June 2010

• Primary care survey could improve local Medicare reimbursements
• House passes Medicare fix; all eyes on Senate
• SCMA Health Reform Survey results being compiled
• Public Health issues pertussis, rabies alerts
• Dr. Jeff Sugarman confirmed as SCMA president-elect
• Resolutions for CMA House of Delegates needed by June 26
• Reminder: New physician signage regulations take effect June 27
• FTC delays Red Flag Rule until end of year
• Get to know new CEO of CMA
• LEGAL NOTES
• PHYSICIANS IN THE NEWS
• HOSPITAL UPDATES
• EVENTS
• VOLUNTEERS NEEDED
• APPLICANTS
• CLASSIFIEDS
• ABOUT SCMA
• TO UNSUBSCRIBE

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.

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.

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.

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/.

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.

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.

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.

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.”

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.

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.

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.

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.

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.

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.

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

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.

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

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.

May 2010

• Still time to RSVP for May 20 Wine & Cheese Reception
• Survey: Proposed Medicare cuts will likely decrease access to care
• SCMA sending out health reform survey and iWalk prescription pads in May
• Cast your vote in the annual SCMA election by May 31
• CMA withdraws from Blue Shield doctor rating scheme
• New physician signage regulations take effect June 27
• LEGAL NOTES
• PHYSICIANS IN THE NEWS
• HOSPITAL UPDATES
• EVENTS
• RESOURCES
• APPLICANTS
• CLASSIFIEDS
• ABOUT SCMA
• TO UNSUBSCRIBE

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.

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.

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. 

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)

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.

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.

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.

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.

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.

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.

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.

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

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.

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

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.

April 2010

• Survey on Impact of Medicare Cuts

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

April 2010

• Medicare rate cuts still pending, despite passage of health reform
• Details about health care reform posted on SCMA website
• County HIV, STD and family planning clinics to close
• New CMA leader to attend SCMA reception on May 20
• Dr. Jeff Sugarman nominated as SCMA president-elect
• Sonoma Medicine is finalist for major award
• RSVPs needed for April 27 Legislative Day in Sacramento
• State expands scope of practice for nonphysicians
• CMA offers free subscriptions to practice-management newsletter
• LEGAL NOTES
• DOCTORS IN THE NEWS
• HOSPITAL UPDATES
• EVENTS
• OBITUARIES
• APPLICANTS
• CLASSIFIEDS
• ABOUT SCMA
• TO UNSUBSCRIBE

Medicare rate cuts still pending, despite passage of health reform

The clock keeps ticking on Medicare rate reductions. Lost in the discussions over passage of health reform legislation is the fact that physicians are scheduled to get a 21% Medicare rate reduction by mid-April if Congress fails to act. The rate reductions, mandated by the sustainable growth rate (SGR) formula, were originally scheduled to take effect March 1. Congress postponed that deadline to April 1, and now Medicare has effectively extended the deadline another two weeks by asking carriers not to process claims with April service dates for 10 business days.

The net effect of these delays is that Congress will have to act immediately upon its return from recess on April 12. While both the House and Senate are expected to postpone the SGR cuts once again, the big question is whether they will do away with the SGR formula for good. The House did vote to repeal the SGR formula last fall, but the Senate has so far failed to act.

CMA and AMA are calling on all physicians and patients to help repeal the SGR formula once and for all. Please contact Sen. Dianne Feinstein, Sen. Barbara Boxer and your local House Representative and deliver a simple message: It’s time to repeal the SGR formula. As noted by AMA President Dr. James Rohack, “Congress’ failure to act on permanent repeal of the broken Medicare physician payment formula has put access to health care for seniors and military families in jeopardy.”

When contacting your representatives, give your name, specialty and practice location. Then tell your representative to stop the 21% cut and repeal the SGR formula once and for all. Contact information for your representatives appears below.

·       Sen. Feinstein - Click Here or use the AMA’s grassroots hotline at 800-833-6354.

·       Sen. Boxer - Click Here or use the AMA’s grassroots hotline at 800-833-6354.

·       House Representative - Click Here or use AMA’s grassroots hotline at 800-833-6354.

Please direct any feedback or questions from your representative to SCMA’s executive director, Cynthia Melody, at cynthia@scma.org or 525-4375.

CMA has also prepared a flyer that you can use to get patients involved in the fight to protect Medicare. The flyer is available at scma.org/resources.

