Keeping You Connected

The SCMA and MLCMS keep you up to date on the latest news,
policy developments, and events

rss

July 2010


Public Health urges physicians to increase pertussis vaccinations


The California Department of Public Health is urging physicians to increase their Tdap vaccinations because of the current statewide pertussis epidemic. To protect infants who are too young to be vaccinated, anyone with potential infant contact should be immunized. CDPH is making additional Tdap vaccine available at no charge to eligible hospitals, so that they can immunize postpartum women and their close household contacts. For more information, visit www.cdph.ca.gov.

Health care providers are also urged to get Tdap vaccinations to protect themselves and their patients. Effective Sept. 1, the Cal/OSHA Aerosol Transmissible Disease Standard requires all hospitals, outpatient medical facilities and other employers covered by the Standard to offer Tdap immunization to their employees who may be exposed to pertussis. Employees who choose not to be vaccinated will be required to sign a declination form.

Pertussis infection rates in California have increased four-fold this year, compared to the same time period in 2009. If current trends continue, the state could experience a 50-year high in pertussis cases, despite wide availability of the Tdap vaccine. So far this year, five California infants less than three months of age have died of the illness.

Physicians are reminded that pertussis immunity from previous infection or vaccination wanes over time. Even fully immunized children become susceptible to pertussis by adolescence. Additionally, because pertussis vaccine for adolescents and adults was not available until 2005, immunization rates in these populations remain low.

book


SCMA Survey: Local doctors still favor public option and single payer


Nearly 80% of Sonoma County physicians still favor the public option, and two-thirds still favor a single-payer system. Those were among the key findings of a health reform survey the SCMA sent to more than 1,000 Sonoma County doctors in May, including both members and nonmembers. Almost 200 physicians responded to the survey, which included a range of multiple-choice and open-ended questions about health reform.

Neither the public option nor single payer appeared in the final health reform legislation signed by President Obama in March, but many local physicians continue to support both proposals. Sixty-two percent were strongly in favor of the public option, for example, and 16% were somewhat in favor. In contrast, only 34% were strongly in favor of the final legislation, with 39% somewhat in favor.

When asked about specific aspects of the new legislation, physicians were nearly unanimous (91%) in supporting increased Medicaid pay for primary care physicians, but they had mixed feelings about the new Medicare Independent Payment Advisory Board, which will regulate Medicare spending. Almost half the respondents favored the board, but about one-fourth were opposed, and one-fourth were neutral. Feelings were similarly mixed for reducing Medicare payments for certain diagnostic imaging services.

Complete survey results appear in the Summer issue of Sonoma Medicine, which was mailed to SCMA members in early July. Results can also be read online at www.scma.org/magazine.

book


Rep. Thompson honored by North Bay physicians


Congressman Mike Thompson, whose district includes several North Bay counties, received the 2010 Legacy Award at the annual CMA District 10 caucus in Santa Rosa on June 26. Thompson was honored for his efforts to promote the health and well-being of California residents.

Among many accomplishments in his long career, Thompson wrote landmark legislation while serving in the California State Senate that required health insurance providers to offer all children comprehensive preventive care. Now, as chair of the Blue Dog Coalition’s health care task force, Thompson leads efforts in Congress to correct low Medicare reimbursement rates for physicians and to implement a comprehensive telemedicine initiative.

CMA District 10 includes medical societies in Del Norte, Humboldt, Lake, Marin, Mendocino, Napa, Solano and Sonoma counties, representing more than 2,300 physicians in all specialties and modes of practice. At their annual caucus, delegates from the North Bay societies vote on resolutions to be presented at the CMA House of Delegates in the fall.

book


Dr. Gutfreund begins term as SCMA president


Catherine Gutfreund, MD, a family physician at Kaiser Santa Rosa, began her one-year term as president of SCMA on July 1. A native of the Midwest, she received her MD from the Medical College of Georgia in 1987. Before moving to Sonoma County in 2000, she worked as a primary care physician at the Wiesbaden Air Base in Germany and completed her family medicine residency at the Henry Ford Health System in Detroit. She was in private practice in both Santa Rosa and Sebastopol before joining Kaiser.

In a wide-ranging interview in the current issue of Sonoma Medicine, Gutfreund discusses the new health reform legislation and the need for further changes. She also describes her plans to focus on women’s health and young physicians while president of SCMA. The interview can be read online at www.scma.org/magazine.

book


Six-month Medicare patch takes effect


The new Medicare legislation signed by President Obama in June retroactively raises physician payment rates by 2.2%, effective June 1. The new rates apply only through November, however. If Congress fails to intervene, Medicare cuts mandated by the sustainable growth rate (SGR) will take effect on Dec. 1.

Physicians who submitted June claims with charges less than the 2.2% update amount will need to contact their local Medicare contractor to request an adjustment. Charges on claims cannot be altered without a request from the physician or provider. CMS has directed physicians not to resubmit claims already submitted to their Medicare contractor.

The new legislation does not include the California geographic payment (GPCI) fix, which would have provided $400 million so that 14 currently underpaid counties, including Sonoma, would be reimbursed based on more accurate geographic practice costs. CMA will pursue that provision in other legislation.

book


Twelve new physicians begin residency training in Santa Rosa


A dozen graduates from the nation’s top medical schools entered the Santa Rosa Family Residency in July. Selected from more than 500 applicants, the new residents have already established impressive records in academic achievement and community service. Between them, they speak 11 different languages, and all but one are fluent in Spanish.

“Health care is changing in this country, and the old models of family medicine, where a physician sits in the office and waits for patients to come to them, are outdated,” said Dr. Jeff Haney, the residency’s program director. “[We] have actively recruited students who want to lead in creating new models of primary care that make patient-centered medical homes a reality across the socioeconomic spectrum.”

The new residents are scheduled to graduate in 2013. If past history is any indication, many will stay in Sonoma County, where about half the family physicians currently in practice attended the residency.

book


Physician volunteers needed for Neighbors in Health on Aug. 1


Doctors from all specialties are encouraged to volunteer for Neighbors in Health, an annual event that provides a day of free health care to uninsured children and teenagers. Volunteers are needed for pediatric and teen clinics, and for immunizations. Slots are available for morning or afternoon shifts.

