Fall 2016

Page 1

California

FAMILY PHYSICIAN

LIVE FROM RIO, HEALTH CARE AND MORE

16

THE AFFORDABLE CARE ACT SIX YEARS LATER: THE GOOD, BAD, AND PROMISING

20

MACRA 101: READY, SET, GO!

24

#NEVERSTOP BEING HEROIC

28

VOL. 67 NO. 4 Fall 2016

CAFP Goes to Orlando!

Success. It’s what California’s finest physicians strive for... and what CAP can help you achieve. Since 1977, the Cooperative of American Physicians (CAP) has provided superior medical professional liability coverage and valuable risk and practice management programs to California’s finest physicians through its Mutual Protection Trust (MPT). As a physician-directed organization, we understand the realities of running a medical practice, and we are committed to supporting you with a range of valuable programs and services. These include a 24-hour adverse outcomes hotline, HR support, EHR consultation, a group purchasing program, and payment and reimbursement education and support, to name a few.

The 6 Most Common HIPAA Violations Revealed in CAP’s Free Guide. CAP’s new compliance guide, The 6 Most Common HIPAA

Violationss, not only explains how to avoid such mistakes, but cites the accompanying penalties for these common – yet easily avoidable – violations. With the right procedures in place, you can focus on practicing medicine and serving your patients instead of worrying about penalties.

For Your Protection. For Your Success.

Request your free copy today! 800-356-5672 | CAPphysicians.com/Compliance

R E G I S T E R B Y 1 0 / 1 5 / 1 6 A N D S AV E U P TO $ 1 7 0 S K I N D I S E A S E E D U C AT I O N F O U N D AT I O N P R E S E N T S

41 ST ANNUAL

Hawaii Dermatology Seminar â„¢

A C O N T I N U I N G M E D I C A L E D U C AT I O N C O N F E R E N C E

JAN UARY 29 - FEBRUARY 3, 2017 G RAN D WAILEA HOTEL, MAUI

E A RN UP TO 34 C ME/CE CREDITS AND MOC-D Jointly provided by

in affiliation with

Publication Partners

G L O B A L A C A D E M Y C M E . C O M / D E R M ATO L O G Y

ϭϱϮϬ WĂĐŝĮĐ ǀĞŶƵĞ ͻ ^ĂŶ &ƌĂŶĐŝƐĐŽ͕ ĂůŝĨŽƌŶŝĂ ϵϰϭϬϵ ͻ ǁǁǁ͘ĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ WŚŽŶĞ ;ϰϭϱͿ ϯϰϱͲϴϲϲϳ ͻ &Ădž ;ϰϭϱͿ ϯϰϱͲϴϲϲϴ ͻ ͲŵĂŝů͗ ĐĂĨƉΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ

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President >ĞĞ ZĂůƉŚ͕ D

^ƵƐĂŶ ,ŽŐĞůĂŶĚ͕

President-Elect DŝĐŚĞůůĞ YƵŝŽŐƵĞ͕ D Immediate Past President :ĂLJ t͘ >ĞĞ͕ D ͕ DW, Speaker >ŝƐĂ tĂƌĚ͕ D ͕ DW, Vice-Speaker tĂůƚĞƌ DŝůůƐ͕ D Secretary/Treasurer ĂǀŝĚ ĂnjnjŽ͕ D Executive Vice President ^ƵƐĂŶ ,ŽŐĞůĂŶĚ͕ Foundation President ŶƚŚŽŶLJ ŚŽŶŐ͕ D AAFP Delegates :ĞĨĨ >ƵƚŚĞƌ͕ D ĂƌůĂ <ĂŬƵƚĂŶŝ͕ D AAFP Alternates ĂƌŽů ,ĂǀĞŶƐ͕ D :ĂLJ t͘ >ĞĞ͕ D ͕ DW, CMA Delegation ƐŚďLJ tŽůĨĞ͕ D ͕ DW,͕ DWW :ĂLJ t͘ >ĞĞ͕ D ͕ DW, DĂƌŝĞ ZĂŵĂƐ͕ D DĂƌŬ ƌĞƐƐŶĞƌ͕ D sĂŶ EŐƵLJĞŶ͕ K &Ğůŝdž EƵŶĞnj͕ D ͕ DW,

Executive Vice President

ƐŚŽŐĞůĂŶĚΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ ŽŶƌĂĚ ŵĞŶƚĂ

Director, Health Policy

ĐĂŵĞŶƚĂΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ :Ğƌƌŝ ĂǀŝƐ͕ , W

Director, CME/CPD

ũĚĂǀŝƐΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ ƌŝĂŶ ĞǀŝŶĞ

Manager, Finance

ďĚĞǀŝŶĞΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ ĚĂŵ &ƌĂŶĐŝƐ

Director, Government Affairs

ĂĨƌĂŶĐŝƐΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ ^ŚĂŶŶŽŶ 'ŽĞĐŬĞ

Director, Membership and Marketing

ƐŐŽĞĐŬĞΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ ^ŽŶŝĂ <ĂŶƚĂŬ

Manager, Medicall Practice Affairs

California FAMILY PHYSICIAN

LJŶƚŚŝĂ <ĞĂƌ͕ D ŝǀ͕ , W Senior Vice President

Quarterly publication of the California Academy of Family Physicians

ĐŬĞĂƌΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ ůŝnjĂďĞƚŚ >ƵŬƌŝĐŚ͕

Manager, Communications and Social Media

ĞůƵŬƌŝĐŚΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ

^ŚĞůůLJ ZŽĚƌŝŐƵĞƐ͕ ͕ & ,W Deputy Executive Vice President

ƐƌŽĚƌŝŐƵĞƐΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ ZŝĐŚĂ ^ĂƌĂƐǁĂƚ

Manager, Medical Student and Residency Relations

ƌƐĂƌĂƐǁĂƚΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ

EĂƚŚĂŶ ,ŝƚnjĞŵĂŶ͕ D ͕ Editor ŽŵŵƵŶŝĐĂƚŝŽŶƐ ŽŵŵŝƚƚĞĞ͗ EĂƚŚĂŶ ,ŝƚnjĞŵĂŶ͕ D ͕ Chair ͻ :ƵůŝĂ ůĂŶŬ͕ D ͻ EĂƚŚĂŶ ,ŝƚnjĞŵĂŶ͕ D ͻ :ĞĨĨƌĞLJ >ƵƚŚĞƌ͕ D ͻ :ĂLJ DŽŶŐŝĂƌĚŽ͕ D ͻ DŝĐŚĞůůĞ YƵŝŽŐƵĞ͕ D ͻ ůďĞƌƚ ZĂLJ͕ D dŚĞ California Family Physician ŝƐ ƉƵďůŝƐŚĞĚ ƋƵĂƌƚĞƌůLJ ďLJ ƚŚĞ ĂůŝĨŽƌŶŝĂ ĐĂĚĞŵLJ ŽĨ &ĂŵŝůLJ WŚLJƐŝĐŝĂŶƐ͘ KƉŝŶŝŽŶƐ ĂƌĞ ƚŚŽƐĞ ŽĨ ƚŚĞ ĂƵƚŚŽƌƐ ĂŶĚ ŶŽƚ ŶĞĐĞƐƐĂƌŝůLJ ƚŚŽƐĞ ŽĨ ƚŚĞ ŵĞŵďĞƌƐ ĂŶĚ ƐƚĂī ŽĨ ƚŚĞ &W͘ EŽŶͲŵĞŵďĞƌ ƐƵďƐĐƌŝƉƟŽŶƐ ĂƌĞ Ψϯϱ ƉĞƌ LJĞĂƌ͘ Ăůů ϰϭϱͲϯϰϱͲϴϲϲϳ ƚŽ ƐƵďƐĐƌŝďĞ͘

ƐŬĂŶƚĂŬΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ

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4

California Family Physician Fall 2016

16 Live from Rio, Health Care and More

Carol Grench, MD

18 Commentary for California Family Physician, “ACA: Six Years and Counting. The Good, Bad, and the Promise” 20 The Affordable Care Act Six Years Later: The Good, Bad, and Promising

Wanda Filer, MD, MBA Ignatius Bau

22 Covered California Plans to Match Primary Care Physicians with Patients

Conrad Amenta

24 MACRA 101: Ready, Set, Go!

Leah Newkirk

26 CAFP Goes to Orlando!

Shelly Rodrigues, CAE, CHCP, FACEHP

28 #NeverStop Being Heroic

Jack Chou, MD

6

Editorial

Six Years of ACA: Changing the Conversation

8

President’s Message

From Where I Sit: The Medical Community Can Overcome Whatever Obstacle is Put in Front of Us

10 Political Pulse

We Really Will Have a Ballot Initiative Bonanza

14 Membership

Your Membership Matters

15 CAFP Foundation

National Conference for Students and Residents

30 EVP’s Forum

Verdict on the ACA? Good, Overall.

Nathan Hitzeman, MD

Lee Ralph, MD Carla Kakutani, MD Shannon Goecke Richa Saraswat Susan Hogeland, CAE

&Žƌ ƵƉĐŽŵŝŶŐ D ĂĐƟǀŝƟĞƐ ǀŝƐŝƚ ĨĂŵŝůLJĚŽĐƐ͘ŽƌŐͬĐŵĞ California Family Physician Fall Fall 2016 ϮϬϭϰ

5

EDITORIAL

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Six Years of ACA: Changing the Conversation >Ğƚ͛Ɛ ŶŽƚ ĨŽŽů ŽƵƌƐĞůǀĞƐ ŚĞƌĞ͘ dŚĞ ĨĨŽƌĚĂďůĞ ĂƌĞ Đƚ ; Ϳ ƌĞŝŶĨŽƌĐĞƐ Ă ůĂƌŐĞůLJ ǁĂƐƚĞĨƵů ĂŶĚ ĚLJƐĨƵŶĐƚŝŽŶĂů ŚĞĂůƚŚ ĐĂƌĞ ƐLJƐƚĞŵ͘ WĂƚĐŚǁŽƌŬ ƉůĂŶƐ͕ ŵƵůƚŝƉůĞ ŵŝĚĚůĞŵĞŶ͕ ƉŚĂŶƚŽŵ ƉƌŽǀŝĚĞƌ ŶĞƚǁŽƌŬƐ ĂŶĚ ŶŽ ĚĞƚĞƌƌĞŶĐĞ ĨŽƌ ƉŚĂƌŵĂĐĞƵƚŝĐĂů ƉƌŝĐĞ ŐĂƵŐŝŶŐ͘ ŶĚ͕ ĂƐ ƚŚĞ ĚƵƐƚ ƐĞƚƚůĞƐ͕ /͛ŵ ŐůĂĚ ƚŚĂƚ ŝƚ ƉĂƐƐĞĚ͘ tŚLJ͍ dŚĞ ͛Ɛ ŵĂŝŶ ŐŽĂů ǁĂƐ ƚŽ ŝŶƐƵƌĞ ŵŽƌĞ ƉĞŽƉůĞ ĂŶĚ ŐŝǀĞ ƚŚĞŵ ƐŽŵĞ ŬŝŶĚ ŽĨ ĂĐĐĞƐƐ ƚŽ ĐĂƌĞ͘ /ƚ ŚĂƐ ĚŽŶĞ ƚŚĂƚ͘ ŶĚ ǁŚĞŶ ŚĞĂůƚŚ ĐĂƌĞ ďĞĐŽŵĞƐ Ă ƌŝŐŚƚ͕ ŶŽ ƐĞƌŝŽƵƐ ƉŽůŝƚŝĐŝĂŶ ŝƐ ŐŽŝŶŐ ƚŽ ƉƵůů ŽƵƚ ƚŚĞ ƌƵŐ͘ dƌLJ ĚŽŝŶŐ ƚŚĂƚ ǁŝƚŚ DĞĚŝĐĂƌĞ͘ KŶĐĞ ŚĞĂůƚŚ ĐĂƌĞ ďĞĐŽŵĞƐ Ă ƌŝŐŚƚ͕ ŵŽƌĞ ĂƚƚĞŶƚŝŽŶ ĐĂŶ ďĞ ƐŚŝĨƚĞĚ ƚŽ ǁŚĂƚ ǁŽƌŬƐ ĂŶĚ ĨŝdžŝŶŐ ǁŚĂƚ ĚŽĞƐŶ͛ƚ͘ dŚĂƚ͛Ɛ ǁŚĞƌĞ ǁĞ ĂƌĞ ŶŽǁ͘

ƚŚŝƐ LJĞĂƌ͘ ĞĨŽƌĞ LJŽƵ ƚĂŬĞ ƚǁŽ ƐƚĞƉƐ ĂǁĂLJ ĨƌŽŵ ŵĞ Ăƚ ŽƵƌ ŶĞdžƚ ŵĞĞƚŝŶŐ͕ LJĞƐ͕ / Ɛƚŝůů ŐŽ ƚŽ ƚŚĞ ĚĞŶƚŝƐƚ ĂŶĚ ŚĂǀĞ ĂďƐŽƌďĞĚ ƚŚĞ ĐŽƐƚ ƉĞƌƐŽŶĂůůLJ͕ ďƵƚ / ĚŝĚ ĨĞĞů ŵŽŵĞŶƚƐ ŽĨ ƉĂŶŝĐ ǁŚĞŶ ŝƚ ŚĂƉƉĞŶĞĚ ĂŶĚ ƐŚĂŵĞ ǁŚĞŶ / ŚĂĚ ƚŽ ĚŝƐĐƵƐƐ ŝƚ ǁŝƚŚ ŵLJ ĚĞŶƚĂů ƉƌŽǀŝĚĞƌ͘ EŽƚ ďĞŝŶŐ ĐŽǀĞƌĞĚ ƐƵĐŬƐ͘ tĞůů͕ ŚĞĂůƚŚ ĐĂƌĞ ƐƉĞŶĚŝŶŐ ŚĂƐ ƐůŽǁĞĚ ĚŽǁŶ͕ ďƵƚ ŝƐ Ɛƚŝůů ƌŝƐŝŶŐ ĂŶĚ ŶŽǁ ŚŝƚƚŝŶŐ ϮϬ ƉĞƌĐĞŶƚ ŽĨ ' W͘ dŚĞ ĐŽŵƉůĞdžŝƚLJ ŽĨ ƌĞŐƵůĂƚŝŽŶ ŝƐ ĞdžƚĞƌŵŝŶĂƚŝŶŐ ƚŚĞ ƉƌŝǀĂƚĞ ƉƌĂĐƚŝƚŝŽŶĞƌ͘ WĂƚŝĞŶƚ ƐŚĂƌĞ ŽĨ ĐŽƐƚ ŚĂƐ ƉƵƚ ƚŚĞ ƐƋƵĞĞnjĞ ŽŶ ƉŚLJƐŝĐŝĂŶ ƚŝŵĞ ŝŶ ŵĂŶĂŐŝŶŐ ƚŚĞ ͞dƌŽũĂŶ ,ŽƌƐĞ ƉŚLJƐŝĐĂů͟ Žƌ ƌĞƐƉŽŶĚŝŶŐ ƚŽ ŵĞƐƐĂŐĞƐ ĨƌŽŵ ƉĂƚŝĞŶƚƐ ůŝŬĞ ͞/͛ǀĞ ďůĞĚ ƚǁŽ ďƵĐŬĞƚƐ ŽĨ ďůŽŽĚ͘ ^ŚŽƵůĚ / ďĞ ƐĞĞŶ͍ / ŚĂǀĞ Ă ĐŽƉĂLJ͙͟ WŚĂƌŵĂĐĞƵƚŝĐĂů ĐŽŵƉĂŶLJ ƐŚĞŶĂŶŝŐĂŶƐ ĨƌŽŵ ƚŚĞ DĂƌƚŝŶ ^ŚŬƌĞůŝ͛Ɛ ƚŽ ƚŚĞ ƉŝWĞŶ ĨŽůŬƐ ƐĞŶĚƐ ŵĞ ŝŶƚŽ ĂŶ ĂŶĂƉŚLJůĂĐƚŝĐ ƌĂŐĞ͘ ŶĚ ǁŚLJ ŚĂƐ ŝƚ ďĞĞŶ ƐŽ ŚĂƌĚ ƚŽ ƉƌĞƐĐƌŝďĞ ŐĞŶĞƌŝĐ ĚŽdžLJĐLJĐůŝŶĞ͕ ĨŽƌ ůŝŬĞ͕ ĨŝǀĞ LJĞĂƌƐ ŶŽǁ͊ dŚĞ ĐůŽƐĞĚ ĚŽŽƌ Zh ĂĚǀŝƐŽƌLJ ƉĂŶĞů ƚŽ DĞĚŝĐĂƌĞ Ɛƚŝůů ďůŽĂƚƐ ƐƉĞĐŝĂůƚLJ ƌĞŝŵďƵƌƐĞŵĞŶƚ ǁŚŝůĞ ƵŶĚĞƌƉĂLJŝŶŐ ƉƌŝŵĂƌLJ ĐĂƌĞ͘ DĞĚŝĐĂů ĞĚƵĐĂƚŝŽŶ ĚĞďƚ ŐƌŽǁƐ ĞǀĞƌ ŚŝŐŚĞƌ͘ hŶĚŽĐƵŵĞŶƚĞĚ ŝŵŵŝŐƌĂŶƚƐ Ɛƚŝůů ŚĂǀĞ ůŝƚƚůĞ ƌĞĐŽƵƌƐĞ ďƵƚ ƚŽ ŐŽ ƚŽ ƚŚĞ ͘ 'ƌƌƌƌ͙͘​͘

