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July SCMS The Message Open2


Table of Contents

2013 Officers and Board of Trustees Anne Oakley, MD President David Bare, MD, President-Elect

To All the Members of the Spokane County Medical Society .

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Terri Oskin, MD Immediate Past President

Relevance of Your Medical Society – Yesterday, Today and Tomorrow .

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Shane McNevin, MD Vice President

Physician Assistants - Partners in the Medical Workforce .

Matt Hollon, MD, Secretary-Treasurer

Academic Health Science Center Steering Committee .

Trustees: Robert Benedetti, MD Audrey Brantz, MD Karina Dierks, MD Clinton Hauxwell, MD Charles Benage, MD J. Edward Jones, MD Louis Koncz, PA-C Gary Newkirk, MD Fredric Shepard, MD Carla Smith, MD

Hot Spotters Group Initiates Collaboration

Newsletter editor – David Bare, MD

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A Project Access Client Profile - Chad Ohl . Membership Recognition for July 2013 .

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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.

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Medical Education Expansion Ahead of Schedule .

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In The News .

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

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Retired Physicians Golf Tourney Another Success .

Spokane County Medical Society Message A monthly newsletter published by the Spokane County Medical Society.

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Regional Strategic Initiatives Update .

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continuing medical education .

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meetings/conferences/events .

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directory order form .

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csa brochure .

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scms members special event .

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“We,

too, must change as circumstances evolve .”

–Baldwin S pencer

July SCMS The Message Open3


To All the Members of the Spokane County Medical Society By Anne Oakley, MD SCMS President

The Spokane County Medical Society Foundation has sponsored several of the past presidents’ participation in Leadership Spokane, a non-profit organization dedicated to networking and training servant leaders for our community. I had the privilege of participating in this amazing program for the last nine months and graduated on June 13. The program focuses on all aspects of life in our community, including education, law enforcement, health care and more, introduced through a series of day-long programs and a lot of homework! My last assignment for the leadership class was to thank my sponsors and to formulate my own personal plan for becoming a leader in my community. This fits in very well with this issue of The Message, as it focuses on what we have accomplished and hope to accomplish for our members. The most rewarding part of the program was meeting and working with people from so many different businesses and organizations, all committed to self-improvement and community values. It is eye opening to see how generous many of our businesses are, including large health care organizations, private groups of doctors and countless individual members. My goal is for the Medical Society (the physician and PA members) to be recognized for the tremendous contributions already being made, as well as to improve our public image by becoming even more involved. Considering what our individual members have accomplished so far, just think what a focused group could accomplish.

I have learned through my interactions in this program that individual physicians are not viewed as particularly generous donors to community causes. Most people have no idea the amount of free or reduced price care given in this town (most construction company owners do not give away every third or fourth house they build!), nor do they understand the debt level many of our members carry or the late age at which they actually begin making any money. We are the only ones who can figure out how to improve our image in this arena and the Medical Society is perfectly poised to provide a positive face in our community for all of us. We really are already doing so much, it is time to improve our PR! It is also time to reconnect with each other. I became involved with the Medical Society because I realized that as an individual I had no political voice. I now realize that there are many more reasons to connect with each other and promote not only what we do, but also our visions for a healthy community. Health care is in very uncertain times, but we are not completely powerless— especially together. Our new CEO, Dean Larsen, has many excellent ideas for ways to make our society a group worth joining. Join with me in supporting those plans. Start or continue your involvement and get to know your local colleagues and your community. Please plan on getting together with other members and their families at the SCMS Members Special Event to be held at Triple Play and Raptor Reef on Saturday, September 7. (See page 17 for more details!)

July SCMS The Message 1


Relevance of Your Medical Society – Yesterday, Today and Tomorrow

The county medical society still serves all the purposes today that it was founded upon and does so for the local practice of medicine regardless of whether independent or employed physician/physician assistant, solo practice or group practice, specialty or primary care.

By Dean F. Larsen, MA, CAE CEO, SCMS

As the new guy on the block with a steep learning curve, I have so far found many more similarities than differences between the Spokane County Medical Society and the two-county medical society I spent seventeen years with in Oregon. Chief among those similarities is the question of relevance and value of county medical societies in today’s medical community. My answer to that question is yes, we most definitely have relevance and value; likely even more today than in decades past. When SCMS was founded in 1888 Grover Cleveland was president; statehood for Washington was a year away; Spokane was still officially the incorporated city of Spokan Falls with a population of approximately 13,000 and there was only one hospital in the region, Providence Sacred Heart, a 31-bed wood building located at the current site of the Spokane Convention Center. Certainly the practice of medicine was simpler in a multitude of ways than it is today. The medical society was founded on the very cusp of the twentieth century, an unprecedented century of exploration, discovery, cultural and industrial change that certainly included medicine at every level. So why did the twenty physicians known to be practicing in the region during that time think it necessary to form a medical society when they might have just as easily continued their independent practices with little or no interaction? A little research reveals that chief among their decision to organize were: to provide the opportunity to meet with colleagues to discuss best practices, exchange information or seek counsel in a particularly difficult case, review the latest developments in medicine and present a united voice or council to elected officials and the community on issues related to health. Fast forward to 2013 and today’s medicine is certainly nothing like it was in the late 19th or early 20th centuries. However, it might be argued that the potential changes, explorations and discoveries of the 21st century will make the last century look relatively static. Since the beginning of the last century, hospitals have grown from simple structures to healthcare systems and the practice of a solo physician providing nearly all the care for a patient over their lifetime has evolved to a community of providers with a wide range of training, education and focuses. Certainly the knowledge of diseases and human physiology as well as treatment options are far beyond anything the SCMS founding physicians could ever conceive. But it is exactly all these changes in medicine that make your county medical society even more relevant today than it was in 1888.

A danger inherent in today’s practice of medicine is to become so myopic inside a specialty, sub-specialty, practice or system of medicine that the individual physician/physician assistant becomes insulated from the larger practice of medicine. SCMS is the best prescription for this specific myopia. Boiled down to its essence, SCMS is focused on our members and the community’s health. Simple! No goal to raise dividends for shareholders, no chasing market share, no alternate or hidden agendas, no contract negotiations and no partisan or shifting politics. Your medical society provides the opportunity to foster strong collegial relationships, participate in local government as well as state and federal government through our affiliation with WSMA, interact with the local business community, promote the profession of medicine and actively foster access to or quality of healthcare in our area through a plethora of programs and initiatives. Sometimes we do that from a leadership position and sometimes as a participant, but always as an honest agent and good partner. Over the next year we will be building on current strong, successful programs while seeking and implementing new programs and services. Our success depends on your energy, participation, suggestions and insights. I invite you to attend an SCMS event, participate in the governance, serve on a committee or volunteer for a program. No matter how you choose to participate, I’m pretty sure you will find interacting with colleagues outside your specific practice both fun and rewarding. So, does today’s county medical society still have relevance? Borrowing from the vernacular of the Midwest… You Betcha!