The event runs from 7:30 a.m. to 7 p.m. on Sunday, August 1, at the Kaiser Permanente Stein Medical Campus, 3925 Old Redwood Highway, Santa Rosa. To volunteer, visit www.unitedwaywinecountry.org/nih or call Christine Goodenough at 528-4485, Ext. 121. About two dozen physician volunteers are still needed for the event, which draws hundreds of uninsured children and teenagers from across the county.

book


Doctors need to verify their Medicare PECOS enrollment


Physicians who have not updated their Medicare enrollment information in the past five years may need to fill out another application or risk facing payment problems for ordered or referred services.

Under new rules that took effect in July, Medicare is authorized to reject claims if an ordering or referring physician is not identified in Medicare’s Internet-based PECOS enrollment system. Thousands of otherwise acceptable Medicare claims could go unpaid merely because they were submitted by providers who enrolled in Medicare before the PECOS database was developed.

Don’t know if you’re in PECOS? CMA has developed a step-by-step guide to walk physicians through the process, from determining if they are already in PECOS to helping them navigate the Internet-based PECOS enrollment system. This guide is available to members at www.cmanet.org. A previously recorded PECOS enrollment webinar is also available for viewing. Nonmember physicians can call CMA at 800-786-4262 for more information.

book


MBC signage requirements now in effect


California physicians are now required to inform their patients that they are licensed by the Medical Board of California, and to provide patients with the board’s contact information.

CMA has prepared a number of resources to help physicians comply with these new regulations, including downloadable posters and customizable patient notices. The materials are available to members at www.cmanet.org. Nonmember physicians can call CMA at 800-786-4262 for more information.

According to the medical board, physicians, not facilities, are responsible for compliance with this regulation. In group settings, only one sign must be posted (should that option be chosen), but it must be posted in a location where it can be seen by all patients.

book


Save the date: North Bay membership dinner on Oct. 28


Former U.S. Surgeon General Dr. Richard Carmona is the featured speaker at the combined North Bay medical societies’ membership dinner on Thursday, Oct. 28. The event, to be held at the San Francisco Yacht Club in Belvedere, begins with a reception at 6 p.m., followed by dinner at 7. Dr. Carmona, a highly respected trauma surgeon and public health expert, served as surgeon general from 2002 to 2006. He will speak about the role of state and local medical societies in disaster preparedness.

book


HOSPITAL/CLINIC UPDATES


Sonoma Valley Hospital has hired a new CEO, Kelly Mather, the chief executive at Sutter Lakeside Hospital in Lakeport for the last eight years. She replaces Carl Gerlach, who has guided Sonoma Valley into the black despite the economic downturn. Earlier this summer, the hospital signed a $23 million contract for seismic upgrades and a new wing.

Petaluma Valley Hospital has cut average door-to-doctor wait times nearly in half this year. During January and February, the average was 35 minutes. That time was reduced to just 18.5 minutes in March and April. The national average is one hour, according to the CDC. “The quicker we can see patients, the quicker we can ease their suffering,” said Dr. Randeep Singh, chief of staff at PVH. The hospital recently pledged to begin care within 30 minutes or less of arrival.

The American College of Radiology has designated the Redwood Regional Medical Group as a “Breast Imaging Center of Excellence.” The designation is the result of peer-review evaluations of all the breast imaging modalities offered by the medical group. RRMG is the first imaging center in Sonoma County to receive the designation.

Kaiser Santa Rosa has received a “certificate of occupancy” from the Office of Statewide Health Planning and Development for its new hospital wing, scheduled to open this fall. The 146,000 square foot expansion will double the size of the emergency department and increase the total number of licensed beds in the hospital from 117 to 167. For the numerically inclined, the projected opening date is 10/10/10.

The long approval process for the new Sutter Medical Center of Santa Rosa hospital may be nearing an end. The county Planning Commission has approved the environmental report for the hospital, leaving the final decision up to the Board of Supervisors in August. The new hospital, to be located near the Wells Fargo Center for the Arts in Santa Rosa, must begin construction by the fall to meet various state requirements.

book


PEOPLE


Dr. Douglas Abbott, an orthopaedic surgeon in Santa Rosa, is closing his office and joining an orthopaedic group in Oregon. Dr. Abbott’s patients will transition to Santa Rosa Orthopaedics.

Dr. Brad Drexler, a Healdsburg obstetrician and gynecologist, is opening a satellite office in Santa Rosa, at Spring Creek Family Practice, 1144 Sonoma Avenue, Suite 119. The phone is 707-545-0717. Dr. Drexler has practiced in Sonoma County for 19 years and offers full ob-gyn services including high-risk obstetrics care, advanced laparoscopic surgery, infertility, tubal reversal, and gyn urology.

Steve Osborn, longtime editor of Sonoma Medicine and SCMA News Briefs, is now directly employed by SCMA as its communications director. He previously worked for Redwood Health Services. The move comes as SCMA assumes responsibility for all aspects of its publications, including editorial services, graphic design and advertising. Osborn will continue to edit the magazine and newsletter, in addition to administering the SCMA website and handling public relations. His e-mail is still sosborn@scma.org, but his phone has changed to 707-540-5096. His old phone at RHS is no longer active.

book


CLASSIFIEDS


Reimbursement specialist
Need help with office inefficiencies? Revenue RN provides outsourced billing, coding and revenue cycle services: www.revenuerecoverynetwork.com.

Office space
Small suite available for reasonable rent. Reception and three rooms, southeast Santa Rosa. Call Connie, 707-525-0211.

How to submit a classified ad
To submit a classified ad for SCMA News Briefs or Sonoma Medicine, contact Erika Goodwin at solanomedsoc@sbcglobal.net or 707-548-6491. The cost is one dollar per word.

book


ABOUT SCMA


The Sonoma County Medical Association, a 501(c)(6) nonprofit association, supports local physicians and their efforts to enhance the health of the community. Founded in 1858, SCMA is affiliated with the California Medical Association and the American Medical Association.

