San Francisco Marin Medicine, Vol. 98, No. 4, Oct/Nov/Dec

SAN FRANCISCO MARIN MEDICINE J OU R NA L O F T H E S A N F R A N C I S C O M A R I N M E D IC A L S O C I E T Y

Standing Up For Medicine, Public Health, Science: End-of-Year Reports Volume 98, Number 4 | OCTOBER/NOVEMBER/DECEMBER 2025

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IN THIS ISSUE

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FEATURE ARTICLES

MONTHLY COLUMNS

4 Editorial: The Cost of Ultra-Processed Food Michael Schrader, MD, PhD

2 Membership Matters

7 Lessons From Six Years Leading Physician Wellness & Engagement at SFMMS Jessie Mahoney, MD

5 Executive Memo: Celebrating Nancy Pelosi's Legacy in Health Care Conrad Amenta

October/November/December 2025 Volume 98, Number 4

6 The 2025 CMA House of Delegates Meeting Ameena Ahmed, MD, MPH

18 A Report By Your AMA Delegates From the AMA I-25 Meeting John Maa, MD and Ameena Ahmed, MD, MPH

WELLNESS

22 Marin County Communities Lead the Nation in Advancing Tobacco and Nicotine Prevention Policies that End the Industry's Influence John Maa, MD; Raven Twilling and Jeremiah Mock, MSc, PhD 24 Interview With City Attorney David Chiu Michael Schrader, MD, PhD

3 President's Message: The Quiet Work of Leading In Hard Moments Jason Nau, MD

24 Connection and Community Are Not Fluff.

They Are Foundational.

Jessie Mahoney, MD

OF INTEREST 8 ANNUAL REPORT 26 In Memoriam: Collin P. Quock, MD

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Editorial and Advertising Offices: San Francisco Marin Medical Society 312 Sutter, Suite 608 SF, CA 94108 Phone: (415) 561-0850 Web: www.sfmms.org

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MEMBERSHIP MATTERS The SFMMS Annual General Meeting SFMMS hosted the 2025 Annual General Meeting and Holiday Party on December 3rd at the Golden Gate Yacht Club. The evening gathered over 60 SFMMS physicians members. Attendees included SFMMS Incoming President, Dr. Sarita Satpathy, SFMMS Past Presidents, Drs. Heyman Oo, Michael Schrader, Man-Kit Leung, Kim Newell Green, Monique Schaulis, Roger Eng, John Maa, and Speaker of the California Medical Association (CMA) House of Delegates, Dr. George Fouras.

SFMMS 2025 President, Dr. Jason Nau presented awards to Dr. Jessie Mahoney, for SFMMS Member of the Year, in recognition of her efforts to support physician wellness and the members of SFMMS, as well as Dr. Shannon Udovic-Constant for her tireless work as the 2025 CMA President. Additionally, Dr. Jason Nau shared information on the newly established American Medical Association (AMA) Lawrence Cheung, MD Public Health and Advocacy Scholarship https://www. sfmms.org/news/sfmms-blog/lawrence-cheung-md-scholarship-for-public-healthand-advocacy-a-word-of-thanks-from-dr-angela-wong.aspx fund, distributing scholarships to talented 3rd or 4th year medical students who have exhibited a passion to improve the health of patients through public health advocacy, as the late Dr. Cheung did during his time with SFMMS, CMA, and AMA. Finally, attendees heard from and were recognized by local legislators, San Francisco Supervisor Connie Chan, and Marin County Supervisor Eric Lucan, for SFMMS’ advocacy efforts in San Francisco and Marin counties. The sentiment throughout the evening was one of appreciation and camaraderie, as Dr. Shannon Udovic-Constant stated “It’s so lovely to be amongst my San Francisco and Marin colleagues, to be home.”

October/November/December 2025 Volume 98, Number 4 Editor Michael Schrader, MD, PhD Managing Editor Steve Heilig, MPH Production Maureen Erwin SFMMS OFFICERS President Jason Nau, MD, DDS President-Elect Sarita Satpathy, MD Secretary Melanie Thompson, DO Treasurer Ian McLachlan, MD Immediate Past President Dennis Song, MD, DDS SFMMS STAFF Executive Director Conrad Amenta Associate Executive Director, Public Health and Education Steve Heilig, MPH Director of Operations and Governance Ian Knox Director of Engagement Molly Baldridge, MPH Senior Director, Advocacy and Policy Adam Francis, CAE 2025 SFMMS BOARD OF DIRECTORS Edward Alfrey, MD Melinda Aquino, MD Julie Bokser, MD Kristina Casadei, MD Clifford Chew, MD Esme Cullen, MD Anthony DiGiorgio. MD Manal Elkarra, MD Cindy Greenberg, MD Tracey Hessel, MD Cynthia Lin, MD Ian McLachlan, MD, Treasurer Jason Nau, MD, President David Pating, MD Dawn Rosenberg, MD Sarita Satpathy, MD, President-Elect Michael Schrader, MD, Editor Yalda Shahram, MD Neeru Singh, MD Dennis Song, MD, DDS, Immediate Past-President Ranna Tabrizi, MD Kenneth Tai, MD Melanie Thompson, DO, Secretary Christina Wang, MD Kristin Wong, MD Andrea Yeung, MD Helen Yu, MD

For questions regarding journal, including possible submissions, contact Steve Heilig: Heilig@sfmms.org

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PRESIDENT’S MESSAGE Jason Nau, MD

THE QUIET WORK OF LEADING IN HARD MOMENTS This past year has tested everyone who works in medicine. Our profession is used to pressure, but the kind we are facing today feels different. The national conversation around healthcare and science has become louder, sharper, and more unsettled. We have all felt the effects of that turbulence, whether in patient interactions, public dialogue, or the policy debates that shape our daily work. As the president of our medical society, I have watched our members navigate this challenging landscape with patience, integrity, and a steady commitment to their patients and colleagues. I want to acknowledge that effort and express my gratitude for the way our community has continued to show up even when the path has not been clear.

One of the defining features of this year was the growing tension between what is happening nationally and what we must focus on locally. The broader cultural climate created real risks in how we communicate about science and public health. It often felt as if any attempt to clarify medical realities could be misinterpreted as taking a political stance. Yet our duty to our patients cannot be put on pause simply because the cultural environment has become sensitive. We were reminded repeatedly that local advocacy is where our influence is most substantial. It is the space where we can engage directly, speak with clarity, and support improvements that have a tangible impact on the care people receive.

This is why our society dedicated significant time this year to building a three-year strategy. We wanted to align our efforts around the mission that has always guided us: advocating for high-quality healthcare in our counties, strengthening the professional community among physicians, and promoting the wellbeing of our members. We often talk about burnout and moral injury, but we sometimes forget that isolation is one of their biggest drivers. Physicians need places to connect, unwind, talk about work, and feel a sense of belonging. In response to that need, we focused on creating more opportunities for members to gather, enjoy activities together, and support one another’s wellness. These moments have been simple, but meaningful.

