vital signs jan 2012
DESCRIPTION
Jan 2012 - Vol. 34 No. 1TRANSCRIPT
January 2012 • Vol. 34 No. 1Official Magazine of
FRESNO COUNTYFresno-Madera Medical Society
KERN COUNTYKern County Medical Society
KINGS COUNTYKings County Medical Society
MADERA COUNTYFresno-Madera Medical Society
TULARE COUNTYTulare County Medical Society
See Inside:CMA’s Center for Economic Services Recoups $2.7 million for MembersMedicare Part B Important Changes for 2012Yosemite Postgraduate Institute
o
Vital Signs
2 JANUARY 2012 / V ITAL S IGNS
VITAL S IGNS / JANUARY 2012 3
Official Publication of
Fresno-Madera Medical Society
Kings County Medical Society
Kern County Medical Society
Tulare County Medical Society
January 2012Vol. 34 – Number 1
Editor, Prahalad Jajodia, MDManaging Editor, Carol Rau
Fresno-Madera Medical SocietyEditorial CommitteeVirgil M. Airola, MDJohn T. Bonner, MDHemant Dhingra, MDDavid N. Hadden, MDRoydon Steinke, MD
Kings RepresentativeTBD
Kern RepresentativeJohn L. Digges, MD
Tulare RepresentativeGail Locke
Vital Signs SubscriptionsSubscriptions to Vital Signs are$24 per year. Payment is due inadvance. Make checks payable tothe Fresno-Madera Medical Society.To subscribe, mail your check andsubscription request to: VitalSigns, Fresno-Madera Medi calSociety, PO Box 28337, Fresno, CA93729-8337.
Advertising Contact:Display:
Annette Paxton,[email protected]
Classified:Carol Rau,
559-224-4224, ext. [email protected]
ContentsVitalSigns
Vital Signs is published monthly by Fresno-Madera Medical Society. Editorials and opinion piecesaccepted for publication do not necessarily reflect the opinion of the Medical Society. All medicalsocieties require authors to disclose any significant conflicts of interest in the text and/or footnotes ofsubmitted materials. Questions regarding content should be directed to 559-224-4224, ext. 118.
CMA NEWS ................................................................................................................................5
NEWS
CMA: 5010 Quick Reference Guide..........................................................................................7
MEDICARE: Part B 2012 Important Changes ............................................................................9
BLOOD BANK: Speaking of Death ..........................................................................................10
AIR QUALITY: Physicians Can Help Create Healthier Places to Live...........................................11
Yosemite Postgraduate Institute ............................................................................................12
CLASSIFIEDS ...........................................................................................................................19
KERN COUNTY MEDICAL SOCIETY ............................................................................................13
• President’s Message
• Membership News
TULARE COUNTY MEDICAL SOCIETY.........................................................................................14
• 2011 Holiday Event
FRESNO-MADERA MEDICAL SOCIETY .......................................................................................16
• President’s Message
• In Memoriam
• FMMS General Meeting Notice
• FMMS Evening at the Fresno Philharmonic
Cover photography: Yellowstone National Parkby Joseph Hawkins, Jr., MD
Calling all photographers:Please consider submitting one of your photographs for publication in Vital Signs. – Editorial Committee
The Pursuit of ExcellenceThe Pursuit of Excellence
Wednesday-Sunday, February 8-12, 2012The Fairmont Chateau – Whistler, BC, Canada
OPENING SPEAKER:Robert “Hoot” GibsonNASA astronautTOPICS: Excellence or Else! Safety in Space:What We Learned from the Challenger & Columbia Tragedies;Technology Revolution Inspired by the Space Program; and America’s Future in Space
Glenn D. Steele Jr. MD, PhD, President & CEO, Geisinger Health SystemTOPIC: Excellence in an Integrated Health System:Looking Ahead to HealthCare Reform
John Popovich Jr. MDPresident & Chief Executive Officer, Henry Ford HospitalTOPIC: Medical Professionalism in Today’s Healthcare World
Mark MorganVice President, General Manager, Anthem Blue Cross – California Small Group BusinessTOPIC: ACO: Impact on PhysiciansAldo De La Torre (not pictured)Vice President, Contracting, Anthem Blue CrossTOPIC: Insurance Exchange:What Does That Mean To Physicians, Insurance Companies & Patients?
Doris Kearns-GoodwinAcclaimed American Historian, Best-Selling Author, Pulitzer Prize Winner, Popular Network PanelistTOPIC: A Moment in Time – A Historical Perspective
77TH ANNUAL WINTER CME SYMPOSIUM 2012TH ANNUAL WINTER CME SYMPOSIUM 2012The Pursuit of Excellence7TH ANNUAL WINTER CME SYMPOSIUM 2012
Joanne M. Conroy MDChief Health Care Officer, Association of American Medical CollegesTOPIC: Update: Impact of Health Care Reform on Academic Medical Centers
Plenary Session Supporter
The target audience for this event is ALL regional physicians of ALL specialties. The 12 CME will cover topics of interest to ALL regional physicians.
M E D I C A L C E N T E R SCommunity
Robert Mecklenburg MDMedical Director, Center for Health Care Solutions at Virginia MasonTOPIC: Health Care Solutions:Adapting the Toyota Production System to Patient Care
Major Supporter
REGISTRATION NOW OPEN – SPACE IS LIMITEDWe encourage you to register online at www.wintersymposium.com
NEW SPEAKERADDED!
CMA NEWS
VITAL S IGNS / JANUARY 2012 5
For the second year in a row, the California MedicalAssociation’s (CMA) Center for Economic Services (CES) hasrecouped more than $2.7 million from payers on behalf of itsmembers. The center’s reimbursement help line has fieldedalmost 2,400 calls about billing andcontracting issues from more than1,200 different physician practices.
To date, CES has recouped$2,706,999 for member physicians.CES is on its way to surpass last year’stotal of more than $2,780,000.