© SCMA 2010
3033 Cleveland Ave. #104
Santa Rosa, CA 95403

book


TO UNSUBSCRIBE


You are receiving SCMA News Briefs because you are a physician or an affiliated medical professional in Sonoma County. If you wish to unsubscribe, contact Steve Osborn at sosborn@scma.org or 707-540-5096.

book


June 2010


Primary care survey could improve local Medicare reimbursements


Results of a survey being e-mailed and faxed today to all local primary care physicians could lead to enhanced Medicare reimbursements in Sonoma County. Data from the survey will be used to designate local Health Professional Shortage Areas (HPSAs). Physicians who provide services in HPSAs are eligible for bonus payments from Medicare.

All primary care physicians are encouraged to complete the survey, which is being conducted by SCMA and Health Action, a partnership of community leaders and organizations committed to improving the health of all Sonoma County residents. The main purpose of the 17-question survey is to assess how well physicians are meeting the primary care needs of county residents. The questions, which take only a few minutes to complete, measure primary care capacity, access, and the degree to which practices have adopted patient-centered care innovations in order to become medical homes.

The deadline for returning the survey is Friday, June 11. Current, accurate information on primary care services is critical to obtaining federal funding for local physicians and the entire community. The survey is the main vehicle for obtaining such information, and the goal is 100% participation. For questions regarding the survey, contact Dr. Mary Maddux-González, Sonoma County Public Health Officer, at mmaddux@sonoma-county.org or 565-4418.

book


House passes Medicare fix; all eyes on Senate


Despite House passage of a bill to stop Medicare SGR cuts and fix the GPCI payment formula, the Senate has left physicians in the lurch once again. This time, senators adjourned for a week-long Memorial Day Recess just as they were poised to take up the bill. As a result, the long-threatened 21% Medicare physician payment cut will go into effect June 1, and the earliest senators can consider a solution is June 7.

In anticipation of the cuts, Medicare has instructed its contractors to hold physician claims for 10 business days. The hold, which will only affect claims with dates of service on or after June 1, gives Congress additional time to act before claims are processed at the lower rate.

The House bill would stop the Medicare SGR (sustainable growth rate) cuts for 19 months. In lieu of the scheduled 21% cut, the bill would implement a 2.2% payment increase for the remainder of this year, and a 1% increase for 2011. The bill also includes a California GPCI (geographic practice cost index) fix, which provides $300 million so that currently underpaid counties, including Sonoma, can be reimbursed at higher rates.

Because the House bill is just another short-term fix of SGR, rather than a repeal, physicians could end up facing a 33% SGR cut in 2012. "As a physician, I am outraged by Congress's inability to protect health care for senior citizens and provide stable funding for Medicare," said CMA President Dr. Brennan Cassidy. "This is a recurring nightmare for seniors and the doctors who serve this vulnerable population."

CMA continues to advocate for a permanent repeal of the Medicare SGR. Congress has known for years about the inadequacies of the SGR formula, but it has not fixed the problem. CMA is lobbying Congress to replace SGR with a payment system that automatically keeps up with the cost of running a practice and is backed by a stable funding formula.

Physicians are an important part of that lobbying effort. Your senators need to hear from you! Call Dianne Feinstein and Barbara Boxer today at 800-833-6354 to let them know the impact the SGR cuts will have on your practice. You will be connected to their offices via the AMA Grass Roots Hotline.

book


SCMA Health Reform Survey results being compiled


Results from the SCMA Health Reform Survey, designed to measure physician attitudes toward recent health reform legislation, will be compiled during June and published in the Summer issue of Sonoma Medicine.

Nearly 200 local physicians—about 20% of the total number practicing in Sonoma County—responded to the survey. In addition to answering a series of multiple-choice questions, almost all respondents wrote comments in response to the open-ended questions at the end of the survey.

The survey was distributed to all local physicians via e-mail and first-class mail on May 6, and it closed two weeks later, on May 21. While merging the e-mail and handwritten surveys will take some time, a few preliminary demographic results are available. The responses came from across the spectrum, with roughly equal numbers of primary care and specialist physicians. All ages were represented as well, ranging from physicians less than 40 years old to those older than 70. Likewise, all modes of practice were represented, with significant numbers of self-employed, salaried and production-based physicians.

SCMA would like to thank everyone who responded to the survey. If you have any questions about the survey, contact Steve Osborn, SCMA publications director, at sosborn@scma.org or 525-4325.

book


Public Health issues pertussis, rabies alerts


Public Health has issued two Health Alerts in recent weeks. The first, dated May 13, notes that pertussis is on the rise in Sonoma County, with 19 confirmed cases and eight probable ones so far this year, compared to only one confirmed case at this time last year. The actual number of cases is probably higher.

Because pertussis is vaccine-preventable, physicians are reminded to review vaccination records with patients and families to ensure that all household members are up to date. A vaccine booster (Tdap) is now available for teens and adults and should be offered when appropriate. For more details on vaccines and treatments, visit the Public Health website at www.sonoma-county.org/health/ph/.

The second alert, dated May 27, confirms that a wild fox recently killed in the Windsor area had rabies. The fox was the first animal in Sonoma County to test positive for rabies since 2008.

While the rabid fox does not mean that rabies is increasing in Sonoma County, physicians should remind their patients to avoid contact with wild animals, including the county’s many feral cats. All dogs and cats, as well as some livestock, should be vaccinated against rabies, and any bites from animals should be treated promptly. For more details on rabies precautions, visit www.sonoma-county.org/health/ph/.

book


Dr. Jeff Sugarman confirmed as SCMA president-elect


Dr. Jeff Sugarman, a Santa Rosa pediatric dermatologist, has been confirmed as SCMA president-elect by a vote of SCMA members. He will serve as president-elect from July 2010 to June 2011. The current president-elect, Dr. Catherine Gutfreund, a Santa Rosa family physician, will become president on July 1, succeeding Dr. Richard Powers.

