Fall 2016

MACRA: What You Should Do To Prepare Rotacare Decision Medicine 2016 Yes On Prop 56 Fall 2016 FALL 2016

SAN JOAQUIN PHYSICIAN

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VOLUME 64, NUMBER 3 • SEPTEMBER 2016

Decision Medicine 2016

14 17 35 36 42 49 FALL 2016

{FEATURES} ANNUAL MEMBERSHIP DINNER

{DEPARTMENTS}

MACRA

22 IN THE NEWS

Understanding the Medicare payment reforms

ROTACARE UPDATE WORKING TOGETHER AS ONE

Dignity Health St. Joseph’s Medical Center in Stockton

DECISION MEDICINE 2016

Hands On Education At Its Finest!

New faces and Announcements

54 PUBLIC HEALTH

Syphilis Continues to Rise in San Joaquin County

60 PRACTICE MANAGEMENT:

Committed to Improving Quality Health Care

63 NEW MEMBERS 65 IN MEMORIAM

YES ON PROP 56

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PRESIDENT Kwabena Adubofour, MD PRESIDENT-ELECT Grant Mellor, MD PAST-PRESIDENT John Zeiter, MD SECRETARY-TREASURER George Savage, MD BOARD MEMBERS Raissa Hill, DO, Dan Vongtama, MD, Alvaro Garza, MD, MPH, Mohsen Saadat, DO, Clyde Wong, MD, Peter Garbeff, MD, Sanjay Marwaha, MD, Ramin Manshadi, MD, Benjamin Morrison, MD

MEDICAL SOCIETY STAFF EXECUTIVE DIRECTOR Lisa Richmond MEMBERSHIP COORDINATOR Jessica Peluso ADMINISTRATIVE ASSISTANT Nicole Bojorques

SAN JOAQUIN PHYSICIAN MAGAZINE EDITOR Lisa Richmond EDITORIAL COMMITTEE Kwabena Adubofour, MD, Lisa Richmond MANAGING EDITOR Lisa Richmond

COMMITTEE CHAIRPERSONS DECISION MEDICINE Kwabena Adubofour, MD

CONTRIBUTING WRITERS

LEGISLATIVE Jasbir Gill, MD

James Noonan, Kwabena Adubofour, MD,

COMMUNITY RELATIONS Joseph Serra, MD

Alvaro Garza, MD, MPH, Brandon Piasecki,

PUBLIC HEALTH Alvaro Garza, MD SCHOLARSHIP LOAN FUND Matthew Wetstein, PhD

CREATIVE DIRECTOR Sherry Lavone Design

CMA HOUSE OF DELEGATES REPRESENTATIVES Robin Wong, MD, Lawrence R. Frank, MD,

Julie Vaishampayan, MD, MPH, Hemal Parikh, MPH, Joseph Serra, MD THE SAN JOAQUIN PHYSICIAN MAGAZINE is produced by the San Joaquin Medical Society

James R. Halderman, MD, Roland Hart, MD, Grant Mellor, MD, Kwabena Adubofour, MD, Raissa Hill, D.O., Ramin Manshadi, MD

SUGGESTIONS, story ideas or completed stories written by current San Joaquin Medical Society members are welcome and will be reviewed by the Editorial Committee.

PLEASE DIRECT ALL INQUIRIES AND SUBMISSIONS TO: San Joaquin Physician Magazine 3031 W. March Lane, Suite 222W Stockton, CA 95219 Phone: 209-952-5299 Fax: 209-952-5298 E-mail Address: lisa@sjcms.org MEDICAL SOCIETY OFFICE HOURS: Monday through Friday 9:00 AM to 5:00 PM Closed for Lunch between 12pm-1pm

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FALL 2016

FALL 2016

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EXECUTIVE DIRECTOR’S REPORT

THE FUTURE IS BRIGHT

DECISION MEDICINE - 2016

As many of you know, each July we facilitate our Decision Medicine program for high school juniors and seniors who are interested in a career as a physician.

It is an extremely busy two weeks with little down time, but ironically we always end up feeling energized by the experience! Every year, a highlight of the program is the one-on-one mentoring opportunity each student receives with a local member physician in their practice. A few lucky students even observed surgery! It is so rewarding to see our health care community continue to rally around this program as they plan fun and engaging activities for students at their facilities. I have to say that if the students I met this summer are any indication, the future of medicine is bright in San Joaquin County! For a glimpse in to this year’s program, please see page 42 and “like” our Decision Medicine Facebook page to watch our awesome highlight video.

Fall kicks off of our annual membership campaign! Membership not only provides you with personal benefits, but opens a wide array to services to your practice managers and staff as a whole. Additionally, we at SJMS and CMA hope you truly appreciate the extensive lobbying and advocacy that takes place every day in Sacramento and in Washington D.C. on your behalf.

In November, we Californians will have the vital opportunity to stand up to tobacco companies and save lives. Proposition 56 will raise the tax on cigarettes and other tobacco products—including electronic cigarettes containing nicotine—which medical experts warn are creating a major public health threat to children. The California Medical Association has joined the American Cancer Society and the American Heart Association in sponsoring Prop. 56, because tobacco hurts all Americans— even those who don’t smoke. Only those who use tobacco will pay this simple user fee. The vast majority of funds generated by Prop. 56 will go to pay for health care for low income Californians through Medi-Cal. Additional funds will be directed to the California Department of Education for smoking prevention programs and medical research into tobacco related diseases. Please join SJMS in voting YES on PROP. 56!

Finally, we hope that you will Save the Date for our annual Holiday Party on Thursday, December 15, at Stockton Golf and Country Club. This year, we will be presenting the Outstanding Achievement in Medicine Award to Dr. Bennet Omalu. More details are in the enclosed advertisement.

All the best,

Lisa Richmond

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FALL 2016

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A message from our President > Kwabena O.M. Adubofour, MD, FACP

Let Us Look After Each Other In a 2002 article published in JAMA, Spickard et al. make this statement: “Physicians must be guided, from the earliest years of training, to cultivate methods of personal renewal, emotional self awareness, connection with social support systems, and a sense of mastery of and meaning in their work. It is not incidental to medicine, but it is at the core of the deepest values of the profession to first, do no harm. Doing no harm begins with one’s self”.

Recently, I have been thinking about the impact of physician burnout in our community. Unfortunately, we have had our share of the adverse impact of physician burnout, and sadly we have not been there for each other in a majority of such cases.

We need to take a serious look at the house of medicine and ask if we are doing enough to decrease the impact of this epidemic amongst the physicians of this community.

Burnout: A Serious Epidemic When you look at published data, the statistics on physician burnout paint a very sad picture and we can no longer ignore these numbers: ABOUT THE AUTHOR ­ Kwabena O.M. Adubofour, MD, FACP Medical Director, East Main Clinic and Stockton Diabetes Intervention Center and Current President of San Joaquin County Medical Society.

- 67 percent of doctors surveyed know a physician who is likely to stop practicing medicine within the next five years as a result of physician burnout.

- Physicians are more than twice as likely to commit suicide as the general population.

- Medical students’ rate of depression is 15-30 percent higher than that of the general public.

- In 2013, 39.8 percent of physicians responded that they were burned out. In 2015, that number jumped to 46 percent.

- Each year roughly 300-400 U.S. physicians commit suicide.

- Over half (51 percent) of female physicians across all specialties reported burnout in 2015.

FALL 2016

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A message from our President > Kwabena O.M. Adubofour, MD, FACP

Definitions Before I dwell on the negative impact of physician burnout, let’s define it. The literature is replete with definitions of burnout. I find the definition offered by Masiach and associates to be the most useful because it goes further in painting the full spectrum of burnout.

They describe burnout as emotional exhaustion, depersonalization and lack of personal accomplishment.

Let’s expand on each of these characteristics: 1) Emotional exhaustion – tiredness, emotional depletion, fatigue; 2) Depersonalization – negative cynical attitudes, impersonal feelings, disengagement, impatience, frustration with patients and staff; 3) Lack of personal accomplishment – inadequacy, sense of failure, apathy to protect against frustration, lack of perceived control.

The Proneness Factor So what is it about being a physician that makes one prone to burnout?

- When you are trained to put your own feeling aside in the care of your patients?

- When you are encouraged to work long hours and to be selfless as you forgo sleep and time with family and friends?

- When you do not have or make the time to recharge, or re-new yourself, be it through exercise or meditation?

- When despite your best efforts you are not appreciated?

- When you are constantly falling behind on your goals?

The above, as well as the high work demands and responsibility for the health and wellbeing of others, place physicians at a greater risk for burnout.

Adverse Impact Some have taken other roads, far from the daily practice

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of medicine, and others have prematurely decided that the sacrifices were too great and have retired – no longer giving off of themselves.

What has caused the most anguish is the knowledge that some in our midst opted to end it all by choosing suicide, leaving behind loved ones and the patients and a job they once cherished.

Recognizing Burnout Let me suggest that we must routinely take a self assessment “burnout” test by asking a few simple questions: - Do you dread going to work?

- Are you more angry than usual?

- Do you feel unappreciated?

- Do you feel happy and fulfilled?

- Do you take time to really laugh and relax?

- Are you overly obsessed with work?

- Are there conflicts outside of work which remain unresolved?

Looking After Each Other We need to look after each other. We need to say something when we see that a colleague may be adversely impacted by a heavy work load and daunting work schedule. We need to recognize the early signs of depression when this disease rears its ugly head in our midst. When, as a leader, you see team members resigning, you need to ask the all-important question as to whether you are fostering a work environment that is toxic.

We need to encourage each other to step back and perform a much needed autopsy of our work-life balance and to be honest in that assessment.

In the pages of a previous edition of our magazine is a

FALL 2016

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FALL 2016

A message from our President > Kwabena O.M. Adubofour, MD, FACP

poem I wrote dealing with this same subject. Written from the point of view of a patient yearning to re-establish the warmth and compassion of the physician-patient relationship – a few lines from the poem “Depleted to Renewal”:

“What you have my permission to do is to bask in the majesty of your calling To rekindle the fire To refill your cup”

So how does one rekindle the fire? How does one adopt meaningful steps to avoid burnout? In an excellent article dealing with strategies to prevent physician burnout Kevin Campbell, MD, lists the following personal and professional strategies: 1) Identify personal and professional values. Do some soul searching. What brings joy to your life both inside and outside of work? Focus on how to find more of these things and weave them into your daily routine.

2) Engage in religious or other spiritual activities.

3) Pay attention to your personal life. Find things that give meaning to life outside of work. Strive for a calmness and sense of well-being. Schedule time off.

4) Spend time with family, friends and engage a supportive partner or spouse.

5) Exercise regularly. Make time to care for your own physical health.

6) Analyze your practice situation and attempt to restructure things in a way that makes you feel empowered and ready for success.

7) Find new meaning in your work and set limits.

8) Develop adequate administrative support systems.

9) Make the practice environment meaningful but fun – pick a day when you and the other members of your staff can spend time together over lunch or dinner.

Make this a regular occurrence and get to know each other and learn to be there for each other and appreciate the role of every staff member. This becomes important when you realize that you spend more time together than with the members of your own family each week. Also pick a day when the clinic can have a “silly” day – wear a red nose or wig to work – someone did say laughter is the best medicine.

10) If you are routinely seeing 40 patients a day in an ambulatory primary care setting as a solo practitioner then it is time to get additional help.

11) Appoint a staff person/physician to be the “wellness champion” of the clinic/department – responsibilities should include fostering a workplace culture supportive of wellness activities.

12) Learn to meditate – this should not be too complex an endeavor. What I have found useful is the practice of a modified form of Vipassana or what has been termed by experts as insight meditation. Taking time out a few minutes every day to be mindful and fully aware of your breathing has been shown to reduce stress. The technique involves gently bringing attention to your breath. Inhale and hold for about 5 seconds and exhale and hold also for about 5 seconds. Continue the cycle for about 5 minutes per session.

Above all, actively seek to be well as you try to make your patients well. That is not all – let us also be there for each other as practitioners of the science and art of medicine.

Each time you encounter a colleague take time to really listen to them, take time to find out if they are well and if you find that there is something wrong say something and help them do something about it. Burnout can be prevented so let’s get to work. Let us look after each other.

In addition to these, let me add the following:

FALL 2016

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This year, Health Plan of San Joaquin awarded 14 students from our community with funding to help them pursue an education in medicine through our Health Careers Scholarship Program.

