September 2009

Your SDCMS Support

teaM IS Here to Help! P.18

DISCover Your New

SDCMS.org P.20

Save tIMe aND MoNeY wItH

SDCMS’ eNDorSeD

partNerS P.22

let SDCMS KNow How we CaN

Better Serve You P.44

Discover the Bounty!

“ P H Y S I C I A N S U N I T E D F O R A H E A LT H Y S A N D I E G O ”

OFFICIAL PUbLICATION OF THE SAN DIEGO COUNTY mEDICAL SOCIETYSEPTEmbER 2009

YOUR SDCmS mEmbERSHIP

Richard E. Anderson, MD, FACPChairman and CEO, The Doctors Company

We reward loyalty. We applaud dedication. We believe doctors deserve more than a little gratitude. We do what no other insurer does. We proudly present the Tribute® Plan. We honor years spent practicing good medicine. We salute a great career. We give a standing ovation. We are your biggest fans. We are The Doctors Company.

You deserve more than a little gratitude for a career spent practicing good medicine. That’s why The Doctors

Company created the Tribute Plan. This one-of-a-kind benefit provides our long-term members with a

significant financial reward when they leave medicine. How significant? Think “new car.” Or maybe

“vacation home.” Now that’s a fitting tribute. To learn more about our medical professional liability program

for SDCMS members, including the Tribute Plan, call (858) 452-2986 or visit www.thedoctors.com/tribute.

Endorsed by

A2550_SanDiegoPhy.indd 1 8/6/09 3:36:28 PM

My mother had Alzheimer’s.

There wasn’t much question … we sort of knew when it was time for hospice.

In reality, we’d lost her long ago. But we loved her and wanted to do the right thing.

The nurse from VITAS suggested we give pet therapy atry. I was a little surprised, but said, “Sure.”

And this volunteer came with a loveable little dog.When she saw the pup, my mother smiled.

I hadn’t seen that smile for so long. She even began totalk of her childhood, of the dog she had as a little girl,as if it were yesterday.

VITAS gave me a little more time with the mother I once knew. I’ll never forget …

VITAS is about life, some of the mostimportant moments of life.

Serving the San Diego area since 1995.

For information, please call 1.800.93.VITAS

VITAS.com

contents voL. 96 | no. 9

2 S a N D I e g o p H Y S I C I a N . o r g | S e p t e M B e r 2 0 0 9

briefly notedWebsite Snapshot and More …

public healthSan Diego County Senior Health Report

VolunteerWith SDCMSF’s Project Access San Diego

physician MarketplaceClassifieds

your sdcMs MeMbershipGive Us Your Feedback!

12

41

contributorsThis Issue’s Contributing Writers

a Message froM your executiVe director

sdcMs’ 2009 seMinars and eVents

coMMunity healthcare calendar

468

10

[ D e p a r t m e n t s ]

18 Your SDCMS Support team Is Here to Help!20 Discover Your New SDCMS.org21 SDCMS Member Benefits policies and procedures22 Save time and Money with SDCMS’ endorsed partners33 MICra: 60,807 reasons to Join SDCMS-CMa34 Find answers to Hundreds of practice Management Questions at SDCMS.org36 More SDCMS and CMa Member Benefits38 SDCMS recorded Seminars available for viewing whenever You are!40 SDCMS Support for Your office Manager44 let SDCMS Know what we’re Doing right aND wrong!

144244

Discover theBounty!

YOUR SDCmS mEmbERSHIP

Atop The White Sands of La Jolla is a special place where residents who need skilled nursing receive the best in care with a positive point of view. Both private and semi-private apartments provide soothing panoramas and a full calendar of activities. Above all, Top of the Sands provides loving attention from dedicated caregivers.

From time to time, we’re able to offer a small number of openings to the general public. We currently have availability for those seeking long-term care, rehabilitation, respite or hospice care for a loved one.

DSS #372000641 COA #056

Skilled nursing with a better outlook.

Discover Top of the Sands at The White Sands of La Jolla.

7450 Olivetas Ave. • La Jol la , CA 92037 • www.whitesandsla jol la .com

DSS #372000641 COA #056

Take a personal tour. Call Rochelle Balaban at 888-719-5884.

For top skilled nursing care in a setting that inspires peace of mind, look up to Top of the Sands.

top of sands ad 8.1875x10.75[mech].indd 1 8/10/09 5:15:12 PM

Discover theBounty!

contributors

OPINIONS expressed by authors are their own and not necessarily those of San Diego physician or SDCMS. San Diego physician reserves the right to edit all contributions for clarity and length as well as to reject any material submitted. Not responsible for unsolicited manuscripts. advertising rates and information sent upon request. acceptance of advertising in San Diego physician in no way constitutes approval or endorsement by SDCMS of products or services advertised. San Diego physician and SDCMS reserve the right to reject any advertising. address all editorial communications to [email protected]. all advertising inquiries can be sent to [email protected]. San Diego physician is published monthly on the first of the month. Subscription rates are $35.00 per year. For subscriptions, email [email protected]. [SAN DIEGO COUNTY mEDICAL SOCIETY (SDCmS) PRINTED IN THE U.S.A.]


Tom GehrinGMr. gehring is executive director and Ceo of the San Diego Medical Society.

marisol GonzalezMs. gonzalez is your SDCMS physi-cian advocate. She can be reached at (858) 300-2783 or at [email protected] with any questions you may have about your practice or your membership.

said m. hashemi, mdDr. Hashemi, SDCMS and CMa member since 1982, practices anesthesiology.

Pamela B. smiThMs. Smith is both the director of the HHSa’s aging and Indepen-

dence Services and the general manager of the HHSa’s east region. Ms. Smith oversees more than 40 different programs and services for older adults and families.

lauren WendlerMs. wendler is your SDCMS office manager advocate. She can be reached at (858) 300-2782 or at [email protected] with any questions your office manager may have.

Wilma J. WooTen, md, mPhDr. wooten is the public health of-ficer for the County of San Diego, Health and Human Services agen-cy (HHSa). She is board certified in family medicine and has a master’s degree in public health. ✚

Managing Editor Kyle LewisEditorial Board Van Chang, MD, Adam Dorin, MD, Robert Peters, MD, PhD, David Priver, MD, Roderick Rapier, MD

Marketing & Production Manager Jennifer RohrSales Director Dari Pebdani Project Designer Lisa WilliamsCopy Editor Adam Elder

sdCms Board of direCTors

offiCersPresident Lisa S. Miller, MDImmediate Past President Stuart A. Cohen, MD, MPHPresident-elect Susan Kaweski, MDTreasurer Robert E. Wailes, MD Secretary Sherry L. Franklin, MD

GeoGraPhiC direCTorsEast County William T. Tseng, MD, Heywood “Woody” Zeidman, MDHillcrest Roneet Lev, MD, Thomas V. McAfee, MDKearny Mesa Adam F. Dorin, MD, John G. Lane, MDLa Jolla J. Steven Poceta, MD, Wayne Sun, MDNorth County Arthur “Tony” Blain, MD, Douglas Fenton, MD, James H. Schultz, MDSouth Bay Vimal I. Nanavati, MD, Anna Sanchez Seydel, MD

aT-larGe direCTorsJohn W. Allen, MD, David E.M. Bazzo, MD, V. Paul Kater, MD, Jeffrey O. Leach, MD, Mihir Parikh, MD, Robert E. Peters, MD, PhD, David M. Priver, MD

Communications Chair Theodore M. Mazer, MDYoung Physician Director Kimberly Lovett, MDRetired Physician Director Glenn Kellogg, MDMedical Student Director Jane BugeaCMA Trustees Theodore M. Mazer, MD, Albert Ray, MD, Robert E. Wailes, MD, Catherine D. Moore, MD, Diana Shiba, MDAMA Delegates Robert E. Hertzka, MD, James T. Hay, MDAMA Alternate Delegates Albert Ray, MDLisa S. Miller, MD

send your letters to the editor to [email protected]

thank you to the Following sDcms endorsed partners for their contributions to this issue of san Diego physician:Alexander & Alexander, Attorneys at Law • ProtectingDoctors.com

Chase Paymentech • ChasePaymentech.com

SOUNDOFF Computing Corporation • SOUNDOFFComputing.com

Torrey Pines bank • TorreyPinesbank.com

Alliant Insurance Services • AlliantInsurance.com

CHmb • CAHealth.com

Coastal Healthcare Consulting Group • HealthcareConsultant.org

Practice Performance Group • PPGConsulting.com

The Doctors Company • TheDoctors.com

TSC, Accounts Receivable Solutions • TSCARSolutions.com

AKT, CPAs and business Consultants • AKTCPA.com

J u N e 2 0 0 9 | S a N D I e g o p H Y S I C I a N . o r g 5

Time to see a

CARLSBAD MEDICAL VILLAGE | CarlsbadMedical/dental offi ce condos from 1,500 to 5,265 SF

DEL NORTE MEDICAL PLAZA | CarlsbadOverlooking Interstate-5 in Carlsbad Medical offi ce suites from 1,000 to 11,000 SF

4S RANCH MEDICAL PLAZA | Rancho BernardoMedical offi ce suites from 1,200 to 40,000 SFPHYSICIANS MEDICAL CENTER | San Diego

Across from Sharp Memorial HospitalMedical offi ce suites from 1,200 to 13,819 SF

PACIFIC MEDICAL PLAZA | San DiegoOverlooking Interstate-805 in Sorrento MesaMedical offi ce suites from 1,500 to 52,500 SF

Our Knowledge is your Property

Contact the Medical Offi ce Specialists:Paul Braun, SVP Chris Ross858.677.5324 [email protected] [email protected]

sDCMS is a business, and you, our member physicians, are our customers. In the past, this state-

ment would have been considered hereti-cal. However, in today’s difficult macro- and micro-economic environments and uncer-tain healthcare climate, and with a relent-less focus on reducing costs and increasing revenues, medical societies must behave as businesses whose only goal is to please their customers — you!

So if you accept the premise that we are a business, what are our lines of business? I as CEO must be able to articulate what SDC-MS’ specific lines of business are. If not, then we are lost in the wilderness, and tagged for extinction. Having reached the rusty and crusty old age of 55, I worry about remem-bering stuff, so with that in mind, I describe our lines of business by reciting the first nine letters of the alphabet.

ADvocacyWe advocate for physicians and the patients whom they serve in San Diego County, Sacramento, and Washington, DC, in part-nership with the California Medical Asso-ciation (CMA).

BeneFitsWe provide you with tangible, measurable, and compelling benefits that make a differ-ence to your bottom line.

CommunicationsWe communicate to, for, and from San Diego County’s physicians.

DataWe maintain the finest physician database in San Diego County.

EngagementWe reach out and touch every physician at least once during the year with personal letters and cards, telephone calls, our e-newsletter “News You Can Use,” our thrice-yearly “What Have We Done for You Late-ly?” letter, our social events, or our many seminars and webinars. We want to make sure you know that we’re here for you!

FounDationSDCMS is a not-for-profit professional


message From your executive DirectorBy tom gehring

The

sof sDcmsDefining our lines of Business, Serving our Customers

S e p t e M B e r 2 0 0 9 | S a N D I e g o p H Y S I C I a N . o r g 7

membership organization [a 501(c)(6) in tax parlance], but we are not a charitable orga-nization. We now have a very robust chari-table arm, the SDCMS Foundation, a 501(c)(3), whose mission is to build a healthier San Diego by addressing unmet healthcare needs for all patients and physicians through edu-cation, innovation, and service. The Foun-dation meets its mission through Project Access San Diego, which links low-income, uninsured San Diegans with volunteer phy-sicians; the Retired Physicians Society; and medical student programs. If you would like to volunteer or donate, please contact Kitty Bailey at (858) 300-2780.

GovernanceBoring but necessary!

HeLpWe’re here for you when you need us. Mari-sol Gonzalez, our full-time physician advo-cate, is dedicated to providing individual-ized assistance to our member physicians, and Lauren Wendler, our full-time office manager advocate, is dedicated to providing individualized assistance to member physi-cians’ office managers.

InFrastructureBoring, but if infrastructure is lacking or failing, then we cannot meet our customers’ needs, i.e., your needs.

