lifeline - cdn.ymaws.com...Yatin Riat Evan Rusoja MD Nicholas J Saade MD Ari D Shaeffer Jack Storey...

lifelinea forum for emergency physicians in california

SEPTEMBER 2016

Page 8

How Patient Satisfaction Scores Fuel the Opioid Epidemic

4 PRESIDENT’S MESSAGE

6 ADVOCACY UPDATE

8 GUEST ARTICLE

10 GUEST ARTICLE 16 ANNOUNCEMENTS

17 UPCOMING MEETINGS & DEADLINES

18 CAREER OPPORTUNITIES

6

California ACEP Board of Directors & Lifeline Editors Roster2015-16 Board of DirectorsMarc Futernick, MD, FACEP, President Lawrence Stock, MD, FACEP, President-ElectAimee Moulin, MD, FACEP, Vice PresidentChi Perlroth, MD, FACEP, Treasurer Vikant Gulati, MD, SecretaryMichael Osmundson, MD, MBA, FACEP, Immediate Past PresidentJohn O. Anis, MD, FACEPRodney Borger, MD, FACEP, At-LargeKevin Jones, DOStephen Liu, MD, FACEPJohn Ludlow, MD, MBACameron McClure, MD, FACEPValerie Norton, MD, FACEPMark Notash, MD, FACEPMaria Raven, MD, MPH, FACEP Vivian Reyes, MD, FACEPEric Snyder, MD, FACEPSybil Zachariah, MD, CAL/EMRA President

Advocacy FellowshipAimee Moulin, MD, FACEP, DirectorJohn Coburn, MD, Advocacy FellowNicolas T. Sawyer, MD, MBA, Advocacy Fellow

Lifeline Medical EditorRichard Obler, MD, FACEP, Medical Editor

Lifeline Staff EditorsElena Lopez-Gusman, Executive DirectorRyan P. Adame, MPA, CAE, Deputy Executive DirectorKelsey McQuaid, MPA, Government Affairs AssociateTyler Jimenez, Program Associate Lucia Romo, Education Coordinator

SEPTEMBER 2016 Index of AdvertisersAnaheim Regional Medical Center Page 18

Burbank Emergency Medical Group Page 18

Emergency Groups’ Office (EGO) Page 7

Emergency Medicine in Yosemite Conference Page 14

Emergency Medical Management Associates (EMMA) Page 7

Emergency Medical Society of Orange County (EMSOC) Page 18

Kaiser Permanente Page 18

MMC Emergency Physicians Medical Group Page 18

Napa Valley Emergency Medical Group Page 18

Ohio ACEP Emergency Medicine Board Review Page 13

Oral Board Exam Prep Page 12

Philip J. Fagan, MD Page 18

Pinnacle Emergency Physicians Page 18

South Coast Emergency Medical Group Page 18

St. Jude Medical Center Page 18

Tri-City Emergency Medical Group Page 18

10

SECURED FOR EMERGENCY CARE!

$500 MILLION

Invitation to Join Physicians

for Fair Coverage Coalition

TABLE OF CONTENTS |

Central Coast Emergency Physicians

Emergent Medical Associates

Emergency Medicine Specialists of Orange County

Front Line Emergency Care Specialists

Loma Linda Emergency Physicians

Napa Valley Emergency Medical Group

Newport Emergency Medical Group, Inc at Hoag Hospital

Pacific Emergency Providers, APC

Tri-City Emergency Medical Group

University of California, Irvine Medical Center Emergency Physicians

Peter Anastopoulos MD

Lukas R Austin-Page MD

Matthew Baluzy MD

Brett Barro MD

Elias Bench MD

Greg Bowlin MD

Richard Bracken MD

William J Bruno

Fernando Carlo MD

Carrie Chandwani

Allen Chang MD

James Chiang

Matthew Correia MD

Nicole D’Arcy

Rosemarie Diaz

Robert C Dixon

Ryan C Dollbaum

Steve Duleh MD

Emily C Earl-Royal MD

Jamie Everett MD

Kelsey Ford MD

Shawn Wanbli Franklin

Michael Ghermezi

Paula Gonella MD

William Goodson MD

Zachary Haberman MD

Molly R Hartrich MD

Mac Henry MD

Andrew J Herzik MD

Rodger L Hurst

David A Kim MD

Casey M Krebs MD

Andrew C Lai MD

Brendan Leach

Brandon K Lee

Brett Lee MD

Matthew A Levin

David A Martin

Jerome J Martin

Mariana Martinez MD

James T Marvel MD

Patrick B Murphy

Sean Nardi

Anna Nguyen

Kent Okawa MD

Edwin Peck MD

Michael Perez MD

Freyr Petursson, Resident

Lisa Remington

Yatin Riat

Evan Rusoja MD

Nicholas J Saade MD

Ari D Shaeffer

Jack Storey MD

Jean H Suh MD

Maria A Tobar

Daniel L Ward

Christopher Winstead-Derlega MD

Elaine Yang MD

WELCOME new members!

100% GROUPS

SEPTEMBER 2016 | 3

By Larry Stock,MD, FACEP

PRESIDENT’S MESSAGE |

Dear California ACEP Member,

I am honored to serve as the new president of our organization, to carry the torch forward for the next year. Challenging times like these require leadership, good communication, and an engaged organization so that together we can accomplish things that as individuals we cannot. Working as a team, your board of directors and your incredibly skilled and effective staff will continue to focus on the key issues of the day. We will work to ensure others see us as we see ourselves and understand the value of emergency medicine. We will work for fairness for our physicians so that we can practice in ways that benefit our patients. The care that our ED team delivers, every minute of every day, to all that seek our help, is that “faint glimmer of civilization”. As the leaders of emergency medicine in California, I thank you for what you do and for trusting me to serve this year as your organization’s leader.

I hope to see you all at AdvancED 2016, our annual assembly, September 20th, in Orange County at the Hyatt Regency.

Larry StockLarry Stock, MD, FACEP

-M. Gustave to Zero, the Lobby Boy, in the 2014 movie The Grand Budapest Hotel

You see, there are still faint

glimmers of civilization left in this

barbaric slaughterhouse that was

once known as humanity.