ȱ £ ȱ ¢ȱ ȱ ȱ ȱ ȱ ȱ ¢ ǰȱ ȱ ȱ ȱ ȱ ǰȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ £ ȱ ȱ ȱ ȱ ȱ ǯ

tŚĂƚ ŚĂƐ ǁŽƌŬĞĚ ƚŚĞ ƉĂƐƚ Ɛŝdž LJĞĂƌƐ͍ tĞůů͕ ŵLJ ĞůĞĐƚƌŽŶŝĐ ŚĞĂůƚŚ ƌĞĐŽƌĚ ; ,ZͿ ĐĂŶ ŶŽǁ ĂĐĐĞƐƐ ƚŚĂƚ ŽĨ ŽƚŚĞƌ ŚĞĂůƚŚ ƐLJƐƚĞŵƐ͘ WƌĞǀĞŶƚŝǀĞ ƐĞƌǀŝĐĞƐ ĂƌĞ ĐŽǀĞƌĞĚ͘ ŝƌƚŚ ĐŽŶƚƌŽů ŝƐ ďĞƚƚĞƌ ĐŽǀĞƌĞĚ͘ Ŷ ĞŵƉŚĂƐŝƐ ŽŶ ĐŽƐƚ ĐŽŶƚĂŝŶŵĞŶƚ ĂŶĚ ǀĂůƵĞͲ ďĂƐĞĚ ĐĂƌĞ ĐŽŶƚŝŶƵĞƐ ƚŽ ĞǀŽůǀĞ͘ &Žƌ ĞdžĂŵƉůĞ͕ / ĚŽŶ͛ƚ ƐĞĞ ŽŶĞ ŽĨ ŽƵƌ ůŽĐĂů ĐĂƌĚŝŽůŽŐLJ ĐĞŶƚĞƌƐ ĚŽŝŶŐ ƚŚĞ ǁŚŽůĞ ďŽĚLJ ƐĐĂŶƐ ŝƚ ŽŶĐĞ ĚŝĚ͘ Ƶƚ ŵŽƐƚ ŐƌĂƚŝĨLJŝŶŐ͕ / ƐĞĞ ƉĂƚŝĞŶƚƐ ǁŚŽ ƚĞůů ŵĞ ŚŽǁ ŚĂƉƉLJ ƚŚĞLJ ĂƌĞ ƚŽ ƐĞĞ Ă ĚŽĐƚŽƌ ĂĨƚĞƌ ƚŚĞLJ ĐŽƵůĚŶ͛ƚ ĨŽƌ ƐŽ ůŽŶŐ ďĞĐĂƵƐĞ ƚŚĞLJ ĚŝĚŶ͛ƚ ŚĂǀĞ ŝŶƐƵƌĂŶĐĞ͘ ,Žǁ ďĂĚ ǁŽƵůĚ ŝƚ ĨĞĞů ŶŽƚ ƚŽ ŚĂǀĞ ŚĞĂůƚŚ ŝŶƐƵƌĂŶĐĞ͍

dŚƌŽƵŐŚ Ă ůŽŐŝƐƚŝĐĂů ƐŶĂĨƵ ŝŶ ƚƌĂŶƐĨĞƌƌŝŶŐ ŵLJ ĨĂŵŝůLJ ƚŽ ŵLJ ǁŝĨĞ͛Ɛ ĚĞŶƚĂů ƉůĂŶ͕ / ĂĐĐŝĚĞŶƚĂůůLJ ĚƌŽƉƉĞĚ ŵLJƐĞůĨ ĨƌŽŵ ĚĞŶƚĂů

6

California Family Physician Fall 2016

EŽ ŝŶĚƵƐƚƌŝĂůŝnjĞĚ ĐŽƵŶƚƌLJ ŚĂƐ Ă ƉĞƌĨĞĐƚ ŚĞĂůƚŚ ĐĂƌĞ ƐLJƐƚĞŵ ͲͲ ǁĞ ŶĞǀĞƌ ǁŝůů ĞŝƚŚĞƌ ͲͲ ďƵƚ ŶŽǁ ǁĞ ŚĂǀĞ ũŽŝŶĞĚ ƚŚĞ &ŝƌƐƚ tŽƌůĚ ŝŶ ƌĞĐŽŐŶŝnjŝŶŐ ŚĞĂůƚŚ ĐĂƌĞ ĂƐ Ă ƌŝŐŚƚ͘ EŽǁ ǁĞ ĐĂŶ Ăůů ĐŽŵĞ ƚŽ ƚŚĞ ƚĂďůĞ ĂŶĚ ŚĂƐŚ ŽƵƚ ƚŚĞ ĚĞƚĂŝůƐ͘ DĞĂŶǁŚŝůĞ͕ ĚŽŶ͛ƚ ĨŽƌŐĞƚ ƚŽ ĨůŽƐƐ͘

Sutter Pacific Medical Foundation (SPMF) has an opportunity for a BC/BE Family Medicine physician to join Sutter Medical Group of the Redwoods (SMGR), a growing multi-specialty group in beautiful Sonoma County. Spanish speaking a plus! Benefits: t 1-2 years guaranteed income t Relocation allowance t Sign on bonus negotiable t Option for shareholder track after two years of employment t Generous compensation and benefits, including paid CME, up to six weeks’ vacation, pension plan and 401(k) Modalities: s 'OOD OPPORTUNITY FOR WORK LIFE BALANCE s #OMPLETELY AMBULATORY .O INPATIENT WORK s 0ATIENT PANEL CAN BE ESTABLISHED WITHIN three to six months SMGR is a 105+ member physician-owned, multi-specialty medical group that has served the City of Santa Rosa and surrounding areas FOR OVER YEARS 3-'2 HAS BEEN NATIONALLY recognized as a medical group that provides the highest quality and most complete health CARE POSSIBLE Located 55 miles north of San Francisco and MILES EAST OF THE 0ACIFIC /CEAN 3ANTA 2OSA is a warm and friendly city of 170,000 within 3ONOMA #OUNTY POPULATION 9OU WILL enjoy a unique blend of culture with exceptional ART WINE FOOD AND RECREATION !MENITIES include 400 wineries in Sonoma County, 27 golf courses, hot air ballooning, hiking, spas, RIVER SPORTS AND WORLD CLASS CUISINE 3ONOMA County also has a professional symphony, excellent public and private schools, fantastic weather, and some of the most affordable HOUSING IN THE "AY !REA 9OU WOULD LIVE AND WORK WHERE OTHERS ONLY DREAM OF VISITING Contact: Isabelle von Tobel

707.521.8841 vontobi@sutterhealth.org

California Family Physician Fall 2016

7

PRESIDENT’S MESSAGE

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From Where I Sit: The Medical Community Can Overcome Whatever Obstacle is Put in Front of Us / ŐƌĞǁ ƵƉ ŝŶ ŵŚĞƌƐƚ͕ DĂƐƐĂĐŚƵƐĞƩƐ ŝŶ Ă ŵĞĚŝĐĂů ĨĂŵŝůLJ͘ ,ĞĂůƚŚ ĐĂƌĞ ǁĂƐ Ă ĨƌĞƋƵĞŶƚ ĚŝŶŶĞƌ ƚĂďůĞ ĐŽŶǀĞƌƐĂƟŽŶ ƚŽƉŝĐ͘ / ŽŌĞŶ ĞŶǀŝƐŝŽŶĞĚ ŵLJƐĞůĨ ĂƐ Ă ĚŽĐƚŽƌ ƚĂŬŝŶŐ ĐĂƌĞ ŽĨ ƉĂƟĞŶƚƐ͘ / ǁŽŶĚĞƌĞĚ ǁŚĂƚ ƚŚĞ ŵĞĚŝĐĂů ĂƚŵŽƐƉŚĞƌĞ ǁŽƵůĚ ďĞ ůŝŬĞ ďLJ ƚŚĞ ƟŵĞ / ĮŶŝƐŚĞĚ ƵŶĚĞƌŐƌĂĚƵĂƚĞ ĂŶĚ ŵĞĚŝĐĂů ĞĚƵĐĂƟŽŶ͘ EŽǁĂĚĂLJƐ͕ ǁŝƚŚ ŚĞĂůƚŚ ĐĂƌĞ Ă ĨƌĞƋƵĞŶƚ ĚŝŶŶĞƌ ƚĂďůĞ ƚŽƉŝĐ ŝŶ ŵLJ ŽǁŶ ŚŽŵĞ͕ / ĐĂŶ͛ƚ ŚĞůƉ ďƵƚ ǁŽŶĚĞƌ ŚŽǁ ŵLJ ŽůĚĞƐƚ ĚĂƵŐŚƚĞƌ͕ :ƵůŝĂ͕ Ă ƐĞŶŝŽƌ ŝŶ ŚŝŐŚ ƐĐŚŽŽů ĐŽŶƚĞŵƉůĂƟŶŐ Ă ŵĞĚŝĐĂů ĐĂƌĞĞƌ͕ ŝƐ ŝŵĂŐŝŶŝŶŐ ŚĞƌ ĨƵƚƵƌĞ ŵŝŐŚƚ ůŽŽŬ͘ / ďĞŐĂŶ ƉƌĂĐƟĐĞ ďĞĨŽƌĞ ƚŚĞ ĂĚǀĞŶƚ ŽĨ ŵĂŶĂŐĞĚ ĐĂƌĞ͘ ,/s ǁĂƐ ƚŚĞ ŶĞǁĞƐƚ ďƵƌŐĞŽŶŝŶŐ ĚŝƐĞĂƐĞ ĚŽŵŝŶĂƟŶŐ ƚŚĞ ŵĞĚŝĐĂů ůĂŶĚƐĐĂƉĞ͘ &ŽƌƚƵŶĂƚĞůLJ͕ ǁĞ ůĞĂƌŶĞĚ ŚŽǁ ƚŽ ŚĂŶĚůĞ ĐĂƉŝƚĂƚĞĚ ƉĂLJŵĞŶƚ ĂŶĚ ŵĂŶĂŐĞĚ ĐĂƌĞ ƐLJƐƚĞŵƐ͘ tĞ ĞǀĞŶƚƵĂůůLJ ƵŶĚĞƌƐƚŽŽĚ ƚŚĞ ĚĞĂĚůLJ ƌĞƚƌŽǀŝƌƵƐ ǁĞůů ĞŶŽƵŐŚ ƚŽ ŬĞĞƉ ŝƚ Ăƚ ďĂLJ ǁŝƚŚ ĐŽŵďŝŶĂƟŽŶƐ ŽĨ ŵĞĚŝĐĂƟŽŶƐ͕ ĞǀĞŶ ƚŚŽƵŐŚ ǁĞ ŚĂǀĞ LJĞƚ ƚŽ ĚĞǀĞůŽƉ Ă ĐƵƌĞ͘ tĞ ůĞĂƌŶĞĚ ĂƐ Ă ŵĞĚŝĐĂů ĐŽŵŵƵŶŝƚLJ ƚŽ ŽǀĞƌĐŽŵĞ ǁŚĂƚĞǀĞƌ ŽďƐƚĂĐůĞ ǁĂƐ ƉƵƚ ŝŶ ĨƌŽŶƚ ŽĨ ƵƐ͘ tŚĂƚ ǁŝůů ďĞ ƚŚĞ ĚŽŵŝŶĂŶƚ ŵĞĚŝĐĂů ŝƐƐƵĞƐ ŽĨ ƚŚĞ ĐŽŵŝŶŐ ĚĞĐĂĚĞ͍ tŝůů ŝƚ ďĞ ƚŚĞ ĨƵƌƚŚĞƌ ŝŶƚƌŽĚƵĐƟŽŶ ŽĨ ŐĞŶŽŵŝĐ ŵĞĚŝĐŝŶĞ Žƌ ƚĞůĞŚĞĂůƚŚ͍ tŝůů ƐŵĂůů ĂŶĚ ƐŽůŽ ƉƌĂĐƟĐĞƐ ďĞ ĐŽŵƉůĞƚĞůLJ ŽǀĞƌƚĂŬĞŶ ďLJ ůĂƌŐĞ ŚĞĂůƚŚ ĐĂƌĞ ƐLJƐƚĞŵƐ͍ tŚĞƌĞ ǁŝůů D Z ĂŶĚ ǀĂůƵĞͲďĂƐĞĚ ŵĞĚŝĐŝŶĞ ůĞĂĚ͍ ĞĨŽƌĞ / ĐĂŶ ŵĞŶƚĂůůLJ ĂƩĞŵƉƚ ƚŽ ƚĂĐŬůĞ ƚŚĞƐĞ ŝƐƐƵĞƐ͕ ůĞƚ͛Ɛ ĂĚĚƌĞƐƐ ƚŚĞ ǁŚŽůĞ ŝƐƐƵĞ ŽĨ ƚŚĞ īŽƌĚĂďůĞ ĂƌĞ Đƚ ; Ϳ ĂŶĚ ŝƚƐ ĨƵƚƵƌĞ͘ dŚŝƐ ŝƐƐƵĞ ŽĨ California Family Physician ŝƐ ĚĞǀŽƚĞĚ ƚŽ ƚŚĞ ͗ ͞^ŝdž zĞĂƌƐ ĂŶĚ ŽƵŶƟŶŐ͗ dŚĞ 'ŽŽĚ͕ dŚĞ ĂĚ͕ ĂŶĚ dŚĞ WƌŽŵŝƐĞ͘͟ tĞůů͕ ŚĞƌĞ ĂƌĞ ŵLJ ƵŶŽĸĐŝĂů ƐĐŽƌĞĐĂƌĚ ĂŶĚ ƉƌŽŐŶŽƐƟĐĂƟŽŶƐ͗

