wire transactions reduces fraud opportunities Many financial services organizations offer online banking services that require dual approval for all outgoing electronic ACH or wire transactions. Organized criminals are using increasingly

Organizations that experienced attempted or actual fraud in 2009 sophisticated software that can compromise computers and online banking credentials. By requiring dual approval for payments, you can reduce your likelihood of falling victim to this form of online business banking fraud.

Know the online threats Social engineering and spear phishing are both sophisticated attacks that can expose and compromise sensitive company information and banking credentials.

Social engineering uses seemingly trusted individuals gaining access to sensitive company information from employees.

Your company representatives should always use caution when speaking with unknown or unidentified callers and limit the sharing of sensitive information.

Spear phishing attacks involve targeted emails that include a malicious payload (e.g. attachment) or a link to a nefarious website. Clicking on the link or opening the attachment often results in the installation of malware on the victim’s computer.

Proper computer controls and employee training dramatically reduce your risk of falling victim to these types of targeted attacks.

Learn to spot online scams Be skeptical! So many online scams succeed based on the gullibility and naiveté of the victim. A slight change of perspective and increased level of paranoia may be warranted.

Consider the following: (1) Urgent notices to reactivate your online account are generally not sent via email.

(2) You didn’t just win a lottery you never entered.

(3) That strange pop-up window on your computer is likely provided by malicious software.

Know who is responsible for computer security within your organization Assigning the responsibility for computer security within your organization is the first step toward ensuring proper controls are in place to mitigate risks associated with computer crimes.

Computer security programs should encompass policy, procedure and training, as well as include solutions for deploying and validating computer security controls.

With the right knowledge, organizations can sufficiently mitigate the risks associated with new and emerging payment fraud threats. Although these threats create unique challenges for small to mid-sized businesses, effective fraud loss prevention programs are key to helping organizations achieve their business goals.

To learn more about Sterling’s products and services from our knowledgeable private banking team, please call Nancy Jean Hake (Team Leader) or Keith Kristin at Sterling Private Banking (509) 458-2881.

Sterling Private Banking is a member of the Spokane County Medical Society – Circle of Friends.

December SCMS Message 4

What can Riverpoint Pharmacy do for your patients?

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IN MEMORIAM

William Lewis Gray, MD William Lewis Gray was born on March 24, 1948 in Winnipeg, Manitoba. He passed away on November 03, 2010 after a courageous battle following a brainstem stoke in 2008.

Dr. Lewis received all of his education in Manitoba and graduated with his Medical Degree on May 23, 1974 from the University of Manitoba. He was a family practice physician for over 30 years since coming to Spokane in 1977.

He loved the outdoors and enjoyed waterskiing, snow skiing, biking, swimming and fishing.

His wife, Crysti and their children Connlee, Mollee and Ty; sons Colin and Trevor; his parents, William and Helen; sisters; brother and many nieces and nephews survive him.

He will be missed by all who knew and worked with him.

December SCMS Message 5

Spokane Regional 4-Year Medical School Kevin Dudley Marketing and Communications Coordinator Greater Spokane Incorporated Medical Schools don’t come together easily. Like a 900-piece puzzle, establishing a medical school and – more importantly – expanding graduate medical education (GME) as a whole in Spokane will take time, collaboration and lots of smarts.

Fortunately, Spokane has a smart team ready and willing to work.

The goal of getting a full four-year medical school to Spokane stems from a shortage of doctors in rural areas. Training medical students in Spokane would increase the chances that they would remain in the region to serve at our area hospitals.

In June, Paul Umbach of Tripp-Umbach – a consulting firm that specializes in advising hospitals – said at Greater Spokane Incorporated’s monthly breakfast that America’s next great health science center would be in Spokane. Umbach estimated establishing a medical school in Spokane – and expanding the regional health care system with more research and bioscience jobs – would bring a $1.6 billion boost to the economy in 20 years, and 9,000 jobs. Reaching these numbers, however, primarily requires planning and funding.

In July, WSU Spokane and Greater Spokane Incorporated (GSI) – the region’s chamber of commerce and economic development council – received $75,000 in grant money from the Health Sciences & Service Authority (HSSA) of Spokane County, which will expand outreach on behalf of the medical education program.

This will help rural communities understand our goal.

“Part of the HSSA Grant is to help communities see what’s in it for them as medical education and research expands in Spokane,” said Barb Chamberlain, Director of Communication and Public Affairs at WSU Spokane and a member of the GSI Public Policy Council. “Otherwise, it’ll feel like (the medical school) is not theirs, it’s Spokane’s. It needs to be owned by the region and supported by the region.”

GSI also received $25,000 from the Empire Health Foundation that will go toward developing a phased business plan to meet the long-term needs of the medical community in eastern Washington. Tripp-Umbach is developing the business plan for this project. The Spokane County Medical Society is involved as well.

GSI President and CEO Rich Hadley is heavily involved in creating a GME Expansion Plan. The team assembled for this task is made up of hospital executives from central and eastern Washington. Hadley is the only non-hospital executive on the team.

In mid-October, academic health leaders met in Spokane and discussed GME expansion, which includes increasing the amount of residencies in eastern Washington. “Ultimately, the idea is to engage, broadly, the health industry, identify how to meet its needs and put together a consortium model to connect medical education solutions to meet those needs,” Hadley said.

In late January, a delegation of Spokane-area business and civic leaders will head to Olympia to advocate on behalf of our local public policy issues – the health sciences campus being the top issue. GSI and its delegation will support WSU’s request for construction funds to construct the Biomedical & Health Sciences Building. The delegation will also request operating funds for WSU and the University of Washington to plan for second-year medical studies at WSU Spokane.

Increasing the number of residencies will be an advocacy issue when GSI sends a delegation to Washington D.C. in April of 2011.

Currently, the number of residencies is capped nationwide. “We need to raise that cap,” Hadley said. “That could open the gates for this project. We’ve got a great team and a long road ahead and it’s important to spread the word throughout the community that this project will significantly benefit Spokane, eastern Washington and the entire state.” There are currently only 100 residency slots given to eastern Washington, compared to 1,550 in western Washington.

When – not if – a full four-year medical school comes to Spokane, the hope is that students will make a home here.

GSI will continue to showcase Spokane as a great place to live and work. With four beautiful seasons, plenty of recreational activities, a low cost of living and so much more, it’ll be easy for these future students to be impressed with Spokane.

The road ahead is long but very manageable. GSI is part of an incredible team with a common goal. With the tenacity of local business leaders and the resilience and collaboration shown, expanded graduate medical education and a four-year medical school can become a reality for Spokane.

The affects of this could propel Spokane to a new level.

expanding the regional health care system with more research and bioscience jobs – would bring a $1.6 billion boost to the economy in 20 years, and 9,000 jobs.

SCMS is interested in assisting our members to participate more actively in key community leadership roles. If you become aware of an open board, a or advisory committee position please notify Michelle Caird at (509) 325-5010 or my email at michelle@spms.org.

December SCMS Message 6

A special thank you to our business sponsors, guests, restaurants, wineries, breweries and volunteers for making the 2010 Epicurean Delight the most fun black-tie gala in the Inland Northwest! Proceeds from this even benefit the Inland Northwest Blood Center and our life saving mission.

Culinary Award Winners • • • • •

Outstanding Hors d ‘Oeuvres: Simply Gourmet - Trio of Rustic Italian Crostini Outstanding First Course: Northern Quest Resort Casino Banquets - Black Raspberry Duck Salad Outstanding Entree: C.I. Shenanigans - Pan Seared Scallops Outstanding Dessert: Madeleine’s Café and Patisserie - Hazelnut and Salted Marjolaine People’s Choice Best Restaurant: Taste of India

Culinary Judges Angela Ramey - Ramey Construction Company, Bill Akers - Premera Blue Cross, Brady Cass - Asuris Northwest Health, Craig Leone - Leone & Keeble, Dan Demchuk - Moss Adams LLP, Debbie Zimmerman - Bank of America, Earl (Marty) Martin - Gonzaga University, Elaine Couture - Providence Holy Family Hospital & Providence Sacred Heart Medical Center and, Children’s Hospital, Heidi Linehan - Gritman Medical Center, Jamie Aitken - BELO (KREM2), Jason Conley - Spokane Public Schools, Jeani Natwick - NAC Architecture, Jennifer Miley - Rockwood Clinic, Larry Sorensen - Washington Trust Bank, Lori Pierce - Randall & Hurley, Luke Baumgarten - The Pacific Northwest Inlander, Michael Olds, M.D. - Spokane EN&T, Pam Seiler - Blood Systems, Inc., Rick Connacher - Kalispel Tribe, Rick Jensen - URM Food Service, Robert (Bob) L. Zins, CPA - Anderson Peretti, Robert Hartman, M.D. - Deaconess Medical Center, Robin Johnston - Johnston Printing, Roger Schultz - Signature Genomics, Scott Schultz - The Davenport Hotel & Tower, Steve Storey - Sterling Savings Bank, Tom Allerding, M.D. - InCyte Pathology