Working with local high schools and nursing programs, as well as San Joaquin Medical Society’s Decision Medicine Program, our hope is that students will pursue their passion for medicine and become part of the solution for expanding access to health care in the communites we serve.

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FALL 2016

MACRA RESOURCE CENTER Tools and information to help physicians understand the Medicare payment reforms

Learn more at www.cmanet.org/macra

Wondering where to start? There are some critical first steps that physicians should take to prepare for MACRA implementation. The most important step is to get educated about MACRA. Some specific actions to consider include: Learn the basics of MACRA – Under the MACRA proposed rule, there will be two main pathways for physician reimbursement, the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). For an overview on the two pathways, download AMA’s MACRA Action Kit (see page 5), which also includes a checklist (see page 2). Also, watch the California Medical Association (CMA) webinar titled, “What Is MACRA? What Is CMA Doing to Improve It? What Steps Can You Take to Prepare Now?” and the Centers for Medicare & Medicaid Services (CMS) webinar, “MACRA and the Quality Payment Program: An Update on the Recent Proposed Rule.” The webinars will allow you to view at your own pace and will give you the basics of MACRA. Remember that this is a proposed rule and is not final – CMS issued its proposed rule on April 27, 2016, and received many comments from interested stakeholders, including CMA. The final rule is expected this fall. CMA encourages practices to get ready, but to remember that the details are subject to change. To read CMA’s comprehensive comments to CMS outlining constructive improvements to MACRA, visit www.cmanet.org/macra. There you will also find a link to AMA’s extensive comments. >>

FALL 2016

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Determine whether you are exempt from

To access your practice’s QRUR report, visit the

MIPS participation – The proposed rule

CMS Enterprise Portal. One person from the

exempts practices from MIPS if they have a low

practice will need to obtain an Enterprise

volume of Medicare patients. This threshold is

Identity Management System (EIDM) account.

defined as $10,000 or less in Medicare billed

For more information on setting up an EIDM

charges and 100 or fewer Medicare patients

account, visit the CMS website.

annually. Physicians in their first year of Medicare participation are also exempt.

Review proposed measures and determine how you will report – Decide

Determine whether your practice meets

which measures will work for your practice and

the requirements for small, HPSA, or

how you will report the data to CMS. For more

non-patient facing physician accommodations

information on the proposed individual quality

and exceptions – The proposed rule provides

measures for MIPS, see Tables A – G on pages

accommodations and additional flexibility for

28,399 – 28,569 of the proposed rule.

various practice sizes and configurations. See the CMS Small Practices Fact Sheet for more information.

Participate in PQRS for 2016 – Whether your practice ends up participating in MIPS or APMs, there will be a quality reporting component. If you haven’t yet successfully participated in CMS’s Physician Quality Reporting System (PQRS), try again in 2016.

CMS has created a 2016 PQRS Implementation Guide that includes a beginner reporter toolkit to help get you started. You’ll gain familiarity with the reporting process and will have access to view your PQRS feedback reports, which can help to guide practice improvements under MACRA. Review QRUR reports to identify where improvements can be made – CMS publishes a mid-year and annual Quality and Resource Use Report (QRUR) to help practices understand their cost and quality assessments under the Value Modifier and quality under PQRS.

Under MIPS there are four reporting categories that allow for different reporting mechanisms: through claims, electronic health records, clinical registry, qualified clinical data registry or the group practice (25+ physicians) reporting option web interface. For more information on reporting mechanisms, see CMS’s “The Merit-Based Incentive Payment System (MIPS)” slide deck (begins on slide 43).

Consider participating in a qualified clinical data registry – If you are not already participating in a qualified clinical data registry, contact your specialty society about participating in theirs. Data registries are a method of reporting that can assist reporting in three of the four MIPS categories.

Evaluate EHR and vendor readiness – Is your EHR considered certified EHR technology (CEHRT)? – Make sure your EHR is certified. To see which EHR systems are CEHRT, see the CMS website.

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Talk with your EHR vendor about how its

Conduct a security risk analysis in early

product supports transition to MIPS – Find out

2017 – Failure to do so will result in a

whether your vendor will meet Medicare MIPS

score of zero for the ACI category. The risk

quality reporting requirements or new payment

analysis should comply with the HIPAA Security

model adoption. Are there any costs associated

Rule requirements. For more information on

with needed updates? Ask about timelines for

conducting a HIPAA security risk analysis CMA

MACRA readiness and interoperability.

members have free access to our on-demand

Document the conversations.

webinar, “HIPAA Security Risk Analysis: How to Make Sense of this Requirement” available on

Review CMS’s list of CPIA – Determine

our website at www.cmanet.org/webinars.

which clinical practice improvement

Additional information can be found in CMA

activities (CPIA) your practice is already doing

On-Call Document #4102, “HIPAA Security

and what adjustments need to be made to

Rule,” also free to CMA members in the online

complete additional activities by 2017. For a list

health law library at www.cmanet.org/cma-on-

of high weight CPIA categories, see Table 23 on

call. The American Medical Association (AMA)

pages 28,263 - 28,265 of the proposed rule. For

website also has resources to help with this

a complete list of proposed CPIA, see Table H

step at www.ama-assn.org/go/hipaa.

on pages 28,570 - 28,586 of the proposed rul View AMA’s STEPS Forward Practice Consider ways your practice can report at least one unique patient for each

Transformation Series learning module – To help practices make the shift to value-based

Advancing Care Information (ACI) measure –

care, AMA has created the STEPS Forward

ACI will replace the EHR incentive program.

learning module. The module includes five

Practices should ensure they can report at least

steps to prepare a practice for value-based

one unique patient (or answer “yes”) for each

health care, answers to common questions and

measure of the base score’s six objectives.

case vignettes describing how physicians can

Ideas (for 2017) include:

create value-based practices.

•

Reach out to existing patients to

Confirm whether you are a participant in

encourage use of the patient portal.

•

any of the advanced APMs already

If your EHR allows you to send a secured

approved by CMS – For a list of the CMS-

message through your patient portal to

approved advanced APMs in the proposed rule,

all of your patients at once, you might

see Table 32 on page 28,312.

consider sending an appointment Stay up-to-date on MACRA related

reminder to all of your patients in 2017.

•

news.

For a complete list of the proposed ACI categories, see Table 6 on pages 28,222 – 28,226 of the proposed rule (with additional information in Section II.E.5.g.7).

•

Sign up to receive CMS MACRA e-mail updates.

MACRA Resource Center > Medicare Payment Reforms

•

Sign up to receive Medicare news directly from

click “Alert Settings,” 4) Type “Medicare” in

CMA through content update alerts. By doing

the search box and hit enter. You can adjust

so, you will be notified anytime a new story

the frequency and format that you receive

about MACRA is posted to our website.

alerts via the account dashboard. For more information, see www.cmanet.org/custom-

To do so, just activate your web account (if

content.

you haven’t already done so) and sign up for custom content alerts on the topics that are of interest to you. You will then be notified any time there is new content posted in one of your interest areas. To do so, 1) Click on “My Account,” 2) In the left sidebar, click on “My Alerts,” 3) Under New Content Alerts,

Check CMA’s MACRA Resource Center at www.cmanet.org/macra for updates!

For additional information on steps you can take now to prepare, see the AMA MACRA checklist (pages 2-3).

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In The News

IN THE

NEWS Most Recent SJMS President Tapped for Health Commission

The San Joaquin County Board of Supervisors appointed John H. Zeiter, MD, to the board of the Health Commission, the governing board of Health Plan of San Joaquin (HPSJ).

John H. Zeiter, MD Dr. Zeiter recently completed his 2015-2016 term as president of the San Joaquin Medical Society, which then nominated him for one of its bylawdesignated seats on the Commission.

Board-certified in ophthalmology, Dr. Zeiter is a long-time local resident with over 25 years of surgical experience. He is managing partner of Zeiter Eye Medical Group, and a clinical professor of ophthalmology at the University of California, Davis (UC Davis) Eye Center.

A graduate of Baylor College of Medicine (Houston, Texas), he completed his training at the Kresge Eye Institute, Wayne State University (Detroit, Michigan), and has published over 20 articles on cataract surgery and glaucoma in medical journals and books.

San Joaquin County Director of Health Care Services, Greg Diederich, San Joaquin Health Commission Chair, said,

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Providing staff, physicians, and patients with relevant & up to date information

“With his commitment to bringing the finest health care to the northern Central Valley, and his vast experience as a doctor, community and medical leader, teacher, and mentor for new generations of dedicated, bright health care professionals, Dr. Zeiter is an invaluable addition to the Commission as we continue to bring provider voices to HPSJ governance.”

HPSJ’s Pharmacy Residency Program 10th Anniversary

Since 2006, HPSJ’s pharmacy department has participated in a nationally accredited managed care residency program. With accreditation from the American Society of Health-System Pharmacists and Academy of Managed Care Pharmacy, this 12-month program offers our next generation of professionals opportunities to learn to balance access, quality, and cost, as well as develop their personal and professional leadership.

There are only 38 such residency programs in the U.S. Applicants come from all over the country and residency graduates are in senior leadership roles throughout the nation.

Building on a long relationship with University of the Pacific’s Thomas J. Long School of Pharmacy, each year UOP interns are accepted at HPSJ. One of the duties of the HPSJ pharmacy resident is to serve as their site preceptor, overseeing the educational experience for the UOP interns.

Two former HPSJ residents are now on staff: Director of Pharmacy and Clinical Analysis Johnathan Yeh, and recent pharmacy resident NhuAnh Le, who has just joined the HPSJ staff as a clinical pharmacist.

FALL 2016

In The News

New Business Intelligence Director at Health Plan of San Joaquin (HPSJ) – Turning Mountains of Complex Data into Useful Information to Better Serve HPSJ Members

Randal M. Smith is HPSJ’s director of business intelligence, a new position for the not-for-profit managed care public health plan with annual revenues of almost $1 billion. He has over 20 years of experience as a healthcare technology leader.

“As opportunities for greater access to quality health care continue to flow from the Affordable Care Act,” Smith said, “it is important to efficiently gather mountains of data, in timely ways, and then translate these statistics into clear information that can illustrate for us how we are doing, and where opportunities exist in HPSJ’s interest to improve the experience for our members and providers.”

Randal Smith

“HPSJ’s information technology department helps our complex systems run smoothly and securely, so that we can deliver innovative solutions to keep our staff, members, providers, and community partners connected,” said HPSJ Chief Information Officer Cheron Vail, PhD. “Randy has devoted his career to translating just this kind of data rich environment into truly useful information that will let us understand and leverage our limited resources for best service to our members,” she added.

New Compliance / Privacy Director Joins Health Plan of San Joaquin (HPSJ)

Jose A. Cosio, MPH, CHC, joined HPSJ as Director of Compliance and Privacy. Certified in healthcare compliance (CHC) by the national Compliance Certifications Board (Minneapolis, Minnesota), he has over 11 years of leadership experience in health plan regulatory services, including: knowledge of managed care utilization management; claims/billing; and continuing

FALL 2016

care, and revenue cycle.

“Through his experiences, Joe will enhance our Compliance Department, including managing HPSJ’s Payment Integrity Program, which helps to identify fraud, waste and, abuse,” said HPSJ Jose A. Cosio, MPH, CHC Compliance Officer Alejandra Clyde, MHA, CHC. “He also will have day-to-day responsibility for HPSJ’s privacy functions,” she added.

Most recently, Cosio was Chief Operations Officer for Visiting Nurse & Hospice Care (Santa Barbara).

Previously, he was Area Administrator for Kaiser Permanente Fontana and Ontario Medical Centers, where he managed a home health and hospice program and ensured the implementation of a regional compliance program to protect the privacy of its members.

Cosio has a master of public health degree from the UCLA. San Joaquin County Administrator Joins Health Commission

San Joaquin County Director of Health Care Services Greg Diederich, Chair of the San Joaquin Health Commission, announced that the Monica Nino San Joaquin County Board of Supervisors has formally appointed San Joaquin County Administrator Monica Nino to the Health Commission, the governing board of Health Plan of San Joaquin (HPSJ).

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In The News

IN THE

NEWS Monica Nino assumed the County Administrator position in June of 2013 after serving as Stanislaus County Chief Executive Officer. She oversees 26 county departments, an annual operating budget of $1.42 billion, and over 6,700 county employees. In addition to the Health Commission, Ms. Nino serves on the Sex Offender Management Board, San Joaquin General Hospital Foundation Board, and iHub San Joaquin.

