coastal medicine march/april 2015

March/April 2015 • V3 N1

Coastal MedicineThe magazine of the Santa Cruz County Medical Society

Save the Date: april 14, 2015

For more information, please contact Yna Shimabukuro, CMA Government Relations at 916.444.5532 or [email protected].

Tuesday, April 14, 2015 • Sheraton Grand Sacramento

CALIFORNIA MEDICAL ASSOCIATION41ST ANNUAL LegiSLATive AdvocAcy dAy

Activities include:

• Webinar: Lobbying 101 and Legislative Training (March 26th)

• Put your training into ACTION and visit your Legislator!

Attendees can stay at the Sheraton Grand at a special rate of $170/night. To make a reservation,

call (800) 325-3535 and mention the “California Medical Rate.”

Please note: Scholarships may be available to medical students for travel and accommodations through

their county medical societies.

Registration is FREE. Reserve your spot today at cal.md/legday2015

March/April 2015 • COASTAL MEDICINE • 3


5The President’s DeskBrian Brunelli, MD,SCCMS President

10Membership News

19National Doctors’ Day

21POLST in 2014: What HealthcareProfessionals Need to KnowJudy Thomas, JD and Mark J Apfel, MD

22Advertisers/ClassifiedsKey Dates/Calendar

23Executive Director’s Message/ Excellence in Health Care Award Hornoree

Back coverWestern Healthcare Leadership Academy

Page 6

Page 13

4 • COASTAL MEDICINE • March/April 2015

SANTA CRUZ COUNTYMEDICAL SOCIETY

PRESIDENT Brian Brunelli MDPAST-PRESIDENT Jeannine Rodems, MD

SECRETARY Christopher O’Grady, MDTREASURER Patrick Meehan, MD

BOARD MEMBERSDavid Benjamin, MD; John Christensen, MD

W. Richard Hencke, MD; Donaldo Hernandez, MD Lisa Hernandez, MD; Dawn Motyka, MD

John Pestaner, MD; Rosalind Shorenstein, MDMichelle Simon, MD; Jack Watson, MD

COMMITTEE/PROJECT CHAIRS & REPSHEALTH SCIENCES MENTORSHIP (UCSC) Jack Watson, MDLEGISLATIVE OUTREACH Tim Allari, MD; Jack Watson, MD

MEMBERSHIP Dawn Motyka, MDMRAC Tobias Yeh, MD

NOMINATING Brian Brunelli, MDNORCAP COUNCIL Rosalind Shorenstein, MD

PHYSICIAN WELL-BEING John Gillette, MD and Martina Nicholson, MD

PRACTICE MANAGERS NETWORK Mary ChamplinQA, CONDUCT, & ETHICS Robert Jones, MD

CMA HOUSE OF DELEGATES REPRESENTATIVESJohn Christensen, MD; W. Richard Hencke, MD;

Christopher O’Grady, MD; John Pestaner, MDJeannine Rodems, MD; Rosalind Shorenstein, MD;

Jack R. Watson, MD

COMMUNITY ENGAGEMENT/PARTNERSCMA Richard Thorp, MD, President

CRUZMED FOUNDATION Jeannine Rodems, MD, PresidentEMERGENCY MANAGEMENT COUNCIL open position,

SCCMS RepresentativeEMERGENCY MEDICAL CARE COMMISSION Marc Yellin, MD,

SCCMS RepresentativeHEALTH IMPROVEMENT PARTNERSHIP Donna Odryna, Board

SSC MEDICAL RESERVE CORPS Jeff Terpstra, Chair

COVER PHOTOFrom iStockPhoto.com, “Walkway along the PacificOcean in Santa Cruz, California”. Photo by alexeys

Coastal Medicine magazine

EDITORIAL COMMITTEE Brian Brunelli, MD; Jeannine Rodems, MD, and Donaldo Hernandez, MD

MANAGING EDITOR Donna Odryna

CONTRIBUTING WRITERS Brian Brunelli, MD; CMA staff; Judy Thomas, JD and Mark J Apfel, MD

COPY EDITOR/LAYOUT Mary Champlin

Coastal Medicine magazine is produced by the Santa Cruz County Medical Society.

OPINIONS expressed by authors are their own and not necessar-ily those of Coastal Medicine magazine or SCCMS. Coastal Medicine reserves the right to edit all contributions for clarity and length and to reject any material submittedin whoe or in part. Acceptance of adertis-ing in Coastal Medicine is no way constitutes approval or endorsemennt by SCCMS of products or services advertised. Coastal Medicine and SCCMS reserve the right to reject any advertising.

SUGGESTIONS, story ideas, or completed stories written by current Santa Cruz County Medical Society members are welcome and will be reviewd by the Editoral Committee.

DIRECT all inquiries, submissions, and advertising to:Coastal Medicine Magazine1975 Soquel Dr #215Santa Cruz CA 95065-1821Phone: (831) 479-7226Fax: (831) 479-7223Email: [email protected]

MEDICAL SOCIETY STAFFEXECUTIVE DIRECTOR Donna J. OdrynaMEMBER SERVICES COORD/OFFICE MANAGER Mary ChamplinBOOKKEEPER Christie Hicks

Copyright ©2015 Santa Cruz County Medical SocietyAll rights reserved. Reproduction in whole or in part withoutwritten permission is prohibited.

POSTMASTERSend address changes to:Coastal Medicine Magazine1975 Soquel Dr #215Santa Cruz CA 95065-1821


It is time for the SGR to go!In an effort to rein in Medicare spending, Congress adopted the Sustained Growth Rate (SGR) formula in 2000. Unfortunately, the SGR formula was quite flawed, and it did not track with real world medical spending. Every year, for more than a decade, physicians have faced significant Medicare payment cuts due to the SGR formula as SGR fell more and more out of step with what are the true costs of providing medical care. Rather than fixing the flawed formula, Congress has enacted 17 patches to stop these Medicare physician payment cuts, (sometimes multiple patches in a single year). The cumulative

cost of these patches is $169.5 billion, which now exceeds the cost of simply repealing the SGR.

Each year physicians wait to see if the patch will come, creating uncertainty right up to the critical moment, and sometimes forces physicians to go many months without being paid. Given that Congress temporarily fixes the SGR every year with a patch, the expected savings of the SGR never occur. Permanently correcting the SGR formula to reflect the reality of medical costs is in ef-fect neutral to the budget. Members of Congress on both sides of the aisle can agree that a permanent repeal of the SGR does not affect the long-term budget deficit.

As the April 1, 2015 deadline rapidly approached, the U.S. House of Representatives overwhelmingly passed bipartisan legislation that would permanently repeal the SGR formula. On March 26th the House passed H.R. 2, the Medicare SGR and CHIP Reau-thorization Act, by a landslide vote of 392 – 37. Congressman Sam Farr has been our advocate on this issue and deserves a hearty ‘Thank you” for all of his efforts over many, many years.

Unfortunately, the Senate was unable to gain the necessary unanimous consent to “hotline” H.R. 2, The Medicare SGR and CHIP Reauthorization Act, to the Senate floor for a vote before leaving for the spring recess. While both the Republican and Democratic Senate leaders believed they had the required 60 votes to pass the bill, a small handful of Republican Senators blocked the ability for the entire Senate to take a vote. They oppose the bill because it is not fully “paid for.” The CMA, SCCMS, and all of organized medicine are extremely disappointed. However, Senate Leader McConnell said the Senate will take up the legislation when they return from spring break under the regular order of business which only requires 60 votes.

