Wednesday, February 21, 2018

OCMA Blog

May Tip of the Month from OCMA Physician Advocate, Mitzi Young

May Tip:

"The Health Exchange is coming...get ready now!  With the implementation of the Patient Protection and Affordable Care Act (ACA), two thirds of California's uninsured will be covered by private insurance through a health insurance exchange purchasing pool. The exchange's goal is to start pre-enrollment in October 2013.

We have developed a toolkit to educate physicians on the exchange and ensure that they are aware of important issues related to exchange plan contracting. The toolkit is available free to OCMA /CMA members only at www.cmanet.org/exchange."

Receiving practice management guidance from Mitzi is a FREE OCMA member benefit!

Mitzi Young
Physician Advocate, Center for Economic Services
888.236.0267
myoung@cmanet.org


OCMA Specialty Spotlight: Humanitarian Healing


Arpan Global Charities (AGC) is a non-profit organization established in 2005 by Dr. Sudeep Kukreja.  The goal of AGC is to bring health and hope to medically underserved populations around the world while providing humanitarian assistance and medical education to those who need it the most.

Arpan Global Charities' 13th international medical volunteer mission took place in the city of Latacunga, Ecuador and a team of 52 dedicated medical and non-medical volunteers participated. Team  members had diverse backgrounds and many years of experience in their respective fields and among them were: 5 nurses, 5 pediatric residents from CHOC Children's Hospital of Orange County, an echo tech, 3 anesthesiologists, 7 pediatricians, 1 cardiologist, 1 dentist, 1 geneticist, 1 gynecologist, 1 CT surgeon, 1 ENT surgeon, 1 ophthalmologist, 1 plastic surgeon, 2 general pediatric surgeons, 1 pediatric orthopedic surgeon, 1 orthopedic surgeon for adults, 1 radiologist, 1 pharmacist, and 10 non-medical volunteers.

Volunteers arrived from the US to Quito in waves and landed in Quito's new airport, located approximately an hour and half away from Latacunga. Although team members faced multiple challenges due to delayed airport pick-ups, lost luggage, and a late arrival to the hotel in Quito at 2:30 AM, the volunteers were eager to start working so they rushed to their rooms to get some rest. The team members were ready at 6 AM for the bus ride to their final destination, the small town of Latacunga.  After a 2-hour trip, the team arrived at a government clinic named Patronato where they immediately examined hundreds of patients and pre-screened them for treatments and/or surgery. Arpan Global Charities rented two facilities with operating rooms in Latacunga for surgeries: Clinica Continental and Instituto de la Mujer. Some surgeries were also performed by the pediatric orthopedic surgeon and the geneticist at Baca Ortiz Children's Hospital in Quito. Furthermore, Arpan's genetics doctor took the initiative to collaborate with local physicians to organize a genetics conference scheduled to take place at the Sheraton Hotel in Quito for the "Rare Diseases Day."  While reaching out and collaborating with local physicians, our medical team established a promising relationship with Quito's medical faculty to discuss the development of a partnership between CHOC Children's Hospital of Orange County and Baca Ortiz Children's Hospital in Quito to promote international collaboration and exchange programs.



Volunteers of Arpan Global Charities also visited 4 different orphanages in Latacunga and Quito where they examined every orphan residing in those centers and facilitated treatment, distributed clothes, and donated toys. Mission volunteers had the opportunity to visit two schools located in very poor areas of their town where they examined every student and discovered some children who had undiagnosed serious medical conditions for which treatment was facilitated. The team of anesthesiologists and nursing staff provided supportive services to patients in the recovery room which allowed skilled surgeons to perform more than one hundred major surgical procedures. With the help of the echo technician, the cardiologist volunteer was able to examine and treat hundreds of patients. Even the dentist surgeon was kept extremely busy from 8 AM to 6 PM everyday with long lines of patients eagerly waiting to see him. 


The help and support of the nursing members, pediatric residents, pharmacist, non-medical volunteers, Ecuadorian volunteers and Ecuadorian medical students was phenomenal. This mission would have not been possible without them.  Besides providing free medical care to the most underserved population in Ecuador, Arpan Global team members were also involved in the education of local nurses, medical students, and doctors in both Latacunga and Quito.

Considering that team members had limited equipment and very scarce medical supplies, it is important to acknowledge their caring attitude and sense of commitment for these qualities enabled them to work long hours on a daily basis to provide humanitarian healing to all their patients.  Indeed, the team's dedication and hard work enabled Arpan Global Charities to touch the lives of more than 1,500 Ecuadorian children and adults. A lot was accomplished during this missionary trip which makes it one of the most exciting and successful medical volunteer missions of Arpan Global Charities.