The election, which concluded May 31, also confirmed Drs. Jan Sonander and Peter Sybert for the SCMA board of directors, and Drs. Dan Lightfoot, Don Van Giesen, Clinton Lane, Katherine McNally and Richard Powers as members of the CMA delegation.

book


Resolutions for CMA House of Delegates needed by June 26


Resolutions for the CMA District 10 caucus are due by June 26. The caucus is the first stop on the way to the CMA House of Delegates, which meets this fall to consider resolutions from around the state. Any SCMA member can submit a resolution to Cynthia Melody at cynthia@scma.org or 525-4375, or to a member of the CMA delegation (see below). Resolutions can cover almost any aspect of medical care, including health reform, medical practice, health facilities, quality of care, medical ethics, legal issues, and public health.

The CMA delegation consists of delegates and alternate delegates. The delegates are Drs. Brad Drexler, Jan Sonander, Leonard Klay, Phyllis Senter, Dan Lightfoot, Don Van Giesen, and Clinton Lane. The alternate delegates are Drs. Edward Chang, Brien Seeley, Lela Emad, Catherine Gutfreund, Katherine McNally, and Richard Powers.

book


Reminder: New physician signage regulations take effect June 27


California physicians will soon be required to inform patients that they are licensed by the Medical Board of California, and to provide patients with contact information for the MBC. The new regulations, which take effect June 27, require physicians to provide the MBC notice by one of three methods:

·       Prominently posting a sign in an area of their offices that is conspicuous to patients, in at least 48-point type in Arial font.

·       Including the notice in a written statement, signed and dated by the patient or patient’s representative, and kept in that patient’s file, stating the patient understands the physician is licensed and regulated by the MBC.

·       Including the notice in a statement on letterhead, discharge instructions, or other document given to a patient or the patient’s representative; the notice must be placed immediately above the patient’s signature line in at least 14-point type.

Regardless of which method you choose, the notice must read as follows: NOTICE TO CONSUMERS: Medical doctors are licensed and regulated by the Medical Board of California, (800) 633-2322, www.mbc.ca.gov.

According to the MBC, physicians, not facilities, are responsible for compliance with this regulation. In group settings, only one sign must be posted (should that option be chosen), but it must be posted in a location where it can be seen by all patients.

A sample MBC sign is available at scma.org/resources. For more information, visit www.mbc.ca.gov.

book


FTC delays Red Flag Rule until end of year


The Federal Trade Commission has delayed the compliance deadline for the Red Flag Rule until the end of 2010. In late May, the AMA filed a lawsuit asking a federal court to prevent the FTC from extending the Red Flag Rule to physicians. “The latest extension to the compliance date is a promising sign,” said Dr. Cecil Wilson, AMA president-elect. “We call on the FTC to exempt physicians from the rule completely.”

book


Get to know new CEO of CMA


Golf, shyness, marriage, Bob Dylan and the future of CMA. What do they all have in common? They define CMA’s new CEO, Dustin Corcoran. The full story is contained in a 9-minute video posted on YouTube and Vimeo. For more details, contact Ron Lopp at 916-551-2042 or rlopp@cmanet.org.

book


LEGAL NOTES


By SCMA Legal Counsel Larry McLaughlin

Physicians are often asked to give testimony involving one of their patients, sometimes at a trial, but most often at a deposition. I’ve frequently given advice as to what fees a physician may charge in such a circumstance. The answer may depend on what type of witness the doctor will be, and how badly his or her testimony is needed.

There are two basic types of physician witnesses: percipient and expert. An “expert” witness is one who is asked to render a present opinion about the patient. Such physicians are normally hired specifically for that purpose, and they are entitled to the fee that an expert would charge, generally a substantial one. Only a few physicians, however, are asked to give such testimony.

A “percipient” witness is one who testifies only as to what they saw or did at a time in the past. An example would be a witness to an auto accident testifying about what they observed. In the “medical” sense, the percipient physician witness will be asked about the diagnosis and treatment of the patient at the time the patient was seen. A good way to imagine such testimony would be the reading of the medical record into evidence. Physicians will usually be a percipient witness.

The law provides that a percipient witness can be compelled to testify for a very low statutory fee plus mileage—less than $100. In my experience, however, most attorneys will agree to compensate doctors for their actual time in preparing the testimony and attending the deposition. This payment is voluntary, and a matter of negotiation.

The physician or office manager should contact the attorney’s office and come to an agreement ahead of time, and then follow it up with a letter confirming the arrangement and the details of the testimony (e.g., when, where, how long). A minimum advance fee should be requested, as doctors sometimes have trouble collecting the fee afterwards.

Unfortunately, there is no “standard” fee for percipient testimony. The fee is whatever will compensate the doctor for his or her time, and possibly “what the market will bear.” In short, the fee is a matter of negotiation. In the event of an impasse, however, the physician should bear in mind that they could be forced to testify for the minimum statutory fee.

Physicians with questions, or who are experiencing difficulty in recovering their fee after testifying, should contact me at 707-579-4523 or lwmclaughlin@juno.com.

book


PHYSICIANS IN THE NEWS


Dr. James Devore, a longtime Santa Rosa family physician, has published White Coat Wrinkle, a 342-page book subtitled “The patient power guide to getting the best care from every doctor, every visit.” Co-authored with corporate consultant Debra Skinner, the book gives patients a behind-the-scenes look at how doctors practice medicine and describes the many different ways doctors communicate with their patients. It includes case studies, anecdotes and personality tests, and is intended to help patients choose the right doctors for their particular needs.

book


HOSPITAL UPDATES


Based on results from a “return on investment calculator” devised by researchers at Harvard Medical School, the St. Joseph Mobile Health Clinic offers a return of $28 for every dollar invested in operations. The calculator is intended to measure the value of preventive services offered by mobile health programs throughout the United States. According to the device, the average return on investment is 20:1. Last year, the St. Joseph mobile clinic provided 3,734 office visits to more than 1,500 patients, with an emphasis on preventive and primary health care and education.

Palm Drive Hospital is considerably smaller than Kaiser Santa Rosa, but the two are the only local hospitals to be certified as Primary Stroke Centers. Palm Drive was certified by the American Osteopathic Association in late May after demonstrating that it exceeded national standards for the treatment of stroke patients. “This means the high quality of our stroke care has been certified by a national organization, something no other small hospital in Sonoma County has achieved,” said neurologist Allan Bernstein, MD, medical director of Palm Drive’s stroke center.

book


EVENTS


An all-day conference titled Connecting California to Improve Patient Care will be held at the Vineyard Creek Hyatt in Santa Rosa on Friday, July 9. Sponsored by Redwood MedNet, a local nonprofit health information exchange, the conference features presentations by more than a dozen regional and national experts on electronic health records, Recovery Act funding, and related topics. Cost before July 1 is $150. To register, visit redwoodmednet.org.