Both Senators Boxer and Feinstein were prepared to support the legislation. The momentum from the House vote should propel the Senate to act quickly when they return from recess. On your behalf, CMA will continue to stay in touch with our Senators over the recess and monitor the situation closely and we all will keep fighting until we achieve passage. We are too close now to let this opportunity slip away!

In the meantime, the Centers for Medicare and Medicaid Services (CMS) said they can hold physician claims on the payment floor for 14 days to avoid the devastating 21% payment cut that is scheduled to begin April 1, 2015. However, the Senate will need to act the first day they return to avoid the actual 21% payment cut.

For up-to-date information on the Senate vote, check the News section on the CMA website (www.cmanet.org). Those reviewing this publication of Coastal Medicine magazine online still have time to contact Senators Boxer and Feinstein to remind them that the SGR is a flawed formula that does not reflect the reality of providing medical care.

The President’s DeskDr. Brian Brunelli is the SCCMS President, serving 2014-2016. He is a Neurologist with the Palo Alto Medical Foundation Santa Cruz. Dr. Brunelli is married and has two children.


The California Legislature had an active year, passing many new laws affecting health care. Below are highlights of the new laws likely to impact physicians next year and beyond. For more details, see “Significant New California Laws of Interest to Physicians for 2015,” in the California Medical Association’s online resource library at www.cmanet.org/resource-library. >>

New Health Laws2015

ALLIED HEALTH PROFESSIONALSAB 1841 (Mullin) - MEDICAL ASSISTANTS Clarifies that medical assistants (MAs) may hand out properly labeled and prepackaged prescription drugs to patients as part of their existing authorization to provide “technical supportive services.” Permits MAs to hand out prescription drugs in non-state operated facilities licensed by the Board of Pharmacy. Requires that a licensed physician and surgeon, a licensed podiatrist, a physician assistant, a nurse practitioner, or a certified nurse-midwife provide the appropriate patient consultation regarding use of the drug.

CONFIDENTIAL INFORMATIONAB 1755 (Gomez) - MEDICAL INFORMATION Revises provisions of law requiring licensed health facilities to prevent disclosure of patients’ medical information by extending the deadline for health facilities to report unauthorized disclosures from five to 15 business days after unlawful or unauthorized access, use, or disclosure has been detected. This bill also authorizes the report made to the patient or the patient’s representative to be made by alternative means, including email, as specified by the patient. This bill also extends the deadline when reporting is delayed for law enforcement purposes, as specified, from five to 15 days


business days after the end of the delay. This bill gives the Department of Public Health full discretion to consider all factors when determining whether to conduct investigations under these provisions.

DRUG PRESCRIBING AND DISPENSINGAB 467 (Stone) - PRESCRIPTION DRUGS: COLLECTION AND DISTRIBUTION PROGRAM Establishes a license and regulatory framework for a “surplus medication collection and distribution intermediary” to facilitate the donation of surplus medications in California. Requires the Board of Pharmacy to license a surplus medication collection and distribution intermediary, established for the purpose of facilitating the donation or transfer of medications between entities under a specified unused medication repository and distribution program. Authorizes the intermediary to charge specified fees. Relates to license renewal. Requires the keeping and maintaining of complete records. Provides that fees collected would be deposited in the Pharmacy Board Contingent Fund.

AB 1535 (Bloom) - PHARMACISTS: NALOXONE HYDROCHLORIDE Authorizes a pharmacist to furnish naloxone hydrochloride in accordance with standardized procedures or protocols developed and approved by both the Board of Pharmacy and the Medical Board. Requires the development of protocols on the education of the person to whom the drug is furnished and notification of the patient’s primary care provider. Requires the pharmacists to complete related training. Prohibits furnishing the medication to the patient without consultation. Authorizes related regulations.

AB 1735 (Hall) - NITROUS OXIDE: DISPENSING AND DISTRIBUTING

Makes it a misdemeanor for any person to dispense or distribute nitrous oxide to a person if it is known or should have been known that the nitrous oxide will be ingested or inhaled by the person for the purposes of causing intoxication, and that person proximately causes great bodily injury or death to himself, herself, or any other person. Requires each transaction to be recorded in a written or electronic document. Requires a signature and proper identification. Makes it a crime to misuse customer information.AB 1743 (Ting) - HYPODERMIC NEEDLES AND SYRINGESDeletes the limit on the number of syringes a pharmacist has the discretion to sell to an adult without a prescription and extends, until January 1, 2021, the statewide authorization for pharmacists to sell syringes without a prescription, as specified. Exempts the possession of a specified amount of hypodermic needles and syringes that are acquired from an authorized source.

HEALTH BENEFIT EXCHANGEAB 617 (Nazarian) - HEALTH BENEFIT EXCHANGE: APPEALSEstablishes an appeals process for eligibility determinations for insurance affordability programs (including Medi-Cal and tax credits available through the California Health Benefit Exchange (Covered California) and requires Covered California to contract with the Department of Social Services to serve as the designated entity to hear appeals.

HEALTH CARE COVERAGESB 959 (Hernandez, E.) - HEALTH CARE COVERAGEProhibits a change in premium rate or coverage for an individual plan contract or policy unless the plan or insurer delivers a written notice of the change at least 15 days prior to the start

of the annual enrollment period applicable to the contract or 60 days prior to the effective date of renewal, whichever occurs earlier in the calendar year. Makes several corrections and clarifications to provisions of law governing individual and small group health insurance, including clarifying that health plans and insurers have a single risk pool for enrollees and insureds.

SB 964 (Hernandez, E.) - HEALTH CARE COVERAGEIncreases oversight of health care service plans with respect to compliance with timely access and provider network adequacy standards. Authorizes a health plan to include in its contracts with providers, provisions requiring compliance with timely access and network adequacy data reporting requirements. Requires DMHC to annually review health plan compliance with timely access standards and to post its final findings from the review, and any waivers or alternative standards approved by DMHC, on its Web site. Authorizes DMHC to develop, and requires health plans to use, standardized methodologies for timely access reporting, and exempts the development and adoption of the standardized reporting methodologies from the Adm inistrative Procedures Act, the body of law governing state regulations, until January 1, 2020.SB 1052 (Torres) - HEALTH CARE COVERAGERequires a health care service plan or insurer that provides prescription drug benefits or maintains drug formularies to post those formularies on its website and to update that posting with changes at specified times. Requires the development of a standard formulary template. Requires plans and insurers to use that template to display formularies. Requires the Covered California website provide a link to the formularies for each health plan through the Exchange.

SB 1053 (Mitchell) - HEALTH CARE


COVERAGE: CONTRACEPTIVESRequires, effective January 1, 2016, most health plans and insurers to cover a variety of Food and Drug Administration-approved contraceptive drugs, devices, and products for women, as well as related counseling and follow-up services and voluntary sterilization procedures. Prohibits cost-sharing, restrictions, or delays in the provision of covered services, but allows cost-sharing and utilization management procedures if a therapeutic equivalent drug or device is offered by the plan with no cost-sharing.

HEALTH CARE FACILITIES AND FINANCING AB 1570 (Chesbro) - RESIDENTIAL CARE FACILITIES FOR THE ELDERLYIncreases training requirements for licensees and staff of Residential Care Facilities for the Elderly (RCFE). Deletes the existing requirement of 40 hours of classroom instruction for RCFE licensee certification training programs and replaces it with 80 hours of required coursework, which shall include at least 60 hours of coursework that shall be attended in person. Adds personal rights, management of antipsychotic medication, managing Alzheimer’s disease and related dementias, and managing the physical environment, including maintenance and housekeeping to the list of items covered in the RCFE licensee certification training program.