4 | LIFELINE a forum for emergency physicians in california

2016-17BOARD OF

DIRECTORSPRESIDENT

Lawrence Stock, MD, FACEPPRESIDENT-ELECT

Aimee Moulin, MD, FACEPVICE PRESIDENT

Chi Perlroth, MD, FACEPTREASURER

Vikant Gulati, MD, FACEPSECRETARY

Vivian Reyes, MD, FACEPIMMEDIATE PAST PRESIDENT

Marc Futernick, MD, FACEP

John O. Anis, MD, FACEPRodney Borger, MD, FACEP

John Coburn, MDCarrieann Drenten, MD

Kevin Jones, DOJohn Ludlow, MD, MBA

Sujal Mandavia, MD, FACEP (At Large)Valerie Norton, MD, FACEP

Maria Raven, MD, MPH, FACEPNicholas Sawyer, MD

James C. Tse, DO (CAL/EMRA)Lori Winston, MD, FACEP

Installed September 19, 2016

SEPTEMBER 2016 | 5

SECURED FOR EMERGENCY CARE!

ADVOCACY UPDATE |

In 2006, SB 1773 was signed into law to raise approximately $50 million per year to augment local Maddy Funds at the county level. That law was reauthorized in 2013 and was scheduled to disappear on January 1, 2017.

In anticipation of the expiring law, California ACEP introduced SB 867 by Sen. Richard Roth (D - Riverside), which extends the Maddy Fund for another decade in order to allow counties, hospitals, and physicians to continue providing emergency services in their communities with these desperately needed funds. The bill also renewed Richie’s Fund, which is the only statewide funding source for pediatric trauma.

This year’s battle was lining itself up to be even more challenging than ever. Not only is Governor Jerry Brown opposed to penalty assessments, but the Legislature had been exploring ways to eliminate penalty assessments during the 2015 legislative session.

Governor Brown has made clear his dislike for penalty fee assessments to pay for programs that he feels should be paid for by taxpayers generally, not just those who pay traffic fines, though he has also expressed support for the goals of the programs themselves – including emergency care funding.

The Legislature’s dislike for penalty assessments became evident during the 2015 session when it requested a study be conducted by the Legislative Analyst’s Office to review the effectiveness of the

various programs funded by these fines. Additionally, the Assembly Appropriations Committee added language about exploring alternatives to fee assessments into a bill to augment emergency medical air transportation reimbursement payments made through the Medi-Cal program.

This year, 50 organizations, including health care organizations, children’s advocacy groups, and local governments across the state, supported the Maddy Fund renewal and California ACEP is grateful for their support. We are pleased we were able to make the case to the Legislature and the Governor that the Maddy Fund is a beneficial program that must be preserved.

California ACEP’s advocacy staff worked overtime to get SB 867 in the best possible position for approval. After multiple meetings with the Governor’s policy staff, Governor Brown signed SB 867 on August 19, 2016! While we are accustomed to victories, this was no small feat.

Thanks to California ACEP’s efforts, an estimated $500 million will flow to the Maddy Fund and the pediatric trauma fund to help you provide important safety net services to the patients in your communities.

If you have any questions about the Maddy Fund or California ACEP’s legislative efforts, please contact by email at [email protected] or by calling the Chapter office at (916) 325- 5455. n

Emergency physicians in California can celebrate a major legislative victory this year! Despite being set to expire, the Maddy Emergency Medical Services Fund (Maddy Fund) was reauthorized for ten more years!

By Elena Lopez-Gusman & Kelsey McQuaid, MPA

$500 MILLION


• Excellent Opportunities for Emergency Physicians

• Very Competitive Compensation

• Hospitals include Arcadia Methodist & Glendale Memorial (Top heart programs).

• Available practice settings in the Greater Los Angeles area.

Contact Debbie Corn for more information(909) 634-3172 or email CV to [email protected]

Southern CaliforniaJOB OPPORTUNITIES

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CON TAC TAndrea Brault M.D., MMM, FACEP(877)346-2211, ext. 278 | [email protected] Via Verde Suite 100 | San Dimas, California 91773

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GUEST ARTICLE

THE BACKSTORY

Here is the story behind the announcement. I, along with several leaders in the prescription drug abuse epidemic, have been advocating for this for the past 4 years. We said that patient satisfaction scores are a barrier to safe prescribing. How can you tell a patient, “No, I can’t give you more pain medication,” when you realize they are going to complain, take it to administration, report you to the medical board, give you bad Yelp reviews, and give you bad patient satisfaction scores. It is much easier to say ‘Yes’ than to say ‘No’. CMS is currently using these scores for hospitals but next in line are emergency physicians, followed by the rest of the medical community.

How Patient Satisfaction Scores Fuel the Opioid Epidemic (Lev)Doctors are caught between a rock (prescribing appropriately) and

a hard place (patient satisfaction scores) when it comes to denying

patients prescriptions for drugs they really want—especially opioids

CMS recently announced that they will remove questions related to pain from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), commonly known as the patient satisfaction

survey. This means that hospitals can continue to use the questions to survey patients about their inpatient

pain management experience, but these questions would not affect the level of payment hospitals receive. This is a big victory for patients and the house of medicine.


For the past 4 years, I have talked about the problem with the satisfaction scores. Some of the stories that explain the problem include a hospital CEO who threatened an emergency medicine group that if they don’t improve their patient satisfaction scores, their contract would be in jeopardy and their jobs on the line. They were not told to prescribe more drugs, they were told, “get your scores up, I don’t care how.” A medical director of a primary care group, who is very proud of their high scores, admitted that they follow safe prescribing guidelines but some physicians don’t, and explain that patient satisfaction is a higher priority. A survey of medical directors at 20 different hospitals stated that most agreed that patient satisfaction scores are a barrier to saying no to patients who were demanding drugs.

My own experience is of a patient who threatened to get me fired for not refilling his pain medications from the emergency department. He said he got other doctors fired and he vowed to do the same to me. Sure enough, he sent a letter claiming unprofessionalism, rude behavior, and “I’ve never been treated this way before.” My reply was I would rather have a patient blackmail me, threaten me, and give me bad patient satisfaction scores than have a dead patient. Was the hospital going to promote patient satisfaction scores over compassionate safe prescribing?