“Our goal is to empower practicesby providing them self-help tools andteaching them how to be effectiveadvocates for physicians and patients,” said Francisco Silva,CMA General Counsel and Vice President. “When the processfails, however, we’re always ready to intervene with the payer orregulator on the member’s behalf.”
Founded in 1999, CES provides members with one-on-oneassistance for billing, contracting and payment problems thatmay arise. With more than 125 years of combined medicalpractice operations experience, CES staff helps members withissues ranging from underpayment or denials by payers toassisting with contract analysis during negotiations.
Assistance from CES can range from education on how toincrease a practices’ efficiency to direct intervention with payersor regulators. This support is reserved exclusively for CMAmembers.
CES also provides members with access to CMA PracticeResources, a regular bulletin offering tips for improving practiceefficiency and viability.
Contact CES staff through its reimbursement help line 888-401-5911. For practical tools, newsletters and other onlineassistance, visit (http://www.cmanet.org/ces).
CMA’s Center for Economic Services RecoupsAlmost $3 million for Members in 2011
$2.7 MILLIONMOREREASONSTO BE A CMAMEMBER
Í Í Í Í Í
CMA’s LEGISLATIVE DAY IN SACRAMENTOTuesday, April 17, 2012
The FMMS will be chartering a bus for the trip to the Capitol.
Information: 224-4224 x 118 or [email protected].
Í Í Í Í Í
SAVE THE DATE
The California Medical Association’s 24-hour online medical-legal library is the most comprehensive health law and medicalpractice resource for California physicians. The medical-legallibrary’s documents include most of the Center for Legal Affairs’California Physician’s Legal Handbook (CPLH), as well as more
specialized information on peer review and other subjects. Thesedocuments are available free to members at www.cmanet.org orby calling the member help center at 800-786-4262.Nonmembers can purchase CMA ON-CALL documents for $2per page at www.cmanet.
California Medical Association’s Medical-Legal Library:available online at www.cmanet.org
6 JANUARY 2012 / V ITAL S IGNS
VITAL S IGNS / JANUARY 2012 7
CMA NEWS
Payor Name Accepting 4010 Additional Information and Plan 5010 Linksafter Jan 1?
Aetna Yes • Aetna reports to CMA that while January 1 is the effective implementation date, they
will continue to accept 4010 transactions without penalty until 3/31/12.
• www.aetna.com, select “healthcare professionals.”
Anthem No • At the time of publication, Anthem reports to CMA that they have no plans to
Blue Cross allow for an extension.
• www.anthem.com/ca/home-providers.html, click “enter” to enter site, search “5010.”
• In preparation for implementation of 5010, Blue Cross notified physicians on
October 24 that when verifying eligibility and benefits information through the
Provider Access website, you will now be required to enter the 3-digit alpha prefix
located on the member’s ID card. If you do not have the 3-digit alpha prefix from the
patient’s ID card, you can use a temporary 3-digit prefix of XDP followed by the
patient’s ID number. Once the system returns the patient eligibility and benefits
information, practices are encouraged to make a note of the actual prefix for future
inquiries. Questions should be directed to the Anthem Blue Cross ProviderAccess
Help Desk at (866) 755-2680.
Blue Shield Yes • Blue Shield reports to CMA they have enacted a contingency plan to support
of California Trading Partners who may need 4010A1 support beyond 1/1/12. However, Trading
Partners must inform Blue Shield of California of this need and provide an action
plan which states when they will be 5010 compliant. Absent a formal notification
from the Trading Partner, Blue Shield will expect 5010 compliance on 1/1/12.
• https://www.blueshieldca.com/provider/home.jhtml, search “5010.”
Cigna No • At the time of publication, Cigna reports to CMA they have no plans to allow for an
extension.
• www.cigna.com, select “healthcare professionals,” then select “resources for health-
care professionals,” select “news from Cigna,” select “HIPAA-special information for
Providers.”
Health Net Unknown • At the time of publication, Health Net had not yet issued any official guidance on
whether they will allow for an extended enforcement period.
Medi-Cal Yes • The Department of Health Care Services announced a likely delay in meeting the
January 1 deadline for implementation of 5010 transactions on 10/13. The notice
states that physicians submitting Medi-Cal fee-for-service claims should plan for
continued use of the current 4010A1 transactions. View the notice on the Medi-Cal
website at www.medi-cal.ca.gov, under newsroom click “Implementation of HIPAA
X12N 5010/NCPDP D.0 & 1.2 Transactions Delayed.” Practices are encouraged to
contact their clearinghouse and practice management system vendors to inquire
about how the vendors are accommodating this delay.
Medicare No • CMS reports that practices must be HIPAA 5010 compliant by January 1, 2012.
Claims submitted in 4010 format will be rejected on January 1. However, CMS will
not enforce any penalties on vendors about which they receive complaints until
March 31.
• Information is available on the Palmetto website at www.palmettogba.com/j1b, click
on “EDI”, then “general.”
United Yes • UHC reports that internal business decisions are underway to allow for this extended
Healthcare enforcement period and they will not reject 4010 transactions until 4/1/12.
• www.unitedhealthcareonline.com/, click “tools and resources,” then “EDI education
for electronic transaction,” then under general EDI click “HIPAA 5010 & ICD-10.”
5010 Quick Reference Guide (Updated 12/07/11)CMA surveyed the major payors in California to find out which of them will continue to accept 4010 transactionsbeyond January 1, 2012. Results, where available, are below. This guide will be updated regularly as newinformation becomes available. Physicians are encouraged to also review CMA’s guide, “Preparing for the New
HIPAA 5010 Standards: A Guide for Physicians,” available in CMA’s online resource library.
