the message january 2011

T HET HE

messageT HE

A M O N T H L Y N E W S M A G A Z I N E O F S C M S – J A N U A R Y 2 0 1 1

SPOKANE COUNTY

MEDICAL SOCIETY

By Brad Pope, MDSCMS President

Is there an ACO in YOUR FUTURE?

The Beacon Community of theInland Northwest and Care Coordination

PRIORITIES & FOCUS

FOR 2011

January SCMS Message Open2

A d va n c e d O r t h o p e d i c C a r e . R i g h t H e r e .

12606 East Mission Spokane Valley

Getting you back to an active lifestyle is the reason The Joint Restoration Center at Valley Hospital

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Knee and hip joint replacements, as well as spinal and neck implants

Cartilage restoration

Fracture and tissue repair

Orthopedic surgeon available 24/7 to treat emergencies

Make Valley Hospital and Medical Center your choice for orthopedic care.

Visit www.spokanevalleyhospital.com/physicians to find an orthopedic specialist.

For orthopedic care that makes you feel this good, we’ve got you covered.

January SCMS Message Open3

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

President’s Message: Priorities and Focus for 2011 . . . . . . . . . . . . . . . . . . . . . . . . 1

Medical Education in Spokane – Update. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

The Beacon Community of the Inland Northwest and Care Coordination . . . . . . . . . . . . 5

Group Health and Providence collaborate to develop better care system . . . . . . . . . . . . 6

Focus on Hospitals and Physicians – Is there an ACO in YOUR FUTURE? . . . . . . . . . . . . . 8

New Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

FYI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Membership Recognition for January 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Scms Continuing Medical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Meetings And Conferences. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Classified Ads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Positions Available . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

“YOU ARE THE SAME TODAY THAT YOU ARE GOING TO BE IN FIVE YEARS FROM NOW EXCEPT FOR TWO THINGS:

THE PEOPLE WITH WHOM YOU ASSOCIATE AND THE BOOKS YOU READ.”

CHARLES JONES

Spokane County Medical Society Message

Brad Pope, MD, EditorA monthly newsletter published by

the Spokane County Medical Society. The annual subscription rate is $21.74

(this includes the 8.7% tax rate).

Advertising Correspondence Quisenberry Marketing & Design Attn: Jeff Akiyama 518 S. Maple Spokane, WA 99204 509-325-0701 Fax 509-325-3889 [email protected]

All rights reserved. This publication, or any part thereof, may not be

reproduced without the express written permission of the Spokane County Medical Society. Authors’

opinions do not necessarily reflect the official policies of SCMS nor the Editor

or publisher. The Editor reserves the right to edit all contributions for clarity and length, as well as

the right not to publish submitted articles and advertisements,

for any reason. Acceptance of advertising for this publication in

no way constitutes Society approval or endorsement of products or

services advertised herein.

2011 Board of TrusteesBrad Pope, MDPresidentTerri Oskin, MDPresident-ElectAnne Oakley, MD Vice PresidentDavid Bare, MDSecretary-TreasurerGary Knox, MDImmediate Past President

Trustees:Keith Kadel, MDMichael Cunningham, MDPaul Lin, MDRandi Hart, MDGary Newkirk, MDCarla Smith, MDRob Benedetti, MDAudrey Routt, MD

Terry Oskin, MDEditor

January SCMS Message 1

President’s Message:

Priorities and

Focus for 2011

Brad Pope, MD

SCMS President

Happy New Year to all of you. It is an honor to be writing from

the President’s page. As we continue to practice medicine during

this time filled with ambiguity, my goal is to have the Spokane

County Medical Society work to keep us focused and in front of

the issues that affect physicians and our patients.

For those of you who haven’t met me, I am a medical director

for Group Health Cooperative’s Eastern Washington/North Idaho

District. I’ve lived and raised two sons in the Spokane Valley since

1983. I’m a family physician, and in

addition to my administrative role,

I still practice as an urgent-care

provider every week.

Last month, Gary Knox reminded

us of our mission:

"The Spokane County Medical

Society exists to promote and

provide leadership in the art and

science of medicine. Furthermore,

the Society strives to improve and

preserve the health of the citizens in

our community."

Leadership in medicine. Improving

and protecting our citizens’ health.

This is our compass and we certainly

need it.

Key issues for 2011

Every December we determine

SCMS’s priorities for the year, based on your feedback. About 50

of you responded to our annual survey with very candid input. To

request the full report, please contact Michelle Caird at 509-325-

5010 x25.

We asked you what the priorities should be for SCMS in 2011.

Five issues rose to the top:

1. Increasing access to primary care

2. Expanding medical school in Spokane to a four-year program

3. Improving hospital relations

4. Strengthening legislative relationships and Promoting

professionalism (tie).

Access to primary care and medical education expansion

As one physician wrote, our priorities should include

“promoting primary care and recruiting more primary care

providers (PCPs) to Spokane. Our PCP population is aging and

more than half are approaching retirement age within the next

5-10 years. We need to promote that primary care is vital and

should be reimbursed as such.” Many echoed these thoughts.

Another key issue is the expansion of our medical school. I’m

confident it will happen—the question is when. Expansion of

graduate and postgraduate medical education is a key long-

term tactics to improve access to care in this area. Currently,

along with business and elected leaders, SCMS advocates for

a four-year, local medical school. Washington State University

and the University of Washington (UW) are behind it too. We’ve

made progress: students already come here for their first, third

and fourth years, and we are working to raise the money for the

medical school building. The issues now are securing the ongoing

budget to pay the faculty and ensuring we provide enough

rotational slots for these students in medical practices and

developing more residency capacity.

You can help. I encourage you to think about how you can

personally support the medical school, for example, by offering

preceptorships or by serving as faculty. Our area leaders welcome

your participation. To learn more about how to support the medical

school, please call Deb Harper, MD, UW School of Medicine

Assistant Dean for Regional Affairs and WWAMI Clinical Coordinator

for Eastern and Central Washington at 509-358-7796 or djharper@

uw.edu or John McCarthy, MD, UW School of Medicine Assistant

Dean for Regional Affairs and WWAMI Clinical Coordinator for

Eastern and Central Washington at 509-358-7795 or [email protected].