ȱ ȱ ȱ ǰȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ¡ ȱ ȱ ¢ǯȱȱ ȱ ǰȱ ȱ ȱ

ȱ ȱ ǯȱȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ ǯ 8

California Family Physician Fall 2016

The Good: ͻ ƚ ůĞĂƐƚ ϮϬ ŵŝůůŝŽŶ ŶĞǁ ƉĂƟĞŶƚƐ ŚĂǀĞ ŚĞĂůƚŚ ŝŶƐƵƌĂŶĐĞ ;ƌŽƵŐŚůLJ ŽŶĞͲŚĂůĨ ďLJ DĞĚŝĐĂŝĚ ĞdžƉĂŶƐŝŽŶ ĂŶĚ ŽŶĞͲŚĂůĨ ďLJ ƚŚĞ ŝŶƐƵƌĂŶĐĞ ĞdžĐŚĂŶŐĞƐͿ͘ ĂůŝĨŽƌŶŝĂ ŚĂƐ ƚŚƌĞĞ ŵŝůůŝŽŶ ŶĞǁ ĞŶƌŽůůĞĞƐ ĨŽƌ DĞĚŝͲ Ăů ĂŶĚ ŵŽƌĞ ƚŚĂŶ ŽŶĞ ŵŝůůŝŽŶ ŶĞǁ ĐŽǀĞƌĞĚ ůŝǀĞƐ ƚŚƌŽƵŐŚ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ͖ ͻ ĞƉĞŶĚĞŶƚƐ ƵƉ ƚŽ ĂŐĞ Ϯϲ ŶŽǁ ĂƌĞ ŶŽǁ ĞůŝŐŝďůĞ ĨŽƌ ĐŽŶƟŶƵĞĚ ĐŽǀĞƌĂŐĞ ŽŶ ƚŚĞŝƌ ƉĂƌĞŶƚƐ͛ ƉůĂŶƐ͖ ͻ WĞŽƉůĞ ǁŝƚŚ ƉƌĞͲĞdžŝƐƟŶŐ ĐŽŶĚŝƟŽŶƐ ĐĂŶŶŽƚ ďĞ ĚĞŶŝĞĚ ĐŽǀĞƌĂŐĞ͖ ĂŶĚ ͻ ŽƐƚ ^ŚĂƌŝŶŐ ZĞĚƵĐƟŽŶ ƉƌŽŐƌĂŵ ŵĂŬŝŶŐ ŚĞĂůƚŚ ŝŶƐƵƌĂŶĐĞ ĨƌĞĞ Žƌ ǀĞƌLJ ĂīŽƌĚĂďůĞ ƚŽ ŵĂŶLJ ůŽǁĞƌ ŝŶĐŽŵĞ ŵĞƌŝĐĂŶƐ ŝƐ ŝŶ ƉůĂĐĞ͘ The Bad: ͻ ^ĞƌŝŽƵƐ ĐŽŶĐĞƌŶƐ ĂďŽƵƚ ƚŚĞ ĨƵƚƵƌĞ ůŽŶŐ ƚĞƌŵ ĮƐĐĂů ƐƚĂďŝůŝƚLJ ŽĨ ƚŚĞ ƉƌŽŐƌĂŵ ĂďŽƵŶĚ͖ ͻ ĂůŝĨŽƌŶŝĂ ƚŚƌŽƵŐŚ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ ĨŽƌ ϮϬϭϳ ŵĂLJ ƐĞĞ Ă ƉƌŽũĞĐƚĞĚ ϭϯ ƉĞƌĐĞŶƚ ƉƌĞŵŝƵŵ ŝŶĐƌĞĂƐĞ ;ǁŚĞŶ ŝŶĐƌĞĂƐĞƐ ǁĞƌĞ ƐƵƉƉŽƐĞĚ ƚŽ ďĞ ƚĂŝůŝŶŐ Žī͊Ϳ͖ ĂŶĚ ͻ dŚĞ ĐƵƌƌĞŶƚ ƚĂdž ƉĞŶĂůƚLJ ŝƐ ŶŽƚ ŚŝŐŚ ĞŶŽƵŐŚ ƚŽ ƉĞƌƐƵĂĚĞ ͞ŚĞĂůƚŚLJ͟ ŝŶĚŝǀŝĚƵĂůƐ ƚŽ ƐŝŐŶ ƵƉ͕ ƚŚƵƐ ĐĂƵƐŝŶŐ ƐĞƌŝŽƵƐ ĐŽŶĐĞƌŶƐ ĂďŽƵƚ ƌŝƐŬ ĐŽŶŐƌĞŐĂƟŽŶ ŝŶ ƚŚŽƐĞ ǁŚŽ ĚŽ ĚĞĐŝĚĞ ƚŽ ƐŝŐŶ ƵƉ͘ The Promise: ͻ dŚĞ ǁŝůů ďĞ ͞ďƵĚŐĞƚ ŶĞƵƚƌĂů͟ ĂŶĚ Ă ͞ŶĞƚ ƉŽƐŝƟǀĞ͟ ĨŽƌ ŽƵƌ ŚĞĂůƚŚ ĐĂƌĞ ƐLJƐƚĞŵ͊ ,ĂǀĞ ǁĞ ĂĐŚŝĞǀĞĚ ƚŚŝƐ ƉƌŽŵŝƐĞ͍ džƉĞƌƚƐ ǁŝůů ĐŽŶƟŶƵĞ ƚŽ ĚĞďĂƚĞ ƚŚŝƐ ŝƐƐƵĞ ĨŽƌ LJĞĂƌƐ ƚŽ ĐŽŵĞ͘ WƌĞƐŝĚĞŶƚ ĂƌĂĐŬ KďĂŵĂ ůĂƵĚĞĚ ƚŚĞ ĂĐĐŽŵƉůŝƐŚŵĞŶƚƐ ŽĨ ƚŚĞ ŝŶ Ă ƌĞĐĞŶƚ :ŽƵƌŶĂů ŽĨ ƚŚĞ ŵĞƌŝĐĂŶ DĞĚŝĐĂů ƐƐŽĐŝĂƟŽŶ ĂƌƟĐůĞ͘ KƚŚĞƌƐ ŚĂǀĞ ůĂŵďĂƐƚĞĚ ŝƚ ƉƵƌĞůLJ ĨƌŽŵ Ă ĮŶĂŶĐŝĂůͬ ĂĐƚƵĂƌŝĂů ďĂƐŝƐ ĂŶĚ ĐŽŶƐŝĚĞƌ ŝƚ Ă ͞ŚŽƵƐĞ ŽĨ ĐĂƌĚƐ͘͟ / ĐĂŶ ƚĞůů LJŽƵ / ƌĞĂůůLJ ĚŽŶ͛ƚ ŬŶŽǁ ƚŚĞ ĐŽŵƉůĞƚĞ ĂŶƐǁĞƌ LJĞƚ͘ / ƚŚŝŶŬ ǁĞ ĂƌĞ ƐƟůů Ă ǁŽƌŬ ŝŶ ƉƌŽŐƌĞƐƐ ĂŶĚ ƐůŽǁůLJ ĞǀŽůǀŝŶŐ͘ Ƶƚ ŵŽƌĞ ŝŵƉŽƌƚĂŶƚůLJ͕ ĨƌŽŵ ǁŚĞƌĞ / Ɛŝƚ ĂƐ WƌĞƐŝĚĞŶƚ ŽĨ ƚŚĞ &W͕ ĐŽŶĐĞƌŶĞĚ ĂďŽƵƚ ŽƵƌ ƉŝƉĞůŝŶĞ ŽĨ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͕ ƚŚĞ ƚŚŽƵŐŚƚƐ ŽĨ ŽƵƌ LJŽƵŶŐĞƌ ƐƚƵĚĞŶƚƐ ĂƌĞ ǁŚĂƚ / ǁĂŶƚ ƚŽ ŬŶŽǁ͘ tŚĂƚ ĚŽĞƐ :ƵůŝĂ ƚŚŝŶŬ Žƌ ĐĂƌĞ ĂďŽƵƚ ƚŚĞ ͍ tŝůů ŝƚ ďĞ ĐŽŵƉůĞƚĞůLJ ƚƌĂŶƐĨŽƌŵĞĚ ďLJ ƚŚĞ ƟŵĞ ƐŚĞ ĐŽŵƉůĞƚĞƐ ŚĞƌ ĞĚƵĐĂƟŽŶ͍ DŝŐŚƚ ŝƚƐ ĞīĞĐƚƐ ĚŝƐƐƵĂĚĞ ŚĞƌ ĨƌŽŵ ƉƵƌƐƵŝŶŐ Ă ĐĂƌĞĞƌ ŝŶ ŵĞĚŝĐŝŶĞ͍ tŚĂƚ ĂďŽƵƚ ŽƵƌ ĐƵƌƌĞŶƚ ŵĞĚŝĐĂů ƐƚƵĚĞŶƚƐ ĂŶĚ ƌĞƐŝĚĞŶƚƐ͍ tŝůů ƚŚĞ ĞīĞĐƚƐ ŽĨ ƚŚĞ ŐƌĞĂƚůLJ ŝŶŇƵĞŶĐĞ ƚŚĞŝƌ ĚĞƐŝƌĞƐ ƚŽ ƚƌĂŝŶ ƚŽ ďĞĐŽŵĞ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͍ &ƌŽŵ ǁŚĞƌĞ / Ɛŝƚ͕ ǁŝƚŶĞƐƐŝŶŐ ŚŽǁ ƚŚŝƐ Ăůů ƵŶĨƵƌůƐ ŝƐ ďŽƚŚ ĞdžĐŝƟŶŐ ĂŶĚ ƐĐĂƌLJ͘ Ƶƚ ƌĞŵĞŵďĞƌ͕ ǁĞ ƐƵƌǀŝǀĞĚ ,DKƐ ĂŶĚ ,/s͘ / ǁŽƵůĚ ďĞ ǁŝůůŝŶŐ ƚŽ ďĞƚ ƚŚĂƚ ǁĞ ĐĂŶ ƐƵƌǀŝǀĞ ƚŚĞ ͘

Mountain Valleys Health Centers, Inc. is a great place to work and rural north eastern California is a great place to live. Whether raising a family, relaxing in seclusion or working your own ranch the communities we live in and serve are a great place to enjoy a little slower pace and a much higher quality of life. Mountain Valleys Health Centers offer numerous attractive employment opportunities for health care professionals. If you are a dedicated, mission driven health care professional or want to be part of the staff of a mission driven corporation, please consider joining our team. MVHC is currently recruiting for a full scope Family Practice physician which includes being on staff at the local rural hospital and, preferably, performing OB.

We offer generous compensation packages including: ‡ )XOO 0HGLFDO %HQHILWV 3DFNDJH ‡ 5HWLUHPHQW 3ODQ ‡ &RQWLQXLQJ (GXFDWLRQ ‡ 372 +ROLGD\V ‡ 1+6& /RDQ 5HSD\PHQW ‡ )7&$ 0DOSUDFWLFH ,QVXUDQFH

Interested Candidates Please Contact: Mountain Valleys Health Centers 'DYH -RQHV &(2 530-294-5114 djones@mtnvalleyhc.org California Family Physician Fall 2016

9

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POLITICAL PULSE

We Really Will Have a Ballot Initiative Bonanza EĞdžƚ ŵŽŶƚŚ͕ ĂůŝĨŽƌŶŝĂ ǀŽƚĞƌƐ ǁŝůů ĚĞĐŝĚ ŝĚ ĚĞ ŽŶ ŽŶ ϭϳ ďĂĂůůůůŽƚ ůůŽƚƚ ŝŶŝŝƟĂ ƟĂƟǀ Ɵ ĞƐ Ɵǀ ĞƐ͕​͕ ŵĂŶLJ ŽĨ ǁŚŝĐŚ ĐŽƵůĚ ĂīĞĐƚ LJŽƵ ĂŶ ŶĚ LJŽ LJ Ƶƌ ƉĂƟ ĂƟĞŶ ƟĞŶ ĞŶƚƐ ƚƐ͘​͘ ƚƐ &W &&W W͛ƐƐ >ĞŐ ĞŐŝƐ ŝƐůĂ ŝƐ ƐůĂ ůĂƟǀ Ɵ Ğ Ɵǀ īĂŝƌƐ ŽŵŵŝƩĞĞ ĂŶĚ ŽĂƌĚ Ě ŽĨ ŝƌ ŝƌĞĐ ĞĐƚŽ ĞĐ ƚŽƌƐ ƚŽ ƌƐ ĐĂƌ Ă ĞĨ ĞĨƵů ƵůůLJ Ƶů ůLJ ƌĞǀ ĞǀŝĞ ŝĞǁĞ ŝĞ ǁĞĚ Ě ĞĂĂĐŚ ŝ ŝƟ ŝŶ ŝƟĂƟǀĞ ĂŶĚ ĂĚŽ Ě ƉƚĞĚ Ě ƚŚĞ ĨŽůůŽ Žǁŝ ǁ ŶŐ ƉŽƐ ŽƐŝƟ ŝƟŽŶ ŽŶƐ͗ Ɛ͗

SUPPORT:

CAFP urges you to WƌŽƉŽƐŝƟŽŶ ϱϮ Ͳ /Ŷ ϮϬϬϵ͕ Ă ĨĞĞ ŽŶ ĂůŝĨŽƌŶŝĂ ŚŽƐƉŝƚĂůƐ ǁĂƐ ĞƐƚĂďůŝƐŚĞĚ ƚŽ ĚƌĂǁ ĚŽǁŶ ĨĞĚĞƌĂů ŵŽŶĞLJ ƚŽ ĨƵŶĚ ŚŽƐƉŝƚĂůͲƉƌŽǀŝĚĞĚ ƵŶĐŽŵƉĞŶƐĂƚĞĚ ĐĂƌĞ͕ DĞĚŝͲ Ăů ƐĞƌǀŝĐĞƐ ĂŶĚ ƐƵƉƉŽƌƚ ĐŚŝůĚƌĞŶ͛Ɛ Ɖ ƉƉ ŚĞĂůƚŚ ĐŽǀĞƌĂŐĞ͘ dŚŝƐ ĨĞĞ ŚĞůƉĞĚ ĂůŝĨŽƌŶŝĂ ŚŽƐƉŝƚĂůƐ ĚƌĂǁ ĚŽǁŶ ƌŽƵŐŚůLJ ΨϮ ďŝůůŝŽŶ Ă LJĞĂƌ ŝŶ ĂĚĚŝƟŽŶĂů ĨĞĚĞƌĂů ŵŽŶĞLJ ƚŚƌŽƵŐŚ DĞĚŝͲ Ăů͘ dŚĞ 'ŽǀĞƌŶŽƌ ĂŶĚ >ĞŐŝƐůĂƚƵƌĞ ŚĂǀĞ ĚŝǀĞƌƚĞĚ ƐŽŵĞ ŽĨ ƚŚĞ ŵĂƚĐŚŝŶŐ ĨƵŶĚƐ ƚŽ ƚŚĞ ƐƚĂƚĞ͛Ɛ 'ĞŶĞƌĂů &ƵŶĚ͕ ŚŽǁĞǀĞƌ͘ dŚŝƐ ŝŶŝƟĂƟǀĞ ǁŽƵůĚ ŵĂŬĞ ƚŚĞ ĨĞĞ ƉĞƌŵĂŶĞŶƚ ĂŶĚ ůŝŵŝƚ ŚŽǁ ƚŚĞ ŵŽŶĞLJ ŝƐ ĂůůŽĐĂƚĞĚ͕ ƉƌĞǀĞŶƟŶŐ ŝƚ ĨƌŽŵ ďĞŝŶŐ ĚŝǀĞƌƚĞĚ ƚŽ ƚŚĞ 'ĞŶĞƌĂů &ƵŶĚ ƵŶůĞƐƐ ĚŽŶĞ ƚŚƌŽƵŐŚ Ă ĨƵƚƵƌĞ ďĂůůŽƚ ŝŶŝƟĂƟǀĞ͘ /ƚ ŝƐ ƐƵƉƉŽƌƚĞĚ ďLJ Ă ǀĂƐƚ ďŝƉĂƌƟƐĂŶ ŐƌŽƵƉ ŽĨ ůĞŐŝƐůĂƚŽƌƐ͕ ŚĞĂůƚŚ ĐĂƌĞ ƉƌŽǀŝĚĞƌ ŽƌŐĂŶŝnjĂƟŽŶƐ͕ ůĂďŽƌ͕ ďƵƐŝŶĞƐƐ ĂŶĚ ŽƚŚĞƌ ĂƐƐŽĐŝĂƟŽŶƐ͕ ĂŶĚ &W͛Ɛ ƌĞĐĞŶƚ ƐƵĐĐĞƐƐ ŝŶ ĐŽŶǀŝŶĐŝŶŐ ƚŚĞ >ĞŐŝƐůĂƚƵƌĞ ĂŶĚ 'ŽǀĞƌŶŽƌ ƚŽ ĂůůŽĐĂƚĞ ΨϭϬϬ ŵŝůůŝŽŶ ƚŽ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶ ƚƌĂŝŶŝŶŐ ŝƐ ƟĞĚ ƚŽ ƚŚŝƐ ĨĞĞ͕ ŵĂŬŝŶŐ LJŽƵƌ ƐƵƉƉŽƌƚ ĞƐƐĞŶƟĂů͘