They reminded us that community is not a luxury. It is a form of resilience.

Another significant step this year was the formation of a new committee dedicated to working with community-based organizations. We want to support patients not only in clinical spaces but also in the environments where they live and work.

Many of the factors that shape health show up outside the exam room. Different terms are used to describe them, but whether we call them social determinants or drivers of health, they are WWW.SFMMS.ORG

real forces that affect the well-being of individuals and families.

Our medical system is stretched. Community organizations are stretched. When we combine our efforts, we can create stronger support networks for people who are navigating everything from housing instability to food insecurity to access barriers.

This committee recognizes that a healthier community requires broader collaboration.

While we focused on these positive steps, we also faced a quieter challenge that is harder to talk about. Many recent policy changes have created risks for the patients we serve, and it has been challenging to get people to recognize the implications. I have experienced this same dynamic in my work with emergency preparedness. You can present threats, data, and clear examples, yet people often drift toward the more comfortable belief that nothing urgent needs to be done. The realities of daily life pull their attention in other directions. The risks feel abstract until a crisis makes them unavoidable.

This reluctance to act on long-term threats is part of human nature, but leadership requires us to help people see what they would rather not see. This year, I found myself thinking often about the Stacey Curve [thank you ACCMA leadership training!], a framework that distinguishes between simple, complicated, complex, and chaotic environments. Medicine is often comfortable in the cumbersome and straightforward spaces where expertise leads to solutions. Policy and culture place us in the complex space where the relationships between cause and effect are uncertain, and the outcomes of decisions are not immediately visible. Leading in this environment demands curiosity, steady communication, and a willingness to adjust as conditions evolve. It does not allow for rigid plans or the illusion of perfect control. It calls for guiding others through uncertainty rather than pretending that uncertainty does not exist.

This was our reality when examining the consequences of HR1 and other policy shifts that may affect access to care in our region. These changes could widen coverage gaps and create new vulnerabilities for patients who are already struggling to navigate the system. Our hope in the coming year is to work closely with healthcare partners across San Francisco and Marin to ensure that people are not left without support. A connected, coordinated network of care is essential. The margin of safety for many individuals is already thin. If we do not act intentionally, even small disruptions can lead to real harm.

Through every challenge, our society continued to reflect, adapt, and respond with integrity. We learned that principled continued on page 28

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Editorial

THE COST OF ULTRA-PROCESSED FOODS Michael Schrader, MD, PhD Ultra-processed foods (UPF) have lately been a political focus. The food we eat affects our health: our weight, our blood pressure, our cholesterol, our infections, and our cancers.

While we like to think that our dietary selections are a matter of choice, our choices are formed by marketing and availability. Our children are coerced into starting poor nutritional habits at an early age when they are impressionable and establishing lifelong habits.

Why have ultra-processed foods become so prevalent? They are generally high calorie, highly preserved, conveniently packaged, and highly flavored with salt and sugar. These foods are hyper palatable causing us to crave them. Our grain and livestock industries are heavily subsidized with government price supports. Huge food processing industries generate more than a trillion dollars annually.

Ultra-processed foods are often defined using the Nova scale of 1 through 4 where 1 is unprocessed or minimally processed, 2 is processed culinary ingredients, 3 is processed food, and 4 is ultra-processed. The latter is industrially processed and includes artificial colors, emulsifiers, preservatives, additives such as maltodextrin and high fructose corn syrup, and is often molded. Ultra processed food are sometimes defined as containing ingredients that would not be found in a home kitchen.

Secretary of Health and Human Services Robert F. Kennedy, Jr. has famously opposed the consumption of ultra-processed foods and has been able to make some small progress on food additives and coloring. Although we have serious disagreements with the Secretary over his vaccine policy, we share common ground on this issue.

San Francisco City Attorney, David Chiu, has now taken the a bold step by bringing a lawsuit against the largest manufacturers of ultra-processed foods. Chiu’s lawsuit accuses these manufacturers of creating a public health crisis by engineering and aggressively marketing these foods.

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SFMMS has long fought against sugary beverages, a class of ultraprocessed foods, which have contributed to the increase in childhood obesity and diabetes.

These sugary beverages are addictive. We have lobbied for sugary beverage taxes and restrictions on selling them in schools.

Similar to our campaigns on tobacco and nicotine containing addictive products, the path forward is consumer education, taxation, and limiting availability.

These efforts have been successful: cigarette vending machines are gone, areas for smoking are restricted, and cigarette taxes are levied. Pharmacies no longer sell cigarettes.

Other countries have taken the lead on warning labels for foods high in sugar, fat, and salt. These labels are on the front of the package and more obvious than the minuscule nutritional information on the backs of American food products. And they carry a health warning.

We can advocate for taxation of ultra-processed foods, restrictions on distribution in schools and in proximity to schools. We can lobby to cut back or eliminate government subsidies for ultra-processed foods. We can support UPF warning labels for foods high in sugar, salt, and fat. And we can support our San Francisco City Attorney in his lawsuit against the makers of ultra processed foods. SFMMS can establish policy at the CMA and AMA—this has already begun. And we can hold RFK Jr.’s feet to the fire by asking him to request a Surgeon General’s Report on the health effects of ultra-processed foods.

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Dr. Schrader, an internist at Dignity Health, is former Chair of the SFMMS delegation to the CMA and a past-president of the SFMMS.

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EXECUTIVE MEMO Conrad Amenta, SFMMS Executive Director

CELEBRATING NANCY PELOSI’S LEGACY IN HEALTH CARE For nearly four decades, Nancy Pelosi has been synonymous with San Francisco’s voice in Washington. Representing California’s 11th Congressional District since 1987, Pelosi combined national leadership with a deep commitment to her hometown, leaving an indelible mark on its health care landscape.

Pelosi entered Congress during the height of the AIDS epidemic, a crisis that devastated San Francisco’s LGBTQ+ community. At a time when federal response was slow and stigma rampant, Pelosi emerged as one of the earliest and most vocal advocates for action. She championed funding for HIV/AIDS research, treatment, and prevention, helping secure billions for programs like the Ryan White CARE Act, the AIDS Drug Assistance Program, and Housing Opportunities for People with AIDS (HOPWA). Her efforts extended beyond legislation: Pelosi supported the creation of the National AIDS Memorial Grove in Golden Gate Park, ensuring that San Francisco’s losses and resilience would be honored nationally. These initiatives not only saved lives but also reinforced San Francisco’s role as a model for compassionate, community-based care.