We cannot and will not provide all lines of business for every customer. We have a seg-mented customer market — from the solo ENT in East County to the family physician at Kaiser — our members run the gamut. But, we at SDCMS have to provide some-thing for everyone. Your SDCMS staff is here to serve you AND your office manag-

ers. Let us know what we can do better. Call me anytime on my cell at (619) 206-8282 or email me at [email protected]. ✚

aBout the author: Mr. Geh-ring is CEO and executive director of the San Diego County Medical Society.

“ P H Y S I C I A N S U N I T E D F O R A H E A LT H Y S A N D I E G O ”

> SDCMS SeMinarS Viewable Online nOw P.9

> iMPleMenting a FaMily ViOlenCe SCreening tOOl P.16

> ChineSe healthCare P.18

OFFICIAL PUbLICATION OF THE SAN DIEGO COUNTY mEDICAL SOCIETY • mARCH 2009

PhySiCian VOlunteeriSM 25% off

advertising in this publication.

Contact Dari Pebdani at 858-231-1231 or [email protected]

sdCms member physicians receive

5946 Priestly Drive, Ste. 200Carlsbad, CA 92008

Personal:• Income Tax Planning• Wealth Management

• Financial Planning

Local:• Employee Benefit Plans

• Profitability Reviews• Outsourced professional services

(CFO, Controller)

Global:• Organizational Structure

• Succession Planning• Internal Control Review and

Risk Assessment

Ron Mitchell, CPADirector of Health Services

[email protected]

CPA’s and Consultants

AKT_SDP_08:Layout 1 8/22/08 3:52 PM Page 1

Call me anytime on my cell at

(619) 206-8282 or email me at [email protected].

sDcms members-only Benefits

2009Free to Member Physicians and Their Office Staff!

octoberHIPPA Updates webinar on oct. 1 (thu.) From 11:30aM to 1:00pM

“10 Strategies for Economic Survival” Seminar/webinar on oct. 15 (thu.) From 11:30aM to 1:00pM

“become a Certified medical Coder in Five Days!” Certified Medical Coder Course on oct 23, 30 and Nov. 6, 13, 20 (all Fridays) From 8:00aM to 4:00pM

november“Preparing to Practice: What You Need to Know bEFORE You begin Your Practice”resident and New physician workshop on Nov. 14 (Sat.) From 8:30aM to 3:30pM

“Electronic Health Records: Are You Ready?” risk Management webinar on Nov. 18 (wed.) From 6:30pM to 7:30pM

“Electronic Health Records: Are You Ready?” risk Management webi-nar on Nov. 19 (thu.) From 11:30aM to 12:30pM

SEmINARS, WEbINARS, AND EvENTS

“Implementation 101: What Physicians Should Know and Do before Adopting an EHR” Seminar/webinar on Sept. 30 (wed.) From 11:30aM to 1:00pM

september“EmR/EHR

Trunk Show” on Sept. 17 (thu.)

From 11:00aM to 7:00pM

SDCMS is currently scheduling its 2010 seminars, webinars, and events. Please let us know which topic or topics you’d like us to cover by sending us an email at

[email protected]

*8 S a N D I e g o p H Y S I C I a N . o r g | S e p t e M B e r 2 0 0 9

For further information, visit SDCmS.org or contact Lauren Wendler at (858) 300-2782 or at [email protected].

J u N e 2 0 0 9 | S a N D I e g o p H Y S I C I a N . o r g 9

Imaging Healthcare Specialists provides expert radiology servicesin southern California, including:

• Accreditation by the American College of Radiology

• Board Certified, Subspecialized Radiologists

• 15 Convenient Locations from Chula Vista to southern Orange and Riverside counties

• Reports and Images Online within Minutes

• Top Notch Customer Service

Your Partner in Health


community healthcare calendar

Suicide in San Diego County: Life Cycle, Ethnic and vulnerable Group TrendsSept. 10 • The Schaetzel Center, Scripps Memorial Hospital • sdchip.org/publica-tions/pub_pdfs/SDWorldSuicidePrev-DayRegForm.pdf

New Advances in Inflammatory bowel DiseaseSept. 12 • Hilton San Diego Resort and Spa • scripps.org/conferenceservices

Fresh Start’s Surgery WeekendA team of dedicated medical volunteers donates their time and expertise to provide disadvantaged children with the highest quality medical services and on-going care. Sept. 12–13, Nov. 7–8 • Center for Surgery of Encinitas • freshstart.org

building Clinical Excellence for mental Health and Drug and Alcohol ProfessionalsSept. 16–17 • Westin San Diego • mhsinc.org/events

American Academy of Urgent Care medicine’s 2009 Urgent Care medicine ConferenceSept. 23–25 • Loews Coronado Bay Resort • aaucm.org

“Healing the Hidden Wounds of War: Understanding and Treating PTSD in the 21ST Century”Presented by the San Diego Psychiatric Society. Sept. 21 • (location TBD) • (858) 300-2787

The Faces of Chronic Fatigue SyndromeOct. 26 – Nov. 1 • Westfield County Fair, Escondido • cfids.org/sparkcfs/health-professionals.asp

4TH Annual Clinical Update on Heart Failures and Arrhythmias: From Prevention to CureOct. 17–18 • Hilton La Jolla Torrey Pines • scripps.org/conferenceservices

9TH Annual Destination Health: Re-newing mind, body, and SoulOct. 18–23 • Marriott Kauai Resort, Kauai, Hawaii • scripps.org/conferenc-eservices

20TH Annual Coronary InterventionsOct. 28–30 • Hilton La Jolla Torrey Pines • scripps.org/health-education

2009 San Diego Day of TraumaOct. 30 • Joan B. Kroc Institute for Peace and Justice, USD • scripps.org/conferenceservices

XvII World Congress of Psychiatric GeneticsOffers a forum for exchange of the lat-est scientific data and education for the interested clinician. Nov. 4–8 • Man-chester Grand Hyatt • (858) 534-3940, [email protected]

New Developments and best Prac-tices in Colorectal Cancer ScreeningNov. 14 • Admiral Baker Clubhouse (Pre-sidio Room) • (858) 458-9439, [email protected].

melanoma 2010: 20TH Annual Cutaneous malignancy UpdateJan. 16–17 • Hilton San Diego Resort and Spa • scripps.org/conferenceservices

7TH Annual Natural Supplements: An Evidence-based UpdateJan. 21–24 • Paradise Point Resort and Spa • scripps.org/conferenceservices

Scripps Cancer Center’s 30TH Annual Conference: Clinical Hematology and OncologyFeb. 13–16 • Omni San Diego Hotel • scripps.org/conferenceservices ✚

To submit a community healthcare event for possible publication, email [email protected]. All events should be physician-focused and should take place in San Diego County.


Chosen by more healthcare providers for our commitment to excellence and breadth of product knowledge, Alliant Healthcare Solutions offers custom-tailored services and

products to meet the needs of any practice. Our highly skilled healthcare insurance professionals can deliver:

Medical malpractice through our partnership ■■

with The Doctors CompanyProperty and casualty■■

Employee benefits■■

For more than eight decades, Alliant Insurance Services has provided innovative and solutions-oriented programs and services for our clients. One of the nation’s leading specialty insurance brokerage firms, Alliant Insurance Services has the experience and drive to meet the needs of SDCMS members.

Contact us at (888) 849-1337

© 2

008

Allia

nt In

sura

nce

Serv

ices

, Inc

. All

right

s res

erve

d. L

icen

se N

o. 0

C36

861

And our commitment and drive pushes us to succeed.

TRUSTED PARTNER OF SDCMS

Alliant, the specialty insurance leader.

We’re in the race to saveyou time and money ...

We’re in the race to saveyou time and money ...


a survey by the Pew Research Cen-ter’s Internet and American Life Project and the California Health-

Care Foundation describes how Ameri-can adults use the Internet to gather and share health information and how trends have shifted in the last decade. Based on a national telephone survey conducted in December 2008, the study showed that 61 percent of American adults look online for health information. Of these “e-patients,” 59 percent have done at least one of the follow-ing activities:• Read someone else’s commentary about

health or medical issues on an online news group, website, or blog;

• Consulted online rankings or reviews of physicians or other providers;

• Consulted online rankings or reviews of hospitals or other medical facilities;

• Signed up to receive updates about health or medical issues; or

• Listened to a podcast about health or med-ical issues.

A smaller subset (20 percent) has actively contributed comments, reviews, and up-dates to online content. The study noted

that increased use of wireless devices and increased participation in social applica-tions by adults aged 18 to 49 indicate that the trend toward online health information exchange should continue to increase.

According to the study, in 2000, 46 per-cent of American adults had access to the Internet, 5 percent of U.S. households had broadband connections, and 25 percent of American adults looked online for health information. Today, 75 percent of American adults go online, 57 percent of American households have broadband connections, and 61 percent of adults look online for health information. Further, many adults now have wireless access to the Internet.

The health topic that attracted the most growth in interest was exercise and fitness. Other topics that gained audience share included specific diseases or medical prob-lems; medical treatments or procedures; prescription or over-the-counter drugs; al-ternative treatments or medicines; depres-sion, anxiety, stress, or mental health issues; and experimental treatments or medicines. For further information, visit PewInternet.org or CHCF.org. ✚

the social Life of health information

noted

State Senator Christine KehoeCalifornia State Senate

P.O. Box 942848Sacramento, CA 94248-0039Telephone: (916) 651-4039

Fax: (916) 327-2188Email: [email protected]

birthday: October 3

State Senator mark WylandCalifornia State Senate

P.O. Box 942848Sacramento, CA 94248-0038Telephone: (916) 651-4038

Fax: (916) 446-7382Email: [email protected]

birthday: October 27

U.S. Representative Darrell Issa

1800 Thibodo Road, #310Vista, CA 92081

Telephone: (202) 225-3906Fax: (202) 225-3303

Email: www.house.gov/issabirthday: November 1

U.S. Senator barbara boxer600 B Street, Suite 2240San Diego, CA 92101

Telephone: (202) 224-3553Fax: (202) 228-2382

Email: www.boxer.senate.govbirthday: November 11

physicians: GeT noTiCed!wish Your legislators

a Happy Birthday!

let your legislators know that you’re paying attention and that you vote — by wishing them a happy birthday!

WEbSITE SNAPSHOT


sdCms ConTaCT informaTionADDRESS 5575 ruffin rd., Ste. 250, San Diego, Ca 92123

TELEPHONE (858) 565-8888

FAX (858) 569-1334

EmAIL [email protected]

WEbSITE SDCMS.org • SanDiegophysician.org

CEO/EXECUTIvE DIRECTOR tom gehring at (858) 565-8597 or at [email protected]

COO/CFO James Beaubeaux at (858) 300-2788 or at [email protected]

DIRECTOR OF mEmbERSHIP DEvELOPmENT Janet lockett at (858) 300-2778 or at [email protected]

DIRECTOR OF mEmbERSHIP OPERATIONS AND PHYSICIAN ADvOCATE Marisol gonzalez at (858) 300-2783 or at [email protected]

OFFICE mANAGER ADvOCATE lauren wendler at (858) 300-2782 or at [email protected]

DIRECTOR OF ENGAGEmENT Jennipher ohmstede at (858) 300-2781 or at [email protected]

DIRECTOR OF COmmUNICATIONS AND mARKETING Kyle lewis at (858) 300-2784 or at [email protected]

SPECIALTY SOCIETY ADvOCATE Karen Dotson at (858) 300-2787 or at [email protected]

ADmINISTRATIvE ASSISTANT AND RECEPTIONIST Betty Matthews at (858) 300-2786 or at [email protected]

LETTERS TO THE EDITOR [email protected]

GENERAL SUGGESTIONS [email protected]

sdCmsf ConTaCT informaTionADDRESS 5575 ruffin rd., Ste. 250, San Diego, Ca 92123

FAX (858) 560-0179

EXECUTIvE DIRECTOR Kitty Bailey at (858) 300-2780 or [email protected]

ASSOCIATE EXECUTIvE DIRECTOR tana lorah at (858) 300-2779 or at [email protected]

PATIENT CARE mANAGER Barbara rodriguez at (858) 300-2785 or at [email protected]

PATIENT CARE mANAGER Brenda Salcedo at (858) 565-8161 or at [email protected]

PROGRAm mANAGER, SURGERY DAYS alisha Mann at (858) 565-8156 or at [email protected]

HEALTHCARE ACCESS mANAGER lauren radano at (858) 565-7930 or at [email protected]

GeT in TouCh Your SDCMS and SDCMSF Support Teams Are Here to Help!