Event Sponsors Kalispel Tribe and Northern Quest Resort & Casino - Bronze Sponsor, CaridianBCT - Partner Sponsor Event Underwriters Asuris Northwest Health, Bank of America, Blood Systems, Inc., The Davenport Hotel & Tower, Deaconess Medical Center, Fidelity Associates Insurance & Financial Services, Gritman Medical Center, InCyte Pathology, Inland Imaging, Inland Northwest Health Services, King Beverage/Stella Artois, Leone & Keeble, Moloney + O’Neill Benefits, Moss Adams, LLP, NAC Architecture, Physicians Insurance A Mutual Company, Premera Blue Cross, Providence Holy Family Hospital & Providence Sacred Heart Medical Center & Children’s Hospital, Ramey Construction Co., Randall & Hurley, Rockwood Clinic, Signature Genomics, Spokane EN&T, Sterling Savings Bank, Surgical Specialists of Spokane, URM Food Service, Washington Dental Service, Washington Trust Bank

Table Sponsors

Cancer Care Northwest, P.S., Deer Park Family Care Clinic P.S., DoubleTree Hotel - Spokane City Center, Gonzaga University, Jan-Pro Cleaning Systems, Jennifer’s Auto Sales, NAI Black, Northwest Heart and Lung Surgical Associates, Odom Corporation, Opportunity Medical, PLLC, Orthopedic Specialty Clinic of Spokane PLLC, Providence Health & Services, Washington Trust Bank - Wealth Management & Advisory Service, Witherspoon, Kelley, Davenport & Toole, P.S.

In-Kind Contributors

AAA Washington, Adventures in Advertising - Sherry Lewis, All Print Inc., ALSCO/American Linen, Ambrosia Bistro & Wine Bar, aNeMonE Handmade Paper Flowers, Angela Utecht, Anne Fritz, Anthony’s Homeport - Spokane, Arbor Crest Wine Cellars, Barlow’s Family Restaurant, Barrister Winery, Beau K Florist, Ben Joyce, Berg’s Shoes, Bozzi Media, Brian Olmstead, Brickhouse Massage, Buck Knives, Cabot Creamery Cooperative, Carleen Hopkins, Cathy J. Simchuk, Christine & Rob Hiatt, Cindy Ryckman, Claudia Campbell, Color Me Mine, Coeur d’Alene Casino Resort Hotel, Crimson & Gray, Dave & Lori Largent - Sprout Salon Spa, The Davenport Hotel & Tower, Divine Corporation, DoubleTree Hotel - Spokane City Center, Dr Pepper Bottling Company of Spokane, Dry Fly Distilling, Dynasty Fine Jewelry, Eagles Ice-A-Rena, Eggers Better Meats, Elements Therapeutic Massage, Ellen Harkness, Ennis Fine Furniture, Evergreen Florist, Exercise Solutions, Ferrante’s Marketplace Cafe, Finders Keepers, Fitness Together, Fitzgerald Ice Co., Flow Adventures, Food Services of America, Fred’s Appliance, Gary Lindeblad, Geary, Carl - Aurora Developments, Georgette & Tom Grainger, Gonzaga University, Grassroots Wellness Spa, Group Coordinators, Hill’s Resort, Human Vitality, Inland Aesthetic Institute, International Sports Properties, Jack & Dan’s Bar & Grill, Jackie Hughes, Jamie & Tracy Aitken, Janice Marich, Jean & Bill Merrill, Jeff & Melinda Bryant, Jensen Distribution Services, Johnston Printing, Kathleen Wendlandt, The Kitchen Engine, KREM2-TV, Lalo’s Pizza, Lamar Advertising, Larry Tobin, Latah Creek Wine Cellars, LCD Exposition Services, Liberty Lake Wine Cellars, Liberty Park Florist and Greenhouse, Maggie’s Grill, Melanie Fisher, Millwood Manufacturing, Mister Car Wash, Mobius Kids, Monique & David Cotton, Mountain Dome Winery, Mountain Gear, Mt. Spokane Ski and Snowboard Park, Nancy & Chuck Wilbert, Neuroeducation, Northwest Museum of Arts & Culture, NW Woman Mag., Odom Corporation, Oz Fitness, P.F. Chang’s China Bistro, Pend d’Oreille Winery, Peters and Sons Flowers & Gifts, Pixie Dust Chocolates, Pounder’s Jewelry, Precept Wine Brands, Preston Premium Wines, Qdoba Mexican Grill, Quisenberry Marketing and Design, Quiznos - Spokane, WA, Riverfront Park, Rockwood Bakery, Rosauers Supermarkets, Inc. (Hucklberries), ROW Adventures, Salli & Anthony Dutton, Schweitzer Mountain Resort, Scott & Vicki Jones, Selina & Jeff Worley, Shape Cosmetic Surgery & MedSpa, Skinsational Body Bar, Snap Fitness, Spokane Chiefs Hockey Club, Spokane Civic Theatre, Spokane Eye Clinic, Spokane Indians Baseball Club, Spokane Wine Magazine, Standard Digital Print, Starbucks - Spokane, E. 29th Ave., Steamplant Grill, Steelhead Bar & Grille, Strands of Thread Quilting - Dianne Strand, Studio Capelli Salon & Spa, Tast of India, Teri & Rob Barros, The Master Solution, The Pacific Northwest Inlander/InHealthNW, Todd & Josie Sackmann, Trezzi Farm Food & Wine, Tri State Distributors, Tuxedo Gallery, University of Idaho, URM Food Service, VINO! A Wine Shop, Waddell’s Pub and Grille, Washington Trust Bank - Private Banking, WestCoast Entertainment, Wild Flowers Florist, Wolf Lodge, Woodcraft, Yuppy Puppy

Media Partners KREM2-TV, Inlander / InHealth NW Friends of INBC Angela Utecht, Family Home Care & Hospice Corp., Hay J’s Bistro, Hollister-Stier Laboratories LLC, Maggie’s Grill, Market Equipment Company, Pathology Associates Medical Laboratories, Ruth Pearson, Thrivent Financial for Lutherans, Transtector Systems, Tuxedo Gallery, Inc., United Pharma

Restaurants ACF Chefs de Cuisine, Beacon Hill, Beverly’s, Bistro on Spruce, Boyd Coffee Co., Catered for You, C.I. Shenanigans, Clinkerdagger, Coeur d’Alene Casino & Resort, Craven’s Coffee, Downriver Grill, The Glover Mansion, Herbal Essence, Huckleberry’s, Just American Desserts, Luna, Madeleine’s Café and Patisserie, Masselow’s, Max at Mirabeau, The Melting Pot, Northern Quest Casino, Rock City Grill, Scratch, Simply Gourmet, Spencer’s for Steaks & Chops, Spokandy, Taste of India, Vin Rouge, Zola

Wineries & Breweries

Arbor Crest Wine Cellars, Caterina Winery, Chateau Ste. Michelle, Columbia Crest, Cougar Crest Estate Winery, Fidélitas, Girly Girl Wines, Glen Fiona, Latah Creek Wine Cellars, Liberty Lake Wine Cellars, Mountain Dome Winery, Okanogan Estate & Vineyards, Overbluff Cellars, Pend d’Oreille Winery, Preston Premium Wines, Robert Karl Cellars, Silver Lake Winery, Terra Blanca Winery & Estate Vineyard , Townshend Cellar, White Heron Cellars, Whitestone Winery, Whitman Cellars, C.I. Shenanigans, Golden Hills Brewing Co., Iron Horse Brewery, Northern Lights Brewery Co., Steam Plant Grill/Coeur d’Alene Brewing Co., Stella Artois/King Beverage

See you next year for the 30th Annual Epicurean Delight! Friday, November 11, 2011!

For more information and event photos visit www.EpicureanDelight.org. *Great care was taken to ensure the accuracy of this list. This list includes names of those who committed to sponsoring, hosting or contributing to Epicurean Delight prior to the press deadline, 11/12/10.

December SCMS Message 7

Psychiatry Residency to Lose Three Training Slots in Spokane — The Reality of the Present John McCarthy, MD UW School of Medicine Assistant Dean for Regional Affairs & WWAMI Clinical Coordinator for Eastern & Central Washington On the day of submission of this article, the Graduate Medical Education community suffered a blow. The Psychiatry Residency, which has been a model for distributive learning in the WWAMI region, learned that because of funding, it will not be recruiting for residents for the upcoming GME cycle. There will be a disruption in residency training with NO new psychiatry residents in the Spokane Psychiatry program in 2011. As a result, the potential for this program to no longer exist in the future in Spokane is all too real but not inevitable. This exemplifies the struggles inherent in this process of growing medical education.

Matt Layton, MD, Psychiatry Director, has worked unwaveringly to secure funding options for the three Track Residents. In spite of some creative approaches to secure funding for these positions, there was not enough. This is a significant loss for the community and region as these residents have had successful tenures here and many have populated our region. Matt, with his usual affable

manner intact, remains optimistic that the program will be able to pick itself back up but as you can imagine, not recruiting for a year is a blow to the program.