An hour-long CMA webinar on POLST Essentials will begin at 12:15 p.m. on Thursday, June 3. The online presentation will review the essential components of an effective Physician Order for Life Sustaining Treatment and discuss implementation of POLST in clinical practice. Other upcoming CMA webinars include:

·       “The Art of Training, Evaluating and Retaining Qualified Personnel for Today’s Medical Practice” (12:15 p.m., June 9)

·       “Medical Foundations, Accountable Care Organizations and the Bundling of Services” (6 p.m., June 9, and 12:15 p.m., June 15)

·       “Implementation of EHR: Practical Considerations” (12:15 p.m., June 22)

To register for CMA webinars, visit cmanet.org/calendar.

book


VOLUNTEERS NEEDED


Many patients have lost their medical insurance. The Jewish Community Free Clinic, free to all faiths, could use a little help. One volunteer shift every other month is not too little. Volunteers are needed for the family clinic on Monday and Thursday evenings from 5:30 to 8:30, and for the pediatrics clinic on Tuesday afternoons, 2:30 to 5. For questions, call Dr. Jerry Connell at 527-7754. To sign up for a shift, contact Deborah Roberts at deborah.roberts@sonoma.edu or 664-2945.

Physician volunteers are needed for Neighbors in Health, an annual event that provides a day of free health care for uninsured children and teenagers. This year’s event is scheduled for Sunday, Aug. 1, at Kaiser Permanente’s Stein Medical Campus, 3925 Old Redwood Highway, Santa Rosa. Doctors are needed in the pediatric clinic, teen clinic and immunization areas. Many shift options are available. To volunteer, visit www.unitedwaywinecountry.org/nih.

book


APPLICANTS


Bryn Duffy, MD, Internal Medicine, 401 Bicentennial Way, Santa Rosa 95403, 393-4187, Fax 393-4554, brynduffy@gmail.com, Texas Tech Univ 2006

Anthony Lim, MD, Family Medicine, 3320 Chanate Rd., Santa Rosa 95404, 547-2220, Fax 303-3318, anthlim@gmail.com, Boston Univ 2010

book


CLASSIFIEDS


Physician consultant needed
Physician Consultant needed in Ukiah 20 hours per week under contract to provide consultative and interpretive medical services related to assessments and program planning for individuals with developmental disabilities in Mendocino and Lake Counties. Responsibilities include: participate as a member of the agency’s eligibility team; provide medical consultation regarding requests for services; provide education for consumers, their supporters, agency staff and service providers; participate in various agency committees and processes; act as a liaison between the agency and the medical community; and assist with the development and advocacy of medical care for individuals with developmental disabilities in the community. There are no direct patient care responsibilities. Successful candidate will be able to perform as a team member; exercise sound clinical judgment; render timely and appropriate decisions; possess thorough follow-up skills; work independently with minimal supervision; and have excellent verbal and written communication skills. Experience in providing care for individuals with developmental disabilities, preferably in pediatrics, is desirable. Send cover letter and resume to Director of Clinical Services, 525 2nd Street, Suite 300, Eureka, CA 95501, or to pokey@redwoodcoastrc.org.

Reimbursement specialist
Get paid faster, save money. Claims processing, patient payment plan, help with Medicare compliance, coding. www.revenuerecoverynetwork.com.

Medical office space
Small suite available for reasonable rent. Three exam rooms, southeast Santa Rosa. Call Connie, 707-525-0211.

How to submit a classified ad
To submit a classified ad for SCMA News Briefs or Sonoma Medicine, contact Nan Perrott at nperrott@rhscommunications.com or 707-525-4226. The cost is one dollar per word.

book


ABOUT SCMA


The Sonoma County Medical Association, a 501(c)(6) nonprofit association, supports local physicians and their efforts to enhance the health of the community. Founded in 1858, SCMA is affiliated with the California Medical Association and the American Medical Association.

© SCMA 2010
3033 Cleveland Ave. #104
Santa Rosa, CA 95403

book


TO UNSUBSCRIBE


You are receiving SCMA News Briefs because you are a physician or an affiliated medical professional in Sonoma County. If you wish to unsubscribe, contact Steve Osborn at sosborn@scma.org or 707-525-4325.

book


May 2010


Still time to RSVP for May 20 Wine & Cheese Reception


All local physicians and their spouses or guests are invited to SCMA’s 10th annual Wine & Cheese Reception on Thursday evening, May 20, at the Landmark Winery in Kenwood. The event is utterly free for SCMA members and a mere $35 for nonmembers. To RSVP, contact Rachel Pandolfi at 525-4375 or rachel@scma.org.

The featured guest will be Dustin Corcoran, the new chief executive of the California Medical Association. Corcoran, who has worked for CMA since 1998, brings an outstanding record for skilled legislative advocacy to his new role as CEO. He will be available at the reception to answer members’ questions and discuss CMA activities.

The relaxed collegiality of the event is enhanced by a superb selection of fine wines, cheeses and hors d’oeuvres, as well as bocce ball for the athletically inclined.

book


Survey: Proposed Medicare cuts will likely decrease access to care


A survey of North Bay physicians conducted in early April revealed that Medicare fee-for-service patients will likely have more difficulty accessing care if a proposed 21% physician rate cut takes effect. Almost 90% of the doctors who responded to the survey said they would reduce the number of new Medicare FFS patients they accept or simply stop accepting them altogether, should the rate cut go into effect.

Thirty-two doctors in Sonoma, Marin, Mendocino and Lake counties responded to the impromptu survey, which was prepared by the Alameda-Contra Costa Medical Association and conducted throughout the Bay Area. Results for other Bay Area counties are still pending.