La Jolla sunset, June 14, 2009. Taken by Said M. Hashemi, MD, SDCMS and CMA member since 1982.


San Diego County

senior health report

county public health officer’s updateBy Wilma J. Wooten, mD, mph, and pamela B. smith

in 2005, some 3,736 seniors aged 65 years or older were hospitalized as a result of a fall. That same year, 125

seniors died from an underlying cause of a fall. That death rate was 10 times higher, for people aged 85 years or older, than for those aged 65 to 74. Males had the higher risk of death from a fall, as did seniors liv-ing in the county’s central region.

These statistics are taken from a new document, “San Diego County Senior Health Report,” just finalized by the Coun-ty’s Health and Human Services Agency (HHSA). The statistics cover not just inci-

dences of falls, but different key health in-dicators of particular importance to older adults.

Over the past year, two divisions of HHSA — Aging and Independence Ser-vices (AIS) and Public Health Services (PHS) — worked together to identify es-sential markers of health concerns and to gather data.

“The ultimate goal is to create a health report card and monitor statistics regularly as our community partners work with us on interventions for positive health chang-es,” says Ellen Schmeding, manager of AIS operations. “Initially, we have not had a baseline from which to work. This report will help us develop our baseline.”

This type of health report will give HHSA and other providers of services for seniors the ability to see the areas that might need more concentrated effort in

prevention and education. For instance, are more fitness programs needed? In what geographical areas? For what ages? The re-port will also be useful statistical material for nonprofit service providers and educa-tors seeking grants.

The report spotlights 17 critical indicators:• Days in Poor Health• Frequent Mental Distress• Overweight and Obese• Physical Activity• Consumption of Fruits and Vegetables• Smoking• Flu Vaccination• Mammogram Screening• Diabetes• Mental Illness/Depression• Alzheimer’s Disease• Substance Use/Abuse• Unintentional Injury• Unintentional Fall Injury

inCidenCes of falls and oTher Key healTh indiCaTors


Once a report is made to public health, the Community

Epidemiology Branch’s job of responding, investigating, and intervening begins

Do You Know of Any

Physician Volunteer

Opportunities?

If you know of any volunteer opportunities for physicians in San Diego County, California, across the united States, or anywhere else in the world, please email the information to [email protected]. SDCMS will publish all physician volunteer opportunities free of charge on our website at SDCMS.org.

• Hip Fracture• Suicide• Elder AbuseThese indicators were chosen because

they represented areas where various programs of HHSA could have measur-able impact on the health of seniors.

Beyond these critical indicators, there are statistics on a variety of chronic dis-eases, such as diabetes, cancer, and arthri-tis. Included is a chapter on infectious dis-eases. There are details on mental health issues, as well as injuries from accidents, attacks, and self-inflicted harm. One section of the injury report details heat-related illnesses, something that AIS has already been successful at impacting with its Cool Zones program.

The Senior Health Report also provides demographic information regarding San Diego County’s senior population, includ-ing such details as grandparents living with grandchildren and owner-occupied vs. renter-occupied housing. There is ma-terial on general “health status” with items from the 2005 California Health Inter-view Survey conducted by UCLA, which showed that more seniors in San Diego County reported being in good health (74 percent) than did seniors in California as a whole (71 percent).

Included are chapters on prevention, with such elements as immunizations and health screenings, as well as informa-tion on the utilization of medical services. There is a “Personal Health Records” sec-tion that health professionals can provide to their patients to help them keep track of their medical history, medications, in-surance information, and more.

This type of health report will give HHSA and other

providers of services for seniors the ability to see the areas that

might need more concentrated effort in prevention and

education.

In various sections of the report, there are phone numbers and websites to com-munity resources that can assist older adults with certain issues, such as free help to quit smoking: 1 (800) NOBUTTS (662-8887). One chapter details the many pro-grams and services for seniors provided by AIS and how to access them.

The “San Diego County Senior Health Report” is available for downloading on the County’s Community Health Statistics Unit website at sdhealthstatistics.com. ✚

aBout the authors: Dr. Woo-ten is the public health officer for the County of San Diego, Health and Human Services Agency (HHSA). She is board cer-tified in family medicine and has a mas-ter’s degree in public health. Ms. Smith is both the director of the HHSA’s Aging and Independence Services and the gener-al manager of the HHSA’s east region. She oversees more than 40 different programs and services for older adults and families.


• In 2007–08, 72.3 percent of San Diego County seniors received a flu shot, lower than the Healthy People 2010 target of 90 percent. The pneumonia vaccination rate of 60.7 percent for seniors was also lower than the Healthy People 2010 goal of 90 percent (“San Diego County Senior Health Report,” May 2009).

• Nearly half of San Diego County seniors have been told that they have some form of arthritis, gout, lupus, or fibromyalgia (“San Diego County Senior Health Report,” May 2009).

To request additional health statistics describing health behaviors, diseases, and injuries, for specific populations, health trends, and comparisons to nation-al targets, please call the County’s Community Health Statistics Unit at (619) 285-6479. To access the latest data, reports and data links, go to sdhealthstatistics.com. ✚

San Diego County Health Stats:


San Diego County Health Stats:

*

* 18 S a N D I e g o p H Y S I C I a N . o r g | S e p t e M B e r 2 0 0 9

sDcmsSupport Team

Your

tom gehringChief Executive Officer and Executive Director

T: (858) 565-8597 (desk)T: (619) 206-8282 (cell)F: (858) 569-1334W: [email protected] tom should you have questions about what SDCMS is doing locally, in Sacramento, and in washington, DC, on the political advocacy front, or if you have general questions, complaints, or concerns about what SDCMS is doing or can do for you as a physician.

James BeaubeauxChief Operations Officer and Chief Financial Officer

T: (858) 300-2788 (desk)T: (619) 851-1235 (cell)F: (858) 569-1334E: [email protected] James should you have questions about SDCMS finances and operations.

Janet LockettDirector ofmembership Development

T: (858) 300-2778F: (858) 569-1334E: [email protected] Janet should you have questions about your SDCMS membership benefits, as well as if you have ideas or suggestions as to how SDCMS can increase the value of your membership and thus serve you better.

*Your sDcms membershipDISCOvER THE bOUNTY!

*

* S e p t e M B e r 2 0 0 9 | S a N D I e g o p H Y S I C I a N . o r g 19

sDcms We’re Here to Help!

Kyle LewisDirector of Communications and marketingmanaging Editor

T: (858) 300-2784 (desk)T: (619) 991-9242 (cell)F: (858) 569-1334E: [email protected] Kyle should you have questions about San Diego physician magazine, SDCMS’ email newsletter (“News You Can use”), SDCMS’ website, or our annual pictorial membership directory. Contact Kyle as well should you like to be contacted by San Diego County media for your expertise in certain medical issues, should you like to place a classified ad (free of charge) or display ad (discounted for member physicians) in San Diego physician magazine.

Jennipher ohmstedeDirector of Engagement

T: (858) 300-2781F: (858) 569-1334E: [email protected] Jen should you have questions about SDCMS committees and leadership, CMa councils and committees, SDCMS events, or how you can become more involved.

marisol gonzalezDirectory of membership Operations and Physician Advocate

T: (858) 300-2783F: (858) 569-1334E: [email protected] Marisol should you have questions about your SDCMS membership status or dues, if you need to change or update your contact informa-tion, or if you need assistance with any political, legal, or economic advocacy issue you’re facing.

Lauren Wendler(Physician) Office manager Advocate

T: (858) 300-2782F: (858) 569-1334E: [email protected] office manager and staff can contact lauren should they have questions about SDCMS’ regularly scheduled seminars and webinars, or should they need assistance with a coding, billing, legal, or compliance issue or any other practice issue they need help with.

Karen DotsonSpecialty Society Advocate

T: (858) 300-2787F: (858) 569-1334E: [email protected] Karen to learn how SDCMS can work with your specialty society to lower operational costs through economies of scale.

*

*

Members-only Benef its Online, All the Time!sDcms.orgDiscover Your

mANAGE YOUR PUbLIC PROFILE

Renew Your SDCmS-CmA membership

Search Our Practice management

FAQ Database

BuIlD Your owN

CuStoMIzaBle weBSIte wItH

ItS owN url

manaGe your WeBsiTe aCCounT

Search past Issues

of San Diego physician

publish and Manage Your own

Classified adsSearch San Diego

County Clinics, Hospices, Hospitals, pharmacies, Support groups, and treatment Centers

Consult Our Calendar of Local

Healthcare Seminars and

Events

Watch Recordings of Previous SDCmS Seminars

Access members-only

Content

Act on the Issues With Our Advocacy Tool

Nonmember physicians Can Join online

Find Patient-centered

Resources

Your sDcms membershipDISCOvER THE bOUNTY!



sDcmsMember Benefits Policies and Procedures

We at the San Diego Medical Society (SDCMS) have standardized our processes and procedures for selecting those companies with which we choose to partner to bring to you and your staff those physician-centric goods and services that you have indicated you want. SDCMS intends to keep you, our member physicians, first and foremost in all decision making when it comes to selecting benefits partners. To that end, we have implemented the following policies and procedures:

choiceSDCMS members will, whenever possible, be given a choice of benefits partners, i.e., SDCMS will not normally enter into exclusive relationships.

member inputGoods and services SDCMS members want and need will be identified and prioritized using secondary research, focus groups, one-on-one interviews, and surveys.

negotiationsSDCMS will negotiate with all potential benefits partners to acquire the best possible deals for our members.

Benefits accrue to membersAll contracts will be entered into with the expressed understanding that all financial gain will accrue to SDCMS’ member physicians and not to SDCMS.

member DiscriminationSDCMS members will receive a better value or a lower cost of goods and services than nonmembers.

ease for memberLittle or no work will be required by SDCMS members to take advantage of any and all benefits partners’ goods and services.

standardized vettingBenefits partners must have current SDCMS members as customers. SDCMS member feedback will be solicited to ascertain acceptable benefits partners. SDCMS member feedback will be reviewed annually. Benefits partners will be asked for proof of solvency. Benefit partners’ local Better Business Bureau membership status will be queried.

market segment DiscriminationMarket segments will be identified using mode of practice data, and goods and services will be identified for each segment, with the intent of offering comprehensive benefits for each of our member market segments.

Feedback and trackingA feedback tracking system will be implemented for both benefits partners and SDCMS members in order to provide benefit dollar values to SDCMS members. SDCMS members and benefits partners will be routinely surveyed to gauge SDCMS member satisfaction with benefits partners.

If you would like to suggest any other policies or procedures, or a specific SDCMS member benefit, please contact Janet Lockett, your SDCMS director of membership development, at (858) 300-2778 or at [email protected]. ✚

All Financial Gain Will Accrue to SDCMS Member Physicians and NOT to SDCMS!



* sDcms’

Save Time and Money With

EndorsedPartners



* Founded by John T. Alexander II, MD, JD, Alexander & Alexander has the advantage of understanding

physicians and strives to solve legal problems with an efficient, common-sense approach, saving you time and money:1. No Billable Hours: Billing by the hour tempts attorneys

to rationalize inefficient behavior, thereby increasing costs without improving outcomes. We determine our charges by the project — complexity of the service, time spent, outcome achieved, and ability to pay — not the hour.

2. Efficient Problem Solving: Because many firms have quotas for billable hours, it is easy for these attorneys’ motivations to become more centered on generating billable hours than on efficient problem solving. Our clients prefer we spend our time solving their legal problems as efficiently and inexpensively as possible, rather than waste time making sure they are charged for every minute.

3. Complimentary Phone Calls and Emails: Physicians know that the best time for a patient to contact their doctor with a problem is when symptoms first appear, before serious disease can set in. Many people resist contacting their attorneys with a quick legal question because they know even a simple encounter can lead to a bill. We don’t keep track of every single call or email. Who has the time?