Practice Management Tip of the Month from OCMA Physician Advocate, Mitzi Young

April Tip:


"A reminder that as of April 1, 2013, Medicare reimbursement for physicians will be cut by 2 percent.

With no solution on the horizon to the budgetary woes in Congress, physicians should be prepared for the 2 percent reduction in reimbursement from the Medicare program. The 2 percent Medicare cuts are part of the $1.2 trillion in cuts required by the Sequestration Transparency Act. Medicaid is exempt from the cuts."

Receiving practice management guidance from Mitzi is a FREE OCMA member benefit! 

Contact Mitzi to schedule a one-on-one consultation to discuss your practice management needs:

Mitzi Young
Physician Advocate, CMA Center for Economic Services
888.236.0267
myoung@cmanet.org 


2014 Physicians of Excellence Nominations

Orange Coast magazine, in conjunction with the Orange County Medical Association (OCMA), will publish its annual list of Orange County Physicians of Excellence in the January 2014 issue and is currently seeking nominations. The Physicians of Excellence program was designed to honor outstanding physicians practicing in Orange County. The selection criteria that will be used to determine physician excellence were developed by a multi-specialty collaboration of the OCMA. 

Anyone can nominate a physician to be considered for the Physicians of Excellence program. Physicians need to be nominated only once to be eligible to apply for selection as a Physician of Excellence. Multiple nominations for the same physician are discouraged. Self-nominations will not be accepted. Once nominated, an application packet will be mailed to the nominee with the details of the application process. Membership in the OCMA is not a requirement for selection. Minimum criteria for Physicians of Excellence include:


- Hold board certification within specialty of nomination
- Maintain a primary practice location in Orange County, California for the last 5 years
- Be in good standing with the Medical Board of California
- Have been in practice within his/her specialty field for the last 5 years consecutively


Nominators are not required to certify that the physician they are nominating meets these criteria.


You may also download the form by simply clicking here.

Submit your nomination form to the Orange County Medical Association by 
June 14, 2013.
 
 
Send to: OCMA, 17322 Murphy Avenue, Irvine, CA 92614 or fax to (949) 398-8120. 

For questions call (949) 398-8100 ext 106 

OCMA Specialty Spotlight: First-of-its-Kind Room Provides a Special Space Where Parents Can Bond with Their Child After Surrogate Delivery

Laguna Hills, CA - Thanks to the generosity of Dr. Jane Frederick, a co-medical director at HRC Fertility, The Women's Hospital at Saddleback Memorial now has a Bonding Room designated specifically for intended parents (parents utilizing a surrogate). The room allows intended parents to bond with their child after delivery by the surrogate. Saddleback Memorial and Dr. Frederick believe it's the first room of its kind in the U.S. 

 

The room was made possible through philanthropic support from Dr. Frederick, one of the longest practicing female reproductive endocrinologists in the Orange County area who has worked with intended parents for over 20 years.  

 

"In the past, Saddleback Memorial would find a place for intended parents to bond with their newborn, but this is the first time a room has been specifically designated for, and designed with, these parents in mind," says Dr. Frederick. "Surrogacy continues to be a viable option for many families and often these families don't have a place to go in a hospital delivery situation.  Parents really need a special place that is theirs and The Women's Hospital at Saddleback Memorial has come through with a beautiful area that is really unique."

 

The Women's Hospital at Saddleback Memorial remains the only women's hospital in South Orange County and is the birthplace of more than 50,000 babies. The Women's Hospital at Saddleback Memorial offers a team of highly trained obstetricians, pediatricians and other specialists who are sensitive to the needs of new mothers and their babies, and are committed to providing the highest level of service. They deliver nearly 3,000 babies a year, and of these, approximately 10 percent are high-risk births and high-risk multiples referred from throughout Orange County and the surrounding area.

 

"This is a beautiful room for our intended parents to celebrate the birth of their child and is complementary to our facility and specialized programs we currently offer," says Dr. Michael Haydon, medical director of The Women's Hospital at Saddleback Memorial.

About Saddleback Memorial Medical Center  

With campuses in Laguna Hills and San Clemente, Saddleback Memorial provides exceptional medical expertise across a range of treatment areas including cancer, stroke, and cardiac care. Innovations such as robotic surgery, low dose CT, and dedicated breast MRI set us apart. In addition, The Women's Hospital at Saddleback Memorial - Laguna Hills offers special comfort and care to new mothers and their babies. A proud member of the MemorialCare Health System and named Best Regional Hospital by U.S. News & World Report for three consecutive years, Saddleback Memorial continues to provide comprehensive care for patients at every stage of their lives.  For more information, go to memorialcare.org/Saddleback.