About 40% of the North Bay respondents were primary care physicians, and the rest were specialists. Most were in solo practice or small groups, and three-fourths had been providing care to Medicare FFS patients for more than 10 years. On average, 43% of the patients in the respondents’ practices were enrolled in the Medicare FFS program.

In addition to reducing the number of new Medicare FFS patients, about one-fourth of the respondents said the rate cut would also reduce their time for treating existing Medicare FFS patients. Another fourth said the cut would reduce the number of existing Medicare FFS patients they treat, and an additional 13% said they would stop treating existing Medicare FFS patients altogether.

The survey results will be used in the ongoing debate about repealing the Medicare SGR formula, the source of the proposed rate cuts. After the cuts nearly took effect in April, Congress delayed enactment until June 1. CMA and other physician groups plan to lobby Congress heavily during May in an effort to repeal the SGR formula once and for all.

book


SCMA sending out health reform survey and iWalk prescription pads in May


SCMA will be sending out two items of interest to local doctors during May.

The first item to be sent is a brief e-mail survey about health care reform. The survey will gauge physician attitudes toward recent reform legislation and solicit comments on other proposed reforms. The results will be published in the Summer issue of Sonoma Medicine. All local physicians are encouraged to complete and return the survey, which should take only a few minutes.

The second item to be sent is an iWalk prescription pad. This 4x5 pad allows physicians to prescribe patients a brisk 30-minute walk five times a week for general well-being. The pad lists a range of options, from “walk on my lunch breaks” to “join an iWalk group in my town.” Each SCMA member will receive one pad. A “4-up” PDF version of the pad is available at scma.org/resources. This version can be printed and trimmed to create additional pads.

The iWalk program is part of a concerted effort by Health Action to improve community health in Sonoma County. For more details, visit iwalksonoma.org

book


Cast your vote in the annual SCMA election by May 31


As a member of SCMA, you are entitled to vote for SCMA officers and board representatives, and for local representatives to the CMA House of Delegates.

To vote, print out the ballot below, then sign and fax to 525-4328 by May 31.

SCMA President-Elect - vote for one

Jeff Sugarman, MD, dermatology

___ Yes         ___ No

SCMA Board of Directors - vote for two

Jan Sonander, MD, family medicine

___ Yes         ___ No

Peter Sybert, MD, anesthesiology

___ Yes         ___ No

CMA Delegation - vote for five

Dan Lightfoot, MD, ophthalmology

___ Yes         ___ No

Don Van Giesen, MD, urology

___ Yes         ___ No

Clinton Lane, MD, internal medicine

___ Yes         ___ No

Katherine McNally, MD, family medicine

___ Yes         ___ No

Richard Powers, MD, family medicine

___ Yes         ___ No

 

_________________________________

Signature (required)

book


CMA withdraws from Blue Shield doctor rating scheme


CMA has withdrawn from a Blue Shield-led initiative to rate doctor performances because the insurer intends to move forward with publishing its ratings on June 1 despite flaws in data collection that result in gross inaccuracies.

“Publishing erroneous information will only serve to confuse patients, increase costs and unjustly destroy the reputations of many fine doctors,” said Dr. Brennan Cassidy, president of CMA. “We are happy to stand on the merits of our work, as long as it is assessed accurately and fairly, but this initiative is far, far short of achieving that goal.”

CMA worked for two years on the California Physician Performance Initiative (CCPI) with other stakeholders but pulled out in mid-April when Blue Shield indicated that it planned to ignore doctors’ input and publish rating data before fixing flaws in performance assessment.

In a letter informing CPPI of its withdrawal, CMA said major problems include:

Confusion for patients, who may be unduly concerned if their physicians do not get a high rating or may be tempted to select a new doctor who has a high rating. Because the ratings will not be an accurate assessment of doctors’ performances, they may cause confusion and anxiety for patients.

More costs for payers and patients. To receive high ratings, physicians will have to compensate for flaws in the reporting system, meaning some may have to order tests or procedures that have already been done but are not captured in claims data.

Lack of adjustments for major factors affecting the patient. For instance, physicians who don’t order cervical cancer screening tests for their patients, even if the patients have already had hysterectomies, would get a lower rating. 

Lack of relevant data collection. The ratings only capture patient data for physicians contracting with the insurer; none of the out-of-network care is reflected. For instance, if a patient sees an out-of-network OB-GYN for a pap smear and fails to inform her primary care physician, the PCP would be penalized because there would be no pap smear claims data submitted to the health plan.

No consideration of the patient’s role. The ratings do not take patient refusal of treatment into account.

“We have worked in good faith with Blue Shield of California and the California Physician Performance Initiative,” Cassidy said. “Unfortunately, the initiative’s governing board, which is dominated by insurers, has chosen to ignore physicians’ grave concerns about this inaccurate rating system. Blue Shield’s ratings are defective and Blue Shield is exercising poor judgment to publish them.”

Talking points about the CPPI initiative have been posted at www.scma.org/resources.

book


New physician signage regulations take effect June 27


California physicians will soon be required to inform patients that they are licensed by the Medical Board of California, and to provide patients with contact information for the MBC.

Despite CMA objections, the Office of Administrative Law recently approved signage regulations for informing patients about how to contact the MBC for information or complaints about California physicians. CMA believes these regulations are an unnecessary administrative burden because state law already requires physicians to post their medical license or wear a name tag indicating their licensing status.

The new regulations, which take effect June 27, require physicians to provide the MBC notice by one of three methods:

Prominently posting a sign in an area of their offices that is conspicuous to patients, in at least 48-point type in Arial font.

Including the notice in a written statement, signed and dated by the patient or patient’s representative, and kept in that patient’s file, stating the patient understands the physician is licensed and regulated by the MBC.

Including the notice in a statement on letterhead, discharge instructions, or other document given to a patient or the patient’s representative; the notice must be placed immediately above the patient’s signature line in at least 14-point type.

Regardless of which method you choose, the notice must read as follows: NOTICE TO CONSUMERS: Medical doctors are licensed and regulated by the Medical Board of California, (800) 633-2322, www.mbc.ca.gov.

According to the MBC, physicians, not facilities, are responsible for compliance with this regulation. In group settings, only one sign must be posted (should that option be chosen), but it must be posted in a location where it can be seen by all patients.