Details about health care reform posted on SCMA website

Two detailed CMA documents about health care reform have been posted on the SCMA website at scma.org/resources. The first, “Pros and cons of health care reform,” provides an overview of the benefits and shortcomings of the recently signed legislation. The second, “What CMA did for physicians in health care reform,” describes CMA’s many successful efforts to advocate on behalf of physicians and patients.

County HIV, STD and family planning clinics to close

Patients who receive HIV, STD and family planning services from county clinics will soon have to seek care elsewhere. On March 30, the Sonoma County Board of Supervisors approved a Department of Health Services plan to eliminate those clinics, thereby saving about $1 million per year. The department’s revenues have declined by $27 million since 2007 and are expected to decline an additional $9.8 million during the 2010-11 fiscal year.

In a March 31 memo to local providers, Public Health Officer Dr. Mary Maddux-González noted that the clinics were originally established at a time when few providers were offering services for HIV and STD. With the subsequent growth of community health clinics, need for the county’s disease-focused clinics has diminished. As stated in Maddux’s memo, “Public Health will cease providing these clinical services given the increase in local primary care infrastructure where patients can be linked to a medical home with the full array of prevention-focused primary care services for their health care needs.”

The STD and family planning clinics, which serve about 60 patients per week, will close on April 2. The HIV clinic, which serves 550 patients, will close on June 30. Because of the complexities of county employment, projected layoffs amount to 20.17 full-time equivalents at most, including 1.3 FTE of physician time.

New CMA leader to attend SCMA reception on May 20

Dustin Corcoran, the new chief executive of the California Medical Association, will be the featured guest at the SCMA wine & cheese reception on Thursday evening, May 20. This annual event, to be held this year at Landmark Vineyards in Kenwood, offers a unique opportunity to gather with your colleagues in an informal setting. A variety of fine wines, cheeses and hors d’oeuvres will be served.

Corcoran, who has worked for CMA since 1998, became the association’s head lobbyist in 2004, serving as the main spokesperson for organized medicine in the state Legislature. He brings an outstanding track record for skilled advocacy to his new role as CEO. He will be available at the reception to answer members’ questions and discuss CMA activities.

The reception is free for SCMA members and their spouse or guest. The cost for nonmember physicians is $35. To RSVP, contact Rachel Pandolfi at 525-4375 or rachel@scma.org.

Dr. Jeff Sugarman nominated as SCMA president-elect

Dr. Jeff Sugarman, a Santa Rosa dermatologist, has been nominated as president-elect of SCMA. He will be joined on the SCMA election ballot by two nominees for the board of directors, Drs. Jan Sonander and Peter Sybert, and five nominees for the CMA delegation: Drs. Dan Lightfoot, Don Van Giesen, Clinton Lane, Katherine McNally and Richard Powers.

SCMA members will vote on the nominees in May. For more information, contact Cynthia Melody at cynthia@scma.org or 525-4375.

Sonoma Medicine is finalist for major award

Sonoma Medicine is a finalist for the annual Maggie awards presented by the Western Publishing Association, a nonprofit group devoted to publications in the western United States. The annual Maggie competition draws entries from throughout the West, including major magazines from Los Angeles and San Francisco. Sonoma Medicine is one of five finalists in the “quarterlies” category. The awards will be announced on May 7.

The Spring issue of Sonoma Medicine, to be mailed to all SCMA members in early April, focuses on breathing, with articles by local experts on nicotine addiction, asthma, sleep apnea, nasal congestion and breathing exercises. Other articles examine antibiotics, dental surgery, medical care in Afghanistan, legal excess, and the family medicine residency.

Each SCMA member receives one free subscription to Sonoma Medicine. Nonmembers can subscribe for just $19.80 per year by completing the subscription form at scma.org/magazine. Article proposals are welcome at any time and should be submitted to the editor, Steve Osborn, at sosborn@scma.org.

RSVPs needed for April 27 Legislative Day in Sacramento

Local physicians interested in attending CMA’s free Legislative Leadership Conference in Sacramento on April 27 should RSVP by April 2. SCMA will be renting a van to travel to Sacramento, so reservations are requested.

The annual conference, which last year drew more than 400 physicians and CMA Alliance members, allows doctors to meet with legislators and express their views on pending health legislation. Appointments for SCMA members have been arranged with Assemblymembers Noreen Evans and Jared Huffman and with Sen. Mark Leno and an aide to Sen. Pat Wiggins.

The conference also includes a morning session featuring speakers from across the political spectrum. This year’s presenters include Assembly Speaker John Perez, Speaker Emeritus Robert Herzberg, CMA President Dr. J. Brennan Cassidy, and CMA’s new chief executive, Dustin Corcoran.