AB 2044 (Rodriguez) - RESIDENTIAL CARE FACILITIES FOR THE ELDERLYRelates to residential care facilities for the elderly. Requires that at least one administrator, facility manager, or designated substitute who has adequate qualifications be on the premises of a facility 24 hours per day. Requires a facility to employ, and an administrator to schedule, a sufficient number of staff members. Requires certain training to include building and fire safety and the appropriate response to emergencies.

SB 1004 (Hernandez, E.) - HEALTH CARE: PALLIATIVE CARERequires the Department of Health Care Services (DHCS) to assist Medi-Cal managed care plans in delivering palliative care services, and requires DHCS to consult with stakeholders and directs DHCS to ensure the delivery of palliative care services in a manner that is cost-neutral to the General Fund, to the extent practicable. Authorizes implementation through all plan letters and similar instructions.

SB 1299 (Padilla) - WORKPLACE VIOLENCE PREVENTION PLANS: HOSPITALSRequires the Occupational Safety and Health Administration Standards Board, no later than July 1, 2016, to adopt standards that require specified hospitals to adopt a workplace violence prevention plan as part of their injury and illness prevention plan to protect health care workers and other facility personnel from aggressive and violent behavior. Requires the Division of Occupational Safety and Health to post a report on violent incidents at hospitals on its website. Exempts certain hospitals.

MEDI-CALSB 396 (De León) - PUBLIC SERVICESRepeals the unenforceable provisions of Proposition 187 relating to public social services, public health care services, public education and other activities of state and local agencies.

SB 1341 (Mitchell) - MEDI-CAL: STATEWIDE AUTOMATED WELFARE SYSTEMRequires the Statewide Automated Welfare System to be the system of record for Medi-Cal and to contain all Medi-Cal eligibility rules and case management functionality. Authorizes the Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) to house the business rules necessary for an eligibility

determination. Requires CalHEERS to make the business rules available to the System consortia to determine Medi-Cal eligibility. Requires notices for the Medi-Cal and premium tax credit programs.

SB 1457 (Evans) - MEDICAL CARE: ELECTRONIC TREATMENT

AUTHORIZATIONRequires requests for authorization for treatment or services in the Medi-Cal program, California Children’s Services (CCS) Program, and the Genetically Handicapped Persons Program (GHPP), excluding those submitted by dental providers enrolled in the Medi-Cal Dental Program, to be submitted in an electronic format determined by the Department of Health Care Services (DHCS) via DHCS’ website or other electronic means designated by DHCS. Requires DHCS to implement an alternate format for submission when DHCS’ website is unavailable due to a system disruption. Implements this requirement by July 1, 2015, or a subsequent date determined by DHCS. Authorizes all-county letters, plan letters, or provider bulletins.

MEDICAL EDUCATIONAB 496 (Gordon) - MEDICAL EVALUATION: SEXUAL ORIENTATION: GENDER IDENTITY Amends existing law that requires continuing medical education accrediting associations to develop standards for compliance with the cultural competency requirement. Authorizes such associations to update these compliance standards in conjunction with an advisory group with expertise in such issues. Expands a recommendation regarding such care to include appropriate treatment and care of the lesbian, gay, bisexual, transgender, and intersex communities.

AB 2214 (Fox) - EMERGENCY ROOM PHYSICIANS AND SURGEONS


6 SAN JOAQUIN PHYSICIAN WINTER 2014

Enacts the Dolores H. Fox Act to require the Medical Board of California to consider including a course in geriatric care for emergency room physicians and surgeons as part of its continuing education requirements.

MEDICAL PRACTICE AND ETHICSAB 1577 (Atkins) - CERTIFICATES OF DEATH: GENDER IDENTITYRequires a person completing a certificate of death to record the decedent’s sex to ref lect the decedent’s gender identity. Requires identity to be reported by the informant, unless the person completing the certificate is presented with a specified document, in which case the person would be required to record the decedent’s sex as that which corresponds with the gender identity as indicated in document. Provides the procedure in the absence of such document.

AB 2365 (Perez, J.) - CONTRACTS: UNLAWFUL CONTRACTSSeeks to make clear in California law that non-disparagement clauses in specified consumer contracts are void and unenforceable. Provides that a contract or proposed contract for the sale or lease of consumer goods or services may not include a provision waving the consumer’s right to make any statement regarding the seller or lessor or its employees or agents concerning the goods or services. Makes it unlawful to threaten or to seek to enforce a provision made unlawful under this bill, or to otherwise penalize a consumer for making any statement protected under the bill. Provides that a provision in violation of this bill is deemed unconscionable and against public policy. Relates to online reviews or comments.

PROFESSIONAL LICENSING AND DISCIPLINESB 1159 (Lara) - LICENSE APPLICANTS:

INDIVIDUAL TAX IDENTIFICATIONProhibits licensing boards under the Department of Consumer Affairs from denying licensure to an applicant based on his or her citizenship or immigration status, and requires a licensing board and the State Bar to require, by January 1, 2016, that an applicant for licensure provide his or her individual taxpayer identification number or a social security number for an initial or renewal license.

PUBLIC HEALTHAB 1559 (Pan) - NEWBORN SCREENING PROGRAM Requires the Department of Public Health to expand statewide screening of newborns to include screening for adrenoleukodystrophy as soon as the disease is adopted by the federal Recommended Uniform Screening Panel.

AB 1819 (Hall) - FAMILY DAY CARE HOME: SMOKING PROHIBITIONProhibits the smoking of tobacco in a private residence that is licensed as a family day care home without regard to whether the act occurs during the hours of operation of the home. Makes a conforming change.

AB 1898 (Brown) - PUBLIC HEALTH RECORDS: REPORTING: HIV/AIDS Adds hepatitis B, hepatitis C, and meningococcal infection to the list of diseases that local health officer reports to the Department of Public Health (for the purpose of the investigation, control, or surveillance of human immunodeficiency virus/acquired immune deficiency syndrome and co-infection).

AB 2069 (Maienschein) - IMMUNIZATIONS: INFLUENZARequires the Department of Public Health to post specified educational information regarding inf luenza disease and the availability of inf luenza vaccinations on the department’s

website. Authorizes the department to use additional available resources to educate the public regarding inf luenza, including, among other things, public service announcements.

AB 2217 (Melendez) – PUPIL AND PERSONNEL HEALTH: AEDSAuthorizes a public school to solicit and receive non-state funds to acquire and maintain an automated external defibrillator (AED). Provides that the employees of the school district are not liable for civil damages resulting from certain uses, attempted uses or non-uses of an AED. Exempts a public school or district, that is in compliance with AED requirements, from civil damage liability.

REPRODUCTIVE ISSUES SB 1135 (Jackson) - INMATES: STERILIZATIONProhibits sterilization for the purpose of birth control of an individual under the control of the Department of Corrections and Rehabilitation or a county correctional facility. Prohibits any means of sterilization of an inmate, except when required for the immediate preservation of life in an emergency medical situation and when medically necessary to treat a diagnosed condition and certain requirements are satisfied. Requires reports of procedures. Relates to notification regarding sterilization.

These are just a sampling of the new laws impacting health care in 2015 and beyond. For a complete list, see “Significant New California Laws of Interest to Physicians for 2015,” in the California Medical Association’s online resource library at www.cmanet.org/resource-library.