C
B C T
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56557 (1/12) ©Seabury & Smith, Inc. 2012
d/b/a in CA Seabury & Smith Insurance Program ManagementCA Ins. Lic. #0633005 AR Ins. Lic. #245544
Fresno-Madera Medical Society
Kern County Medical Society
Tulare County Medical Society
On Nov. 1, 2011, the Centers for Medicare & Medicaid Services(CMS) updated payment policies and Medicare payment ratesfor physicians’ services furnished in 2012.
Highlights of major changes in the fee schedule that impactpayment policy and physician billing include:
E-PRESCRIBINGCMS finalized the rules for the 2012 and 2013 e-prescribing
incentive payment, and the 2013 and 2014 payment penaltyprograms.
E-prescribing incentive payments will continue for 2012 and2013. To qualify for an incentive payment, physicians:
• May use claims, registry or electronic health record (EHR)-based reporting methods.
• Must electronically prescribe on the same day as thedenominator service, and submit 25 claims containing thee-prescribing measure code (G8553) with one of thedenominator codes (90801-90802, 90804-90809, 90862,92002, 92004, 92012, 92014, 96150-96152,99201-99205,99211-99215, 99304-99310,99315-99316, 99324-99328,99334-99337,99341-99345, 99347-99350, G0101, G0108,G0109).
The incentive payment for 2012 is 1 percent, and for 2013 itis .5 percent of the total estimated allowed charges forprofessional services covered by Medicare Part B and furnishedby an eligible professional during the reporting period.
There are three methods to avoid the penalty for 2013 and2014:
• Physicians who are successful e-prescribers in 2011 (thosewho receive the incentive payment) will be exempt frompenalty in 2013. Physicians who are successful e-prescribersin 2012 will be exempt in 2014.
• Physician who successfully report the measure code G8553at least 10 times during the first six months of 2012 (for the2013 calendar year penalty) and in the first six month of2013 (for the 2014 calendar year penalty) will avoidapplication of the e-prescribing penalty. CMS improved theprogram to allow physicians to submit the measure codeG8553 without linking to qualifying visit (denominator)codes. The measure code can be used with any fee scheduleservice during which an electronic prescribing eventoccurred. The claim must still be submitted to Medicare forpayment.
• Physicians will be allowed to apply for additional hardshipexemptions online, but only from January through June 30of each calendar year.
PHYSICIAN QUALITY REPORTING SYSTEM (PQRS)As in prior years, there have been changes to the individual
measures and measure groups. The final rule:• Finalized 211 individual measures, including 26 new ones• Retained 44 EHR measures currently reportable in the EHR
incentive program
• Finalized 23 new measure groups, including eight newmeasures groups for reporting:• Cardiovascular Prevention• COPD• Inflammatory Bowel Disease• Sleep Apnea• Dementia• Parkinson’s• Elevated Blood Pressure• Cataracts
Check measures carefully for proper reporting. A completelisting of the 2012 measures will be posted to the CMS websitehttp://www.cms.gov/PQRS// in the near future.
CMS finalized its proposal to provide interim feedback reportsfor physicians reporting individual measures and measure groupsthrough claims-based reporting for 2012 and beyond. Thesereports will be a simplified version of annual feedback reportsthat CMS currently provides and will be based on claims for thefirst three months of each program year. The interim feedbackreports will be provided to physicians during the summer of eachprogram year.
The rule redefined “group practice” under the Group PracticeReporting Option as a group of 25 or more eligible professionals.Organizations wishing to use the GPRO method must again self-nominate.
CMS finalized its proposal to use 2013 as the reporting periodfor the 2015 PQRS penalty. If CMS determines that a physicianor group practice has not satisfactorily reported quality data forthe 2013 reporting period, then its 2015 payments will bereduced 1.5 percent. Now is a good time to become familiar withthe PQRS reporting system before your payments are negativelyaffected.
ADVANCED IMAGING SERVICES MULTIPLEPROCEDURE PRICING
CMS has finalized a proposal to apply a 25 percent reductionto the payment for the professional component of second andsubsequent advanced imaging services such as CT, MRI, PET,and MRA furnished by the same physician on the same patientin the same session on the same day.
The highest fee schedule service will be allowed at 100percent of the fee schedule. Subsequent advanced imagingservices will be allowed at 50 percent for the technicalcomponent, as in the past, and 75 percent for the professionalcomponent.
LAB TEST SIGNATURES NO LONGER REQUIREDCMS has retracted the requirement for physicians to sign
paper lab requisitions for clinical diagnostic laboratory tests.
VITAL S IGNS / JANUARY 2012 9
Please see Medicare on page 10
Medicare Part B 2012 Important Changes:What They Mean to Your Practice
MED I C A R E
10 JANUARY 2012 / V ITAL S IGNS
ANNUAL WELLNESS VISIT(AWV) CHANGES
CMS has adopted criteria for ahealth risk assessment (HRA) to beused in conjunction with the AWV.The HRA is self-reportedinformation which can be done bythe patient alone or with assistance,takes no more than 20 minutes tocomplete and addresses demo -graphic data, psychosocial risks,behavioral risks, activities of dailyliving (ADL), and instrumentalADLs.
CMS is increasing the paymentfor the AWV codes to recognize theadditional office staff time requiredto administer and HRA to theMedicare population. CMS is alsocontinuing its policy of not cover -ing a routine physical exam as partof these services.
Additional information aboutcoverage and payment changes willbe published by CMS over the nextfew months through MLN Mattersarticles at http://www.cms.gov/MLNMattersArticles/.
Contact: CMA ReimbursementHelp Line at 888-401-5911, [email protected].
MedicareContinued from page 9
Speaking of Deathby Lauren Ward Larsen
(a story about… life… and an important influence onCentral California Blood Center)
Years ago during a particularly hectic speaking schedule, a woman followed me out ofthe conference hall where I’d just given a keynote address at a regional Red Crossmeeting. I was rushing off to catch my next flight, but she seemed determined to have aword with me. She looked as if she’d been crying and a bit angry.