ŌĞƌ ƐŝŐŶŝĮĐĂŶƚ ĚĞůŝďĞƌĂƟŽŶ͕ &W ĂĚŽƉƚĞĚ ƚǁŽ ƉŽůŝĐLJ ƐƚĂƚĞŵĞŶƚƐ ŝŶ ůŝĞƵ ŽĨ ƉŽƐŝƟŽŶƐ ŽŶ WƌŽƉŽƐŝƟŽŶ ϲϭ ĂŶĚ ϲϰ ;ďĞůŽǁͿ͘ KƵƌ ŶĞǁ ƉŽůŝĐŝĞƐ state: WƌĞƐĐƌŝƉƟŽ ƟŽŶ ƟŽ Ŷ ƌ Ŷ ƌƵŐ ƵŐ ŽƐ ŽƐƚƚ Ž ŽŶƚ ŶƚĂ ĂŝŶŵĞŶ ĂŝŶŵ Ğ ƚ ĂŶ ĞŶ ĂŶĚ Ě Wƌ WƌŝĐ ŝĐĞ Ğ dƌ dƌĂ ĂŶƐƉ ƐƉĂ ĂƌĞŶ Ăƌ ĞŶĐLJ ĐLJLJ &W ƐƵƉ ƉƉŽ ƉŽƌƚƐƐ Ɖƌ Ɖ ŽŐŐƌĂŵƐ ǁŚŽ ŽƐĞ ƉƵ ƵƌƉŽ ƉŽƐĞ ŝƐ Ɛ ƚŽ ƚŽ ĐŽŶ ŽŶƚĂ ƚĂŝŶ ƚŚĞ ƌŝƐ ŝƐŝŶ ŝŶŐ ĐŽƐƚƐ ŽĨ ƉƌĞƐĐƌŝƉƟŽŶ ĚƌƵŐƐ͕ ƉƌŽǀŝĚĞĚ ƚŚĂƚ ƚŚĞ ĨŽůůŽǁŝŶŐ ĐƌŝƚĞƌŝĂ ĂƌĞ ƐĂƟƐĮĞĚ͗ ;ĂͿ ƉŚLJƐŝĐŝĂŶƐ ŵƵƐƚ ŚĂǀĞ ƐŝŐŶŝĮĐĂŶƚ ŝŶƉƵƚ ŝŶƚŽ ƚŚĞ ĚĞǀĞůŽƉŵĞŶƚ ĂŶĚ ŵĂŝŶƚĞŶĂŶĐĞ ŽĨ ƐƵĐŚ ƉƌŽŐƌĂŵƐ͖ ;ďͿ ƐƵĐŚ ƉƌŽŐƌĂŵƐ ŵƵƐƚ ĞŶĐŽƵƌĂŐĞ ŽƉƟŵƵŵ Ɖ Ɖ ƉƌĞƐĐƌŝďŝŶŐŐ Ɖ ƉƌĂĐƟĐĞƐ ĂŶĚ ƋƵĂůŝƚLJ ŽĨ ĐĂƌĞ͖ Ƌ LJ ;;ĐͿͿ Ɖ ƉĂƟĞŶƚƐ ŵƵƐƚ ŚĂǀĞ ĂĐĐĞƐƐ ƚŽ Ăůů ƉƌĞƐĐƌŝƉƟŽŶ ĚƌƵŐƐ ŶĞĐĞƐƐĂƌLJ ƚŽ ƚƌĞĂƚ ƚŚĞŝƌ ŝůůŶĞƐƐĞƐ͖ ;ĚͿ ƉŚLJƐŝĐŝĂŶƐ ŵƵƐƚ ŚĂǀĞ ƚŚĞ ĨƌĞĞĚŽŵ ƚŽ ƉƌĞƐĐƌŝďĞ ƚŚĞ ŵŽƐƚ ĂƉƉƌŽƉƌŝĂƚĞ ĚƌƵŐ;ƐͿ ĂŶĚ ŵĞƚŚŽĚ ŽĨ ĚĞůŝǀĞƌLJ ĨŽƌ ƚŚĞ ŝŶĚŝǀŝĚƵĂů ƉĂƟĞŶƚ͖ ĂŶĚ ;ĞͿ ƐƵĐŚ ƉƌŽŐƌĂŵƐ ŝŶĐĞŶƟǀŝnjĞ ƌĞƐĞĂƌĐŚ ĂŶĚ ĚĞǀĞůŽƉŵĞŶƚ ŽĨ ĐůŝŶŝĐĂůůLJ ŶĞĞĚĞĚ ƉƌĞƐĐƌŝƉƟŽŶ ĚƌƵŐƐ͕ ǁŚŝůĞ ĞŶƐƵƌŝŶŐ ƉĂƟĞŶƚƐ ĐĂŶ ƌĞĂƐŽŶĂďůLJ ĂīŽƌĚ ƚŚĞŝƌ ŵĞĚŝĐĂƟŽŶƐ ĂƐ ůŽŶŐ ĂƐ ĐůŝŶŝĐĂůůLJ ŝŶĚŝĐĂƚĞĚ͘ /Ŷ ĂĚĚŝƟŽŶ͕

ϭͿ &W ƵƌŐĞƐ ƚŚĞ ĞůŝŵŝŶĂƟŽŶ ŽĨ ƚŚĞ DĞĚŝĐĂƌĞ ƉƌŽŚŝďŝƟŽŶ ŽŶ ĚƌƵŐ ƉƌŝĐĞ ŶĞŐŽƟĂƟŽŶ ĂŶĚ ĞŶĐŽƵƌĂŐĞƐ ĨĞĚĞƌĂů ůĞŐŝƐůĂƟŽŶ ƚŽ ŐŝǀĞ ƚŚĞ ^ĞĐƌĞƚĂƌLJ ŽĨ ƚŚĞ ĞƉĂƌƚŵĞŶƚ ŽĨ ,ĞĂůƚŚ ĂŶĚ ,ƵŵĂŶ ^ĞƌǀŝĐĞƐ ƚŚĞ ĂƵƚŚŽƌŝƚLJ ƚŽ ŶĞŐŽƟĂƚĞ ĐŽŶƚƌĂĐƚƐ ǁŝƚŚ ŵĂŶƵĨĂĐƚƵƌĞƌƐ ŽĨ ĐŽǀĞƌĞĚ WĂƌƚ ĚƌƵŐƐ͘ ϮͿ &W ƐƵƉƉŽƌƚƐ ĂŶ ĂƉƉƌŽƉƌŝĂƚĞ ďĂůĂŶĐĞ ďĞƚǁĞĞŶ ŝŶĐĞŶƟǀĞƐ ĨŽƌ ŝŶŶŽǀĂƟŽŶ ĂŶĚ ĞīŽƌƚƐ ƚŽ ƌĞĚƵĐĞ ƌĞŐƵůĂƚŽƌLJ ĂŶĚ ƐƚĂƚƵƚŽƌLJ ďĂƌƌŝĞƌƐ ƚŽ WƌŽƉŽƐŝƟŽŶ ϱϱ Ͳ dŚŝƐ ŝŶŝƟĂƟǀĞ ĞdžƚĞŶĚƐ ďLJ ƚǁĞůǀĞ LJĞĂƌƐ &WͲ ĐŽŵƉĞƟƟŽŶ ĂƐ ƉĂƌƚ ŽĨ ƚŚĞ ƉĂƚĞŶƚ ƐLJƐƚĞŵ͘ ƐƵƉƉŽƌƚĞĚ WƌŽƉŽƐŝƟŽŶ ϯϬ ƉĞƌƐŽŶĂů ŝŶĐŽŵĞ ƚĂdž ŝŶĐƌĞĂƐĞƐ ĞŶĂĐƚĞĚ ϯͿ &W ŽƉƉŽƐĞƐ ĂŶƟĐŽŵƉĞƟƟǀĞ ďĞŚĂǀŝŽƌ ďLJ ƉŚĂƌŵĂĐĞƵƟĐĂů ŝŶ ϮϬϭϮ ŽŶ ŝŶĚŝǀŝĚƵĂůƐ ĞĂƌŶŝŶŐ ŵŽƌĞ ƚŚĂŶ ΨϮϱϬ͕ϬϬϬ ĂŶŶƵĂůůLJ ;ŵŽƌĞ ĐŽŵƉĂŶŝĞƐ ĂƩĞŵƉƟŶŐ ƚŽ ƌĞĚƵĐĞ ĐŽŵƉĞƟƟŽŶ ĨƌŽŵ ŐĞŶĞƌŝĐ ƚŚĂŶ ΨϱϬϬ͕ϬϬϬ ĨŽƌ ũŽŝŶƚ ĮůĞƌƐͿ͘ dŚĞƐĞ ĨƵŶĚƐ ŚĂǀĞ ďĞĞŶ ĐƌƵĐŝĂů ƚŽ ŵĂŶƵĨĂĐƚƵƌĞƌƐ ƚŚƌŽƵŐŚ ŵĂŶŝƉƵůĂƟŽŶ ŽĨ ƉĂƚĞŶƚ ƉƌŽƚĞĐƟŽŶƐ ĂŶĚ ŵĂŝŶƚĂŝŶŝŶŐ ƐƚĂƚĞ ŚĞĂůƚŚ ƉƌŽŐƌĂŵƐ͖ ƚŚĞŝƌ ůŽƐƐ ĐŽƵůĚ ŵĞĂŶ ĐƵƚƐ ŽĨ ƵƉ ĂďƵƐĞ ŽĨ ƌĞŐƵůĂƚŽƌLJ ĞdžĐůƵƐŝǀŝƚLJ ŝŶĐĞŶƟǀĞƐ͘ ƚŽ ΨϮ ďŝůůŝŽŶ ƉĞƌ LJĞĂƌ͘ ϰͿ &W ĞŶĐŽƵƌĂŐĞƐ ƚŚĞ ŵŝƟŐĂƟŽŶ ŽĨ ƌĞƐƚƌŝĐƟŽŶƐ ƚŚĂƚ ůŝŵŝƚ ƉĂƟĞŶƚ ĂĐĐĞƐƐ ƚŽ͕ ĂŶĚ ŵĂƌŬĞƚ ĐŽŵƉĞƟƟŽŶ ĨŽƌ͕ ƉƌĞƐĐƌŝƉƟŽŶ ŵĞĚŝĐĂƟŽŶ͘ WƌŽƉŽƐŝƟŽŶ ϱϲ Ͳ dŚŝƐ ŝŶŝƟĂƟǀĞ ŝŶĐƌĞĂƐĞƐ ƚŚĞ ĐŝŐĂƌĞƩĞ ƚĂdž ďLJ ΨϮ͘ϬϬ ϲ ϱͿ &W ĞŶĐŽƵƌĂŐĞƐ ƉƌĞƐĐƌŝƉƟŽŶ ĚƌƵŐ ƉƌŝĐĞ ĂŶĚ ĐŽƐƚ ƚƌĂŶƐƉĂƌĞŶĐLJ ƉĞƌ ƉĂĐŬ͕ ǁŝƚŚ ĞƋƵŝǀĂůĞŶƚ ŝŶĐƌĞĂƐĞƐ ŽŶ ŽƚŚĞƌ ƚŽďĂĐĐŽ ƉƌŽĚƵĐƚƐ ĂŶĚ ĂŵŽŶŐ ƉŚĂƌŵĂĐĞƵƟĐĂů ĐŽŵƉĂŶŝĞƐ͕ ƉŚĂƌŵĂĐLJ ďĞŶĞĮƚ ŵĂŶĂŐĞƌƐ ĂŶĚ ĞůĞĐƚƌŽŶŝĐ ĐŝŐĂƌĞƩĞƐ ĐŽŶƚĂŝŶŝŶŐ ŶŝĐŽƟŶĞ͘ /ƚ ǁŽƵůĚ ĂůůŽĐĂƚĞ ƌĞǀĞŶƵĞƐ ŚĞĂůƚŚ ŝŶƐƵƌĂŶĐĞ ĐŽŵƉĂŶŝĞƐ͘ ƉƌŝŵĂƌŝůLJ ƚŽ ŝŶĐƌĞĂƐĞ ĂĐĐĞƐƐ ƚŽ ĐĂƌĞ ĨŽƌ DĞĚŝͲ Ăů ƉĂƟĞŶƚƐ ďLJ ƌĂŝƐŝŶŐ ϲͿ &W ƐƵƉƉŽƌƚƐ ŝŶĐƌĞĂƐĞĚ ŵĂŶƵĨĂĐƚƵƌĞƌ ƌĞďĂƚĞƐ ŝĨ ƚŚĞ ƉƌŝĐĞ ŽĨ Ă DĞĚŝͲ Ăů ƉƌŽǀŝĚĞƌ ƉĂLJŵĞŶƚ ƚŽ DĞĚŝĐĂƌĞ ůĞǀĞůƐ ĂŶĚ ĂŶŶƵĂůůLJ ŝŶǀĞƐƚƐ ŐĞŶĞƌŝĐ ĚƌƵŐ ƌŝƐĞƐ ĨĂƐƚĞƌ ƚŚĂŶ ŝŶŇĂƟŽŶ͘ ΨϰϬ ŵŝůůŝŽŶ ŝŶ ƌĞƐŝĚĞŶĐLJ ĨƵŶĚŝŶŐ͘ &ƵŶĚƐ ǁŽƵůĚ ĂůƐŽ ďĞ ƵƐĞĚ ĨŽƌ ϳͿ &W ƐƵƉƉŽƌƚƐ ƐŚŽƌƚĞŶŝŶŐ ĞdžĐůƵƐŝǀŝƚLJ ƟŵĞ ƉĞƌŝŽĚƐ ĨŽƌ ďŝŽůŽŐŝĐƐ͘ ƚŽďĂĐĐŽ ƵƐĞ ƉƌĞǀĞŶƟŽŶͬĐŽŶƚƌŽů ƉƌŽŐƌĂŵƐ͕ ƚŽďĂĐĐŽͲƌĞůĂƚĞĚ ĚŝƐĞĂƐĞ ϴͿ &W ƐƵƉƉŽƌƚƐ ƚŚĞ ĨƌĞĞĚŽŵ ŽĨ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ƚŽ ƵƐĞ ƚŚĞ ŵŽƐƚ ƌĞƐĞĂƌĐŚ͕ ůĂǁ ĞŶĨŽƌĐĞŵĞŶƚ ĂŶĚ ĚĞŶƚĂů ĚŝƐĞĂƐĞ ƉƌĞǀĞŶƟŽŶ ƉƌŽŐƌĂŵƐ͘ ĞīĞĐƟǀĞ ƉŚĂƌŵĂĐĞƵƟĐĂůƐ ǁŚĞŶ ƉƌĞƐĐƌŝďŝŶŐ ĚƌƵŐƐ ĨŽƌ ƚŚĞŝƌ ƉĂƟĞŶƚƐ ĂŶĚ ĞŶĐŽƵƌĂŐĞƐ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ƚŽ ƐƵƉƉůĞŵĞŶƚ ŵĞĚŝĐĂů ũƵĚŐŵĞŶƚ WƌŽƉŽƐŝƟŽŶ ϲϯ Ͳ dŚŝƐ ŝŶŝƟĂƟǀĞ ƉƌŽŚŝďŝƚƐ ƉŽƐƐĞƐƐŝŽŶ ŽĨ ůĂƌŐĞͲĐĂƉĂĐŝƚLJ ǁŝƚŚ ĐŽƐƚ ĐŽŶƐŝĚĞƌĂƟŽŶƐ ŝŶ ŵĂŬŝŶŐ ƚŚĞƐĞ ĐŚŽŝĐĞƐ͖ ĂŵŵƵŶŝƟŽŶ ŵĂŐĂnjŝŶĞƐ ĂŶĚ ƌĞƋƵŝƌĞƐ ƚŚĞŝƌ ĚŝƐƉŽƐĂů ďLJ ƐĂůĞ ƚŽ ϵͿ &W ĞŶĐŽƵƌĂŐĞƐ ĞdžƉĂŶĚĞĚ ƚŚŝƌĚ ƉĂƌƚLJ ĐŽǀĞƌĂŐĞ ŽĨ ƉƌĞƐĐƌŝƉƟŽŶ ĚĞĂůĞƌƐ͕ ĚĞƐƚƌƵĐƟŽŶ Žƌ ƌĞŵŽǀĂů ĨƌŽŵ ƚŚĞ ƐƚĂƚĞ͘ /ƚ ǁŽƵůĚ ĂůƐŽ ƌĞƋƵŝƌĞ ƉŚĂƌŵĂĐĞƵƟĐĂůƐ ĂƐ ĐŽƐƚ ĞīĞĐƟǀĞ ĂŶĚ ŶĞĐĞƐƐĂƌLJ ŵĞĚŝĐĂů ƚŚĞƌĂƉŝĞƐ͖ ŵŽƐƚ ŝŶĚŝǀŝĚƵĂůƐ ƚŽ ƉĂƐƐ ďĂĐŬŐƌŽƵŶĚ ĐŚĞĐŬƐ ĂŶĚ ŽďƚĂŝŶ ĞƉĂƌƚŵĞŶƚ ϭϬͿ &W ĞŶĐŽƵƌĂŐĞƐ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ƚŽ ĐŽŶƐŝĚĞƌ ƉƌĞƐĐƌŝďŝŶŐ ƚŚĞ ůĞĂƐƚ ŽĨ :ƵƐƟĐĞ ĂƵƚŚŽƌŝnjĂƟŽŶƐ ƚŽ ƉƵƌĐŚĂƐĞ ĂŵŵƵŶŝƟŽŶ͘ DŽƐƚ ĂŵŵƵŶŝƟŽŶ ĞdžƉĞŶƐŝǀĞ & ͲƌĂƚĞĚ ŐĞŶĞƌŝĐ ƉƌŽĚƵĐƚƐ͕ ƵŶůĞƐƐ ŝƚ ŝƐ ŶŽƚ ĂǀĂŝůĂďůĞ͖ ƐĂůĞƐ ǁŽƵůĚ ŚĂǀĞ ƚŽ ďĞ ŵĂĚĞ ƚŚƌŽƵŐŚ ůŝĐĞŶƐĞĚ ĂŵŵƵŶŝƟŽŶ ǀĞŶĚŽƌƐ ĂŶĚ ĂŶĚ ƌĞƉŽƌƚĞĚ ƚŽ ƚŚĞ ĞƉĂƌƚŵĞŶƚ ŽĨ :ƵƐƟĐĞ͘ >ŽƐƚ Žƌ ƐƚŽůĞŶ ĮƌĞĂƌŵƐ ϭϭͿ &W ĞŶĐŽƵƌĂŐĞƐ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ƚŽ ďĞĐŽŵĞ ĨĂŵŝůŝĂƌ ǁŝƚŚ ƚŚĞ ĂŶĚ ĂŵŵƵŶŝƟŽŶ ŵƵƐƚ ďĞ ƌĞƉŽƌƚĞĚ ƚŽ ůĂǁ ĞŶĨŽƌĐĞŵĞŶƚ͘ /ƚ ǁŽƵůĚ ƉƌŝĐĞƐ ŝŶ ƚŚĞŝƌ ĐŽŵŵƵŶŝƟĞƐ ŽĨ ƚŚĞ ŵĞĚŝĐĂƟŽŶƐ ƚŚĞLJ ƉƌĞƐĐƌŝďĞ ĂŶĚ ƚŽ ĂůƐŽ ƉƌŽŚŝďŝƚ ƉĞƌƐŽŶƐ ĐŽŶǀŝĐƚĞĚ ŽĨ ƐƚĞĂůŝŶŐ Ă ĮƌĞĂƌŵ ĨƌŽŵ ƉŽƐƐĞƐƐŝŶŐ ĐŽŶƐŝĚĞƌ ƚŚŝƐ ĂůŽŶŐ ǁŝƚŚ ƚŚĞ ƚŚĞƌĂƉĞƵƟĐ ďĞŶĞĮƚƐ ŽĨ ƚŚĞ ŵĞĚŝĐĂƟŽŶƐ ĮƌĞĂƌŵƐ ŝŶ ƚŚĞ ĨƵƚƵƌĞ͘ ƚŚĞLJ ƐĞůĞĐƚ ĨŽƌ ƚŚĞŝƌ ƉĂƟĞŶƚƐ͘ 10

California Family Physician Fall 2016

ŽŶƟŶƵĞĚ ŽŶ ƉĂŐĞ ϭϮ ххх

MED7 has been providing urgent care services in the Greater Sacramento area since 1987

Urgent care clinics are located in Roseville, Carmichael, Folsom & North Sacramento. All shifts 9am to 9pm. Full time is 13 shifts per month. We offer our full time physicians the following: full malpractice coverage, medical & dental coverage at no cost for the physician & any dependents, disability policy & we have a simple IRA you can contribute to with 3% matching. Part time is 6 to 8 shifts per month. For more information about MED7 and our clinics please visit our website: www.med7.com We offer an attractive compensation package. Contact Merl O’Brien,MD, at: (916) 791-1300, ext.11111; or email CV to: sherry@med7atwork.com.