“With Monica Nino’s long and distinguished leadership as a public administrator, and her deep roots in both San Joaquin and Stanislaus counties, she will provide valuable knowledge and perspective to the Commission when it comes to stewardship and oversight roles across the two-county geography HPSJ serves,” said Diederich.

HPSJ has arranged for CMEs to be offered with no charge to attendees. CEUs for this training are pending.

For information, or to reserve a space, please contact HPSJ Provider Services staff: Crystal Trejo (ctrejo@hpsj.com; 209-461-2283), or Amanda Yang (ayang@hpsj.com; 209-469-8333).

Space is limited.

NCQA Accreditation Seal - SAVE THE DATE Transgender Training (September 2016)

CMEs Available, CEUs Pending

Kwabena Adubofour, MD

Jennifer McNeil, MD

Richard Goldman, MD

Raghunath Reddy, MD

Health Plan of San Joaquin (HPSJ) has arranged for in-depth presentations by a panel of Stanford University medical experts on transgender care for patients at each phase of their journey.

Presentations will occur twice during September 2016: Saturday, September 10 (9:00am – 1:00pm), HPSJ Community Room (French Camp) Saturday, September 17 (9:00am – 1:00pm), Doubletree Modesto All local physicians are invited to attend at no charge. Breakfast, lunch and coffee service will be provided during the training.

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SAN JOAQUIN PHYSICIAN

Recognizing Physicians with Humankindness

Each quarter, St. Joseph’s Medical Center recognizes physicians in the community that go beyond clinical excellence to deliver healing with compassion and kindness,

FALL 2016

In The News

also known as humankindness. Most recently, Kwabena Adubofour, MD, Richard Goldman, MD, Jennifer McNeil, MD, and Raghunath Reddy, MD, were recognized by their patients and peers for going above and beyond to display genuine kindness to their patients.

St. Joseph’s invites you to nominate physicians practicing humankindness at St. Joseph’s or in the community to receive recognition. Call 209-467-6486 or e-mail Catherine.Swenson@dignityhealth.org for more information.

St. Joseph’s Medical Center is Fit-Friendly

St. Joseph’s Medical Center has been recognized as a Platinum-Level Fit-Friendly Worksite by the American Heart Association for helping employees eat better and move more. This award demonstrates St. Joseph’s commitment to providing a healthy workplace for our employees. As a Platinum Level Award recipient, St. Joseph’s has taken steps to offer employees physical activity options in the workplace, increase healthy eating options at the worksite, promote a wellness culture in the workplace, and implement at least nine criteria outlined by the American Heart Association in the areas of physical activity, nutrition and culture.

The Fit-Friendly Worksite program is a catalyst for positive change in the American workforce by helping worksites make their employees’ health and well-being a priority. For more information about the Fit-Friendly Worksites program and how it’s helping to improve the health of Americans by focusing on the workplace, visit heart.org/worksitewellness.

St. Joseph’s Embarks on ER Expansion Project

Construction is now underway on an exciting project to expand the Emergency Room at St. Joseph’s Medical Center to meet the growing needs of our community. With the addition of 8,000 square feet to the Emergency Room, St. Joseph’s ER will increase its footprint by nearly 60 percent.

Every change and addition to the ER will help to maximize efficiency, improve workflows, reduce wait times, and offer

FALL 2016

more privacy for patients and loved ones during difficult times. The new Emergency Department wing will enhance our SuperTrack process - reducing wait times to be seen by a provider and then discharged, ultimately freeing up resources and space to care for and admit patients faster and more efficiently.

The costs to overhaul the existing emergency room are considerable at close to $8 million, but hold tremendous benefits for our community—impacting people of all ages and socio-economic backgrounds. St. Joseph’s Foundation of San Joaquin is a non-profit organization that helps to advance the needs of St. Joseph’s through the generous support of community donors. To learn more or support this project call St. Joseph’s Foundation at 209-467-6347.

St. Joseph’s Honored for Environmental Sustainability

Dignity Health St. Joseph’s Medical Center has been awarded the Greenhealth Partner for Change Award from Practice Greenhealth, the nation’s leading health care community dedicated to transforming health care worldwide so that it reduces its environmental footprint, becomes a community anchor for sustainability, and a leader in the global movement for environmental health and justice.

The Greenhealth Partner for Change Award recognizes health care facilities that continuously improve and expand upon their mercury elimination, waste reduction, recycling, and source reduction programs. At a minimum, facilities applying for this award must be recycling 15 percent of their total waste, have reduced regulated medical waste, are well along the way to mercury elimination, and have developed other successful pollution prevention programs in many different areas. This is the tenth year that St. Joseph’s Medical Center has been recognized by Practice Greenhealth.

In addition to being a Practice Greenhealth Partner for Change, St. Joseph’s Medical Center is also the first hospital in the state to be recognized as a Certified Green Business.

St. Joseph’s has a long legacy of environmental stewardship.

SAN JOAQUIN PHYSICIAN

25

In The News

IN THE

NEWS Since 2008, St. Joseph’s has recycled more than 16 million pounds of waste, ranking the hospital as the second highest facility in the Dignity Health system for percentage of waste stream recycled. Additionally, St. Joseph’s has a partnership with MedShare, which acts as a recycling and distribution center for surplus medical supplies and equipment.

and develop successful trauma prevention and recovery programs in the South Stockton Promise Zone coverage area, through the Healing South Stockton Initiative. Trauma prevention and recovery was identified as a key community health issue after an analysis of the 2016 Community Health Needs Assessment, which outlines the health priorities identified in San Joaquin County.

Initiative to Address Trauma in South Stockton Receives $850K

Healing South Stockton will aim to identify victims of trauma as early as possible and engage them in immediate and accessible behavioral health and social support services.

Also, the initiative will help provide a full range of recovery services to victims, develop trauma-informed care practices at all agencies working in South Stockton, promote trauma prevention by creating safer neighborhoods and healthy families, and establish policies to ensure ongoing trauma prevention and treatment. The initiative will also help to expand and support trauma recovery and prevention programs already in place.

St. Joseph’s Medical Center’s Community Health Department, in partnership with the Healthier Community Coalition, led the effort to receive a grant for $850,000 for the Healing South Stockton Initiative, which will seek to expand and develop successful trauma prevention and recovery programs in South Stockton over the next three years.

The grant, funded by the California Accountable Communities for Health Initiative (CACHI), will be awarded to the Coalition over a three-year period to expand

HAVE SOMETHING TO SHARE? We welcome submissions to our In-the-News Section from our community healthcare partners. We prefer Word files and .jpg images and may edit for space restrictions. Send your files to lisa@sjcms.org one month prior to publication (February 1st for the Spring issue, May 1st for the Fall issue, August 1st for the Fall issue and November 1st for the Winter issue).

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SAN JOAQUIN PHYSICIAN

FALL 2016

In The News

This collaborative effort represents a broad array of groups that have worked in strong partnership over many years, including St. Joseph’s Medical Center, which will serve as the facilitator and fiscal agent for the initiative, Kaiser Permanente, Reinvent South Stockton Coalition, Community Medical Centers, Health Plan of San Joaquin, Stockton Unified School District, San Joaquin County Health Care Services Agency, and California Public Health Advocates and others.

provides direct visualization inside the artery during a procedure by incorporating an imaging fiber on the tip of the catheter that acts like a small camera. This technology is referred to as lumivascular (lumi = light, vascular = artery).

Avinger’s Pantheris atherectomy catheter system allows physicians to see and remove plaque simultaneously during atherectomy.

This minimally-invasive procedure involves shaving plaque away from inside the artery under direct visualization, enabling physicians to

Dameron Hospital Dameron first to offer breakthrough Lumivascular Technology to Treat PAD

efficiently clear out the blockage and restore normal blood flow.

Dameron Hospital is now operating the FDA-cleared Avinger Ocelot and Pantheris catheter system to treat peripheral artery disease (PAD) and is the first hospital in the area to offer this state-of-the-art technology.

According to Dr. Daren Primack, Cardiologist and Medical Director for Dameron Hospital’s Peripheral Vascular Program, this new lumivascular technology system is an incredible advancement in the treatment of vascular disease in the legs and feet.

Dameron Hospital is using the Avinger Ocelot catheter system to help restore blood flow in completely blocked arteries in patients’ legs using a small intravenous catheter that

FALL 2016

More information is available at dameronhospitalpad.com.

Antonio Garcia Appointed Chief Nursing Officer of Doctors Hospital of Manteca

Antonio Garcia, MSN, RN, has been appointed Chief Nursing Officer of Doctors Hospital of Manteca. Garcia is an accomplished nurse leader with extensive experience in patient care and clinical excellence.

“Tony is a great addition to our leadership team,” said Ike Mmeje, CEO of Doctors Hospital of Manteca. “He has a strong track record of effectively leading and implementing strategies that have significantly enhanced clinical practice and outcomes. He has shown himself to be a very dedicated nurse leader with a passion for high-quality patient care and clinical excellence.”

“I am excited at this opportunity to join the team at Doctors Hospital of Manteca and work with my colleagues to further the hospital’s mission of enriching the health and lives of the patients and the community we serve,” said Garcia.

“I’m confident we’ll continue to achieve that goal by providing an exceptional care experience of the best quality and value for each and every patient.”

Garcia comes to Doctors Hospital of Manteca from Kaiser Permanente San Jose Medical Center in San Jose, CA, where he served as Service Director for the Emergency Department and Urgent Care.

Prior to that, he was Clinical Adult Services Director for ICU, Step Down, Telemetry, Medical Surgical Unit, and the Orthopedic/Surgical/

SAN JOAQUIN PHYSICIAN

27

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http://www.imq.org/education/caprrc.aspx FALL 2016

In The News

IN THE

NEWS Oncology unit at Kaiser Permanente San Jose Medical Center.

Before joining Kaiser Permanente, Garcia was Director of Nursing for the Medical/Surgical and Oncology units at Harris County Hospital District, LBJ General Hospital, in Houston, Texas. Before that, he was Manager of Emergency and Trauma Services and an emergency nurse/charge nurse at River Oaks Hospital in Houston. Prior to launching his nursing career, Garcia served as a professional firefighter in Toronto, Canada.

Garcia earned his bachelor’s degree in nursing and his master’s degree in nursing administration, both at the University of Houston in Houston.

The American Cancer Society’s Annual Making Strides Against Breast Cancer Walk Scheduled for October 8 in Stockton

On Saturday, October 8, 2016, The American Cancer Society is hosting its fifth annual Making Strides Against Breast Cancer at San Joaquin Delta College.

The event is a 5k walk that honors survivors, provides information, and raises funds for the Society’s breast cancer services as well as research toward preventing, curing and treating breast cancer.

FALL 2016

Making Strides

These services include “Look Good, Feel Better,” which provides those undergoing treatment with free wigs and makeups tips, and “Reach to Recover,” where newly diagnosed breast cancer patients are paired with survivors to help them through their journey. Additionally, the Society funds groundbreaking research, which has led to advances such as Herceptin, Tamoxifen, and the use of mammography as the standard in breast cancer detection.

Those interested can form teams or walk as individuals.

Since there is not a registration fee, participants are encouraged to fundraise. For more information visit, www.MakingStridesWalk.Org/Stockton, email StocktonCAStrides@cancer.org or call ACS at 209-941-2679.

SAN JOAQUIN PHYSICIAN

29

In The News

IN THE

NEWS CMA Alliance Past President Nancy Schneider, elected to serve as AMA Alliance Treasurer

At the Annual Meeting of the American Medical Association Alliance in Chicago, Nancy Schneider Nancy Schneider, Stockton, CA, Past AMA Alliance Director, Past President of the California Medical Association Alliance, and Past President of the San Joaquin County Medical Society Alliance, was elected to serve as AMA Alliance Treasurer for 2016-17.

Nancy Schneider will oversee all financial aspects of the organization and will chair the Finance Committee.

Established in 1922, the AMA Alliance—an affiliate of the American Medical Association—is the largest organization representing the physician family. Its nationwide network encompasses all stages of the physician family lifestyle from the training years through retirement.

The Alliance is the most valuable organization for today’s significant challenges to the physician family in the current medical environment. AMAA supports its members by providing resources to help each individual or couple as they negotiate the ups and downs of this unique lifestyle. The goals are to unite and empower the members. The result is an engaged organization with members helping each other and the communities in which they live.

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SAN JOAQUIN PHYSICIAN

San Joaquin General Hospital Auxiliary

The San Joaquin General Hospital Auxiliary has had a busy few months since its Spring General Membership meeting. At that meeting on April 12, the membership approved numerous allocation requests from various hospital departments.