SCMS is also committed to working with all of you to continue

Project Access. It is very clear that whatever happens, there

will always be a segment of our community of patients that will

benefit from this important program that exists because of your

commitment to volunteer your services to patients who are

eligible. Project Access is a great example of how our community

of physicians and other service providers step up as professionals

to improve health.

Improving hospital relations

Hospital relations are another issue of concern. There is real

and valid tension in our community as hospitals consolidate with

new partners. As one physician writes, “I would like to see the

County Medical Society responding to the power plays between

the hospital systems, which have clearly stopped acting for the

benefit of our patients or physicians in the community.”

Many of you suggested that SCMS should be a mediator

and facilitate cooperation between hospitals that have enjoyed

decades of healthy competition—collegially. Many of you

expressed concern that division within the community can harm

patients and our professionalism. As a society of professionals we

must collegially communicate and work together for our patients,

regardless of how our respective organizations interact.

I welcome your ideas on how SCMS can help relieve the

tension and division. Please contact me at [email protected]. One

excellent suggestion is that we focus on the common ground of

issues that are important to all of us such as community health,

moving data between providers, and care coordination.

We will do this, as there is indeed much common ground.

For example, we all agree that physicians must work together to

address the spiraling costs of health care and increase access.

One issue that has very significant impact on spiraling costs

Continued on page 3

I encourage you to

think about how you

can personally support

the medical school, for

example, by offering

preceptorships or by

serving as faculty.


Medical Education in

Spokane – Update

Deb Harper, MD

UW School of Medicine Assistant Dean for Regional Affairs and

WWAMI Clinical Coordinator for Eastern and Central WA

The Spokane County Medical Society is working with the UW,

WSU, Greater Spokane Incorporated (GSI) and others to plan for

expanding our medical education here.

The plans include trying to have all four years of medical

education in Spokane (we currently have years 1, 3 and 4) and

expanding our residencies.

GSI has hired Tripp-Umbach, a firm that specializes in

communities working to expand medical education to help with

the planning. Our own Representative John Driscoll was able to

get our area $250,000 to help the UW work with our community

to expand residencies. That effort is being chaired by John

McCarthy, MD and is being facilitated by the Huron Group. Both

of these efforts are being coordinated for maximum efficiency

and efficacy.

The impetus for this effort has come from several sources

that have simultaneously sprung into existence and now are

collaborating. The SCMS has long been a leader in expanded

medical education. A few years ago our business community

realized that they needed to make sure we would have enough

physicians here in the future and they figured out that allopathic

medical schools have research facilities that are good for our

economy. Community leaders realized that we have too few

medical student spots for our population and our children have

one-third the chance to get into their state medical school than

children in most other states!

These are exciting and difficult times for medical education

in Spokane. Difficult times, because of the state’s current dire

economic picture, but exciting times to see so many smart and

hardworking people from so many parts of our community

working together for this common goal. If you’re interested

in more information or want to become involved in medical

education, please email me. We won’t be able to use all of our

physicians this year, but soon we will need many more physician

teachers and mentors.

SCMS is interested in assisting our members to participate more actively in key community leadership roles. If you become aware of an open board, a or

advisory committee position please notify Michelle Caird at (509) 325-5010 or my

email at [email protected].

In Memoriam

Margaret "Peggy" O'Meara Brink, M.D.

Margaret Brink passed away on December 7, 2010 after

almost 94 years of adventure and service to others. She

was born January 19, 1917 in Edmonton, Alberta to George

and Florence O'Meara. After graduating from the L.C.I.

High School, she attended the University of Alberta. Upon

completing her M.D. in 1943, she enlisted in the Canadian

Army, making history as the first female physician ever to

join the Canadian Forces. She served as a Major in the

medical corps during W.W. II. Peggy returned to Lethbridge

to set up private practice and became their first public

health officer. On May 9, 1951 she married orthopedic

surgeon, Dr. Francis Brink, fellow Lethbridge native and U.

of Alberta graduate, who had immigrated to Spokane in the

1940's. Rather than establish her own practice, she focused

on raising her family while attaining her Washington State

Medical License, filling in locum tenens to physicians in

Spokane and northeastern Washington. Her career also

included being on staff at Eastern State Hospital, Interlake

School and Deaconess Hospital Emergency Room. She was

active in the medical community serving as President of the

Auxiliary, lecturing at the Sacred Heart Nursing School and

mentoring Deaconess Hospital's physician Residents and

their families. After retiring from medical practice in 1984,

she continued to maintain her license until well into her

80's. She volunteered at the Shriner's Hospital. Peggy and

Francis were passionate about world travel and adventure

visiting all continents besides Antarctica. Her favorite spot

was her cabin at Priest Lake.

She is preceded in death by her parents; her husband of 55

years, Francis; daughter, Madeline; brother, Ted; and beloved

sister, Isobel. She is survived by daughters Johanna Flynn

(Jim) of Olympia, WA; and Nancy O'Leary (Martin) of Spokane,

WA.; grandsons Ian O'Leary (Nichelle) of Seattle, WA; Seamus

Flynn of Dublin, Ireland; and Connor Flynn of Portland, OR;

granddaughter, Erin O'Leary Hanser (Seth) of Redmond, WA;

great-granddaughters, Margaret and Helen Hanser, and many

beloved nieces, nephews, and their families.


Continued from Page 1

and access is in the way physicians manage chronic pain and

chronic narcotic use. Recently SCMS hosted a community forum

featuring the perspectives of law enforcement, community

health activists, care providers and the judicial system. These

stakeholders assert that Spokane has a serious problem, and the

medical community must play a leading role to address it. This

year SCMS will work to provide direction on how to best manage

chronic pain patients with chronic nonmalignant pain and their

opiate use. Each of us has a role in addressing this pervasive

problem that is currently consuming valuable limited resources

of time and money. The SCMS will work toward clarifying a

community approach to this serious issue. Each of us has an

obligation to learn what the community approach will be and

understand and fulfill our individual role in that approach.