Nicholas Abidi, MDPeggy Albrecht, MDKim Albridge, MDChristen Allaman, MDTimothy Allari, MDKenneth Andrews, DOSaqib Ansari, MDCarlos Arcangeli, MDNicholas Astromoff, MDElise Atkins, MDNathan Atkinson, MDKenneth Averill, MDRebecca Barker, MDThomas Barker, MDJames Beckett, MDDavid Benjamin, MDWilliam Berg, MDJohn Bergren, MDGeoffrey Bernstein, MDJoydip Bhattacharya, DODale Bishop, MDCraig Blackwell, MDBruce Block, MDSusan Borba, MDEdward Bradbury, MDRyan Brandt, MDMelissa Braverman, MDElizabeth Brennan, MDMonique Browns, MDBrian Brunelli, MDAlan Buchwald, MDJacquelyn Busse, MDMark Byrne, MDAndrew Calciano, MDWilliam Cao, MDEric Carlblom, MDCesar Castillo, MDDennis Chamberlain, MDSatish Chandra, MDHoward Chen, MDRobert Chen, MDClement Cheng, MDNancy Chin, MDArunasree Chinnakotla, MDNazia Choudhury, MDJohn Christensen, MDKarl Christoffersen, MDMary Morrill Chuba, MDPatrick Clyne, MDJessica Cohen, MD

Michael Conroy, MDKathy Corby, MDMichael Coulson, MDAlbert Crevello, MDBrent Culver, MDMichael Dacey, MDAnders Dahlstrom, MDRami Dakkuri, MDIgbekele Daodu, MDJennifer Daodu, MDVanessa de la Cruz, MDGael Decleve, DOThomas Deetz, MDLawrence de Ghetaldi, MDAmr Dessouki, MDDenise Devereaux, MDJanna Doherty, MDWilliam Ebert, MDBruce Eisendorf, MDMichael Ellison, MDJames Engelman, MDDawn Faber, MDJoseph Fabry, DOHannah Farquharson, MDJoseph Franks, MDKatherine Gabriel-Cox, MDJeanne Gallagher, MDJoe Gallagher, MDJudith Garcia, MDSteven Garner, MDMichael Gansaeuer, MDLaura Garvin, MDRudolf Gausling, MDMelissa Gerlach, MDSharan Gill, MDJames Glancy, MDAlan Goldsobel, MDMaria Granthom, MDNancy Greenstreet, MDStephen Halpern, MDConrad Hamako, MDRichard Hamner, MDMargaret Hansen, MDMatthew Hansman, MDMonica Harish, MDWilliam Harmon, MDCiara Harraher, MDKaren Harrington, MDWilliam Hart, MDKathryn Harvey, MD

Kevin Hasenauer, MDHossein Hassani, MDCarol Haubach, MDCarlene Hawksley, MDW. Richard Hencke, MDRose Marie Hendrix, DODonaldo Hernandez, MDLisa Hernandez, MDDarien Heron, MDDouglas Hetzler, MDChristian Heywood, MDBernard Hilberman, MDBhuris Himanshu, MDPatricia Hinz, MDTerry Hollenbeck, MDRex Hsei, MDScott Imahara, MDAnne-Marie Jackson, MDSargon Jacob, DOJulie Jaffe, MDLaura James-Beckham, MDSharon Jamieson, MDFrank Jan, MDJennie Jet, MDJay Johnson, MDMichael Johnson, MDDean Kashino, MDEric Kashnow, MDJohn Kaufmann, MDVictoria Kaufmann, MDRobert Keet, MDSuzanne Kerley, MDAnna Kesler-Diaz, MDDaniel Kim, MDEunice Kim, MDSuejin Kim, MDDavid Kipps, MDJeffrey Kishiyama, MDStefan Klein, MDAlexandra Klikoff, MDWendi Knapp, MDPhillip Knorr, MDJane Koopman, MDPaul Krause, MDSurinder Kumar, MDAlexis Lane, MDThomas Larson, MDJill Lauren, MDDawn Lawson, MDGordon Lee, MD

Louis Lee, MDBrett Lenkin, MDLarry Levin, MDAndrew Lewis, DO Wennie Liao, MDLaura Likar, MDRodney Lowe, MDJason Luksich, MDKaren Lynch, MDBeata Mach, MDTracy Maclay, MDMaggie MacMillan, MDSteven Magee, MDMorgan Magid, MDZen Majuk, MDDaniel Marcus, MDRoy Martinez, MDTony Masri, MDMichelle Massie, MDDiane McGrew, MDKevin McHugh, MDAmy McMullen, MDWilliam Mears, MDPatrick Meehan, MDLester Miller, MDLinda Miller, MDRobert Moler, MDPatrick Monahan, MDHolly Moore, MDPeggy Moore, MDAaron Morse, MDDawn Motyka, MDMarsha Muir, MDMarin Muller, MDJohn Munro, MDRandall Nacamuli, MDVidya Nagaraju, MDJackson Nagle, DOSuzy Nassralla, MDTanya Nauenberg, MDElizabeth Newsom, MDDarryl Nounnan, MDJosh Novic, MDChristopher O’Grady, MDKimberly Owens, MDJoseph Palascak, MDMary Patz, MDJohn Pestaner, MDAlfred Petrocelli, MDDavid Pilcher, MD

SCCMS, CMA, and the 40,000 other members of California organized medicine thank each of you for your committment to advocacy for all physicians in the state. In this time of need for renewed advocacy, your membership matters! Thank you.

Rejoining MembersWelcome SCCMS/CMA Members


Himabindu Pitta, MDMarie Pletsch, MDRajeswari Ponnuswamy, MDNaghmeh Pooya, MDLawrence Poree, MDBenjamin Potkin, MDRobert Potts, MDDeepa Prakashpathy, MDRobert Quinn, MDWilliam Raffo, MDMichael Rankin, MDJanelle Rasi, MDLeroy Rasi, MDRandall Rea, MDJonathan Redwine, MDPeter Reynolds, MDFrancisco Rhein, MDShawna Riddle, MDSteven Roberts, MDJeannine Rodems, MDJuan Rodriguez, MDMaritina Rodriguez, MDDavid Rose, MD

Mark Rosen, MDLawrence Rosenbaum, MDVaal Rothman, MDMatthew Ryan, DOHoward Salvay, MDMartha Sandoval, MDAmeeshi Sawhney, DONeil Sawhney, MDSusan Schaefer, MDCasey Schirmer, MDMark Schmetz, MDJennifer Schreck, MDMarc Seftel, MDKarl Segnitz, MDPallavi Sharma, MDMolly Shields, MDPatrick Shields, MDWarren Scott, MDLinda Shaw, MDWells Shoemaker, MDMichael Shorenstein, MDRosalind Shorenstein, MD

Kathrin Sidell, MDMichelle Simon, MDRajinder Singh, MDSunita Singh, MDRebecca Small, MDDaniel Spilman, MDDavid Sofen, MDDavid South, MDJames Spiegel, MDWerner Stamm, MDNicole Sudduth, MDChristopher Summa, MDMichael Suval, DOSharon Tapper, MDJames Telfer, MDMarilyn Todd, MDArthur Vedder, MDMichele Violich, MDBrian Waddle, MDJohn Walther, MDBrian Ward, MDPaul Ware, MD

Suzanne Ware, MDTimothy Washowich, MDJack Watson, MDTamara Watson, MDThomas Welle, DOKenneth Westphal, MDBradley Whaley, MDMelinda White, DORichard Williams, MDJeffrey Williams, MDVickie Winkler, MDJames Wolfe, MDGlenn Wong, DOAndrew Wu, MDMichael Wu, MDAdam Yarme, MDTobias Yeh, MDMarc Yellin, MDMichael Yen, MDThomas Yen, MDDarlene Zanker, MDDean Zweng, MD

Danessa Brown, M.D.Urgent CareDignity Health Med Grp1820 41st Ave, Capitola684-7611

New MembersWelcome to organized medicine. We appreciate your committment.