A sample MBC sign is available at www.scma.org/resources. For more information, visit www.mbc.ca.gov.

book


LEGAL NOTES


By SCMA Legal Counsel Larry McLaughlin

My legal firm receives many calls from physician offices about releasing the medical records of deceased patients and minor children. Regulations governing the release of such records are found in the “patient access” law (Health & Safety Code 123100 et seq).

Records of a deceased patient may be released to the “beneficiary” or “personal representative” of the deceased. A beneficiary is one who is entitled to the deceased’s property by being an heir, or by being named in a will or trust. A personal representative is an executor or administrator of an estate. Many patients die without any testamentary documents, so medical office staff should use common sense in determining whether records can be released to a particular person. For example, when the deceased’s spouse is well known to staff, they can generally assume that the spouse is an heir, and therefore a beneficiary, of the deceased.

With some exceptions, records of a minor child may be released to a parent or guardian. The exceptions occur when a minor legally consents to treatment, such as contraception or prenatal care. In such cases, release of medical records to a parent or guardian must be refused. Please contact our office when faced with such a situation.

A parent can be “natural” (biological) or adoptive. Grandparents, aunts, uncles and other relatives of a minor child are not the child’s parents and are therefore not entitled to see the child’s medical records. When parents are divorced, both are still entitled to see or copy their children’s medical records.

A guardian is generally appointed by court order. If staff has any doubts about a guardian’s status, they should ask to see the court order and take other reasonable precautions.

SCMA physicians and staff who have questions about releasing medical records or any other legal topics can contact me at 579-4523 or lwmclaughlin@juno.com.

book


PHYSICIANS IN THE NEWS


Dr. Edward Chang, an otolaryngologist at Kaiser Santa Rosa, has been appointed to the Continuing Medical Education Steering Committee at the Institute for Medical Quality. The IMQ, on behalf of CMA, accredits California-based hospitals and other health care organizations to offer AMA Category 1 credits for continuing medical education.

SCMA President-Elect Dr. Catherine Gutfreund is quoted at length in “Thanks, Doc,” a recent syndicated editorial about Doctor’s Day. The editorial, which appeared in the Sonoma West Times, the Healdsburg Tribune and the Windsor Times, offers a concise overview of medical practice in Sonoma County and recognizes the many contributions of local physicians.

The Annadel Medical Group, an affiliate of the St. Joseph Health System, has added four primary care physicians and a neurosurgeon to its expanding roster of physicians. Longtime Santa Rosa family physician Dr. James DeVore has joined the group, along with newly arrived internists Dr. Marlon DeCastro and Dr. Noel Serrano. A third internist, Dr. Eki Abrams, will join the group in August, after completing her residency. The neurosurgeon, also a recent arrival, is Dr. Bryan Pereira.

Dr. Ronald Chapman, the health officer for Solano County, will become the chief medical officer for Partnership HealthPlan on June 1, replacing Dr. Chris Cammisa. Partnership provides managed Medi-Cal services to several North Bay counties, including Sonoma, where the regional medical director will continue to be Dr. Marshall Kubota.

Dr. Charles Elboim, a breast surgeon and medical director of the Redwood Regional Breast Center in Santa Rosa, has been appointed as a surveyor of breast care practices throughout Sonoma County by the National Accreditation Program for Breast Centers. Elboim will work on a survey team for the NAPBC, which accredits breast care centers based on quality indicators and other factors.

Dr. Roger Pitzen, a longtime family and emergency medicine physician in Sebastopol, has received the Kaiser/UCSF Award for Excellence in Teaching. Pitzen was nominated for the award by his students at UCSF, where he serves as an associate clinical professor.

book


HOSPITAL UPDATES


Because of provisions in the new health reform legislation, Sutter Medical Center of Santa Rosa has nixed plans for building a physician-owned medical center next to its proposed hospital near the Wells Fargo Center. The new legislation prohibits the type of physician ownership model Sutter was proposing for the facility, which would have been a 28-bed acute care hospital emphasizing invasive cardiology and outpatient surgery. Sutter is now exploring other options and doesn’t expect the change in plans to affect the timetable for replacing its aging hospital on Chanate Road.

Regardless of its age, the Chanate Road hospital continues to receive awards for its quality of care. Medicare recently ranked the facility in the top 10% of U.S. hospitals in six of 10 critical measures, and the California Hospital Assessment and Report Taskforce (CHART) gave the hospital a “certificate of excellence” for its quality of care, patient experience, and safety measures.

Palm Drive Hospital plans to exit bankruptcy and improve its facilities by selling $10 million in bonds. The bonds, to be marketed by a securities firm in San Francisco, are expected to generate the revenue needed to repay $2.2 million owed to creditors, as well as a $3 million bridge loan from the county. The remainder will be used to renovate the hospital’s physical plant. Announcement of the hospital’s plans was made by Neil Todhunter, who continues to be the hospital’s interim CEO. His scheduled replacement, Richard Robinson, unexpectedly declined the job in early April, so the CEO search has resumed.

book


EVENTS


Easter Seals Northern California is sponsoring an all-day Physician Symposium on Saturday, May 15, at the Petaluma Community Center. The topic is developmental and behavioral screening in primary care. Presenters include Dr. Barbara Bennett, a professor of pediatrics at UCSF, and Dr. Maria Pilar Bernal, chief of autism spectrum disorder services at Kaiser Permanente. The symposium offers 5.75 hours of CME. To register, visit noca.easterseals.com or contact Cindy Fasano at 415-382-7450 or cfasano@noca.easterseals.com.

The SCMA Alliance needs volunteers to direct traffic and ensure safety during its annual Garden Tour on Friday, May 14. The event, to be held in Windsor, raises funds for the Santa Rosa Community Health Centers and the Windsor Alliance Medical Center. Interested volunteers should contact Nancy Sumida at 537-7728 or nsumida7@gmail.com.