Legislative relations

You also indicated you want SCMS to continue lobbying with

lawmakers about medical liability reform and fair reimbursements

for Medicaid and Medicare. You want to be informed about the

real impact of federal reform and are concerned about how it

could impact on your ability to provide quality patient care. You

write, “Keep us informed of the political candidates and their

positions on medical issues that affect our community.”

These are universal concerns that we all share. This year SCMS

will continue to send delegates to Olympia and Washington, DC

to address our issues. I also encourage you to get involved by

attending meetings of professional societies or elected officials,

attending the Legislative Summit in Olympia, or by writing to your

congressional representatives. To learn more about how to get

involved, feel free to contact me.

Professionalism

The patient relationship, that inspired so many of us to become

doctors, continues to be squeezed between malpractice concerns

as well as regulatory, insurer, and employer demands. Patients are

frustrated and confused by their billing or are shocked at the real

costs of their care.

This is where our mission should again speak to us:

leadership in medicine. We cannot simply sit back and lament

how times are always changing for the worse. Nor can we just

show up for work every day and do what everyone else expects

us to do as our professionalism erodes. If we do, then we’re at

risk of becoming just another skilled laborer tightly managed and

regulated by other entities.

I’ve personally chosen to take on physician leadership roles

because it gives me the opportunity to influence the type of care

that tens and even hundreds of thousands of people get. There

are serious problems with our health care delivery and financing

system. Physicians need to continue to be leaders in solving these

problems and increase our leadership roles if we want to do the

best for our patients and preserve the professionalism of the

healer role in our society.

I encourage you to think about how you currently lead and how

you might increase your leadership role. Hopefully I’ve suggested

some tangible ways you can act immediately in our community.

The topics that you have collectively raised as SCMS’s priorities

will be our work for the coming year. We need your continuing

input and leadership to be effective. Working together as

professionals with the interest of our patients at heart I know we

can make progress in addressing these important issues.


Spokane County Medical Society

2010 PHYSICIAN/CITIZEN OF THE YEAR NOMINATION FORM

DEADLINE FOR NOMINATIONS IS FEBRUARY 15, 2011 !

Any member of the Spokane County Medica l Society is el igible for nominat ion.

Nominee:

Office Address:

EXAMPLES FOR EACH OF THE FIVE SECTIONS MUST BE INCLUDED: (Attach pages as needed.)

Contributed to public understanding and appreciation of the role of medicine and to an improved public image

of our profession and its members.

Demonstrated high standards of competence, ethics, and professionalism.

Showed outstanding ability in medicine.

Worked for the advancement of the medical profession.

Contributed to the betterment of our community and nation.

NOMINATED BY: DATE:

Please submit to:

SCMS

Physician of the Year Nomination, Orange Flag Building

104 S. Freya St., Ste. 114, Spokane, WA 99202-4868

Or fax to: (509) 325-5409


The Beacon Community

of the Inland Northwest

and Care Coordination

Jac Davies, MS, MPH

Director, Beacon Community of the Inland Northwest

The Beacon Community of the Inland Northwest (BCIN) is

working to support the achievement of meaningful use of health

IT across 14 counties in eastern Washington and northern Idaho

with a focus on prevention and improved management of adult

type 2 diabetes.

Over the 36-month project timeline the BCIN intends to

accomplish the following goals:

Increasing meaningful use of health information technology for

all medical conditions

Promoting cost efficiency by reducing use and costs of

emergent and inpatient care for diabetes-related complications

Improving quality of care by increasing compliance with

diabetes preventive health services

Improving core preventive measures for individuals with

diabetes

The key mechanism for meeting these goals is the

implementation of a common approach to and common

tools for care coordination across the region. The National

Coalition on Care Coordination defines care coordination

as, “… a client-centered, assessment based interdisciplinary

approach to integrating health care and social support services

in which an individual’s needs and preferences are assessed, a

comprehensive care plan is developed, and services are managed

and monitored by an identified care coordinator following

evidence-based standards of care.” Care coordination can

enhance the delivery of health care by providing physicians with

the necessary tools and support to more effectively manage their

patients’ health conditions.

We can all agree that our healthcare system has many areas in

need of improvement. Agreement on where we begin is often a

harder step to take. One might begin with a review of the Institute

of Medicine’s Six Aims for Improvement, based on the widely

referenced Crossing the Quality Chasm report, and how they

relate to care coordination.

Patient safety. Coordination of care can improve overall patient

safety by managing and compiling information from various

caregivers such as prescriptions and lab exams and routing

them back to the primary care provider.

Health care must be effective and based on best practices

and medical evidence. Care coordination among providers has

become a best practice based on proven strategies that are

currently being utilized by many health care organizations.

Health care must be patient-centered and include the

patient in the care process. Patient-centered care also

means understanding the patient’s culture, literacy needs,

socioeconomic background and environmental needs

throughout the continuum of care. Through the care

coordination process, patients are armed with community

resources that can assist with other non-medical needs that

impact health.

Health care must be timely. The essence of care coordination is

timely patient care. Using care coordination as a mechanism for

care delivery will arm the provider with resources for a timely

and accurate plan of care.

The healthcare system must be efficient. Coordinating care

to manage patients’ health conditions will improve patient

outcomes, decrease costs and improve quality.

For more information on the Beacon Community of the Inland

Northwest, please visit www.inhs.org or call (509) 232-8148.

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Group Health

and Providence

collaborate to

develop better

care system

Tom Schaaf, MD

Group Health Assistant Medical Director

It was a timely coincidence that SCMS decided the January

Message would focus on hospital-

based systems of care, because last

month Group Health and Providence

Health Care announced we will

collaborate to develop an innovative

health care system in the Spokane

region.

Together our two organizations

plan to develop ways to manage

the full continuum of care for

patients—everything from health

education and prevention, visits

with physicians, hospitalization,

rehabilitation therapy and home

health services, to end-of-life care.

In a nutshell, this means sharing

clinical information, developing joint

clinical programs and best practices,

and exploring new payment models

focused on providing value, not solely producing volume.