Pelosi’s health care advocacy reached its zenith with the Affordable Care Act (ACA) in 2010. As Speaker of the House, she was widely credited as the architect who steered the landmark legislation through Congress. The ACA transformed access to health care across the country, banning discrimination based on pre-existing conditions and expanding coverage to millions— including tens of thousands in San Francisco. Pelosi often highlighted how the law aligned with San Francisco’s values of equity and inclusion, particularly for vulnerable populations such as

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LGBTQ+ individuals and those living with chronic illnesses.

Her commitment did not end with passage. Pelosi fought persistent attempts to dismantle the ACA, organizing campaigns to protect Medicaid and premium subsidies that keep coverage affordable.

In recent years, she worked to extend enhanced tax credits under the Inflation Reduction Act, which lowered premiums for millions and capped insulin costs for seniors.

These measures have had tangible effects in San Francisco, where high living costs make affordable health care essential.

Beyond national legislation, Pelosi secured direct investments for local health programs. She helped channel federal funds to Zuckerberg San Francisco General Hospital for mental and behavioral health initiatives, including addiction treatment and prenatal care for vulnerable populations. She also supported community health centers in neighborhoods like the Tenderloin, which serve unhoused residents and transgender individuals—underscoring her belief that health care is a human right.

Pelosi’s health care legacy reflects a broader philosophy: that policy should protect the most marginalized. From confronting the AIDS epidemic to expanding access through the ACA and defending safety-net programs, her work has shaped San Francisco’s health infrastructure and influenced national standards.

As she prepares to retire, her contributions stand as a testament to how local advocacy can drive transformative change on a national scale.

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THE 2025 CMA HOUSE OF DELEGATES MEETING Ameena Ahmed, MD, MPH

The California Medical Association (CMA) convened its 153rd annual House of Delegates (HOD) meeting in Sacramento on October 18-19, 2025.

More than 1,000 California physicians and physicians-in-training gathered to debate and establish broad policy on the major issue, Responding to Federal Funding Cuts and Other Attacks on Health Care, Public Health and Medicine.

Among the many policies adopted were those opposing administrative or financial procedures that make it more difficult for physicians to provide timely care to patients; opposing federal and state policies that increase uncompensated care provided by physicians, clinics, and hospitals; reaffirming CMA’s strong commitment to ensuring access to full reproductive health care, including abortion services, for all patients; opposing Federal defunding of Planned Parenthood; and supporting protections for physicians who provide gender-affirming care in California and opposing any civil, criminal, or licensure actions against them.

The SFMMS contributed a statement supporting medication abortion access in particular, as that is under severe attack nationally.

The House also conducted elections and CMA installed its new officers. Shannon Udovic-Constant, M.D., served as President of the CMA. Dr. Udovic-Constant, who is past president of SFMMS and a pediatrician in San Francisco, was the 156th president of CMA and the fifth woman to hold the position.

She will now serve as immediate past-president of the CMA. San Luis Obispo pediatrician René Bravo, M.D., was installed as the 157th CMA president. In uncontested elections, former

SFMMS President George Fouras, M.D., was elected Speaker of the House and Jack Chou as President-Elect. Dr. Chou will serve on the executive committee in that role for one year, and will be installed at the conclusion of next year’s annual meeting. SFMMS Past President Brian Grady, M.D., ran a principled campaign for Vice-Speaker; Dr. Anna Yap of Sacramento was elected Vice- Speaker.

The House adopted governance reforms, as the culmination of a multiyear process that included input from delegations and individual members. The purpose of the reforms is to allow the House to best fulfill its duty to set policy for the CMA, and to achieve a good balance between member engagement and participation, as well as efficiency.

Dr. John Maa spearheaded the efforts of the SFMMS delegation to raise funds in support of CalPAC, the statewide Political Action Committee of the CMA. With Dr. Maa’s leadership and the generous participation of 100% of our delegates, SFMMS won the victory bell again this year, recognizing our delegation’s achievement in raising the most funds for CalPAC. This year, ours was one of 4 delegations to achieve 100% participation.

CalPAC funds directly support the political advocacy work of CMA and support efforts to elect physicians to public office. As much as HOD sets CMA policy, the work of CalPAC in the electoral process gets policy implemented by California lawmakers and policymakers.

THE 2025 SFMMS CMA DELEGATION Digiorgio, Anthony Congdon, Jayme Ahmed, Ameena (CHAIR) Satpathy, Sarita Eng, Roger Hessel, Tracey Kwok, Michael McLachlan, Ian Schaulis, Monique Schrader, Michael Song, Dennis Thompson, Melanie Cummings, Anne Meisel, Ben Alfrey, Ed

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Anker, Bryan Fung, Gordon Grady, Brian Huang, John Javaherian, Kavon Maa, John Margolin, Robert Nau, Jason Oo, Heyman Wang, Christina Wilson, Candace Yu, Helen (VICE-CHAIR) Blaustein, Mel Calman, Andrew Aquino, Melida

Desai, Mansi Goswamy, Juhi Hamblin, Colin (Basil) Hazboun, Rajaie Khan, Javaid Sarma, Karthik Milligan, Cathlin Mittal, Anita Patel, Shilpen Teng, Peter Tibuni-Sanders, Susan Windon, Charles Wong, Kristin

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LESSONS FROM SIX YEARS LEADING PHYSICIAN WELLNESS & ENGAGEMENT AT SFMMS Jessie Mahoney, MD In 2019, when I assumed the role of physician wellness lead for the San Francisco Marin Medical Society (SFMMS), I did not know that an extraordinary partnership was ahead.

I brought nearly two decades of experience in physician wellbeing. I also brought a wish. A wish for wellness to no longer be a separate initiative but instead be infused into everything.

A wish for wellness to be meaningful and integrated. Infused throughout medicine naturally and easefully.

In our first meeting Conrad—the new executive director— shared that he also believed that well-being should not stand alone as a separate initiative. His early and unwavering belief offered more than permission; it offered partnership, alignment, and a shared understanding that wellness is not extra—it is foundational.

Molly had also been recently hired as the Director of Engagement. She brought a steady presence, creativity, and organizational skills that made every offering over the past six years into something meaningful. Molly worked to ensure our programs were thoughtfully designed, beautifully executed, and infused with ease and hospitality. Her attention to detail made physicians feel welcomed, valued, and held.

From the beginning, wellness at SFMMS was deeply collaborative. It also offered something striking and unprecedented in wellness. Something profound and fundamental.

SFMMS said yes. Again and again. SFMMS said yes to innovative, creative, outside-the-box approaches rather than standardized offerings. SFMMS said yes to ideas that were experiential and yes to programs that honored physicians as whole humans—with nervous systems, families, identities, and lives.

At a time when many institutions struggled to operationalize wellness beyond symbolic gestures, SFMMS repeatedly said yes to meaningful, relational, non-performative offerings that support and transform physicians.

Why “Yes” Mattered Well-being initiatives can easily become narrow, compliance-driven, educational, or disconnected from the emotional and relational realities of practice. Physicians are busy, burned out, and increasingly isolated from one another and from the meaning that drew them to medicine.