I encourage you to engage in the understanding of what transitioning our medical community is going to entail. I promise you, it will be affecting your future, your patient’s future, and the health of your region. This concept is one in which we will do better if we can embrace and guide, as opposed to one in which our future will be shaped for us.

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December SCMS Message 8

Graduate Medical Education Summit —The Vision for the Future John McCarthy, MD UW School of Medicine Assistant Dean for Regional Affairs & WWAMI Clinical Coordinator for Eastern & Central Washington In Spokane this October, a first occurred when over 150 leaders in medical education from across the WWAMI region convened at Riverpoint campus. The meeting was remarkable in that it addressed the regional leaders’ needs and desires for advancing training in graduate medical education. Based on program evaluations, the GME Summit was highly thought of in terms of advancing the conversations necessary to seriously explore this growth. National GME leaders in attendance commented on the uniqueness of this meeting and the spirit of cooperation that seemed apparent within the region. The fact that multiple stakeholders requested a regular meeting similar to the Summit supports the value it offered the region. It is also an indicator of the interest to develop a strategic approach to regional GME expansion.

The University of Washington School of Medicine was the lead in convening hospital administrators, community leaders, medical societies, UWSOM department chairs, and current GME leaders to discuss such issues as: potential models to develop GME within the region, creative financing of GME and current and potential growth opportunities. Clearly, the decision to create GME is not an easy one - it involves a significant commitment during a time when the financial outlay is significant and the level of federal support is limited. In spite of this, there is a commitment to advance the conversation and move in the direction of creating both undergraduate (medical school) and GME in this community and in the eastern part of the state.

Over the next month and a half, there will be an ongoing evaluation of the environment for medical education on the eastern side of the state. Huron Consulting Group, a national firm with expertise in GME, has been contracted with in early November to help us define the opportunities and hurdles implicit in developing GME opportunities with the ultimate goal of bringing new residencies and fellowships to the region. They will be taking on a Herculean task. The need for this is clear. We need to develop the expertise, financial resources, and medical culture that support this. With the advancement of GME, the addition of a medical school will be a synergistic endeavor.

The biggest impediment to the goal of advancing medical education currently is financial. However, it will take a collaborative, creative and collective approach to work through this challenging need. What can you do to advance the issue of increasing medical education? Talk with your legislators, community leaders, colleagues, medical schools, and residencies; acknowledge a desire for involvement; support the infrastructure that currently exists; help teach; take courses in faculty development; get involved and let us know of your interest. We appreciate those of you who have already contacted us – rest assured as situations arise, we will call on you for assistance.

It is clear to me that the eastern part of the state needs to be able to supply the physicians necessary to populate the region.

We know that residents tend to gravitate to practice in a close proximity to where they train. This of course is not an absolute and Spokane has historically been a great importer of physicians.

As the demands for physicians increase throughout the entire country (and these demands are increasing - ask any hospital administrator or specialty group), it will become harder to import physicians. Join us in working to position our community and the region to be prepared for the changes that will influence how medicine is provided to our community and region. Contact us at John McCarthy, MD, mccajf@uw.edu or Deborah Harper, MD, djharper@uw.edu.

December SCMS Message 9

December SCMS Message 10

Health care in 2010: A wrap-up from the perspective of organized medicine Bradley Pope, MD Medical Director Group Health Permanente As I sat down to write this piece, I realized there is no way to accurately “wrap-up health care in 2010.” Instead I will describe what I would like to see as the state of health care 10 years from now. I know where we want to end up: With a coordinated system of care in which practitioners are paid for what they know and can teach their patients. The challenge is understanding where we’ve been the last couple of years, where we are today, and where we want to be a month, a year, and two years from now on the way to 2020.

While Congress may make some changes in the healthcare law as we know it today, I don’t think they will drive changes that will get us to 2020. The reforms were really changes in insurance, not the way care is delivered today or in the future.

These coverage-related changes—coverage for offspring up to 26 years, no pre-existing condition exclusions for children, reducing the “donut hole” for pharmaceuticals—are important, but they don’t move us very far in the direction of coordinated, patient-centered care. And they don’t do much to control costs.

No one knows better than doctors and patients that the system is broken. Every day they experience the miscommunication, the repeated or unnecessary tests, and the pressure to do more in less time in order to get paid enough to keep the lights on and the doors open. Federal legislation won’t likely address the cost trends that have led to the current crisis in health care in any meaningful way. It’s going to be up to those of us practicing medicine in our own communities and working in concert with our colleagues and local institutions to find the ways to reach the 2020 ideal.

Group Health has been selected to pilot accountable care organizations (ACO) for the State of Washington. An ACO attempts to bring together key pieces of care that today are often performed by clinicians across several organizations who don’t have all the tools and financial incentives to work as a team.

We know that good things happen when we can bring together all the players to focus on the important 5-Rs: the Right care at the Right time from the Right person in the Right setting and to the Right endpoint. The challenge we face now—whether we’re in a managed care system or a solo practice—is to align the financial incentives, performance and efficiency management systems, and the new methods of delivering coordinated and integrated care to focus on outcomes rather than volume. The end result will be better, safer care and a sustainable cost trend. What’s important to

Group Health is the mission set by our founders in 1947: deliver high quality care to the most people. As we begin forming the first ACO, we’ll be asking our partners to focus on that goal and work collaboratively to make it a reality.

This past year has seen some remarkable changes in health care in Spokane. Partners have become competitors and everyone is finding new challenges and opportunities in the marketplace. The Rockwood-Deaconess partnership is an example of a national trend—hospital-based health care systems either purchasing or merging with large established clinics. This is one way of bringing doctors, vendors and facilities together into a team with a set of common tools and incentives. The national discussion about ACOs asks whether organizations can work together to be accountable for the care of patients across the continuum of the care experience without common ownership. Are there ways to collaborate, align incentives, and share clinical information across several organizations?

The important lesson about health care in 2020 is that we’re already moving that way. In Spokane, for example, a cancer patient taking anticoagulants wanted to use the time between courses of chemotherapy to travel to Europe. And, travel she did. Using cell phone, e-mail, and instant messaging she was able to monitor and adjust her anticoagulants regularly and complete the trip safely. To make it happen, the Group Health anticoagulation management team worked closely with her oncologist from Cancer Care Northwest. That’s an example of what we can accomplish when we work together to keep the patient at the center of our focus.

While we all experience the day-to-day pressures to stay in business, I’m encouraged because at the end of the day we’re still able to focus on trying to do the best for our patients. We know that when costs go up, access goes down and people suffer. What’s really important is that just changing the rules about insurance coverage isn’t really going to change health care and lead us to that ideal 10 years from now. It will take the good work and creative thinking of physicians, hospitals, clinics, and others in health care to bring about coordinated, cost-effective health care in our community. Spokane has an excellent community of physicians, broad and deep in subspecialties. Our hospitals and other facilities are world-class.

We’ve all heard the ancient curse that goes, “may you live in interesting times.” It’s fair to say we do, and will continue to for a good while. These next few years will be intense for all of us in the healing professions, whether we work in managed care, a solo practice, or in a hospital-based system. 2010 will be remembered as the year when the big changes started to take effect in Spokane and across the country. I’m working with many of you toward the end result that will be a system of health care in which care is delivered seamlessly across delivery systems, where physicians are paid for the value they deliver not the volume they produce, and where patients can afford to get the care they need when they need it.

December SCMS Message 11

December SCMS Message 12

Spokane County MEDICAL SOCIETY 2010 Priorities and Focus Goals - Progress Report Keith Baldwin SCMS CEO The Spokane County Medical Society (SCMS) developed a set of Priorities and Focus Goals with input from members.

The Priorities identified the wishes of the members to have the Society advocate, research, evaluate, and implement programs and activities on their behalf to advance the profession and improve patient care.

In response to concerns about medical liability and improving quality in the process the leadership successfully advocated with the legislature against provisions to the Wrongful Death Act. They supported the WSMA sponsored Clinical Performance Improvement Network (CPIN) established as an educational network to advance Quality Improvement, reduce variations in care and, ultimately, base payments on something other than the classic fee-forservice methodology.

Also initiated were collaborative initiatives to support community-wide public health efforts to discuss a community-wide response to pain management assessment and treatment. This involved a Pain Management Resource Assessment in Spokane County and a meeting of the Spokane Prescription Opioid Task Force.

Drs. Knox and Clyde successfully advocated for physician and patient funding needs (e.g. Interpreter Services) in the State Budget. Drs. Knox and Pope advocated for repair of the SGR formula with our Federal Legislators in WA DC. In addition, Keith Baldwin responded to Dr. David Hoak’s request for an article in the SCMS newsletter about the Medicare PECOS SYSTEM that is required for physicians who refer or receive referrals of Medicare patients. Keith also attended the Community Forum, “Building Communities for Successful Aging Accessing Health Care” sponsored by Aging and Long Term Care of Eastern Washington which addressed the availability of primary care services.