About MemorialCare Health System


MemorialCare Health System is a not-for-profit, integrated delivery system that includes six top hospitals - Long Beach Memorial, Miller Children's Hospital Long Beach, Community Hospital Long Beach, Orange Coast Memorial, and Saddleback Memorial's 2 campuses; two medical groups - MemorialCare Medical Group, Memorial Prompt Care; an Independent Practice Association (IPA) - Greater Newport Physicians; MemorialCare HealthExpress retail clinics; and numerous outpatient health centers throughout the southland. For more information, go to memorialcare.org.


Jane Frederick, MD 

Dr. Jane Frederick (Second from right in photo) is a co-medical director of HRC Fertility in Orange County. Practicing in California since 1990, Dr. Frederick is an internationally noted specialist in Reproductive Endocrinology and Infertility. She has developed a diverse clinical practice in reproductive surgery, IVF, and the genetic screening of embryos. Dr. Frederick is board certified in Reproductive Endocrinology/Infertility and Obstetrics/Gynecology from the University of Southern California.  She has recently been honored as the top 10% of specialists in the nation by US News and World Report.

 

Orange County Fertility's Facebook

Dr. Jane Frederick's Facebook

Orange County Fertility's Website


OCMA Women Physician Leadership Conference Proves to be Huge Success

Women Physicians Share Insights at Local Conference

Article written by Physicians News Network,
 
www.physiciansnewsnetwork.com/orange_county

Presentations from Women's Conference speakers available at the end of the article

A women’s conference last week offered local female doctors an unprecedented opportunity to learn from each other, and gain critical insight from top women leaders on how to achieve work-life balance, while taking on leadership roles.

The conference, entitled Retreat, Relate, Reform: Women Physicians Leading Change, took place on March 15 at the Promenade Gardens in Costa Mesa. It was organized by the Orange County Medical Association.

Dr. Lisa Thomsen, a Glendora-based family practitioner in private practice and a board member of the Cooperative of American Physicians Inc. (CAP), said the conference exceeded her expectations.

“It was great to see examples of women doing it all,” Thomsen said. “They are very strong leaders.”

Dr. Kelly Traver, an internal medicine physician, medical director for Crossover Health, delivered the keynote address. She focused on the importance of physicians dealing with increasing levels of stress. The goal is to to adapt, in order to successfully continue practicing, and deliver the best care.

There is a constant pressure on physicians to deliver better care at a lower cost, but according to studies, physicians who are simply in a better mood can come up with correct diagnosis three times faster.

While physicians address the harmful effects of stress when treating their patients, they often ignore to take care of themselves, said Traver.

When speaking about new reimbursement models and payment systems, she said “the more complex compensation systems become, the less effective they become”.

Dr. Sharon Levine, president of the California Medical Board, talked about lessons in physician leadership and the importance of cultivating leaders inside the organizations themselves. She discussed creating a culture that motivates people, fosters new ideas and recognizes those who contribute to the organization.

While the older generation of women physicians felt privileged to have a chance to become doctors, to take on leadership roles, and were eager to take on extra work load at the expense of their personal lives, we cannot expect the current generation to do the same, she said.

Dr. Tanya Spirtos, CMA trustee, gave updates on the current state of the ACA implementation and the issues that directly affect physicians, such as the problem with a three-month grace period for people who will be subsidized on the exchange, which can result in physicians not getting reimbursed by the insurance companies when patients default on their monthly payments.

Spirtos said physicians need positive incentives, not penalties, and they have an unprecedented opportunity now to affect how incentives will work as the ACA gets implemented.

Thomsen said she was impressed with the speakers and their take-away messages. She pointed to Levine’s “quiet strength” as exemplary female physician leadership.

As Levine noted, for many women, their appointment to leadership roles is often accidental, but they take on those roles and rise to the challenge.

Thomsen welcomed the views of a presenter who noted that women can become physician leaders by taking small steps and engaging in different organizations throughout their lives. The gained confidence often catapults women to the next stage, and ultimately, into leadership roles.

She said there was one thing in particular that the keynote speaker said that struck a note with her. “Life is really long,” Traver said. “You don’t need to do everything at once.”

Presentations:

"The Healthiest You" - by Kelly Traver, MD

"Lessons in Leadership: The Challenges of Change" - by Sharon, Levine, MD

"Gender Equity, Ensuring a Positive Work Environment & Executive Contracts"                          -By Shannon Jenkins, Esq.