THE TYRANNY OF BAD DATA

The issue of satisfaction scores is an emotional subject for many physicians. When I speak about it at conferences, there is outrage how something so unscientific can be used against them. Such data would never be allowed in any medical journal but is used to grade our performance and given the highest importance.

In January of this year, CMS held a webinar to address this concern. They specifically stated that, “HCAHPS is designed and validated only for INTER hospital comparison, not comparison of wards, staff, etc. HCAHPS questions are not tailored for individual physicians, nurses, or other staff. CMS strongly opposes use of the HCAHPS Survey to identify individual providers.” But when hospital administrators

were shown this information, they said the webinar is not going to change anything. When $2 million a year is at stake due to HCAHPS scores, physicians will continue to get individual scores on a regular basis. How else can they improve the scores?

ADVOCACY MATTERS

I am very proud of our advocacy efforts. I was told that CMS would never change. Measuring the patient experience is part of the Affordable Care Act. The ACA requires measuring the patient experience, although there is no mandate to link money to the scores. The AMA, CMA, and ACEP stated that this battle has been lost. But people were dying, and government needed to do their share in fighting the epidemic.

I spoke to the director of the National Drug Control Policy of Senator Diane Feinstein’s office, Director Michael Botticelli, and leaders at CDC. I wrote resolutions that were passed by CMA and ACEP to oppose financial incentives on satisfaction scores that were not evidence-based. And most importantly, I gained support of the parent community that is behind the fight of the opioid epidemic.

The parents who have lost sons and daughters to prescription drugs are similar to the Mothers Against Drug Driving. They have a strong voice. They were outraged that a doctors pay can be linked to how happy their patients are. They would much rather have their son or daughter angry at the doctor for denying a prescription and be alive today.

We are fighting an epidemic where we need to change medical culture. Seventy-eight Americans die every day from an accidental opioid overdose. We need to undo the past 10 years of medical education where physicians were told they were undertreating pain and needed to prescribe more. It is very hard to RE-educate. It is even harder if there is money involved that can push the wrong decision.

Being a physician is more like being a parent rather than customer service at Nordstrom’s. Sometimes the best parent is the one who

says no and is strict rather than being permissive. Can you imagine giving your teenagers apparent satisfaction scores after you discipline them for being caught drinking alcohol or something else?

Thank you to all the advocates in the medical and parent community who helped make remove the satisfaction score barrier from safe prescribing.

ABOUT THE AUTHORRoneet Lev, MDhttp://iepc.org/

For 22 years, Dr. Roneet Lev has been (and still is) practicing as a full-time emergency physician at Scripps Mercy Hospital in San Diego. She also serves as the Director of Operations for the Emergency Department. She graduated from the University of Texas Medical school in San Antonio, and an emergency medicine residency program at UCSD. Dr. Lev served as President of the California Chapter of the American College of Emergency Physicians from 2000 to 2001, and is President of IEPC, Independent Emergency Physicians Consortium, an organization providing collaboration and services to over 30 independent emergency departments in California. In October 2012, she established the San Diego and Imperial County Prescription Drug Abuse Medical Task Force with the goal of reducing deaths and mortality from prescription drugs. Her vision is to unite the medical community in changing the culture of over prescribing. She uses data to drive change for improved prescribing habits. This includes comparison of medical examiner prescription related deaths and CURES reports. She is passionate about this subject and is willing to assist any county or medical practice who wants to work on Safe Prescribing and decrease prescription drug abuse. n

NOTE: This article is reprinted with permission from “The Doctor Weighs In” blog (thedoctorweighsin.com). The views and opinions in this article do not necessarily reflect those of California ACEP.

SEPTEMBER 2016 | 9

As a prominent provider of hospital-based physician services, you’re probably as frustrated as I with regard to how insurance companies and the lobbyists they’ve engaged have changed the playing field and ultimately the dialogue

with regard to the delivery of out-of-network physician services.

This has dramatically impacted market forces and public opinion by generally painting physicians in an unfavorable light in the eyes of the public with frequent claims of ‘egregious physician billing and charges’ with no mention of high deductible health plans, narrow networks or insurance company coverage gaps. This has resulted in

the passage of more than several onerous state balance billing laws,

the frequent and continued filing in state legislatures of bills which

place artificially low caps on out-of-network reimbursement, and

ultimately the failure of state and federal elected officials to recognize

the value and importance of the medical services we provide to our

patients and the communities we serve.

In response, a group of concerned hospital based physician groups

came together earlier this year to form the Physicians for Fair

Coverage Coalition (PFC).

Some of our members have asked us (me) about legislation in other states which seeks to ban bal-ance billing. While our advocacy efforts are dedicated to California, we are keenly aware that the discussions happening across the country about out-of-network charges and reimbursement have the potential to impact our members. As a result, we wanted to make you all aware of a nationwide coalition that is forming called Physicians for Fair Coverage. Below you will see an invitation to join the coalition which describes a little more about them, as well as contact information in the event you wish to reach out to them directly.

Invitation to Join Physicians for Fair Coverage Coalition

GUEST ARTICLE

By: Marc Futernick, MD, FACEP, President


ABOUT PFC

PFC is a cooperative effort of physician organizations operating in all 50 states. Our members are comprised of the largest emergency medicine and anesthesia practice management groups in the country. We are also seeking the participation of radiology hospital based groups and other coalitions and associations that support these needs. Our mission is to educate legislators, regulators, and the public on topics related to the fair reimbursement for physicians, specifically the complex issues of minimum benefit standards and billing for out-of-network services.

PFC OBJECTIVES

PFC’s primary objective is to educate members and committees of the state and federal government and relevant regulatory agencies on the issues affecting physician reimbursement and patient access to care. We have just been legally constituted and are applying for our non-profit status.

PFC plans a vigorous agenda for the next year. We anticipate addressing legislative and regulatory initiatives affecting some or all of the following issues, as well as others that may arise:

• Advocate for fair payment for medical services at all levels of state and federal government, by protecting access to high quality professional provider healthcare services and patient rights.

• Develop and Implement a proactive strategy to promote fair coverage of physician and provider services provided In and Out of Network.

• Monitor and respond to threats to fair coverage on the federal and state level, maintaining contact in all states affected by threats to fair reimbursement.

• Coordinate and mobilize, where possible and appropriate, with other groups and coalitions on a national and state basis in the pursuit of common goals and objectives.