I make house calls. Jurene Phaneuf SPECIALIZING IN P H Y S I C I A N R E L O C AT I O N S

July SCMS The Message 2

C E L L : 5 0 9 -2 9 4 -119 2 O F F I C E : 5 0 9 - 5 3 5 -74 0 0 J U RE N E P H A N EU F @ G M A IL .C O M


Physician Assistants - Partners Academic Health Science in the Medical Workforce Center Steering Committee By Louis Koncz, PA-C President, Washington Academy of Physician Assistants SCMS Board of Trustees

By Gary Knox, MD Rockwood Health System

As we all prepare for the Affordable Care Act to be implemented in January there are unknowns as well as known challenges. Those include, not fully understanding consumers/ patient-centered care, staying with a previously successful business model for too long or failing to understand that change is constant. There is going to be a need to re-think staffing models from what has been traditionally accepted to what is innovative in terms of resource allocation to include being evidence-based, costeffective, produces the best outcomes and patient-centered. The pressures surrounding healthcare delivery are many including declining third-party reimbursement, increased demands of an aging population, new entrants to the health care marketplace, emerging technology (knowing when to and when not to use), increased regulatory and reporting burdens and new economic realities and care models. These forces place increased demands on all healthcare professionals and health systems. We are moving from a fee-for-service model to a fee-for-value model. Improved outcomes (episodic or disease driven) and lower costs will be the mark of success. There is no question that there will be workforce shortages especially in primary care. Physician Assistants (PAs) will be a key part of the solution. PAs always practice in teams with physicians to provide high quality, cost effective medical care in virtually all health care settings. PAs are state-licensed to practice medicine with the supervision of a physician. The Governor recently signed a bill into law that will help the PA practice, as well as improve access to care. Physician supervision was increased from three to five PAs. This will allow practices to hire more PAs to help with the increased workload and access to care. It will also decrease supervision required in rural areas from 10% to available by phone since new technology such as Electronic Health Records can be reviewed as necessary. PAs are now found in many settings, but the role they play in physician-directed care is identical to the vision of the physicians who created the profession. The future for the PA profession looks promising and continues to be one of the top professions for the future. As previously mentioned, with the influx of patients into healthcare the demand for PAs will continue to rise. We look forward to being PArtners with physicians in providing quality, cost-effective health care.

The Academic Health Science Center Steering Committee, representing a wide range of academic, medical, research, business and civic leaders, was formed in 2009 to develop a strategic plan to expand medical education in the greater Spokane region. I have been fortunate to be able to participate on the Academic Health Science Center Steering Committee over the last four years. At first I was invited as a representative of the Medical Society when I was President Elect and I have continued to participate on the committee as a representative of Rockwood Clinic. There has been a lot of progress since the beginning. What may have seemed like “pie in the sky� to some when we first began meeting is now becoming a reality. Although the vision for the expansion of the WWAMI program and turning it into a four-year health sciences center has largely been driven by the business and academic communities, it has been important all along to have representation from the medical community on the steering committee. A number of other physicians and I have had the opportunity to meet with both state and federal legislators to advocate for the funds for the new building that is almost complete on the health sciences campus at Riverpoint. The legislators had many questions about how the medical community viewed the expansion. They wanted to know how much support there was in the medical community for the expansion and specifically for the increased need for teaching and clinical rotations that new medical students and new residents will require. Although there are still some hurdles to be crossed when it comes to providing more graduate medical education and funding for the further expansion of WWAMI, and for accreditation of the expanded number of medical students, there is a significant amount of interest in the medical community in helping to educate the future generation of doctors. Many of the prospective new physicians looking at our community are interested in participating with medical education and are excited that we are truly building a four-year medical school here. They can see the new building and know that the project is moving ahead. It has been interesting and gratifying to participate on the committee as a physician representative. But, the most important contribution from the medical community will be the commitment to participate in the necessary teaching and clinical rotations of the students and residents that are in our community as a result of the efforts of so many stakeholders to make the Academic Health Science Center at Riverpoint a reality.

July SCMS The Message 3


Hot Spotters Group Initiates Collaboration to Care for Most Vulnerable Citizens By Lee Taylor Director Strategic Initiatives, SCMS

Consistent Care Washington’s (CCW) Medical Director, Dr. Darin Neven and Spokane’s Assistant Fire Chief, Brian Schaeffer, have long known that thoughtful, efficient collaboration between key community providers of health and social services has tremendous potential to improve the overall well-being of Spokane’s most vulnerable citizens while simultaneously reducing the overall costs of care to the community. Bringing that ideal to fruition, however, has always been an elusive goal amid the complex web of bureaucratic and political considerations that necessarily attend these discussions. The work of one physician in Camden, N.J. has fundamentally changed that dynamic by demonstrating just how revolutionary common-sense, community cooperation can be, thereby paving the way for similar changes all over the nation—changes that the Hot Spotters Group is now ideally positioned to carry out in Spokane. The Hot Spotters grew out of the work of Dr. Jeffrey Brenner, who began with a single test case. Armed with data showing that one percent of the individuals who utilized Camden’s medical facilities accounted for thirty percent of the system’s costs, Brenner asked social workers and emergency department (ED) doctors to help him identify the most frequent utilizers of the city’s hospitals. He zeroed in on a 560-pound male in his midforties with severe congestive heart failure, chronic asthma, uncontrolled diabetes, hypothyroidism, gout and a history of smoking and alcohol abuse. His highly vulnerable condition led to frequent, lengthy hospitalizations and precious little prospect for long-term improvement. Brenner gained an in-depth knowledge of the patient’s history and current circumstances and then surrounded him with services by coordinating his medical care with diligence and continuity that had been sorely lacking. He then went several steps farther by involving himself in the patient’s housing, behavioral health and substance abuse issues. After three years, the patient had lost 220 pounds and been alcohol-free for a year, cocaine-free for two years and smoke-free for three years. Brenner’s intensive intervention disrupted a vicious circle of illness and despair that had become this patient’s reality. He replicated this approach with 36 “super-utilizers” through his newly-formed Camden Coalition, achieving a 40% reduction in hospital and ED visits and a 56% reduction in hospital bills across this group. While the precise impact is nearly impossible to measure, given the complex and unstable nature of the patients’ circumstances, there is overwhelming consensus that the benefits are vast for both patients and communities. Moreover, the outcome appears to be an unmitigated good with no natural opposition constituency.