To RSVP, contact Rachel Pandolfi at 525-4375 or rachel@scma.org.

State expands scope of practice for nonphysicians

Despite continued opposition from CMA, the California Office of Administrative Law has removed requirements that physicians be involved in critical health care activities in hospitals, such as patient admissions, medical examinations and patient transfers. Instead, new regulations will allow these activities to be performed by a “licensed health care provider acting within the scope of his or her licensure.”

The regulations also allow each facility to decide who can do what under a welter of competing advice from 30 licensing boards. CMA believes differing practices among facilities will cause confusion, thus endangering patients and inviting expensive and unnecessary lawsuits.

Portions of the regulations that would have weakened medical staff self-governance and mandated that clinical psychologists be granted medical staff membership in private hospitals were removed because of opposition from CMA and the Psychiatric Association.

CMA remains concerned about the impact of these regulations on patient care and is exploring all appropriate avenues to seek relief. The regulations take effect on April 2.

CMA offers free subscriptions to practice-management newsletter

CMA is offering free subscriptions to a new monthly publication, “CMA Practice Resources.” The first issue, to be published later this month, is filled with tips and tools to help physicians and their office staff improve practice efficiency and viability. Physicians, office managers, administrators and billing staff can subscribe by visiting www.cmanet.org/news/cpr. 

LEGAL NOTES

By SCMA Legal Counsel Larry McLaughlin

A medical office manager called me recently to say that one of their patient’s attorneys had accused her of breaking the law.

The patient was the plaintiff in an injury lawsuit, and the office manager had received a subpoena for records from the defense attorney in Los Angeles, with the date for compliance prominently displayed. Reasoning that it would take a while for mail to reach L.A., the office manager mailed the records early.

The patient’s attorney subsequently called the office manager to say that he objected to the records being released and planned on going to court to oppose the release. It was too late, however, because the office manager had already mailed the records. That was when the unhappy attorney accused her of breaking the law.

Errors in complying with subpoenas are actually a fairly common occurrence. Subpoenas are often confusing, and I advise physicians and staff receiving them to call me for advice. In this case the subpoena had the standard warning under the compliance date: “Do not release the requested records prior to the date and time stated above.” This warning language is often missed.

Sometimes when the requesting attorney uses a copy service to receive the records, the service will call the physician's office to demand an early release. Physicians and staff, however, should be aware that the law prohibits early release of records unless specifically waived by the patient. In the case described above, the office manager should have called the defense attorney’s office to ascertain how they planned to receive the records.

There are many other rules pertaining to subpoenas. SCMA physicians and staff are encouraged to contact me whenever you receive a subpoena, so I can walk you through the process. I can be reached at 707-579-4523 or lwmclaughlin@juno.com.

DOCTORS IN THE NEWS

SCMA President Dr. Richard Powers has received the “Sonoma Family Physician of the Year” award from the California Academy of Family Physicians.

“Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth,” a book published last year by Santa Rosa pediatrician Dr. Mark Sloan, is one of five finalists in the “creative nonfiction” category for the 2010 Northern California Book Awards. Other finalists in that category include books by well-known Bay Area authors Michael Chabon and Dave Eggers. The awards will be announced April 18 at the San Francisco Public Library.

St. Joseph Health System honored 17 SCMA physicians as “top docs,” based on post-discharge patient survey results from 2009. The honorees for Petaluma Valley Hospital were Drs. James Leoni, Jonathan Choe, Mark Northfield and Stephen Steady. For Santa Rosa Memorial Hospital, the honorees were Drs. Kent Yinger, James Steele, Douglas Green, Thomas Degenhardt, Michael Grafe, Larry Marianella, Mark Schakel, Jon-Michael Castelli, Mark Homicz, Masis Babajanian, Douglas Jicha, Robert James and Patrick Coleman.

HOSPITAL UPDATES

Palm Drive Hospital has hired Richard Robinson as its new CEO. A native of Modesto, Robinson was most recently CEO of Women’s & Children’s Hospital, an 84-bed facility in Louisiana. Although Robinson serves at the will of the Palm Drive Health Care District Board, he is actually an employee of Brim Healthcare, a nationwide management and consulting firm that has helped Palm Drive emerge from bankruptcy. The hospital is expected to be profitable this year.

Santa Rosa Memorial Hospital has renewed its Level II Trauma Center designation with Sonoma County. The renewal will last at least until 2018, with an option to extend the designation to 2022. Since receiving the designation in 2000, the trauma center has treated an average of 1,450 patients per year with serious or life-threatening injuries. “Memorial Hospital has consistently maintained the highest level of service,” said Sonoma County DHS Director Rita Scardacci. “This designation continues to make trauma care available to our community and the region.”