Desautel Hege completed key informant interviews with physicians to develop a strategic plan for Project Access outlining an update to the website, increasing physician volunteers and improving communication. A Project Access PROVIDER RECOGNITION DAY was held on November 17with a City of

A Project Access PROVIDER RECOGNITION DAY was held on November 17 with a City of Spokane Proclamation by Mayor Mary Verner.

Spokane Proclamation by Mayor Mary Verner.

Dr. Brad Pope became the liaison to the EC and BOT for the Medical Home Model and in the area of Primary Care including demonstration. Information from the presentations on the “ABC’s of New Delivery Models” at the WSMA Leadership Conference in May that highlighted Accountable Care Organizations was placed in the SCMS Newsletter The SCMS EC discussed the SCMS vision for a shared hospital/ physician medical record and the importance of maintaining this resource to improve patient care in the community. The SCMS Informatics Committee co-sponsored with INHS three meaningful use seminars, one of which coincided with the INHS NMIS September Conference in Spokane.

SCMS wrote a letter of initial support for the Beacon Community of the Inland Northwest (BCIN) Grant that INHS received from the federal office, ONC, and a number of physicians are on BCIN work groups. The Informatics Committee received regular reports from BCIN and provided comments on their progress as they implement the $15 million grant.

Keith Baldwin participated on the SRHD sponsored program advisory board for “Neighborhoods Matter”, which is focused on the East Central neighborhood.

Dr. Clyde visited the Vancouver, Canada Medical School Campus with other representatives from WWAMI and GSI in late 2009 that initiated the Medical School expansion initiative.

Tripp – Umbach, a consulting firm commissioned to determine the community and economic impact of a four- year Medical School on Spokane, presented to the March SCMS BOT meeting.

Dr. Knox participated in a panel during the Tripp Umbach Community and Economic Impact Presentation at the GSI meeting and later on a panel to update and advise legislators on the progress of the four-year Medical School at Riverpoint campus. In addition, Drs. Gary Knox and Brad Pope, with Keith Baldwin, participated in the UW School of Medicine GME Summit to explore key issues in expanding GME in the region. Graduate Medical Education focus articles appeared in both the March and October issues of the SCMS Newsletter. Dr. Gary Knox provided an SCMS orientation session to the 1st year WWAMI Medical Students at the River Point Campus and participated in an SCMS sponsored Faculty Recognition event.

December SCMS Message 13

Continued on page 19

Beacon Community of the Inland Northwest and Meaningful Use Jac Davies, MS, MPH Director, Beacon Community of the Inland Northwest Spokane and the Inland Northwest are one of 17 communities and regions across the country selected by the Department of Health and Human Services to serve as pilot communities, or Beacons, to demonstrate the wide-scale use of health information technology for the coordination of care. The project, called the Beacon Community of the Inland Northwest or BCIN is focusing on extending existing health information exchange to provide a higher level of connectivity between health care providers throughout the region, increasing coordination of care for patients with diabetes and enabling quality measurement and reporting.

In addition to providing better access to patient information, the BCIN will help participating health care providers meet the new health information technology “meaningful use” requirements from CMS. The CMS meaningful use regulations define very specific expectations for the use of health information technology in health care. Health care professionals and hospitals that meet those expectations and demonstrate compliance with certain criteria can receive incentive payments. In the first two years of the incentive program, criteria for the meaningful use of health information technology fall into three general categories: UÊ Enhancing delivery of care through techniques such as e-prescribing and Computerized Physician Order Entry (CPOE) UÊ Exchanging health information electronically with other providers of care or business partners, such as labs or pharmacies UÊ Reporting clinical quality, public health and other measures electronically To receive incentive payments, you must meet all of the core criteria and a set number of additional criteria from a menu set, at least one of which must be related to population health. Each eligible professional who demonstrates meaningful use of health information technology can receive up to $44,000 over five years in the Medicare incentive program or up to $63,750 over six years in the Medicaid incentive program. Payments begin as early as 2011.

Medical Referral Line One of the many benefits the Spokane County Medical Society offers to its physician-members is our Medical Referral Line. This service allows SCMS staff to support area medical practices by providing names of physicians accepting new patients to community members who are searching for a physician. Our sincere thanks to those of you who are already members of our Medical Referral Line!

While healthcare providers can assure compliance with the meaningful use criteria that are primarily internal to their practice, such as CPOE, the criteria that include health information exchange and quality reporting will require connectivity to and reliance on external systems. Participation in the BCIN can help providers fill in those gaps. The BCIN will support broad connectivity with hospitals, providers, pharmacies and home health agencies to exchange health information and assist in improved patient care.

The BCIN will also supply care coordination tools and resources for providers and their patients, elevating quality scores and allowing for a more comprehensive measurement of success. Additionally, the BCIN will support electronic reporting of quality measures to public agencies.

To learn more about participating in the Beacon Community of the Inland Northwest, please visit http://www.inhs.info/sub. aspx?id=1598 or call (509) 232-8148.

Membership Recognition for December 2010 Thank you to the members listed below. Their contribution of time and talent has helped to make the Spokane County Medical Society the strong organization it is today.

30 Years Charles J. Miller, MD

12/18/1980

20 Years Gerald T. Inahara, MD H. Kennedy Cathcart, DO Jeffrey W. Karp, MD Kevin D. Sweeny, MD Michael J. Wymore, MD Michael R. Moore, MD

12/12/1990 12/12/1990 12/12/1990 12/12/1990 12/12/1990 12/12/1990

10 Years Sol Barnett, MD Elizabeth A. Grosen, MD Erin A. Church, MD Paul T. Dunn, MD Scott B. Ahrndt, PA-C Susan M. Laing, MD Thomas J. Bassler, Jr., MD

12/1/2000 12/13/2000 12/13/2000 12/13/2000 12/13/2000 12/13/2000 12/13/2000

We are in need of more physicians to whom we can refer patients. Wouldn’t you like to be part of this service, which assists both the physician and the patient? Is your practice able to accept new patients? If so, please let us know by calling 325-5010, and we’ll fax you a Medical Referral Update form to complete and return.

We welcome physicians in all specialties, but our greatest need is for primary care physicians – especially those who accept Medicare and/or Medicaid!

December SCMS Message 14

An interview with Deb Harper, MD - WSMA Past President Keith Baldwin SCMS CEO Dr. Harper, to start our discussion, please give us some background on your current activities, e.g. your specialty, practice setting, WWAMI responsibilities, WSMA activities over the years.

I work as a general pediatrician for Group Health two days a week. One half day a week I do child abuse exams and consults at Partners with Families and Children. Two and a half days a week I work for the UW School of Medicine helping coordinate clinical clerkships and electives for our students. I became involved in organized medicine for a couple of reasons. One was I was ‘volunteered’ to serve on committees at Valley Hospital. Another was that, when our boys were in elementary school, I would only serve on boards that met on Wednesdays, as that was the day Bob had the boys in his karate class. I served on the SCMS Board of Trustees and became very interested in measuring the quality of medical care in outpatient settings.

Describe for us in a little more detail the WSMA Presidency, what is involved in serving, how you got to this point in your WSMA service and what’s next?

Bwaaah ha ha ha (demented, power mad, cackle). Well, I always wanted the chance to be the Boss of All the Doctors. That’s a joke and usually gets a laugh when I’m speaking to physicians. The WSMA Presidency is like being in a tiny red plastic kayak trying to turn a big tanker. You don’t have personal influence, but as part of a large group of physicians you do get to participate in many game-changing events. It does take a lot of time. I was able to take three months off from my clinical work so I could travel

around the state and meet with physician and physician assistant groups and hear their concerns and ideas. I was able to testify in Olympia about our ideas.

Tell us what activities you enjoyed the most, why and how you think your background and training prepared you for that role.

I most enjoyed being with physician and physician assistant groups. Wow, what a select group of smart people who understand science and evidence and can have civil discussions.

It was a privilege to serve them.

What advice would you give the President- Elect as he begins to serve his year in the Presidency?

Enjoy yourself. And be sure to get enough sleep!

Finally, congratulations on being a role model for professional service to your colleagues. Do you have any comments for the profession that might help prepare physicians for the leadership challenges of the future, especially with the passage of healthcare reform?

I think we will see the needs of physicians change as more and more of us become employed and as more of us become closely associated with hospitals. Although everyone else thinks physicians will be driven to larger groups, I look around the world and see that in every country, no matter their healthcare system and financing, have physicians in small groups as well as large ones. I think upcoming leaders will need to be able to find common interests with employed physicians, independent physicians, proceduralists and primary care. I hear a lot of doctors who don’t want to be in leadership, they don’t want to become co-opted. I think they are wrong, I think if we don’t step up, who will. I want to see physicians as the leaders of healthcare in this country. I encourage all physicians to become involved in their group’s practice, hospital committees, organized medicine and the community at large. I invite our Spokane physicians to come to the WSMA Leadership Conference in Lake Chelan on May 13-14, 2011. It’s a great way to get started; it’s family friendly and casual, too.