I wondered if I’d somehow offended her with some of my, shall we say, offbeathumor.“That story,” she said, gripping my arm. “The one about Jenny Eller…” Jenny’sstory was – and still is – one I tell often, not because it’s got such a happy ending, butprecisely because it doesn’t.
Jenny was 17 when she was diagnosed with leukemia. Decisions regarding collegescholarships – Princeton or Berkeley? – were superseded by chemo, blood transfusions,and oncologist appointments. As Jenny’s need for blood grew, so too did her desire togive back. She volunteered with her local blood center, helping the staff by recruitingmore donors, speaking at events, and making thank-you calls to those who’d recentlydonated blood. Years after her diagnosis, in a hospital room filled with friends and family,Jenny lost her battle with leukemia. She never did get that college degree, but she didget four more years that she wouldn’t have otherwise gotten had it not been for all theblood that supported her body throughout the cancer treatments.
On the night she died, Jenny’s father, Dean, promised to carry on her work with theblood center. Within days of burying his daughter, he spoke in her place at a luncheonto recruit blood donors. Four years and many blood center talks later, Dean left his careeras a mortgage banker and took over as CEO of the blood center.
And two years ago, the new Jenny Eller Donation Center opened its doors to thepublic. More than a decade after her passing, Jenny continues to have an impact onothers, not the least of which, me.
While some wonderful, in fact inspiring, things have come about as a result of Jenny’sdeath, I’ll bet her parents would trade them all for more time with her here on earth. Butdeath is a part of the “business” we’re in. Not everyone gets the second chance that I –and many others – did.
I wondered if the woman who’d followed me into the hallway, and was still grippingmy arm, was going to scold me for highlighting this harsh reality in what was billed as a“motivational” talk. I braced myself for whatever she had to say.
“I was sitting in there listening to your story and the other stories you were sharing,and I found myself getting upset – even angry – at the unfairness of it all.” Then shestarted crying. “I lost my daughter to leukemia a few months ago,” she continued. “Theytried everything, including regular transfusions, but in the end she still died. I guesshearing all those blood recipient stories with happy endings really started to make mefeel like I’d been ripped off. But then you shared Jenny’s story and I realized I’m notalone. So thank you for doing that. I really needed to hear her story – and how herparents responded to that loss.”
Death is the one experience in life that we all have in common. Ultimately, there’sno escaping it. In our line of work, we certainly hope to help patients defer death – togive families more time together. So let’s continue to fight the good fight, but let’s nevershy away from sharing the heartbreaks that are inevitable. We owe it to those who’ve losta “Jenny.”
Lauren Ward Larsen is the author of “Zuzu’s Petals: A True Story of Second Chances,” which shares herstory of becoming a 200-pint blood recipient and the unexpected life that unfolded as a result. She is also thepresident and chief ambassador of the Foundation for America’s Blood Centers. She can be reached [email protected], or via her website at www.laurenwardlarsen.com. �
(from ABC Newsletter, August 26, 2011)
MED I C A R EB LOOD B ANK
VITAL S IGNS / JANUARY 2012 11
Every year, after enjoying our family’sChristmas dinner at my mother’s condo, weall walk about 100 yards past her back gateand onto the track at Fresno PacificUniversity. We walk a few laps around thetrack while talking and joking with eachother. Then it’s back inside to savor mymother’s peach cobbler.
Having an all-weather track next door ispretty unusual in Fresno, but walkableneighborhoods are almost as scarce. Thankfully there are effortsafoot to change that.
Why is that important? Fresno has the dubious distinction ofhaving some of the poorest quality air in the nation, as well as avery high rate of childhood obesity – 43% of Fresno Countyschool kids are overweight or obese. That compares to 38%statewide.
Making our neighborhoods more walker-friendly and bicycle-friendly would not only help our air quality but also help ourresidents combat obesity and diabetes. Unfortunately, there areno randomized controlled trials to prove that such changes wouldactually cut obesity rates. But we didn’t need RCTs before webegan telling our patients to stop smoking.
There is some indirect evidence: Lund in 2002 reported a positive association between a sense
of community and neighborhoods with mixed uses, access to civicamenities, and walkable neighborhoods.1
Portland, voted the 2nd most bicycle friendly city in the world(Amsterdam is number 1), has quadrupled its miles of bike pathsover the last 20 years. Over the same time period, bike trips havequadrupled in number – all without increasing the number of bikeaccidents.
In these tough economic times, new construction is slow, sothe focus must be on existing neighborhoods. For example, somehave proposed putting 4-lane roads on a “road diet,” convertingthe road to three lanes with bicycle lanes and pedestrian-crossingislands.
3 KEYS TO “SMART GROWTH” ARE:Create walkable neighborhoods. These types of communities
are desirable places to live, work, learn, worship, and play.2
Foster distinctive, attractive communities with a strong senseof place.
Mix land uses; i.e. site houses in close proximity with schools,retail stores, gyms, libraries, etc..
Our air quality sub-committee recently heard a presentationby Keith Bergthold, head of the Sustainable Division in FresnoCity. He would like to improve our residents’ access to tree-lined
A I R Q U A L I T Y
Physicians Can HelpCreate Healthier Places to Live
by Don H. Gaede, MD
sidewalks, bike paths,and green spaces usingsmart growth principles.
According toBergthold, being“green”– that is beinge n v i r o n m e n t a l l yresponsible – is nolonger just a fad andtechnologically cool, itis imperative.
To quote a LakotaSioux proverb:
“We do not inheritthe earth from our
ancestors; we borrow it from our children.”Fresno City’s strategy for sustainability can be summarized
into 5 areas:1. New City BeautifulFresno will be recognized for the innovative integration of
buildings within their neighborhoods, good urban design, and forgiving priority to public health, open spaces, public art, historicpreservation, urban forests and the protection of natural habitats.
2. Sierra View 2025The Sierra Nevada mountain range will be clearly visible to
all Valley residents by 2025. Public health will be improved byhaving cleaner air, enhanced public transportation andadditional opportunities for walking and cycling.