Here’s one example of how it can work in practice. Today, a

patient goes to the primary care physician (PCP) because of a

persistent headache (presuming the patient even has a primary

care physician). In most practices, the PCP has, at the most, 10-15

minutes to see the patient. In 15 minutes, the PCP needs to get

up to speed on the recent chart notes and discuss the presenting

condition (headache) with the patient, leaving no time to do

acomplete neurologic work-up on the patient.

What often happens is the PCP refers the patient along to a

neurologist, or, if the patient can’t get in to see the neurologist

for several weeks, medication or an MRI may be ordered that may

not be necessary. The neurologist may or may not get the chart

notes from the visit to the PCP or the patient’s medical history.

And, the PCP and neurologist may never talk to each other about

the patient condition or the best course of treatment.

The patient must relay the information back to the PCP and be

seen again by the PCP for follow-up. In this fragmented process,

the patient gets treated, but unnecessary tests and medication

may be ordered. The exam done by the neurologist may not have

been necessary.

Imagine every patient has a PCP who has sufficient time to do

a thorough history and exam. There’s time to review diagnostic

and therapeutic options and do shared decision making with the

patient. If neurology input is needed, both the PCP and specialist

have the time, methods and inclination to approach diagnosis

and treatment as a team. Patient charts are sent electronically to

the neurologist, who has the time to review the chart and send

back a message about further follow-ups (therapy, work-up,

diagnostic, and whether consult is needed). Both the PCP and

the consulting specialist are paid to provide care in that fashion.

PCPs are paid for the time spent with the patient to coordinate

care and consulting specialists are paid for providing consult to

other providers.

Providence and Group Health share a long history of improving

patient care together. Thirteen years ago, Providence Hospital

helped us pioneer our first full-scale hospitalist program in

Spokane. Today Providence hopes to leverage Group Health’s

success with the medical home.

I am excited to begin a broader conversation with others who

are interested in helping to build this model of care in Spokane.

Tom Schaaf, MD, is the assistant medical director for Group

Health Cooperative’s Eastern Washington/North Idaho District.

Board-certified in Family Medicine, Dr. Schaaf has practiced at

Group Health in Spokane since 1992 and founded its hospitalist

program in 1997. He practiced as a hospitalist until 2004 before

becoming medical director.

In a nutshell, this

means sharing clinical

information, developing

joint clinical programs

and best practices, and

exploring new payment

models focused on

providing value, not

solely producing

volume.

SCMS is interested in assisting our members to participate more actively in key community leadership roles.

If you become aware of an open board, a or advisory committee position please notify Michelle Caird

at (509) 325-5010 or my email at [email protected].


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Focus on Hospitals and

Physicians – Is there an

ACO in YOUR FUTURE?

The two sources below look at the key issues that hospitals

and physicians are being asked to consider if they are evaluating

Accountable Care Organization (ACO) development or

participation. Which set of issues makes sense for you and

your practice may depend on whether you are affiliated with a

system or are freestanding. If you have a perspective, the SCMS

leadership would be interested in knowing it. Please contact us at

SCMS ([email protected]) regarding your comments.

Positioning hospitals to become successful ACOs

The Washington State Hospital Association submitted a

comment letter in response to the Centers for Medicare and

Medicaid Services' request for information about Accountable

Care Organizations (ACOs)

and the Medicare Shared

Savings Program. Based on

the most serious concerns

of member hospitals, health

systems and clinics, WSHA's

comments addressed two key

issues for Washington State:

the calculation of "shared

savings" and the need to

consider variation in spending

of providers and the required

flexibility for rural health care.

The Accountable Care

Organization (ACO) program

becomes effective in 2012.

It is important that hospitals

interested in developing or joining an ACO position themselves

under this model by assessing their ability to coordinate care to

achieve savings.

Key issues recently raised by Becker’s Hospital Review

(available at www.spcms.org at Our Bookmarks) include:

Assessing relationships with physicians

Evaluating and possibly expanding primary care provider

services.

Determining which additional providers to incorporate into an

ACO.

Exploring partnerships with other physician groups, hospitals

and health systems.

Preparing for the possibility of reduced admissions.

The AMA makes recommendations to CMS for physician-led,

patient-centered ACOs.

The AMA submitted its most detailed comments (available at

www.spcms.org on our Facebook page) to date to the Centers

for Medicare & Medicaid Services (CMS) on how Medicare should

structure physician-led and patient-centered accountable care

organizations (ACOs). The recommendations were submitted

on December 2, in response to a specific request from CMS for

comments on how to ensure that solo and small group practices

have the opportunity to actively participate in Medicare's ACO

program.

The AMA's recommendations to CMS on structuring physician-

led ACOs include:

Developing new payment models for physicians that move

Medicare away from today's dysfunctional physician payment

system—the threat of Medicare physician payment cuts will

impede physicians' efforts to improve care coordination, such

as employing case managers and investing in infrastructure to

monitor and improve quality.

A range of specific new payment methods that CMS

should consider in addition to shared savings, including an

accountable medical home payment system and bundled

payments for specific medical conditions, such as congestive

heart failure.

Increased access to loans and grants for small physician

practices.

Easing of antitrust restrictions that prevent physicians from

collaborating.

Timely access to quality data.

The AMA also urges CMS to allow patients to voluntarily select

a Medicare ACO and to undertake a proactive effort to educate

and encourage beneficiaries to take steps that will help make

ACOs successful. For example, patients should be able to:

Choose and consistently use a primary care physician as a

medical home.

Select specialty physicians, hospitals and other providers that

coordinate effectively with their primary care medical home

and each other.

Engage in shared decision-making processes with their

physicians about appropriate treatments for their conditions.

Participate in other types of programs developed by their

physicians to maintain and improve their health at an affordable

cost.

This education effort should be developed in cooperation with

physicians and launched well in advance of the ACO program's

initiation.

The AMA also makes recommendations on the types of quality

measures ACOs should use. At least in the initial years of the

program, CMS should avoid making ACOs collect and report

quality measures beyond those already required under other CMS

programs, such as the Physician Quality Reporting System (PQRS),

formerly known as the Physician Quality Reporting Initiative.