Primary Care Opportunities in Southern California Loma Linda University Faculty Medical Group, is seeking candidates for the following positions: • Inpatient Hospitalist • Outpatient Clinics in Loma Linda and outlying areas • Federally Qualified Health Center • Community-Based Outpatient Clinics/VA We are looking for applicants that BE/BC in Family Medicine or Internal Medicine, with a commitment to developing comprehensive quality primary care services. Includes opportunities for onsite teaching and metoring Loma Linda University students and residents. Loma Linda University is located East of Los Angeles, known as the Inland Empire. The beached of Newport, Laguna, and Malibu are only 60-90 minutes to the West, with superb swimming, sunbathing, surfing, and sailing. Also 60 minutes to the West is downtown Los Angeles, with its top-quality restaurants, world-renowed museums, opera, and other cultural opportunities. The Big Bear Mountain Ski resort is about an hour drive from LLU. The golf courses, shopping, and spas of Palm Springs are an hour drive to the East and the World-class Mammoth Mountain resort is a 6 hour drive to the North. These opportunities are not eligible for a J1 Waiver.

Interested candidates, please send your CV to: Mike Unterseher Director of Physician Recruitment recruitmd@llu.edu 800-328-1163

Two engaging courses, one getaway destination: PALLIATIVE MEDICINE IN CLINICAL PRACTICE 2017 Learn from leading experts how to improve symptom management and complex medical decision making for patients with advanced illnesses. FEBRUARY 13-15, 2017

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JW MARRIOTT DESERT SPRINGS RESORT & SPA PALM DESERT, CALIFORNIA

DĂƌŝũƵĂŶĂ WŽƐƐĞƐƐŝŽŶ ĂŶĚ WĞƌƐŽŶĂů hƐĞ &W ƐƵƉƉŽƌƚƐ ƚŚĞ ĚĞĐƌŝŵŝŶĂůŝnjĂƟŽŶ ŽĨ ƚŚĞ ƉŽƐƐĞƐƐŝŽŶ ĂŶĚ ƉĞƌƐŽŶĂů ƵƐĞ ŽĨ ŵĂƌŝũƵĂŶĂ͕ ďƵƚ ƚŚĞ ůĂĐŬ ŽĨ ƐĐŝĞŶƟĮĐ ĚĂƚĂ ĂŶĚ ƉĞĞƌͲƌĞǀŝĞǁĞĚ ƌĞƐĞĂƌĐŚ ƉƌĞǀĞŶƚƐ &W ĨƌŽŵ ĞŶĚŽƌƐŝŶŐ ŝƚƐ ƌĞĐƌĞĂƟŽŶĂů ƵƐĞ͘ &W ƐƵƉƉŽƌƚƐ ƚŚĞ ĨŽůůŽǁŝŶŐ ŵĞĂƐƵƌĞƐ ƚŽ ŝŵƉƌŽǀĞ ƉĂƟĞŶƚ ƐĂĨĞƚLJ ĂŶĚ ĞdžƉĂŶĚ ƚŚĞ ƌĞůŝĂďŝůŝƚLJ ĂŶĚ ƐƚƌĞŶŐƚŚ ŽĨ ŵĂƌŝũƵĂŶĂ ƌĞƐĞĂƌĐŚ͗ ͻ dŚĞ ĨĞĚĞƌĂů ŐŽǀĞƌŶŵĞŶƚ ƐŚŽƵůĚ ĐŚĂŶŐĞ ƉŚĂƌŵĂĐĞƵƟĐĂů ĐĂŶŶĂďŝŶŽŝĚƐ ĨƌŽŵ ^ĐŚĞĚƵůĞ / ƚŽ Ă ^ĐŚĞĚƵůĞ // ĚƌƵŐƐ ƚŽ ĨĂĐŝůŝƚĂƚĞ ƌĞƐĞĂƌĐŚ͕ ĂŶĚ ƉƌŝǀĂƚĞ ŵĂŶƵĨĂĐƚƵƌŝŶŐ ĂŶĚ ĚŝƐƚƌŝďƵƟŽŶ ŽĨ ŵĂƌŝũƵĂŶĂ ƐŚŽƵůĚ ďĞ ƉĞƌŵŝƩĞĚ ĨŽƌ ƌĞƐĞĂƌĐŚ ƉƵƌƉŽƐĞƐ͘ ͻ /Ŷ ƐƚĂƚĞƐ ŝŶ ǁŚŝĐŚ ŵĂƌŝũƵĂŶĂ ŝƐ ůĞŐĂůŝnjĞĚ͕ ƌĞƐĞĂƌĐŚ ƐŚŽƵůĚ ďĞ ĐŽŶĚƵĐƚĞĚ ŝŶƚŽ ƚŚĞ ŽǀĞƌĂůů ƐĂĨĞƚLJ ĂŶĚ ŚĞĂůƚŚ ĞīĞĐƚƐ ŽĨ ƚŚĞ ƌĞĐƌĞĂƟŽŶĂů ƵƐĞ ŽĨ ŵĂƌŝũƵĂŶĂ͕ ĂƐ ǁĞůů ĂƐ ƚŚĞ ĞīĞĐƚƐ ŽĨ ůĞŐĂůŝnjĂƟŽŶ ŽŶ ƉĂƟĞŶƚ ĂŶĚ ƐŽĐŝĞƚĂů ŚĞĂůƚŚ͘ ͻ dŚĞ ĨĞĚĞƌĂů &ŽŽĚ ĂŶĚ ƌƵŐ ĚŵŝŶŝƐƚƌĂƟŽŶ͕ Žƌ Ă ƐŝŵŝůĂƌ ƐƚĂƚĞ ĂŐĞŶĐLJ͕ ƐŚŽƵůĚ ƚŚŽƌŽƵŐŚůLJ ŝŶǀĞƐƟŐĂƚĞ ƌĞĐƌĞĂƟŽŶĂů ĂŶĚ ŵĞĚŝĐŝŶĂů ŵĂƌŝũƵĂŶĂ ĨŽƌ ƐĂĨĞƚLJ ĂŶĚ ĞĸĐĂĐLJ͕ ŝŶĐůƵĚŝŶŐ ŵŽŶŝƚŽƌŝŶŐ ĨŽƌ ƉƵƌŝƚLJ͕ ƐƚĂŶĚĂƌĚŝnjĂƟŽŶ ŽĨ ƐƚƌĞŶŐƚŚ ĂŶĚ ƉƌŽƉĞƌ ƵƐĂŐĞ͕ ĂƐ ǁĞůů ĂƐ ƚĞƐƟŶŐ ĨŽƌ ŚĂƌŵĨƵů ĐŽŶƚĂŵŝŶĂŶƚƐ ƐƵĐŚ ĂƐ ŝŶƐĞĐƟĐŝĚĞƐ͕ ŚĞƌďŝĐŝĚĞƐ Žƌ ŵŽůĚƐ͘ /Ŷ ĂĚĚŝƟŽŶ͕ &W ďĞůŝĞǀĞƐ ŽƵƌ ƐŽĐŝĞƚLJ ŵƵƐƚ ƌĞĐŽŐŶŝnjĞ ĚƌƵŐ ƵƐĞ ĂŶĚ ĂďƵƐĞ ĂƐ ŵĞĚŝĐĂů ĂŶĚ ƐŽĐŝĂů ƉƌŽďůĞŵƐ ƚŚĂƚ ŵƵƐƚ ďĞ ƚƌĞĂƚĞĚ ǁŝƚŚ ŵĞĚŝĐĂů ĂŶĚ ƐŽĐŝĂů ƐŽůƵƟŽŶƐ͘ &W ĐĂůůƐ ŽŶ ƚŚĞ WƌĞƐŝĚĞŶƚ ĂŶĚ ŽŶŐƌĞƐƐ ƚŽ ĞŵƉŽǁĞƌ ĂŶ ŽďũĞĐƟǀĞ ĐŽŵŵŝƐƐŝŽŶ ƚŽ ƌĞĐŽŵŵĞŶĚ ƌĞǀŝƐŝŽŶ ŽĨ ŶĂƟŽŶĂů ĚƌƵŐ ůĂǁƐ ƚŽ ƌĞĚƵĐĞ ƚŚĞ ŚĂƌŵ ĐĂƵƐĞĚ ďLJ ĐƵƌƌĞŶƚ ƉŽůŝĐŝĞƐ͘ WƌŽƉŽƐŝƟŽŶ ϲϭ Ͳ dŚŝƐ ŝŶŝƟĂƟǀĞ ǁŽƵůĚ ƉƌŽŚŝďŝƚ ƐƚĂƚĞ ĂŐĞŶĐŝĞƐ ĨƌŽŵ ƉĂLJŝŶŐ ŵŽƌĞ ĨŽƌ Ă ƉƌĞƐĐƌŝƉƟŽŶ ĚƌƵŐ ƚŚĂŶ ƚŚĞ ůŽǁĞƐƚ ƉƌŝĐĞ ƉĂŝĚ ĨŽƌ ƚŚĞ ƐĂŵĞ ĚƌƵŐ ďLJ ƚŚĞ hŶŝƚĞĚ ^ƚĂƚĞƐ ĞƉĂƌƚŵĞŶƚ ŽĨ sĞƚĞƌĂŶƐ īĂŝƌƐ ;s Ϳ͘ ^ƵƉƉŽƌƚĞƌƐ ĂƌŐƵĞ ƚŚĞ ŝŶŝƟĂƟǀĞ ǁŽƵůĚ ůŽǁĞƌ ĚƌƵŐ ƉƌŝĐĞƐ ĂŶĚ ŝŶĐƌĞĂƐĞ ƚƌĂŶƐƉĂƌĞŶĐLJ͘ KƉƉŽŶĞŶƚƐ ĂƌŐƵĞ ƚŚĂƚ ƚŚĞ ŝŶŝƟĂƟǀĞ ŝƐ ƉŽŽƌůLJ ǁƌŝƩĞŶ ĂŶĚ ǁŝůů ŶŽƚ Įdž ƚŚĞ ƌŝƐĞ ŝŶ ƉƌĞƐĐƌŝƉƟŽŶ ĐŽƐƚƐ͘ EŽŶƉĂƌƟƐĂŶ ĂŶĂůLJƐƚƐ ŚĂǀĞ ƌĂŝƐĞĚ ĐŽŶĐĞƌŶƐ ƌĞŐĂƌĚŝŶŐ Ă ůĂĐŬ ŽĨ ƌĞůŝĂďůĞ ŝŶĨŽƌŵĂƟŽŶ ŽŶ ĚƌƵŐ ĐŽƐƚƐ ĂŶĚ ƵŶŝŶƚĞŶĚĞĚ ĐŽŶƐĞƋƵĞŶĐĞƐ ƚŚĂƚ ĐŽƵůĚ ƌĞƐƵůƚ ŝĨ ƚŚĞ ŵĞĂƐƵƌĞ ƉĂƐƐĞƐ͘ dŚĞ s ͛Ɛ ĚƌƵŐ ƉƌŝĐŝŶŐ ĚĂƚĂ ŝƐ ĐŽŶĮĚĞŶƟĂů͕ ĂƐ ĂƌĞ ŵŽƐƚ ƐƚĂƚĞ ƉƌŝĐŝŶŐ ĂŐƌĞĞŵĞŶƚƐ ǁŝƚŚ ĚƌƵŐ ĐŽŵƉĂŶŝĞƐ͘ /ƚ ŝƐ ƉŽƐƐŝďůĞ ƚŚĞ ƐƚĂƚĞ ŝƐ ƌĞĐĞŝǀŝŶŐ Ă ďŝŐŐĞƌ ĚŝƐĐŽƵŶƚ ƚŚĂŶ ƚŚĞ s ŝŶ ƐŽŵĞ ŝŶƐƚĂŶĐĞƐ͘ dŚĞƌĞ ŝƐ ĂůƐŽ ĐŽŶĐĞƌŶ ƚŚĂƚ ƚŚĞ ůĂŶŐƵĂŐĞ ŽĨ ƚŚĞ ŝŶŝƟĂƟǀĞ ƟĞƐ ƚŚĞ ƉƌŝĐĞ ƚŽ ǁŚĂƚ ƚŚĞ s ƉĂLJƐ͕ ĂƐ ŽƉƉŽƐĞĚ ƚŽ ƚŚĞ ĂĐƚƵĂů ĐŽƐƚ ŽĨ ƚŚĞ ĚƌƵŐ͕ ǁŚŝĐŚ ĐƌĞĂƚĞƐ ĂŶ ŝŶĐĞŶƟǀĞ ĨŽƌ ĐŽŵƉĂŶŝĞƐ ƚŽ ƌĂŝƐĞ ƚŚĞ s ƉƌŝĐĞ͕ ĂƐ ŽƉƉŽƐĞĚ ƚŽ ůŽǁĞƌŝŶŐ ƚŚĞ ƐƚĂƚĞ ƉƌŝĐĞ͘ WƌŽƉŽƐŝƟŽŶ ϲϰ Ͳ dŚŝƐ ŝŶŝƟĂƟǀĞ ǁŽƵůĚ ůĞŐĂůŝnjĞ ŵĂƌŝũƵĂŶĂ ĂŶĚ ŚĞŵƉ ƵŶĚĞƌ ƐƚĂƚĞ ůĂǁ ĂŶĚ ůŝĐĞŶƐĞ ĂŶĚ ƌĞŐƵůĂƚĞ ƚŚĞ ŵĂƌŝũƵĂŶĂ ŝŶĚƵƐƚƌLJ͘ /ƚ ǁŽƵůĚ ŝŵƉŽƐĞ ƐƚĂƚĞ ƚĂdžĞƐ ŽŶ ƚŚĞ ƐĂůĞ ĂŶĚ ĐƵůƟǀĂƟŽŶ ŽĨ ŵĂƌŝũƵĂŶĂ͘ /ƚ ǁŽƵůĚ ĂůƐŽ ĐƌĞĂƚĞ ƉĂĐŬĂŐŝŶŐ͕ ůĂďĞůŝŶŐ͕ ĂĚǀĞƌƟƐŝŶŐ ĂŶĚ ŵĂƌŬĞƟŶŐ ƐƚĂŶĚĂƌĚƐ ĂŶĚ ƌĞƐƚƌŝĐƟŽŶƐ ĨŽƌ ŵĂƌŝũƵĂŶĂ ƉƌŽĚƵĐƚƐ͕ ĂůƚŚŽƵŐŚ ŝƚ ƉƌŽŚŝďŝƚƐ ŵĂƌŬĞƟŶŐ ĂŶĚ ĂĚǀĞƌƟƐŝŶŐ ƚŽ ŵŝŶŽƌƐ͘ /ƚ ǁŽƵůĚ ĂƵƚŚŽƌŝnjĞ ƚŚĞ ĚĞƐƚƌƵĐƟŽŶ ŽĨ ƌĞĐŽƌĚƐ ĂŶĚ ƌĞƐĞŶƚĞŶĐŝŶŐ ŽĨ ƉƌŝŽƌ ŵĂƌŝũƵĂŶĂͲƌĞůĂƚĞĚ ĐŽŶǀŝĐƟŽŶƐ͘ 12