The Spokane County Medical Society already has many of the pieces in place to build upon this approach and adapt it to fit the needs of the Inland Northwest. Project Access was founded in 2003 and has grown in leaps and bounds in its mission of coordinating specialty-level, universal, and on-demand health care access for low-income, uninsured, medically underserved citizens. This was followed, in 2012, by the creation of Consistent Care Washington that aims to create broad and deep capabilities for community care coordination targeting patient populations that are frequent users of ED and other medical services. Now, key leaders in the community have come together to work toward comprehensive collaboration with community providers of medical, behavioral health, substance abuse, housing and other social services. Collectively, the Hot Spotters Group shares a vision of building an efficient system of care and support that leads to recovery for the most vulnerable clients in our community. This will be accomplished through intense coordination between those agencies that have the most direct access to this population. The Hot Spotters Group leadership team consists of: • Darin Neven, MD, CCW Medical Director • Brian Schaeffer, Assistant Fire Chief, Spokane Fire Department • Sheila Morley,Community, Housing & Human Services Program Coordinator, City of Spokane • Joe Beckett, MS, CDP, Mental Health Care Coordinator, Spokane County Regional Support Network • Lee Taylor, Director of Strategic Initiatives, Spokane County Medical Society • Sarah Bates, Operations Manager, CCW / Project Access • Barry Pfundt, Staff Attorney, Center for Justice

We are particularly excited to initiate an unprecedented level of cooperation between the City of Spokane and Spokane County—a partnership that will have far-reaching benefits, particularly in regards to the continuity of care for individuals who may be relatively transient throughout the region and the information available to the care providers who encounter them. These are exciting times for those who seek to bring a new level of collaboration and communication to what is often a frustrating and complex system – a system that allows many people to fall through the cracks at great and unnecessary cost to the community at large. Together, we will demonstrate that compassion and fiscal responsibility are not mutually exclusive goals and that innovative collaboration is the best catalyst for deep and lasting improvement.

July SCMS The Message 4


A Project Access Client Profile - Chad Ohl

Membership Recognition for July 2013

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.

By Jim Ryan Project Access Program Coordinator

On January 16, Chad Ohl, an uninsured 19-year- old software design student from Liberty Lake, Wash., visited the emergency room with an intense headache that had persisted for three weeks. An MRI and bone scan of Chad’s head were ordered, at which time he was referred to Project Access by Inland Imaging. Chad’s Project Access application was received on January 18 and approved three days later. By February 1, the required tests had been performed and analyzed at Inland Neurosurgery and Spine Associates. Dr. Gruber made a diagnosis of eosinophilic granuloma and recommended surgical intervention. Chad had surgery on February 12 to remove a tumor and a follow-up surgery in early March. He now has a clean bill of health and is back at school. Chad had no income and no insurance at the onset of his medical issues. He wrote to Project Access in June, saying “My family and I would like to thank Project Access and all the organizations who donated their care to me during my illness and hospitalization. Had it not been for the generous contributions our family would have been financially devastated. It is wonderful to live in a community that has an organization like Project Access and the institutions who support it.”

40 Years Michael J. Metcalf, MD Sun Myung Lee, MD

7/1/1973 7/7/1973

20 Years Stephen A. Carlson, MD Donald E. Ellingsen, MD Cynthia A. Hahn, MD Michael A. Kwasman, MD Henry H. Lin, MD David W. Little, MD Linda M. Partoll, MD Steven J. Richards, MD William E. Schulte, MD

7/21/1993 7/21/1993 7/21/1993 7/21/1993 7/21/1993 7/21/1993 7/21/1993 7/21/1993 7/21/1993

10 Years Robert K. Durnford, III, MD Andrew B. Miller, MD Richard A. Jensen, Jr., MD L. Douglas Waggoner, Jr., MD

7/7/2003 7/14/2003 7/15/2003 7/21/2003

A sincere Thank You to Dr. Gruber and Inland Neurosurgery and Spine for their participation in Project Access and to all participating providers! Do you have a great Project Access patient story? Please let us know. Contact Sarah at (509) 532-8877 or sarah@spcms.org

July SCMS The Message 5


Medical Education Expansion Ahead of Schedule

The community push for expanded medical education – led by Greater Spokane Incorporated – was instrumental in the fast growth.

In 2009, the Spokane Community found out how much of an impact expanding medical education in Spokane could have. TrippUmbach, a market research consultant, estimated that the eastern Washington region would see $1.6 billion in annual economic impact and more than 9,000 jobs supported by the Academic Health Science Center on the Riverpoint campus by 2030.

That building was a major catalyst in attracting new faculty and new research.

All of that, of course, depended on meeting certain benchmarks: a new biomedical building, moving the College of Pharmacy from Pullman to Spokane, adding second-year medical studies, attracting researchers, growing Graduate Medical Education (GME) and much more.

While there is great progress in many areas, there is work to be done in others, namely growing GME numbers. As we’ve written before in this space, central and eastern Washington have just 6.8 residency slots per 100,000 people, while the national average is 35.7. Tripp-Umbach’s updated study notes that the community risks falling behind in growing the medical workforce if it doesn’t get an increased amount of GME slots. Finding new funding mechanisms might be needed, suggests Tripp-Umbach.

By Kevin Dudley, Marketing and Communications Coordinator at Greater Spokane Incorporated

Today, the Biomedical and Health Sciences Building is set to open this fall, the College of Pharmacy will indeed move to Spokane, the first class of second-year medical students will begin classes this fall in Spokane (thanks to funds raised by the community), and WSU Spokane has attracted top researchers to town.

“Our leadership is influential and that led to gaining the new medical school building,” said Rich Hadley, President and CEO of Greater Spokane Incorporated.

“There is a tremendous increase in programmatic activity, faculty recruitment and so forth with the consolidation of the College of Pharmacy and expected growth in medical sciences,” Roberts said.

As with any project, it’s good to assess yourself. The community brought Tripp-Umbach back to get an update on where we’re at in growing medical education. The initial prognosis is good.

Finding new funding mechanisms is needed because of budget constraints in Washington D.C. (current GME slots are federally funded). Tripp-Umbach suggests creating a regional consortium with local health care leadership and private and other non-traditional funding sources. Growing GME slots in the region is crucial for growing our workforce and meeting our workforce needs.

According to Tripp-Umbach, the current economic impact of activities at the Riverpoint campus is $349 million, which is about $20 million more than what was expected for 2013 during the 2009 study. Many of the community’s achievements since 2009 are approaching 2017 estimates.

Tripp-Umbach also suggests that the community should think about creating a “Bio-Innovation Center” on campus that could serve as the go-to place for industry and hospital partners and begin strategizing a marketing campaign to attract existing and start-up bioscience companies.

In the 2009 study, the region estimated that jobs supported by activities on the Riverpoint campus would reach the 2,374 mark by 2017. Currently, more than 1,800 jobs are supported by activities on the Riverpoint campus. The 2017 benchmark is well within reach.

“The best picture is a simulation center connected to a clinical medical center that medical school students can gain experience in,” Hadley said.

Research – which can be commercialized, thus having a larger economic impact in the long run – has grown from having a $12 million economic impact in 2009 to a $21 million economic impact in 2013. Breaking ground on the Biomedical and Health Sciences Building was a catalyst in attracting researchers like Michael Gibson and Phil Lazarus, two distinguished researchers in the biomedical realm. Attracting new research to campus impacts the students and the community. Research faculty members compete for grant money and can spur private company investments. Money brought in from research supports the students’ education, according to Dr. Ken Roberts, Director of WWAMI Spokane.