Doan Le, M.D.PediatricsDignity Health Med Grp1820 41st Ave, Capitola476-3000

Nilda Moreno-Ruiz, M.D.OB/GYNDignity Health Med Grp1779 Dominican Way, SC462-2825

Shailinder Singh, M.D.PediatricsDignity Health Med Grp1820 41st Ave, Capitola 476-3000

Retired MembersThese members retired in late 2014 or early 2015. Congratulations and enjoy your well earned retirement!

David McNutt, MDSCCMS Representative to the Emergency Management CouncilMember 2000—2014

Edward Menges, MDPractice: Radiology Medical

Group of Santa CruzMember 1989—2014

Howard Nelson, MDPractice: Radiology Medical Group of Santa CruzMember 1981—2014

Stuart Mumm, MDPractice: Harbor Medical GroupMember 2001—2014

Martina Nicholson, MDPractice: Harbor Medical

GroupMember 1992—2014

J. Ronald Fisher, MDPractice: Radiology Medical

Group of Santa CruzMember 1993—2014


1Source: Workers Compensation Insurance Rating Bureau of California, http://www.wcirb.com/sites/default/files/documents/insurance-commissioners-decision-01012015_1.pdf

Time to go shopping...

...for a better deal on workers’ compensation.

There has never been a better time to shop the sponsored workers’ compensationplans offered through the Santa Cruz County Medical Society/CMA.

That’s because workers’ compensation insurance rates in California continueto move upward. The Insurance Commissioner recommended an increase of 6.7%in pure premium rates for 2015 compared to the average premiums chargedas of July 20141. Your plan may experience a higher or lower rate increase thanrecommended by the Department of Insurance.

Don’t just sit back and accept higher rates! Call Mercer to see if you can get a better deal through the Santa Cruz County Medical Society/CMA. Workingwith Mercer as the program administrator, the Society sponsors best-in-class insurance plans at competitive premiums.

By becoming involved with the sponsored plans you will receive valuable protection for your practice and employees while supporting the good work ofyour Society!

Take control of your workers’ compensation costs. Call 800-842-3761 now foryour free, no-obligation quote. Or visit www.CountyCMAMemberInsurance.comfor more information and to download an application or premium indication form.

Mercer Health & Benefits Insurance Services LLC • CA Ins. Lic. #0G39709Copyright 2015 Mercer LLC. All rights reserved. • 777 South Figueroa Street, Los Angeles, CA [email protected] • www.CountyCMAMemberInsurance.com800-842-3761 • 71697 (5/15)

Sponsored by:

Scan for more info!

MERCER Project 71697, SCCMS, (5/15)

Full Size: 8.5” x 11” Bleed: 8.75” x 11.25”Folds to: N/A Perf: N/AColors: 4c =(process)Stock: N/APostage: N/AMisc: N/A

71697 SCCMS April 2015 WC Ad:Ad 3/31/15 2:19 PM Page 1


20 14DELEGATESHOUSE OF

HOUSE OF DELEGATES

California Medical Association delegates set policy and elect officers at annual meeting

More than 500 California physicians convened in San Diego, December 5-7 for the 2014 House of Delegates (HOD), the annual meeting of the California Medical Association (CMA). Each year,

physicians from all 58 California counties, representing all modes of practice, meet to discuss issues related to health care policy, medicine and patient care and to elect CMA officers. >>


14 SAN JOAQUIN PHYSICIAN SPRING 2015

This year, nearly 100 resolutions and reports were introduced and debated in reference committees (both in person and online prior to the meeting). During the HOD weekend, the delegates met to debate and vote on reference committee recommendations. A total of 63 resolutions were adopted.

This year also saw an expanded “virtual” reference committee process that will enable a shorter, two-day meeting in future years. Reference Committees A (Science and Public Health), B (Government Health Programs and Health System Reform) and F (Health Professions and Facilities) conducted all testimony online in advance of the meeting. All CMA members were invited to participate in the online debate, and nearly 500 online comments were recorded. The reference committee members then met via conference call in advance of the meeting to develop their recommendations, which were presented to the House for f loor debate.

The House also elected a new president, Humboldt surgeon Luther F. Cobb, M.D., while Riverside physician Steven E. Larson, M.D., was tapped as president-elect.

The full 2014-2015 CMA Executive Committee includes:• President Luther F. Cobb, M.D., Eureka• President-Elect Steven E. Larson, M.D., Riverside• Speaker of the House of Delegates Theodore M. Mazer, M.D., San Diego• Vice-Speaker of the House of Delegates Lee T. Snook, M.D., Sacramento• Chair of the Board of Trustees David Aizuss, M.D., Los Angeles • Vice-Chair of the Board of Trustees Robert E. Wailes, M.D., Encinitas• Immediate Past President Richard E. Thorp, M.D., Paradise

Reports and ResolutionsThe following are summaries of some of the resolutions that were adopted as policy. (The full actions of the HOD are available to members at www.cmanet.org/hod, under the “documents” tab.)

TobaccoCMA has been a tireless advocate for stronger restrictions on the tobacco industry for decades. The House continued that tradition, adopting five antismoking resolutions.

Resolution 104-14 asks CMA to support the removal of the tobacco control pre-emption from the California Penal Code so that local governments would have the ability to increase the legal age of tobacco sales to 21.

Resolutions 101-14, 102-14 and 103-14 address the sales, advertising regulation and taxation of electronic cigarettes. These resolutions seek legislation to ban the usage of electronic cigarette devices in public places, to ban advertising of electronic cigarettes and to urge state government to tax these items to generate funds to support research into their efficacy as smoking cessation aids, the health impacts of electronic cigarettes and for education.

This year, nearly 100 resolutions and reports were introduced


SPRING 2015 SAN JOAQUIN PHYSICIAN 15

Resolution 105-15 asks CMA to support the concept of a tobacco-free military, including ending sales on military bases and establishing smoke-free military installations, and to refer this for national action.

These resolutions come at a time when CMA is dedicating itself to smoking cessation in the state in an effort to save lives and taxpayer money. In December, CMA announced it had joined an unprecedented coalition of health care groups seeking to increase the tobacco tax by $2-per-pack by the end of 2016 to save lives and to defray the cost of diseases caused by smoking.

Called the Save Lives California coalition, other members include the American Heart Association, American Lung Association, American Cancer Society Cancer Action Network, SEIU California, Health Access California and the California Hospital Association. The group will seek an increase in tobacco taxes either through legislation or ballot measure.

It is hoped that a tax increase will lower the cost of providing care to smokers in the state. A recent study on California’s tobacco use by the University of California at San Francisco School of Nursing’s Institute for Health and Aging found that smoking costs $18.1 billion in California – $487 for each resident, or $4,603 per smoker – in direct health care costs and indirect costs from lost productivity due to illness and premature death.

By increasing tobacco taxes the group hopes to save more than 100,000 lives per year, prevent more than 150,000 young people from ever smoking and save billions in health care dollars spent on tobacco-related diseases.

End of Life IssuesResolution 402-14 urges that all public and private health insurers be required to reimburse for counseling for end-of-life planning as an integral part of good medical care. This resolution was referred for national action.

Resolution 501-14 supports the goal of developing a Physician Orders for Life-Sustaining Treatment (POLST) online registry in California that would be secure, easy to fill out online, have real time updates, be HIPAA compliant, contain a review of forms for proper completion and allow accessibility from any electronic health record system.

Resolution 502-14 supports allowing trained nurse practitioners/advance practice nurses and physician assistants to be authorized to complete and sign POLST orders to improve the use of this type of end-of-life authorizations and also allow for a review by the patient’s supervising physicians, when appropriate.