• Develop strategies to address coercive contracting by health plans and hospitals.

• Drafting of fair model legislation.

We have contributed financially in proportion to our respective clinical activities, determined on the basis of specialty. All dues will go to supporting the mission of PFC.

WHY IS PFC IMPORTANT?

PFC will fill the gap nationwide in communicating important aspects of physician practice that the general public – including legislators

and regulators – lacks the experience to grasp on its own. Our concerted efforts by pooling financial, intellectual, and manpower resources, will allow us to reach a broader and more meaningful audience than any one practice, and specialty group could reach on its own.

PFC's goal is to maintain close ties and coordination of resources with relevant national trade and specialty associations (e.g., AMA, ACEP, ASA, EDPMA, etc.) as well as specialty societies and local coalitions on a state-by-state basis. Our goal is cooperative action and avoidance of duplication. Additionally, because many of our members are active through their groups on a regional and national level, we have a widespread perspective on physician reimbursement issues.

PFC Board is 100% volunteer. We will have paid staff and this will be a full time job for them. All the money your group contributes goes towards the goals set by the Board of Directors.

WHY SHOULD MY ORGANIZATION GET INVOLVED?

We need your help. The issues and threats grow bigger each year. We have lost the balanced billing fight in many states, and the health plans have become more sophisticated in their efforts. They are picking us off one state at a time. PFC is small enough to be nimble, but big enough to have influence. We need your group’s input and efforts. We need more financial support for lobbying. We need your physicians and staff to help with direct lobbying efforts. We need you.

HOW DOES MY ORGANIZATION BECOME A PFC MEMBER?

PFC has a very informal structure and no application process. If you are interested, please contact Iva Clement at the number at the bottom of the page. She can provide you with more details about getting your group involved. We charge dues based on clinical activity, the bigger your group the larger the dues, with caps on the upper end.

Meetings are generally scheduled around decisions to be made and are usually conference calls. Once or twice a year we meet in person for face-to-face discussions, usually with our lobbyists present.

Despite our small size and informal structure, we believe we will be very successful in pressing for our agenda. As physicians in state after state have lost the balanced billing “wars,” we all know we need to band together. WE NEED YOUR HELP. n

Please join us.For more information, please contact:

Iva Clement800-893-9598, X 1151

SEPTEMBER 2016 | 11

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OHIO ACEPEMERGENCY MEDICINE BOARD REVIEW COURSES



www.ohacep.org (614) 792-6506Approved for AMA PRA Category 1 Credits TM.

Ohio ACEP is excited to partner with

California ACEP

February 2017!

We Are.

COMPREHENSIVE.RELEVANT. ESSENTIAL.

OHIO ACEPEMERGENCY MEDICINE BOARD REVIEW COURSES



www.ohacep.org (614) 792-6506Approved for AMA PRA Category 1 Credits TM.

Ohio ACEP is excited to partner with

California ACEP

February 2017!

Wednesday, January 11th (Yosemite Valley Lodge Mountain Room Restaurant – formerly Yosemite Lodge Mountain Broiler) • 9:30 AM Brunch (Yosemite Valley Lodge Mountain Room Restaurant – formerly Yosemite Lodge Mountain Broiler):

Richard Stennes, M.D.: “My Travels Around the World—On and Off the Ship” Jerry Hoffman, M.D.: A Few Remarks from the ‘Skeptic.’

• 1:00 PM Ranger Guided Group Hike: Mirror Lake (Meet in The Majestic Yosemite Hotel Lobby – formerly Ahwahnee Lobby) • 5:30-6:30 PM Reception (Half Dome Village - formerly Curry Village): It’s A Party In Honor of Billy Mallon, M.D.

and A Number of the Elders of Emergency Medicine Martha Chessie: Basketry Shane Hendren: Navaho Metalsmith Kathleen O’Hara: Photography

• 6:30 PM Dinner (Half Dome Village - formerly Curry Village) • 7:00-7:15 PM Welcome and Introductions: (Half Dome Village - formerly Curry Village)

Ron Crowell, M.D. & Larry Stock, M.D., President of California Chapter • 7:15-8:00 PM Ryan McGarry, M.D.: “The Making of ‘Code Black,’ the TV production” • 8:00-9:30 PM Jeremey Kittel: American Fiddler, Violinist and Composer

2017 Emergency Medicine in Yosemite January 11 – 14, 2017

_________________________________________________________________________________________

Sponsored by Yosemite Medical Education Foundation (YMEF) Co-Sponsored by California ACEP

“This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Center for Emergency Medical Education (CEME)

and Yosemite Medical Education Foundation. The Center for Emergency Medical Education is accredited by the ACCME to provide continuing medical education for physicians.”

The Center for Emergency Medical Education designates this live activity for a maximum of 14.0 AMA PRA Category 1 Credits™.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CME

F A C U L T Y

Graham Billingham, M.D. – Thomas Lee, M.D. – Tommy Korn, M.D. – Tsuyoshi Mitarai, M.D. – David Schriger, M.D.

Paul Auerbach, M.D. – Ramin Tabatabai, M.D. – Christian Tomaszewski, M.D. – Dan Imler, M.D.

Thursday, January 12th (Yosemite Valley Lodge Garden Terrace – formerly Yosemite Lodge Garden Terrace) • 7:45-8:45 AM Paul Auerbach, M.D.: “Leadership and Where Emergency Medicine Should Lead” (1 Hour CME) • 8:45-9:45 AM Ramin Tabatabai, M.D.: “Managing the Unstable AFIB Patient” (1 Hour CME) • 9:45-10:15 AM BREAK: Visit Exhibitors & Sponsors (Yosemite Valley Lodge Mountain Room Restaurant

– formerly Yosemite Lodge Mountain Broiler) • 10:00 AM Spousal Program (Yosemite Valley Lodge Bar): Judith Crowell, M.D., Dermatologist:

Final Edition - “Part VII, How to Invest Intelligently in Your Ongoing Beauty” • 10:15-11:15 AM Christian Tomaszewski, M.D.: “Cardiac Toxins: Beyond ACLS” (1 Hour CME) • 11:15-12:15 PM Dan Imler, M.D.: “The Febrile Infant: Update 2017” (1 Hour CME) • 1:30 PM Ranger Guided Group Hike: Vernal Falls (Meet in Happy Isles parking lot) • 5:15 PM Wine and Cheese Reception (Majestic Solarium – formerly Ahwahnee Solarium):