In his old position at the University of Minnesota, Roberts said innovative education methods dominated the medical campus. He said any sort of innovation center must bring the campus and business community together. “As more and more simulation comes to medical education, it’s companies that develop these simulators, so they like to have relationships with academic institutions.” Growing at a rapid pace came as a pleasant surprise to Roberts, who said he figured the community and campus were on a steady course. “There is definitely a feeling that we’re growing very quickly in a very sustainable way,” he said. “This is not risky growth, this is programmatic growth. It’s solid.”

“We’re very set on developing both – the growth of the medical school and research,” he said.

July SCMS The Message 6


Regional Strategic Initiatives Update

Major Components of the New Mission and Vision By Lee Taylor, Director Strategic Initiatives, SCMS

The community health and wellness regional strategic initiatives are programs of the Spokane County Medical Society Foundation (SCMSF). They are primarily carried out in two programs - Project Access and Consistent Care Washington (CCW).

Project Access Project Access is a network of over 600 physicians, pharmacists, allied healthcare providers and hospitals serving people with no other access to health care. Since 2003 $56 million of free care have helped 6,500 residents of Spokane County. Project Access served 1013 clients in 2012, up from 651 in 2011, providing medical services valued at over $12 million. Over $23 in medical services value was delivered for each dollar invested in operating funds. Project Access recently introduced the ED to Primary Care Program which provides access to primary care medical services from providers willing to donate their services for low-income uninsured people residing in Spokane County. Participating providers are Group Health and Providence Internal Medicine Residency Spokane. They provide no cost care for up to six months for approximately 50 patients per year referred by all four Spokane Emergency Departments (ED). Project Access provides support for establishing ED protocols, enrollment screening, care coordination and outcome tracking.

the Camden, New Jersey Coalition of Healthcare Providers, which originally coined the name, “Hot Spotters”. The Hot Spotters group focuses on high risk patients with a history of high utilization of health care services and develops a community care plan that will provide the best care available while working to reduce community costs. The group includes the fire and police departments, behavioral health, substance abuse and housing services providers and Consistent Care Washington staff. This group is embarking on a very important focus on community-wide collaboration to solve some of the most challenging medical and behavioral health cases in the community. The Spokane County Medical Society Foundation’s Consistent Care Washington (CCW) program leads the work of the Hot Spotters group. The leadership team for this collaborative group includes: • Darin Neven, MD, CCW Medical Director • Brian Schaeffer, Assistant Fire Chief, Spokane Fire Department • Sheila Morley, Community, Housing & Human Services Program Coordinator, City of Spokane • Joe Beckett, MS, CDP, Mental Health Care Coordinator, Spokane County Regional Support Network • Lee Taylor, Director of Strategic Initiatives, Spokane County Medical Society • Sarah Bates, Operations Manager, CCW / Project Access • Barry Pfundt, Staff Attorney, Center for Justice

Consistent Care Washington (CCW) The overarching goal of CCW is to work collaboratively with the Spokane community and other communities in the Northwest to accomplish the triple aim of reducing the cost of care, improving the patient experience and boosting the overall health of the population served. CCW is collaborating with community partners to create broad and deep capabilities for patient care coordination targeting patient populations that are frequent users of the ED and other medical services. CCW care coordination services are focused strategically to be non-duplicative and to add value across the regional medical community, rather than being competitive with other existing care coordination services provided by other health care service providers. CCW is managing the following initiatives that leverage the collaborative community efforts to better serve complex patient groups who are high utilizers of our hospital EDs and other community healthcare services.

1 Hot Spotters Group This group evolved from years of important work by the ED doctors and case managers, the city police and fire departments and other providers of health services. The Prescription for Housing project was the catalyst that recently launched this group. The work of the group is modeled after

• Hot Spotters Group Vision Working collaboratively with community providers of medical, behavioral health, substance abuse, housing and other social services, the Hot Spotters Group will build an efficient system of care and support that leads to recovery for the most vulnerable clients in our community. The vision includes promoting continuous innovation in administration, operations, technology, service delivery and business models.

• Hot Spotters Key Strategies • Focus on improving efficiency through improved collaboration and communication across the provider network. • Establish common goals, objectives and outcome measurements across the provider network. • Align Hot Spotters Group objectives with the City of Spokane, the Spokane County Regional Support Network (RSN), hospital systems, managed care health plans, Eastern Washington Regional Health Improvement Collaborative (RHIC) and other organizations focused on improving community health.

July SCMS The Message 7

Continued on next page


2 Prescription for Housing

5 Behavioral Health Work Group

CCW received a grant from the City of Spokane called the Health Housing Homeless Systems Integration Pilot Project. The community name for the project is Prescription for Housing because the clients who will benefit from the services provided need health care services to “turn the ship” in the right direction for successful transition away from homelessness. The pilot project will serve approximately 40 homeless persons with complex medical conditions. Legal support services and outcome measurement services provided by a health care economist are components of the program. The expected outcomes of the pilot project are to create a collaborative system of care by engaging community partners in development and implementation of an effective system of providing medical care and social services for homeless clients with high risk medical conditions that will continue after the grant ends.

3 Inland Northwest Transitional Respite Program CCW was the catalyst to significantly expand the small onebed homeless respite program developed by WSU PhD nursing student Becky Doughty, in collaboration with the House of Charity. Sparked by the need for more respite housing for the homeless clients in the Prescription for Housing program, CCW brought together the leadership of Catholic Charities, operators of House of Charity for men, and Volunteers of America, operators of Hope House for women, to discuss rapid expansion of the program. Thanks to CCW and funding from the Providence Health Services Foundation, within two months the respite program grew to six beds for men and three beds for women and plans are being made for further expansion. CCW continues to play a key role in this new expanded program and the ongoing care for homeless clients.

4 Framework for Cost Effectiveness Analysis Evaluating the cost-effectiveness of a community-based healthcare performance-improvement program is critical in order to assess whether the resources allocated to it are being put to their best use. The Framework for Cost Effectiveness Analysis will perform a financial analysis of the Prescription for Housing Program, the Hot Spotters initiative and other communitybased health coordination programs. CCW is currently working with Providence Healthcare and Washington State University Department of Health Policy and Administration to gather de-identified data on the costs of healthcare provided to clients in these programs. This framework will pave the way for gathering data from other medical and behavioral health services organizations to build a more comprehensive base of data and better outcome measurements for health improvement programs.

This workgroup brings together the ED providers, case management staff, hospital Psychiatric staff and providers of behavioral health services to establish community-wide protocols and pathways for discharging acute mentally ill patients from the local hospital emergency departments in Spokane. This work group meets approximately once per quarter to follow up on the projects that were defined in an all-day planning meeting facilitated by a Lean Practices Black Belt facilitator on staff at Providence Health and Services. The ongoing meetings are attended was attended by behavioral health services providers, case managers, social workers and hospital psychiatric staff .