What shifts culture is belonging, psychological safety, shared humanity, and community.

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This requires permission. Permission to experiment. Permission to listen deeply. Permission to be vulnerable and real. And permission to center whole-person needs.

SFMMS supported programming that offered these in abundance. Despite the pandemic, over these six years, we created spaces that helped physicians reconnect with themselves and with one another. Some of what we offered included: Yoga in the Redwoods; one-on-one virtual coaching; Women in Medicine gatherings; culinary medicine events; book clubs; immersive wellness retreats; special events for retired physicians and solo and small practices; museum meetups; coffee gatherings; farmers market connections and more.

The impact has been clear and measurable. Participation has skyrocketed; sponsorship interest for wellness programming grew substantially; physicians repeatedly described feeling more connected, engaged, seen, and valued.

Medical societies matter in wellness. Medical societies hold a unique and powerful position in the wellness landscape. One that most societies haven’t capitalized on yet.

Medical societies sit outside the healthcare institutions where physicians practice. Systems often struggle with wellness because internal hierarchy, pressure, productivity demands, liability, and culture limit vulnerability and experimentation.

Physicians understandably feel cautious about sharing struggles within the same institution that evaluates them. Medical societies, by contrast, offer a neutral space; freedom from institutional politics; cross-specialty community and belonging; connection without pressure; a nonjudgmental space to honor the full complexity of the lived physician experience. This vantage point allows societies to support physician well-being in ways hospitals and clinics cannot.

Over the last six years, SFMMS demonstrated that local medical societies have a broad, largely untapped capacity to strengthen community, leadership resilience, and personal sustainability.

Wellness as a Love Story Three weeks ago, I gave a TEDx talk titled: What Would Love Do? What if, before every difficult decision or conversation in healthcare, we paused long enough to ask: What would love do?

Medicine would change. Team culture would change. Patient care and leadership systems would evolve meaningfully. Endcontinued on page 28

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A REPORT BY YOUR AMA DELEGATES FROM THE AMA I-25 MEETING John Maa, MD and Ameena Ahmed, MD, MPH In November of 2025, your SFMMS delegation to the AMA traveled to Washington DC to join the California Delegation and PACWest at the AMA Interim (I-25) Meeting. SFMMS Delegation Members include CMA Immediate Past President Shannon Udovic Constant, MD; Man-Kit Leung, MD; Christina Wang, MD; Brian Grady, MD; George Fouras, MD; Jack Resneck, MD; Karthik Sarma, MD; and Shilpen Patel, MD. At the four day meeting, the AMA House discussed key policy resolutions. For highlights of I-25, please see the link here, which highlights policy related to scope of practice, AI, rural health care and Substance Use Disorder: https://www.ama-assn.org/health-care-advocacy/advocacyupdate/nov-21-2025-advocacy-update-spotlight-2025-amainterim-meeting As an update to the Annual meeting (I-25) in Chicago in June 2025: an emergency resolution called for the “immediate reversal” of the HHS decision by Secretary RFK Jr. to terminate the 17 members of the Advisory Committee on Immunization Practices (ACIP). The White House response in August was to remove the AMA from all ACIP vaccine advisory panels. Afterwards, U.S. Senator Bill Cassidy called the AMA “anti-science” and “anti-patient,” and in December he demanded more information from the AMA about the physician payment system. https://www.politico.com/news/2025/10/26/rfk-doctors-gopama-pediatricians-health-care-00622695 At I-25, a new streamlined online Reference Committee format was refined further, now with consent calendars for in person-testimony that resulted in much shorter sessions and a very efficient deliberation before the House. This process change may provide guidance to future GTAC reforms at the CMA HOD. The California delegation is especially proud that two resolutions authored by Dr. Shilpen Patel about prior authorization were adopted by the House of Delegates with the endorsement of both the CMA and PacWest. The AMA newsroom reported “Delegates took several actions to push back against this payer practice, including adopting a resolution for the AMA to ‘advocate that low-cost medications and procedures should not require prior authorization.’ ” A controversial guest speaker before the House was CMS Administrator Dr. Mehmet Oz who called upon MDs to speak up even when the message isn’t popular. He began his comments describing family members who are surgeons, before addressing Medicaid enrollment, Affordable Care Act subsidies, prior authorization, and Medicare waste, fraud and abuse. https://www.medpagetoday.com/meetingcoverage/ama/118572 The AMA released a press statement afterwards by President Bobby Mukkamala highlighting the areas of agreement and differences with Dr. Oz, and a path forward in policy discussions.

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I-25 was very active for physicians seeking leadership offices.

California CMA leaders Dr. Toluwalase (Lase) Ajayi and Dr. Alex Ding will be running for re-election to the AMA Board of Trustees, while Dr. Steven Wang will run for the Council on Medical Service at A-25. Dr. Al Ray was re-elected as our PacWest Chair. Meet and greet sessions were held for four MDs running for elected office: 1) Dr. Richard Pan in California, 2) Dr. Sion Roy for California State Senate (Santa Monica), 3) Dr. Amish Shah in Arizona, and 4) Dr. Tina Shah in New Jersey.

Fundraising for the Lawrence Cheung Memorial Fund continued after reaching its goal in June, and the first AMA scholarship recipient will be announced by the AMA Foundation in 2026.

Lawrence had always emphasized the importance of AMPAC and political fundraising, and would have been very pleased to see the California delegation reaching 100% participation at I-25 for the first time ever.

If you would like to support the SFMMS PAC you can do so here: https://www.sfmms.org/advocacy/sfmms-pac/make-a-contribution.aspx Finally, the AMA announced the Community Health Impact Lab micro grants to support physician-led initiatives aimed at improving health outcomes at the community level. This program funds innovative, community centered projects that address a broad range of health related challenges faced by populations with limited access to care. Through this initiative, the AMA seeks to empower physicians to implement creative solutions to respond to the unique challenges in their communities. The application deadline is March 1, 2026, and more information is available below. https://www.cvent.com/c/abstracts/a3f72f40-d453-4d94-993eb74b108da6cc

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John Maa, MD, is a surgeon practicing in Marin County and San Francisco and was 2018 SFMMS President.

Ameena Ahmed, MD, MPH, is board-certified in Internal Medicine and Preventive Medicine – Public Health. She is a primary care physician at Kaiser Permanente.

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Do You Work With Uninsured People Who Need Specialty Care?

Uninsured people who earn up to 400% of the federal poverty level ($5,217 per month for an individual, $10,717 for a family of four) are eligible for free specialty care.

Operation Access has immediate openings to provide donated surgical and specialty care through its network of participating medical volunteers and hospital partners. Visit operationaccess.org to refer someone or get involved as a volunteer.

REFERRAL PROCESS SEND REFERRAL TO OPERATION ACCESS

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Filling out our referral form is now optional but recommended to ensure we have a complete referral. If more convenient, send referral via fax or email through your Electronic Health Records system along with a patient demographics page.