4. No Annoying Add-ons: Physicians cannot understand why a one-minute phone call or email shows up on their bill as a 15-minute charge, or why it costs $5 for a simple fax, when nearly every other business considers this part of the cost of doing business. With our firm you will never be nickel-and-dimed for faxes, postage, email, copying, or courier service.

5. Attorney Contact: Many physicians feel they have limited access to their attorney because phone calls are not promptly returned. Clients often feel forgotten and are not updated regularly about the status of their case. When contact is made, clients know they are on the clock. We guarantee easy access to your attorney, and promise prompt return calls.Alexander & Alexander is dedicated to restoring respect

to the legal profession by providing efficient legal services, eliminating financial conflicts of interest, and redefining the dynamics of client-attorney communication.

chase Paymentech provides credit card processing solutions for healthcare providers that can improve

receivables and better manage operating costs. Accept credit card, debit card, and electronic payments from your patients and …• Cut Paper Work Costs: Eliminate the need to prepare

and send account statements, and save time, expense, and per-item fees associated with processing, reconciling, and depositing paper checks.

• Trim Collection Costs: Reduce the costs and administrative work related to collecting on delinquent, open accounts.

How a Physician-based Law Firm Can Minimize Your CostsBy alexander & alexanderl eG a l s e rv i C e s

Endorsed Partneralexander & alexander (protectingdoctors.com) — created by a physician-attorney — can provide unique insight into all of your legal needs, including medical malpractice, business law, real property transactions, tax planning, and trust and estate planning.

Member Benef italexander & alexander’s unique tower law System can save you about half of what you might normally pay, with SDCMS members receiving an additional 10 percent discount!

ContactJohn alexander, MD, FaCS, JD, at (858) 369-5121 or at [email protected].

Potential value: $500!

Credit and Debit Card Processing for SDCMS MembersBy Chase PaymenTeChm e r C h a n T s e rv i C e s


• Increase Customer Satisfaction: Offer patients the payment options they look for and expect. Rededicate resources to spending time with patients, instead of tracking payments.

• Reduce Collections: Decrease the time to collect outstanding invoices from the current 30 or 60 days to as little as two days.

• Assure Payment: Eliminate collections issues related to patient solvency and the risk of exposure related to bad debt losses.

• Free Up Working Capital: Lowering outstanding receivables translates into less need to tap precious company funds or lines of credit to finance open account balances.

the IT landscape is quickly changing — especially in the medical industry. New rules, regulations, and

technology “solutions” are permeating the landscape, and it is important you stay informed. Your practice is reliant on productive use of technology assets: plan, purchase, use, maintain and secure. Keep the following in mind:

1. Backup and Disaster Recovery: Planning for backups and disaster recovery strategies are business issues, not technical issues. You cannot electronically back up what you do not have stored electronically. Conversely, you cannot electronically recover lost data that you have not backed up. Carefully select what exactly needs to be backed up and absolutely make certain you have working, onsite and offsite backups in place. Communicate with your staff on contingencies and have proper documentation.

2. Software Requirements Before Hardware Purchases: Find out what the environment and hardware requirements are for your software or electronic medical system before you procure the hardware meant to work with it. Never purchase hardware first, only to come to find out it will not be compatible with your selected software program or system.

3. Cloud Computing Versus Onsite Client/Server: After you have selected your software or electronic medical system and determined its requirements, you now have to decide how you plan to implement it at your practice. Dependent on your specialty, your budget, and your staff, you will find that options exist for the implementation to be in the “cloud” on the Internet, in your office with a client/server infrastructure, or a hybrid/combination of both. Carefully investigate the costs and ramifications of all three scenarios.

4. Windows 7 Release and Windows XP: Windows 7 will be released to the public on October 22, 2009. Unlike its predecessor and much-maligned Windows Vista, the new Windows 7 is much more stable and faster. It is considered to be the next go-to operating system for Microsoft and thereby the medical software field. As such, make sure that any software or electronic medical system you are considering for purchase is or will be compatible with Windows 7 in the near future. Moving forward you will find computers will be pre-installed only with Windows 7, so unless you can exercise your downgrade rights to Windows XP, you want to ensure software compatibilities.

sDcms’Save Time and Money With

EndorsedPartners

(continued)

Endorsed PartnerChase paymentech (chasepaymentech.com) provides fast, secure, and cheaper credit card payment processing, excellent customer ser-vice, and innovative payment options.

Member Benef itSDCMS members receive upgraded customer service, preferred rates on MasterCard and visa transactions, free competitive cost analysis, no set-up costs, online reporting and reconciliation tools, expert consultation, no disruption to existing bank relationships, and a guaranteed 10–20 percent savings from current costs.

ContactJarrod Newman at (214) 849-3635 or [email protected] for a com-plimentary competitive cost analysis

Potential value: $1,500 for high-dollar, high-volume cost!

Technology Assets: Plan, Purchase,Use, Maintain, and SecureBy soundoff ComPuTinG CorPoraTionT eC h n o lo Gy s o lu T i o n s

5. Proactive Maintenance Versus Break/Fix: To control IT costs, you will want to carefully evaluate the benefits of a fixed budget proactive maintenance and support plan versus the costlier, random, and reactive break/fix approach. A proactive maintenance, monitoring, and support plan will dramatically reduce or eliminate day-to-day computer issues in your practice while maximizing your network’s speed, performance, and stability.

checking accounts and lines of credit are the basic products banks offer, but a good bank with talented

bankers can advise you on so much more:1. Personal Attention: When you think of a good bank, a

person should come to mind, specifically, a banker who

knows you, your practice, and your financial position, as well as someone who answers the phone when you call. Automated phone directories, rotating staff, or lack of personal attention can rob you of the banking expertise you deserve.

2. Savvy Technology: Does your banker know about the latest ways to save you time and money, and do they implement new technology to maximize both? Just as the future of healthcare records lies in electronic files, your bank should be able to keep up with the times with systems that integrate with online platforms.

3. Guidance and Advice: The bank that will serve you best is one that is well-versed in your industry and is comfortable dealing with the intricacies inherent in your practice needs. Their expertise will create flexibility to accommodate and inclusively anticipate your requests, particularly when it comes to credit facilities.


Endorsed Partnertorrey pines Bank (torreypinesbank.com) is a “low-maintenance” bank that meets business owners’ high expectations while requiring of them the absolute minimum of time and effort.

Member Benef itapproved SDCMS members receive no-fee lines of credit, $1,000 fee discounts on commercial real estate loans, waived monthly maintenance fees on personal accounts for practice partners and employees up to $10/month, free first order of standard checks for personal accounts, increased deposit interest rates, waived monthly maintenance fee for business online banking and bill pay services, atM fees waived up to $15/month, and free courier service or remote deposit service.

ContactYvonne Desmond at (858) 259-5323 or at [email protected].

Potential value: $2,500!

Endorsed PartnerSoundoff Computing Corporation (soundoff-computing.com) provides best-of-breed hard-ware, software, and network technologies for your medical practice, utilizing best practices for all aspects of It implementations.

Member Benef itSDCMS member physicians receive free site inspection and subsequent infrastructure recommendations; free inventory and assess-ment of network and hardware computing assets; free analysis of Internet/telco/data ac-tivity and subsequent roI recommendations.

Contactofer Shimrat at (858) 569-0300 or at [email protected].


* Get the Most Out of Your Banking RelationshipBy Torrey Pines BanKBa n K i n G P r o d u CTs a n d s e rv i C es


4. Financial Strength: Looking for a bank with capital adequacy, liquidity with minimal non-performing assets may not have been a concern in the past, but today it is paramount you understand the financial strength of your bank to ensure successful continuity in your banking relationship.

5. Peer Recommendations: A bank recommendation from your peer group is of considerable value. Your peers in the medical industry have similar needs and potentially the same challenges you have. A bank with a proven track record of handling your peers’ needs is more likely to be able to address your needs too.Consider these points when having your next financial

check-up with your banker or a prospective bank that is asking for your business. Your business is valuable and you deserve a bank that will appreciate your business.

previously known as the Robert F. Driver Company, Alliant Insurance Services — San Diego County’s

premier specialty insurance agency for over 84 years — has grown into a national specialty insurance firm. Alliant is different because we specialize in specific industries, the medical industry, for example, with special programs designed for your medical practice. We know you have to save time and money in order to run a profitable medical practice, and we guarantee you’ll save both.1. All Your Insurance Needs. Receive the lowest cost

with the most protective coverage available on all your insurance needs, or a guaranteed cash award of up to $1,000 towards your SDCMS dues.

2. Medical liability Insurance. We are trained expert brokers for all medical liability insurance companies, including The Doctors Company. Regardless of whom you have your coverage with now, we will work with your existing carrier to lower your rates or find you a company that will at renewal.

3. Health and Dental Insurance. We will help you find the most comprehensive and least expensive health and dental insurance program for you and your staff. We have many choices to fit each physicians practice. When you need someone to work through a medical insurance problem for you or your staff, we will take care of it for you.

4. Workers’ Compensation. Alliant is the specialty leader for workers’ compensation insurance. Just let us know when your plan renews, and we will give you the best option to hold down your rates.Alliant is dedicated to making your insurance purchasing

effortless and at the lowest possible cost. No one in San Diego County is more experienced than our brokers and staff to take good care of you.


EndorsedPartners

(continued)

Endorsed Partneralliant Insurance Services (alliantinsurance.com) is California’s largest premier specialty insurance broker and ranks among the 13 largest in the nation.

Member Benef itSDCMS members receive discounts on a comprehensive portfolio of insurance products and services, including savings of 5–10 percent or more off of the cost of insurance, or cash rebates related to practice size, a savings of 7–12 percent on long-term disability income protection, and no-cost human resources consulting.

ContactMark allan at (800) 654-4609 or at [email protected].

Potential value: $1,000–$2,500!

What You Need to Know About InsuranceBy allianT insuranCe serviCesi n s u r a n C e P r o d u C Ts a n d s e rv i C e s


electronic health record (EHR) software implementation is a complex process affecting

physicians, staff, and patients — it needs to be approached carefully and methodically in a multistep process in order to avoid disastrous outcomes:1. Practice Needs Assessment: Ask practice staff to identify

how an EHR will improve their job and what they believe they need from a system. Identify stakeholders who will ultimately use the EHR and assist in the implementation within the practice, garner staff feedback, and help facilitate and improve “buy-in” from physicians and staff on use of the system later on.

2. Readiness Assessment: Look at internal and external environments to assess your practice’s readiness to move towards EHR — this will become your “EHR Road Map.” Review the practice’s financial status and strategic plan. Do you plan to implement other technologies during this time? Are there major staff changes on the horizon? Are you understaffed? Are the existing charts ready for conversion? Are there plans for relocation? Is there a physician EHR champion? Is high-speed Internet connectivity available?

3. Workflow Analysis: Review how your practice completes

the work associated with the patient encounter and all related components — practice management, clinical and patient care.

4. EHR Vendor Selection: Take your “EHR Road Map” — which has the needs assessment and key functions required for your practice — and identify EHR software systems that meet your requirements. Check with your IPA, affiliated health system, and SDCMS for their recommended EHR and possible subsidy programs.

5. EHR Implementation: Work with the EHR vendor to further define workflows, build and test the software, train staff on its use, and provide onsite “go-live” support. Active communication between all stakeholders to manage expectations and concerns will assist in having a well-organized and planned implementation.Implementation of an EHR system requires careful

planning and will consume a large amount of resources. When done properly and with preparation and resources, practices can realize true efficiencies, improve communication and coordination, and improve the quality of patient care.

Endorsed Partneramerican Security rx (americansecurityrx.com), a California Department of Justice and California Board of pharmacy approved Security printer (Sp-9), provides tamper-resistant California security prescription forms for controlled medications.

Member Benef itSDCMS members receive discounts on tamper-resistant prescription forms.

Contactamerican Security rx at (877) 290-4262 or at [email protected].

Potential value: $300!

Endorsed PartnerCHMB Solutions (chmbsolutions.com) provides outsourced medical billing, revenue cycle management services, information technology support, and hardware solutions to physician practices, clinics, and multispecialty organizations.

