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January 2011


Survey: 20% of county’s primary care doctors plan to retire by 2015


One in five local primary care physicians plans to retire during the next five years, according to a comprehensive survey released on Jan. 10 by the Sonoma County Department of Health Services. “Even as demand for primary care increases with the growth and aging of our population,” said Public Health Officer Mary Maddux-González, MD, “many primary care physicians are approaching retirement and fewer medical students—the next generation of physicians—are entering primary care.”

 

The survey, which had a 100% response rate from local primary care physicians, was conducted during the summer and fall of 2010. Cosponsors included Health Action, the Redwood Community Health Coalition and SCMA. An article about the survey appears in the current issue of Sonoma Medicine, available at www.scma.org/magazine. The complete report can be found at www.sonoma-county.org/health/ph/data.

 

The survey measured both physician and practice characteristics. Among the key findings:

 

• Of the 1,071 physicians in Sonoma County, 46% are primary care physicians (PCPs)—a much higher percentage than the rest of California, where only 34% of physicians are PCPs.

 

• About two-thirds of local PCPs are family physicians. The rest are general internists, pediatricians and geriatricians.

 

• Almost half the local PCPs (47%) are female, again a much higher percentage than the rest of California.

 

• Almost half the local PCPs (45%) are older than 55.

 

• Only 4% of local physicians are Latino, but Latinos comprise nearly one-fourth of the local population and 42% of its births.

 

• More than two-thirds of local PCPs (68%) work in large or very large practices, such as Kaiser, Sutter and community health centers. Ten percent work in medium-sized practices, and 22% are in solo or small practices.

 

• More than three-fourths of local PCPs (76%) use electronic health records.

 

Survey results have already been submitted to the federal government, which will use them to identify any Health Professional Shortage Areas in the county. Results will also be used to assess local primary care capacity.




Public Health Update: flu vaccines, new pertussis law


By Deputy Public Health Officer Mark Netherda, MD

 

Although influenza activity has been low in Sonoma County and nationally so far this flu season, reported cases have increased in the past several weeks. Flu season in Northern California typically peaks during January and February, so more cases are anticipated in the coming weeks. Clinicians are encouraged to keep vaccinating throughout the flu season—it is never too late to vaccinate.

 

Handy CDC references regarding testing, treatment and prevention of influenza during the 2010-11 flu season are listed below.

 

• Guidance for clinicians on the use of rapid influenza diagnostic tests.
www.cdc.gov/flu/professionals/diagnosis/clinician_guidance_ridt.htm

 

• Antiviral drugs for seasonal flu.
www.cdc.gov/flu/about/qa/antiviral.htm

 

• Interim guidance on the use of influenza antiviral agents.
www.cdc.gov/flu/professionals/antivirals/guidance/

 

• Influenza antiviral drug resistance.
www.cdc.gov/flu/about/qa/antiviralresistance.htm

 

• Seasonal flu vaccine safety and pregnant women.
www.cdc.gov/flu/protect/vaccine/qa_vacpregnant.htm

 

• Updated recommendations for obstetric health care providers.
www.cdc.gov/flu/professionals/antivirals/avrec_ob2011.htm

 

Under a new law (AB 354), California middle and high school students must be vaccinated against pertussis. Beginning July 1, all students entering 7th through 12th grades in both public and private schools will be required to show proof of receiving a Tdap booster vaccination before starting school.

 

Many families are unaware of this new law and will need to be encouraged by their clinicians to get their children vaccinated ahead of the July 1 deadline. No vaccine shortage is anticipated, but physicians and parents are urged to vaccinate ASAP to avoid a potential backlog of children needing immunizations.

 

 “With more than 7,800 confirmed cases and the deaths of 10 infants [in 2010], California experienced its worst outbreak of Pertussis in more than 50 years," said California Department of Public Health Director Dr. Mark Horton. "Protecting the health of California’s youth is one of our most urgent priorities. This new legislation will help us achieve our goal.”

 

For more information, visit www.cdph.ca.gov/programs/immunize/Documents/EarlyAlertToProviders-AB354.pdf.




Wanted: 100 iWALK employers


Physicians are always telling patients to get more exercise, but what about their own staff? Now doctors can walk the talk by becoming iWALK employers and promoting a culture of fitness in the workplace.

 

Any doctor’s office in Sonoma County can sign up for iWALK by visiting www.iwalksonoma.org/iWALKEmployer. The goal is for employees to get at least 150 minutes of walking or other exercise per week. Employers can organize weekly walking groups or sign up for the iWALK Challenge, a 90-day effort that culminates in the Human Race on May 7. More details are available at www.iwalksonoma.org.

 

iWALK, which is cosponsored by SCMA, is the exercise initiative within Health Action, a coordinated effort to combat obesity and other health problems in Sonoma County.




Office of Administrative Law rejects regulations for discount health plans


The Office of Administrative Law (OAL) has rejected regulations that would have legitimized “discount health plan” referral services. CMA vigorously fought these regulations, and has opposed a number of legislative attempts to legitimize these illegal referral services.

 

The Department of Managed Health Care proposed the regulations in February 2010, but OAL sided with CMA, ruling that the regulations are inconsistent with an opinion issued by the California Attorney General that concluded discount health plans are illegal.

 

Discount health plans charge patients a monthly membership fee in exchange for a list of physicians whose services they can supposedly access at a discounted rate. The promised discounts are often illusory, and the physicians are often listed without their consent or knowledge.