Other Community Collaboration Activities Regional Health Improvement Collaborative Steering Committee

The vision of the EWRHIC is to promote the health of our region’s residents, making the eastern Washington region the healthiest in the state. The Collaborative aim is to achieve improved personal and community health and reduced costs through coordination of providers and public resources in the most effective and efficient way. SCMS works closely with the EWRHIC to align initiatives and promote community collaboration.

Partnership for Patients - Care Transitions Pilot SCMS is sharing the project management of the Care Transitions Pilot Project in Spokane with the Washington State Hospital Association (WSHA). This work is part of the Centers for Medicare and Medicaid Services’ (CMS) Partnership for Patients National campaign to reduce harm by 40% and readmissions by 20% by the end of 2013. The Partnership for Patients project leverages local and national resources with the goal of identifying solutions that are already working and bringing lessons learned to other hospitals in the region. The Pilot program offers customized technical assistance to the Spokane region to build upon and further develop a tool kit that will be offered region wide. This tool kit will be a regional resource containing best practices as well as tested tools and information. These tools will help communities maximize quality, safety and financial outcomes and facilitate coordinated and standardized transition processes across settings. Community meetings with representatives from all four hospitals, Rockwood Clinic, Providence Medical Group, Group Health, Columbia Medical Associates, all of the community clinic systems and three major Home Health service providers have taken place, and will continue to jointly address the top priority work needed to reduce hospital readmissions. If you would like to discuss how we can partner with you or your organization on these or other community health initiatives, please call me at (509) 220-2651 or email me at lee@spcms.org.

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Retired Physicians Golf Tourney Another Success

Monkman for walking away with the trophy. Frank Browne took third place with a 70. For the fourth year in a row, Bob Notske won the 17 & over division with a 67! Leonard Vanderbosch and Joe Rush tied with a 72 for second place. Another repeat this year was Super Senior Roy Zimmer with a 69.

By Patrick Freuen, MD Senior Physicians Chair

A morning filled with sunshine and camaraderie was enjoyed by the 24 golfers at the Retired Physicians Annual golf tournament at the Manito Golf Club held on Friday, May 17. Lunch and the presentation of prizes followed the golfing.

Thanks to Nike Golf for supplying the golfers with balls and prizes. This golf outing is about fellowship and renewing old friendships among colleagues. If you are a retired/senior physician golfer and did not receive a flyer, please contact Michelle at SCMS at (509) 325-5010 with your information.

George Monkman and Patrick Freuen tied for first place with 67 in the under 17 division. The tie was decided by determining who had the best score on hole number 6. Congratulations to George

Retired physicians - be sure to mark your calendars for our annual dinner get-together Thursday October 17 at Manito Golf & Country Club. More details will follow!

Robert Notske, MD winner of the 17 & over division

George Monkman, MD winner of the under 17 division

Roy Zimmer, MD winner of the Super Senior division

Thank You

to Dr. Patrick Freuen

Chair of the 2013 Retired Physicians’ Golf Tournament and Luncheon.

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In The News Darin Neven, MD Receives Providence Sisters’ Mother Joseph Award (From the May 16, 2013 edition of the Inland Register)

Dr. Darin Neven, an emergency room physician and medical director for the Consistent Care Program at Providence Sacred Heart Medical Center, Spokane, was chosen by the Sisters of Providence to receive the 2013 Mother Joseph Award. The Mother Joseph Award is given annually to a person who “exemplifies the values and courage of Mother Joseph,” the first provincial superior of the Sisters of Providence in the West. Dr. Neven recognized the plight of homeless individuals leaving the emergency room or the hospital and returning to the streets and shelters. That moved him to take a lead role in providing continuing care for this most vulnerable population. In addition to projects like Respite Housing, he is the medical director of the Consistent Care Program, created to provide wraparound services and resources to the most vulnerable. “As a busy emergency room physician, Dr. Neven comes in contact with many people of diverse needs,” said Providence Sister Jo Ann Showalter, Provincial Councilor. “It would be simpler for him if he said, ‘I’ve done what I can.’ Instead, a flame of love and compassion won’t allow him to stop before he has exhausted all possibilities, especially for the indigent and homeless patients. The same charity of Christ that impelled Mother Joseph also impels him.” Dr. Neven’s emergency room experiences have inspired him to create and champion innovative measures to care for the poor and vulnerable, many of whom resort to hospital emergency rooms for their primary health-care needs. He was nominated for the Mother Joseph Award by Sara Clements-Sampson, benefits manager for Maria House, part of Providence Health Care. She brought him to the nominating committee’s attention for his “compassion for the most poor and vulnerable in the Spokane community.” One of his roles has been on a Department of Health committee developing state guidelines for prescribing opioids for chronic pain by health-care providers in emergency departments. The guidelines reinforce the needs for a primary-care provider to prescribe and monitor use of powerful and addictive pain meds such as Vicodin, Percocet and OxyContin. Dr. Neven and other Spokane emergency room doctors began a pilot project sharing a database in 2006 that since has spread to other parts of Washington State. Frequent recipients of pain medications in emergency rooms are identified and helped to enroll in pain and addiction management programs. In the Consistent Care Program, Dr. Neven helps find patients the services they need, including a primary care provider, mental health resources, substance abuse resources, and even housing resources. He is improving their lives by giving them hope and access to better health. July SCMS The Message 10


The following physicians and 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 to the Spokane County Medical Society, 104 South Freya Street, Orange Flag Building, Suite 114, Spokane, Washington, 99202.

Hill, Chandler H., MD Emergency Medicine Med School: U of Washington (2005) Internship: Hennepin County Medical Center (2006) Residency: Hennepin County Medical Center (2008) Fellowship: Hennepin County Medical Center (2009) Practicing with Valley Hospital /Sacred Heart Emergency Departments 08/2013

PHYSICIANS

Kaur, Jasdeep, MD Internal Medicine Med School: Oregon Health & Sciences U (2010) Internship: Oregon Health & Sciences U (2011) Residency: Oregon Health & Sciences U (2013) Practicing with Holy Family Hospital 08/2013

Barry, Robert T., MD Diagnostic Radiology Med School: Medical College of PA (1995) Internship: Washington U, Boise (1996) Residency: U of Arizona (2000) Practicing with Inland Imaging 01/2014 Bettesworth, Jacob G., DO Anesthesiology Med School: Kansas City U of Medicine and Biosciences (2007) Internship: Riverside Methodist Hospital (2008) Residency: Ohio State U Medical Center (2011) Fellowship: Nationwide Children’s Hospital (2012) Practicing with Providence Anesthesia Services 06/2013

Lawson, Andrew J., MD Family Medicine/Sports Medicine Med School: Western U (2010) Internship: Valley Family Medicine -Renton (2011) Residency: Valley Family Medicine -Renton (2013) Practicing with Providence Family Medicine Residency 08/2013