Include specific procedure requested and referral coordinator information.

Attach relevant chart notes—including the medical need for the procedure.

Include radiology reports (e.g. ultrasound, CT scan, X-Rays), lab results, or other necessary items indicated on the referral guidelines.

OPERATION ACCESS SCREENS THE PATIENT We contact the patient to screen for eligibility by phone. Patients are generally contacted within 10 days of referral receipt. An appointment will not be scheduled in this call.

ELIGIBLE PATIENTS

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We send a text to eligible patients to explain the program and outline the process.

The referring clinic is notified of the eligibility status of all referrals in the semimonthly Referral Status Notification, requesting action on incomplete and unreachable referrals. *Eligibility: Uninsured and not covered by Medi-Cal, Medicare, and Workers Comp; Earn up to 400% of FPL; In need of outpatient procedure but not ongoing care.

WAIT TIMES Eligible patients are scheduled with a participating specialist. Most referrals can be sent to a specialist within 1 month. The average wait from referral to appointment is 1-3 months.

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When a specialist is available, an Operation Access case manager contacts the patient to confirm the appointment.

Our case managers try to coordinate appointments close to where the patient resides, but patients may need to travel to a specialist in another county.

We notify clinics when cases are completed and provide information about the outcomes, where the patient was served, and how to obtain the medical records Send referrals by fax to (415) 733-0019 or by email to referrals@operationaccess.org.

Call us with any questions at (415) 733-0052 or visit www.operationaccess.org.

Direct address (within EMRs): operationaccess@direct.sacvalleymedshare.org

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WELLNESS

CONNECTION AND COMMUNITY ARE NOT FLUFF. THEY ARE FOUNDATIONAL. Jessie Mahoney, MD More than ever, I have been focusing on building community and connection. For myself. And for others. As an empty nester who recently moved to a new community, a solo small business owner, and an entrepreneur, community and connection have risen higher on my priority list.

The benefits of community and connection are unparalleled.

Connection is profoundly human—and profoundly impactful.

Studies show it improves health outcomes, strengthens relationships, reduces burnout, and makes work and home life more joyful.

Trees and forests use connection and community as a source of strength and longevity. They connect underground in a vast web of roots and fungi, sharing nutrients and signals. This is how the forest survives and thrives. Humans need this too. We are meant to survive and thrive in community. We need connection for healing, growth, and the development of individual and collective strength. Feeling a sense of community is a form of medicine that helps calm our personal and collective nervous systems. It allows each of us to function optimally. Making friends and forging deep connections can be challenging, especially for women in medicine.

I and SFMMS aspire to make connections easier—by sharing tools and by providing opportunities to gather. You can learn more about SFMMS events at sfmms.org/events and you can learn more about my work at jessiemahoneymd.com. As I transition from my role as Chair of the SFMMS Membership Engagement Committee, I will still continue to work to gather physicians in community to connect deeply. Just like the surrounding forests, the more we can support each other and deeply connect with like-minded individuals, the more we will thrive both individually and collectively. Community and connection are not soft extras. They are essential for transforming yourself and transforming medicine.

Jessie Mahoney is a pediatrician, a certified life coach for physicians, and a yoga instructor. She is the Chair of the SFMMS Physician Wellness Task Force. She practiced pediatrics and was a Physician Wellness leader at Kaiser Permanente for 17 years.

Other Recommended Listening: Healing Medicine Podcast with Dr. Jessie Mahoney and Dr. Ni-Cheng Liang To listen, scan the QR codes with your smartphone or visit https://www.jessiemahoneymd.com/healing-medicine-podcast

From Powerless to Purposeful: Reclaiming Choice and Agency in Medicine Empowerment isn't about pretending everything is fine; it's about remembering that we always can choose our response. Today, Dr. Jessie Mahoney and Dr. Ni-Cheng Liang explore the healing power of choice. We share how we can shift from complaining into creativity and how we can move from victimhood to agency, mindfully.

Be Radiantly You: The Antidote to Exhaustion and Judgment

Exhaustion and disconnection don't always stem from doing too much, often they stem from pretending too much. In today's episode, we explore surprising truths about energy, authenticity, and what it really means to show up as yourself in medicine and in life.

Menopause Without Overwhelm: Choice, Compassion, and the Power of the Pause with Dr. Susan Baumgaertel

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Whether you're in perimenopause, menopause, or postmenopause—or supporting someone who is—this episode is full of gentle truths and nourishing permission to live this season with intention, softness, and spaciousness. Dr. Susan Baumgaertel is a profoundly thoughtful and creative physician who passionately reframes menopause around nourishment, pleasure, and presence at its center. With decades of experience in internal medicine and a unique blend of architectural and artistic insight, Susan offers a menu of sup portive, holistic, and empowering approaches for midlife and beyond.

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Gathering Our SFMMS Members in 2025 To learn more about our upcoming events and offerings, visit our SFMMS events page at https://www.sfmms.org/news-events/events.

SFMMS Small & Solo Practice Mixer “Very warm and collegial atmosphere. I met a specialist that I refer to, which was great. I really enjoyed listening to personal stories about colleagues’ roads to private practice, successes, failures, learning moments.”

– SFMMS Member

In September, SFMMS co-hosted our annual small and solo practice with the Pacific Professional Building/2100 Webster. The evening included welcome reception, talks by solo practice physicians who practice in Pacific Professional Building, and tours of several medical office suites.

With over 50 physicians in attendance, SFMMS plans on continuing this annual event for many years to come, so that our small and solo practice physician members can continue to connect and network with one another.

mixer a the

host

SFMMS at the Marin Country Farmer’s Market

In October, SFMMS with support and coordination of Dr. Laura Allen, SFMMS Member, gathered a group of SFMMS members and their family/friends to visit the Marin Country Farmer’s Market. The group enjoyed coffee and a tour of vendors at the farmer’s market. Stay tuned for more events like this, as Marin Country Mart has offered to host SFMMS again with more in-depth events, such as cooking classes!

MEC the the

SFMMS Financial Planning Mixer

“Such a great discussion about financial strategies specifically for physicians. It was great to share ideas with colleagues!”

– SFMMS Member

In November, SFMMS with support and coordination of Dr. Brian Grady, SFMMS Past President and MEC Member, gathered a small group of our members for our second financial planning mixer and dinner. The goal of this second gathering was to continue the financial planning discussion on the needs of our physician members and to share resources. Every member who registered for this event received a free copy of a curated list of financial planning books by White Coat Investors and Dr. Grady.

California Doctors in Retirement (CADRE) Gathers Monthly in Greenbrae

"The monthly CADRE meeting is always fun. This gathering is for special people, who have had unique lives. As retired SF and Marin physicians, we can be best understood by each other.” Join your fellow retired physician colleagues for CADRE (CAlifornia Doctors in REtirement) for casual conversation, connection, & free coffee, monthly (3rd Thursday of the month) at Peet's Coffee in Greenbrae.