Member Benef itSDCMS members receive a 50 percent discount on startup fees and a $33 per-physician-per-month services credit, 10 percent off of outsourced It support, 10 percent off of already-discounted Dell hardware solutions, and a free coding hotline.

Contactron anderson at (760) 520-1340 or at [email protected]. email your coding question(s) to SDCMS at [email protected].


Five Things You Need to Know About EHR/EMR ImplementationBy ChmB soluTionsB i l l i n G s o lu T i o n s


By ellen BeCK, md

Bad managed care contracts can be a continual plague on your practice, your patients, and your finances.

Many physicians find themselves seeing too many patients in order to maintain cash flow as a result of poor reimbursement from their contract portfolio. You can avoid this stressful cycle by spending a little time to understand your contracts so that you can take charge of your practice:1. Evaluate Your Internal Contracting Procedures: Do

you have copies of your contracts? Do you have a copy of the rates or a rate grid? Do you know if you are making money or losing money on a specific code? Do you know what your time is worth in comparison to reimbursement? It takes only a few hours to construct a simple contracting grid. Every practice should have a grid of their top 10 health plans and their top 20 codes. You will be amazed at what you find with a simple review.

2. Cancel Silent PPO Entities: Most practices are infested with bad contracts, the worst being silent PPOs. A silent PPO is an administrative organization that exists for the purpose of discounting your claims on the backend after the services have been rendered. A quick review of your EOBs will identify these entities. Terminate them today.

3. Watch Out for These Three Revenue Robbing Clauses:a. All Products Clauses: These clauses obligate you to see

all plans, all members, under all conditions. Negotiate separate agreements for different product lines.

b. Affiliate and Reciprocity: These clauses allow the plans to sell or lease your rates to all their friends, and they usually charge a fee when they sell or lease your discount. Eliminate this clause completely.

c. Notice Requirements: Make sure the plan cannot

change/amend the contract without sufficient notice, and that you can terminate the contract in that same timeframe.

4. Contracts Are Negotiable: CMA reported that HMOs in California made more than $4.3 billion in profit last year alone. Anthem Blue Cross sent over $1 billion in profit back to Indiana last year. Health plan executives often make more than a $1 million a year. The average premium increase last year was 11 percent, while deductibles and co-payment amounts were increased. Business is good at the health plans. They have plenty of money to negotiate contracts, and they have multiple fee schedules they can offer providers. Ask for a raise — they do every year.

5. Terminate Bad Contracts: Out-of-panel business is good business. Strategic termination of plans can lead to record profits. Physicians are fear-based when it comes to taking a stand against a plan that is financially detrimental to their practice. Stop subsidizing bad plans and implement a portion of out-of-panel business.If you don’t have time to review your contracts, it is not

an expensive process to have someone review them for you. Hire a company that can sit down with you and your staff and explain the contract rates, clauses, and pitfalls. After a


EndorsedPartners

(continued)

Endorsed PartnerCoastal Healthcare Consulting group (healthcareconsultant.org) is a specialty consulting firm that assists clients with managed care contracting, contract negotiations, credentialing, revenue enhancement, and strategic planning.

Member Benef itSDCMS members receive a free contracting analysis, a discount on hourly rates, and a package price on services for contract negotiations, including health plan contracts!

ContactKim Fenton, president, at (949) 481-9066 or at [email protected].

Potential value: 10 percent of Net Revenue!

Do You Have Managed Care Contracts or a Managed Care Mess?By CoasTal healThCare ConsulTinG GrouPCo n T raCT a n a lys i s

*

* short period of time, you will become educated and able to figure out the financial viability of each contract. Don’t sign every contract that comes your way, and learn how to take control of your practice and your future — it is easier than you think!

practice consultants can be a cost-effective way to get the solution to a problem. They bring specialized

knowledge you can “rent” by the hour. But will the advice be worth the cost? Whenever you purchase something expensive, you should ask the same question: What’s the return I expect from this investment?1. Specify Your Need: If you don’t clearly define the

problem you are tying to solve, you could wind up with the wrong consultant. Said another way, you may be buying the solution to a problem you don’t have.

2. Beware of Prepackaged Solutions: You need a consultant with enough experience that you can be sure will provide a customized solution based on a thorough analysis. So, while the reputation of the firm is important, it’s not nearly as important as those of the individuals you will be working with.

3. Check References: It’s a good idea to ask prospective consultants how many clients they have worked with who are like you. Then ask for all of their names and make a few calls. If possible, call references you know and whose opinion you respect.

4. Don’t Shop for a Bargain: The best consultants won’t be the cheapest. But, as is often the case with a medical diagnosis, the difference between the best and second best may be the difference between success and failure for your project.

5. Use Your Instincts: You’re inviting someone into your practice who will have access to sensitive, private business information. You’ll be asked to trust the wisdom of some critical business advice. Go beyond your five senses to evaluate a consultant’s “fit” with you and your practice.

6. Get a Written Proposal: Look for simple, jargon-free language; if you can’t understand the proposal, there’s not much hope for the advice to follow. What exactly is the consultant proposing to do? How much will it cost?

What are the expected benefits, outcomes? How long will it take? When does the consultant get paid? What if you aren’t satisfied with the results?

7. Look for a Consultant Who Empowers the Client: Management consultants are rarely smarter than their clients, just more experienced and better trained in business. There aren’t many problem solutions a physician can’t be made to understand.

Management Expertise PRNBy PraCTiCe PerformanCe GrouPP raCT i C e m a n aG e m e n T Co n s u lT i n G


Endorsed Partnerpractice performance group (ppg) (ppgConsulting.com) provides high-performance medical practice management services for physicians, including consulting, expert witness, workshops, speaking, and a monthly newsletter.

Member Benef itSDCMS members receive discounted management consulting (the greater of 10 percent or $500) on productivity and patient flow, personnel, governance and management, market strategy and tactics, practice acquisitions, sales and mergers, and a free one-year subscription to its newsletter, unCommon Sense. ppg also conducts free half-day seminars for SDCMS members and their staffs at SDCMS’ offices.

ContactJeffrey Denning or Judy Bee at (858) 459-7878 or at [email protected].

Potential value: $1,000-$2,500!


Founded by California physicians in 1976 in response to a crisis in insurance affordability and availability,

The Doctors Company remains fiercely committed to protecting the practice of good medicine. Today, we are the largest national insurer of physician and surgeon medical liability, with more than 45,000 insured physicians, including 19,000 in California and more than 2,500 of your San Diego County colleagues.

With seven physicians on our 12-member board of gover-nors — including two local San Diego County physicians — we possess unique insight into what SDCMS members need from their insurance company.

Our medical liability program offers SDCMS members a unique combination of coverage features, aggressive claims handling, industry-leading patient safety programs, and tan-gible economic benefits.

Here are answers to common questions about our SDCMS program:Q: If I join The Doctors Company’s SDCMS program, can I get a discount on my premium?A: Yes. Subject to underwriting approval, The Doctors Company is offering a 5 percent premium discount for eligible SDCMS members.

Q: What are the program benefits?A: Our SDCMS program benefits include a discount for eligible members, a consent-to-settle provision, free tail coverage at any age, prior acts coverage, and free continuing medical education programs. SDCMS members insured with The Doctors Company are also eligible to participate in the Tribute® Plan, a one-of-a-kind financial career award that honors physicians for their loyalty to The Doctors Company and for their dedication to practicing good medicine.

Q: Is The Doctors Company financially secure?A: With The Doctors Company, you gain the assurance of having a company with $2.8 billion in assets on your side. Our conservative fiscal approach and conscientious investment strategies have earned us financial strength ratings of A (Strong) by Fitch Ratings and A- (Excellent) by A.M. Best Company, and we were named to the Ward’s 50, a list of the top 50 performing (out of over 3,000) of all property casualty companies. So you can count on us to have the power and financial foundation to protect your practice at anytime, anywhere.

Q: What is The Doctors Company’s claims defense record?A: For more than 30 years, we have built our reputation on providing the most aggressive claims defense in the industry. In fact, our defense is so effective that over 82


EndorsedPartners

(continued)

SDCMS’ Exclusively Endorsed Medical Liability Insurance Program Since 2005By The doCTors ComPanyP r o f e s s i o n a l l i a B i l i T y i n s u r a n C e

Endorsed Partnerthe Doctors Company (tDC) (thedoctors.com) enjoys a reputation as the industry vanguard for low California rates, aggressive claims defense, expert patient safety programs, superior customer service, and exemplary member benefits.

Member Benef itMost SDCMS members are eligible for a 5 percent discount on insurance premiums and a 7.5 percent dividend credit.

ContactJanet lockett, your SDCMS director of membership development, at (858) 300-2778 or at [email protected].

Potential value: $500-$2,500!


percent of claims filed against our physicians are closed with no payment to the plaintiff. Of the few claims that go to trial, over 87 percent result in victory for our physicians. You can be sure that if a claim is leveled against you, our expert defense team will be with you each step of the way, marshaling every resource necessary to resolve it.

Discover the advantages of our SDCMS program. To learn more about our program for SDCMS members, call us at (800) 352-0320 or email us at [email protected].

1. Be sure that you have done your due diligence in attempting to notify the debtor of any delinquent balance owing, prior to placement with a collection agency.

2. You are not required to send a certified letter notifying the debtor that their delinquent balance will be referred to a collection agency.

3. Do your research on the collection agency you hire to be sure they comply with federal and state rules and regulations that govern the collection industry and that they have the capability of meeting your needs.

4. Collection agencies have much more success collecting delinquent bills when they have more demographic information for the debtor. HIPAA Business Associate Agreements provide for the sharing of this information.

5. Delinquent balances owing for patients that were eligible at the time of service or become eligible for Medi-Cal for past dates of service cannot be reported to a consumer reporting agency, and collection activity must cease immediately.

it is a challenging time to be in healthcare. Overregulation and complex reimbursement models peel away profits.

The forces of the payor market favor consolidation of clinics and healthcare providers. Increased demand for healthcare causes staff shortages, which in turn cause higher employee-related costs. Many organizations find themselves providing more care for less profit with more overhead.

We have developed our healthcare division upon the philosophy that we help our clients best by providing a deep understanding of their industry. By using a firm that focuses on the business of healthcare, our clients are able to mitigate

Endorsed PartnertSC accounts receivable Solutions (tscarsolutions.com) has provided personalized, innovative collection and total accounts management services since 1992. this local, family-owned business’ management team has combined experience of more than 50 years in the healthcare billing and collection field.

Member Benef itSDCMS members receive a 10 percent discount on monthly charges.

ContactCatherine Sherman at (888) 687-4240, ext. 14, or at [email protected].

Potential value: $350–$500!

Before You Outsource Your Delinquent Accounts to a Collection AgencyBy TsC aCCounTs reCeivaBle soluTionsC o l l eC T i o n s s e rv i C e s

* Providing You a Deep Understanding of Your IndustryBy aKT CPasaC C o u n T i n G s e rv i C e s

* financial risks and take advantage of the opportunities that may be available.

We place the highest value on being personally committed to our clients, making their success our greatest success. We offer individualized counsel based on a real understanding of each client’s objectives. We support our clients wherever their needs take them, offering services that are global in reach, holistic in scale, and performed by a team of dedicated financial service professionals.

AKT’s Healthcare Services Team is made up of experienced professionals who share their strengths in audit and assurance services, tax issues, financial planning, and business and organizational consulting.

AKT’s Healthcare Services Team is ready to help you navigate the complex, ever-changing nature of your business by bringing to your organization a significant depth of resources in finance, accounting, and consulting services. ✚


EndorsedPartners

(continued)

Endorsed PartneraKt Cpas and business consulting llp (aktcpa.com) has provided audit, tax preparation and planning, accounting assistance, and business consulting to San Diego County clients for more than 50 years.

Member Benef itSDCMS members receive a 15 percent discount on standard rates for professional services, with an unconditional satisfaction guarantee: “SDCMS members who are not completely satisfied with the work aKt performs for them pay only what they thought the work was worth.”

Contactron Mitchell at (760) 268-0212 or at [email protected].

Potential value: $500-$2,000!