Annually the Auxiliary asks each SJGH department manager to submit a list of equipment and/or other departmental needs that are not covered by regular department operating budgets.

Managers of each department, after discussion with staff, submit a request form to the Auxiliary itemizing the equipment or departmental need which they wish the Auxiliary to fund.

The Auxiliary Board considers each request and submits a recommendation for approval to the general membership at the April meeting. This year the total allocation amount is $26,966.61. Over the past three years, the Auxiliary has funded approximately $90,000 for purchases of needed items in a wide variety of hospital departments.

Grants of allocation funds for 2016 for hospital departments will purchase a Physio Trainer for Occupational Therapy, Breast Milk Warmers for the Intensive Care Nursery, special Mayo stands for patient rooms for the ER, an Accuvein (vein finder) for the Cardiology Department, a number of training kits including a Premature Anne Manikin for Nursing Education and a donation to the SJGH Foundation to be used towards the new MRI equipment and facility. We are very pleased that we could approve so many requests.

The SJGH Auxiliary is composed of many active, enthusiastic, and committed volunteers. We always are open to new volunteer applicants and encourage those who are interested to contact Volunteer Coordinator Lillianna Carmona at 209-468-6041 or lcarmona@sjgh.org.

FALL 2016

Philip Edington, MD, Proudly Welcomes Charles Kim, MD, to Center For Sight

Dr. Charles Kim started with Center for Sight in August 2016. He is a board-certified Ophthalmologist specializing in Oculo-plastics. He is an expert in surgery involving Charles Kim, MD the eyelids, tear system, orbit, and any injury of the face. He received his undergraduate degree in Molecular & Cell Biology at University California, Berkeley. Dr. Kim served as Chief Resident, New York Presbyterian / Weill Cornell Medical College in Philadelphia and completed his Oculoplastic surgery fellowship at the world famous Wills Eye Hospital. Dr. Kim attended medical school at the University of California, Davis, and was awarded a Regents’ scholarship for academic excellence.

Dr. Kim specializes in Botox, Dernal Fillers, Chemical Peels, Blepharoplasty, Eyelid Crease Fixation, Eyelid Lesions, Trichiasis, Tear Duct Obstruction, Orbital Decompression, and much more.

Philip Edington, MD, Proudly Welcomes Daniel Wee, MD, to Center For Sight

Dr. Daniel Wee has been with Center for Sight since January 2016. He received his Bachelor’s degree at Northwestern University and continued his studies at Washington University in St. Louis School of Medicine. He completed his internship at St. Francis Hospital and residency at University of South Carolina School of Medicine.

He then completed his Cornea and Anterior Segment Fellowship at Tufts University School of Medicine. He has also done various researches and projects from 2003-2011 such as Sports Injuries, Intraventricular Hemorrhage

FALL 2016

for advanced Retinopathy of Prematurity, Predictability, Efficacy, Stability and Safety of Zyoptix XP Epi-Lasik for patients with Myopia and Myopia with Astigmatism, and much more.

Dr. Wee specializes in Cataract Surgery, Pterygium Daniel Wee, MD Excisions, and Corneal Transplants. He also speaks both English and Spanish.

Dr. David Greenhalgh to Lead Multi-Center Study to Improve Burn Outcomes $2 Million Grant Funds Research on Resuscitation Practices for Burn Patients

The Department of Defense awarded David Greenhalgh, MD, a $2 million grant to fund a four-year study on how to improve outcomes in burn patients. Dr. Greenhalgh is Chief of Burns

JAMES SAFFIER, MD On-Site Medical Director Internal Medicine, Hospice & Palliative Care

Choose Hospice of San Joaquin • Family Satisfaction Survey scores rated higher than the State and National Averages • Only Hospice with a Hospice House in San Joaquin County • Pediatric Care Team (209) 957-3888 | www.hospicesj.org 3888 Pacific Ave. Stockton, CA 95204

SAN JOAQUIN PHYSICIAN

31

In The News

and valuable science can be in their lives? The San Joaquin County Office of Education, STEM Department, organizes a volunteer group called TOPS (Teaching Opportunities of Partners in Science). The program places volunteers at an elementary school where they teach hands-on science for approximately eight hours per month. All training and materials

are given to the volunteer. The kids are usually ages 8-10 so you don’t have to be a science expert; rather, we look for people with a passion or interest in science, engineering, technology, or math. Contact Nancy Flocchini Stenzler today if you or someone you know is interested at nstenzler@sjcoe.net or 209-430-0652.

David Greenhalgh, MD

at Shriners Hospitals for Children Northern California and the University of California Davis Health System, where he leads a comprehensive burn program that provides care for thousands of children and adults throughout California.

ABRUPT is the title of the multi-center study that will evaluate resuscitation practices for burn patients during the first 48 hours of hospitalization.

Short for “Acute Burn Resuscitation Observational Trial”, ABRUPT will obtain descriptive information on burn resuscitation practices, specifically in the administration of albumin, a serum of proteins commonly found in blood plasma.

“ABRUPT will provide solid data to support or dispute the hypothesis that earlier administration of albumin results in an overall reduction in the amount of abnormal swelling in burn patients and, in turn, fewer respiratory complications,” says Dr. Greenhalgh.

Twenty burn centers in the North America, including the UC Davis Medical Center, will participate in the study.

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SAN JOAQUIN PHYSICIAN

FALL 2016

WEBINARS

EDUCATION •

SEMINARS

DID YOU KNOW?

•

PODCASTS

•

AND MORE

CMA offers free webinars to its members

Through its robust webinar series, the California Medical Association (CMA) gives physicians and their staff have the opportunity to watch live presentations on important topics of interest and learn from industry experts from the comfort of their homes or offices. The webinars are free to CMA members and members’ staff and provide the timely information needed to help run a successful medical practice. What’s more, all webinars are available on-demand immediately following the live airing, providing an ever-growing resource library accessible at any time.

SEPT

28

2016 Ballot Measures: How Your Vote Can Increase Access to Care

September 28, 2016 | 12:15pm - 1:15pm | Members Only In 2016, CMA is taking the issue of Medi-Cal funding to the people through two ballot measures: • Prop. 55 would extend the state’s higher income taxes for those earning more than $500,000 per year.

• Prop. 56 would increase California’s cigarette tax by $2 per pack, with an equivalent increase on other tobacco products, including e-cigarettes.

PRESENTER: Janus Norman is CMA’s Senior Vice President for Government Relations and Political Operations, and serves as CMA’s chief lobbyist. He has worked on numerous campaigns during his career, including several ballot measures.

This webinar will present an overview of the 2016 ballot initiative campaigns in which CMA is involved, with a focus on their impact on patient access to care and the state of health care in California. We will also briefly review other initiatives CMA has taken a position on.

OCT

5

CHPI Physician Quality Rating Program: Navigating the Review and Corrections Process October 5, 2016 | 12:15pm - 1:15pm

With the California Healthcare Performance Information System (CHPI) publishing clinical quality ratings for approximately 13,000 California physicians later this year, physicians will soon begin receiving notices advising of their quality scores along with information on how to confirm or correct their data.

This webinar will provide an overview of the CHPI quality rating project, along with step-by-step instructions on how physicians can review their data for accuracy before the quality scores are published.

Is Your Practice at Risk for a HIPAA Security Breach?

NOV

2

November 2, 2016 | 12:15pm - 1:15pm

Medical practices are at increasing risk for HIPAA security breaches such as ransomware, or theft of electronic patient information. Increased dependency on electronic health records and exchange of data with other providers, or staff turnover can compromise security.

In this webinar, CMA’s HIPAA advisor, David Ginsberg, will discuss common threats and breaches, how to safeguard and strengthen your systems, and what to do if you have a breach.

PRESENTERS: Emily London is a senior manager at the Pacific Business Group on Health (PBGH), where she currently manages the Patient Assessment Survey and communications for the Multi-Payer Claims Database project.

Pete Sikora is a senior manager at the PBGH, where he leads the development of CHPI, one of the first physician-level quality rating systems in the country.

PRESENTER: David Ginsberg is Co-Founder and President of PrivaPlan Associates, Inc., a leading provider of HIPAA privacy, security and breach notification services, consulting and products for the health care and business associate industry. He also has more than 30 years of experience in the health care industry.

REGISTER ONLINE TODAY! WWW.CMANET.ORG/EVENTS *Webinars are free for CMA members and their staff ($99 for non-members).

FALL 2016

SAN JOAQUIN PHYSICIAN

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SAVE THE DATE SAN JOAQUIN MEDICAL SOCIETY’S

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UPDATE:

ROTACARE STOCKTON

By Joseph Serra, MD

It is with a great deal of satisfaction that we provide this update regarding the establishment of a RotaCare Free Clinic in South Stockton at the Dorothy Jones Community Center. You will recall the feature article in the Spring Issue of the San Joaquin Physician which explains the basics of our vision. We can now provide the solid progress we have made since that time.

We spent several months trying to attain our state license, which now requires an affiliation with a licensed medical establishment. This was extremely difficult in our county.

However, we have been accepted as an affiliated free clinic

by RotaCare Bay Area, Inc. They have twelve clinics from Marin County to Monterey, and recently decided to extend their scope beyond primarily the bay area. They visited our clinic site and we attended one of their board meetings, where Dr. Cathy Peterson provided a presentation. They voted unanimously to accept Rotacare Stockton as their newest member clinic!

This is excellent because we do not have to reinvent the wheel. They have been—and will continue to be—most helpful in the formation of our clinic. Our medical director, Dr. Walt Wager, is now one of their medical directors. The advantages are endless. They are rolling out electronic record keeping at this time.

Our Board of Directors is now an Advisory Council to RotaCare Bay Area. Dr. Earl Taylor and Barbara Whitney,

RN, are in charge of physician and nurse recruitment, respectively, and will be looking for Physician Assistants and Nurse Practitioners.

The clinic hours will be Thursday evening from 4:308:30pm. Visits are by appointment only, which are made by phone from 1-4pm same day. Ideally, we will see between 20-25 patients per day with problems such as diabetes, hypertension, and obesity, with two physicians working per evening. Therefore, if we had 12 physician volunteers, that would mean volunteering one evening per month. We will provide basic evaluation and treatment as indicated, and patients requiring further care will be referred appropriately.

Our patient population will be uninsured, underinsured, and undocumented. (It is estimated that even with affordable care, 11% of people will not be covered by insurance) All physician volunteers, nurses, nurse practitioners, and qualified others will be covered by malpractice insurance.

We are beginning our fundraising at this time. We will be contacting hospitals, corporations, Rotary Clubs, and friends.

On October 6th, we have planned a “Friend-Raising Event at Stockton Golf and Country Club. More information will be coming soon.

Those wishing to volunteer including specialists, please contact wwager@comcast.net or joseph.serra@outlook.com; Thank you for your interest. This is an excellent way to serve your community!

TE

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SAN JOAQUIN PHYSICIAN

FALL 2016

working together as

ne

Two major players in California’s healthcare industry are

teaming up to bring a new level of innovation to Dignity Health St. Joseph’s Medical Center in Stockton The old saying that “two heads are better than one” is ringing true at Stockton’s St. Joseph’s Medical Center, where a pair of the biggest names in California’s healthcare industry

have joined forces to increase quality and access to care at one of the region’s longest serving facilities.

In November of 2015, Kaiser Permanente entered into a partnership with Dignity Health to purchase a 20 percent ownership interest in St. Joseph’s, allowing the facility to become the Stockton hospital for Kaiser Permanente members in the region. Earlier this year,that partnership went live, with Kaiser’s members in Stockton now turning to St. Joseph’s Medical Center for care. >>

Working Together As One > Dignity Health St. Joseph’s Medical Center

For physicians, patients and the community at large, this unique partnership promises to bring a variety of changes to Stockton’s largest hospital.

“It’s very exciting,” said Don Wiley, St. Joseph’s Medical Center’s president and chief executive officer. “We have two of the largest healthcare systems in California collaborating and their focus is right here in Stockton.”

While working together is nothing new for the two organizations – Kaiser contracts with St. Joseph’s Behavioral

The facility is Stockton’s largest, and busiest hospital, serving more than 17,000 patients a year. The facility is also Stockton’s largest private employer, with a staff of more than 2,000.

Kaiser Permanente also has a long history in the region, having provided care in Stockton for nearly 40 years.