Although additional quality measures may ultimately be

warranted, it is impractical to develop a single national set of

such measures prior to implementation of the Medicare Shared

Savings Program, because the areas where ACOs will focus their

cost reductions will likely vary significantly from region to region.

Furthermore, measures that may be appropriate for one ACO

model may not be appropriate for another. ACOs should be

allowed to report on a hybrid of nationally and locally focused

quality measures related to their particular patient population.

Comments? Send them to [email protected].

The Accountable Care

Organization (ACO) program

becomes effective in 2012.

It is important that hospitals

interested in developing

or joining an ACO position

themselves under this model

by assessing their ability to

coordinate care to achieve

savings.


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

PHYSICIANS

Borden, Rodney B., MDAnesthesiology

Med School: U of Texas Medical Branch (1994)Internship/Residency: John Sealy Hospital (1998)Practicing with Anesthesiology Associates, PS beginning 1/2011

Dajnowicz, Anthony M., MDPediatrics/Neonata-Perinatal Medicine

Med School: Wayne State U (1985)Internship: St Francis Medical Center (1986)Residency: Loma Linda U (1990)Fellowship: Loma Linda U (1993)Practicing with Pediatrix Medical Group beginning 2/2011

Freter, Mark A., MDFamily Medicine

Med School: U of Missouri (1991)Internship/Residency: U of Missouri (1994)Practicing with Northwest Pacific Emergency Physicians beginning 1/2011

Quisano, Melissa A., MDFamily Medicine

Med School: Loma Linda U (2006)Internship/Residency: Family Medicine Spokane (2009)Practicing with Columbia Medial Associates since 3/2010

Ruiz, Veronica G., MDFamily Medicine

Med School: U of Texas Medical Branch (2000)Internship/Residency: Via Christi Hospital (2003)Practicing with Rockwood Quail Run Clinic in the near future

PHYSICIANS PRESENTED A SECOND TIME

Fernandes, Neville O., MDAnesthesiology

Med School: U of Texas Medical BranchPracticing with Anesthesiology Associates, PS beginning 1/2011

Hercl, Grace, DOInternal Medicine

Med School: Ohio U College of Osteo Medicine (1999)Practicing with Sound Physicians since 12/2010

Klarnet, Jay P., MDMedical Oncology

Med School: SUNY (1980)Practicing with Rockwood Clinic since 11/2010

PHYSICIAN ASSISTANT

Weidner, Philip L, PA-CPhysician Assistant

Med School: U of Washington, Medex Northwest (2010)Practicing with Rockwood Clinic beginning 1/2011

PHYSICIAN ASSISTANTS PRESENTED A SECOND

TIME

Holmstrom, Timothy E., PA-CPhysician Assistant

Med School: U of Washington, Medex Northwest (2010)Practicing with Rockwood Clinic in the near future

McLeod, Pamela S., PA-CPhysician Assistant

Med School: Cornell Medical School (1980)Practicing with Inland Neurosurgery and Spine Associates since 10/2010

Wilson, Sarah L., PA-CPhysician Assistant

Med School: U of Washington, Medex Northwest (2010)Practicing with Inland Cardiology Associates since 12/2010


FYI

Survey Results Published

Our congratulations to Drs. Doug Weeks, Cynthia Corbett

and Glen Stream for their recent article published in the October

2010 issue of the Journal for Healthcare Quality titled “Beliefs of

Ambulatory Care Physicians about Accuracy of Patient Medication

Records and Technology-Enhanced Solutions to Improve

Accuracy”

In 2008 Inland Northwest Health Services (INHS) received

funds from the Washington State Health Care Authority

to explore possible solutions for inaccurate or unavailable

medication information often seen in the ambulatory care

setting. One of the Medication Reconciliation project’s first

steps was to survey physicians and mid-level practitioners (who

have prescribing authority) about the scope of the problem.

It was recommended that the Informatics Committee serve as

a venue for a one-hour pre-planning focus group that could

provide valuable input on the issues and impacts that would help

to define the survey process. The SCMS membership was then

surveyed in early 2009 based on those recommendations. The full

text article is available at www.spcms.org

Seven Healthcare Organizations Launch Data-Sharing

Collaborative

Andis Robeznieks

Seven health organizations will work together in an effort

coordinated by the Dartmouth Institute for Health Policy and

Clinical Practice to share data on outcomes, quality and costs

associated with common conditions and treatments with the

goal of determining best practices. The six health systems

participating with Dartmouth Institute are the Cleveland Clinic,

Dartmouth-Hitchcock, Denver Health, Geisinger Health System,

Intermountain Healthcare and the Mayo Clinic. They have a

combined patient population of 10 million people.

The organizations will share data on knee replacement,

diabetes, heart failure, asthma, weight-loss surgery, labor and

delivery, spine surgery and depression. Noting that costs range

from $16,000 to $24,000 per surgery, according to a Dartmouth

news release, knee replacements will be the first item on the

agenda, with data-sharing initiatives for diabetes and heart failure

to begin early next year.

Unveiling of Implementation Plan for Health Insurance

Exchanges

The Washington State Health Care Authority (HCA) recently

convened a Health Insurance Exchange Stakeholder Meeting to

discuss issues surrounding the possible creation of a state-based

health insurance exchange. The meeting also made public a draft

of the Governor's request for legislation to create a health benefit

exchange development board. The board would be tasked with

creating a business plan, making recommendations about key

elements, and establishing a timeline for the implementation of

a state health benefits exchange. Legislation is expected to be

introduced during the upcoming state legislative session.

Health Reform Law Provides New Center to Test Payment

and Delivery Models

CMS formally launched the Center for Medicare and Medicaid

Innovation this week. Created by the Affordable Care Act, the

innovation center will test new delivery and payment models

aimed at improving care and reducing costs. The well-funded

innovation center could provide opportunities in addition to or

outside of Accountable Care Organizations.