Gov. Brown's proposed budget would cut health and human services


Gov. Jerry Brown’s 2011-12 budget proposal includes major cuts to health care, in an attempt to close a projected $25.4 billion shortfall. The proposal would close the deficit through a mix of spending cuts, revenue increases, and other solutions (such as taking money from special funds). The spending cuts total $12.5 billion, with $1.7 billion slashed from Medi-Cal alone.

 

Of particular interest to physicians are proposals to:

 

• Cut Medi-cal provider rates by 10% ($720 million)

 

• Control Medi-Cal utilization ($217 million)

 

• Impose Medi-Cal copayments ($557 million)

 

• Contain costs in the Healthy Families program ($39 million)

 

Medi-Cal currently covers 7.7 million Californians and is expected to add up to 2 million more after full implementation of federal health reform.

 

Even at current rates, most physicians lose money treating Medi-Cal patients. As a result, it is nearly impossible to find physicians accepting new Medi-Cal patients in certain specialties. When Medi-Cal patients can’t find a doctor, many will end up in the emergency room, the most costly and least efficient venue for receiving treatment.

 

“With California's Medi-Cal rates already among the lowest in the nation, California's health care safety net cannot sustain these drastic cuts,” said CMA President Dr. James Hinsdale. “CMA will continue to fight for physicians and work to preserve access to care for California's low-income populations.”




PEOPLE


A front-page profile of former SCMA president Dr. Leonard Klay in the Jan. 3 Press Democrat described the many accomplishments of his long career, including delivering more than 7,000 babies, serving as a plaintiff in the successful RICO lawsuit against health insurers, and winning the 2010 Plessner Award from CMA. The full text of the article is available at www.pressdemocrat.com.

 

Orthopedic surgeons Dr. Briant Smith and Dr. Steven Smith have joined the Redwood Regional Medical Group. Dr. Briant Smith, who used to practice at Kaiser Santa Rosa, specializes in joint replacement. Dr. Steven Smith, formerly in private practice, specializes in adult reconstructive surgery.




RESOURCES


A presentation on the XMRV retrovirus and its relationship to cancer will begin at  7 p.m. on Monday, Jan. 17, at Santa Rosa Memorial Hospital, conference room B. The event is free but is only open to licensed medical professionals. RSVPs are required and should be directed to Susan Friedl at 396-5835 or susan@gordonmedical.com. The presenter is Judy Mikovits, PhD, a cell biologist.

 

A free one-hour webinar on embezzlement will be held on Wednesday, Feb. 2, at 12:15 p.m. and 6 p.m. This CMA webinar is for physicians only; no staff members will be approved for participation. Presenter Debra Phairas, president of Practice & Liability Consultants, will discuss measures doctors can take to prevent embezzlement, which is estimated to affect one in six physicians at some point in their careers. To register, visit www.cmanet.org/calendar.

 

Nonprofit health organizations in Sonoma County are encouraged to apply for Community Grants from the Pacific Foundation for Medical Care. The grants, generally in the $10,000 range, are awarded twice a year by the nonprofit foundation to support local projects that enhance health services. The application deadline for the next round of grants is April 2. For application materials, contact Kathy Pass at 525-4281 or kpass@rhs.org. For more information, visit www.pfmc.org.

 

A four-day course on difficult headache patients will be held in Rancho Mirage on President’s Day Weekend, Feb. 18-21. The course is sponsored by the Diamond Headache Clinic and includes 20.5 hours of Category 1 credit. To register, visit www.dhc-fdn.org.

 

A one-day seminar on pediatric orthopedics will take place at the Shriners Hospital in Sacramento on Saturday, March 5. The course, valid for 5 hours of Category 1 credit, includes presentations by several noted orthopedic surgeons. To register, contact 916-453-2041 or ncal.education@shrinenet.org.

 

The latest issue of CMA Practice Resources includes articles on EOB disclosures, timely access regulations and Blue Cross contract amendments. For a free subscription, visit www.cmanet.org/news/cpr.

 

The OMSS Advocate is a quarterly newsletter for members of the CMA Organized Medical Staff Section. To read the current issue, visit www.cmanet.org/news.




APPLICANTS


George Bisbee, MD, Internal Medicine*, 500 Doyle Park Dr. #G04, Santa Rosa 95405, 303-8344, Fax 303-8345, Univ Iowa 1970

 

Catherine Davis, MD, Internal Medicine*, 500 Doyle Park Dr. #303, Santa Rosa 95405, 303-8300, Fax 303-8301, UC Los Angeles 1989

 

Hong Luo, MD, Anatomic & Clinical Pathology*, Gyn Pathology, PO Box 1676, Sebastopol 95473, 829-5883, Fax 829-5895, Tianjin Med Univ 1988

 

Robert Schaefer, MD, Internal Medicine*, 500 Doyle Park Dr. #G03, Santa Rosa 95405, 303-8344, Fax 303-8345, Pritzer Univ 1969

 

Seema Shah, MD, Obstetrics & Gynecology, 500 Doyle Park Dr. #103, Santa Rosa 95403, 579-1102, Fax 579-1386, Jefferson Med Coll 2002

 

David Sisler, MD, Family Medicine*, 24 W. El Rose Dr., Petaluma 94952, 763-9891, Fax 762-2311, Univ Minnesota

 

Paul Umino, MD, Family Medicine, 24 W. El Rose Dr., Petaluma 94952  , 763-9891, Fax 762-2311, Creighton Univ 1970




CLASSIFIEDS


Office Space

Small suite for lease. Reception, 3 rooms, Summerfield Rd., Santa Rosa. Contact 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 erika@scma.org or 707-548-6491. The cost is one dollar per word.




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 2011
2901 Cleveland Ave. #202
Santa Rosa, CA 95403




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