Physician volunteers are needed for Neighbors in Health, an annual event that provides a day of free health care for uninsured children and teenagers. This year’s event is scheduled for Sunday, Aug. 1, at Kaiser Permanente’s Stein Medical Campus, 3925 Old Redwood Highway, Santa Rosa. Doctors are needed in the pediatric clinic, teen clinic and immunization areas. Many shift options are available. To volunteer, visit www.unitedwaywinecountry.org/nih.

book


RESOURCES


The May issue of CMA Practice Resources, a free monthly e-mail bulletin, is available at www.cmanet.org/news/cpr. The new bulletin includes articles on reporting unfair payment practices, knowing your rights for timely payments, and other tips and tools for improving practice efficiency and viability.

The American Lung Association is asking physicians to sign a petition supporting advanced clean cars in California. The proposal is intended to improve air quality and reduce petroleum consumption. For the petition and more information, visit Medical Professionals Pledge Support for Clean Air on the ALA website.

book


APPLICANTS


Marshall Kubota, MD, Family Medicine*, 415 Humboldt St., Santa Rosa 95404, 419-7904, Fax 545-2313, mkkubota@aol.com, St. Louis Univ 1979

Bryan Pereira, MD, Neurological Surgery*, 500 Doyle Park Dr. #303, Santa Rosa 95405, 303-8340, Fax 303-8341, bryanmpereira@live.com, St. John’s Med Coll 1976

Noel Serrano, MD, Internal Medicine*, 500 Doyle Park Dr. #303, Santa Rosa 95405, 303-8300, Fax 303-8301, oluty1974@gmail.com, Univ Santo Tomas 1999

* board certified

book


CLASSIFIEDS


Physician consultant needed
Physician Consultant needed in Ukiah 20 hours per week under contract to provide consultative and interpretive medical services related to assessments and program planning for individuals with developmental disabilities in Mendocino and Lake Counties. Responsibilities include: participate as a member of the agency’s eligibility team; provide medical consultation regarding requests for services; provide education for consumers, their supporters, agency staff and service providers; participate in various agency committees and processes; act as a liaison between the agency and the medical community; and assist with the development and advocacy of medical care for individuals with developmental disabilities in the community. There are no direct patient care responsibilities. Successful candidate will be able to perform as a team member; exercise sound clinical judgment; render timely and appropriate decisions; possess thorough follow-up skills; work independently with minimal supervision; and have excellent verbal and written communication skills. Experience in providing care for individuals with developmental disabilities, preferably in pediatrics, is desirable. Send cover letter and resume to Director of Clinical Services, 525 2nd Street, Suite 300, Eureka, CA 95501, or to pokey@redwoodcoastrc.org.

Locum tenens physician available
Family practice, occ med, urgent care. Part/full-time. Fluent in Spanish. 415-601-7858.

Reimbursement specialist
Get paid faster, save money. Claims processing, patient payment plan, help with Medicare compliance, coding. www.revenuerecoverynetwork.com.

Medical office space
Small suite available for reasonable rent. Three exam rooms, southeast Santa Rosa. Call Connie, 707-525-0211.

How to submit a classified ad
To submit a classified ad for SCMA News Briefs or Sonoma Medicine, contact Nan Perrott at nperrott@rhscommunications.com or 707-525-4226. The cost is one dollar per word.

book


ABOUT SCMA


The Sonoma County Medical Association, a 501(c)(6) nonprofit association, supports local physicians and their efforts to enhance the health of the community. Founded in 1858, SCMA is affiliated with the California Medical Association and the American Medical Association.

© SCMA 2010
3033 Cleveland Ave. #104
Santa Rosa, CA 95403

book


TO UNSUBSCRIBE


You are receiving SCMA News Briefs because you are a physician or an affiliated medical professional in Sonoma County. If you wish to unsubscribe, contact Steve Osborn at sosborn@scma.org or 707-525-4325.

book


April 2010


Survey on Impact of Medicare Cuts


In cooperation with other Bay Area medical societies, SCMA is conducting the following survey about the potential impact of the pending 21.3% cut in fees to physicians in the Medicare fee-for-service (FFS) program (excludes Medicare HMOs). The Medicare FFS payment formula—known as the Medicare Sustainable Growth Rate (SGR)—triggers recurring cuts and has kept payment rates unchanged or lower since 2001. To help educate the public about the impact of Medicare cuts, we would appreciate your completion of this survey by April 14.

To complete the survey, print this e-mail, mark your answers, and fax back to SCMA at 525-4328. You may also respond by e-mail to scma@scma.org. Questions may be directed to SCMA at 525-4375. Thank you.

1.         Primary Medical Specialty: ___________________________________

2.         Practice Size:
         □ Solo/Small Group (1-4 physicians)
         □ Medium Group (5-150)
         □ Large Group (151-1000)

3.         Practice Setting:
         □ Office-Based
         □ Hospital-Based
         □ Other _______________________

4.         How many years have you been in the Medicare FFS Program?
         □ 2 years or less
         □ 2 to 10 years
         □ More than 10 years
         □ I do not participate because of:
         □ poor reimbursement
         □ not applicable to specialty/practice
         □ other: _____________________________

5.         Approximate percentage of your patients in the Medicare FFS program? ______

6.         Approximate percentage change (if any) in the number of Medicare FFS patients since 2001 (year of last substantive Medicare pay increase): _______

7.         The 21.3% pay cut will affect my Medicare FFS patients as follows (check all that apply):

         □ Will not reduce the # of existing patients I treat
         □ Will reduce time for treating existing patients
         □ Will reduce the # of existing patients I treat
         □ Will stop treating all existing patients
         □ Will not reduce the # of new patients I accept
         □ Will reduce the # of new patients I accept
         □ Will stop accepting new patients

8.         Congress’ failure to stop future pay cuts will affect my Medicare FFS patients as follows (check all that apply):

         □ Will not reduce the # of existing patients I treat
         □ Will reduce time for treating existing patients
         □ Will reduce the # of existing patients I treat
         □ Will stop treating all existing patients
         □ Will not reduce the # of new patients I accept
         □ Will reduce the # of new patients I accept
         □ Will stop accepting new patients

9.         I am willing to help make the public aware of the impact of Medicare’s payment policies (via press conferences, interviews with news reporters, etc.)
         □ Yes    No   (if yes, please complete below)

Name (optional):                   ___________________________________

Contact number (option



Your Ad Here! Call (707) 525-0102