Kaiser members in the Stockton area were previously served by Dameron Hospital.

In short, a partnership between Dignity Health and Kaiser Permanente could really be looked as the joining of two very familiar faces.

“This has “This has been a long journey for both Dignity Health been a long and Kaiser Permanente, Our conversations grew over journey for both Dignity time and we recognized that there was really an Health opportunity to grow and innovate together.” and Kaiser Permanente,” Friberg said.

Health Center for behavioral health “Our conversations grew over time and services – the new partnership we recognized that there was really represents a new, and enhanced, level an opportunity to grow and innovate of commitment being put forward by together.” both Kaiser Permanente and Dignity While the two organizations both Health. have a long-term presence in the “It goes well beyond contracting.

Stockton community, joint ownership It’s a commitment, and it’s one that’s of St. Joseph’s Medical Center has really long term,” said Deborah Friberg, required both Dignity and Kaiser Kaiser Permanente’s senior vice Permanente to deviate from their president and area manager for the “business-as-usual.”

Central Valley. “St. Joseph’s can really From a governance standpoint, the now draw from the expertise of Kaiser partnership has called for the formation Permanente and Dignity Health.” of new, joint board of directors, with For members of the Stockton four members from Dignity and three community, neither organization could from Kaiser Permanente. be looked at as the “new kid on the “I think that shows, in the case of block.”

Kaiser, they were looking for a true St. Joseph’s Medical Center has investment, and also a ‘say-so’ in the been serving San Joaquin County and overall direction of the hospital,” Wiley the Stockton community since 1899. said.

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SAN JOAQUIN PHYSICIAN

FALL 2016

On the hospital f loor, implementing this partnership called for the credentialing of roughly 130 Kaiser Permanente physicians, adding to the existing 600 physicians that previously made up the medical staff at St. Joseph’s. The hospital is expected to see anywhere from a 12 to 15 percent increase in services due to the inf lux of Kaiser Permanente members, Wiley said.

In all, Kaiser Permanente has more than 110,000 members in the Stockton area, representing roughly 24 percent of the Central Valley and 40 percent of the

FALL 2016

area’s commercial market.

While the official transition of Kaiser Permanente patients officially took place only months after the official agreement was signed, representatives from both Dignity and Kaiser Permanente acknowledge that it was anything but an overnight switch.

“These types of partnerships take a long time to develop,” Wiley said.

To help ease the transition process, working groups consisting of more than 100 employees were

SAN JOAQUIN PHYSICIAN

39

Working Together As One > Dignity Health St. Joseph’s Medical Center

established to help identify and address potential issues that would arise both before and after the partnership went live.

“Each one of these issues had to be addressed and the solutions were varied,” Friberg said, noting that ensuring a smooth transition didn’t simply end when the partnership went live earlier this year.

“We still have a very active working group,” she added.

One issue that demanded significant attention was that of

the hospital, and vice versa at the physicians’ offices.

“So far, it’s worked pretty well,” Wiley said.

Another challenge was ensuring that the arrival of new patients to St. Joseph’s didn’t impact the level of care and attention that had been provided to existing patients for more than 100 years.

“All of these changes are being made with an eye on serving our existing population,” Wiley said.

“Our goal is to retain the status of being the busiest community

“Both Dignity Health and Kaiser Permanente are excited about this. This structure presents an opportunity to bring innovation from both sides, while increasing the level of service for all patients.”

electronic medical records, and how two unique organizations would integrate their systems to best serve patients at the hospital.

Dignity Health and Kaiser Permanente independently use two different electronic medical record keeping systems, with Dignity operating on MEDITECH at the hospital, while Kaiser Permanente physicians were using Epic Systems.

With the transition to St. Joseph’s, all incoming Kaiser Permanente physicians were trained on the MEDITECH system, and processes were put in place to ensure that the information for Kaiser patients could be securely accessed at

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SAN JOAQUIN PHYSICIAN

hospital and to retain the loyalty of our medical staff.”

Both sides note that the partnership will hold greater benefits than just the additional patients, and will also allow St. Joseph’s to make capital improvements to its existing 366bed facility.

“It’s certainly been an enabler for us to invest in our facilities and make improvements to areas that we had previously targeted,” Wiley said.

Already in the works is the nearly 8,000 square-foot expansion of the hospital’s emergency department, an improvement that is expected to increase bed capacity by nearly 60 percent, Wiley said. St. Joseph’s

also plans to expand its neonatal and postpartum care units, while also making significant improvements and expansions to its catheterization laboratory.

These expansions had been planned by St. Joseph’s leadership for some time, but the added investment and financial security established by the partnership with Kaiser Permanente helped fast track many of the changes.

“We ended up with a nice model that allows for these improvements, while also stabilizing St. Joseph’s financial situation long term,” Wiley said.

In addition to the tangible improvements, leadership from both Dignity Health and Kaiser Permanente note that St. Joseph’s will benefit from having the backing of two of California’s strongest healthcare brands.

“In today’s health care industry, it just makes sense that, where you can collaborate, you do so,” Wiley said. “We had one of those opportunities, and I think it made sense to explore.”

With the partnership now underway, physicians, patients and the community at large can look forward to the many benefits that said collaboration promises to bear.

“Both Dignity Health and Kaiser Permanente are excited about this,” Friberg said. “This structure presents an opportunity to bring innovation from both sides, while increasing the level of service for all patients.”

FALL 2016

Use State-of-the-Art Lumivascular Technology to Treat Patients with Peripheral Artery Disease

LUMIVASCULAR TECHNOLOGY: TWO IS BETTER THAN ONE! • Enhanced technology allows physicians to treat patients with PAD in a minimally invasive way, resulting in quick recovery time • Ocelot maneuvers through totally blocked arteries in the legs using an integrated “camera” to see from inside the artery • Pantheris allows for removal of plaque with unprecedented precision using an innovative image-guided therapy

“With the lumivascular technology system, we now have the means to help patients with PAD get on the road to recovery and better health.These two state-of-the-art medical technologies are just two more ways Dameron is enhancing their treatment capabilities with a goal of bringing better outcomes to patients and empowering physicians in their practice.” –Dr. Daren Primack, Dameron Hospital Medical Director for Peripheral Vascular Program

Dameron Hospital is the first hospital in Sacramento, San Joaquin and Stanislaus counties to provide its community with these state-of-the-art technologies.

Ocelot Pantheris

FOR MORE INFORMATION ABOUT LUMIVASCULAR TECHNOLOGY AT DAMERON HOSPITAL, Call Our Physician Outreach Liaison at 209-715-3618.

Decision Medicine 2016:

Hands On AT ITS FINEST!

BY BRANDON PIASECKI

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SAN JOAQUIN PHYSICIAN

FALL 2016

Education They felt like they were on the set of Grey’s Anatomy when they got to go on rounds with the doctors at San Joaquin General Hospital. “Yes, but without all the drama!” the medical school students and residents laughed in response. This experience was one of many that students from San Joaquin County were able to take part in during the 2016 Decision Medicine Program. For me, it was another “best two weeks of my summer break,” that I am already missing with the start of the school year fast approaching. >>

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As a high school Chemistry teacher, I always strive to make my curriculum as real as possible for my students. From labs, raps, and discussions, I do a decent job engaging my students, but the structure of our school system is such that students still remain vastly naïve to the demands and the day-to-day lifestyle of potential future careers they will embark on. Decision Medicine has been an educational experience at the pinnacle of hands-on learning, as students were fully immersed in the life of a doctor for two whole weeks this past summer. I think it would be safe to say that students would even balk and exchange awkward glances at the usage of the phrase “educational experience” to describe the program; it was just fun!

It’s not easy to gain a coveted spot in the lineup for Decision Medicine. After a rigorous vetting process with a written application, students engage in an interview in front of a panel, reminiscent of Shark Tank, only with

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doctors instead of business moguls. Ok, that may a bit extreme, but in the mind of a teenager this thought was probably not far off upon initial introduction of the panel. The group this year was incredibly talented and diverse, representing many different schools, cultures, backgrounds, and stories. It was a true representation of talent in our county: 24 students from 18 different schools with an average GPA of 4.26; from Tracy up to North Stockton.

Educators across the board would agree that the mark of a truly inspiring lesson in the classroom is one where students don’t even realize that they are learning, when the level of investment and fun being had in the classroom is equal to the amount of learning going on. This effect was present every single day of the Decision Medicine program. From day one, there was little down time! The students began the program with an immersive team-

FALL 2016

building day built around challenging ropes course activities at Venture Academy. They were able to experience what several hospitals, including St. Joseph’s, San Joaquin General, Dameron, and Kaiser Permanente Modesto were like behind the scenes, and each day offered a new, engaging, special learning experience students will not soon forget.

Due to the efforts of many of the hospitals and physicians, there were several opportunities for students to observe surgeries, including a thyroidectomy, ACL surgery, and a cholecystectomy, among others. All of the students earned both CPR and First Aid certifications, thanks to St. Joseph’s Medical Center and the American Red Cross. They were able to observe firsthand the power of medicine serving the underprivileged and homeless population at Community Medical Centers, Gleason House and St. Mary’s Dining Room, which was an eye opening and awesome experience.

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Haneen Abbas

Tracy High School

Elizabeth Alvarado

Health Careers Academy

Steven Blackwell

Millennium High School

Andrea Bravo

Franklin High School

Sergia Cabral De Matos

East Union High School

Kartik Goswami

Saint Mary's High School

Fatima Iqbal

John C. Kimball High School

Jerice Kent Banola

Bear Creek High School

Sabah Khan

Stockton Early College Academy

Celida Lizarraga

Stockton Collegiate International Schools

D'Angelo Martinez

Middle College High School

Sawsan Muthana

Weston Ranch High School

Abirath Nakka

Lincoln High School

Uchechukwu Nwabuzoh

Saint Mary's High School

Soleil Richardson

Benjamin Holt College Preparatory Academy

Julien Santos

Cesar Chavez High School

Bea Saptang

Stockton Early College Academy

Maha Siddiqui

Millennium High School

Sidney Stockman

Pacific Law Academy

Sandra Sunio

Bear Creek High School

Abigael Tabora

Edison High School

Si Hao Tang

Manteca High School

Maya Tureez

Middle College High School

Annie Yu

Middle College High School SAN JOAQUIN PHYSICIAN

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There were several opportunities for hands on learning, from the dissection of a pig heart with an amazing team of cardiologists and heart surgeons from California Pacific Medical Center in San Francisco, to typing their own blood at Dameron Hospital. Students were able to visit Shriners Hospitals for Children and engage in “medical play” with the patients, a day that never ceases to be among one of the most intense but powerful days of the program.

Since the program’s inception, I would argue that this is one of the most valuable educational tools that we have in San Joaquin County. Due to the time-intensive nature of medical school and the road to becoming a full-fledged

doctor, we are just now beginning to reap the rewards from this program, which began in 2001. There currently are a several residents who are Decision Medicine products, and more alumni who are in Medical School at this very moment, planning on eventually making their way back to their roots to give back to the community that raised them.

It is these immersive, hands-on, inspiring educational experiences that give students the necessary drive to achieve their goals in all fields, and Decision Medicine has proven yet again to be a key player in the effort to gain high quality, homegrown physicians for San Joaquin County.

HPSJ Health Careers Scholarships Decision Medicine Students Honored HPSJ Chief Medical Officer Lakshmi Dhanvanthari, MD, (center) presented $2,500 HPSJ Health Careers Scholarships to DM 2016 graduates Crystal Torres (left), attending UCLA, and Si Jie Tang (right), attending Yale, at the August 7 ceremony at Stockton Golf and Country Club. They were joined by HPSJ-DM program mentors HPSJ Chief Information Officer Cheron Vail (far left) and HPSJ Project Management Director Fran Hattner (far right). Dr. Dhanvanthari said, “We are proud to recognize your outstanding academic achievements and the commitment you have demonstrated to service in San Joaquin and Stanislaus counties. We have faith in the potential you continue to show and we join with your family, as well as your teachers and friends, to support your efforts as you pursue your health career higher education goals.”

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FALL 2016

YES on

56

California’s Proposition 56 Will Raise Tobacco Tax to Save Lives, Protect Children In November, Californians will have a vital opportunity to stand up to tobacco companies and save lives.

Proposition 56 will raise the tax on cigarettes and other tobacco products, including electronic cigarettes containing nicotine, which medical experts warn are creating a major public health threat to children.