Obama Signs Red Flags Bill

Dom Nicastro

President Obama signed the bill that changes the Red Flags

Rule's definition of "creditor" and relieves some physicians of

having to comply with the Federal Trade Commission's identity

theft prevention law.

Earlier in the month, the House and Senate passed the bill

officially titled "Red Flag Program Clarification Act of 2010."

The enforcement date for the Red Flags Rule is Dec. 31, 2010.

The FTC said earlier this year on its website that it delayed

enforcement at the request of Congress as it "considers

legislation that would affect the scope of entities covered by the

rule." Compliance date was November 1, 2008.

Red Flags calls for "creditors" to establish a program to protect

patients from medical identity theft.

The bill calls for changes to the FTC's definition of "creditor."

Smaller entities such as physician practices and doctor's

offices have long debated they should be let off the hook from

complying. Some have filed lawsuits. Jeff Drummond, health law

partner in the Dallas office of Jackson Walker LLP, says the law

doesn't actually "remove physicians from the Red Flags Rule." It

clarifies in a reasonable way, he says, what a "creditor" is.

"I think the FTC went way overboard with their definition of

'creditor' including anyone who takes payment after providing

the service," Drummond says. "Taken to its logical extreme,

McDonald's and Burger King are not creditors, but Chili's is. So,

it's a good change to rein in an overbroad regulatory agency."

Some physicians will still be creditors; plastic surgeons and

lasik surgeons, for example, if they take payments over time from

their patients.

Drummond adds it's not that hard to establish an identity theft

prevention program, as the Red Flags Rule require; doctors have

to have HIPAA programs in place anyway.

"It's just good practice, and good customer service, to have an

ID theft prevention program in place," Drummond says. "So, even

if you don't have to, you ought to."

Dom Nicastro is a senior managing editor at HCPro, Inc. in

Marblehead, MA. He edits the Briefings on HIPAA and Health

Information Compliance Insider newsletters. E-mail him at

[email protected].


MEMBERSHIP RECOGNITION

FOR JANUARY 2011

Thank you to the members listed below. Their contribution of

time and talent has helped to make the Spokane County Medical

Society the strong organization it is today.

50 Years

Charles R. Wolfe, MD 1/12/1961

40 Years

John M. Collins, MD 1/26/1971

Terrance P. Judge, MD 1/26/1971

L J. Wiwatowski, MD 1/26/1971

30 Years

Douglas G. Norquist, MD 1/27/1981

R. Steven Brisbois, MD 1/28/1981

Robert H. Gersh, MD 1/28/1981

William R. Osebold, MD 1/28/1981

10 Years

Jamie L. Kooy, MD 1/1/2001

Kawal D. Chester, MD 1/2/2001

e medical profession and healthcare community should foster physician well-being

A sense of community with one’s peers is vital to personal well-being

Changes in the healthcare environment and contributing to personal and professional challenges and new stressors for physicians

Physicians should have resources available to them to anticipate and manage episodic personal issues

Physician Health is Important.Eastern Washington Physician Health Committee

We are available to assistyou in the following areas:

Steve BrisboisMichael Metcalf Paul Russell Phil Delich Michael Moore

Robert Sexton Jim Frazier

Mira Narkiewicz Patrick Shannon Deb Harper

Sam Palpant Alexandra Wardzala Mike Henneberry Tad Patterson Hershel Zellman

COMMITTEE MEMBERSJim Shaw, MD,


SCMS CONTINUING

MEDICAL EDUCATION

2011 Program Schedule

In 2011, SCMS will hold 5 Category I CME Programs.

(Schedule subject to change)

FEBRUARY

Neurology Update 2011

Wednesday, February 9

Sacred Heart Medical Center

(Mother Joseph Room)

5:30 – 9:15 pm

(Three one-hour topics will be presented)

APRIL

Update in Pain Management

Evening Seminar for the

Primary Care Update Conference

Thursday, April 28

Red Lion Inn at The Park

5:30 – 9:15 pm

(Two one and one-half hour topics will be presented)

JUNE

Endocrinology Update 2011

Wednesday, June 8

Deaconess Health and Education Center

5:30 – 9:15 pm


OCTOBER

Moderate (Conscious) Sedation and Analgesia

Wednesday, October 5


5:30 – 9:15 pm

(SCMS’ annual program to satisfy JCAHO requirements

and provide a refresher course to members of the medical

community in order to increase patient safety.)

NOVEMBER

Topic TBD

Tuesday, November 8


5:30 – 9:15 pm


Meetings and Conferences

CONTINUING MEDICAL EDUCATION

Neurology Update 2011: This three-hour seminar is sponsored

by the Spokane County Medical Society. Conference held on

February 9, 2011 at the Sacred Heart Medical Center in the

Mother Joseph room (near the cafeteria). Contact Jennifer

Anderson at (509) 325-5010 or email [email protected] for more

information.

Update in Internal Medicine 2011: This seminar is sponsored

by the Spokane Society of Internal Medicine. Conference will be

held on February 25-26, 2011 at the Spokane Convention Center.

Contact Merry Maccini at (509) 468-0236 or email spokanesim@

gmail.com for more information.

How Physicians Can Make the Most of the New World Order

- WSMA/WSMGMA Joint Conference Thursday, February 3, 2011

SeaTac Hilton Conference Center. This program addresses a host

of factors which now define the physician practice context—

clinically and financially. Contact Jenelle Dalit at (206) 441-9762 or

(800) 552-0612 or email [email protected].

OTHER MEETINGS AND CONFERENCES

Institutional Review Board (IRB) – Meets the second Thursday of

every month at noon at the Heart Institute, classroom B. Should

you have any questions regarding this process, please contact the

IRB office at (509) 358-7631.

Caduceus Recovery Group Meeting for Healthcare

Professionals – Meets every Thursday evening, 6:15 p.m. – 7:15

p.m., at 626 N. Mullan Rd, Spokane. Contact (509) 928-4102

for more information. Non-smoking meeting for Healthcare

Providers in recovery.