Martha Chessie: Basketry Annie Hoffman: Artist

Jeremy Kittel: Fiddler • 5:45-6:45 PM Pepper Trail, Ph.D: "Voyage to The Origin of Species: Reminiscences of Charles Darwin (in Person)." • 6:45-7:00 PM Annie Hoffman: My Work • 7:00-7:30 PM Shane Hendrin, Navaho Metalsmith: “My Family’s 300 Years in the West”

Friday, January 13th (Yosemite Valley Lodge Garden Terrace – formerly Yosemite Lodge Garden Terrace) • 7:45-8:45 AM Graham Billingham M.D.: “ED Malpractice and Emerging Risk: Latest Update” (1 Hour CME) • 8:45-9:45 AM Dan Imler, M.D.: “What’s New with Pediatric Sedation” (1 Hour CME) • 9:45-10:15 AM BREAK: Visit Exhibitors & Sponsors (Yosemite Valley Lodge Mountain Room Restaurant

– formerly Yosemite Lodge Mountain Broiler) • 10:00 AM Spousal Program (Yosemite Lodge Bar): Martha Chessie: “An Introduction to Basket Weaving” • 10:15-11:15 AM Ramin Tabatabai M.D.: “Oncologic Emergencies” (1 Hour CME) • 11:15-12:15 AM Christian Tomaszewski, M.D.: “Diagnostic Errors: Strategies to Avoid” (1 Hour CME) • 1:00 PM Ranger Guided Group Hike: Yosemite Falls Trail (Meet in Trailhead parking lot) • 5:00 PM Wine and Cheese Reception (Majestic Solarium – formerly Ahwahnee Solarium):

Charles Cramer: Photographer Shane Hendren: Navaho Metalsmith

• 5:30-6:15 PM Paul Auerbach, M.D.: “Disaster Response: Preparing and Responding. From Mega-disasters to Your Home.” (1 Hour CME)

• 6:15-7:00 PM Stephen Ainlay, Ph.D., President, Union College: “A College President’s Perspective on the State of Higher Education in America: Where it is, Where it Needs To Go, and How Can We Afford to Get There?”

• 7:00-7:45 PM Thomas Lee, M.D.: “Health Access in Complex Emergencies: Burma;” Documentary: “The Black Zone” by Grace Baek (1 Hour CME)

Saturday, January 14th (Yosemite Valley Lodge Garden Terrace – formerly Yosemite Lodge Garden Terrace) • 7:30-8:30 AM Tommy Korn, M.D.: “Spooky Eye Emergencies Not to Miss! - 2017 Update & Review” (1 Hour CME) • 8:30-9:30 AM Tsuyoshi Mitarai, M.D.: “Ultrasound as a Stethoscope to Care for Critically Ill:

Its Clinical Applications” joint lecture with MyPhuong Mitarai, MD (1 Hour CME) • 9:30-9:45 AM BREAK • 9:45-10:45 AM David Schriger, M.D.: “The Emergent Shoulder, A Case Review” (1 Hour CME) • 10:45-11:45 PM David Schriger, M.D.: “Literature Review” – “Relationship between Global and 1st World EM

and How That Relates to the EP's Behavior and Self Worth” (1 Hour CME) • 12:00-1:15 PM Buffet Lunch: Onsite only (Yosemite Valley Lodge Garden Terrace – formerly Yosemite Lodge Garden Terrace) • 12:30-1:15 PM David Paradis, M.D.: “Emergency Physician Up Close and Personal: The Year I climbed

Shasta, Rainier and Denali”

OHIO ACEP EMERGENCY MEDICINE BOARD REVIEW

February 9-13, 2017, Irvine, CaliforniaRegister at www.ohacep.org *Approved for AMA PRA Category 1 Credits™

FREE ORAL BOARD EXAM PREP – EXAMINERS & EXAMINEES

Volunteer/Sign-up at: https://www.surveymonkey.com/r/YM8Z5ST

CALIFORNIA ACEP SPONSORED CONFERENCES

• ADVANCED, Orange County, CA Tuesday, September 20, 2016

The California Emergency Medicine Advocacy Fund (CEMAF) has transformed California ACEP’s advo-cacy efforts from primarily legislative to robust efforts in the legislative, regulatory, legal, and through the Emergency Medical Political Action Committee, political arenas. Few, if any, organization of our size can boast of an advocacy program like California ACEP’s; a program that has helped block Medi-Cal provider rate cuts, stop the $100 million raid on the Maddy EMS Fund, and fight for ED overcrowding solutions – and that’s just the last year! The efforts could not be sustained with-out the generous support from the groups listed below, some of whom have donated as much as $0.25 per chart to ensure that California ACEP can fight for emergency medi-cine. Thank you to our 2015-16 contributors (in al-phabetical order):

• Alvarado Emergency Medical Associates• Antelope Valley Emergency Medical Associates• Beach Emergency Medical Associates• Berkeley Emergency Medical Group • Centinela Freeman Emergency Medical Associates• CEP America• Chino Emergency Medical Associates• Coastline Emergency Physicians Medical Group• Culver City Emergency Medical Group• Eden Emergency Medical Group • EMP Management Group• Hollywood Presbyterian Emergency Medical

Associates• Mills Peninsula Emergency Medical Group• Montclair Emergency Medical Associates• Napa Valley Emergency Medical Group• Orange County Emergency Medical Associates• Pacific Coast Emergency Medical Associates• Pacific Emergency Providers• Pacifica Emergency Medical Associates• Riverside Emergency Physicians• San Dimas Emergency Medical Associates• San Francisco Emergency Medical Associates, Inc. • Sherman Oaks Emergency Medical Associates• South Coast Emergency Medical Group, Inc.• Tarzana Emergency Medical Associates• TeamHealth• Temecula Valley Emergency Physicians, Inc.• Tri-City Emergency Medical Group• US Acute Care Solutions• Valley Emergency Medical Associates• VEP Healthcare, Inc.• West Hills Emergency Medical Associates

CEMAFDonors ANNOUNCEMENTS |


For more information on upcoming meetings, please e-mail us at [email protected]; unless otherwise noted, all meetings are held via conference call.