Are you looking for Additional Wellness Resources?

The SFMMS Wellness page, curated by your SFMMS colleagues, includes upcoming and past wellness events, resources and more. Learn more by visiting the SFMMS Wellness page at www.sfmms.org/get-help/physician-wellness or by scanning the QR code with your smartphone.

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MARIN COUNTY COMMUNITIES LEAD THE NATION IN ADVANCING TOBACCO AND NICOTINE PREVENTION POLICIES THAT END THE INDUSTRY’S INFLUENCE John Maa, MD; Raven Twilling; and Jeremiah Mock, MSc, PhD On October 16, 2025, the Tiburon Town Council in Marin County made history by passing a policy that moved California one step further in the State’s Tobacco and Nicotine Endgame. Tiburon Councilmembers voted unanimously to prohibit the sale of all commercial tobacco and nicotine products (except for FDA-approved cessation aids). This policy ensures that Tiburon’s children and teens will never be exposed to point-ofsale advertising that targets them in their community, and it will ensure that tobacco/nicotine users are supported in their efforts to quit. Tiburon is the third U.S. city to end the sale of all commercial tobacco and nicotine products, following the California cities of Beverly Hills in 2019 and Manhattan Beach in 2020. Tiburon is the first in the nation to pass an ordinance without exceptions or allowances.

This Endgame policy is the culmination of Tiburon’s decades of policymaking and educational work that created conditions where no retailers felt there was a viable market to start selling tobacco. Mayor Holli Thier, who sponsored the ordinance, emphasized that Tiburon’s Endgame policy will save lives, prevent youth from being targeted by the tobacco and nicotine industry, reduce addiction, and protect Tiburon’s environment, noting that “this generation of youth refuses to be exploited by the tobacco industry as so many generations have been before.”

Following Tiburon’s lead, on November 16, the Town of Ross advanced its own landmark Endgame policy,preemptively ending the sale of all commercial sales of tobacco, cigars and nicotine products. Rhett Krawitt of the Marin Youth Advocacy Committee,

Raven Twilling (Marin Youth Advocacy), Dahlia Zail (Marin County resident and advocate), John Maa, Rhett Krawitt (Redwood High School student), Diana Garcia (Novato High School student), Bob Curry (Smoke-free Marin Coalition), Holli Thier (Honorable Mayor of Tiburon).

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a cancer survivor, explained, “I live with the adverse health effects of medicines necessary to save my life. It is important that youth do not have to live with the effects of unnecessary chemicals and nicotine. That’s why this policy is critical for supporting youth health in Ross and helping youth stay away from harmful nicotine products.” Ross Mayor Julie McMillan agreed stating, “I think it is important to go forward and make it as difficult as possible to purchase tobacco products.” Mayor Pro Tem Elizabeth Robbins said, “I respect and applaud the students’ activism. Tobacco is addicting, and it causes health issues.”

SFMMS President Dr. Jason Nau reinforced this message, stating, “We believe that keeping tobacco and nicotine products out of Ross is a critical step in safeguarding the future of the community.” The Endgame policies in Tiburon and Ross, he noted, along with President-elect Dr. Sarita Satpathy, build upon decades of scientific consensus and professional advocacy. UCSF researcher Dr. Ruth Malone added, “These towns are making history by standing against the tobacco industry and protecting a healthy environment for everyone. There is simply no longer a reason that these harmful and addictive products should be widely sold.”

On October 23, the Marin County Board of Supervisors unanimously passed an ordinance ending the sale of e-cigarettes and introduction of heated tobacco products, and establishing minimum pricing and packaging for other tobacco and nicotine products. This policy was championed by Dr. Lisa Santora, the Marin County Public Health Officer, and Dr. Melanie Thompson, and will increase the price of a pack of cigarettes and other tobacco and nicotine products to $12, followed by scheduled increases of $1 every two years.

The tobacco and nicotine industry’s products remain the leading cause of preventable disease and premature death in the U.S. and California. In 2023, the industry's products killed more than 480,000 people nationally and 40,000 Californians. Nationally, each year, involuntary exposure to secondhand smoke kills about 34,000 people. The industry’s highly addictive tobacco products are the only consumer products that, when used as intended, kill nearly half of their users.

Seven years ago, the California Department of Public Health (CDPH) announced a revolutionary statewide endgame goal, namely to end the epidemic of tobacco use and nicotine addiction in every community, and end the tobacco and nicotine industry’s influence by 2035. CDPH (see UNDO.org) and California commu-

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nities are working to counter the big tobacco and nicotine companies’ so-called “tobacco harm reduction” rebranding and prevent the companies from marketing their newest highly addictive products, like nicotine pouches, that the companies deceptively claim are “better alternatives” even though they deliver nicotine, a highly addictive neurotoxin.

CDPH surveys consistently show that nearly 70% of adults agree that the sale of nicotine products should not be allowed (other than FDA-approved cessation aids). In 2022, Californians took a major step toward this goal by voting overwhelmingly (63.4%) in favor of Proposition 31, which banned the sale of nearly all flavored commercial tobacco and nicotine products.

This vote demonstrated widespread public support for policies that end, once and for all, the harms of tobacco use and nicotine addiction. Marin County had the highest percentage of voters in any county (81.5%) who supported the proposition, largely because all eleven jurisdictions in Marin already had policies prohibiting the sale of flavored tobacco and nicotine products.

The World Health Organization estimates that one billion people will die from tobacco use this century unless significant and coordinated action is taken. These Marin policies illuminate a path forward for local, statewide, national, and international efforts to eliminate the industry’s influence, prevent youth uptake, and support cessation. Local governments can lead the way, even during a period of stalled federal momentum, with bold prevention policies that are feasible and advance their communities’ health priorities. These policies reflect a growing movement among young people who are demanding stronger protections from the industry’s predatory marketing of highly addictive products. The Marin victories, driven largely by high school students, offer renewed inspiration and a blueprint for communities that are committed to protecting public health and preventing addiction before it begins.

John Maa, MD, is a surgeon practicing in Marin County and San Francisco and was 2018 SFMMS President.

Raven Twilling is a public health program coordinator specializing in tobacco and nicotine prevention, youth engagement, and local policy advocacy. She was born and raised in Marin County.

Jeremiah Mock, MSc, PhD, is a professor at the University of California San Francisco who specializes in studying endgame policymaking. He is a Marin County resident.

The Free Clinic Movement and Addiction Medicine: Medical Students Tour the Haight

In what has long been an annual offering, sponsored by the UCSF Medical Alumni Association, first-year medical students joined together for an educational tour of the Haight-Ashbury district, centered on Dr. David Smith’s founding of the Haight-Ashbury Free Clinic in 1967 and the subsequent development of Addiction Medicine as a speciality. After an introduction by Smith, the SFMMS’s Steve Heilig toured them through key historic points and issues, winding up at the new Counterculture Museum where they received copies of Smith’s memoir. A few comments from students are below.