December SCMS Message 15

FYI Tobacco Quitline Referring your patients who use tobacco to the Washington Tobacco Quitline for help in quitting may increase their chances of being successful. One way to do this is through the FAX Referral System. You and your patient fill out a form, the patient signs it and you fax it to the Tobacco Quitline. It’s quick and confidential.

Online fax referral training is available to help you understand this process. It gives you protocol and referral forms to download and use in your practice. You can get CME credits for this training.

Find the online training course at www.faxreferral.org.

Washington Receives Planning Grant for Health Insurance

Advanced Care Planning Covered by Medicare On November 2, CMS pre-posted the physician payment final rule, addressing changes to the physician fee schedule and other Medicare Part B payment policies. In welcome news, the revisions add “voluntary advance care planning” to the definition of both “first annual wellness visit” and “subsequent annual wellness visit” for the purposes of reimbursement. “Voluntary advance care planning” means assisting the patient in preparing an advance directive and a discussion of whether the physician is willing to follow the patient’s advance directive. WSHA has long been a supporter of better conversations and documentation between patients and their caregivers about their end of life wishes. CMS also issued responses to several comments received.

The official Federal Register publication will occur on November 29. (Taya Briley, tayab@wsha.org).

Exchange The Washington State Health Care Authority applied for a State Health Exchange Grant, receiving close to $1 million for planning and implementing a state-based health insurance exchange as part of the federal health care reform law. The federal grant will be used to develop a plan focusing on cost containment and quality, and assessing the information technology infrastructure necessary to support the exchange. Last month, California became the first state to enact legislation to create a state-based exchange. (Dekker Dirksen, dekkerd@wsha.org) Many Washington Hospitals Recognized for Stroke Care The Weekly Report was remiss in congratulating only two of the 13 hospitals recognized by the American Heart Association/ American Stroke Association. The hospitals earned awards for their success in using “Get With The Guidelines” to improve quality of care for heart disease and stroke patients. Washington honorees include: Central Washington Hospital, Wenatchee, Silver Evergreen Hospital Medical Center, Kirkland, Silver Plus Harborview Medical Center, Seattle, Gold Legacy Salmon Creek Medical Center, Vancouver, Gold Plus Northwest Hospital & Medical Center, Seattle, Silver Overlake Hospital Medical Center, Bellevue, Gold Plus Providence Regional Medical Center Everett, Everett, Gold Plus Providence Sacred Heart Medical Center, Spokane, Gold Plus Providence St. Peter Hospital, Olympia, Silver Plus St. Joseph Medical Center, Tacoma, Silver Swedish Medical Center, Seattle, Gold Valley Medical Center, Renton, Gold Silver Plus Virginia Mason Medical Center, Seattle, Gold Plus Hospitals who received a gold award followed treatment guidelines at least 85 percent of the time and have maintained this performance level for consecutive twelve-month intervals.

Silver award hospitals maintained this performance level for at least twelve months. The plus designation represents a current gold or silver award and additional 75 percent compliance with module specific quality measures for at least twelve consecutive months. (Beth Zborowski, bethz@wsha.org).

December SCMS Message 16

Continued from page 13 SCMS has plans for five CMEs in 2011, including one in conjunction with the Primary Care Update Conference. SCMS will work with Dr. Newkirk to provide AAFP credit for the CME in addition to CAT I credit.

The SCMS EC approved a new security badge, for purchase, for multi-hospital security access in July for all members.

An EWU MBA/Health Certificate Intern completed a research project to analyze and develop plans to meet the needs of employed physicians who are members of the SCMS. The results will be provided to the membership in early 2011.

The SCMS website added features such as video of significant events involving members, a photo archive, hot topics section and other improvements. The BOT updated the Advertising Policy which finalized a new Agreement with Quisenberry Marketing for paid advertising on the SCMS website and Newsletter. In addition, Dr. Pope suggested and George McAlister created an “EMR Wiki” to encourage best practices in the use of the physician office EMR. An Editorial Calendar was approved by the EC for the Newsletter, to focus attention on topics of interest.

Keith Baldwin created a new concept for the Circle of Friends program, a “relationship management program” to support recruitment and retention of physicians and complement the Medical School initiative. The new name is “Community of Professionals.”

Sarah Bates was hired for Sales and Marketing of the Medicor program in September to facilitate the Medicor Strategic Plan.

Keith Baldwin and Karen Hagensen developed several office space alternatives and after review the current lease was extended for five years. The EC approved an update to the SCMS Conference Room to provide greater flexibility.

Dr. Clyde presided over a meeting of the four hospital Medical Staff Officers with Tim Layton, JD and Denny Maher, JD, MD, presenting Medical Staff Bylaw information and offering their legal counsel for Medical Staff Organizations under the auspices of PLS-WA.

The Drama of Health Insurance Equals Trauma to Your Bottom Line Brad Davis CEO/President – On Stage Health The midterm election results have been tallied. Change is occurring in America and in the worlds of health and health insurance.

While employers value healthy employees and employees appreciate a company who offers health promotion benefits, a problem arises when people think that having health insurance means they are healthy. Definitions: Health is the degree of physical well being a person enjoys while health insurance is one of several

methods to pay for the delivery of healthcare. An illustration: Think of the difference between your home and home insurance or your car and car insurance.

Countless employers pay a portion or all of employees’ health insurance costs; some even pay costs for family members. In spite of increasing health insurance rates, though, the health of people often tracks a different trajectory. Healthy employees do not have to be as expensive as many benefit plans are!

Let’s evaluate three “health benefit” approaches for business owners: UÊ Going “bare” - everyone hopes for the best with no consideration of how health is achieved, maintained or renewed. We all know something about going “bare.” It’s fun in the sun but not in the wind or snow. Going “bare” ignores the principles of health and hopes that employees can over-eat, under-exercise, smoke, lose sleep, and neglect primary care and still lead a profitable and productive life.

UÊ Trauma thru Drama - businesses pay exorbitant sums to have other companies determine how employees use medical services.

Trauma thru Drama is where we transfer healthcare decisions to companies who stipulate who people can see, how often they can go and how much medical care they can receive. The results are working around the system or trying to fit healthcare into “deductibles” and “eligibility.” A person is not rewarded for going to the health club or skipping dessert.

UÊ Alternatives come in a variety of colors and textures. Examples follow: The newest alternative is a physician services membership plan that allows people to see their doctor while not paying a co-pay or deductible. On Stage Health provides this type of plan through a growing number of physician groups [www.OnStageHealth. com]. Monthly dues are minimal ranging from $39 - $69. Included is nearly every service occurring in primary care physicians’ offices; sometimes even lab tests and menu priced X-rays are included.

Freedom Health Group, a nurse practitioner-based model is also available locally [www.FreedomHealthGroup.com].

A second alternative is an HSA [Health Savings Account] linked with a high deductible insurance plan that works together or independently to offer pre-tax money and lower premiums for catastrophic medical needs. Those plans make sense just like having house insurance in the event your house burns down.

Primary care services generally comprise 75% of a person’s lifetime medical care, improve a person’s immediate quality of life and may reduce other medical expenses.

UÊ Physician membership plans are an increasingly popular solution for individuals and employers and give direct access to medical care and expert advice.

UÊ If a person or company can add a lower premium, high deductible insurance plan they can protect against catastrophic loss.

UÊ Pre-tax savings tend to be wisely and effectively used by individuals.

Your ballot is open….take action!

To your health and wealth!

December SCMS Message 17

In the News

Meetings and Conferences

Dwain Judah, PA-C Northwest Neurological, PLLC, the office of David R. Greeley, M.D, FAAN, is pleased to introduce Dwain Judah, PA-C. Dwain began his career in the medical field within the scope of practice in the US Air Force. Upon graduation from the University of Washington, Dwain has experience in Family Practice, Emergency Medicine and Cardiothoracic Surgery. He is dedicated to providing superb care with excellent communication within the neurological community.

Update in Internal Medicine 2011: Sponsored by the Spokane Society of Internal Medicine. Conference will be held on February 25-26, 2011 at the Spokane Convention Center. For more information contact Merry Maccini at (509) 468-0236 or email spokanesim@gmail.com.

Institutional Review Board (IRB) – Second Thursday of every month at noon at the Heart Institute, classroom B. Questions regarding the process, please contact the IRB office at (509) 358-7631.

Caduceus Recovery Group Meeting for Healthcare Professionals – Meets every Thursday evening, 6:15 p.m. – 7:15 p.m., 626 N. Mullan Rd, Spokane. Contact (509) 928-4102 for more information. Non-smoking meeting for Healthcare Providers in recovery.