| CALIFORNIA ACEP UPCOMING MEETINGS & DEADLINES

SEPTEMBER 2016

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OCTOBER 2016


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NOVEMBER 2016


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SEPTEMBER 2016

6th at 9am Reimbursement CommitteeConference Call

8th at 10am Government Affairs Committee (GAC)Conference Call

9th at 10am Practice Management CommitteeConference Call

19th at 10:30am Chapter Board of Directors MeetingOrange County, CA

20th ADVANCED 2016Orange County, CA

OCTOBER 2016

6th at 10am Council DelegationConference Call

7th at 10am Member Services CommitteeConference Call

14th - 15th ACEP CouncilLas Vegas, NV

16th - 19th ACEP 2016 Scientific Assembly Las Vegas, NV

NOVEMBER 2016

1st at 9am Reimbursement CommitteeConference Call

10th at 10am Government Affairs Committee (GAC)Conference Call

10th at 1pm Practice Management CommitteeConference Call

15th at 10am CAPP Board of Director’s MeetingSacramento, CA

17th at 10am Board of Directors MeetingSacramento, CA

24th - 25th Thanksgiving Holiday, Office Closed

SEPTEMBER 2016 | 17

CAREER OPPORTUNITIES |

To advertise with Lifeline and to take advantage of our circulation of over 3,000 readers, including Emergency Physicians, Groups, and Administrators throughout California who are eager to learn about what your business has to offer them, please contact us at [email protected] or give us a call at (916) 325-5455.

ANAHEIM, CALIFORNIA: Anaheim Regional Medical Center’s Democratic ED Physician group has immediate part time/full time positions available for BC /BE Emergency Physicians. We have a busy, high acuity department with 44,000 annual visits. Shifts are 9-10 hours long with night shift/holiday differential and double coverage during peak hours. We offer a competitive salary, paid malpractice and full partnership opportunities. Interested physicians E-mail your CV and references to [email protected], [email protected] or call us at 714-999-5112.

BAKERSFIELD, CALIFORNIA: Pinnacle Emergency Physicians (2007-present) with 3 local ED's (10h shifts) seeking FT/PT, BC/BE docs (all trauma goes to the County Hospital)

• Memorial Hospital: 80k/y, STEMI, Stroke & Burn Receiving Center, currently 24/7 Peds, PICU, OB and adult hospitalist services…Peds ED opening 4/2017

• Mercy Downtown: 37k/y, Stroke Receiving Center w/ adult hospitalist services• Mercy Southwest: 52k/y, Stroke Receiving Center w/ adult hospitalist services

Staffed by 40 FT/PT physicians and 40 FT/PT mid-levels. PT: $230/h, hotel provided.FT: 120h/mo, full profit sharing after 2 1/2y plus CME, health, retirement contribution, paid malpractice with no tail, quarterly bonus, sign on bonus, interest free loan for moving expenses. Income in top 5-10% nationwide. Low cost of living, white water rafting, mountain biking/hiking, 2h to DTN LA or central coast beaches, 4h to Mammoth, Las Vegas, San Francisco, San Diego. Contact: Les Burson, DO, Medical Director [email protected] 661-332-1064 or Dr. Kian Azimian, MD, Assistant Medical Director [email protected] 661-616-8930

BURBANK: Burbank Emergency Medical Group at Providence St.Joseph Medical Center for 43 years has PT/FT positions available. 64K visits,8&10 hr shifts with 54 hrs MD and 50 hrs PA/NP coverage.BC/BE only. Send CV or for more details: [email protected] or 818-848-0552

CENTRAL COAST: MMC Emergency Physicians Medical Group at Marian Regional Medical Center-Santa Maria-seeking a qualified BC/BE Emergency Physician to join a stable, independent, single hospital, democratic group. Partnership opportunity available in this well-supported ED with growing census of >80,000 visits/year. New hospital/new ED opened in 2012. Practice alongside experienced colleagues at a STEMI receiving center, a Level III Trauma Center and a certified Stroke Center that offers 24/7 in-house hospitalists, OB laborists and intensivists in addition to a NICU, peds hospitalists and FP residents. Live on the beautiful Central Coast, anywhere from San Luis Obispo to Santa Ynez/Solvang, with easy commutes to work and easy access to beaches/mountains/wine country along with all types of outdoor recreation. This is the job your residency director told you to find.For more details, contact David Ketelaar, MD at [email protected] Phone (805) 440-0837

DOWNTOWN LOS ANGELES: Emergency Physician needed. $350,000 + incentive per year, malpractice paid, half days, half nights. ABEM ABOEM with experience. Present core group average 23 yrs tenure. 36,000 annual visits, paramedic receiving (no peds) STEMI Stroke, physician coverage 36-40 hrs/day, NP & PA coverage 12-20 hrs/dayFAX CV to 213 482 0577 or call 213 482 0588 or [email protected]

FULLERTON, CALIFORNIA: Join our ED team in beautiful north OC at St Jude Med Ctr. Our 36 bed state of the art ED serves >60K pts/yr with 54 hrs MD, 44 hrs PA and 100% scribe coverage per day, 9 hr shifts. We have held this stable contract for >36 years, have excellent back-up, 24hr in house Critical Care, OB, neonatologist and hospitalists. We are a STEMI receiving center, “Advanced Comprehensive Stroke Center” and provide excellent compensation with night differential. Partnership track available. EM BC/BE mandatory. Send CV to [email protected]

NORTHERN CALIFORNIA, NAPA - Independent Medical Group is seeking qualified candidates to staff their minor emergency department. Candidates include: near retirement Emergency Physicians, Family Practice physicians, Urgent care Physicians or Emergency department Nurse Practitioners.If interested, forward C.V. to Tony Mottalei M.D. [email protected]

NORTHERN & CENTRAL CALIFORNIA: Kaiser Permanente is looking for excellent BE/BC Emergency Medicine physicians interested in full time or less than full time position with dynamic physician group throughout Northern and Central California.The Permanente Medical Group, Inc. offers:

• Competitive salary• Recruitment bonus• Mortgage loan program (approval required)• Comprehensive benefits package, including excellent retirement plans• Malpractice insurance coverage• Cutting-edge technology