California Family Physician Fall 2016

&W͛Ɛ ^ĞŶŝŽƌ &W ĞůĞŐĂƚĞ ĂƌůĂ <ĂŬƵƚĂŶŝ͕ D ͕ ĂŶŶŽƵŶĐĞĚ ŚĞƌ ƌĞƟƌĞŵĞŶƚ ĨƌŽŵ ƚŚĞ ĚĞůĞŐĂƟŽŶ ǁŝƚŚ ƚŚĞ ĐůŽƐĞ ŽĨ ƚŚĞ ϮϬϭϲ ŽŶŐƌĞƐƐ͘ ĂƌůĂ ŚĂƐ ƐĞƌǀĞĚ ƚŚŝƐ ĚĞůĞŐĂƟŽŶ ĂƐ ĂŶ ĂůƚĞƌŶĂƚĞ ĂŶĚ ĚĞůĞŐĂƚĞ ĂŶĚ ůĞĚ ůĞĐƚ :ĂĐŬ ŚŽƵ ĐĂŵƉĂŝŐŶ ƚĞĂŵƐ͘ ^ŚĞ ǁŝůů ĐŽŶƟŶƵĞ ƚŽ ƐĞƌǀĞ ĂƐ ĐŚĂŝƌ ŽĨ ƚŚĞ &W͛Ɛ >ĞŐŝƐůĂƟǀĞ īĂŝƌƐ ŽŵŵŝƩĞĞ ĂŶĚ &WͲW ͕ ĂŶĚ ŚĂƐ ũƵƐƚ ďĞĞŶ ƌĞĂƉƉŽŝŶƚĞĚ ƚŽ ƚŚĞ ŶĂƟŽŶĂů &ĂŵDĞĚW ŽĂƌĚ ŽĨ ŝƌĞĐƚŽƌƐ͘ dŚĂŶŬƐ ƚŽ ĂƌůĂ ĨŽƌ ŚĞƌ LJĞĂƌƐ ŽĨ ƐĞƌǀŝĐĞ͕ ŐĞŶƚůĞ ŐƵŝĚĂŶĐĞ͕ ĂŶĚ ƚŚŽƵŐŚƞƵů ůĞĂĚĞƌƐŚŝƉ͘

THE STRENGTH TO HEAL and stand by those who stand up for me. Learn n the latest treatments and play an impo mportant role in the care of Sold mp oldiers ol and th heir famil ilies. As a physician on the U.S. Army Reserve health care team, you’ll continue to practtice in yourr comm munity and serve when ne eeded. You’ll work with the most advanced techn nollogy and disting guish you urse rself while rs e wo orking g with dedicated proffessio onalss. You’lll make a difference. To learn more about the U.S. Army health care team, call 310-216-4433 or visit healthcare.goarmy.com/eb19.

©2013. Paid aid d for o by the h Uni Unitted St S ate es Army. All A rights reserved.

California Family Physician Fall 2016

13

MEMBERSHIP

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Your Membership Matters /͛ǀĞ ũƵƐƚ ƌĞƚƵƌŶĞĚ ĨƌŽŵ >ŽƐ ŶŐĞůĞƐ ĂŶĚ ƚŚĞ &W Foundation’s Family Medicine Summit͕ ŵLJ ĨŝƌƐƚ ƐŝŶĐĞ ũŽŝŶŝŶŐ ƚŚĞ &W ƚĞĂŵ ŝŶ Ɖƌŝů͘ tĞ ŚĂĚ ŵŽƌĞ ƚŚĂŶ ϮϬϬ ƐƚƵĚĞŶƚƐ͕ ƌĞƐŝĚĞŶƚƐ͕ ƐƉĞĂŬĞƌƐ ĂŶĚ ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵ ĞdžŚŝďŝƚŽƌƐ ʹ ŽƵƌ ďŝŐŐĞƐƚ ƚƵƌŶŽƵƚ ĞǀĞƌ͘ dŚŝƐ ĂŶŶƵĂů ĞǀĞŶƚ ŝƐ Ă ŽŶĞͲŽĨͲĂͲŬŝŶĚ ŽƉƉŽƌƚƵŶŝƚLJ ĨŽƌ ŽƵƌ ƐƚƵĚĞŶƚƐ ĂŶĚ ƌĞƐŝĚĞŶƚƐ ƚŽ ŐĂŝŶ ĐůŝŶŝĐĂů ŬŶŽǁůĞĚŐĞ͕ ŐĞƚ ĂĐƋƵĂŝŶƚĞĚ ǁŝƚŚ ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵƐ ĂŶĚ ĚĞǀĞůŽƉ ŵĞĂŶŝŶŐĨƵů ƌĞůĂƚŝŽŶƐŚŝƉƐ ǁŝƚŚ ŽƚŚĞƌ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͘

DŽŶĚĂLJ͕ DĂƌĐŚ ϲ͘ tĂŶĚĂ &ŝůĞƌ͕ D ͕ D ͕ & &W͕ ƐŽŽŶͲƚŽͲďĞ ŽĂƌĚ ŚĂŝƌ ŽĨ ƚŚĞ ŵĞƌŝĐĂŶ ĐĂĚĞŵLJ ŽĨ &ĂŵŝůLJ WŚLJƐŝĐŝĂŶƐ͕ ǁŝůů ĚĞůŝǀĞƌ ƚŚĞ ŬĞLJŶŽƚĞ ĂĚĚƌĞƐƐ͘ tĞŶĚLJ dĂLJůŽƌͲdĂŶŝĞůŝĂŶ ǁŝůů ĐŽŶĚƵĐƚ ŽƵƌ ͞WƌŽĚƵĐƚŝǀĞ ^ƚŽƌLJƚĞůůŝŶŐ͟ ǁŽƌŬƐŚŽƉ ƚŽ ŚĞůƉ ĂƚƚĞŶĚĞĞƐ ĨƌĂŵĞ ƐƚŽƌŝĞƐ ƚŽ ĞĨĨĞĐƚ ĐŚĂŶŐĞ ĂŶĚ ŝŶĨůƵĞŶĐĞ ŶŽƚ ŽŶůLJ ƉŽůŝĐLJŵĂŬĞƌƐ͕ ďƵƚ ĂůƐŽ ƉĂƚŝĞŶƚƐ͘

dŚŝƐ ŵĞĞƚŝŶŐ ŝƐ ŽƉĞŶ ƚŽ Ăůů &W ŵĞŵďĞƌƐ͕ ǁŚĞƚŚĞƌ Žƌ ŶŽƚ LJŽƵ ĂƌĞ Ă ĚĞůĞŐĂƚĞ Žƌ ĂůƚĞƌŶĂƚĞ ĨƌŽŵ LJŽƵƌ ĐŽƵŶƚLJ ĐŚĂƉƚĞƌ Žƌ Ă ŐĞŶĞƌĂů ĂƚƚĞŶĚĞĞ͕ hd LJŽƵ ŵƵƐƚ ƌĞŐŝƐƚĞƌ ŝŶ ĂĚǀĂŶĐĞ͘ KƵƌ ĚĂLJ͕ ĨŽĐƵƐŝŶŐ ŽŶ ƐŽĐŝĂů ŝƐƐƵĞƐ ĨĂĐŝŶŐ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ͕ >ĞĂƌŶ ŵŽƌĞ ĂďŽƵƚ ƚŚĞ D D ĂŶĚ ƌĞŐŝƐƚĞƌ Ăƚ ŽƵƌ ǁĞďƐŝƚĞ ŝŶĐůƵĚĞĚ Ă ĐŽŵƉĞůůŝŶŐ ƉĂŶĞů ŽŶ ƚŚĞ ƐŽĐŝĂů ĚĞƚĞƌŵŝŶĂŶƚƐ Ăƚ ĨĂŵŝůLJĚŽĐƐ͘ŽƌŐͬĂůůͲŵĞŵďĞƌͲĂĚǀŽĐĂĐLJͲŵĞĞƚŝŶŐ͘ EĂŵĞƐ ŽĨ ŚĞĂůƚŚ͕ ĨĞĂƚƵƌŝŶŐ ƌƐ͘ DŝĐŚĞůůĞ YƵŝŽŐƵĞ ĂŶĚ DŝĐŚĂĞů ŽĨ ĚĞůĞŐĂƚĞƐ ĂŶĚ ĂůƚĞƌŶĂƚĞƐ͕ ĂƐ ǁĞůů ĂƐ ĂŶLJ ƌĞƐŽůƵƚŝŽŶƐ ĨŽƌ ZŽĚƌŝŐƵĞnj ĂŶĚ ĂƚƚŽƌŶĞLJ /ŐŶĂƚŝƵƐ ĂƵ͕ ĂŶĚ ŵŽĚĞƌĂƚĞĚ ďLJ ŽƵƌ ĚŝƐĐƵƐƐŝŽŶ͕ ĂƌĞ ĚƵĞ ƚŽ &W ďLJ ĞĐĞŵďĞƌ ϵ͕ ϮϬϭϲ͘ /Ĩ LJŽƵ ƉƌĞƐŝĚĞŶƚ͕ ƌ͘ >ĞĞ ZĂůƉŚ͖ ĞĚƵĐĂƚŝŽŶĂů ƐĞƐƐŝŽŶƐ ŽŶ ĐƵůƚƵƌĂů ĂƌĞ ŝŶƚĞƌĞƐƚĞĚ ŝŶ ƐĞƌǀŝŶŐ ĂƐ Ă ĚĞůĞŐĂƚĞ Žƌ ĂůƚĞƌŶĂƚĞ ĨŽƌ LJŽƵƌ ŚƵŵŝůŝƚLJ͕ ŵŽďŝůĞ ŚĞĂůƚŚ ƚĞĐŚŶŽůŽŐLJ͕ ĚǀĞƌƐĞ ŚŝůĚŚŽŽĚ ǀĞŶƚƐ ĐŽƵŶƚLJ ĐŚĂƉƚĞƌ͕ LJŽƵ ĐĂŶ ĐŽŶƚĂĐƚ ƚŚĞ ĐŚĂƉƚĞƌ ĚŝƌĞĐƚůLJ͕ Žƌ ; Ϳ ƐĐŽƌĞƐ ĂŶĚ ĐŽŵŵƵŶŝĐĂƚŝŽŶƐ ĂŶĚ ůĞĂĚĞƌƐŚŝƉ͖ Ă ƐƉĞĐŝĂů ĐŽŶƚĂĐƚ ŵĞ ĨŽƌ ĂƐƐŝƐƚĂŶĐĞ͘ zŽƵ ĐĂŶ ƌĞĂĐŚ ŵĞ Ăƚ ;ϰϭϱͿ ϯϰϱͲ ƐĞƐƐŝŽŶ ĨŽƌ ƐƚƵĚĞŶƚƐ ŽŶ ĂƉƉůLJŝŶŐ ƚŽ ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵƐ ϴϲϲϳ͕ ĞdžƚĞŶƐŝŽŶ ϮϮϲ͕ Žƌ ƐŐŽĞĐŬĞΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ͘ ĂŶĚ Ă ƐƉĞĐŝĂů ͞ƐƉĞĞĚ ĚĂƚŝŶŐ͟ͲƐƚLJůĞ ƐĞƐƐŝŽŶ ĨŽƌ ƌĞƐŝĚĞŶƚƐ ƚŽ ĂƐŬ ƋƵĞƐƚŝŽŶƐ ĂŶĚ ŐĂŝŶ ŝŶƐŝŐŚƚƐ ĨƌŽŵ ĞdžƉĞƌŝĞŶĐĞĚ ĨĂŵŝůLJ LJ ƚŚĞ ƚŝŵĞ ƚŚŝƐ ŝƐƐƵĞ ŽĨ &W ŝƐ ƉƌŝŶƚĞĚ͕ LJŽƵ ǁŝůů ďĞ ĂůƐŽ ƉŚLJƐŝĐŝĂŶƐ ĨƌŽŵ Ă ǀĂƌŝĞƚLJ ŽĨ ƉƌĂĐƚŝĐĞ ƐĞƚƚŝŶŐƐ͘ ƚ ƚŚĞ ĞŶĚ ŽĨ ĂďůĞ ƚŽ ƌĞŶĞǁ LJŽƵƌ &W ĂŶĚ &W ŵĞŵďĞƌƐŚŝƉ Ăƚ ǁǁǁ͘ ƚŚĞ ƉƌŽŐƌĂŵ͕ ǁĞ ŚĂĚ ŽƵƌ ƉŽƉƵůĂƌ ZĞƐŝĚĞŶĐLJ &Ăŝƌ Ăƚ ǁŚŝĐŚ ĂĂĨƉ͘ŽƌŐͬĐŚĞĐŬŵLJĚƵĞƐ͘ zĞƐ͕ ƚŚĞ ĚƵĞ ĚĂƚĞ ŝƐ Ă ĨĞǁ ŵŽŶƚŚƐ ƐƚƵĚĞŶƚƐ ĐŽŶŶĞĐƚĞĚ ǁŝƚŚ ŵŽƌĞ ƚŚĂŶ ϯϬ ŽĨ ĂůŝĨŽƌŶŝĂ͛Ɛ ĨĂŵŝůLJ ŽƵƚ͕ ďƵƚ ƚŚĞ ĞŶĚ ŽĨ ƚŚĞ LJĞĂƌ ǁŝůů ďĞ ŚĞƌĞ ďĞĨŽƌĞ ǁĞ ŬŶŽǁ ŝƚ͘ ŵĞĚŝĐŝŶĞ ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵƐ͘ ZĞŶĞǁŝŶŐ ĞĂƌůLJ ůĞƚƐ LJŽƵ ƌĞƐƚ ĞĂƐLJ͕ ŬŶŽǁŝŶŐ ƚŚĞƌĞ ǁŝůů ďĞ ŶŽ ůĂƉƐĞ ŝŶ LJŽƵƌ ŵĞŵďĞƌƐŚŝƉ ďĞŶĞĨŝƚƐ ĂŶĚ LJŽƵ ǁŽŶ͛ƚ ŚĞĂƌ ĨƌŽŵ KŶĞ ŽĨ ŵLJ ĨĂǀŽƌŝƚĞ ƉĂƌƚƐ ŽĨ ƚŚĞ ĚĂLJ ǁĂƐ Ă ůŝǀĞůLJ ĚŝƐĐƵƐƐŝŽŶ ƵƐ ƌĞŵŝŶĚŝŶŐ LJŽƵ ƚŽ ƌĞŶĞǁ͘ WůƵƐ͕ ƚŚĞ ƚŝŵĞ ƚŚĂƚ &W ƐƚĂĨĨ ďLJ ƌ͘ ĂƌŽů ,ĂǀĞŶƐ ŽŶ ŐĞŶĞƌĂƚŝŽŶĂů ĚŝĨĨĞƌĞŶĐĞƐ ͲͲ ǁŚĂƚ ƚŚĞLJ ĚŽĞƐŶ͛ƚ ƐƉĞŶĚ ŽŶ ĨŽůůŽǁͲƵƉ ĐĂůůƐ ĂŶĚ ĞŵĂŝůƐ ŝƐ ƐƉĞŶƚ ĂƐƐŝƐƚŝŶŐ ŵĞĂŶ ĨŽƌ ůĞĂƌŶŝŶŐ͕ ĞĚƵĐĂƚŝŽŶ͕ ĐŽŵŵƵŶŝĐĂƚŝŽŶ͕ ůĞĂĚĞƌƐŚŝƉ ŵĞŵďĞƌƐ ĂŶĚ ĂĚǀŽĐĂƚŝŶŐ ĨŽƌ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĂŶĚ ƉĂƚŝĞŶƚƐ͊ ĂŶĚ ĐĂƌŝŶŐ ĨŽƌ ƉĂƚŝĞŶƚƐ͘ / ƐĂǁ ƌ͘ ,ĂǀĞŶƐ͛ ǁŽƌĚƐ ŝŶ ĂĐƚŝŽŶ ƚŚĂƚ ĚĂLJ ͲͲ ƉƌĂĐƚŝĐŝŶŐ ƉŚLJƐŝĐŝĂŶƐ ƐŚĂƌŝŶŐ ƚŝŵĞ ĂŶĚ ŝŶƐŝŐŚƚƐ ǁŝƚŚ ŽƵƌ /Ĩ LJŽƵ ŚĂǀĞ ŽƉƚĞĚ ĨŽƌ ŵĞŵďĞƌƐŚŝƉ ĂƵƚŽͲƌĞŶĞǁĂů͕ LJŽƵƌ ϮϬϭϳ LJŽƵŶŐĞƌ ŵĞŵďĞƌƐ͕ ǁŚŽ ĐĂŵĞ ĂǁĂLJ ŝŶƐƉŝƌĞĚ ĂŶĚ ĞŵƉŽǁĞƌĞĚ͘ ĚƵĞƐ ƉĂLJŵĞŶƚ ǁŝůů ŚĂǀĞ ďĞĞŶ ďŝůůĞĚ ƚŽ LJŽƵƌ ĐƌĞĚŝƚ ĐĂƌĚ ŝŶ / ĐĂŶ͛ƚ ĐŽƵŶƚ ƚŚĞ ŶƵŵďĞƌ ŽĨ ƉĂƌƚŝĐŝƉĂŶƚƐ ǁŚŽ ƐƚŽƉƉĞĚ ĂŶĚ ůĂƚĞ ^ĞƉƚĞŵďĞƌ͘ /Ĩ LJŽƵ ŚĂǀĞ ŽƉƚĞĚ ĨŽƌ ŵĞŵďĞƌƐŚŝƉ ĂƵƚŽͲ ƚŚĂŶŬĞĚ ƐƚĂĨĨ ĨŽƌ ƉƵƚƚŝŶŐ ŽŶ ƐƵĐŚ Ă ŐƌĞĂƚ ƉƌŽŐƌĂŵͶĂ ƉƌŽŐƌĂŵ ƌĞŶĞǁĂů ŽŶ ƚŚĞ ŝŶƐƚĂůůŵĞŶƚ ƉƌŽŐƌĂŵ͕ LJŽƵƌ ĐƌĞĚŝƚ ĐĂƌĚ ǁĂƐ ƚŚĂƚ ĐŽƵůĚŶ͛ƚ ŚĂǀĞ ďĞĞŶ ĂĐĐŽŵƉůŝƐŚĞĚ ǁŝƚŚŽƵƚ ƚŚĞ ƐƵƉƉŽƌƚ ŽĨ ďŝůůĞĚ ƚŚĞ Ψϭϱ ĂĚŵŝŶŝƐƚƌĂƚŝǀĞ ĨĞĞ ŝŶ ůĂƚĞ ^ĞƉƚĞŵďĞƌ ĂŶĚ ŽƵƌ ƐƉĞĂŬĞƌƐ͕ ŝŶĐůƵĚŝŶŐ͕ ŝŶ ĂĚĚŝƚŝŽŶ ƚŽ ƚŚŽƐĞ ĐŝƚĞĚ ĂďŽǀĞ͗ ƌƐ͘ LJŽƵƌ ŝŶƐƚĂůůŵĞŶƚƐ ǁŝůů ďĞ ďŝůůĞĚ ŽŶ ƚŚĞ ϭϬƚŚ ŽĨ ĞĂĐŚ ŵŽŶƚŚ ZĂƵů LJĂůĂ͕ dŽŵ ĞŶƚ͕ &ƌĂŶĐŝƐ ŚƵ͕ ŚƌŝƐ &ůŽƌĞƐ͕ :ĞĨĨ >ƵƚŚĞƌ͕ ďĞƚǁĞĞŶ KĐƚŽďĞƌ ĂŶĚ ƵŐƵƐƚ͘ /Ĩ LJŽƵ ĂƌĞŶ͛ƚ ĞŶƌŽůůĞĚ ŝŶ ĂƵƚŽͲ ŶŶĞ DŽŶƚŐŽŵĞƌLJ͕ ZĂĐƋƵĞů WĞŶĂ͕ :ĞĂŶŝŶĞ ZŽĚĞŵƐ͕ >ĂƵƌĞŶ ƌĞŶĞǁĂů ĂŶĚͬŽƌ ĂŶ ŝŶƐƚĂůůŵĞŶƚ ƉůĂŶ͕ LJŽƵ ŵĂLJ ŵĂŬĞ ƚŚĂƚ ^ŝŵŽŶ͕ ĂǀŝĚ dƌĂŶ͕ DĂƚƚ sĂƌĂůůŽ ĂŶĚ &W͛Ɛ ^ŚĞůůLJ ZŽĚƌŝŐƵĞƐ͘ ĐŚĂŶŐĞ Ăƚ ĂŶLJ ƚŝŵĞ ďLJ ĐŽŶƚĂĐƚŝŶŐ ƚŚĞ &W͘ KĨ ĐŽƵƌƐĞ͕ ŝĨ dŚĂŶŬ LJŽƵ͊ LJŽƵ ŶĞĞĚ ĂŶLJ ĂƐƐŝƐƚĂŶĐĞ ǁŝƚŚ ƌĞŶĞǁŝŶŐ LJŽƵƌ ŵĞŵďĞƌƐŚŝƉ Žƌ ƌĞƉŽƌƚŝŶŐ LJŽƵƌ D ͕ ƉůĞĂƐĞ ůĞƚ ƵƐ ŬŶŽǁ͘ ďŝŐ &W ĞǀĞŶƚ ĐŽŵŝŶŐ ƵƉ ŝƐ ƚŚĞ ůů DĞŵďĞƌ ĚǀŽĐĂĐLJ dŚĂŶŬ LJŽƵ ĨŽƌ LJŽƵƌ ŵĞŵďĞƌƐŚŝƉ͘ / ůŽŽŬ ĨŽƌǁĂƌĚ ƚŽ ŵĞĞƚŝŶŐ Meeting ; D DͿ͕ DĂƌĐŚ ϰͲϲ͕ ϮϬϭϳ͕ Ăƚ ƚŚĞ ŝƚŝnjĞŶ ,ŽƚĞů ŝŶ ŵĂŶLJ ŽĨ LJŽƵ Ăƚ ƚŚĞ D D͕ ĂŶĚ Ăŵ Ă ƉŚŽŶĞ ĐĂůů Žƌ ĞŵĂŝů ^ĂĐƌĂŵĞŶƚŽ͕ ĨŽůůŽǁĞĚ ďLJ >ŽďďLJ ĂLJ ŽŶ DŽŶĚĂLJ͕ DĂƌĐŚ ϲ͘ ĂǁĂLJ ŝĨ LJŽƵ ŶĞĞĚ ĂƐƐŝƐƚĂŶĐĞ͘ D D ƉĂƌƚŝĐŝƉĂŶƚƐ ĐŽůůĂďŽƌĂƚĞ ĂŶĚ ůĞĂƌŶ ŚŽǁ ƚŽ ĞĨĨĞĐƚŝǀĞůLJ ĂĚǀŽĐĂƚĞ ŽŶ ŬĞLJ ŝƐƐƵĞƐ ĚƵƌŝŶŐ ƚŚĞ ƐĞƐƐŝŽŶƐ DĂƌĐŚ ϰͲϱ͕ Shannon Goecke is CAFP’s Director of Membership and ƚŚĞŶ ƉƵƚ ƚŚĞŝƌ ƐŬŝůůƐ ŝŶƚŽ ĂĐƚŝŽŶ ǁŝƚŚ ǀŝƐŝƚƐ ƚŽ ůĞŐŝƐůĂƚŽƌƐ ŽŶ Marketing.