*60,807 reasons to Join sDcms-cmaMICRA Protects California’s Physician Workforce, SDCMS and CMA Protect MICRA

SPECIALTYSAN DIEGO COUNTY

FL-NY-mI AvERAGE

mICRA SAvINGS

allergy

anesthesiology

Cardiology (invasive)

Cardiovascular Surgery

Dermatology (lipo/cosmetic)

emergency Medicine

Family practice (nonsurgical)

general Surgery (excl. bariatric)

Internal Medicine (noninvasive)

Neurosurgery

oB/gYN

ophthalmology (lasik/cosmetic)

orthopedic Surgery

otolaryngology (cosmetic)

pathology

pediatrics (nonsurgical)

plastic Surgery

proctology

psychiatry (nonshock)

radiology (noninvasive)

thoracic Surgery

urology

average all Specialties

$3,931

$10,472

$13,408

$32,123

$21,897

$19,993

$7,447

$35,273

$9,730

$55,364

$41,128

$10,963

$29,037

$19,468

$8,759

$9,179

$23,641

$19,041

$4,712

$13,880

$32,123

$14,947

$19,842

$15,712

$40,944

$67,843

$150,053

$36,765

$77,312

$34,087

$148,878

$38,827

$242,785

$168,796

$39,931

$139,386

$80,025

$29,085

$27,773

$95,007

$59,544

$17,191

$63,956

$143,093

$57,267

$80,648

$11,781

$30,472

$54,435

$117,930

$14,868

$57,319

$26,640

$113,605

$29,097

$187,421

$127,668

$28,968

$110,349

$60,557

$20,326

$18,594

$71,366

$40,503

$12,479

$50,076

$110,970

$42,320

$60,807

MICRA, the Medical Injury Compensation Reform Act of 1975, reformed the medical malpractice insurance system in California through imple-mentation of a $250,000 cap on non-economic damages, a limit on attorneys’ fees, full disclosure of collateral sources of compen-sation, and periodic payments for awards over $50,000. While a medical malpractice crisis continues to affect thousands of physicians across the nation — not to mention patient access to care — MICRA has kept the doors of medicine open and has protected the healthcare safety net in California by keeping medical malpractice insurance available and affordable. The San Diego County Medical Society (SDCMS) and the California Medical Association (CMA) will fight to support the continua-tion of MICRA, including the $250,000 cap on non-economic damages. ✚*


* Whenever I, your SDCMS physician advocate, or Lau-

ren Wendler, your SDCMS office manager advocate, answer a question posed by a member physician or his or her office manager, we log both the question and the answer into an FAQ database that is now available as a members-only benefit at SDCMS.org.

To access SDCMS’ FAQ database, simply go to SDCMS.org, hover your cursor over the blue “Physicians and Office Staff” tab in the upper left, scroll down the menu options until you get to “FAQ,” and click. Once there you can search by keyword categories that encompass economic advocacy questions, employment questions, legal advocacy questions, licensure questions, member benefit questions, and more. In order to access the answers though, you must be logged in as an SDCMS member physician or the office manager of a member physician. Lauren and I are here to help if you have trouble logging in. Some examples of what you’ll find in our online FAQ database include:

economic advocacyQuesTion: I no longer want to take TRICARE pa-tients. What do I need to do to terminate my contract?

aNSwer: Physicians who wish to terminate their contract with TRICARE should send a 90-day termination letter to Blue Shield TRICARE, Attn.: Provider Relations, P.O. Box 629017, El Dorado Hills, CA 95762-9017.

QuesTion: I treat patients from my home state, and I have a patient stuck paying for medical bills because the out-of-state insurance company will not pay for it. The patient verbally consented to pay for the bills, but is mad at me. What can I do?aNSwer: Best practice is always to have the patient sign a release of financial responsibility so that the patient is very clear that they will be responsible for services that are not covered by their insurance plan. The physician should also inform the patient at the time of service that in the event the service is not covered by the patient’s plan, the patient will be financially responsible. CMA ON-CALL document #0110 (“Billing Patients”) has sample release forms. If the physi-cian is not contracted with the insurance company, then the physician can and should bill the patient.

Legal AdvocacyQuesTion: If a receptionist is trained by the phy-sician they work for, and the physician’s medical assistant is not present, but the physician has the receptionist (who is trained) continue the duties of the medical assistant, is there anything wrong with this from a professional liability standpoint?aNSwer: According to The Doctors Company, as long as the physician has documented the hours spent in training and the physician has this covered in his or her professional liability coverage policy, then this is fine. The Medical Board of California has posted the hours required for medical assis-tant training on its website at medbd.ca.gov.

* *Ask Your Physician Advocate

sDcmsDiscover Your

FAQ DatabaseHUNDREDS OF YOUR PRACTICE mANAGEmENT QUESTIONS ALREADY ANSWERED AT SDCmS.ORGb Y m A R I S O L G O N z A L E z




* QuesTion: I received a subpoena from a public defender for one of my patients. My patient does not want me to release their records. What do I do?aNSwer: Most subpoenas that physicians receive arise out of civil lawsuits during the discovery process prior to trial and ask for the production of medical records only. This type of request is called a “Deposi-tion Subpoena for Production of Business Records.” Because patients have a right of privacy with respect to medical information, special requirements apply to subpoenas for medical records. Physicians should re-fer to CMA ON-CALL document #1180, “Subpoenas: Guides for Responding,” for further clarification.

member BenefitsQuesTion: How can I take advantage of the free assessment of network and hardware mem-ber benefit?aNSwer: SOUNDOFF Computing Corporation (soundoffcomputing.com) is SDCMS’ endorsed in-formation technology (IT) partner. SDCMS member physicians receive free site inspections and subse-quent infrastructure recommendations; free inventory and assessment of network and hardware computing assets; free analysis of Internet/Telco/data activity, and subsequent ROI recommendations. Contact Ofer Shimrat at (858) 569-0300.

QuesTion: Does SDCMS know of anyone who can offer insurance to physicians?aNSwer: Alliant Insurance Services, Inc. (alliantin-surance.com) is SDCMS’ endorsed insurance partner. SDCMS members receive discounts on a compre-hensive portfolio of insurance products and services, including savings of 5–10 percent or more off of the cost of insurance or cash rebates related to practice size, a savings of 7–12 percent on long-term disability income protection, and no-cost human resources consulting. Contact Mark Allan at (800) 654-4609.

QuesTion: Does SDCMS or CMA have a dis-counted auto insurance benefit?aNSwer: Along with your spouse, you as an SDCMS-CMA member can receive a 4.5–14 percent discount on all lines of coverage from the Automobile Club of Southern California. Contact AAA at (800) 924-6141. ✚

aBout the author: Ms. Gonzalez is your SDCMS physician advocate. She can be reached at (858) 300-2783 or at [email protected] with any questions you may have about your practice or your membership.

* Does your attorney think like a physician?

SDCMS Members Receive10% Off All Services

Call Today: 858.369.5121Visit our website at www.protectingdoctors.com

Medical Malpractice Defense Medical Nuisance Protection

Business Law Real Property Transactions

Trust & Estate Planning Tax Planning

Tired of paying inflated legal bills? With a physician-attorneyon your side, you won’t. Our system uses NO BILLABLE HOURS,

saving you about half the normal fee.

Endorsed by

Tracy Zweig AssociatesA R E G I S T R Y & P L A C E M E N T F I R M

Physicians Nurse PractitionersPhysician Assistants

Locum Tenens Permanent Placement

Voice: 800-919-9141 or 805-641-9141FAX : 805-641-9143

[email protected]

Project4:Layout 1 9/22/08 11:22 AM Page 1


Physician Advocate on StaffHave a question? Don’t know where to begin? Contact your full-time, SDCMS physician advocate, Marisol Gonzalez, to get the answers to all your questions (see page 34).

Office manager Advocate on StaffLet your office manager and staff know that they have a full-time office manager advocate at SDCMS ready to help them with any questions they may have (see page 40).

San Diego County Physician mailing ListsNeed to promote your practice or an event? Receive one free physician mailing list annually and a discount on all additional mailing lists requested in the same year.

SDCmS membership CertificateReceive a free SDCMS membership certificate.

InvestmentsInvest with Dunham & Associates and discount your SD-CMS dues by $150.

SDCmS Pictorial membership DirectoryAppear in SDCMS’ annual pictorial membership directory. Receive a free directory each year and a 50 percent discount on additional directories purchased. Receive 50 percent off advertising rates.

Free Coding HotlineAccess a free coding hotline (provided by CHMB Solu-tions). Email your coding question(s) to SDCMS at [email protected].

San Diego Physician magazineReceive a free subscription to the voice of San Diego County’s physicians. Place free classified ads and receive 25 percent off display ads.

San Diego magazineReceive a gift subscription, included with your SDCMS

active physician membership. A portion of membership dues ($1) will be allocated to your 12-month subscription. A discounted subscription is available for resident physician members.

SDCmS Email Newsletter, “News You Can Use”Receive the latest in medical, local, state, and federal news critical to your practice … free of advertising.

SDCmS Seminars/WebinarsAttend free of charge all SDCMS seminars and webinars (including Office Managers Forums), covering legal issues, HIPAA, risk management issues, how to begin your practice, contract negotiations, getting paid, billing, and much more.

California Emergency Driving EmblemReceive a free California physician emergency driving em-blem and additional emblems discounted at $10.

SDCmS News AlertsStay informed of the news that affects your bottom line and your patients’ health with faxed and emailed alerts sent by SDCMS to you, free of charge … and free of advertising!

SDCmS and CmA WebsitesAccess members-only SDCMS and CMA websites to find valuable resources, such as access to SDCMS’ FAQ database, the ability to build your own website, free of charge, the ability to place and manage your own classified ads, free of charge, and much more (see page 20).

Engagement in Healthcare IssuesBe part of the solution! Become involved in any of a broad spectrum of engagement opportunities both SDCMS and CMA afford their member physicians, including joining an SDCMS or CMA committee or becoming a physician leader.

Hertz DiscountsSave up to 15 percent on daily Hertz car rental rates. Special international discounts are also available. Visit Hertz.com

* *sDcmsTake Advantage of Your

Physician-centric Goods and ServicescmaBENEFITSanD



* * or call Hertz at (800) 654-2200. Frequent traveler miles and bonus points may be earned for qualifying rentals. An SDCMS-CMA members-only code is needed to take advantage of this discount.

Auto InsuranceAlong with your spouse, receive 4.5–14 percent discounts on all lines of coverage from the Automobile Club of Southern California.

HIPAA ComplianceReceive a discount on a complete, do-it-yourself HIPAA privacy and secu-rity compliance toolkit (CD-ROM).

Epocrates Clinical Reference GuidesReceive a 30 percent discount off of a one-year subscription and a 35 per-cent discount off of a two-year subscription to Epocrates’ clinical reference guides. Students and residents receive a 50 percent discount.

CmA ON-CALL DocumentsYou can access, free of charge, thousands of pages of medical-legal, regula-tory, and reimbursement information, through CMA’s online library.

CmA’s Weekly Newsletter, “Alert”Delivered directly to you, free of charge, via email or fax.

Free CmA Reimbursement Hotline(888) 401-5911

Free CmA Legal Hotline(415) 882-5144

Free CmA Legislative Hotline(866) 462-2819

Free CmA Physician Confidential LineA 24-hour phone service for physicians, dentists, medical students, resi-dents, and their families and colleagues who may have an alcohol or other chemical dependence or mental/behavioral problem. Completely confiden-tial. Using it will not result in any form of disciplinary action or referral to any disciplinary body. Call (213) 383-2691.

medicAlert Individual and KidSmart ProgramProvides 24-hour individual or child emergency identification and family notification services that safeguard and identify individuals/children in an emergency. SDCMS-CMA members receive: 1) 24-hour emergency re-sponse center; 2) identification; 3) family notification; 4) medical informa-tion management.

Staples business Advantage ProgramSDCMS-CMA members receive: 1) deep discounts (up to 80 percent) on your everyday office supply needs; 2) Internet ordering and no-hassle, online returns; 3) online customizable reports; 4) free, next-business-day delivery; 5) award-winning customer service; 6) experienced account man-ager; 7) customer appreciation days.