TPMG, Inc. allows you to combine a medical practice of which you can be proud and a quality of life you deserve. To apply, send your curriculum vitae to Narlyn Villaruel at [email protected] or call (800) 777-4912. http://physiciancareers-ncal.kp.org

SAN DIEGO, CALIFORNIA: Coastal San Diego emergency department seeking qualified, board-certified/eligible emergency medicine physician to join our independent, democratic group. Location is by the beach in Northern San Diego with year round outdoor life and outstanding schools. Tri-City Medical Center Emergency Department is a dynamic, high-acuity department with an excellent specialty call-panel, PGY3&4 Emergency Medicine Residents, and advanced practice PA's. Practice is designed with quality of life in mind, including 8 hour shifts with overlap and extensive provider coverage. Salary potential reaches top 3% nationally. "A"- Rated malpractice insurance with tail coverage provided. Forward CV to Teresa Riesgo email: [email protected] phone: 760-439-1963

SANTA BARBARA, CALIFORNIA: SEEKING BC/BE EMERGENCY PHYSICIANS South Coast Emergency Medical Group, an independent physician group is seeking to hire BC/BE emergency physicians at our two hospitals in Santa Barbara. Santa Barbara Cottage Hospital is a 483 bed tertiary care hospital with 46,000 ED visits. Santa Barbara Cottage is a STEMI receiving center, a stroke center, level 2 trauma center and teaching hospital. Goleta Valley Cottage Hospital is a busy community hospital with a new state of the art medical facility and over 20,000 emergency department visits. We are looking for part-time, possibly full-time physician for both hospitals. Some weekend and overnight shifts are expected. We offer a minimum of double physician coverage at Santa Barbara, 12-16 hours of double coverage from an APP daily at Goleta and nearly 24/7 scribe coverage. Our malpractice coverage with tail is excellent and we offer the benefit of living in a beautiful beachside community with great schools, little traffic and year round sun. Over 90% of our EDMDs who have joined our group have chosen to stay because we have top caliber physicians and staff. If you are interested in this rare opportunity to live and work in an amazing place, please email your CV to Sylvia Kim, MD at [email protected].

SOUTHERN CALIFORNIA OPPORTUNITIES:• Tustin, CA - Orange County - 73-bed community hospital, 8-bed ER, paramedic receiving,

low volume. 10 x 24hr = $240,000/yr + incentive• East Los Angeles - 120-bed community hospital urgent care (non paramedic receiving)

volume 700/mo. Guarantee $100/hr.• Norwalk, CA - 60-bed hospital. 500-600 patient/mo. Paramedic receiving. $110/hr.

FAX CV to 213 482 0577 or call 213 482 0588 or email [email protected]

SOUTHERN CALIFORNIA – ORANGE COUNTY: Full time and part time independent contracting emergency physicians needed for high volume, high acuity practices. Chest Pain Center, Stroke Center, Pediatric Level II trauma center - large independent group with forty years of clinical excellence for two acute care facilities. Expanding group needs BC/BE emergency physicians and pediatric emergency physicians. Excellent compensation, malpractice paid, scribes, midlevel providers, 8 – 9 hour shifts, excellent call panel coverage.Email CV and references to [email protected], fax to 714-543-8914

American Medical Response (AMR)Ken Bradford, Operations841 Latour Court, Ste D, Napa, CA 94558-6259Phone: (707) 953-5795Email: [email protected]

A Work Safe Environment Steve Bristow, EMTP3140 Aldridge Way, El Dorado Hills, CA 95762Phone: (925) 708-5377Email: [email protected]: www.worksafeenvironment.com

EMS AcademyNancy Black, RN, Course Coordinator1170 Foster City Blvd #107, Foster City, CA 94404Phone: (866) 577-9197Fax: (650) 701-1968Email: [email protected]: www.caems-academy.com

Compliance TrainingJason Manning, EMS Course Coordinator3188 Verde Robles Drive, Camino, CA 95709Phone: (916) 429-5895 Fax: (916) 256-4301 Email: [email protected]

CSUS Prehospital Education ProgramDerek Parker, Program Director3000 State University Drive East, Napa Hall, Sacramento, CA 95819-6103Office: (916) 278-4846 Mobile: (916) 316-7388 Email: [email protected]: www.cce.csus.edu

ETS – Emergency Training ServicesMike Thomas, Course Coordinator3050 Paul Sweet Road, Santa Cruz, CA 95065Phone: (831) 476-8813 Toll-Free: (800) 700-8444 Fax: (831) 477-4914 Email: [email protected]: www.emergencytraining.com

Looking for an ITLS course?

Please call 916.325.5455 or E-mail Lucia Romo: [email protected] for more information.EMREF is a proud sponsor of California ITLS courses.

Fast Response School of Health Care EducationrotceriD cidemaraP ,NR/PCIM ,ffonbuD asiL

2075 Allston Way, Berkeley, CA 94704Phone: (510) 809-3646Fax; (866) 628-5876Email: [email protected]: www.fastresponse.org

Loma Linda University Medical Center tnatsissA evitartsinimdA ,senoJ enyL

Department of Emergency Medicine11234 Anderson St., A108, Loma Linda, CA 92354Phone: (909) 558-4344 x 0 Fax: (909) 558-0102 Email: [email protected]: www.llu.edu

Medic AmbulanceJames Pierson, EMT-P506 Couch Street, Vallejo, CA 94590-2408 Phone: (707) 644-1761 Fax: (707) 644-1784Email: [email protected]: www.medicambulance.net

Napa Valley CollegeGregory Rose, EMS Co-Director2277 Napa Highway, Napa CA 94558Phone: (707) 256-4596Email: [email protected] Web: www.winecountrycpr.com

NCTI – National College of Technical InstructionLena Rohrabaugh, Course Manager333 Sunrise Ave Suite 500, Roseville, CA 95661Phone: (916) 960-6284 x 105 Fax: (916) 960-6296Email: [email protected] Web: www.ncti-online.com

Oakland Fire DepartmentSheehan Gillis, EMT-P, EMS Coordinator 47 Clay Street, Oakland, CA 74607Phone: (510) 238-6957Fax: (510) 238-6959 Email: [email protected]: http://www.oaklandnet.com/fire/