Taxing tobacco saves lives and gets people to quit smoking. Taxing tobacco is proven to prevent wouldbe smokers – including youth – from ever starting. And only those who choose to continue or start this deadly and costly habit will pay.

The California Medical Association has joined the American Cancer Society Cancer Action Network, American Lung Association in California and American Heart Association in sponsoring Prop. 56, because tobacco hurts all Californians – even those who don’t smoke.

FALL 2016

The leading cause of preventable death in our state and the nation, tobacco kills 40,000 Californians annually.

Each year, tobacco causes more deaths than guns, car accidents, HIV, alcohol and illegal drugs combined.

Meanwhile, Californians spend $3.5 billion dollars each year treating cancer and other tobacco-related diseases through Medi-Cal. Only those who use tobacco products will pay this simple user fee. The vast majority of funds generated

by Prop. 56 (estimated to be up to $1 billion annually with an additional $1 billion in federal matching funds) will go to pay for health care for low income Californians through Medi-Cal. Medi-Cal now serves over 12 million people, almost one third of the state’s population and half of all California children.

Prop. 56 directs additional funds to the University of California for graduate medical education, Denti-Cal, the California Department of Public Health and the

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Yes On Prop 56 > Protecting Kids

California Department of Education for smoking prevention programs, and the University of California for medical research into tobacco-related diseases.

Prop. 56 will protect children.

Studies show that 90 percent of smokers start as teens. This year alone, an estimated 16,800 California youth will start smoking, one-third of whom will eventually die from tobacco-related diseases.

Tobacco companies are aggressively marketing youth-

themed, candy-flavored electronic cigarettes containing nicotine to hook a new generation of young consumers. Teen use of e-cigarettes tripled in a single year, and flavored tobacco products are creating a dangerous new public health threat, particularly to youth and minorities.

Teens who use e-cigarettes are twice as likely to start smoking traditional cigarettes.

It has been proven that higher tobacco taxes reduce teen smoking, yet California’s tobacco tax is among the lowest in the nation.

Prop. 56 will keep kids from becoming addicted to nicotine.

Prop. 56 will safeguard children and improve California’s communities, economy and health care system.

Although we have made some great strides, we cannot stand down from combatting tobacco’s deadly addiction.

Learn more at YesOn56.org.

Twitter: @YesOn56 Facebook: @YesOn56 Instagram: @YesOn56

Paid for by Yes on 56-Save Lives California, a coalition of Doctors, Dentists, Health Plans, Labor, Hospitals and Non-profit Health Advocate Organizations. Major funding by California Hospitals Committee on Issues, (CHCI) Sponsored by California Association of Hospitals and Health Systems (CAHHS) and California State Council of Service Employees Issues Committee.

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San Joaquin Medical Society and CMA Members Enjoy: Vast CMA Resources:

Serving the counties of San Joaquin, Calaveras, Alpine, and Amador

“My Membership provides me a Voice in Sacramento and Washington DC.” Thomas McKenzie, MD

• • • • • • •

Contract Analysis Reimbursement Hotline Legal Hotline Legislative Hotline HIPAA Compliance Free Monthly Webinars on various topics Extensive Online Resources including over 200 letters, agreements, forms, etc.

• Plus – Free Legal Advice with CMA ON-CALL Documents

San Joaquin Medical Society Resources: • • • • • • • • • • •

DocBookMD phone app Annual Directory Free CME Seminars Cost Saving Benefits Quarterly Publication Website/Online Resources Insurance Savings Alliance Membership Annual Social Events Patient Referrals Office Manager Forum and Practice Resources

Your Membership Investment supports our Advocacy efforts on your behalf in Sacramento and Washington DC

Phone: (209) 952-5299

www.sjcms.org

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FALL 2016

Free CME Presentation for San Joaquin Area Physicians

The Anatomy of a Lawsuit The Cooperative of American Physicians, Inc. (CAP) is proud to join the San Joaquin Medical Society in hosting a free, no-obligation CME risk management presentation designed to help physicians run safer, more successful practices.

Our presentation, The Anatomy of a Lawsuit presented by Susan Schmid, Esq., Managing Attorney, for Schmid & Voiles will discuss what physicians can expect throughout the lawsuit process with examples from past cases.

Ms. Schmid has been representing physicians for more than 40 years, is a frequent and sought-after lecturer for medical and legal seminars and is a member of the American Board of Trial Advocates (ABOTA).

Join Us: Tuesday, October 18, 2016 Brookside Country Club 3603 St Andrews Drive Stockton, CA 95219

Event Times: 6:00 p.m.—Registration & Cocktails 6:30 p.m.— Dinner & Program

Cost & Parking: Complimentary To RSVP or For More Information:

Space is limited and reservations are required.

To RSVP, please call 800-361-5569 or email RSVP@CAPphysicians.com by October 11, 2016.

About CAP: For nearly 40 years, the Cooperative of American Physicians, Inc. (CAP) has provided California’s finest physicians with superior medical professional liability coverage through the Mutual Protection Trust, the only organization of its kind rated A+ (Superior) by A.M. Best for its financial stability. More than 12,000 members strong, CAP is a recognized leader in the state’s medical professional liability arena.

About San Joaquin Medical Society: Founded in 1874, The San Joaquin Medical Society is a professional association representing physicians from every medical specialty and practice setting as well as residents from San Joaquin General Hospital. For more than 130 years, SJMS has been at the forefront of current medicine, ensuring that its members are represented in the areas of public policy, government relations and community relations. *The Cooperative of American Physicians, Inc. is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide continuing medical education for physicians. The Cooperative of American Physicians, Inc. takes responsibility for the content, quality and scientific integrity of this CME activity. CAP designates this educational live activity for a maximum of 0.5AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. This credit may also be applied to the CMA Certification in Continuing Medical Education.

Public Health

Update

PUBLIC HEALTH STAFF INVESTIGATE TRANSMISSIBLE CASES AND CONTACTS, MAINTAIN RECORDS OF ALL REPORTED CASES, CAN CONFIRM HISTORY OF PRIOR TREATMENT, AND CAN ANSWER QUESTIONS REGARDING SYPHILIS TESTING, DIAGNOSIS, AND TREATMENT AT 209-468-3845.

Syphilis Continues to Rise in San Joaquin County

Julie Vaishampayan, MD, MPH, Alvaro Garza, MD, MPH, Hemal Parikh, MPH Syphilis, a genital ulcerative disease caused by the bacterium Treponema Pallidum, is associated with significant complications if left untreated and can facilitate the transmission and acquisition of HIV infection. Additionally, untreated early syphilis in pregnant women may result in perinatal death of the infant in up to 40 percent of cases and, if acquired during the 4 years before pregnancy, can lead to infection of the fetus in 80 percent of cases.

After declining significantly up to the year 2000, syphilis has been on the rise throughout

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the United States. That year, there were just under 2,000 cases of primary and secondary (P&S) syphilis reported in the U.S., rising tenfold to 19,999 reports in 2014. In California, 3,808 cases were reported in 2014; a rate of 9.9/100,000 population. After San Francisco, San Joaquin Valley counties have the next five highest rates of syphilis in the state. The Valley counties differ significantly from the rest of the state for higher rates of syphilis in women and of congenital syphilis.

In San Joaquin County (SJC), reported cases

FALL 2016

of P&S syphilis have increased dramatically in the past seven years, from seven cases reported in 2008 to 129 in 2015. The rate in 2014 was 12.2/100,000 population. For men, the county and state rates were similar, 20 and 18.3, respectively. For women, the county rate (4.8) was three-fold greater than for the state (1.6).

Congenital syphilis is similarly high at 59/100,000 live births in 2015, three-fold higher than the state rate of 20 in 2014.

These high rates called for a Health Officer designation of SJC as an area with high syphilis morbidity in March of this year. The designation calls for all health care providers to

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follow quality standards of care and guidelines as established by the California Department of Public Health, the U.S. Centers for Disease Control and Prevention (CDC), and the U.S. Preventive Services Task Force (USPSTF).

These require screening for syphilis three times during all pregnancies: at the initial prenatal visit, again early in the third trimester, and again at delivery.

Recently, the USPSTF gave a Grade A recommendation for syphilis screening in non-pregnant adults and adolescents at increased risk for syphilis. Screening for syphilis in non-pregnant populations

is an important public health approach to preventing the sexual transmission of syphilis and subsequent vertical transmission of congenital syphilis. Men who have sex with men and people with HIV infection are considered at high risk. Other risk factors include history of incarceration, commercial sex work, certain racial/ethnic groups, and being a male younger than 29 years.

To help in targeted screening, clinicians should be aware of the risk factors for syphilis in SJC. During 2013–2015, the rate of syphilis increased among both men and women.

The highest rates, and risks,

SAN JOAQUIN PHYSICIAN

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Primary & Secondary (P&S) Syphilis by Gender, and Congenital Syphilis, San Joaquin County 160

Male P&S

Female P&S

Congenital 6

140

120

Number of Cases

38 100

2 80

1

2

6

8

17

4

60

24

4 5

40

20

0

2 2

1 2

9

7

5

2006

2007

2008

66

69 43

39 25

24

2009

2010

*2016 YTD as of 6/30/2016

are in the 25-29 year age group for both genders, along with Black or Latino race/ ethnicity. Important risk factors amenable to change include methamphetamine use, unemployment, homelessness (38 percent of P&S syphilis in women, 2016), and sexworking (25 percent of P&S syphilis in women, 2016).

These can be addressed by social policies and programs in cities and counties, for which clinicians can advocate.

The issue of JAMA in which the USPSTF recommendations were published includes an article on why syphilis has

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68

9 3 1

91

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2011

2012

2013

2014

2015

2016 YTD*

Year of Report

increased again. Perhaps most important, funding for public health measures has diminished at the federal, state, and local levels and this was exacerbated by the economic recession of 2008-2010. Also, there have been declines in safer-sex behaviors probably in part because of better HIV/AIDS treatment and reduced fear. Further, there has been increased use of the internet for finding sexual partners, and substance abuse.

That same article urges that awareness of syphilis needs to be increased in clinical settings, particularly where

high-risk patients are given services. It further notes that healthcare providers need to improve on the practice of taking a sexual history and applying the recommended screening approaches as per the USPSTF and CDC. Missing screening opportunities for being reluctant or unwilling to ask about sexual behaviors is a disservice to the patient.

Clinicians, therefore, play a critically important role in early identification and treatment of syphilis.

In SJC, about eight percent of syphilis in women and 16 percent of syphilis in men are diagnosed and reported by private physicians. More than half are diagnosed and reported by emergency departments and the public health clinic. This is a reminder for all clinicians to consider, when appropriate, syphilis in differential diagnoses, and to test and report all cases to PHS within one work day. Public health staff investigate transmissible cases and contacts, maintain records of all reported cases, can confirm history of prior treatment, and can answer questions regarding syphilis testing, diagnosis, and treatment at 209-468-3845.

FALL 2016

Proud to be the First Medical Group Offering Single Site Robotic Surgery in the Valley

Gill GillObstetrics Obstetrics &&Gynecology Gynecology Highly Skilled Minimally Invasive Surgical Team Param Gill, MD

Jacqualin Miller,DO

Just like no two individuals are exactly alike, each woman has unique healthcare needs. For over 60 years, the specialists of Gill Obstetrics & Gynecology have been

trusted to provide innovative, personalized care to women in our community. For women with gynecological issues requiring surgery, our team of highly skilled THE THE VALLEY’S VALLEY’S LEADER LEADER INyou IN ROBOTIC ROBOTIC SURGERY SURGERY FOR FOR WOMEN WOMEN surgeons will help consider the options just right for you, including single site robotic surgery.

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Schedule an gynecological gynecological care,care, our our team team of of Appointment Today

Jasbir S. Gill, M.D.

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Smaller incisions • Reduced ••Reduced blood blood lossloss

Philip D. Ross, M.D.

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Whether it’sready time for your annual doctors doctors are ready are to give to give you you the the

Shorter hospitalization • Minimal ••Minimal scarring scarring

check-up, orcare if you prenatal personalized personalized care youneed you deserve. deserve.

• Reduced discomfort carein andin general orValley specialized Proud Proud topain to be&be the the First First Medical Medical Group Group Offering Offering Single Single Site Site Robotic Robotic Surgery Surgery the the Valley • Faster recovery time Harjit Sud, M.D.

David L. Eibling M.D.

Eugenia L. Hurlbut, D.O.

• Reduced blood loss •

Param Param Gill,Gill, MD MD William Colliflower, M.D.