Subscription ServicesSDCMS-CMA members receive 50 percent off subscriptions to popular magazines. ✚

“Privileged to Provide Care andClinical Research Since 1975”

www.SanDiegoArthritis.comOffices: Mission Valley, Poway,

Chula Vista, El Centro, & Yuma, AZ

San Diego Arthritis Medical Clinic3633 Camino del Rio South, #300

(intersection of I-8 and I-15)San Diego, CA 92108-4014

Michael I. Keller, M.D., Director Puja Chitkara, M.D.

Ara H. Dikranian, M.D.Oleg Gavrilyuk, M.D.G. Paul Ignat, M.D.

Smitha Chiniga Reddy, M.D.Timothy F. Lazarek, F.N.P.Jennifer Marconato, R.N.

For more information, please contact Vicki, Infusion Coordinator

619.287.9730 x 590

To better serve you and your patients …

The San Diego Arthritis Medical Clinic announces

new exTenDeD hOuRS of Infusion Services—

Mission Valley

7:00AM until 6:00pM Monday thru Friday

providing excellence in the administration of Remicade,

Orencia, Rituxan, Reclast, Aredia, Boniva IV and other leading

medications for the treatment of rheumatologic, dermatologic and gastroenterologic disorders

sDcmsRecorded Seminars


Available for Viewing Whenever You Are!

• what You DoN’t Know CaN Hurt You! (08/09)• oSHa refresher Course (08/09)• Communicating in a HIpaa world (07/09)• Manage Your payor Contracts (06/09)• Maximize Your Cash Flow (06/09)• Keep Your legal *** out of trouble (06/09)• Best practices in revenue Cycle Management

(05/09)• How to Handle legal Notices (04/09)• the red Flags rule (04/09)• what the Health Is Happening in washington, DC,

and Sacramento (04/09)• Dealing with problem employees (04/09)• the patient-centered Medical Home (04/09)• optimize Compliance and reimbursement (02/09)• Contract Negotiations for Medical office Managers

(02/09)• Health plan Contracting Savvy for physicians

(02/09)• Coding to optimize Compliance and reimbursement

(02/09)• How to attract and Keep the Best patients (01/09)• Medicare update 2009 (01/09)

• e-prescribing for Dummies (01/09)• top 10 procedures to Cover Your assets (01/09)• electronic Medical records (11/08)• Sexual Harassment (10/08)• e-prescribing Facts and Myths (10/08)• Medicare transition to palmetto Seminar (08/08)• Hospital Medical Staff leadership Seminar (08/08)• Best practices for Disciplinary procedures and termi-

nations (05/08)• preparing to practice (04/08)• Contract Negotiations (04/08)• Maximize Your reimbursements with effective

Collections (03/08)• Best practices in revenue Cycle Management

(02/08)• oSHa for Dummies (01/08)• Handling Disclosure (01/08)

For assistance in locating a seminar or in logging into SD-CMS’ website, please contact Kyle Lewis at (858) 300-2784 or at [email protected]. All SDCMS seminars are made available for viewing online within 24 hours of their date of occurrence. Thank you for your membership! ✚

Don’t forget about SDCMS’ webinar capability. If you or your office manager can’t get away from the office to attend an SDCMS seminar in person, you can always attend virtually (our webinar) or watch the seminar at SDCMS.org whenever you’re free. SDCMS seminars and webinars are always free to member physicians and their office staff. Seminars currently available for viewing include:



Pay Early … Save MoneyRenew Online Today at SDCMS.org or

Call SDCMS at (858) 565-8888

Early Bird Special!

SDCMS-CMA Members SavE $50SDCMS-CMA MeMber PhySiCiAnS: If you are paying full, non-discounted dues and are with a medical group of 19 or fewer physicians, you will receive a 5% discount off of your 2010 SDCMS-CMA dues if you renew and pay in full before October 31, 2009.

ContaCt Dari PebDani at 858-231-1231 or [email protected]

San Diego Physician is the only publication that is distributed to all 8,500 physicians in San Diego County. Advertising is a cost-effective and profitable way to increase your referral business.

inCrease Your referral business

* QUESTION: even if our hearing-impaired patients do not show up for an appointment, we have to pay a sign-language interpreter $150 per visit. are we allowed to charge a deaf patient the fee for the interpreter if they do not show up for their appointment?ANSWER: The practice cannot bill the patient for the cost of the interpreter, even if the patient does not show up, as this violates the Americans with Disabili-ties Act. The practice can bill the patient for the standard no-show fee, but not the cost of the interpreter. If the physician has already attempted to collect from the patient, then the practice should also send a letter to the patient indicating that he or she was billed in error. Keep in mind that this is information only and should not be taken as legal advice.

QUESTION: the City of San Diego sent a notice informing our practice that all of the 20-minute loading parking spaces in front of our outpatient surgi-cal suite will be converted to two-hour parking spaces. are there any statutes

that protect the surgical patients’ loading spaces that we may cite in our appeal?

ANSWER: California’s Disabled Persons Act is a disability-access law that prohibits both policies as well as structural impediments that deny disabled individuals full and fair access to public accommodations of all kinds, including

medical facilities, hospitals, clinics, and physicians’ offices. Also, federal law and the American Disabilities Act provide that a failure to “remove architectural barriers” in existing facilities as well as not comply-ing with requirements when there is new construction or remodeling may invoke discrimination. For further information, consult CMA’s ON-CALL document #0811, “Patient Access to Physician Offices/Facili-ties: Barrier Removal and New Construc-tion” — available free to SDCMS-CMA members at cmanet.org. ✚

aBout the author: Ms. Wendler is your SDCMS office manager advocate. She can be reached at (858) 300-2782 or at

[email protected] with any questions your office man-ager may have.

*

officeSupporting Your

manager

Are we allowed to

charge a deaf patient the fee for the interpreter

if they do not show up for their

appointment?



YOUR SDCmS OFFICE mANAGER ADvOCATE HAS THE ANSWERS!b Y L A U R E N W E N D L E R


Sign up NOW at SDCMSF.orgWe need your volunteer commitment to help even one patient.

Our Medical Community Liaison, Rosemarie Marshall Johnson, MD, can answer your questions. Dr. Johnson can be paged at 619.290.5351. You may

also contact Lauren Radano, healthcare access manager, at 858.565.7930.

Project Access is actively recruiting physicians,

hospitals, and ancillary service providers to

participate in our program. Together we can ensure that our vulnerable populations

have access to needed healthcare services.

Your commitment to Project Access is needed for our success! Please visit our

website at SDCMSF.org to learn more and to sign up.

san Diegoproject acccess

Project Access takes the hassle out of volunteering, with our staff doing the legwork so that you and your staff can focus on patient care.

• Enrolling Patients based on Need: we verify financial status so that you can be assured that your volunteer service is reaching those who are most in need.

• making Appropriate Referrals: we use referral guidelines that ensure that when a project access patient comes to your office, he or she can take full advantage of the visit.

• Providing Enabling Services: we provide services such as transportation and translation so that you don’t have to wonder if a patient is going to miss an appointment or if there will be a language

barrier.• Providing Case management Services: we work

with each patient one-on-one to coordinate follow-through on all medical needs.• Providing All Needed Services: through our

partnerships, we ensure that a full scope of services is available to all of our patients, from

office visits, hospital services, and even a defined pharmacy benefit.

The heart of the program is to assist patients who cannot afford medical services and who do not have insurance or qualify for public health insurance programs.



classifieds

TO SUbmIT A CLASSIFIED AD, email Kyle Lewis at [email protected]. SDCMS members place classified ads free of charge (excepting “Services Offered” ads). Nonmembers pay $250 (100-word limit) per ad per month of insertion.

NEW mEDICAL bUILDING ALONG I-15: Pinnacle Medical Plaza is a new 80,000 SF building recently completed off Scripps Poway Parkway. The location is per-fect for serving patients along the I-15 from Mira Mesa to Rancho Bernardo and reaches west with easy access to Highway 56. Suites are available from 1,000—11,000 SF and will be improved to meet exact requirements. FREE RENT INCENTIVES and a generous improvement allowance is provided.

For information, contact Ed Muna at 619-702-5655, [email protected]

www.pinnaclemedicalplaza.com

LEASING, RENEWALS & SALES: Call the Healthcare Real Estate Special-ists at Colliers International for a com-plete inventory of all available medical office space for lease or for sale in your area, or for valuable vacancy and absorp-tion information. Use our knowledge and expertise to help you negotiate a new lease, renewal, or purchase to assure you obtain the best possible terms. There is no charge for our consulting services.

Contact Chris Ross at 858.677.5329email [email protected]

CLINICAL STUDIES

CLINICAL STUDY: Dr. timothy Bailey, board-certified endocrinologist and aCrp-certified phy-sician investigator, invites you to participate in a research study to determine if treating obstruc-tive sleep apnea (oSa) may lead to improvements in diabetes control and other health benefits for people with type 2 diabetes. tests results ob-tained from wearing a sleep-screening device in your home overnight may indicate whether or not you have oSa. If positive, you will be scheduled for an overnight visit to a sleep clinic and then as-signed to sleep apnea therapy and lifestyle coun-seling or you will receive lifestyle counseling with sleep apnea therapy occurring upon completion of the study, if you would like treatment. If you are interested in this study or would like more infor-mation, please call (877) 567-2627 or email us at [email protected]. [731]

OFFICE SPACE

vISTA TRI-CITY OFFICE bUILDING: For more relaxed patients and staff …. Beautiful new 1,420ft2 building ready for improvements. Con-venient access and parking for patients and staff. Nicely landscaped and windows throughout for a low-stress patient experience. Street signage in-cluded. very close to tri-City Hospital and Scripps Coastal Medical Center with nearby freeway ac-cess. $2.50/ft2 triple net. please contact [email protected] or (760) 716-4639. [742]

PHYSICIANS WANTED TO SHARE OFFICE IN CLINIC, YUmA, Az: Directly across from new Yuma regional Medical Center. prime location. Several office spaces available. Your private of-fice would be in a fully operational clinic. Shared services include reception/billing, X-ray, exam rooms, and more. ample onsite parking, public transportation nearby. located at 2475 S. ave-nue a. For tour and questions, direct inquiries to (858) 349-2007 or [email protected]. [741]

mEDICAL OR PROFESSIONAL OFFICE SUITES FOR LEASE, EL CENTRO, CA: In his-

toric downtown area, near County offices, court-house, and el Centro regional Medical Center. prime location; build to suit, and competitive rates with tenant incentives. 6,000ft2 can be di-vided; with private entrances. Near I-8 and pub-lic transportation with ample parking. located at 441 w. State St., el Centro, Ca. Direct inquiries to (858) 349-2007 or [email protected]. [686]

mEDICAL OR PROFESSIONAL OFFICE SUITES FOR LEASE, YUmA, Az: Directly across from new Yuma regional Medical Center. prime location; build to suit, and competitive rates with tenant incentives. Ideal for sole prac-titioners. 1,000ft2 suite with private entrance or 150ft2 to 4,000ft2 within the clinic. ample onsite parking, public transportation nearby. located at 2475 S. avenue, Yuma az. Direct inquiries to (858) 349-2007 or [email protected]. [685]

SUITES FOR LEASE, mISSION vALLEY PRO-FESSIONAL mEDICAL/OFFICE bUILDING: prime location, build to suit, and competitive rates with tenant incentives make this a fabu-lous value. Suites approximately 1,000ft2. at rt 15 and rt 8, just minutes from six major hospi-tals. ample parking. easy freeway access and public transportation nearby. visit website for riverview Center, 3633 Camino del rio South at http://lease.svn.com/3633Camino. Contact (858) 349-2007 or [email protected]. [684]

PROFESSIONAL OFFICE SPACE TO SHARE OR LEASE: up to 1,400ft2 in a medical complex, near alvarado Hospital, SDSu college area. am-ple parking, high visibility street location, ideal for any specialty or allied medical professionals. Call (858) 243-2425 or Jim at (619) 441-1115. [733]

mIRA mESA mEDICAL OFFICE SPACE AvAIL-AbLE: three exam rooms, two staff stations, one office/consult room, space is available three weekday afternoons. If interested, please contact our office manager at (858) 458-0940 or fax a letter of interest to (858) 458-3688. [732]

LA JOLLA OFFICE SPACE FOR LEASE: Newly remodeled medical office space for lease in la