Physician Family Fitness Meeting – For physicians, physician spouses and their adult family members to share common problems and solutions experienced in the course of a physician’s practice and family life. Tuesdays from 6:30 p.m. – 8 p.m. at the Sacred Heart Providence Center for Faith and Healing Building (Room 14), due east of the traffic circle near the main entrance of SHMC. Format: 12-Step principles, confidential and anonymous personal sharing. No dues or fees. Guided by Drs. Bob and Carol Sexton. The contact phone number is (509) 624-7320.

Brian Seppi, MD Dr. Michael Weinstein, 2nd Vice President on the WSMA Executive Committee, is leaving Washington State shortly for a new position in Palm Springs. He was an excellent officer and contributor to the WSMA’s leadership.

In accordance with the WSMA Bylaws, President Dr. Dean Martz appointed Dr. Brian Seppi to fill the remainder of Dr. Weinstein’s term on the Executive Committee. The WSMA Board of Trustees approved Dr. Seppi’s appointment. Dr. Seppi will serve through the end of Dr. Weinstein’s term that runs through the final session of our annual meeting in September.

Dr. Seppi is an internist and the Medical Director of The Physicians Clinic of Spokane. He was the 2007 Spokane County Medical Society Board President and has been a member of the WSMA Board of Trustees since 2009.

December SCMS Message 18

CLASSIFIED ADS RE AL ESTATE

MEDICAL OFFICES/BUILDINGS

Luxury Condos for Rent/Purchase near Hospitals. 2 Bedroom Luxury Condos at the City View Terrace Condominiums are available for rent or purchase. These beautiful condos are literally within walking distance to the Spokane Hospitals (1/4 mile from Sacred Heart, 1 mile from Deaconess). Security gate, covered carports, very secure and quiet. Newly Remodeled. Full appliances, including full-sized washer and dryer. Wired for cable and phone. For Rent $ 850/month. For Sale: Seller Financing Available. Rent-to-Own Option Available: $400 of your monthly rent will credit towards your purchase price. Please Contact Dr. Taff (888) 930-3686 or dmist@inreach.com.

Good location and spacious suite available next to Valley Hospital on Vercler. 2,429 sq ft in building and less than 10 years old. Includes parking and maintenance of building. Please call Carolyn at Spokane Cardiology (509) 455-8820.

FOR SALE with Lease Option. Beautiful custom-built lake home with attached “in-law house.” Main home has two bedrooms, two baths and complete office. Rock garden, private driveway with security gate, two car garage, AC, wood floors, central VAC, fireplace, washer & dryer. “In-law” house has 2 bedrooms, 1 bath, office and separate carport. Lease option - $1,200 for main house; $800 for in-law suite or $2,000 for both. Country living but close to Cheney and Spokane. Contact Jerry Krause, jerrykrause3@aol. com or krausej@athletics.gonzaga.edu or (509) 280-8179.

All Costs Included – Upscale View Condo One of a kind, separate entrance condo built into an upscale home on the north side. (Owners rarely in residence) This home is located in a quiet, upscale-gated community, with panoramic views overlooking a small lake and golf course. It is totally turnkey furnished, dishes, linens, cleaning supplies etc. All new appliances, modern decor.

One bedroom (king size bed/rollway for guests) one bath, laundry room w/full size wash/dryer and one car garage with extra storage. Heat/AC, Utilities/Water, Cable TV, Internet/Wi-Fi, Long Distance phone. Golf/walking trails right out the door. Close to Holy Family Hospital and Whitworth College. Please call (509) 954-8339 for details. Also willing to rent "unfurnished.”

YOU’RE INVITED TO

WEBINAR FOR ELIGIBLE P ROFESSIONALS ABOUT THE M EDICARE AND M EDICAID E LECTRONIC H EALTH R ECORDS (EHR) INCENTIVE P ROGRAMS

December 07, 2010 – 8:00 AM - 9:00 AM (PST) Location: Webinar Presenters: CMS – Region 10 Event Details: The Medicare and Medicaid EHR incentive will provide incentive payments to Eligible Professionals as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. The programs begin in 2011.

Northpointe Medical Center offers modern, accessible space in the heart of a complete medical community. If you are interested in locating your business here, please contact Tim Craig at (509) 6886708. Basic info: $23 sq/ft annually. Full service lease. Starting lease length 5 years includes an $8 sq/ft tenant improvement allowance.

Available space: *Suite 210 - 2286 sq/ft *Suite 209 - 1650 sq/ft *Suite 205 - 1560 sq/ft *Suite 302 - 2190 sq/ft Sublease: Furnished Medical Office Space – Shared suite including all furniture and exam room equipment. Two exam rooms, one provider office, one nurse’s station and shared surgery suite, medical records storage area, reception and waiting area. 963 sq ft total, original lease $23/sq ft.- will negotiate lower rate. Excellent location in a full-service medical building with lab and radiology services. Call (509) 981-9298.

South Hill – on 29th Avenue near Southeast Boulevard – Two offices available in a beautifully landscaped setting. Both offices are corner suites with windows down six feet from the ceiling.

Generous parking. Ten minutes from Sacred Heart or Deaconess Hospitals. Phone (509) 535-1455 or (509) 768-5860.

Indian Trail Professional Building - 11,243 sf professional medical/ office building at 5011 W. Lowell Ave. Main floor space located off of the main floor entrance -4,389 sf of Class “A” General Medical Practice or Urgent Care Center space. Tenant Improvement Allowance is available, subject to terms of lease. Floor plans and marketing materials - emailed upon request. Contact Patrick O’Rourke, CCIM with O’Rourke Realty, Inc. at (509) 624-6522 or cell (509) 999-2720. Email: psrourke@comcast.net.

North Spokane Professional Building has several medical office suites for lease. This 60,000 sf professional medical office building is located at N. 5901 Lidgerwood directly north of Holy Family Hospital. The building has various spaces available for lease from 635 to 6,306 usable sq ft. The building has undergone extensive remodeling, including two elevators, lighted pylon sign, refurbished lobbies, corridors and stairways. Other tenants in the building include, pediatricians, dermatology, dentistry, pathology, and pharmacy. Floor plans and marketing materials emailed upon request. Tenant Improvement Allowance available, subject to terms of lease. Contact Patrick O’Rourke, CCIM, with O’Rourke Realty, Inc. at (509) 624-6522 or cell (509) 999-2720. Email: psrourke@comcast.net.

For more information go to CMS.gov December SCMS Message 19

When it comes to your family’s ER care, we’ve got you covered.

For all kinds of emergencies and people of all ages, our Emergency Department has the specialized physicians, staff and facilities to provide quality care.

& Level III Certified Trauma Center & Pediatric care staff experienced in treating childhood conditions ranging from asthma to injuries

& Pediatric MRI and CT & Close-to-home location with easy access right off I-90 & Fast Track Unit for less serious emergencies

Visit www.spokanevalleyhospital.com for more information.

12606 East Mission Spokane Valley

Fa m i ly E m e r g e n c y Ca r e . R i g h t H e r e .

December SCMS Message 20

NOTICE As of November 1, all Project Access medical claims are processed

by First Choice Health Network. Please update your records and send all claims to:

First Choice Health Network P O Box 2289 Seattle, WA 98111-2289 Confirmation responses from First Choice Health Network will not be sent. If you have any questions regarding patient eligibility, please contact Project Access at (509) 532-8877.

Physician Health is Important.

Eastern Washington Physician Health Committee We are available to assist you in the following areas: t t t t t t t t t

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ɨJT DPNNJUUFF B GVTJPO PG UIF GPSNFS 4$.4 DPNNJUUFF BOE POF JODMVEJOH NFNCFST PG NFEJDBM TUBĊT PG $PNNVOJUZ )FBMUI 4FSWJDFT BOE 1SPWJEFODF )FBMUI $BSF )PTQJUBMT NFFUT RVBSUFSMZ UP FEVDBUF PVSTFMWFT BCPVU QIZTJDJBO IFBMUI JTTVFT SFWJFX VUJMJ[BUJPO BOE TBUJTGBDUJPO XJUI UIF 8FMMTQSJOH &BSMZ "TTJTUBODF 1SPHSBN &"1 BOE QMBO BDUJWJUJFT QSPHSBNT BOE SFTPVSDFT UP BEESFTT OFFET JO UIFTF BSFBT 4PNF PG UIF HVJEJOH QSJODJQMFT PG UIJT DPNNJUUFF BSF The medical profession and healthcare community should foster physician well-being A sense of community with one’s peers is vital to personal well-being Changes in the healthcare environment and contributing to personal and professional challenges and new stressors for physicians Physicians should have resources available to them to anticipate and manage episodic personal issues

COMMITTEE MEMBERS Jim Shaw, MD, $IBJS Steve Brisbois Michael Metcalf Paul Russell Phil Delich Michael Moore

Robert Sexton Jim Frazier Mira Narkiewicz Patrick Shannon Deb Harper December SCMS Message 21

Sam Palpant Alexandra Wardzala Mike Henneberry Tad Patterson Hershel Zellman

December SCMS Message 22

Editorial “There is a tide in the affairs of men, which taken at the flood, leads on to fortune. Omitted, all the voyage of their life is bound in shallows and in miseries. On such a full sea are we now afloat. And we must take the current when it serves, or lose our ventures.”