3. Solar ValleyFresno will become a leader in renewable energy use by
maximizing new renewable sources as well as increasing theefficiency of our existing uses.
4. Green Enterprises and Economic DevelopmentThe City of Fresno will become a center for innovative
business enterprises that focus on the “triple bottom line” ofproviding environmental, economic and social benefits.
5. City as Good StewardThe City of Fresno will lead by example by greening up its
facilities and practices, embracing a zero waste initiative, etc.
Making our city a healthier place to live won’t happenwithout a lot of support from people – like us. Physicians canwield a powerful voice when it comes to decisions about how ourcity grows. I encourage you to speak up as plans are developed,and let our local leaders recognize the importance of developinghealthy, attractive neighborhoods.
1 “Pedestrian Environments and Sense of Community.” J Planning EducationResearch 21 (3) 301-12.
2 Making Healthy Places; ed L. Dannenberg, H. Frumkin, and R. Jackson.(Island Press 2011), 153.
Don H.Gaede, MD
12 JANUARY 2012 / V ITAL S IGNS
Make plans to attend
YosemitePostgraduate
Institute
YosemitePostgraduate
Institute
Make plans to attend
MARCH 23-25MARCH 23-2520122012
Topics include: Topics include:
Wilderness MedicineWilderness MedicineDermatologyDermatology
GastroenterologyGastroenterologyCancerCancer
UrogynocologyUrogynocologyPulmonaryPulmonaryDementiaDementia
For further information,For further information,
(559) 224-4224 x118(559) 224-4224 x118e-mail: [email protected]: [email protected]
website: fmms.orgwebsite: fmms.org
MARCH 23-252012
Topics include:
Wilderness MedicineDermatology
GastroenterologyCancer
UrogynocologyPulmonaryDementia
For further information,
(559) 224-4224 x118e-mail: [email protected]
website: fmms.org
VITAL S IGNS / JANUARY 2012 13
2229 Q StreetBakersfield, CA 93301-2900
661-325-9025Fax 661-328-9372
website: www.kms.org
KCMS Officers
Joel R. Cohen, MDPresident
Wilbur Suesberry, MD President-elect
Noel Del Mundo, MDSecretary
Ronald L. Morton, MDTreasurer
Portia S. Choi, MD Immediate Past President
Board of DirectorsAlpha Anders, MDBrad Anderson, MD
Eric Boren, MDLawrence Cosner, MD
John Digges, MDJ. Michael Hewitt, MD
Melissa Larsen, MDMark Nystrom, MDEdward Taylor, MD
CMA Delegates:Jennifer Abraham, MD
Eric Boren, MDJohn Digges, MD
Ronald Morton, MD
CMA Alternate Delegates:Lawrence Cosner, Jr., MD
Patrick Leung, MDMichelle Quiogue, MD
Staff:Sandi Palumbo,
Executive Director
Kathy L. HughesMembership Secretary
PO Box 1029Hanford, CA 93230
559-582-0310Fax 559-582-3581
KCMS Officers
Theresa P. Poindexter, MDPresident
Jeffrey W. Csiszar, MDPresident-elect
Mario Deguchi, MDSecretary Treasurer
Mario Deguchi, MDPast President
Board of DirectorsBradley Beard, MDJames E. Dean, MDLaura Howard, MD
Ying-Chien Lee, MDBo Lundy, MD
Michael MacLein, MDKenny Mai, MD
CMA Delegates:Jeffrey W. Csiszar, MD
Thomas S. Enloe, Jr., MDTheresa P. Poindexter, MD
CMA Alternate Delegates:Laura L. Howard, MD
Staff:Marilyn Rush
Executive Secretary
Kern Kings
President’s Message
JOEL R. COHEN, MD
JOEL R. COHEN, MD: 2012 KCMS PRESIDENT
Joel Cohen was born in Pittsburgh, PA in 1958. He graduatedfrom Jefferson Medical College, PA receiving his Medical Degreein 1983. He completed his Internship and OBGYN Residencyfrom 1983-87 at Mt. Zion Hospital/Medical Center, San Francisco.Dr. Cohen is certified by the American Board ofObstetrics/Gynecology.
Dr. Cohen has been associated with Kaiser Permanente since1987 and a member of KCMS since 2000. He is married to Hopeand they have three children, Adam, Rebecca and Joshua. In hisspare time, he enjoys travel, sports and gardening.
When asked why Dr. Cohen was a KCMS member and what didhe hope to gain/achieve as KCMS President, he replied: medicineis in a transition; there is a lot of disruption to the community thatwe serve, as well as to the physicians and their families. I hope tobring some value to the KCMS physician membership to help allof us survive through this transition.
NOVEMBER 2011Active ................................250Resident Active Members .....1Active/65+/1-20hr .................5Active/Hship/1/2 Hship ........0Government Employed..........6Multiple memberships ...........1Retired..................................61Total ...................................324
New members, pending dues .1New members, pendingapplication .............................0Total Members ..................325
Membership Recap
There’s Still TimeTo submit any changes/corrections and/or an updated photo for
your listing in the 2012 Membership Directory. Please take a minute to review your listing!