Other IssuesParent to parent education of child vaccination: In an effort to



stem the tide of personal belief vaccine exemptions and prevent more vaccine-preventable disease outbreaks, CMA passed Resolution 115-14 supporting the development and evaluation of educational efforts, based on science and in collaboration with health care providers, for parents who want to help educate and encourage other parents reluctant to vaccinate their children. This resolution was referred for national action.

Physician reimbursement: The CMA delegates passed Resolution 408-14, which asks that CMA continue to advocate for non-contracted physicians’ ability to bill and collect usual, customary and reasonable charges. The resolution also asks CMA to support legislation or regulation requiring that payors reimburse out-of-network providers an interim payment amount at an amount no less than the provider’s charges or a fair payment standard based on an unbiased database of charges, according to specialty and geography. Once made, the interim payment may be disputed via an appropriate dispute resolution mechanism, such as binding arbitration.Electronic Health Records: Resolution 513-14 asks CMA to support efforts to harmonize standards and specifications that would enable interoperability of electronic health record systems and facilitate the exchange of health information among health care providers.

Awards and ElectionsNew CMA president sets sights on tort reform, burdensome regulations and membership growth

The new CMA president Luther Cobb, M.D., during his inaugural speech at the association’s annual meeting, said that CMA must use the political capital it has “banked” by recently defeating the trial lawyers’ Proposition 46 to further reshape the future of medical liability.

“Now that the trial attorneys have so amply demonstrated the wrong way to do it, CMA can chart a course for meaningful and durable reform,

that is fair to those truly injured by medical mishaps, while protecting the overwhelming majority of doctors who try their best every single day to do the right thing,” said Dr. Cobb, a board-certified, self-employed physician practicing in general, thoracic and vascular surgery in Humboldt County. “If we can cut out the gross waste on the overhead of the adversarial tort system, all will benefit.”

Dr. Cobb also spoke on the necessity of regulatory reform, saying there were many unnecessary, burdensome regulations that need to be struck from the books. One example he cited was the need for a minimum level of humidity in operating rooms to prevent the risk of sparks from ether anesthesia, which is highly f lammable. “We no longer use f lammable anesthetics and haven’t for a half century, yet this regulation persists. This makes ORs uncomfortable for surgeons, can interfere with the vision of those wearing protective eyewear and make the patients sweat, increasing the risk of infection,” he said.

Looking out at the diverse members of the CMA HOD, Dr. Cobb said recent growth in CMA membership, which now exceeds 40,000, has been unprecedented in its history. “For many years, we on the board and the executive committee watched as membership numbers slowly declined. The conventional wisdom was that this was inevitable, that physicians just weren’t joiners,” he said. “But, with diligent organization and effort at the grassroots level, our membership has been steadily growing. We set what many thought was a ludicrous goal of 5 percent annual growth and we have achieved that.”

“And yet, all of us know many physicians who, for whatever reason, have declined to join,” he said. “If it were only for the Proposition 46 victory, they will have saved in a single year’s worth of malpractice premiums enough to pay for a lifetime of membership,” he said. “But our nonmember friends have to be reminded of how powerful and successful our CMA is, and this is a one-on-one collegial conversation. All of us as individuals and as groups can do better to recruit new membership or re-recruit those who have lapsed. We must pledge ourselves to that effort.”


SPRING 2015 SAN JOAQUIN PHYSICIAN 17

In addition to his involvement in organized medicine, Dr. Cobb serves as chief of staff of the Mad River Community Hospital in Arcata, where he has been an active member of the medical staff since 1997. He previously served as the hospital’s chief of staff from 2000 to 2002 and vice-chief of staff from 2009 to 2011. Dr. Cobb is also on the medical staff of St. Joseph Hospital in Eureka.

Previously, Dr. Cobb served as attending surgeon, director of trauma services and director of the vascular surgery clinic at Santa Clara Valley Medical Center in San Jose, as well as clinical associate professor of surgery at Stanford University School of Medicine and the chairman of the surgery department at Mad River Community Hospital.

CMA HOD chooses president-elect, speaker and vice speaker At CMA’s annual meeting, Riverside physician Steven E. Larson, M.D., was named CMA president-elect. He will serve as president-elect for one year, and will take office as president during the October 2015 annual meeting.

Dr. Larson has served as chair of the CMA Board of Trustees since 2011. He is the current CEO and chairman of the board of Riverside Medical Clinic, a multi-specialty medical group. He has been affiliated with the clinic since 1980.He is an assistant clinical professor of medicine at Loma Linda University School of Medicine and a clinical professor of biomedical sciences at University of California at Riverside. His medical staff appointments include Riverside Community Hospital, Parkview Community Hospital and Riverside County Regional Medical Center.

Dr. Larson earned his medical degree from the Medical College of Wisconsin in Milwaukee, graduating in 1975. He completed his residency in internal medicine in 1978 and a fellowship in infectious diseases in 1980, both at the Medical College of Wisconsin Affiliated Hospital in Milwaukee. He earned a master’s degree in public health from Loma Linda University in 1988. He is board certified in both internal medicine and infectious diseases.

Also reelected to the 2014-2015 CMA Executive Committee were Speaker of the House Theodore M. Mazer, M.D., a San Diego otolaryngologist, and Vice Speaker Lee T. Snook Jr., M.D., a Sacramento pain management specialist.

Dr. Mazer is a board-certified otolaryngologist running a small, solo practice. He served on the association’s Board of Trustees from 2002-2010 and has chaired various committees, including those focusing on medical services and access to specialty care. Dr. Mazer served as vice speaker of the CMA House of Delegates for two years before being elected to the post of speaker in 2013.

Dr. Snook is a medical director, president and founder of the Metropolitan Pain Management Consultants, Inc., in Sacramento. He is board certified in anesthesiology, internal medicine, addiction medicine and pain medicine. Dr. Snook is also a certified medical review officer and a qualified medical evaluator. He is also chair of the CMA Worker’s Compensation Technical Advisory Committee and spent nine years as a member of CMA’s Board of Trustees representing the Solo and Small Group Practice Forum.

CMA elects new chair and vice chair of its board of trusteesThe CMA Board of Trustees elected David H. Aizuss, M.D., as its new chair and Robert E. Wailes, M.D., as vice chair.

Dr. Aizuss is a board certified ophthalmologist practicing in Los Angeles. Through the David H. Aizuss, M.D., Medical Corporation, and the Ophthalmology Associates of the Valley Medical Surgical Group, a partnership of medical corporations, Dr. Aizuss focuses exclusively on direct patient care.

He also serves as an assistant clinical professor of ophthalmology at the UCLA Geffen School of Medicine. Dr. Aizuss is a medical staff member at Tarzana Hospital and West Hills Hospital in Los Angeles County, and belongs to several professional societies, including the American Academy of Ophthalmology, the

American Society of Cataract and Refractive Surgery, the Cornea Society and the American Medical Association.

Dr. Aizuss has served as vice chair of the board since 2011. He is also a former president of the Los Angeles County Medical Association and the California Academy of Eye Physicians and Surgeons.

Dr. Wailes, a pain specialist and board certified anesthesiologist, is the founder, co-owner and medical director of Pacific Pain Medicine Group in Oceanside and Encinitas.

He has served as president of the San Diego County Medical Society and represents the American Academy of Pain Medicine at the American Medical Association.

Two other new members of the Board of Trustees were also elected: Jerry Abraham, M.D., Resident and Fellow Section, and Mark Ard, Medical Student Section.