William Shakespeare in Julius Caesar While the term “tide” may seem an understatement, there is no question that this quote from William Shakespeare feels particularly apt today for those of us who have dedicated our lives to medicine. The tide, or tsunami, we are facing is an overwhelming combination of factors that will change the practice of medicine as we know it.

Payment reform, meaningful use, accountable care organizations, health information exchange and mergers and acquisitions - It seems that every day there is a new initiative focused on fixing healthcare and new corporate strategies for responding to those initiatives. In such an environment it is understandable for individuals or organizations to hesitate -- to wait for more information before making a decision or to sit on the sidelines until the world stabilizes before moving ahead.

There are certainly risks from moving ahead. The largest is the risk of making an expensive mistake from selecting the wrong technology or the wrong partner. But there are also risks from hesitating – the loss of opportunities for important strategic alignments or for enhanced financial reimbursement. The greatest risk is the loss of critical opportunities to shape the environment and not just respond to it. Everyone practicing medicine today needs to weigh these risks.

As physicians in the Inland Northwest we are fortunate to live in a region where historic decisions by many of our Medical Society members and healthcare organizations in our communities have reduced the risks from moving ahead. We are not starting from scratch in responding to all of the coming environmental changes.

We have a long history of early adoption of health information technology, resulting on one of the highest rates of Electronic Medical Record penetration in the country. For many years we have been receiving electronic data about our hospitalized patients along with their lab tests and imaging results.

We also have a long history of collaboration, between rural and urban practices and within the Spokane and Coeur d’Alene metropolitan areas. More than fifteen years ago the physicians who first organized the Spokane County Medical Society Informatics Committee took a stand against competition based on patient health information. The sharing of health information is critical to our ability to care for our patients.

Because of this history, we as physicians and as a community stand to lose more by hesitating than by moving ahead. If we hesitate, we risk the loss of our long-standing collaborative approach to healthcare along with the willingness and ability to share patient information for better delivery of care. In the rush to establish market position, we risk missing out on opportunities to take advantage of shared community infrastructure that can make all of our practices more efficient and effective.

Physicians were instrumental in driving collaboration around health information in this community, and we can and should continue to promote and advance this important concept. Ensure that community collaboration and health information sharing are included in any new business alliances. Support and participate in community initiatives such the Beacon Community of the Inland Northwest. Sharing key tools and infrastructure such as those that will be provided by the Beacon project will not only benefit our patients, but will help us all have more effective and more satisfying practices.

In keeping with the quote at the beginning of this piece, we’ll close with another tidal reference – time and tide wait for no one.

The coming year will bring us tremendous opportunities as well as challenges. Let’s not miss the tide.

Kevin Kavanaugh – Chair Jon Copeland - Vice Chair David Bare Carl Bodenstein Jeffrey Butler Gary Cantlon Don Cubberley Gordon Decker Bryan Fuhs Richard Gascoigne

Amanda Gray David Henzler David Hoak Stefan Humphries Frank Otto Samuel Palpant Vijayakumar Reddy Brian Seppi Glen Stream Deborah Wiser

Congratulations to IMRS Residents and Faculty Judy Benson, MD Program Director Internal Medicine Residency Spokane Internal Medicine Residency Spokane (IMRS) residents and faculty participated in the annual American College of Physicians (ACP) state meeting in early November. Drs. Anupam Arora and Priya Kanwar were chosen to present case reports to the group. Congratulations to Dr. Arora who won the resident abstract competition. He will be going to San Diego in April for the National ACP meeting.

The IMRS residency team comprised of Drs. Deepthi Mani, Priya Kanwar and Dori McAbee gave a very strong performance in the Resident Jeopardy Competition and the team came in second place. They answered some incredibly difficult questions.

Finally, the IMRS faculty, Drs. Sam Palpant and Matt Hollon, gave several excellent sessions.

Kudos to all participants.

December SCMS Message 23

The following physicians/physician assistants have applied for membership, and notice of application is presented. Any member who has information of a derogatory nature concerning an applicant’s moral or ethical conduct, medical qualifications or such requisites shall convey this to our Credentials Committee in writing 104 S Freya St., Orange Flag Bldg #114, Spokane, Washington, 99202.

PHYSICIANS

Wade, Gary L., MD Diagnostic Radiology Med School: Loma Linda U (1979) Practicing with Inland Imaging Associates, PS since 11/2010 Woerlein, Christoph T., MD Gastroenterology Med School: Christian-Albrechts U, Germany (1995) Practicing with Rockwood Clinic, PS since 10/2010

PHYSICIAN ASSISTANTS Fernandes, Neville O., MD Anesthesiology Med School: U of Texas Medical Branch Internship/Residency: Vanderbilt U Medical Center (2004) Practicing with Anesthesiology Associates, PS beginning 1/2011

Holmstrom, Timothy E., PA-C Physician Assistant Med School: U of Washington, Medex Northwest (2010) Practicing with Rockwood Clinic McLeod, Pamela S., PA-C Physician Assistant Med School: Cornell Medical School (1980) Practicing with Inland Neurosurgery and Spine Associates since 10/2010

Hercl, Grace, DO Internal Medicine Med School: Ohio U College of Osteo Medicine (1999) Internship/Residency: Sun Coast Hospital (2002) Practicing with Sound Physicians beginning 12/2010

Wilson, Sarah L., PA-C Physician Assistant Med School: U of Washington, Medex Northwest (2010) Practicing with Inland Cardiology Associates beginning 12/2010

Klarnet, Jay P., MD Medical Oncology Med School: SUNY (1980) Internship/Residency: Millard Fillmore Hospital (1983) Fellowship: U of Washington (1987) Practicing with Rockwood Clinic since 11/2010 Stewart, David C., MD Anesthesiology Med School: Virginia Common Wealth U (2001) Internship/Residency: UC, San Diego (2006) and (2010) Practicing with Anesthesiology Associates, PS beginning 1/2011

PHYSICIAN ASSISTANTS PRESENTED A SECOND TIME

PHYSICIANS PRESENTED A SECOND TIME

Cassel, Maria C., PA-C Physician Assistant Med School: U of Washington, Medex Northwest (2004) Practicing with Providence Health Services dba NW Heart & Lung Surgical Associates since 10/2010

Anthes, Tara B., MD Diagnostic Radiology Med School: U of Washington (2003) Practicing with Inland Imaging Associates, PS beginning 1/2011

Forsyth, Ryan, D., PA-C Physician Assistant Med School: Idaho State U (2010) Practicing with Inland Vascular Institute since 9/2010

Deegan, Janet R., MD Family Practice Med School: U of Wisconsin (1988) Practicing with Providence Physician Services since11/2010

Hedden, Elizabeth M., PA-C Physician Assistant Med School: U of California, Davis (1988) Practicing with Rockwood Clinic, PS since 9/2010

Hartnett, Kimberly L., MD Surgery/ Colorectal Surgery Med School: U of North Carolina (2000) Practicing with Surgical Specialists of Spokane since 11/2010

Martin, Jennifer L., PA-C Physician Assistant Med School: U of Washington, Medex Northwest (2004) Practicing with Northwest Cardiothoracic & Transplant Surgeons, PS since 10/2010

Icenogle, Deborah A., MD Pediatrics Med School: U of New Mexico (1975) Practicing with Providence Pediatrics North beginning 12/2010

December SCMS Message 24

at rrehn@newmg.org. Mailing address is NorthEast Washington Medical Group, 1200 E Columbia, Colville, WA 99114. Visit our website at www.newmg.org for more information.

POSITIONS AVAILABLE INTERNAL MEDICINE POSITION OPENING – NorthEast Washington Medical Group is currently recruiting for a full-time (Monday through Thursday) Internal Medicine physician to join us in beautiful Colville, a rural northeast Washington community located 75 miles north of Spokane. NorthEast Washington Medical Group serves a surrounding area of approximately 30,000 in the very rural tri-county area. This is an outpatient based Internal Medicine position with call. There is supporting physician call in Family Practice, OB, surgery, and orthopedics. Our clinic physicians have privileges at Providence Mount Carmel Hospital, a 25-bed, full service critical access facility with 24/7 ER and ancillary service coverage. This is an outstanding practice community located in the middle of a wonderful recreation area with limitless opportunities for outdoor activities. Qualified individuals should contact Ramon Canto, MD, Internal Medicine Medical Director, by phone at 509684-7706 or Ron Rehn, D.H.A., Chief Executive Officer at 509684-7723 or e-mail at rrehn@newmg.org. The mailing address is NorthEast Washington Medical Group, 1200 E Columbia, Colville WA 99114. Visit our website at www.newmg.org for more information about Colville Medical Center P.S. PHYSICIAN OPPORTUNITIES AT CHAS – At Community Health Association of Spokane (CHAS), we believe doctors should practice what they are passionate about: serving patients and the community. We are looking for physicians to join our great team!