Cannon, Todd A., MD Anesthesiology Med School: U of Washington (2004) Internship: U of Washington (2006) Residency #1: U of Washington (2005) Residency #2: U of Washington (2011) Fellowship: Jefferson Medical College (2013) Practicing with Anesthesia Associates (Deaconess & Valley) 09/2013 Condon, Erik J., MD Anesthesiology Med School: Wake Forest U (2005) Internship: Wake Forest U (2006) Residency: Wake Forest U (2009) Fellowship: Duke U Medical Center (2013) Practicing with Providence Anesthesia Services (Sacred Heart) 08/2013 Do, Johnny N., MD Internal Medicine Med School: Eastern Virginia (2007) Internship: U of California - Irvine (2008) Residency #1: U of California -Irvine (2009) Residency #2: Pennsylvania State U (2013) Practicing with Holy Family Hospital 08/2013 Guzman Aguayo, Nelio, MD Pediatric and Adult Nephrology Med School: U de Tamaulipas, Mexico (2003) Internship: U of Texas (2006) Residency: U of Texas (2009) Fellowship: U of Texas (2013) Practicing with PMG - Kidney Care of Spokane 07/2013

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Marchion, Christina S., MD Family Medicine Med School: U of Washington (2010) Internship: Family Medicine Residency of Idaho (2011) Residency: Family Medicine Residency of Idaho (2013) Practicing with Providence Family Medicine Residency 08/2013 Mezei, Gabor C., MD Obstetrics Med School: Semmelweis U, Budapest Hungary (1999) Internship: Semmelweis U, Budapest Hungary (2000) Residency #1: Semmelweis U, Budapest Hungary (2002) Residency #2: Semmelweis U, Budapest Hungary (2005) Residency #3: St Peter’s U Hospital (2010) Fellowship #1: Yale U - Research (2004) Fellowship #2: Penn State U (2013) Practicing with PMG - Maternal Fetal Medicine 07/2013 Mejia, Juan C., MD Surgery Med School: U Autonoma de Guadalajara (2004) Internship: U of Texas Health Science Center (2006) Residency: U of Texas Health Science Center (2010) Fellowship #1: U of Pittsburgh Medical Center (2012) Fellowship #2: U of Pittsburgh Medical Center (2013) Practicing with PMG - Kidney Transplant Surgery 08/2013 Plymale, Jennifer M., MD Pediatrics Med School: U of Washington (2004) Internship: U of California, Davis (2005) Residency: U of California, Davis (2007) Fellowship: Medical College of Wisconsin (2013) Practicing with PMG - Center for Congenital Heart Disease 08/2013 Preugschat, Dexter A., MD Internal Medicine Med School: Eastern Washington U (2010) Internship: Providence Sacred Heart Internal Med. Residency Program (2011) Residency: Providence Sacred Heart Internal Med. Residency Program (2013) Practicing with PMG - Internal Medicine Hospitalists 07/2013

IN MEMORIAM

Richard Louis Pokorny, MD Richard Louis Pokorny, MD passed away on 8 June 2013. Dr. Pokorny, who preferred to be known as Rich, was a veteran of World War II. He had a long and successful career as an anesthesiologist in Spokane. Born 27 March 1924 in La Crosse, Kansas, Rich was the fourth and youngest son of Charles and Roberta Smith Pokorny. After graduation from La Crosse High School in 1942, Rich volunteered for service in the US Navy. He was selected for officer’s training through the V-12 program and was sent to Washburn Municipal University in Topeka, Kansas, where he received a BS degree in 1947. Rich graduated from the University of Kansas School of Medicine in 1950. During his senior year there he met Vivian Decker, RN. They were married in June 1950. After completing his training in anesthesiology in 1953, he joined the US Army Medical Corps, where he served as the Chief of Anesthesiology at the US Army General Hospital in Nurnberg, Germany in 1954-55. In 1957, he and his family moved to Spokane where he joined the Physician Anesthesia Group. Over the course of some 35 years as a working physician, he was a member of the board of directors of the American Society of Anesthesiologists, president of the Washington State Society of Anesthesiologists and president of the Spokane County Medical Society. After his retirement in 1985, Rich and Vivian traveled extensively for a number of years. Rich and Vivian had three children Brad, Diana, and Alan and seven grandchildren. Brad, born in 1954, currently resides in Durham, NH, with his wife, Ruwa. They have two sons, Remz and Zane. Diana, born in 1957, currently resides in Studio City, CA. She has two daughters, Sophie and Zoe. Alan, born in 1961, resides with his wife, Valerie Logsdon, in Spokane. They have two sons, Trey and Logan, and a daughter, Annie. He will be missed by his family and friends.

Roberts, Meghan E., MD Internal Medicine Med School: U of Minnesota (2004) Internship: Providence Sacred Heart Internal Med. Residency Program (2011) Residency: Providence Sacred Heart Internal Med. Residency Program (2013) Practicing with PMG - Internal Medicine Hospitalists 08/2013

PHYSICIANS PRESENTED A SECOND TIME Wister, Jason D., MD Pediatrics Practicing with Pediatrix Medical Group 08/2013 Snelson, Timothy, MD Emergency Medicine Practicing with Valley Hospital Emergency Department 08/2013 July SCMS The Message 12


POSITIONS AVAILABLE PHYSICIAN OPPORTUNITIES AT COMMUNITY HEALTH ASSOCIATION OF SPOKANE (CHAS) 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.  To learn more about physician employment opportunities, contact CHAS Human Resources at (509) 444-8888 or hr@chas.org. Visit our website to learn more and to apply www.chas.org. QTC MEDICAL GROUP is one of the nation’s largest private providers of medical disability evaluations. We are contracted through the Department of Veterans Affairs to manage their compensation and pension programs. We are currently expanding our network of Family Practice, Internal Medicine and General Medicine providers for our Washington Clinics. We offer excellent hours and we work with your availability. We pay on a per exam basis and you can be covered on our malpractice insurance policy. The exams require NO treatment, adjudication, prescriptions to write, on-call shifts, overhead and case file administration. Please contact Gia Melkus at (800) 260-1515 x5366 or gmelkus@qtcm.com or visit our website www.qtcm.com to learn more about our company. PRIMARY CARE INTERNIST WANTED (Pullman) Immediate opportunity for BE/BC primary care internist to join a privately owned, multi-specialty, physician practice. Palouse Medical offers a competitive employment package, guaranteed first year salary, comprehensive benefits and partnership potential. Dedicated to delivering quality care, we are proud to offer an extensive array of patient services and on-site laboratory and imaging departments. We can’t wait to introduce you to the communities that we love and serve. Call Theresa Kwate at (509) 332-2517 ext. 20 or tkwate@ palousemedical.com. Contact us today and discuss your future at Palouse Medical! PROVIDENCE FAMILY MEDICINE RESIDENCY SPOKANE - Immediate opening with Providence Family Medicine Residency Spokane (PFMRS) for a full- time BC/BE FP physician who has a passion for teaching. PFMRS is affiliated with the University of Washington School of Medicine.  We have seven residents per year in our traditional program, one per year in our Rural Training Track and also administer OB and Sports Medicine Fellowships.  This diversity benefits our educational mission and prepares our residents for urban & rural underserved practices.  We offer a competitive salary, benefit package and gratifying lifestyle.  Please contact Linda Barkley, Program Assistant at (509) 459-0688 or Linda. Barkley2@providence.org. 