Having the chance to learn from Steve about the first free clinic in the US and the birth of addiction medicine was a privilege I wish more people in the city could experience. I grew up here, and it was an eye-opening and incredibly fun way to explore our community and the challenges Dr. David Smith and the field of addiction medicine faced to reach where we are today.

– Avani Mylvara

Having volunteered with a student-run free clinic in college, it was incredibly inspiring to visit the birthplace of the first free clinic in America. The tour by Steve Heilig (and his dog!) was an amazing and immersive way to learn more about Dr. David Smith and San Francisco history, especially as someone who is new to the area. Healthcare is absolutely a right, and not a privilege, and I feel even more affirmed in this belief.

– Rebecca Li

I had the privilege of attending the Haight-Ashbury Insider Tour with Steve Heilig, who shared powerful insights into the history of addiction care and the founding of the HaightAshbury Free Clinic. As someone new to San Francisco, I was grateful to learn about the city’s roots in community-based care and mutual aid. One especially meaningful moment was meeting someone who had worked alongside Steve for many years. Hearing them reflect on their shared efforts showed how enduring his impact has been within the community.

– Leona Hariharan

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INTERVIEW WITH CITY ATTORNEY DAVID CHIU Michael Schrader, MD, PhD Can you tell us what the job of SF City Attorney entails?

I oversee an office of 350 legal professionals who provide legal services to our Mayor, Board of Supervisors, elected officials and the 100+ departments, boards and commissions that comprise the $16 billion government of the City and County of San Francisco, which includes our public health system. We provide legal advice to our clients, draft countless contracts and ordinances, and defend and bring thousands of lawsuits. My office has over two dozen teams, including a Health & Human Services Team that advises our $3 billion San Francisco Department of Public Health.

And what do you like most about being the SF City Attorney?

Like the work of a physician, my job changes every 15 minutes and is never dull, as I work alongside other public servants to protect the health of our city. I love being able to take on the burning issues of the day; at the moment, that includes tackling public safety, our housing challenges, homelessness, addiction and mental health crises on our streets, and revitalizing our downtown economy. At this time of inequality and climate crisis, I’ve prioritized the enforcement of worker protections, consumer protections, and environmental protections. During an era when the federal administration is routinely violating the rule of law, my job is to protect the values, funding, and communities of San Francisco and California, which our lawyers are doing aggressively.

What drew you into politics and leadership?

Growing up as the son of first-generation immigrants, I never dreamed of becoming an elected official or even a lawyer, because my family knew no elected officials or lawyers. But I learned about service from my father, who was a doctor, and my mother, who was a teacher. I studied the civil rights movement in college and was inspired to get graduate degrees in public policy and law. That education put me on the path to become a criminal prosecutor, civil rights attorney, founder of a public affairs technology company, local and state legislator, and now San Francisco City Attorney.

You are particularly interested in issues that affect the medical profession and our patients. You were instrumental in keeping Laguna Honda open, you won a huge settlement against pharmacies for dispensing opioids, you have defended reproductive rights, backed soda taxes, backed tobacco and vaping controls. What fascinates you about health issues?

Growing up as the son of a doctor and the grandson of a Chinese herbalist, I have always been fascinated by medicine, the human body, and the life sciences. In high school, I aspired to become a doctor. In college, I majored in biochemistry for two 24

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years, completed all of my premed courses, and did my undergraduate thesis on trends in national health care politics.

I signed up to take the MCATs, but after months of Kaplan prep classes, I realized that my calling was in public policy and law. But, I’ve always been deeply drawn to the idea that health care is absolutely fundamental to life, liberty and the pursuit of happiness—and the Declaration of Independence reminds us that the government has an enormous responsibility for those fundamentals. A measure of our success as a society is whether everyone has access to affordable, outstanding health care, and throughout my career as an elected official, I have been dedicated to that vision.

Several years ago when Laguna Honda was threatened with closing you filed an injunction to keep it open temporarily.

What was your strategy then?

Our office rarely sues a federal administration that we work with well, but unfortunately, the threatened closure of the largest skilled nursing facility in California by the Biden Administration left us with no choice. The lives of hundreds of patients were on the line, and we sued in order to compel a conversation that would put our 150-year-old institution back on stable footing.

Fortunately, we were able to resolve the hospital’s legal issues, and my lawyers and I were honored to work with the hospital’s leadership to save Laguna Honda.

You have long partnered with SFMMS leadership in pursuing our mutual goals. How did this partnership begin and how has it helped you reach your goals?

When I was first elected to public office 17 years ago, I enjoyed getting to know the leaders at SFMMS. Since then, I have relied on the expertise of so many great SFMMS physicians on a myriad of topics.

On the Board of Supervisors, I helped to lead efforts to tax Big Soda, and championed the seismic safety of our City’s hospitals, including the rebuild of the former St. Luke’s, Chinese Hospital, and the new CPMC Cathedral Hill Hospital. In the Legislature, I was the Assembly lead author on our country’s strongest transparency law for drug prices, authored major reproductive health laws, and led a coalition to hold the lead paint industry accountable for poisoning an entire generation of kids. As City Attorney, I led efforts to deliver a record $350 million of opioid settlement dollars to pay for public health programs, brought lawsuits against online tobacco retailers unlawfully selling flavored tobacco, and established a practice of obtaining gun violence restraining orders. I did all of this work alongside and with the advice of tremendous medical professionals.

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We understand that now you are planning to focus on ultra-processed foods which are increasingly recognized as contributing to obesity, diabetes, hypertension and even cancer. What is your plan?

This month, I filed a first-of-its-kind lawsuit against the largest manufacturers of ultra-processed foods, which impose enormous costs on millions of Americans, cities and states. I had learned about many studies, enormous data sets, and the consensus within the international scientific community that these products make us sick, plain and simple. And my lawyers have documented the role of Big Tobacco over the years in purchasing major food companies, transferring their addiction scientists and marketers to this new industry, and making untold billions while knowing their products make people very sick.

This fight may take years, but my City Attorney’s Office has successfully held accountable industries that profited enormously from products they knew harmed the health of millions — tobacco, lead paint, opioids. This is our next fight, and I’m grateful to doctors who have supported us along the way and provided valuable insights.

The San Francisco Bay Area has always been a thought leader for our country and SFMMS has been at the forefront of some of the national public health efforts. How can we forward public health initiatives about tobacco, sugary beverages, firearms, reproductive care, healthcare access, aid in dying nationally?