Physician Family Fitness Meeting – Physician Family Fitness

is a recently created meeting for physicians, physician spouses,

and their adult family members to share their common problems

and solutions experienced in the course of a physician’s practice

and family life. The meetings are on Tuesdays from 6:30 p.m. – 8

p.m. at the Sacred Heart Providence Center for Faith and Healing

Building, due east of the traffic circle near the main entrance of

SHMC. Enter, turn right, go down the stairs, Room 14 is on your

right. Format: 12-Step principles, confidential and anonymous

personal sharing; No dues or fees. Guided by Drs. Bob and Carol

Sexton. The contact phone number is (509) 624-7320.


CLASSIFIED ADS

REAL ESTATE

Luxury Condos for Rent/Purchase near Hospitals. 2 Bedroom

Luxury Condos at the City View Terrace Condominiums are

available for rent or purchase. These beautiful condos are

literally within walking distance to the Spokane Hospitals (1/4

mile from Sacred Heart, 1 mile from Deaconess). Security gate,

covered carports, very secure and quiet. Newly Remodeled. Full

appliances, including full-sized washer and dryer. Wired for cable

and phone. For Rent $ 850/month. For Sale: Seller Financing

Available. Rent-to-Own Option Available: $400 of your monthly

rent will credit towards your purchase price. Please Contact Dr.

Taff (888) 930-3686 or [email protected].

FOR SALE with Lease Option. MUST SEE!!! Beautiful custom-

built Lake home with attached “daughter house.” Main home has

two bedrooms, two baths and complete office. Rock Garden,

private driveway with security gate, two car garage, AC, wood

floors, central VAC, fireplace, washer & dryer. “Daughter” house

includes 2 bedrooms, 1 bath, office and separate carport. Lease

option - $1,200 for main house; $800 for in-law suite or $2,000 for

both. Country living but close to Cheney and Spokane. Contact

Jerry Krause, [email protected] or [email protected].

edu or cell #, 509-280-8179.

All Costs Included--Upscale View Condo One of a kind, separate

entrance condo built into an upscale home on the north side.

(Owners rarely in residence) This home is located in a quiet,

upscale-gated community, with panoramic views overlooking

a small lake and golf course. It is totally turnkey furnished,

dishes, linens, cleaning supplies etc. All new appliances, modern

decor. One bedroom (king size bed/rollway for guests) one

bath, complete laundry room w/full size wash/dryer and one car

garage with extra storage. ALL COSTS ARE INCLUDED! Heat/AC,

Utilities/Water, Cable TV, Internet/Wi-Fi, Long Distance phone.

Golf and walking trails right out the door. Close to Holy Family

Hospital and Whitworth College. Please call 954-8339 for details.

Also willing to rent "unfurnished.”

MEDICAL OFFICES/BUILDINGS

Good location and spacious suite available next to Valley

Hospital on Vercler. 2,429 sq ft in building and less than 10 years

old. Includes parking and maintenance of building. Please call

Carolyn at Spokane Cardiology (509) 455-8820.

Northpointe Medical Center Located on the North side

of Spokane, the Northpointe Medical Center offers modern,

accessible space in the heart of a complete medical community. If

you are interested in locating your business here, please contact

Tim Craig at (509) 688-6708. Basic info: $23 sq/ft annually. Full

service lease. Starting lease length 5 years that includes an $8 sq/

ft tenant improvement allowance. Available space: *Suite 210 -

2286 sq/ft *Suite 209 - 1650 sq/ft *Suite 205 - 1560 sq/ft *Suite

302 - 2190 sq/ft

For Lease 3700 sq ft of second floor space in a new 18,900

sq ft building. It is located just a few blocks from the Valley

Hospital at 1424 N. McDonald (just South of Mission). First floor

tenant is Spokane Valley Ear Nose Throat & Facial Plastics. $24

NNN. Please call Geoff Julian for details (509) 939-1486 or email

[email protected].

Sublease: Furnished Medical Office Space ~ Need immediate

space for one or more north Spokane care providers? This

shared suite is ready for occupancy; all furniture and exam room

equipment included. Two exam rooms, one provider office, one

nurse’s station and shared surgery suite, medical records storage

area, reception and waiting area. 963 sq ft total, original lease

$23/sq ft; will negotiate lower rate. Excellent location in a full-

service medical building with lab and full radiology services. For

more information, call (509) 981-9298.

South Hill – on 29th Avenue near Southeast Boulevard - Two

offices now available in a beautifully landscaped setting. Building

designed by nationally recognized architects. Both offices

are corner suites with windows down six feet from the ceiling.

Generous parking. Ten minutes from Sacred Heart or Deaconess

Hospitals. Phone (509) 535-1455 or (509) 768-5860.

Indian Trail Professional Building has medical space available for

lease. A 11,243 sf professional medical / office building located

in the growing Indian Trail Community directly across from the

new Sundance Shopping Center. Address is 5011 W. Lowell Ave

or the SWC of Indian Trail and Lowell Avenue, Spokane, WA. The

main floor space located off of the main floor entrance consists

of 4,389 sf of Class “A” General Medical Practice or Urgent Care

Center space. A Tenant Improvement Allowance is Available,

subject to terms of lease. Floorplans and marketing materials can

be emailed upon request. Please contact Patrick O’Rourke, CCIM

with O’Rourke Realty, Inc. at (509) 624-6522 or cell (509) 999-

2720. Email: [email protected].

North Spokane Professional Building has several medical

office suites for lease. This 60,000 sf professional medical office

building is located at N. 5901 Lidgerwood directly north of Holy

Family Hospital at the NWC of Lidgerwood and Central Avenue.

The building has various spaces available for lease from 635 to

6,306 usable square feet available. The building has undergone

extensive remodeling, including two new elevators, lighted pylon

sign, refurbished lobbies, corridors, and stairways. Other tenants

in the building include, pediatricians, dermatology, dentistry,

pathology and pharmacy. Floor plans and marketing materials

can be emailed upon request. A Tenant Improvement Allowance

is Available, subject to terms of lease. Please contact Patrick

O’Rourke, CCIM, with O’Rourke Realty, Inc. at (509) 624-6522 or

cell (509) 999-2720. Email: [email protected].