Enjoy a quality life/work balance and excellent benefits including competitive pay, generous personal time off, no hospital call, CME reimbursement, 401(k), full medical and dental, NHSC loan repayment and more. Experience pure patient care at CHAS. To learn more about physician employment opportunities, contact Kelly McDonald at (509) 444-8888 or kmcdonald@chas.org.

URGENT CARE POSITION – First Care Med Centers has four Urgent Care locations in Spokane, WA. We are seeking a Board Certified physician with comparable Urgent Care experience for a full-time position. Excellent salary and benefits package with flexible work schedule - 12-hour shifts and no call. Please contact Evelyn Torkelson at torkele@empirehealth.org or (509) 473-7374.

EMERGENCY ROOM PHYSICIAN POSITION OPENING – NorthEast Washington Medical Group is currently recruiting for a full-time ER physician to join us in beautiful Colville, a rural northeast Washington community located 75 miles north of Spokane.

NorthEast Washington Medical Group consists of 27 providers that serve a surrounding area of approximately 30,000 in the very rural tri-county area. We offer flexible hours for an ER physician or FP physician with Emergency Room experience. Our ER physicians enjoy working in the new emergency department at Mount Carmel Hospital, a 25-bed, full service critical access facility with 24/7 ER and ancillary service coverage. This is an outstanding practice community located in the middle of a wonderful recreation area with limitless opportunities for outdoor activities. Qualified individuals should contact Ed Johnson, MD, ER Medical Director, via phone at 509-685-7831 or e-mail at edjohnsonmd@hotmail.com or Ron Rehn, DHA, Chief Executive Officer, via phone at 509-684-7723 or e-mail

OUTREACH CLINIC AT HOUSE OF CHARITY – This is an opportunity to volunteer and bring to the underserved in our community first line medical care. We need one or two more doctors to help us. We see the homeless, predominantly, two afternoons each week. Join four Board MDs and twelve RNs to rotate once or twice monthly in an excellent, well-equipped clinic with pharmacy. If you are completely retired, the state will pay for your medical license and malpractice. For more information and to sign up, call Dr. Arch Logan, Medical Director, at (509) 325-0255 or Ed McCarron, Director of the House of Charity, at (509)624-7821.

PROVIDENCE PHYSICIAN SERVICES is recruiting for BE/BC Pediatrician and BE/BC Family Practice Physicians to join us in Spokane. Excellent opportunity to join a collegial, physician-led medical group affiliated with the region’s most comprehensive and caring hospitals. Providence offers generous hiring incentives, competitive compensation, comprehensive benefits and flexible work arrangements to fit individual needs. Providence Physician Services (PPS) is our physician-led network of more than 100 primary and specialty care physicians in multiple clinic locations in the greater Spokane area. PPS physicians offer exceptional patient-centered care as a reflection of our Providence values.

PPS partners with some of the region’s most advanced hospitals: Providence Sacred Heart Medical Center & Children's Hospital and Providence Holy Family Hospital in Spokane, and Providence Mount Carmel Hospital in Colville and Providence St. Joseph's Hospital in Chewelah. Providence Physician Services is part of Providence Health & Services, a not-for-profit network of hospitals, clinics and physician partners in Alaska, California, Montana, Oregon and Washington. Providence has a proud 150-year history in the West, and we continue to grow with the communities we serve. With more than 300 physician opportunities in virtually all specialties, we offer physicians diverse lifestyle choices, flexible work arrangements and robust practice support. Learn more at www.providence.org/ physicianopportunities or contact Mark Rearrick mark.rearrick@ providence.org or April Mayer april.mayer@providence.org.

PEDIATRIC HOSPITALISTS OPPORTUNITIES: If you would like the opportunity to participate in the growth of our pediatric services at Deaconess and Valley Medical Centers, please consider joining our multi-disciplinary team. We need four to five Pediatric Hospitalists to care for our general pediatric patients at either facility. You will be working with nurses with many years of pediatric expertise who are very excited about their work with children. You will be part of a team of hospitalists providing 24-hour coverage/365 days per year.

Please contact Evelyn Torkelson Director, Physician Recruitment, at torkele@empirehealth.org for more details.

December SCMS Message 25

Continued on page 27

December SCMS Message 26

Continued from page 25

EASTERN STATE HOSPITAL PSYCHIATRIST ESH, the 287-bed Joint Commission accredited, CMS certified state psychiatric hospital in eastern WA, is recruiting for a psychiatrist for one of the two long-term wards on the Forensic Services Unit. The psychiatrist would be the attending psychiatrist/team leader for 30 patients committed to the hospital under a court order of not guilty by reason of insanity. Salary is $161,472 annually with competitive benefits and opportunity for additional paid on-call duty (afternoons/nights/weekends/holidays). Twenty minutes southwest of Spokane, WA. Join a stable Medical Staff of 30+ psychiatrists, physicians and physician assistants. Contact Shirley Maike at (509) 5465.4352 or email maikeshi@dshs.wa.gov. Eastern State Hospital, PO Box 800, Medical Lake, WA 99022-0800.

EASTERN STATE HOSPITAL PHYSICIAN ESH, the 287 bed state psychiatric hospital in eastern WA, is recruiting for a family practice or internal medicine physician to provide medical care on the Adult Psychiatric Unit with a caseload of 30 patients. The physician would be part of the treatment team, which is comprised of the attending psychiatrist, social worker, RN, and recreation therapist. The physician will treat common medical conditions and refer for consultation to providers in the community for care that cannot be provided at ESH. Will supervise two certified physician assistants who provide care on other patient care units. Salary: $149,952 annually with competitive benefits. Twenty minutes southwest of Spokane, WA. Join a stable Medical Staff of 30 psychiatrists, physicians and Physician Assistants. Contact Shirley Maike, 509.565.4352, email maikeshi@dshs.wa.gov. Eastern State Hospital, PO Box 800, Medical Lake, WA 99022-0800.

SPOKANE REGIONAL OCCUPATIONAL MEDICINE has an exceptional opportunity for a physician to join one of the most well known occupational medicine clinics in the Spokane area. Spokane Regional Occupational Medicine has made a commitment to help improve or restore the health of workers who incur occupationally related illnesses or injuries. Our treatment approach takes a comprehensive view that encompasses the medical, psychosocial and functional outcomes of the injured worker and follows best practices as defined by Washington State L&I’s Center of Occupational Health and Education (COHE).

Spokane Regional Occupational Medicine is affiliated with Valley Hospital and Medical Center as well as Deaconess Medical center, and Rockwood Clinic. This affiliation provides exceptional administrative support, offers state of the art diagnostic services’ improving our ability to diagnose and treat, and a referral system that is unmatched. Spokane Regional Occupational Medicine invites you to see what we have to offer, please contact Evelyn Torkleson, physician recruiter at (509) 473-7374 or email at torkele@ empirehealth.org.

St. Luke’s Community Grand Opening Nicole Stewart Director of Marketing and Communications On November 30, 2010 St. Luke’s Community made its grand opening. Solely dedicated to physical and medical rehabilitation services, St. Luke’s Community is an innovative therapy space located in St. Luke’s Rehabilitation Institute.

St. Luke’s Community provided modules of real-life community settings. From the store, bank, library, office and restaurant to the bus, care and airplane, St. Luke’s Community is designed with the everyday mind. Patients can practice getting in a car and putting on their seatbelt. They can cross the street and navigate the curb. They can board a plane and a bus. It will challenge patients to reach personal goals, overcome barriers and achieve the best possible outcomes in their recovery so they can get back to living life to its fullest. Patients can practice real life… and get back to achieving theirs.

St. Luke’s Community is located in the lower level of St. Luke’s Rehabilitation Institute. As the largest freestanding rehabilitation facility and only Level 1 trauma rehabilitation hospital in the region, St. Luke’s Rehabilitation Institute serves thousands of patients each year who have suffered a stroke, spinal cord injury, brain injury or other illness or injury.

The module sponsors include Layman Law Firm, Red Lion Hotels Corporation, Spokane Transit Authority, Southwest Airlines, Tomato Street Italian Restaurant, Walgreens, Washington Trust Bank and Wendle Ford. Bouten Construction and Nystrom Olson Architecture helped bring the community to St. Luke’s patients.

For more information on St. Luke’s Community and ways to support the project, please contact the INHS Foundation at (509) 473-6099 or visit www.st-lukes.org/community.

December SCMS Message 27

December SCMS Message 28

PRSRT STD

SPOKANE COUNTY MEDICAL SOCIETY - ORANGE FLAG BUILDING 104 S FREYA ST STE 114 SPOKANE, WA 99202

U.S. Postage

PAID Spokane, WA Permit No. 512

ADDRESS SERVICE REQUESTED

Printed on GP Spectrum速 Paper: Certified by the Sustainable Forestry Initiative. Please recycle.

December SCMS Message 29