There’s a saying in politics: “As goes San Francisco, so goes California; and as goes California, so goes the country.” The leadership of SFMMS has been instrumental to significant national public health movements, and your impact cannot be underestimated. I am proud to have stood alongside SFMMS leaders as we have taken on Big Tobacco and Big Soda. Your doctors advised my colleagues and me during the COVID pandemic.

When Roe v. Wade was struck down, your leaders stood with me as I launched the Legal Alliance for Reproductive Rights with the Bar Association of San Francisco—70 law firms providing pro bono assistance to providers and patients. I look forward to continuing to team up with SFMMS in future fights for the public health of San Franciscans and Californians.

What challenges are next for you?

Given the authoritarian bent of the Trump Administration, the next three years will be challenging for all of us. In 2025 thus far, I have had to bring 13 lawsuits against the Trump Administration, which is six times the pace of our office’s litigation compared to the first Trump term. We have sued not because we want to, but because we must. We’ve had to go to court to ensure access to critical health care data, to protect health care funding, and to stand up for health care for our most vulnerable, reproductive health care, and gender-affirming care. These are righteous fights that I am honored to be a part of.

Our Office’s consumer protection docket, which includes our lawsuit against the ultra-processed food industry, is always busy but rewarding. And, we continue to advise and support policymakers in the critical work of running our City and working tirelessly to make San Francisco the best place to live, work, and visit.

Incoming President, Dr. Sarita Satpathy and Past President, Dr. John Maa with City Attorney of San Francisco, David Chiu at a press conference for San Francisco's lawsuit against companies for ultraprocessed food. SFMMS Past President and associate clinical professor at UCSF, Dr. Kim Newell Green (not pictured) stated during the press conference, "...the products also affect consumers’ mental health."

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We are saddened to hear of the passing of our esteemed colleague, Collin P. Quock, MD. Dr. Quock was a leader whose lifelong connection to Chinese Hospital began with his birth here in 1940, and his impact on our institution has been profound and enduring.

After returning from medical training in 1971, he set up private practice in the community as an internist and cardiologist.

He served as Chief of Medical Staff at Chinese Hospital, and helped shape many of the clinical services that define Chinese Hospital today.

His vision and leadership contributed to the development of the cardiopulmonary unit, the intensive and coronary care services, critical-care nurse training, and the foundations of the Hospital’s emergency department.

Beyond his clinical leadership, Dr. Quock was a dedicated teacher, innovator, and community advocate. He established the

Annual Chinese Hospital Lecture and Award, supported national efforts advancing Asian American health, taught at UCSF for 37 years, and played a pivotal role in expanding cardiac care, home health services, and dialysis access for our community.

His commitment to preserving our history through the hospital archives and Medical Staff archives ensures that future generations will understand and appreciate our roots.

In 2024, Dr. Quock was honored the Chinese Hospital Outstanding Physician Leadership Award.

We honor Dr. Quock’s extraordinary service, compassion, and unwavering dedication to Chinese Hospital and its Medical Staff. His legacy will continue to guide and inspire us. Our thoughts are with his wife, Betty, and their family during this difficult time.

SF Free Clinic Seeking Physician Volunteers to Help Provide Care to the Uninsured The San Francisco Free Clinic, founded in 1993 by Drs. Patricia and Richard Gibbs, provides free medical care to more than 2,500 uninsured patients each year—over 6,000 visits in total.

We provide primary and urgent care services but we rely on the generosity of volunteer specialists for curbsides and consults.

These are unprecedented times. With policy changes expected to significantly increase the number of uninsured, and safety-net clinics already stretched thin, the need for physician volunteers has never been greater. Your contribution—whether through specialist consultations or general support—can have a direct and immediate impact on patients who have nowhere else to turn.

Colleagues who volunteer with us describe the experience as both nourishing and a powerful reminder of why they entered medicine.

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To learn more or to volunteer, please see the fact sheet at https://sffc.org/volunteer

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LESSONS FROM SIX YEARS LEADING PHYSICIAN WELLNESS & ENGAGEMENT AT SFMMS continued from page 7

of-life care, pediatric care, and interdisciplinary collaboration would deepen.

Imagine healthcare spaces designed as houses of love—a real model being explored in Vietnam—where human presence, relational care, and nervous system safety matter as much as clinical expertise.

The TEDx talk won't be released until later winter but SFMMS has already taken meaningful steps toward that vision simply by saying yes to offerings that honor physicians as whole people, not just professional identities. They have supported physician wellness and engagement grounded in compassion and understanding that physician well-being is essential to quality, safety, ethics, and sustainability.

A Transition, Not a Departure As I conclude my formal wellness role with SFMMS, I am not stepping down so much as stepping up. My work in physician well-being has expanded rapidly. I now partner with hospitals, medical groups, and academic medical centers across the country through leadership workshops, keynote speaking, institutional coaching, and immersive retreats at Nicasio Creek Farm.

The momentum is extraordinary, and the need is urgent. To continue, I must make space—for myself, for growth, and for the future leaders who will carry the wellness vision forward at SFMMS with clarity, creativity, and heart. What I leave behind is not a program, but a proof of concept:

President's Message continued from page 3

leadership is not loud. It is steady. It asks us to stay focused on our mission even when the world around us is unpredictable.

It asks us to nurture relationships, encourage discussion, and make room for diverse experiences. It asks us to protect the community we serve in ways that may not always be visible to the public but are essential to the long-term health of our region.

As we look ahead, I invite each of you to remain engaged with the society's work. We need your insight, your voices, and your presence. The challenges we face will not resolve on their own,

• Local medical societies can lead.

• Connection is medicine.

• Creativity belongs in wellness.

• Psychological safety multiplies engagement.

• Saying yes transforms culture.

None of this would have been possible without Conrad’s early belief that wellness belonged everywhere and Molly’s steady, skillful stewardship in bringing each offering to life with ease and excellence.

Looking Forward SFMMS is beautifully positioned to continue nurturing physician well-being as a foundational component of leadership identity, professional sustainability, and ethical medical practice.

The shared yeses of the past six years have created a strong and enduring foundation.

With thoughtful leadership, collaboration, and curiosity, medical societies across California—and beyond—could follow suit.

Wellness is not soft work. It is strategic work. It is sustainability work. It is workforce retention, leadership development, patient care quality, and moral resilience work. Most importantly, it is human work.

I am deeply grateful to the SFMMS leadership, membership, and staff for the privilege of stewarding this vision—and for saying yes, again and again.

– Jessie Mahoney, MD

but together we can strengthen the systems that support our patients and one another. I am grateful for your dedication and for the trust you place in this organization. I remain committed to serving you and to supporting a healthier future for the communities we care for.

Jason Nau, MD, is an emergency physician at Kaiser Permanente in San Rafael, CA, where he’s been caring for his community for 26 years. A self-proclaimed serial hobbyist and amateur philosopher, he’s driven by curiosity, always eager to explore new ideas, and unafraid to have his beliefs challenged—and occasionally overturned.

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