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California Family Physician Fall 2016

ȱ ȱȱ

CAFP FOUNDATION

National Conference for Students and Residents &W͛Ɛ EĂƚŝŽŶĂů ŽŶĨĞƌĞŶĐĞ ĨŽƌ ^ƚƵĚĞŶƚƐ ĂŶĚ ZĞƐŝĚĞŶƚƐ ;E ^ZͿ͕ :ƵůLJ ϮϴͲϯϬ ŝŶ <ĂŶƐĂƐ ŝƚLJ͕ ǁĂƐ ĂŶ ĞdžƉĞƌŝĞŶĐĞ ƚŽ ƌĞŵĞŵďĞƌ͘ dŚĞ ĨŝƌƐƚ ĚĂLJ ŽĨ ƚŚĞ ĐŽŶĨĞƌĞŶĐĞ ĨĞĂƚƵƌĞĚ Ă ƉĂŶĞů ŽĨ ƉŚLJƐŝĐŝĂŶ ĐŚĂŵƉŝŽŶƐ ĨƌŽŵ ĚŝĨĨĞƌĞŶƚ ƉƌĂĐƚŝĐĞ ƐĞƚƚŝŶŐƐ ƐŚĂƌŝŶŐ ƚŚĞŝƌ ĂĚǀŽĐĂĐLJ ĞdžƉĞƌŝĞŶĐĞƐ͘ ƌƐ͘ EĂƚĂƐŚĂ ŚƵLJĂŶ͕ :ĞŶŶŝĨĞƌ ƌƵůů ĂŶĚ ƵďŝŶ ĂŵĂŶŝĂ ; ŽŐŐD Ϳ ƐƉŽŬĞ ĂďŽƵƚ ŽƉƉŽƌƚƵŶŝƚŝĞƐ ĨŽƌ ƐƚƵĚĞŶƚƐ ĂŶĚ ƌĞƐŝĚĞŶƚƐ ƚŽ ďĞĐŽŵĞ ĐŚĂŵƉŝŽŶƐ ŽĨ ƉƌŝŵĂƌLJ ĐĂƌĞ͘ ƌ͘ ŚƵLJĂŶ ƐŚĂƌĞĚ ŚĞƌ ŵĂŶƚƌĂ͕ ͞^ŚŽǁ ƵƉ͘ ^ƉĞĂŬ KƵƚ͘ ŚĂŶŐĞ ƚŚĞ ƵůƚƵƌĞ͘͟ dŚŝƐ ƌĂŶŐ ĞƐƉĞĐŝĂůůLJ ƚƌƵĞ ĨŽƌ ƐƚƵĚĞŶƚƐ ǁŚŽ ĨĂĐĞ Ă ĐƵůƚƵƌĞ ŝŶ ŵĞĚŝĐĂů ƐĐŚŽŽů ƚŚĂƚ ƉƵƐŚĞƐ ƚŚĞŵ ĂǁĂLJ ĨƌŽŵ ĐĂƌĞĞƌƐ ŝŶ ƉƌŝŵĂƌLJ ĐĂƌĞ͘ dŚŝƐ ĚŝǀĞƌƐĞ ĂŶĚ ŝŶĨŽƌŵĂƚŝǀĞ ƉĂŶĞů ŬŝĐŬĞĚ ŽĨĨ E ^Z ǁŝƚŚ Ă ďĂŶŐ͊ &W͛Ɛ ĐŽŶƚŝŶŐĞŶƚ ŽĨ ƐƚƵĚĞŶƚ ĂŶĚ ƌĞƐŝĚĞŶƚ ĂƚƚĞŶĚĞĞƐ ŵĂĚĞ ƚŚĞ ŵŽƐƚ ŽĨ ŝƚƐ ƚŝŵĞ Ăƚ E ^Z͕ ŝŶĐůƵĚŝŶŐ ƚŚĞ ĞůĞĐƚŝŽŶ ŽĨ ŽƵƌ ŽǁŶ ůĞdž D͘ DĐ ŽŶĂůĚ͕ D Ɛ ĂƐ ŶĞdžƚ LJĞĂƌ͛Ɛ ZĞƐŝĚĞŶƚ ŚĂŝƌ ŽĨ EĂƚŝŽŶĂů ŽŶĨĞƌĞŶĐĞ͘ ůĞdž ƐĂŝĚ ͞dŚŝƐ ĞǀĞŶƚ ŝƐ ƵŶůŝŬĞ ĂŶLJ ŽƚŚĞƌ ĐŽŶĨĞƌĞŶĐĞ ĂŶĚ ŝƐ ŵLJ ĨĂǀŽƌŝƚĞ ǁŝƚŚŝŶ ƚŚĞ ǁŚŽůĞ &W ĐĂůĞŶĚĂƌ͘ dŚĞ ĞŶĞƌŐLJ ĂŶĚ ĞŶƚŚƵƐŝĂƐŵ ŝƐ ƉĂůƉĂďůĞ ĂŶĚ ĐŽŶƚĂŐŝŽƵƐ͘ / Ăŵ ĞdžƚƌĞŵĞůLJ ĞdžĐŝƚĞĚ ƚŽ ďĞ ŐŝǀĞŶ ƚŚĞ ƉƌŝǀŝůĞŐĞ ĂŶĚ ŚŽŶŽƌ ƚŽ ďĞ ZĞƐŝĚĞŶƚ ŚĂŝƌ ŽĨ EĂƚŝŽŶĂů ŽŶĨĞƌĞŶĐĞ ŝŶ ϮϬϭϳ͘ / ǁŝůů ĐŽŶƚŝŶƵĞ ƚŽ ďƵŝůĚ ŽŶ ƚŚŝƐ ĞƐƚĂďůŝƐŚĞĚ ĨŽƵŶĚĂƚŝŽŶ ƚŽ ƐŚŽǁ ƌĞƐŝĚĞŶƚƐ ĂŶĚ ƐƚƵĚĞŶƚƐ ǁŚĂƚ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ŝƐ Ăůů ĂďŽƵƚ͘͟ tĞ ŬŶŽǁ ůĞdž ǁŝůů ďƌŝŶŐ Ă ůĞǀĞů ŽĨ ĞŶƚŚƵƐŝĂƐŵ ĂŶĚ ĞŶŐĂŐĞŵĞŶƚ ƚŽ E ^Z ƚŚĂƚ ǁŝůů ŵĂŬĞ ĂůŝĨŽƌŶŝĂ ƉƌŽƵĚ͊ &W &ŽƵŶĚĂƚŝŽŶ ĂǁĂƌĚĞĚ ƐĐŚŽůĂƌƐŚŝƉƐ ƚŽ ĞŝŐŚƚ ƐƚƵĚĞŶƚƐ ƚŽ ĂƚƚĞŶĚ E ^Z͘ ŶĚƌĞǁ >Ğ͕ tĞƐƚĞƌŶ hŶŝǀĞƌƐŝƚLJ͕ Ă ^ƚƵĚĞŶƚ ŽƵŶĐŝů ŵĞŵďĞƌ ĂŶĚ ƐĐŚŽůĂƌƐŚŝƉ ƌĞĐŝƉŝĞŶƚ͕ ǁĂƐ ĞƐƉĞĐŝĂůůLJ ŝŶƐƉŝƌĞĚ ďLJ ƌ͘ tĂŶĚĂ &ŝůĞƌ͛Ɛ ƐƉĞĞĐŚ ĂŶĚ ĨŽƵŶĚ ŚŝŵƐĞůĨ ƌĞŝŶǀŝŐŽƌĂƚĞĚ ƚŽ ĐŽŶƚŝŶƵĞ ŚŝƐ ĂĚǀŽĐĂĐLJ ĨŽƌ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ͘ ,Ğ ƐĂŝĚ͕ ͞dŚĞ ŵŽƐƚ ƌĞǁĂƌĚŝŶŐ ĞdžƉĞƌŝĞŶĐĞ ƚŽ ŵĞ ǁĂƐ ďĞŝŶŐ ŝŵŵĞƌƐĞĚ ŝŶ ƚŚĞ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ĐƵůƚƵƌĞ ĂŶĚ ƐƵƌƌŽƵŶĚĞĚ ďLJ ĐŽůůĞĂŐƵĞƐ ǁŚŽ ƐŚĂƌĞĚ ŵĂŶLJ ĐŽŵŵŽŶ ŝŶƚĞƌĞƐƚƐ͘͟ sŝĐƚŽƌŝĂ