Linda Colliflower, RNC, NP

Jacqualin Jacqualin Miller,DO Miller,DO Kayla D. Mapps, M.D. Jacqualin Miller, D.O.

Catherine Mathis, M.D.

gynecological care, our team of

Chikanele E. Okorie, M.D.

Lynette Bird, R.N., B.S.N.

Vicki Patterson-Lambert, R.N.P.C.

Highly Highly Skilled Skilled Minimally Minimally Invasive Invasive Surgical Surgical Team Team doctors are ready to give you the

locations toover serve youspecialists Just like Justno liketwo no individuals two individuals are exactly are exactly alike,alike, each each woman woman has Convenient unique has unique healthcare healthcare needs. needs.

For over For 60 years, 60 years, the the specialists of GillofObstetrics Gill Obstetrics & Gynecology & Gynecology havehave beenbeen trusted trusted to provide to provide innovative, innovative, personalized personalized care care toStockton: women to women in our in1617 community. ourN. community.

For women For with2A with gynecological gynecological issues requiring requiring surgery, surgery, our team our team of highly of highly skilled skilled California St.,women Ste. – Ph. (209)issues 466-8546 Minimal scarring surgeons surgeons will help will help you consider you consider the options the options just right just right for you, for including you, including singlesingle site robotic site robotic surgery. surgery. personalized care you deserve.

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Lodi:Medical 999 S. Fairmont Ave., Ste. 225 & 230 – Ph. (209) 334-4924 • Galt: (209) 745-7473 First Group Offering Single Site Robotic Surgery Jackson: 817 Court St., Ste. 8, Jackson, CA 95642 – Ph. (209) 223-1031 Param Gill, MD Jacqualin Miller,DO Manteca: 1234 E. North St., Ste. 102 – Ph. (209) 824-2202

Healthcare Healthcare Just Just asas Unique Unique asas You! You! We accept most health insurance, including Medi-Cal

Highly Skilled Minimally Invasive Surgical Team

PRENATAL POSTPARTUM & POSTPARTUM CARE CARE • HIGH • HIGH RISK RISK PREGNANCY PREGNANCY INFERTILITY •60INFERTILITY • INVITRO • INVITRO FERTILIZATION FERTILIZATION JustPRENATAL like no two & individuals are exactly alike, each woman has unique healthcare needs. For•over years, the specialists of Gill Obstetrics & Gynecology have been GILLOBGYN.COM trusted to provide personalized•care women inINCONTINENCE our INCONTINENCE community. For women with gynecological issues requiring surgery,•our of highly skilled GYNECOLOGY GYNECOLOGY • ENDOMETRIOSIS •innovative, ENDOMETRIOSIS URINARY •toURINARY • OVARIAN • OVARIAN CYSTIC CYSTIC DISORDER DISORDER LAPAROSCOPY •team LAPAROSCOPY surgeons will help you consider options just right for you, including single siteCANCERS robotic surgery.• ROBOTIC HYSTEROSCOPY • DIAGNOSIS & TREATMENT OFthe CERVICAL, UTERINE, OVARIAN SURGERY HYSTEROSCOPY • DIAGNOSIS & TREATMENT OF CERVICAL, UTERINE, OVARIAN CANCERS • ROBOTIC SURGERY

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PRENATAL & POSTPARTUM CARE • HIGH RISK PREGNANCY • INFERTILITY • INVITRO FERTILIZATION GYNECOLOGY • ENDOMETRIOSIS • URINARY INCONTINENCE • OVARIAN CYSTIC DISORDER • LAPAROSCOPY Maya Nambisan, M.D. M.D. Darrell R. Darrell Jasbir M.D. S. Gill, M.D. Thomas Streeter, Linda Bouchard, M.D. M.D. Philip D. Ross, PhilipM.D. D. Ross, M.D. Maria E. Escalona, Maria E. Escalona, M.D. M.D. Pennisi,P.M.D. Pennisi, M.D. Jasbir S. Gill, Thomas M.D. Streeter, M.D. Maya Nambisan, Burns, M.D. R. Burns, M.D. Tonja Harris-Stansil, Tonja Harris-Stansil, M.D. M.D. Linda Bouchard, Param K. Gill, Param M.D. K. Gill, M.D. Vincent P. Vincent HYSTEROSCOPY • DIAGNOSIS & TREATMENT OF CERVICAL, UTERINE, OVARIAN CANCERS SURGERY Harjit Sud, M.D. David L. Eibling M.D. Ofelia Ortiz, M.D. Alecia Russell, D.O.• ROBOTIC Gail Joseph, M.D. Vincent P. Pennisi, M.D. Param K. Gill, M.D. Kimberley Fillmore, M.D.

David L. Eibling David L. M.D. Eibling M.D.

Harjit Sud,Harjit M.D.Sud, M.D.

JasbirParam S. Gill, M.D.M.D. K. Gill,

Jacqualin D.O. Miller, D.O. Linda Colliflower, RNC, NP RNC, NP Mathis, M.D. Mathis, M.D. Jacqualin Miller, Eugenia L.Eugenia Hurlbut,L.D.O. Hurlbut, D.O.Linda Colliflower, William Colliflower, William Colliflower, M.D. M.D. Catherine Catherine

Thomas M.D. Vincent P.Streeter, Pennisi, M.D.

MayaS.Nambisan, Jasbir Gill, M.D. M.D.

Lynette R.N.,Bird, B.S.N. R.N., B.S.N. Kayla D. Mapps, Kayla D.M.D. Mapps, M.D. Chikanele Chikanele Vicki Patterson-Lambert, Vicki Patterson-Lambert, R.N.P.C. R.N.P.C. E. Okorie,E.M.D. Okorie, M.D.Lynette Bird,

Linda Bouchard, Burns, M.D. Maya Nambisan, Tonja M.D. Harris-Stansil, Darrell M.D. R. Burns, M.D. Maria E. Escalona, M.D. M.D. Linda Bouchard, Thomas Darrell Streeter,R.M.D. TonjaM.D. Harris-Stansil, M.D.

Eugenia Philip L. Hurlbut, D.O. D. Ross, M.D.

Kayla D.Escalona, Mapps, M.D. M.D. Maria E.

Convenient Convenient locations locations to serve to serve youyou 1617 1617 N. California N. California St., Ste. St., Ste. 2A –2A Ph.– (209) Ph. (209) 466-8546 466-8546 Stockton: Stockton: 25092509 W. March W. March Lane,Lane, Ste. Ste. 250 -250 Ph.- (209) Ph. (209) 957-1000 957-1000

David L. Eibling M.D.

Lodi: Lodi: 999 S. 999Fairmont S. Fairmont Ave.,Ave., Ste. Ste. 225 & 225 230 & 230 – Ph.– (209) Ph. (209) 334-4924 334-4924 • Galt: • Galt: (209)(209) 745-7473 745-7473 Jackson: Jackson: 817 Court 817 Court St., Ste. St., Ste. 8, Jackson, 8, Jackson, CA 95642 CA 95642 – Ph.– (209) Ph. (209) 223-1031 223-1031 Chikanele E. Okorie, M.D. Lynette Bird, R.N., B.S.N. Jacqualin Miller, D.O. Catherine Mathis, M.D. Patterson-Lambert, R.N.P.C. William Colliflower, M.D. Manteca: Manteca: 12341234 E. North E. North St., Ste. St., Ste. 102 –102 Ph.–Vicki(209) Ph. (209) 824-2202 824-2202Philip D. Ross, M.D.

Harjit Sud, M.D.

Linda Colliflower, RNC, NP

Eugenia L. Hurlbut, D.O.

Linda Colliflower, RNC, NP

William Colliflower, M.D.

Catherine Mathis, M.D.

Jacqualin Miller, D.O.

Kayla D. Mapps, M.D.

Chikanele E. Okorie, M.D.

Lynette Bird, R.N., B.S.N.

Vicki Patterson-Lambert, R.N.P.C.

David Russell, M.D.

We accept We accept mostmost health health insurance, insurance, including including Medi-Cal Medi-Cal

Convenient locations to serve you GILLOBGYN.COM GILLOBGYN.COM Stockton: 1617 N. California St., Ste. 2A – Ph. (209) 466-8546 2509 W. March Lane, Ste. 250 - Ph. (209) 957-1000

Lodi: 999 S. Fairmont Ave., Ste. 225 & 230 – Ph. (209) 334-4924 • Galt: (209) 745-7473 Jackson: 817 Court St., Ste. 8, Jackson, CA 95642 – Ph. (209) 223-1031 Manteca: 1234 E. North St., Ste. 102 – Ph. (209) 824-2202 FALL 2016

We accept most health insurance, including Medi-Cal

GILLOBGYN.COM

SAN JOAQUIN PHYSICIAN

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A financial safety net for you—

AND THE ONES YOU LOVE 10- AND 20-YEAR LEVEL TERM LIFE No matter where you are in life, SJMS Group Level Term Life Insurance benefits can be an affordable solution to help meet your family’s financial protection needs.

Mercer and SJMS leveraged the buying power of your fellow members to secure dependable and affordable life insurance benefits at competitive premiums from ReliaStar Life Insurance Company, a member of the Voya® family of companies.

With quality life insurance benefits extended at competitive rates, you’ll rest easy knowing you’ve provided coverage for your loved ones through the Group 10-Year and 20-Year Level Term Life Plans.

As a member, you can conveniently help protect your family’s financial future with the Group 10-Year and 20-Year Level Term Life Plan.

It features: • Benefits up to $1,000,000 • Rates that are designed to remain level for 10 or 20 full years* • Benefit amounts that never change during the level term period provided premiums are paid when due

See For Yourself: Get more information about your Group 10-Year and 20-Year Level Term Life Plans, including eligibility, benefits, premium rates, exclusions and limitations, and termination provisions by visiting www.CountyCMAMemberInsurance.com or by calling 800-842-3761.

Sponsored by:

Administered by:

Underwritten by: ReliaStar Life Insurance Company, a member of the Voya® family of companies 75554 (6/16) Copyright 2016 Mercer LLC. All rights reserved.

Mercer Health & Benefits Insurance Services LLC • CA Insurance License #0G39709 777 S. Figueroa Street, Los Angeles, CA 90017 • 800-842-3761 • CMACounty.insurance.service@mercer.com • www.CountyCMAMemberInsurance.com * The initial premium will not change for the first 10 or 20 years unless the insurance company exercises its right to change premium rates for all insureds covered under the group policy with 60 days’ advance written notice.

The County Medical Associations & Societies receive sponsorship fees for insurance programs that offset the cost of program oversight and support member benefits and services.

FALL 2016

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practice management Free to SJMS/CMA Members!

resources

The Office Manager’s Forum empowers physicians and their medical staff with valuable tools via expert led educational sessions from industry professionals who are committed to delivering quality health care.

For more than 130 years, the San Joaquin Medical Society (SJMS) has been at the forefront of current medicine, providing its physician’s and their staff with assistance and valuable practice resources. SJMS is proud to offer the Office Manager’s Forum, a monthly educational seminar designed to enhance the healthcare environment with professional development opportunities while providing solutions to some of the challenges that come from managing a practice.

Attendees gain knowledge on a broad array of topics related to the field of medical staff services, office management, billing and coding, human resources, accounting and back office support.

The Office Manager’s Forum is held on the second Wednesday of each month from 11:00AM – 1:00PM at Papapavlo’s in Stockton and includes a complimentary lunch. Attendance is always FREE to our members. Non-members are welcome and may attend for one month at no cost to experience one of the quality benefits that comes with Society Membership ($35.00 thereafter). Registration required.

For more information or to be added to the mailing list e-mail Jessica Peluso, SJMS Membership Coordinator, at Jessica@SJCMS.org or call 209-952-5299.

SEPTEMBER 14TH 2016:

“EVOLUTION OF THE CARE DELIVERY MODEL” 11:00AM to 1:00PM

For the independent, entrepreneurial medical provider to be successful, it will take agility, cost-effectiveness and a willingness to develop new and unique partnerships. The independent practice is being bombarded from all sides: from rising costs and declining reimbursement, to changing regulations and the increasing complexities of administering the business side of medicine. The pressures to consolidate due to the industry evolution has independent practices seeking innovative ways to secure their autonomy into the future.

Recent research indicates that nearly 75 percent of independent practitioners wish to remain so, the challenge revolves around adapting their business practices to ensure that potential.

Irv Barnett, MBA – Founder.

Irv has been in health care management since 1986.