For a complete list of the Board of Trustees, visit www.cmanet.org/bot.

Firebaugh internist wins CMA’s annual “country doctor” awardMore than 30 years ago, Oscar M. Sablan, M.D., an internist, and his wife Marcia Sablan, M.D., a family physician, decided to work in a rural area for three years to get their medical loans forgiven as part of the National Health Service Corp, a federal program to supply debt relief to newly graduated physicians who agree to work in underserved areas.

The couple moved from tropical Hawaii, where Dr. Sablan was serving his integrated medicine residency at the Queen’s Medical Center, Honolulu, to the dusty rural town of Firebaugh, 100 miles east of Fresno. The plan was for the couple to do their three-year service in rural Fresno County and then walk away with their debts forgiven. They started their practice on the corner of O and 9th streets and have been there ever since.



Service and ValueMIEC takes pride in both. For over 35 years, MIEC has been steadfast in our protection of California physicians. With conscientious Underwriting, excellent Claims management and hands-on Loss Prevention services, we’ve partnered with policyholders to keep premiums low.

Added value: n Zero-profit carrier with low overhead n Dividends with an average savings on 2011 premiums of 40.4%*

For more information or to apply: n www.miec.com n Call 800.227.4527 n Email questions to [email protected]

* (On premiums at $1/3 million limits. Future dividends cannot be guaranteed.)

“ As your MIEC Claims Representative, I will serve

your professional liability needs with both

steadfast advocacy and compassionate support.”

Senior Claims Representative Michael Anderson

“ As your MIEC Claims Representative, I will serve

your professional liability needs with both

steadfast advocacy and compassionate support.”

MIEC Belongs to Our Policyholders!

Lamont D. Paxton, MDVice Chairman, Board of Governors

Keeping true to our mission MIEC has never lost sight of its original mission, always putting policyholders (doctors like you) first. For 40 years, MIEC has been steadfast in our protection of California physicians with conscientious Underwriting, excellent Claims management and hands-on Loss Prevention services; we’ve partnered with policyholders to keep premiums low.

Added value: n No profit motive and low overhead n Dividends for an average savings of 25% on 2015 premiums for

California physicians*

For more information or to apply: n www.miec.com n Call 800.227.4527 n Email questions to [email protected]

* On premiums at $1/3 million limits. Future dividends cannot be guaranteed.

MIEC 6250 Claremont Avenue, Oakland, California 94618 • 800-227-4527 • www.miec.com

SJMS_01.09.15 MIEC

Owned by the policyholders we protect.

SJMS_01.09.15.indd 1 2/2/15 9:44 AM

During the 2014 CMA House of Delegates, Dr. Sablan received the Frederick K.M. Plessner Memorial Award, an award given each year to honor the California physician who best exemplifies the ethics and practice of a rural country practitioner.

Dr. Sablan and his wife are the only full-time doctors in the tiny town of 7,800 and they are still treating many of the same families as when they arrived three decades ago. The whole town, from wealthy ranchers to migrant farm workers, relies on the couple. The Sablans have guided Firebaugh families through pneumonias, accidents, injuries, cancers and bypass surgeries to better health.

As the Sablans built up their medical practice, they realized that they could only do so much in the exam room. So they turned to politics. Dr. Sablan has served on the local school board for close to 20 years and his wife has served as Firebaugh’s mayor for 10 years and has sat on the city council for over 30 years.

In addition to practicing medicine and community service in public positions, in 1981 the couple started the community’s annual free Christmas day dinner, which feeds 650 plus people every year. Dr. Sablan has also served as the Firebaugh-Las Deltas Unified School District team physician for all sports for 33 years.

It is common knowledge that rural regions of California have long faced shortages of doctors. While small towns near Firebaugh struggle to hang onto doctors, Dr. Sablan’s long-standing commitment to the community makes him an exception.Learn more about Dr. Sablan by watching the award video, available on CMA’s YouTube channel, www.youtube.com/cmaphysicians.

CMA’s 2014 Nye Award given to Santa Monica psychiatristSanta Monica psychiatrist Maria T. Lymberis, M.D., was named the 2014 recipient of CMA’s Gary S. Nye, M.D., Award in recognition of her 30 years of leadership in the area of physician well-being.This award, given annually during the

association’s House of Delegates meeting, was established in 2009 in recognition of Dr. Nye, who has been a leader in bringing attention to and developing solutions to the issue of physician impairment and rehabilitation.Dr. Lymberis’ career has been defined by a commitment to the development and defense of ethical medical standards. For the past three decades, she has also worked on issues involving physician health, rehabilitation of physicians and malpractice prevention.Dr. Lymberis has been in full-time solo private practice specializing in psychotherapy in Santa Monica since 1970. Certified by the American Board of Psychiatry and Neurology in both psychiatry and child/adolescent psychiatry, Dr. Lymberis is a clinical professor of psychiatry at the Geffen UCLA School of Medicine and a graduate psychoanalyst of the Los Angeles Psychoanalytic Institute, where she taught for over 20 years as a senior faculty member. She is also a senior expert consultant for the Medical Board of California. Among her many accomplishments, Dr. Lymberis is the founder and president of two nonprofit organizations: Hellenic American Psychiatric Association and The Psychiatric Education and Research Foundation.

Other NewsAnnual gala raises more than $50,000 for public health programsThe CMA President’s Reception and Awards Gala hosted members of the CMA House of Delegates and guests for an evening of dinner, dancing and a live auction. The event raised more than $50,000 to support the public health projects of the CMA Foundation.Held at the elegant U.S. Grant Hotel in San Diego immediately following CMA’s annual House of Delegates session on Saturday evening, the event was sold out with over 450 people in attendance, including more than 35 medical students and residents. Also in attendance was the largest ever contingent of past CMA presidents (20) attending the event.

Among the big ticket items auctioned off were a trip to New York City, golfing in Scotland and a San Juan Island getaway.

A special thank you goes out to the 2014 gala sponsors: NORCAL Mutual, Union Bank, The Doctors Company, Pfizer, Cooperative of American Physicians, Mercer, The Permanente Medical Group, Southern California Permanente Medical Group and United Healthcare.

Join the CMA Foundation’s anti-sugary beverage campaign!The CMA Foundation kicked off a social media campaign at the CMA House of Delegates to engage physicians in educating their patients about sugary drinks and how they increase the prospect of developing diabetes. The CMA Foundation and the Network of Ethnic Physician Organizations are both sponsoring the campaign with funding from the California Endowment.

As part of the campaign, physicians can request a poster for their offices that shows a large can of soda with the lettering “Type 2 Diabetes” and “Did you know that one junk drink a day can increase your risk of Type 2 diabetes by 25 percent.” Physicians are encouraged to place the posters in their waiting rooms where patients can see it to help open a dialog on the topic of sugary drinks and their effect on health.

Physicians are also asked to take pictures of themselves engaged in conversations with their patients and post them to social media, like Twitter or Facebook, with the hashtags #beatthesweet and/or #sugarlesspour. These hashtags will allow the foundation to find your post. The CMA Foundation will repost photos with these hashtags to its Facebook page.

To get your free poster contact Lisa Kirkland at [email protected] or (916) 779-6643.

Thank youto our members, and all physicians, in Santa Cruz county for taking excellent

care of our community.

National Doctors’ Day is a time to celebrate the contribution of physicians who serve our country by caring for their communities. The first Doctors’ Day observance was March 30, 1933. President George W. Bush designated it on October 30, 1990.


20 • COASTAL MEDICINE • March/April 2015 © 2015 NORCAL Mutual Insurance Company

Our beats in

Our heart beats in California … and has for almost 4 decades.