Jolla. Shared space with orthopaedic surgeons. preferably part-time needs. Convenient location near the orthopaedic Surgery Center in la Jolla. Contact Jo turner for more information at (619) 733-4068 or email [email protected]. [641]

CHULA vISTA OFFICE SPACE TO SHARE: two oB/gYNs occupy an office space over 5,000ft2. a third physician retired, and that space is avail-able immediately. located on the Sharp Chula vista campus, this space is ideal for an oB/gYN medical practice or compatible. Contact Dorina at (619) 427-8892, ext. 113, or gail at (619) 427-8892, ext. 109, or fax letter of interest to (619) 422-7660. [728]

LOOKING TO SUbLEASE SPACE IN ENCINI-TAS: allergy-immunology specialists interested in subleasing space in encinitas area. Ideally de-sire two days a week, three exam rooms and one consultation room. Contact trudy at (858) 292-1144 or at [email protected]. [727]

SCRIPPS/XImED mEDICAL OFFICE SPACE AvAILAbLE: 1–1.5 days per week. receptionist help available if needed. Includes consultation office, exam room, assistant office, front desk, and shared waiting room. Contact Cindi at (858) 452-6226. [725]

mEDICAL OFFICE SPACE AvAILAbLE ON SHARP CHULA vISTA mEDICAL CENTER CAmPUS: 752 Medical Center Court, Chula vista, Ca 91911. available July 5, 2009. rental sublease office space: two (2) exam rooms, share consultation room, front desk space, turnkey operation, clean and friendly environment. For further information, please contact Connie espi-noza, office manager, at (619) 527-7700, ext. 236, or at [email protected]. [723]

HILLCREST OFFICE SPACE FOR LEASE: Hill-crest, Mercy Medical Building (4060 Fourth ave., 6th floor). 1,947 usable square feet, consisting of four exam rooms, one large or-style procedure room, two business offices, large waiting area, and small lab area. Beautiful views of San Di-ego. Copious shelves for medical files. reception counter. t1 capability, and 220 volt outlet. please call (858) 361-7300 or the onsite building man-ager at (619) 293-3081. [671]

LEADED PROCEDURE ROOm IN KEARNY mESA FOR SUbLEASE: located directly across for Sharp Memorial Hospital in the new, Class a physician’s Medical Center. perfect for non-sedat-ed, minor procedures, including spinal injections. the space includes an integrated workstation with phone and Internet access. Common areas include kitchen (break room), private restroom, staff work stations, front desk, and patient lobby. a back way entrance accommodates gurney ac-cess. this is a potential alternative to costly sur-gical centers. terms negotiable. Contact [email protected] for more details or


classifieds

SmALL GROUP SEEKS PART-TImE, AFTERNOONS, FAmILY mEDICINE, INTERNAL mEDICINE OR PEDIATRICS PHYSICIAN: Must be bilingual (Spanish/English or Tagalog/English); EMR familiar; team oriented; no On-Call, office only. Chula Vista. Opportu-nity to increase hours, as desired. Medi-cal and dental insurance. Flexible hours. Malpractice paid. Low and middle income patients; established and walk-ins.

Send resume to MD, Inc., P.O. Box 533, Chula Vista, CA 91912; Lucy@drpolak-

soffice.com; fax: 619.427.6821

fax a letter of interest to (858) 565-4146. [722]

ESCONDIDO OFFICE/SURGICAL SUITE TO SHARE: plastic surgeon has 2,000ft2 office with aaaaSF-accredited surgical suite to share two days a week. Five minutes to palomar Medi-cal Center and I-15, this freestanding, single-level office is wheelchair and stretcher accessible. It contains doctor’s office, four staff work stations, three exam rooms, paCu, kitchen/eating area, and two bathrooms equipped for disabled. or is fully equipped and supplied, and approved for general anesthesia. Save money over surgicen-ters. ample parking. Minimum one day per week. please call Yale Kadesky, MD, at (760) 741-5466 or email [email protected]. [719]

HILLCREST mEDICAL OFFICE ACROSS FROm SCRIPPS mERCY HOSPITAL: office sublet available in the Mercy Medical Building di-rectly across from Scripps Mercy Hospital. great space for an adult primary care or a specialist. First floor, excellent staff, t1 line, eHr capable, voicemail, website, and more! Call for more infor-mation and a tour (619) 205-1480. [674]

LA mESA OFFICE SPACE TO SHARE: over 6,000ft2 oB/gYN office of three doctors, with space available immediately. Ideal for a medi-cal practice or clinical studies and is located on grossmont Hospital campus. Contact la Mesa oB/gYN at (619) 463-7775 or fax letter of inter-est to (619) 463-4181. [648]

PHYSICIAN POSITIONS AvAILAbLE

CHIEF mEDICAL OFFICER TO SERvE FIvE FEDERALLY QUALIFIED HEALTH CENTERS: MHCS is a mission-driven organization that serves both rural and urban residents of San Diego Coun-ty. we have been in business for 35 years and offer a competitive salary, medical benefits, vacation, paid holidays, sick time, CMe reimbursement, and license reimbursement. Board certified, family practice, and bilingual english/Spanish preferred. this position will require 60 percent clinical and 40 percent administrative. Send Cv to [email protected] or (619) 478-9164. You may con-tact Hr directly at (619) 478-5254, ext 30. visit www.mtnhealth.org. [738]

FAmILY PRACTICE PHYSICIAN FOR A bUSY FEDERALLY QUALIFIED HEALTH CENTER: MHCS is a mission-driven organization that serves both rural and urban residents of San Diego County. we have been in business for 35 years and offer a competitive salary, medical benefits, vacation, paid holidays, sick time, CMe reimburse-ment, and license reimbursement. Board certified and bilingual english/Spanish preferred. Send Cv to [email protected] or (619) 478-9164. You may contact Hr directly at (619) 478-5254, ext 30. visit www.mtnhealth.org. [737]

SOUTHERN INDIAN HEALTH COUNCIL INC. IN ALPINE IS SEEKING A bOARD-CERTI-FIED mEDICAL DIRECTOR/PHYSICIAN: great benefits and competitive wages! please call (619) 445-1188, ext. 291, for details or visit our website

at http://www.sihc.org — look under “employ-ment” and then “Medical.” [736]

FAmILY PRACTICE PHYSICIAN — ENCINITAS: North County Health Services, a Joint Commis-sion, federally qualified community health cen-ter, celebrating 35 years of service, has an op-portunity for BC/Be family practice MD for a lead position in our encinitas health center. work-life balanced hours, include occasional Saturdays (shared with other clinicians). attractive com-pensation, including bonus for call and incentive. Benefit program includes extensive health and welfare benefit choices, retirement plan (403b) with match, generous time off (pto), holidays, malpractice, and reimbursement for CMes (ex-pense and time) and licensure. this is an oppor-tunity to make a difference in the lives of patients who are under-insured or do not have insurance coverage, without having overhead expense or management concerns. Spanish language knowl-edge helpful but not required. please send Cv to C. Bekdache at [email protected] or fax to (760) 736-8740. [717]

Ob/GYN PHYSICIAN — ENCINITAS: North County Health Services, a Joint Commission, federally qualified community health center, cel-ebrating 35 years of service, has an opportunity for BC/Be oB/gYN. Hours and call shared with other clinicians and NMws. attractive compen-sation, including bonus for call and incentive. Benefit program includes extensive health and welfare benefit choices, retirement plan (403b) with match, generous time off (pto), holidays, malpractice, and reimbursement for CMes (ex-pense and time) and licensure. this is an oppor-tunity to make a difference in the lives of patients who are under-insured or do not have insurance coverage, without having overhead expense or management concerns. Spanish language knowl-edge helpful but not required. please send Cv to C. Bekdache at [email protected] or fax to 760-736-8740. [718]

PRImARY CARE JOb OPPORTUNITY: Home physicians is a fast growing group of doctors who make house calls. great pay ($60–$100+/

hour), flexible hours, choose your own days (full or part time). No weekends, no call, transporta-tion and personal assistant provided. Call Chris Hunt, MD, at (858) 279-1212. [711]

PHYSICIAN POSITION WANTED

PULmONARY/CRITICAL CARE/SLEEP mEDI-CINE PHYSICIAN: would like to join similar group or solo physician. Highly experienced in critical care (fellowship at Cook County Hospital in Chicago). also certified in gI. Fax: (619) 934-4566. [743]

NONPHYSICIAN POSITIONS AvAILAbLE

WOmEN’S HEALTH NURSE PRACTITIONER: progressive Mission valley office looking for a part-time/full-time nurse practitioner with strong gynecological experience, including Hrt. Fax resume to (619) 220-8567. [726]

mEDICAL CODING SUPERvISOR: experi-enced, with California coding certificate needed for multi-specialty physician group in Imperial County. Knowledge of all aspects of billing neces-sary. It experience a plus. Must have great people and communication skills. excellent benefits. M–F. email résumé to [email protected]. [721]

mEDICAL EQUIPmENT

THREE FULL-SERvICE EXAmINATION TA-bLES: excellent condition. $1,000 each. Call (619) 585-0476 and ask for Cindy. [739]

2007 NOvASURE EQUIPmENT IN EXCEL-LENT CONDITION FOR SALE: the NovaSure System is intended to ablate the endometrial lin-ing of the uterus in premenopausal women with menorrhagia (excessive bleeding) due to benign causes for whom child bearing is complete. the NovaSure procedure takes approximately 90 sec-onds to perform, has excellent patient outcomes and reimbursement for physicians. the 2008 National average Medicare reimbursement rate is 2,014.80 for in-office procedures. Bought New in 2007 for $25K, lightly used. price $18K. please call (760) 473-4002. please visit www.novasure.com/novasure-procedure. [720] ✚

PlaCe your adverTisemenT

here

Contact Dari Pebdani at 858-231-1231 or

[email protected]

your sDcms membership


What Do you Want From your sDcms-cma membership?let us Know!Your SDCMS physician leadership and staff are committed to serving you, San Diego County’s 2,500-plus SDCMS member physicians, in ways that bring success to your practice, strength to our profession, and health to our communities. Help us do a better job by giving us your feedback!

Fax your comments to SDCmS at (858) 569-1334 or call us with your input at (858) 565-8888. Thank you for your membership!

What are we doing right?

What are we doing wrong?

Name (optional):

MPT and so much more.

CAP is ...Award-Winning Risk Management

Assertive Claims Defense

The Dedicated Legal Power of Schmid & Voiles

An Insurance Agency for Physicians and their Practices

Superior Financial Stability

An Aggressive State and Federal Health Care Advocate

More Than 10,000 Members Strong

Mutual Protection Trust (MPT) is the nation’s only medical professional liability

provider rated A+ (Superior) by A.M. Best four years straight!

Superior Physicians. Superior Protection.

S a n D i e g o

o r a n g e

L o S a n g e L e S

P a L o a L T o

S a c r a m e n T o

800-252-7706 | www.cap-mpt.com

The Mutual Protection Trust (MPT) is authorized under Section 1280.7 of the California Insurance Code as an unincorporated interindemnity arrangement among physician members of the Cooperative of American Physicians, Inc. (CAP). Members do not pay insurance premiums. Instead, they pay tax-deductible assessments, based on risk classifications, for the amount necessary to pay claims and administrative costs. No assurance can be given as to the amount or frequency of assessments. Members also make a tax-deductible Initial Trust Deposit, which is refundable according to the terms of the MPT Agreement. ©2009

SDCMS_1192REV.indd 1 7/24/09 12:40 PM

Introducing MyCME from NORCAL Mutual. Review our wide array of risk

management resources and services. Register for and complete CME

courses at your convenience. Submit your Attestation Form online. Print

transcripts and certificates…everything from one easy-to-navigate website.

Learn more at www.norcalmutual.com/cme

or call 800.652.1051, ext 2244.

Our passion protects your practice

A Bright Invention from NORCAL

san diego county Medical society5575 ruFFIN roaD, SuIte 250SaN DIego, Ca 92123

[ returN ServICe reQueSteD ]

$5.95 | www.SANDIEGOPHYSICIAN.org

PRSRT STDU.S. POSTAGE

PAIDDENVER, CO

PERMIT NO. 5377

September 2009

Documents

Transcript of September 2009