He spent the last 19 years serving physicians throughout California. He has served as the President of California MGMA and has been a featured speaker at meetings around the country. Providing exceptional leadership around value-driven practice management techniques, Irv helps practices prepare for the future!

OCTOBER 12TH 2016:

“ALL THE WAYS HPSJ CAN SUPPORT YOUR PRACTICE & HPSJ PATIENTS” 11:00AM to 1:00PM

With growing numbers of patients to care for, thanks to the Affordable Care Act and expanded Medi-Cal, it has never been more important for busy practices to find practical support. Health Plan of San Joaquin (HPSJ), a not-for-profit health plan, has been serving members and our multicultural community since 1996.

As the leading Medi-Cal Managed Care provider in San Joaquin and Stanislaus counties, HPSJ offers a broad network of providers and works closely with physicians and practice staff to develop programs and services to ensure quality health care for over 337,000 members.

Here in one place, over lunch, a team of HPSJ presenters will offer a crisp program and answer your questions about the following ways they stand ready to help your practice: • Health education and referral opportunities HPSJ

programs for Prenatal and Postpartum health; and CHEER (Community Health Education and Engagement Referral) • Interpretive services • Kids Oral Health, an HPSJ Initiative • Transportation • HPSJ Health Navigators • Post-ER calls • Prior Authorized (PA) services -- providers notifying patients • Coordinated care for your patients (Care Management, Disease Management, and Prior Authorization reduction) • NEW Provider Partnership Program • Member satisfaction results • HEDIS TEAM HPSJ, seen at their French Camp offices with pictures of Health Commission governing board members in the background, will join us to lay out all the ways they are helping their members who are your patients. From left, they are: Lei McMiller (Health Education/Social Services Manager), Patricia Sabella (CM/UM director), Setar Testo (Health Educator), Jenny Dominguez (Health Promotion and Cultural & Linguistics Programs Manager), Tamara Foster (HEDIS & Accreditation Manager), and Linda Reynolds (Provider Services Manager).

NOVEMBER 9TH, 2016: “TBD” 11:00AM to 1:00PM

DECEMBER 7TH 2016:

“MEDICARE UPDATES 2016” 11:00AM to 1:00PM

Join us for our annual Medicare Update workshop for physicians and office staff. This two-hour seminar will cover relevant information about current, future and proposed changes for the coming year!

Cheryl Bradley – Associate Director, CMA Center for Economic Services

eMR implementation can be hard.

let us make it easy.

CROWN ENTERPRISES IS A LOCAL FULL SERVICE INFORMATION TECHNOLOGY COMPANY SPECIALIZING IN PROVIDING MEDICAL PRACTICES:

• Certified EMR/PM software selection • Reaching Meaningful Use for Federal Stimulus Money Funding • Hardware Installation and Repair • Business Continuity & Disaster Recovery • HIPPA/HiTech Regulatory Compliance • Network and Systems Security • Local Affordable Flat Fee IT Support

We guide our clients through every critical step and our process ensures improved operational efficiencies, quality of care, and increased practice profits.

Call us today for a complimentary consultation at (209) 390-4670 62

SAN JOAQUIN PHYSICIAN

FALL 2016

New Members

19 NEW

SJMS MEMBERS THIS SUMMER!

...and even more on the way.

Nadeem Tahir-Kheli, MD

Ambreen Rahman, D.O.

Jennifer McEvoy MD

Gail Joseph, MD

1335 S. Fairmont Ave Lodi, CA 95240

2100 Powell Street, Suite 920 Emeryville, CA 94608

7373 West Lane Stockton, CA 95210

1234 E. North Street, Ste 102 Manteca, CA 95336

Ajub Medical College

209-476-2166 Lake Erie College of Osteopathic

209-476-2000 UC Irvine

209-824-2202 University of Pittsburg School of

Family Medicine

Reza Sepehrdad, MD Interventional Cardiology

Emergency Medicine

Medicine

Patricia Olise-Ojemen, MD

OB/GYN

Medicine

Pediatrics

Ofelia Ortiz, MD OB/GYN

2100 Powell Street, Suite 920

2185 W Grant Line Road Tracy, CA 95377

999 S. Fairmont Ave, Ste 230

Emeryville, CA 94608 Tufts University School of Medicine

209-476-2000 University of Benin

Lodi, CA 95240 209-334-4924

Radiation Oncology

Rujani Rudrangi, MD

1800 N California Street Stockton, CA 95204

Rheumatology

Logithya Subendra-Konini, MD

500 W Hospital Rd

Family Practice

209-467-6560

Stockton, CA 95231

7373 West Lane

OB/GYN

University of Vermont College of Medicine

209-468-6506 Osmania Medical College

Suresh Hosuru, MD

Manavjyot Heer, MD

Stockton, CA 95210 209-476-2000 Ross School of Medicine

999 S. Fairmont Ave, Ste 230 Lodi, CA 95240 209-334-4924

2505 W Hammer Lane

2151 Grant Line Rd

Family Practice

David Russell, MD

Stockton, CA 95209 Kurnool Medical College, India

Tracy, CA 95377 209-833-2367

7373 West Lane Stockton, CA 95210

OB/GYN

1617 N California St, Ste 2A

Alice Kim, D.O.

University of California School of Medical - L.A.

209-476-2000 Touro University

Stockton, CA 95204 209-466-8546

27200 Calaroga Ave Hayward, CA 94545

Scott Neeley, MD

Shaulnie Mohan, D.O.

Phuladelphia College of Osteopathic Medicine

510-264-4026 Touro University College of

1800 N California Street Stockton, CA 95204

7373 West Lane Stockton, CA 95210

Osteopathic Medicine

209-467-6417

Boston University School of Medicine

999 S. Fairmont Ave., Ste 130

Katherine Shafer, MD

General Surgery

Lodi, CA 95240 209-550-3927

Emergency Medicine

New York Medical College

Gauravjit Singh, MD

Internal Medicine

Emergency Medicine

FALL 2016

Hospitalist

Critical Care Medicine

Kam Chan, D.O.

Otolaryngology

UMDNJ- Robert Wood Johnson Medical School

Alecia Russell, MD

Michigan State University

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Fortunately, there’s the Manteca Wound Center.

Hard-to-heal wounds demand advanced care. At the Manteca Wound Center, we use the latest treatments and sophisticated case management to help patients with chronic wounds heal faster. And when wounds heal, lives improve.

For more information, please call the Manteca Wound Center today.

A Department of Doctors Hospital of Manteca

(209) 823-7190 64

SAN JOAQUIN PHYSICIAN

FALL 2016

In Memoriam

In Memoriam Darius Sepehr “Doc” Noori • Irving Christopher Hudlin Jr.

DARIUS SEPEHR “DOC” NOORI August 5, 1950 - May 15, 2016

He will be missed, but more importantly he will be remembered as a man who lead by example how a life should truly be lived.

FALL 2016

Dr. Darius “Doc” Noori, age 65, a resident of Acampo, CA, moved on to his next great adventure on Sunday, May 15, 2016.

He was born August 5, 1950, in Shiraz, Iran.

In 1965, at the age of 15, Doc came to the United States to pursue his higher education. He managed this with the encouragement of his father, and the assistance of the U.S. Ambassador. After studying Chemical Engineering then Geology, Doc went on to complete his PharmD at University of the Pacific in 1977. He then earned his MD in 1984 from Ross University and went on to specialize in Internal Medicine and Geriatrics. He settled in Lodi in 1993.

Doc was an avid traveler, skier, sailor, motorcyclist, bicyclist, SCUBA diver, sports car enthusiast, and licensed pilot. He loved adventure, and was always planning his next trip to the far points of the globe. It was on a ski trip to Mammoth Mountain in 1989 that he met his wife, Nancy Little.

With family members, his best friend Ivan, and various friends in tow, he visited Austria, Belgium, Bolivia, Brazil, Canada, Chile, China, Columbia, Cuba, Czech Republic, Ecuador, Egypt, England,

France, Germany, Greece, Hong Kong, India, Israel, Italy, Japan, Monaco, Nepal, the Netherlands, Norway, Peru, Portugal, Russia, Spain, Switzerland, Thailand, North and South Vietnam, Venezuela, United Arab Emirates, New Zealand, Turkey, Vatican City, and all three Guyanas. He also visited Bosnia, Mexico, and Yugoslavia as a member of Doctors Without Borders.

He has trekked to the base camp on Mount Everest twice. The second time was in 2015 when the earthquake occurred, and he had already purchased tickets for a third trip this September. Doc remains a legend among his friends and acquaintances-not only for his travels or his accomplishments, but for his integrity, generosity, and joy of life. He will be missed, but more importantly he will be remembered as a man who lead by example how a life should truly be lived.

He is preceded in death by his father Colonel Mansour Sephernoori and mother Zam Zam Soleimani. He is survived by his wife, Nancy Little, his daughters Brenley and Daria, and his sons Jake and Austin, as well as his brother Kamy and sisters Pari and Maheen Sephernoori.

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In Memoriam

IRVING CHRISTOPHER HUDLIN JR. November 18, 1954 - May 22, 2016

Widely known as a skilled surgeon and clinician, Chris is remembered by his friends and colleagues as a kind, deeply caring and generous man with a driving passion for helping others by delivering outstanding patient care.

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SAN JOAQUIN PHYSICIAN

An extraordinary soul left us Sunday May 22, 2016. Chris passed away surrounded by the immense love and support of his wife, his children and three closest friends.

Chris was born November 18, 1954 to Irving and Thelma Hudlin in Fort Campbell, Kentucky. As a military brat, Chris was afforded the opportunity to experience many parts of the world, Okinawa, Japan, and Bangkok, Thailand, to name a few. These experiences instilled in him a sense of adventure and curiosity that he carried with him his entire life.

As an undergraduate, Chris attended Michigan State University attaining a degree in Biochemistry. He then received his Doctor of Medicine degree from Washington University School of Medicine in 1980. Chris completed his General Surgery residency at David Grant Medical Center, Travis Air Force Base, where he received the Air Force Achievement Medal. Chris then joined the medical staff at St. Joseph’s Medical Center in 1988. He also obtained privileges at three other local hospitals.

Widely known as a skilled surgeon and clinician, Chris is remembered by his friends and colleagues as a kind, deeply caring and generous man with a driving passion for helping others by delivering outstanding patient care.

Chris loved working with the residents

at San Joaquin General Hospital. He took a special interest in each and every one of them. He was a long-serving Chief of General Surgery at SJMC and was the Chief of Surgery for the Sutter Gould Medical Group which he joined in 2007. Chris was instrumental in the expansion of SGM in Stockton and a key visionary in the creation of the multispecialty presence. Chris served on countless committees and boards.

He spearheaded the Philanthropy initiative for Sutter as well as the Sutter Breast Cancer Support Group.

Everyone that came in contact with Chris knew they were special. He was a man of many talents and gifts who loved life and knew how to live it to the fullest. His positive attitude, sense of humor, beautiful smile, and unique laugh were intoxicating. He loved time at home, sipping a fine wine from his cellar and cooking his favorite grilled veggie dish. Chris took every opportunity he could to play golf or tennis, two sports he was passionate about. His last, best adventure was a trip to Italy last fall with his wife and close friends.

Chris is survived by his wife Carol, his children Ryan, Marisa and Brittany, his mother Thelma and his sisters Colleen and Sharon (Pierre). Also, by numerous nieces, nephews, aunts and cousins. He is predeceased by his father Irving.

FALL 2016

STOCKTON MRI & Molecular Imaging Medical Center, Inc. 2320 N. California Street • Stockton, CA 95204 PHONE 209-466-2000 • Fax 209-466-2600 w w w. s to c k to n m r i . co m

The Most Advanced and Comprehensive Medical Imaging Center in San Joaquin County Just Got Better with the Addition of the Central Valley’s only 128 Multislice CT Scanner with Lowest Radiation Dose Imaging Services Include: • The first PET-CT since 2003 • Full service of Nuclear Medicine • Most advanced G. E. High Field MRI (1.5 Tesla) • Full service of Digital Radiography and Fluoroscopy • New GE Logic 9e 3D & 4D Ultrasound Unit • 128 Slice Siemens CT Scanner

All Board Certified Radiologists with fellowship: Javad Jamshidi, MD Francis Isidoro, MD Brian Morrow, MD

The Fastest 128 Multislice High Resolution CT in community practice:

Siemens Somatom Definition AS+ (128) FALL 2016

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San Joaquin Medical Society 3031 W. March Lane, Suite 222W Stockton, California 95219-6568

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