PHI Air Medical, CaliforniaGraham Pierce, Course Coordinator 801 D Airport Way, Modesto, CA 95354Phone: (209) 550-0884 Fax: (209) 550-0885Email: [email protected] Web: http://www.phiairmedical.com/

Riggs Ambulance ServiceGreg Petersen, EMT-P, Clinical Care Coordinator100 Riggs Ave, Merced, CA 95340Phone: (209) 725-7010Fax: (209) 725-7044Email: [email protected]: www.riggsambulance.com

Rocklin Fire DepartmentChris Wade, Firefighter/Paramedic3401 Crest Drive, Rocklin, CA 95765Phone: (916) 625-5311Fax: (209) 725-7044Email: [email protected]: www.rocklin.ca.us

Rural Metro AmbulanceBrian Green, EMT-P1345 Vander Way, San Jose, CA 95112Phone: (408) 645-7345Fax: (408) 275-6744Email: [email protected]: www.rmetro.com

ytefaS cilbuP egelloC roinuJ asoR atnaSTraining CenterBryan Smith, EMT-P, Course Coordinator5743 Skylane Blvd, Windsor, CA 95492Phone: (707) 836-2907 Fax: (707) 836-2948Email: [email protected] Web: www.santarosa.edu

WestMed CollegeBrian Green, EMT-P5300 Stevens Creek Blvd., Suite 200, San Jose, CA 95129-1000Phone: (408) 977-0723 Email: [email protected] Web: www.westmedcollege.com

Search for upcoming courses: http://cms.itrauma.org/CourseSearch.aspx

American Health Education, IncPerry Hookey, EMT-P7300B Amador Plaza Road, Dublin, CA 94568Phone: (800) 483-3615Email: [email protected]: www.americanhealtheducation.com

Verihealth/Falck Northern California Ken Bradford, Training Coordinator2190 South McDowell Blvd, Petaluma, CA 94954Phone: (707) 766-2400Email: [email protected] Web: www.verihealth.com

Allan Hancock CollegeMike DeLeo, EMT – Course Coordinator800 S. College, Santa Maria, CA 93454Phone: (805) 878-6259Fax: (805) 922-5446Email: [email protected]: www.hancock.cc.ca.us



California EMS AcademyNancy Black, RN, Course Coordinator1170 Foster City Blvd #107, Foster City, CA 94404Phone: (866) 577-9197Fax: (650) 701-1968Email: [email protected]: www.caems-academy.com





Fast Response School of Health Care EducationLisa Dubnoff, MICP/RN, Paramedic Director2075 Allston Way, Berkeley, CA 94704Phone: (510) 809-3646Fax; (866) 628-5876Email: [email protected]: www.fastresponse.org

Loma Linda University Medical CenterLyne Jones, Administrative Assistant Department of Emergency Medicine11234 Anderson St., A108, Loma Linda, CA 92354Phone: (909) 558-4344 x 0 Fax: (909) 558-0102 Email: [email protected]: www.llu.edu

Medic AmbulancePerry Hookey, EMTP, Education Coordinator506 Couch Street, Vallejo, CA 94590-2408 Phone: (707) 644-1761 Fax: (707) 644-1784Email: [email protected] Web: www.medicambulance.net


NCTI – National College of Technical InstructionLawson E. Stuart, RN, CEN, EMT-PLena Rohrabaugh, Course Manager333 Sunrise Ave Suite 500, Roseville, CA 95661Phone: (916) 960-6284 x 105 Fax: (916) 960-6296Email: [email protected] Web: www.ncti-online.com




Rocklin Fire DepartmentChris Wade, Firefighter/Paramedic4060 Rocklin Road, Rocklin, CA 95677Phone: (916) 625-5311Fax: (209) 725-7044Email: [email protected]: www.rocklin.ca.us


Santa Rosa Junior College Public Safety Training CenterBryan Smith, EMT-P, Course Coordinator5743 Skylane Blvd, Windsor, CA 95492Phone: (707) 836-2907 Fax: (707) 836-2948Email: [email protected] Web: www.santarosa.edu


EMREF offers the following California providers list:




















































EMS AcademyNancy Black, RN, Course Coordinator1170 Foster City Blvd #107, Foster City, CA 94404Phone: (866) 577-9197Fax: (650) 701-1968Email: [email protected]: www.caems-academy.com






Fast Response School of Health Care EducationrotceriD cidemaraP ,NR/PCIM ,ffonbuD asiL

2075 Allston Way, Berkeley, CA 94704Phone: (510) 809-3646Fax; (866) 628-5876Email: [email protected]: www.fastresponse.org

Loma Linda University Medical Center tnatsissA evitartsinimdA ,senoJ enyL

Department of Emergency Medicine11234 Anderson St., A108, Loma Linda, CA 92354Phone: (909) 558-4344 x 0 Fax: (909) 558-0102 Email: [email protected]: www.llu.edu

Medic AmbulanceJames Pierson, EMT-P506 Couch Street, Vallejo, CA 94590-2408 Phone: (707) 644-1761 Fax: (707) 644-1784Email: [email protected]: www.medicambulance.net


NCTI – National College of Technical InstructionLena Rohrabaugh, Course Manager333 Sunrise Ave Suite 500, Roseville, CA 95661Phone: (916) 960-6284 x 105 Fax: (916) 960-6296Email: [email protected] Web: www.ncti-online.com




Rocklin Fire DepartmentChris Wade, Firefighter/Paramedic3401 Crest Drive, Rocklin, CA 95765Phone: (916) 625-5311Fax: (209) 725-7044Email: [email protected]: www.rocklin.ca.us





American Health Education, IncPerry Hookey, EMT-P7300B Amador Plaza Road, Dublin, CA 94568Phone: (800) 483-3615Email: [email protected]: www.americanhealtheducation.com

Verihealth/Falck Northern California Ken Bradford, Training Coordinator2190 South McDowell Blvd, Petaluma, CA 94954Phone: (707) 766-2400Email: [email protected] Web: www.verihealth.com





























































































lifelineCalifornia Chapter, American College of Emergency Physicians

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OHIO ACEP EMERGENCY MEDICINE BOARD REVIEW


February 9 - 13, 2017

Irvine, California

Ohio ACEP in partnership with

in February 2017 in Irvine, CA!

Approved for AMA PRA Category 1 Credits TM.www.ohacep.org | (614) 792-6506

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