Completed information may be returned via the following options:1) Fax: 661-328-93722) Email: [email protected]) Mail: Membership Secretary
Kern County Medical Society; 2229 Q Street; Bakersfield, CA93301-2900
14 JANUARY 2012 / V ITAL S IGNS
Tulare
3333 S. FairwayVisalia, CA 93277
559-627-2262Fax 559-734-0431
website: www.tcmsonline.org
TCMS OfficersGaurang Pandya, MD
President
Steve Cantrell, MDPresident-elect
Thomas Gray, MDSecretary/Treasurer
Steve Carstens, DOImmediate Past President
Board of DirectorsVirinder Bhardwaj, MDCarlos Dominguez, MD
Parul Gupta, MDMonica Manga, MD
Christopher Rodarte, MDH. Charles Wolf, MD
CMA Delegates:Thomas Daglish, MD
Roger Haley, MDJohn Hipskind, MD
CMA Alternate Delegates:Robert Allen, MD
Ralph Kingsford, MD Mark Tetz, MD
Sixth District CMA TrusteeJames Foxe, MD
Sixth District CMA AlternateThomas Daglish, MD
Staff:Steve M. BeargeonExecutive Director
Francine HipskindProvider Relations
Gail LockePhysician Advocate
Thelma YearyExecutive Assistant
TCMS Holiday Event 2011The Tulare County Medical Society proudly hosted its annual membership holiday dinner onDecember 1, 2011 at the Visalia Convention Center. The event provided everyone who attended anoccasion for wonderful conversation and comradery. Recognition and praise were also in order as Dr.Kathryn Hall was very deservingly awarded the 2011 George Tiss, M.D. Memorial Award. TheVintage Press prepared and served an extraordinary dinner and members of the Exeter Union HighSchool Jazz Band performed with delightful accord. In addition, many generous donors provided anarray of items for the silent auction in which all monies raised will be donated to the SamaritanCenter. From a weekend vacation package to Dom P’erignon Champagne and an assortment of lovelybaskets, there was an opportunity to do all the holiday shopping. All in all a spectacular evening!Thank you to everyone who attended. Please mark your calendar for next year’s holiday event onDecember 7, 2012.
Dr. and Mrs. John Booker, and Mrs. Diane Post
Dr. and Mrs. Charles Boniske Dr. and Mrs. Onsy Said
Dr. and Mrs. Mark Reader, Dr. and Mrs. Oscar Hernandez, and Dr. and Mrs. Songlin Liang
VITAL S IGNS / JANUARY 2012 15
Tulare
Tulare Holiday Celebration, continued from page 14
Dr. and Mrs. John Coffey and Dr. and Mrs. Tom Gray, TCMS Secretary/TreasurerDr. and Mrs. Thomas Matthews, 2008George Tiss MD, Memorial Award Recipient
Dr. Bruce Hall, Dr. Kathryn Hall, 2011 George Tiss MD, MemorialAward Recipient and Mrs. George Tiss.
Dr. Gaurang Pandya with Dr. and Mrs. DavidBryson
2012 TCMS President Dr. Gaurang Pandya and TCMS ImmediatePast President Dr. Steve Carstens.
Mrs. Janiece Redd with Dr. and Mrs TimSpade.
Dr. and Mrs Luis Velosa; Dr. Monica Manga,TCMS Board Member; and Mr. Jorge Daza
CMA Alternate Delegate Dr. and Mrs. Mark Tetz, Dr. and Mrs.Richard Clutson and Dr. and Mrs. Bruce Le
Mr. Richard Neilson, Mr. Paul Lerro, Dr. Elsa Lerro and Dr. KathrynHall
THE YEAR AHEADAs this year’s president, I spent time last year trying to convince colleagues to join FMMS. Usuallythere are two excuses that prospective members give for not joining. The first, which is connectedto the second, is that the dues are too high, and secondly, they don’t see the benefits membershipprovides them , and therefore, FMMS is a passé entity with no relevance and not worth joining.Interestingly, most of these non-FMMS physicians belong to other local ethnic medical societies.
I would like to clarify these two points.First of all, membership in FMMS also requires membership in the California Medical
Association (CMA), which is in affiliated with the AMA. Joining the AMA is recommended, butnot obligatory. Whether you agree or not agree with everything they say and do, the CMA andAMA are the voices of the doctors at the state and national levels and who the legislators andCongress look to for input. Dues for both the FMMS and CMA may seem high, but the cost of notbelonging may be even higher. It’s like the saying that “education is too expensive…but what aboutthe cost of ignorance.”
Among some of things FMMS does are:
• Advocacy: Meets with local, state legislators and members of Congress to discuss preserving thepractice of medicine for both the patients and physicians, including the preservation ofMICRA, which saves all of us practicing physicians thousands of dollars yearly on ourmalpractice premiums
• Continuing Medical Education• Practice Management Education: Teaching physicians, residents and office staff how to run the
office more efficiently through a variety of means. • Financial Education• Promote friendship and collegiality amongst doctors
There is a tremendous amount of advocacy work that is done behind the scenes by the FMMSand CMA. In fact a great deal of money goes to advocate the state legislature – monitoring proposedbills and fighting the ones that are nocive to the profession and encumber the practice of medicine.
One of the most important advocacy activities that took place in 2011 was to repel themandatory 30 percent fee cuts of the SRG for Medicare and to repel the 10 percent cut to Medi-Cal, and so far we have not succeeded. As you all know, the SRG formula has been a constant pointof battle for us. It is ill conceived, and it comes back to haunt us every year. We need to fix it onceand for all, and we need to keep working on this.
Of paramount importance is the advocacy to preserve MICRA. Few of you remember the headydays of the 70’s when the malpractice insurance crisis was raging. Doctors couldn’t afford theinsurance. Many did practice by going “bare,” having no malpractice insurance while others wereclosing their practices and/or leaving the state. This insurance crisis led to the creation of MICRA(Medical Injury Compensation Reform Act.)
MICRA has made the malpractice attorneys very unhappy, and every year they try to overturn itor reform it by raising the $250,000 non-economic cap. If they succeed, you will pay a lot more onyour yearly malpractice premiums – much more than the yearly FMMS/CMA dues.
Many tell me that this is not their problem because they work for someone else who pays thepremiums while they receive a monthly check. Well beware; if your employer’s expenses increaseand revenue decreases, certainly your pay check will decrease too.