Spectrum HealthCare Resources has an immediate opportunity for a civilian Family Practice Physician at Fairchild Air Force Base. This contract position offers: Full-time; Outpatient setting; Monday through Friday, 7:30am to 4:30pm; Manageable patient load (20-25 per day) and Shared on-call responsibilities (mostly telephone consulting). The position will have the following requirements: Current and unrestricted medical license; Successful completion of a family medicine residency; Board Certified by the ABFM or AOBFP; BLS, ACLS, PALS and Ability to work in a team setting. Contact Spectrum recruiter Lisa Paska for more information at Lisa_Paska@spectrumhealth.com or (314) 744-4107. PROVIDENCE HEALTH & SERVICES has immediate opportunities for BE/BC Family Physicians to join our expanding primary care team in Spokane, eastern Washington’s largest city. Newborns to geriatrics, no OB. Regular 8-5 hours, five-day week. New physicians will join Providence Medical Group, our physician-led multispecialty medical group with clinics throughout the metropolitan area. Excellent compensation and benefits. Providence Medical Group (PMG) – Eastern Washington is our physicianled network of more than 200 primary and specialty care providers in multiple clinic locations in Spokane and Stevens County. PMG partners with some of the region’s most advanced hospitals: Providence Sacred Heart Medical Center & Children’s Hospital, Providence Holy Family Hospital, Providence Mount Carmel and Providence St. Joseph’s Hospital. Contact Mark Rearrick at mark.rearrick@providence. org or (509) 474-6605 for more information. PROVIDENCE MEDICAL GROUP (PMG) - Eastern Washington is recruiting for an excellent Family Medicine physician to join our care team in this scenic suburb of Spokane. Full-time opportunity with our growing medical group in what will be a large, state-of-the-art medical ambulatory center (construction completion target is spring 2014). No OB. Outpatient only. Competitive compensation and comprehensive benefits. Providence Medical Group – Eastern Washington is our physician-led network of more than 200 primary and specialty care providers in multiple clinic locations in Spokane and Stevens County. PMG partners with some of the region’s most advanced hospitals: Providence Sacred Heart Medical Center & Children’s Hospital, Providence Holy Family Hospital, Providence Mount Carmel and Providence St. Joseph’s Hospital. Contact Mark Rearrick at mark.rearrick@providence.org or (509) 474-6605 for more information. FULL-TIME LICENSED PHYSICIAN ASSISTANT – PA wanted for expanding clinic in Spokane, Wash. Currently patients are seen four days per week, Monday through Thursday, 8am to 5pm. Approximately 24 patients per day. This could expand into five days a week in the future. No call, weekends or holidays. Fabulous benefit package offered. Vacation and CME benefits provided. Starting salary DOE. If interested, submit resume and cover letter to Kris Norton, Office Manager at knorton@neuroandspine.com.

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Continuing Medical Education Moderate (Conscious) Sedation and Analgesia: 3.0 Hour(s) of Category 1 CME credit, sponsored by the Spokane County Medical Society. Tuesday, September 17 5:30 – 9:15 p.m. at the Providence Sacred Heart Medical Center Mother Joseph Room. This is SCMS’ annual program to satisfy JCAHO requirements and provide a refresher course to members of the medical community in order to increase patient safety. For more information contact Karen Hagensen at (509) 325-5010 or email karen@spcms.org. Rockwood Health System Breast and General Tumor Boards: The tumor boards are jointly sponsored by Rockwood Health System and the Spokane County Medical Society. Tumor Boards will be held weekly June – December 2013. Each Tumor Board is worth 1.0 Category 1 CME credits. For more information please contact Sharlynn M. Rima CME Coordinator at SRima@ rockwoodclinic.com. Promoting Healthy Families (Practice Management Alerts from the American Medical Association) is designed to help physicians successfully talk about healthy behaviors with their adult patients in a way that may spark—and help sustain—positive changes for the whole family. The continuing medical education activity includes a video module, a detailed monograph and patient handout. These activities have been certified for AMA PRA Category 1 CreditTM. For more information www.ama-assn.org.

National Environmental Health Association Courses sponsored by the CDC and EPA available. Courses include National Environmental Public Health Performance Standards Workshop: Building Local and National Excellence, Biology and Control of Insects and Rodents Workshop, Environmental Health Training in Emergency Response and Environmental Public Health Tracking 101. For more information go to the website at www.nehacert.org. Physician Family Alanon Group:  Physicians, physician spouses or significant others and their adult family members share their experience, strength and hope concerning difficult physician family issues.  This may include medical illness, mental illness, addictions, work-related stress, life transitions and relationship difficulties. We meet Tuesday evenings after 6 p.m.  The format is structured by the 12-Step Alanon principles.  All is confidential and anonymous.  There are no dues or fees. To discuss whether this group could be helpful for you, please contact Bob at (509) 998-5324.

Meetings/Conferences/Events Institutional Review Board (IRB) - Meets the second Thursday of every month at noon at the Heart Institute, classroom B. Should you have any questions regarding this process, please contact the IRB office at (509) 358-7631. Spokane Catholic Medical Association – is pleased to present a lecture by Father Robert Spitzer, SJ, PhD, on “The Contemporary Scientific Evidence for the Existence of God”. Father Spitzer is the past president of Gonzaga University. He is an author, educator, philosopher, and founder of the Magis Center of Reason and Faith (www.magisreasonfaith. org). Please join us on 3 October, Thursday evening at 6 p.m. at Providence Auditorium, Sacred Heart Medical Center. All health care professionals are welcome. Atheists and agnostics are especially welcome. For more information contact Al Oliva, MD at (509) 220-3586.