St. Joseph Health System has opened North County Hospice, a new hospice facility in Healdsburg. The medical director is Dr. Gary Johanson, a palliative medicine specialist in Sonoma County for the past three decades. The site is St. Joseph’s third hospice facility in the county, along with Memorial Hospice and Hospice of Petaluma.

EVENTS

A free weekly support group for patients with chronic illness will begin at Palm Drive Hospital on April 6. The meetings, which run from 2 to 3:30 p.m., will be facilitated by David Murphy, PhD, a psychologist specializing in management of chronic conditions. No advance registration is necessary. For more details, contact Dr. Murphy at 566-7026.

The Institute for Medical Quality is offering a one-day training program for new medical staff leaders in Irvine on Tuesday, April 13. The program, which costs $405 for CMA members and $445 for nonmembers, features sessions on the role of medical staff leaders, how to run effective meetings, and tips for staying accredited and licensed. To register, visit www.imq.org or call Leslie Iacopi at 415-882-5167.

Dr. Allan Bernstein will present a free lecture, “New Research on Memory Disorders,” at 2 p.m. on April 23 at Primrose, 2080 Guerneville Rd., Santa Rosa. Bernstein, former chief of neurology at Kaiser Santa Rosa, is an internationally known researcher and educator. Reservations for his lecture are required because of limited space. To reserve a spot, call 578-8360.

The Garden Tour, an annual fund-raiser sponsored by the SCMA Alliance and Foundation, will be held in Windsor on May 14 and 15. Six local families will open their private gardens for self-guided tours. Two homes will also be open for viewing. Funds raised by the tour will be donated to the Santa Rosa Community Health Centers and the Windsor branch of the Alliance Medical Center. Tickets are $40, and lunches will be available for purchase at the Windsor Golf Course. Raffle tickets for local restaurants will be sold as well. To purchase tickets, visit www.scmaa.org or call Janet Shane at 578-4537.

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.

OBITUARIES

Dr. Gertrude Van Steyn, a pioneering woman physician who practiced in Santa Rosa from 1939 to 1981, died in March at the age of 95. Born in Holland, she grew up on a farm in Sebastopol and rode horseback to high school in Santa Rosa. She attended UC Berkeley and received her DO from the College of Osteopathic Physicians and Surgeons in Los Angeles.

After completing an internship at Los Angeles County Hospital, Van Steyn joined Dr. Caroline Weber in Santa Rosa, at a time when women physicians were quite rare. In an interview published in Sonoma Medicine in 1993, Van Steyn noted that some doctors at that time “had very strong feelings against both a woman and an osteopath.” As an example, she described an appendix case she had at the old General Hospital in Santa Rosa where she was not allowed to assist on her own patient.

In the 1940s, Van Steyn established her own practice, eventually building an office on Cherry Street in 1954. She practiced solo there until 1979, when she was joined by Dr. Gary Greensweig. She was famous around town for working long hours and not taking appointments. In the Sonoma Medicine interview, she noted, “When I’d get there in the morning, there would be a big line-up, and we’d take them in turn. Nobody griped or objected. They were taken in turn, whether they were poor or rich.”

After retiring in 1981, Van Steyn tended to her 14-acre property south of Santa Rosa. She raised sheep, horses and other livestock, and she fed many wild animals as well. She also traveled extensively. “I’m interested in the historical pioneer trails of the Western settlers,” she said in the interview. “I have followed many of them.”

APPLICANTS

Veronica Jordan, MD, Family Medicine, 3320 Chanate Rd., Santa Rosa 95404, 547-2220, Fax 303-3318, UC San Francisco 2007

Gian Nhan, MD, Anesthesiology*, Pain Medicine, 1739 Fourth St., Santa Rosa 95404, 528-6331, Fax 538-2154, Loma Linda Univ 1994

Renee Theisen, MD, Emergency Medicine*, 401 Bicentennial Way, Santa Rosa 95403, 393-4800, Fax 393-4741, Univ Michigan 2005

* board certified

CLASSIFIEDS

Medical billing/reimbursement specialist
Out-source, save money. Coding, RAC review, EHR, credentialing services. www.revenuerecoverynetwork.com

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

Office to share in Novato
165 Rowland Way #303. Medical office to share with urologist. 2100 sq ft. Three exam rooms. One small conference room. Rent completely negotiable dependent on level of service use and overhead. Contact Dr. Peter Bretan, 415-892-0904 or bretanp@msn.com.

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.

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

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.