Since 1975 NORCAL Mutual has served healthcare professionals throughout the Golden State.

Strength, stability and innovative products are just a few reasons why physicians continue to

look to us for their medical professional liability insurance. We provide you:

Industry-leading claims and risk solutions support 24/7

Full access to our interactive risk management library

Flexible coverage options tailored to your needs

California is important to us. So is your peace of mind. See how homegrown strength can help

protect your practice.

Proud to be endorsed by the Santa Cruz County Medical Society

Visit heart.norcalmutual.com or call your agent/broker today. 844.4NORCAL (844.466.7225)


The new California POLST went into effect on October 1, 2014, and healthcare

professionals must take note of key changes to the form.

POLST (Physician Orders for Life-Sustaining Treatment) is a physician order signed by both a doctor and patient that specifies the types of medical treatment a patient wishes to receive toward the end of life. POLST is a tool that en-courages conversation between providers and patients about their end-of-life treatment options, and helps patients make more informed deci-sions and communicate their wishes clearly. As a result, POLST can prevent unwanted or medically ineffective treatment, reduce patient and family suffering, and help ensure that patient wishes are followed.

Most changes to POLST in 2014 are in Sections B and C, where the order of treatment choices are reversed for consistency, now starting with most aggressive treatment to least aggressive treatment. The POLST Documentation Committee and Task Force also developed goal statements for these sections in order to clarify and help patients bet-ter understand treatment options. Get a copy of the 2014 POLST as a PDF here: http://capolst.org/wp-content/uploads/2014/08/Final-2014-ENG-CA-POLST-Form.pdf

All information relevant to the new POLST can be found at http://caPOLST.org/2014polst. There you will find downloadable versions of the new form in English, Armenian, Chinese, Farsi, Hmong, Japanese, Korean, Pashto, Russian, Span-ish, Tagalog and Vietnamese. POLST in braille can be ordered.

A list of upcoming POLST education opportuni-ties can found at http://coalitionccc.org/training-events/polst-education.

Previous versions of POLST will still be honored after the 2014 form goes into effect. However, it is ideal to complete a 2014 version of POLST—and void older versions of the form—when a patient’s POLST is updated.

Healthcare professionals with questions about POLST are encouraged to connect with their local POLST Coalition, or contact the Coalition for Compassionate Care of California at [email protected].

Judy Thomas, JD, is executive director of the Coalition for Compassionate Care of California (CCCC), an attorney who has worked in healthcare for more than 20 years, and is Chair of the National POLST Paradigm Task Force.

Mark J Apfel, MD, is medical director of Anderson Valley Health Center in Boonville, CA, and serves on the California POLST Physician Leadership Council.

POLST in 2014: What healthcare professionals need to know

By Judy Thomas, JD and Mark J Apfel, MD


We appreciate the support of our publication advertisers!

MercerNORCAL Mutual

KEY DATESCALENDAR

Practice Managers NetworkA monthly meeting for practice man-agement staff to network, exchange ideas and share resources.• Meets the 3rd Wednesday each month, 8:00—9:00am at the SCCMS Office.

Legislative Leadership DayCMA members have the unique op-portunity to join hundreds physicians, medical students and CMA Alliance members who come to Sacramento every spring for Legislative Leader-ship Day to lobby their elected repre-sentatives as champions for medicine and their patients.• April 14, 2015 (Sacramento)

SCCMS/CruzMed Foundation GalaJoin us for an evening of celebration in honoring the 2014 Excellence in Health Care Award winner, Dr. Marti-na Nicholson. It is also an importnat evening for the CruzMed Foundation which award scholarships to pre-med students and hold its first fundraiser. Several of our members are vitners or have family members who are vitners and we will be showcasing their wines at our wine and food pairing stations.• Thurs, June 4, 2015, Hollins House

Western Health Care LeadershipAcademyThe Leadership Academy is the West Coast’s premier opportunity for phy-sicians, practice managers and other health care leaders to learn about leading-edge trends and develop-ments in the rapidly changing health care marketplace, to access informa-tion and tools to help ensure the viability of medical practice, and to acquire the leadership skills needed to successfully manage change. For more information, visit www.calead-ershipacademy.com• May 28—31, 2015 (Hollywood)

House of Delegates (HOD)The delegates meet once a year to establish CMA policies on key issues that affect the practice of medicine, from medical ethics to critical mat-ters of public health. Each year the HOD debates and takes action on more than 100 resolutions, each of them authored by members like you. For more details, visit www.cmanet.org/about/cma-governance/house-of-delegates.• 2015 HOD – October 16-18, 2015 (Anaheim)

Office SpaceNear Dominican Hospital, this second floor space is above Wells Fargo Bank, next door to the Medi-cal Society. There is a sink and space for a refrigerator. Open floor plan with 1 enclosed office. 1200 sq ft. No elevator. Rent based on terms of occupancy.

Contact Donna Odryna [email protected]

For Rent

Advertising

Starting in 2015 Coastal Medicine magazine will publish 6 issues per year. New pricing and ad publica-tion choices are available. Payment in full is required at time of order. For full details email [email protected] or call 831-479-7226 to have a Media Kit sent to you.

Executive Director’s Message

Donna Odryna is the Exeuctive Director of the Santa Cruz County Medical Society and its affili-ated organizations, CruzMed Founda-tion and Santa Cruz County Medical Reserve Corps.

We are thrilled to announce that Dr. Martina Nicholson is the recipient of the 2014 Excellence In Health Care Award. She will be honored at the Medical Society’s up-coming Cork & Cuisine Gala and Awards Celebration on Thursday, June 4, 2015.

In addition to being a member of the Santa Cruz County Medical Society (SCCMS) for more than 23 years, Dr. Nicholson has been a prominent leader in our community working for the betterment of the medical profession and quality patient care. She has represented our Society as a Delegate at several CMA House of Delegates meetings, served as the SC-CMS Board of Governors President in 2002-2003, and has continued to serve as a leader within the Society advocating for the well being of physicians in our county. Among several other associations, she has also served as a member of the American Medical Association, American College of Obstetricians and Gynecologists and the American Medical Writers Association.

Initially established to honor and recognize Dr. Richard M. Shapiro, the Excellence In Health Care Award is given annually to a physician member who exemplifies the highest standards of the medical profession. Demonstrating excellence of clinical knowledge, com-passion in rendering care, commitment to community service and continuous leadership achievement in the improvement of the health care delivery system are qualities of all Excel-lence In Health Care recipients.

Dr. Nicholson is the 10th physician member to be honored and joins past recipients Richard M. Shapiro, MD, Fred B. Tomlinson, MD, Joseph T. Anzalone, MD, John R. Gillette, MD, Thomas Deetz, MD, David L. Kipps, MD, S. Allan Dorosin, MD, Michael Alexander, MD, and John Anane-Sefah, MD.

On behalf of the Santa Cruz County Medical Society Board of Governors and its members, I extend our congratulations and appreciation for all the that Dr. Martina Nicholson has accomplished and contributed to the health and well being of her colleagues, patients, and the community.

Invitations are forthcoming, so please save the date and join us!

Join us to honor Dr. Martina NicholsonRecipient of the 2014

Excellence in Health Care Award

ThursdayJune 4, 2015

HollinsHouse


May 29 - 31, 2015 • Hollywood, CA

VIP UPGRADE AVAILABLE

Exclusive opportunities to meet and interact with

Malcolm Gladwell and Siddhartha Mukherjee, M.D!


1975 Soquel Dr #215Santa Cruz CA 95065-1821

coastal medicine march/april 2015

Documents