"Health Care Reform Impact on Physicians" - by Tanya Spirtos, MD - For a copy of this presentation, please contact Ashley Buchwald at abuchwald@ocma.org


Sequestration FAQ: How will the cuts affect California physicians?

Across-the-board federal budget cuts were triggered on Friday, March 1, because Congress failed to come to an agreement on how to reduce the federal deficit. Although it is still possible that Congress will reach some sort of a compromise before most of the cuts take effect on April 1, physicians should prepare for a 2 percent reduction in reimbursement from the Medicare program beginning in April.

 

The 2 percent Medicare "sequestration" cuts are part of the $1.2 trillion in cuts required by the Sequestration Transparency Act, part of a deal worked out to end last year's debt-ceiling crisis. The cuts are evenly split between defense spending and discretionary domestic spending. The mandatory Medicare cuts will result in a savings of $11 billion in 2013. Medicaid is exempt from the cuts.

 

The California Medical Association (CMA) continues to fight these Medicare cuts.While CMA understands the need to address our nation's budget deficit, CMA is urging Congress to take a more targeted approach than arbitrary across-the-board cuts that will harm public health and negatively impact access to care for children, seniors and military families.

 

For more information, see "Sequestration FAQ: How will the cuts affect California physicians?" This FAQ answers the most commonly asked questions about the sequestration cuts as they relate to health care. This document will be regularly updated as additional details become available.


OCMA Member Update on Dual Eligibles Demonstration Project

February 25, 2013

 

Over the last 8 months as CalOptima has been building the foundation for the duals demonstration in Orange County, the OCMA has worked consistently and diligently to represent the interests of physicians and their patients.  The critical decision during this early stage of the demonstration was CalOptima board approval of a health care delivery system to serve the duals patients.

Click here for detailed background information.

 

The OCMA strongly advocated that individual physicians, currently serving the duals patients, be included in the delivery system.  A number of these physicians see their duals patients through Medicare Fee-for-Service, and it is important that duals patients continue to have access to their current physicians.

 

OCMA sent a letter to the CalOptima CEO outlining the reasons for the individual contract option.  This letter is the culmination of months of work and summarizes the many points we carried to individual CalOptima board members and their senior staff.  

Click here for the letter to sent to the CalOptima CEO on behalf of OCMA. 

 

We are very pleased to inform our members that the CalOptima board approved a health care delivery system that will include the individual physicians.  At the February meeting of the board, they considered a number of options and, in the end, agreed to develop a network model that will offer an individual contract option to physicians.  

Click here for the approved actions that were passed by the CalOptima board.

 

There remain a number of other important decisions relative to the duals demonstration, but we have achieved the major milestone noted above.  The OCMA will continue to be an active participant in the duals demonstration, decision-making processes and will continue to update the membership as we reach other critical decision points.


Orange County Doctors give Testimonials in Honor of Outstanding Service Provided by Preferred Business Partner, The Doctors Company


“We have used The Doctors Company for our insurance needs for the past 10 years. We began with their medical malpractice coverage, which they did a tremendous job maintaining and always fighting for us to get the best possible rate. We later utilized their services in providing us with our business personal property, workers compensation, employment practices liability and professional liability for our facility. Their customer service is outstanding and I know if I ever need anything I only need to call. They are a vital part of our organization and we look forward to working with them for many years to come.” 

Kimberly Massoudi
Chief Operating Officer

Outpatient Healthcare, Inc.


“Our practice has been a client of The Doctors Company for several years.  They have always met our needs and had our best interests at heart.  They have been devoted to our practice and our physicians.  The Doctors Company’s representatives are supportive and always there to assist our practice in any way they can.  We are pleased to have The Doctors Company as a vital part of our practice.” 


Michael Muhonen, M.D.
WCP Neurosurgical Associates


“Over the past 10 years, we have experienced tremendous growth in our two long-term groups that contract with our ministry, with the addition of over 100 physicians in 13 new specialties.  Additionally we have added five distinct new medical groups to our organizational model across the state.  In every case and step of our journey, The Doctors Company’s leadership has been supportive and insightful and demonstrated a true partnership approach in meeting our needs.  Account management has been flawless, and the whole team at The Doctors Company is sincerely viewed as partners by our physicians and senior management team.”

C. R. Burke 
President and CEO
St. Joseph Heritage Healthcare


“Whether it be for a major problem, or merely for some sage advice, The Doctors Company is always there when you need them. In our experience, one telephone call results in an expeditious and appropriate response. The staff and management are outstanding, friendly and caring. I recommend The Doctors Company to any physician or medical care organization."