Another important function of the FMMS is education. We do this at several levels. The mostvisible CME meeting we have is the annual Yosemite Postgraduate Institute in the Spring. This hasbeen going on for many years (2012’s will be the 61st) and has made FMMS well known throughoutthe State. If you have never attended one, you really don’t know what you are missing. There is also
16 JANUARY 2012 / V ITAL S IGNS
Fresno-Madera
Please see FMMS President’s Message on page 18
Post Office Box 28337Fresno, CA 93729-8337
1040 E. Herndon Ave #101Fresno, CA 93720
559-224-4224Fax 559-224-0276
website: www.fmms.org
FMMS Officers
Sergio Ilic, MDPresident
Ranjit Rajpal, MDPresident Elect
Prahalad Jajodia, MDVice President
Stewart Mason, MDSecretary/Treasurer
Oscar Sablan, MDPast President
Board of GovernorsA.M. Aminian, MD
Hemant Dhingra, MDUjagger-Singh Dhillon, MD
William Ebbeling, MDBabak Eghbalieh, MDAhmad Emami, MDDavid Hadden, MDS. Nam Kim, MDKhalid Rauf, MD
Rohit Sundrani, MDMohammad Sheikh, MD
CMA DelegatesFMMS President
A.M. Aminian, MDJohn Bonner, MDAdam Brant, MDMichael Gen, MDBrent Kane, MDKevin Luu, MD
Andre Minuth, MDRoydon Steinke, MDToussaint Streat, MD
CMA Alternate DelegatesFMMS President-elect
Don H. Gaede, MDPrahalad Jajodia, MDPeter T. Nassar, MDTrilok Puniani, MD
Dalpinder Sandu, MDSalma Simjee, MDSteven Stoltz, MDRajeev Verma, MD
CMA YPS DelegatePaul J. Grewall, MD
CMA YPS AlternateYuk-Yuen Leung, MD
CMA Trustee District VIVirgil Airola, MD
Staff:Sandi Palumbo
Executive Director
President’s Message
SERGIO D. ILIC, MD
VITAL S IGNS / JANUARY 2012 17
Fresno-Madera
FMMS GeneralMembership Meeting
Heart-Healthy Humor
featuring:
Aaron Stewart,Comedian
A good laugh is the best medicine forone’s health – and for at least a fewhours – takes one away from theabsurdities of life. Plan to spend anentertaining and therapeutic evening withcomedian, Aaron Stewart – a premier andlong-standing comic of Fresno’s comedyscene.
Wed., February, 1, 2012To Be Determined
$15 FMMS member
$30 FMMS nonmember
Information and reservations: 224-4224 x 118or [email protected]
presents...
an Evening with theFresno Philharmonic
WickedDivas
Bewitching, Beguiling, Bedazzling.Wicked Divas is a concert of amazingvoices, humor, energy and sassdelivering diva showstoppers fromBroadway, opera and popular music,highlighted by selections from the Tony-award winning Broadway musical,Wicked. Begin your evening enjoyinghors d’oeuvers and beverages whilesocializing at an exclusive pre-concertreception for Fresno-Madera MedicalSociety members and guests.
Sat., February 11, 2012The William Saroyan Theatre6:00 p.m. Reception • 8:00 p.m. Concert
For further information or tickets,call 224-4224, x118 or [email protected]
With appreciation to our reception sponsor:Premier Valley Bank
18 JANUARY 2012 / V ITAL S IGNS
THEODORE STEINBERG, MD63-year member
Theodore Steinberg, MD, a retiredophthalmologist, passed away Nov.2, 2011 at the age of 101.
Dr. Steinberg was born in theUkraine in 1910 and came toAmerica in 1924 after changing hislast name to circumvent the pre -vailing quotas on Eastern Euro peanimmigrants. After learning English,he went on to earn undergraduatedegrees from Boston University andthe Massachusetts Institute of Tech -nology, a medical degree from TuftsMedical School in 1938 – and in1970 – a law degree from Hum -phreys College.
He completed his ophtha -lmology residency at Green’s EyeHospital in San Francisco. Afterserving in the US Army, Dr.Steinberg came to Fresno in 1947and opened his private practice. Heretired in 1994 at the age of 84.
During his long, lustrous career –Dr. Steinberg served as president ofthe Fresno-Madera Medical Societyin 1967, Chair of the ophthal -mology residency program at UCSF,Fresno, president and foundingmember of both the California andAmerican Academys of Ophthal -mology – in addition to serving formany years as a delegate to theCMA and AMA. He also became anationally recognized expert onmedical malpractice, medicalmanpower and medical ethicsissues, testifying before the USCongress and the CaliforniaLegislature on numerous occasionsand serving on a number of advisorypanels.
Dr. Steinberg is survived by twochildren and three grandchildren.
the Annual Central Valley Cardiology Symposium in Madera every Fall, which ischaired by our president-elect, Dr. Ranjit Rajpal.
There is also practice management education for physicians such as: ElectronicMedical Records, the Health Care reform, Risk Management, Coding & Billing. Anymedical-legal questions can be accessed through the CMA’s huge medical legal library online.
The educational activities do not stop at the level of doctors. They are also providedto the medical office managers on a variety of topics that enable them to run your officemore efficiently. A few months ago we had a very informative meeting on how toimprove the quality and efficiency of the office staff, overcome the most frequent pitfallsof a doctor’s practice and how to retain and increase patient load.
If you are not a member and/or you do not participate, these activities go unnoticedand thus, the complaint “FMMS does not do anything for me.”
FMMS is also here to promote better communication, understanding and workingrelationships within the medical community. For this we have social events andquarterly membership meetings. We want to make one or two of the meetings moresocial than medical. For example, this past September we had an excellent and enjoyablemeeting when Dr. Rindahl gave a nice talk about his climb of Mount Everest. It was afull house, and everyone had a great time. We are also planning on having one of ourmeetings at a local winery in Madera.