POSITIONS AVAILABLE

EASTERN STATE HOSPITAL PSYCHIATRIST – ESH is recruiting

for a psychiatrist. Joint Commission accredited, CMS certified,

state psychiatric hospital. 287 beds. Salary $161,472 annually with

competitive benefits and opportunity for paid on-call duty. Join a

stable Medical Staff of 30+ psychiatrists, physicians and physician

assistants. Contact Shirley Maike, 509.565.4352, email maikeshi@

dshs.wa.gov. PO Box 800, Medical Lake, WA 99022-0800.

EASTERN STATE HOSPITAL PHYSICIAN – ESH, the 287 bed

state psychiatric hospital in eastern WA, is recruiting for a family

practice or internal medicine physician to provide medical care

on the Adult Psychiatric Unit with a caseload of 30 patients.

The physician would be part of the treatment team, which is

comprised of the attending psychiatrist, social worker, RN,

and recreation therapist. The physician will treat common

medical conditions and refer for consultation to providers in

the community for care that cannot be provided at ESH. Will

supervise two certified physician assistants who provide care

on other patient care units. Salary: $149,952 annually with

competitive benefits. Twenty minutes southwest of Spokane,

WA. Join a stable Medical Staff of 30 psychiatrists, physicians

and Physician Assistants. Contact Shirley Maike, 509.565.4352,

email [email protected]. Eastern State Hospital, PO Box

800, Medical Lake, WA 99022-0800.

EMERGENCY ROOM PHYSICIAN POSITION OPENING –

NorthEast Washington Medical Group is currently recruiting for

a full-time ER physician to join us in beautiful Colville, a rural

northeast Washington community located 75 miles north of

Spokane. NorthEast Washington Medical Group consists of 27

providers that serve a surrounding area of approximately 30,000

in the very rural tri-county area. We offer flexible hours for an ER

physician or FP physician with Emergency Room experience. Our

ER physicians enjoy working in the new emergency department

at Mount Carmel Hospital, a 25-bed, full service critical access

facility with 24/7 ER and ancillary service coverage. This is an

outstanding practice community located in the middle of a

wonderful recreation area with limitless opportunities for outdoor

activities. Qualified individuals should contact Ed Johnson, MD,

ER Medical Director, via phone at 509-685-7831 or e-mail at

[email protected] or Ron Rehn, DHA, Chief Executive

Officer, via phone at 509-684-7723 or e-mail at rrehn@newmg.

org. Mailing address is NorthEast Washington Medical Group,

1200 E Columbia, Colville, WA 99114. Visit our website at www.

newmg.org for more information.

INTERNAL MEDICINE POSITION OPENING – NorthEast

Washington Medical Group is currently recruiting for a full-time

(Monday through Thursday) Internal Medicine physician to join

us in beautiful Colville, a rural northeast Washington community

located 75 miles north of Spokane. NorthEast Washington

Medical Group serves a surrounding area of approximately

30,000 in the very rural tri-county area. This is an outpatient

based Internal Medicine position with call. There is supporting

physician call in Family Practice, OB, surgery, and orthopedics.

Our clinic physicians have privileges at Providence Mount Carmel

Hospital, a 25-bed, full service critical access facility with 24/7 ER

and ancillary service coverage. This is an outstanding practice

community located in the middle of a wonderful recreation area

with limitless opportunities for outdoor activities. Qualified

individuals should contact Ramon Canto, MD, Internal Medicine

Medical Director, by phone at 509-684-7706 or Ron Rehn, D.H.A.,

Chief Executive Officer at 509-684-7723 or e-mail at rrehn@

newmg.org. The mailing address is NorthEast Washington

Medical Group, 1200 E Columbia, Colville WA 99114. Visit our

website at www.newmg.org for more information about Colville

Medical Center P.S.

PHYSICIANS – Are you looking to expand your clinical horizons?

Here’s an opportunity to serve your community and our nation’s

veterans. We are looking for physicians to provide night

coverage, weekends and holidays to do admissions and hospital

coverage. 12 to 16 hours shifts are available. For additional

information, please contact VA Medical Center, Jim Erickson,

Administrative Assistant to the Chief of Staff, 4815 N. Assembly,

Spokane, WA 99205. 509-434-7211. An Equal Employment

Opportunity.

PHYSICIAN OPPORTUNITIES AT CHAS – At Community Health

Association of Spokane (CHAS), we believe doctors should

practice what they are passionate about: serving patients and the

community. We are looking for physicians to join our great team!

Enjoy a quality life/work balance and excellent benefits including

competitive pay, generous personal time off, no hospital call,

CME reimbursement, 401(k), full medical and dental, NHSC loan

repayment and more. Experience pure patient care at CHAS. To

learn more about physician employment opportunities, contact

Kelly McDonald at (509)444-8888 or [email protected].

OUTREACH CLINIC AT HOUSE OF CHARITY – This is an

opportunity to volunteer and bring to the underserved in our

community first line medical care. We need one or two more

doctors to help us. We see the homeless, predominantly, two

afternoons each week. Join four Board MDs and twelve RNs

to rotate once or twice monthly in an excellent, well-equipped

clinic with pharmacy. If you are completely retired, the state

will pay for your medical license and malpractice. For more

information and to sign up, call Dr. Arch Logan, Medical

Director, at (509)325-0255 or Ed McCarron, Director of the

House of Charity, at (509)624-7821.

URGENT CARE POSITION – First Care Med Centers has four

Urgent Care locations in Spokane, WA. We are seeking a Board

Certified physician with comparable Urgent Care experience for

a full-time position. Excellent salary and benefits package with

flexible work schedule - 12-hour shifts and no call. Please contact

Evelyn Torkelson at [email protected] or (509)473-7374.


SPOKANE COUNTY MEDICAL SOCIETY - ORANGE FLAG BUILDING

104 S FREYA ST STE 114

SPOKANE, WA 99202

ADDRESS SERVICE REQUESTED

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

PRSRT STDU.S. Postage

PAIDSpokane, WA

Permit No. 512

the message january 2011

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