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Endocrinology – Physician

Spokane, Washington Columbia Medical Associates, a subsidiary of Group Health Physicians, is currently seeking a BC/ BE Endocrinologist to join our Medical Group in Spokane, Washington. The position offers the following: • Competitive Salary and Generous Benefit Package. • Full-time opportunity joining two established providers. • Opportunity to become a shareholder. Our physicians are committed to maintaining the health and well -being of their patients through preventative -care measures and working closely with community specialists. Our new partnership with Group Health and collaborative care models ensure patients have access to the best care in Spokane. For additional information or to submit your CV, please contact: Cayley Crotty, Crotty.c@ghc.org GHP Recruiting Dept. | 1-800-543-9323 | Or visit Grouphealthphysicians.org

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Cl assified Ads REAL ESTATE

MEDICAL OFFICES/BUILDINGS

Comfortable Three-Bedroom Home in quiet neighborhood for rent. Good storage in kitchen, gas stove, dishwasher, refrigerator, washer/dryer and fireplace. Comes furnished or can negotiate. Close to Hamblen Grade School, Sac Middle School and Ferris High School. Three bedrooms, three baths, large living room, family/TV room, master bedroom has private bathroom, two-car garage. Large windows in living room look out into large fenced yard with automatic sprinkler system (front and back). Snow blower and lawnmower provided. Call (408) 594-1234 or (509) 993-7962. Large Second Owner Custom Built Executive Home with unparalleled views of Liberty Lake and Spokane Valley on five acres available for sale or lease. Custom hardwood floors and woodwork throughout, cherry office shelves, cathedral ceilings, central air, three car garage, brick porch, tile roof, large deck, three fireplaces, four bedrooms, four bathrooms, formal dining room, large kitchen, large eating room and den. Walk out basement, wood stove, kitchen and bathroom. Large 30’ x 100’ pole barn with separate utilities, two phase power, three twelve-foot overhead doors. 30 x 60 sports court. Large animals allowed. Water rights included. 4Kw grid interactive, portable battery backup solar system available. Offered for $600k or for lease $3250, no pets/smokers. Seller is a real estate broker at (509) 220-7512. Beautiful Priest Lake Cabins for Rent Our newly restored cabins are located on the historic site of Forest Lodge in the entrance to the scenic Thorofare. Two cabins are available. Each sleeps 8. They are located at the water’s edge, have gorgeous views, bordered by the National Forest and 18 acres of private land. The beds and furnishings are all new and cabins have all the amenities - decks, docks, beaches with fire pits, walking trails and forest to explore. Boating, hiking, swimming, sailing, snowmobiling in winter or just relaxing in the sunshine. You will enjoy a peaceful, fun-filled vacation at this amazing site. For available dates, pricing, photos and details call Jeannie or John at (509) 448-0444.

South Hill – on 29th Avenue near Southeast Boulevard Two offices now available in a beautifully landscaped setting. Building designed by nationally recognized architects. 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. 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 at the NWC of Lidgerwood and Central Avenue.  The building has various medical office spaces available for lease from 635 to 10,800 contiguous usable square feet. and has undergone extensive remodeling, including two new elevators, lighted pylon sign, refurbished lobbies, corridors and stairways.  Other tenants in the building include urgent care, family practice, pediatrics, dermatology, dentistry, pathology and pharmacy. Floor plans and marketing materials emailed upon request.  A Tenant Improvement Allowance is available, subject to terms of lease.  Contact Patrick O’Rourke, CCIM, CPM® with O’Rourke Realty, Inc. at (509) 624-6522, mobile (509) 999-2720 or psrourke@comcast.net.

MARK YOUR CALENDARS Watch for more details!

2013 SCMS EVENTS Community of Professionals River Cruise July 11 Thursday

Spokane River—Post Falls, ID

Triple Play/Raptor Reef Family Event September 07 Saturday

Hayden Lake, ID

Moderate (Conscious) Sedation Program September 17 Tuesday SHMC—Mother Joseph Room

CME prior to WSMA Annual Meeting September 27 Friday The Davenport Hotel

Senior Physicians Dinner October 17 Thursday Manito County Club

Orange Flag Building

Phone: (509) 325-5010

104 South Freya Street, Suite 114

Fax: (509) 325-5409

Spokane, WA 99202-4686

Website : www.spcms.org

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Spokane County

MEDICAL SOCIETY


Stay and Play rates starting at $199! Rates include golf for two players- 18 holes, cart with GPS, practice facility and one night stay.

8 0 0 5 2 3 2 4 6 4 | U S H W Y 9 5 , W O R L E Y, I D A H O | C I R C L I N G R A V E N . C O M July SCMS The Message 20


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. 307

ADDRESS SERVICE REQUESTED

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

Hayden Lake-ID, English Point, 100` frontage, 3 bdrm, 2 bath, 2400 sq ft, custom contemporary home, 2 car attached garage, fantastic deck, tram to water, very distinctive architecture. Call Bill Fanning $838,000

Hayden Lake-ID, 1 block from Hayden Lake Country Club, 95’ frontage, 3300 sq ft, 4 bedrooms, 4 baths, double garage, plus detached stacked 2 car garage with guest quarters, 2 slip boat dock, gated entry. Call Bill Fanning $1,699,000

Coeur d’Alene Lake, Rockford Bay, 90’ frontage, 6 bedrooms, 4 baths, 4440 sq ft, custom log home in immaculate condition, granite countertops, new dock with covered slip, community sewer & water. Call Bill Fanning $1,495,000

Clear Lake-WA, 200’ frontage, 3 bdrms, 3 baths, 2614 sq ft, den, 2 car attached garage, 24 x 36 pole building, dock, large veranda, cathedral ceilings, hardwood floors. Call Jenna Nicol $549,000

Coeur d’Alene Lake-ID, Black Rock Beach Estates, 90’ frontage, 3 bdrms, 3 baths, 2720 sq ft, 2 car attached garage, boat dock, gated community. Call Bill Fanning $795,000

Jump Off Joe Lake-WA, 150’ frontage, 3 bdrms, 1 bath, 1632 sq ft, fireplace and pellet stove, 2 kitchens, deck, patio, garden,dock, fishing room, incredible views. Call Jenna Nicol $195,000

Coeur d’Alene Lake-ID, Half Round Bay, 263’ frontage, 2.3 acres, custom home, 5452 sq ft, 6 bdrms, 5 baths, extra lot has 125’ frontage, dbl garage, 20’ x 36’ shop, guest quarters, xtra large dock w/ boat garage. Call Bill Fanning $975,000

W NE

Deer Lake-WA, Tamarack Bay, large lot-approx. 1/2 usable acre, appvd for 2nd home bldg site, 2 bdrm home w/ 2 lofts, sleeps 6, 2 car detached garage, lots of ‘off street’ parking incl RVs, private ‘shared’ dock w/ 2 boat slips, public water/ sewer, great view. Call Jenna Nicol $259,000

Waterfron t. Bec ause it’s Our Pass io n, you are getting the best!

Loon Lake-WA, 50’ frontage, main home: 2 bdrm, 1 bath, 1242 sq ft, guest house above shop: 3 bdrm, 1 bath, 1600 sq ft, 2 car garage plus RV parking, flat JENNA NICOL lawn area, multiple decks, large EZ dock. Call Jenna Nicol $339,000 EXCLUSIVELY WATERFRONT cell (509) 290-3698 direct (509) 321-1110 fax (509) 321-1131

Lake Pend Oreille-ID, Cape Horn Beutler - Waterfront Estates, 170’ deep water frontage, 4 bdrms, 2.5 baths, 3460 sq ft, extensive owner’s suite, private lot, high quality finishes, gated entry, large BILL FANNING dock with gazebo. Call Jenna Nicol BROKER $1,195,000

www.21Waterfront.com

E! IC R P

cell (509) 999-5444 direct (509) 321-1132 fax (509) 321-1131


The Message, July 2013