Arthur Goldstein, MD
President & CEO
Women’s Healthcare Physicians


How are Business Partners Selected?

After a potential Business Partner has been identified, either by an OCMA staff member's research or via referral, the vetting process begins. The vetting process is rigorous, thorough, and all final decisions regarding approval or denial are made by the OCMA Services Committee.

The OCMA Services Committee only approves those relationships that benefit you while refusing those of questionable value. In order to add value to your membership with OCMA, you can count on us to provide only business partnerships which offer unique and exclusive discounts on products and services, or preferential status in service delivery. 

OCMA's Business Partners help you accomplish your goals of being a successful physician, and running/maintaining an effective practice.  


OCMA Specialty Spotlight: Doctor Recognizes a Need for Fewer Loopholes in the Delivery of Healthcare in California

Recently Dr. Johnson took on a complicated case involving a 13 year old male suffering from a symptomatic left mandibular cyst.

 

The young patient complained of swelling, pain and recurrent headaches. Before finding Dr. Johnson the patient had been turned away from treatment due to insurance. After initial consultation with the patient, Dr. Johnson found he was unable to treat the patient's urgent condition due to insurance constraints.  The patient was referred back to his insurance for definitive care. Later, the patient's mother and father called, frustrated with the inability of the insurance company to properly refer to a surgeon for definitive and prompt care.

 

The patient was re-examined and noted to have increasing pain, swelling and was now damaging other dental structures. Dr. Johnson's staff subsequently called the insurance company on behalf of the family, urging them to assign a person responsible to get their son treated. Unfortunately this took several months, and many phone calls from Dr. Johnson's staff to get the required approval to treat the patient in a hospital setting.

 

Once the services were approved, Dr. Johnson was able to perform the initial recommended biopsy and decompression at Mission Hospital in Mission Viejo.  The pathology report showed an inflamed dentigerous cyst with a prominent hyperplastic follicle and segments of dental papilla.  There was no evidence of malignant growth histologically.  

Cyst-pre operative tennis ball sized 

.

Home and office care continued over the next several months from the initial decompression, sometimes referred to as marsupialization, proved successful as the size of the cyst was reduced by approximately half its original size. The tooth and periodontal structures which were initially compromised by the growth of the cyst began to heal.  The boy's headaches and jaw pain improved over the next several months.    


Cyst-now golf ball sized (about 1/2 the initial size)

The recommended treatment was extraction of tooth #17, supernumerary tooth and cyst under general anesthesia.  During surgery, the original tumor and the initial cyst was identified. The cyst components, including soft cystic material as well as osseous material, mass and other hard tissues appearing to look like teeth were all removed.  The area was examined for any residual areas of cyst.  The remaining osseous structure in the jawbone appeared to be intact without any evidence of infiltration or fracture.  The boy, now 14, has continued to heal, although now a consultation with a dental orthopedist is recommended to evaluate for a dento-facial skeletal deformity.

 

The case illustrates the need for fewer loopholes in the delivery of healthcare in California. The difficulties with case assignment, surgeon contact, treatment authorization and follow-up care were all compromised in this situation.  There were several unnecessary dental/doctor consultations, as well as visits to the emergency department in order to finally alert the insurance company of the urgency of the patient's needs.  The insurance company also failed to find a treating surgeon in-network within a 50 mile radius.  It seems unimaginable that a qualified, contracted surgeon could not be secured in a timely manner.  The delay in treatment  likely caused the need for more extensive care, causing missed days at school and work days for the parents.

 

Arthur Johnson, III, DDS, MD  

 Arthur Johnson, III, DDS,MD earned his degree in dentistry at the University of Michigan in 1993.  He continued his studies at the University of Pennsylvania, where he earned a degree in medicine in 1998.  Dr. Johnson completed his residency program at Johns Hopkins Hospital.  He maintains hospital affiliation at Mission Hospital in Mission Viejo. Sustaining a private practice in Southern California for more than ten years, Dr. Johnson has volunteered with Health Care International since 1993, where he provides medical and dental care to the underserved regions of Jamaica. He is a member of the Laguna Niguel Rotary Club whose mission is service, volunteerism and goodwill.  He's an active member of the California Medical Association and Diplomat of the American Board of Oral and Maxillofacial Surgery.

 

Dr. Johnson's concern with a patient's dental health expands beyond tooth removal. Dr. Johnson takes pride in helping to change or improve a patient's smile with bone grafts and implants and correcting facial and jaw abnormalities or traumatic injuries with reconstructive surgery.  His attention to detail and philosophy of providing optimal, quality care with the least amount of invasive surgery has earned him the trust from patients and confidence from referring doctors.  


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