The big event we are planning for 2012 is bringing a nationally known lecturer to ourMay 11 meeting, Raymond Kurzweil, a scientist, inventor and futurist , who is going tospeak about the great changes that are about to occur in the next 25 to 30 years, due tothe explosion of knowledge in technology. His topic: “2045: the year man becomesimmortal.” The topic is unbelievably interesting, raises multiple questions in all areas ofthe medical field and should provoke a nice debate.
This year we will have a number of financial services available to our members suchas wealth management, pension plan managing and Financial Investment classes tolearn the basics of investing etc.
In order to access these benefits, you have to be a FMMS member. Plus – you need toread our monthly publication Vital Signs, read your email and visit our website –fmms.org - to learn of all these opportunities. Otherwise you’ll still be asking whatFMMS does for you.
Remember, there is strength in numbers. We need to be united. Please join, and don’tlet current members carry your burden on their shoulders. We pay the dues, and themoney is well spent. Participate and you’ll be rewarded.
I just came back from the NORCAP Educational Forum in San Francisco where therewere extensive lectures on several topics such as “The Impact of the Affordable Care Acton the future of the Medical Practice”, “New Physician Payment Models” and“Organizing Physician ACOs: Report From the Front.” For those who do not know yet,ACOs are Accountable Care Organization. The meeting was excellent and leaves nodoubt that we all need to unite to be able to influence the changes that are coming.FMMS plans on bringing one of the main speakers to Fresno in February or March tobring us current information on ACOs.
.
Fresno-Madera
FMMS President’s Message
Continued from page 16
VITAL S IGNS / JANUARY 2012 19
Classifieds
MEDICAL OFFICES
Gar McIndoe (661) 631-3808David Williams (661) 631-3816Jason Alexander (661) 631-3818
FOR LEASE1902 B Street – 1,695 sf.
2701 16th St. – 2,4002007 17th Street – 5,090 rsf.1311 Columbus St. – 4,400 sf.
Crown Pointe Phase II – 2,000-9,277 rsf.Meridian Professional Center – 1,740-9,260 rsf.
2204 “Q” Street – 2,894 rsf.4040 San Dimas St. – 2,035 rsf.
9300 Stockdale Hwy. – 3,743 - 5,378 rsf.9330 Stockdale Hwy. – 1,500-7,700 rsf.
3115 Latte Lane – 5,637 rsf.2731 H Street – 1,400 sf.
3941 San Dimas Street – 3,959 rsf.SUB-LEASE
4100 Truxtun Ave. – Can Be SplitMedical Records & Offices
Sprinklered – 4,764 usf. • Adm. & Billing – 6,613 rsf.
DENTAL OFFICE FOR LEASE OR SALE3115 Latte Lane – 5,697 rsf.
2023 Brundage Lane – 3,500 sf.FOR SALE
Crown Pointe Phase II – 2,000-9,277 rsf.Meridian Professional Center – 1,740-9,260 rsf.
2000 Physicians Plaza – 17,939 sf. gross9900 Stockdale Hwy. – 2,000-6,000 rsf.
Fresno Women’s Medical Group welcomesboard certified OBG, Preti Srivatsa, MD andboard certified FM, Robin Linscheid, MD.Accepting new patients & most insurance. Call559-322-2900 for appointments. Rare opening for a new client. Medical Billingservice. Professional, precise, collection experts.559-499-1233, [email protected] Psychiatry Clinic: A sliding feescale clinic operated by the UCSF Fresno Dept. ofPsychiatry at CRMC M-F 8am-5 pm. Call 320-0580.
High quality medical suite on NE corner ofPalm/Barstow. Approx. 2030 sf, 4 exam rms. 2offices, lg reception area. Available Jan. 2012.Excellent move-in incentives. Call Justin or Garryat 559-449-2424. www.russellgsmithinc.com Medical office space, 3,000-7,000 sf in primelocation near Fresno Surgical Hospital.Negotiable rates. Call 559-273-0600.
Established IM and CD group seeks F/T physi-cian. Ancillary services on site. Located adjacentto SAMC. Excellent opportunity for new andestablished practices. Call Kim at 559-435-2633or 559-289-5535.
ANNOUNCEMENT FOR LEASE OR SALE
PHYSICIAN/PROVIDED WANTED
CME Activities
MEMBERS: 3 months/3 lines* free; thereafter $20 for 30 words.NON-MEMBERS: First month/3 lines* $50; Second month/3 lines* $40; Third month/3 lines* $30.*Three lines are approximately 40 to 45 characters per line. Additional words are $1 per word.Contact the Society’s Public Affairs Department, 559-224-4224, Ext. 118.
The Late Preterm Infant and Breastfeeding Challenges – January 6, 201212:30pm-1:30 pm; CRMC/Sequoia West; Credit: 1 hour; Fee: N/C; Contact: 559-459-1777.
Asthma Burden in the Central Valley, Updated Treatment Standards –January 12, 2012
12:30pm-1:30pm; Clovis Community Hosp./Outpatient Conference Rm; Credit: 1 hour; Fee: N/C; Contact: 559-459-1777.
California Association of Neurological Surgeons Annual Meeting –January 13-15, 2012
Anaheim, CA; Credit: 12 hours QME; Contact: 916-457-2276.
Electroconvulsive Therapy: Current Controversies – January 19, 20124pm-5pm; UCSF-Fresno Center; Credit: 1 hour; Fee: N/C; Contact: 559-459-1777.
Updates in Pulmonary Medicine – January 24, 20126pm-8pm; Kaweah Delta Health Care District; Credit: 2 hours; Fee: N/C; Contact: 559-624-2595.
Guide to Breastfeeding Infants with Special Needs – February 2, 201211:30am-4pm; UCSF-Fresno Center; Credit: pending; Fee: N/C;Contact: 559-459-1777.
VITAL SIGNSPost Office Box 28337Fresno, California 93729-8337
HAVE YOU MOVED?Please notify your medical society ofyour new address and phone number.
PRSRT STDU.S. Postage PAIDFresno, CAPermit No. 30
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