ŽŐŐŝĂŶŽ͕ ^ƚĂŶĨŽƌĚ hŶŝǀĞƌƐŝƚLJ͕ ǁĂƐ ĞdžĐŝƚĞĚ ƚŽ ĞŶŚĂŶĐĞ ŚĞƌ ŝŶƚĞƌĞƐƚ ŝŶ ŚĞĂůƚŚ ƉŽůŝĐLJ ďLJ ŐĞƚƚŝŶŐ ŝŶǀŽůǀĞĚ ǁŝƚŚ ƚŚĞ &W ƐƚƵĚĞŶƚ ĐŽŶŐƌĞƐƐ ĂĐƚŝǀŝƚŝĞƐ͘ ^ŚĞ ǁĞŶƚ ƚŚƌŽƵŐŚ ƚŚĞ ƉƌŽĐĞƐƐ ŽĨ ƌƵŶŶŝŶŐ ĨŽƌ ĂŶ ĞůĞĐƚĞĚ ƉŽƐŝƚŝŽŶ ĂŶĚ ĨŽƵŶĚ ŝƚ ĨƵŶ ĂŶĚ ŝŶĨŽƌŵĂƚŝǀĞ͘ ůƚŚŽƵŐŚ ƐŚĞ ĚŝĚŶ͛ƚ ǁŝŶ͕ ŝƚ ǁĂƐ Ă ŐƌĞĂƚ ŝŶƚƌŽĚƵĐƚŝŽŶ ƚŽ ŽŶŐƌĞƐƐ ĂĐƚŝǀŝƚŝĞƐ ĂŶĚ ƐŚĞ ŝƐ ŶŽǁ ŝŶ ƚŚĞ ƉƌŽĐĞƐƐ ŽĨ ĂƉƉůLJŝŶŐ ĨŽƌ ĂŶ ĂƉƉŽŝŶƚĞĚ ƉŽƐŝƚŝŽŶ͘ sŝĐƚŽƌŝĂ ƐĂŝĚ ͞E ^Z ƐƚƌĞŶŐƚŚĞŶĞĚ ŵLJ ĐŽŵŵŝƚŵĞŶƚ ƚŽ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ĂŶĚ ŐĂǀĞ ŵĞ Ă ĚĞĞƉĞƌ ƉĞƌƐƉĞĐƚŝǀĞ ŽĨ ƚŚĞ ǁŝĚĞ ƌĂŶŐĞ ŽĨ ŽƉƉŽƌƚƵŶŝƚŝĞƐ ƚŽ ŵĂŬĞ ĂŶ ŝŵƉĂĐƚ ŝŶ ŚĞĂůƚŚ ƉŽůŝĐLJ ĂƐ Ă ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ƉŚLJƐŝĐŝĂŶ͘͟ dŚĞ &ŽƵŶĚĂƚŝŽŶ ŚŽƐƚĞĚ ŝƚƐ ĂŶŶƵĂů ĂůŝĨŽƌŶŝĂ ƌĞĐĞƉƚŝŽŶ ŽŶ ƚŚĞ &ƌŝĚĂLJ ĞǀĞŶŝŶŐ ŽĨ ƚŚĞ ĐŽŶĨĞƌĞŶĐĞ͘ tĞ ŚĂĚ Ă ũĂŵͲ ƉĂĐŬĞĚ ƌŽŽŵ͕ ǁŝƚŚ ĂůŝĨŽƌŶŝĂ ŵĞĚŝĐĂů ƐƚƵĚĞŶƚƐ͕ ƌĞƐŝĚĞŶƚƐ͕ ƌĞƐŝĚĞŶĐLJ ĨĂĐƵůƚLJ ŵĞŵďĞƌƐ ĂŶĚ ĞǀĞŶ &W ůĞĂĚĞƌƐ ũŽŝŶŝŶŐ ƵƐ ĨŽƌ ƚŚĞ ŝŶĨŽƌŵĂů ŐĂƚŚĞƌŝŶŐ͘ KǀĞƌĂůů͕ &W EĂƚŝŽŶĂů ŽŶĨĞƌĞŶĐĞ ϮϬϭϲ ǁĂƐ Ă ŐůŽƌŝŽƵƐ ƐƵĐĐĞƐƐ ʹ ǁĞ ŽŶůLJ ǁŽŶĚĞƌ ŚŽǁ ŶĞdžƚ LJĞĂƌ ĐĂŶ ƚŽƉ ŝƚ͊ Richa Saraswat is CAFP’s Manager of Medical Student and Residency Relations

ŶĚƌĞǁ >Ğ͕ ƐĐŚŽůĂƌƐŚŝƉ ǁŝŶŶĞƌ͖ >ĂƵƌĂ ŽĂŶ͕ D ͕ ZĞƐŝĚĞŶĐLJ ĐŽƵŶĐŝů ĐŽͲĐŚĂŝƌ͖ ĂŶĚ ZŝĐŚĂ ^ĂƌĂƐǁĂƚ͘

California Family Physician Fall 2016

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Live from Rio, Health Care and More / ŚĂĚ ƚŚĞ ũŽLJ ŽĨ ƐĞĞŝŶŐ ŵLJ ĚĂƵŐŚƚĞƌ͕ ŝůĞĞŶ 'ƌĞŶĐŚ͕ ĨĞŶĐĞ ĨŽƌ WĂŶĂŵĂ ŝŶ ƚŚĞ KůLJŵƉŝĐƐ͘ ^ŚĞ ĚŝƐĐŽǀĞƌĞĚ ĨĞŶĐŝŶŐ ďLJ ŐĞƫŶŐ ůŽƐƚ ŝŶ ĂǀŝƐ͕ ĂƐ Ă ĐŚŝůĚ͘ ^ŚĞ ŚĂƉƉĞŶĞĚ ďLJ ƚŚĞ ĂǀŝƐ &ĞŶĐŝŶŐ ůƵď͕ ƐĂǁ Ă ŶŽƟĐĞ ĨŽƌ Ă ĐĂŵƉ ƚŚĞ ŶĞdžƚ ǁĞĞŬ͕ ĂŶĚ ĐĂŵĞ ŚŽŵĞ ĂƐŬŝŶŐ ŝĨ ƐŚĞ ĐŽƵůĚ ŐŽ͘ &ƌŽŵ ůĞƐƐŽŶ ŽŶĞ͕ ƐŚĞ ǁĂƐ ŚŽŽŬĞĚ͊ ƚ ƚŚĞ KůLJŵƉŝĐƐ͕ ƐŚĞ ǁŽŶ ŚĞƌ ĮƌƐƚ ŵĂƚĐŚ͕ ƚŚĞŶ ůŽƐƚ ƚŽ ƚŚĞ ŶƵŵďĞƌ ƚŚƌĞĞ ŝŶ ƚŚĞ ǁŽƌůĚ͕ ĐŽŵŝŶŐ ŝŶ ϯϬƚŚ͘ &Žƌ ŵĞ͕ ĂƐ Ă ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶ͕ ŝƚ ǁĂƐ ŝŶƚĞƌĞƐƟŶŐ ƚŽ ƐĞĞ ƚŚĞ ŵĞĚŝĐĂů ƐŝĚĞ ŽĨ ƚŚĞ KůLJŵƉŝĐƐ͘ dŚĞ ŚĂƌĚ ǁŽƌŬ ƚŚĂƚ ŐŽĞƐ ŝŶƚŽ ǁŽƌŬŝŶŐ LJŽƵƌ ǁĂLJ ƵƉ ƚŚĞ ůĞǀĞůƐ͕ ĨƌŽŵ ůŽĐĂů ƚŽƵƌŶĂŵĞŶƚƐ͕ ĂŶĚ ĮŶĂůůLJ ƚŽ ƚŚĞ tŽƌůĚ ƵƉ ĐŽŵƉĞƟƟŽŶƐ͕ ǁĂƐ ǁĞůů ďĞLJŽŶĚ ǁŚĂƚ / ŚĂĚ ŝŵĂŐŝŶĞĚ͘ ƵƌŝŶŐ ƚŚĞ ůĂƐƚ ϭϲ LJĞĂƌƐ͕ ƐŚĞ ŚĂƐ ŐŽŶĞ ƚŽ ŵŽƌĞ ƚŚĂŶ ϱϬ ĨŽƌĞŝŐŶ ĐŝƟĞƐ ʹ Ăůů ŽŶ ƚŚĞ ƉĂƚŚ ƚŽ ƋƵĂůŝĨLJ ĨŽƌ ƚŚĞ KůLJŵƉŝĐƐ͘ ^ŚĞ ŚĂƐ ŚĂĚ ŵƵůƟƉůĞ ŝŶũƵƌŝĞƐ͕ ƐƚĂƌƟŶŐ ǁŝƚŚ ĂŶ > ƌĞƉĂŝƌ ŚĞƌ ũƵŶŝŽƌ LJĞĂƌ ŽĨ ŚŝŐŚ ƐĐŚŽŽů͘ ^ŚĞ ŚĂƐ ŚĂĚ ďĂĐŬ ƉĂŝŶ͕ ĚĞǀĞůŽƉĞĚ ŬŶĞĞ ĂƌƚŚƌŝƟƐ͕ ƐƉƌĂŝŶĞĚ ŚĞƌ ǁƌŝƐƚ͕ ĮŶŐĞƌƐ͕ ĂŶŬůĞ ĂŶĚ ĨŽƌĞĂƌŵ ĂŶĚ ŚĂĚ ĞůďŽǁ ƚĞŶĚŽŶŝƟƐ͘ ^ŚĞ ŚĂƐ ŚĂĚ ĚŝīĞƌĞŶƚ ŝŶĨĞĐƟŽŶƐ ŝŶĐůƵĚŝŶŐ ƚƌĂǀĞůĞƌ͛Ɛ ĚŝĂƌƌŚĞĂ ĂŶĚ ŵƵůƟƉůĞ ƌĞƐƉŝƌĂƚŽƌLJ ďƵŐƐ͘ ^ŚĞ ŚĂĚ ŝŬĂ Ăƚ ŚƌŝƐƚŵĂƐ͕ ďĞĨŽƌĞ ŝƚ ǁĂƐ ǁĞůůͲŬŶŽǁŶ Žƌ ĞǀĞŶ ŝŶ hƉͲƚŽͲ ĂƚĞ͘ dŚĞ ĚŝƐƚĂů ũŽŝŶƚ ƐǁĞůůŝŶŐ ǁŝƚŚ ŝŬĂ ǁĂƐ ŝŵƉƌĞƐƐŝǀĞ͕ ƐǁĞůůŝŶŐ Ăůů ƚŚĞ ũŽŝŶƚƐ ŝŶ ŚĞƌ ŚĂŶĚƐ͘ dŚĞ ĞŵŽƟŽŶĂů ƐƚƌĞƐƐ͕ ƵƉƐ ĂŶĚ ĚŽǁŶƐ͕ ǁĂƐ ĂůƐŽ ŚĂƌĚ͘ ƌƵŐ ƚĞƐƟŶŐ ŝƐ ĂŶ ŽŶŐŽŝŶŐ ĐŽŶĐĞƌŶ͘ &Žƌ ϭϲ LJĞĂƌƐ / ŚĂǀĞ ďĞĞŶ ƌĞĂĚŝŶŐ ƚŚĞ ďĂŶŶĞĚ ůŝƐƚ͘ ŝůĞĞŶ ŚĂƐ ŶŽƚ ĞĂƚĞŶ ƉŽƉƉLJ ƐĞĞĚƐ ĂŶĚ ŚĂƐ ďĞĞŶ ĐůĞĂŶ͘ ^ŚĞ ŚĂƐ ƚƵƌŶĞĚ ĚŽǁŶ ͞ŶĂƚƵƌĂů͟ ƌĞŵĞĚŝĞƐ Žƌ ŵĞĚŝĐĂƟŽŶƐ ĨƌŽŵ ĨŽƌĞŝŐŶ ƚƌĂŝŶĞƌƐ ĂŶĚ ĨƌŝĞŶĚƐ ǁŚĞŶ ƐŚĞ ŚĂƐ ďĞĞŶ ŝŶũƵƌĞĚ Žƌ ƐŝĐŬ Ăƚ ƚŽƵƌŶĂŵĞŶƚƐ͘ ŚŝŐŚ ůĞǀĞů DĞdžŝĐĂŶ ĨĞŶĐĞƌ ǁĂƐ ďĂŶŶĞĚ ƚŚĞ ǁĞĞŬ ďĞĨŽƌĞ ƚŚĞ KůLJŵƉŝĐƐ͘ ^ŚĞ ĚĞŶŝĞĚ ĚŽŝŶŐ ĂŶLJƚŚŝŶŐ͕ ĞdžĐĞƉƚ ƚĂŬŝŶŐ ĂŶ ŚĞƌďĂů ĚŝĞƚ Ɖŝůů͘

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California Family Physician Fall 2016

INSPIRE greatness 'Ĺ˝Ĺ?ĹśĹ? ƚŽ ZĹ?Ĺ˝ Ç Ĺ?ƚŚ ŽŜůLJ ĆšĹšĆŒÄžÄž Ç ÄžÄžĹŹĆ? ƚŽ ƉůĂŜ Ç Ä‚Ć? Ä‚ Ä?Ĺ?Ćš ĚĂƾŜĆ&#x;ĹśĹ?͘ ^ŽžÄž Ä?ŽžžŽŜ ĆŒÄžĆ?ƉŽŜĆ?ÄžĆ? ƚŽ ĹšÄžÄ‚ĆŒĹ?ĹśĹ? Ä‚Ä?ŽƾĆš Ĺ?ůĞĞŜ͛Ć? Ĺ?Ĺ˝Ĺ?ĹśĹ? ƚŽ ƚŚĞ KůLJžƉĹ?Ä?Ć? Ç ÄžĆŒÄž Íž ĆŒÄžĹśÍ›Ćš LJŽƾ Ä‚ĨĆŒÄ‚Ĺ?Äš ŽĨ Ĺ?ĞƍŜĹ? Ĺ?ĹŹÄ‚Í?Í&#x; Ĺ˝ĆŒ Íž/ƚ͛Ć? ŜŽĆš Ć?Ä‚ĨÄž Ĺ?Ĺś ZĹ?Ž͕ Ä‚ĆŒÄž LJŽƾ Ć?ĆľĆŒÄž LJŽƾ Ç Ä‚ĹśĆš ƚŽ Ĺ?Ĺ˝Í?Í&#x; ZĹ?Ĺ˝ Ç Ä‚Ć? Ä‚ Ĺ?ĆŒÄžÄ‚Ćš ƉůĂÄ?Äž ƚŽ Ç€Ĺ?Ć?Ĺ?ĆšÍ˜ / ĨĞůƚ Ä‚Ć? Ć?Ä‚ĨÄž Ä‚Ć? / ĚŽ Ĺ?Ĺś EÄžÇ zĹ˝ĆŒĹŹ Ĺ?ĆšÇ‡Í˜ zŽƾ ĹŠĆľĆ?Ćš ŚĂǀĞ ƚŽ Ä?Äž Ć?ĞŜĆ?Ĺ?Ä?ĹŻÄžÍ˜ tÄž Ć?ƚĂLJĞĚ Ä?LJ Ä‚ Ä?ĂŜĂů ƚŚĂƚ žĂLJ ŚĂǀĞ ŚĂĚ Ç Ä‚Ć?ƚĞ Ĺ?Ĺś Ĺ?ƚ͕ Ä?ƾƚ ĨŽĆŒ ƚŚĞ žŽĆ?Ćš Ć‰Ä‚ĆŒĆšÍ• ZĹ?Ĺ˝ Ç Ä‚Ć? ĨÄ‚Ĺ?ĆŒĹŻÇ‡ Ä?ĹŻÄžÄ‚ĹśÍ˜ ĆľĆŒĹ?ĹśĹ? ƚŚĞ ĞŜĆ&#x;ĆŒÄž Ć&#x;žĞ Ç Äž Ç ÄžĆŒÄž Ĺ?Ĺś ZĹ?Ĺ˝ Ç Äž ŽŜůLJ Ć?Ä‚Ç ĆšÇ Ĺ˝ žŽĆ?Ć‹ĆľĹ?ƚŽĆ?͘ /Ćš Ç Ä‚Ć? Ç Ĺ?ĹśĆšÄžĆŒ ĆšĹšÄžĆŒÄžÍ• Ç ĹšĹ?Ä?Ĺš Ĺ?Ć? ÄšĆŒÇ‡ Ć?ĞĂĆ?ŽŜ͘ ^Ĺ˝ ĨÄ‚ĆŒ Ä‚ĹŻĹŻ ƚŚĞ h^ ĂƚŚůĞƚĞĆ? Ç ĹšĹ˝ ŚĂǀĞ Ä?ĞĞŜ ƚĞĆ?ƚĞĚ ĨŽĆŒ Ĺ?ĹŹÄ‚ ŚĂǀĞ Ä?ĞĞŜ ŜĞĹ?Ä‚Ć&#x;ǀĞ͘ DĞĚĹ?Ä?Ä‚ĹŻ Ä?Ä‚ĆŒÄž ĨŽĆŒ ƚŚĞ ĂƚŚůĞƚĞĆ? Ç Ä‚Ć? Ĺ?ŽŽÄšÍ˜ Ĺ˝Ä?ĆšĹ˝ĆŒĆ? ĨĆŒŽž Ä‚ĹŻĹŻ Ĺ˝Ç€ÄžĆŒ ƚŚĞ Ç Ĺ˝ĆŒĹŻÄš Ç€ŽůƾŜĆšÄžÄžĆŒ ƚŽ Ä?Ä‚ĆŒÄž ĨŽĆŒ ƚŚĞ ƚĞĂžĆ?͘ ĆľĆŒĹ?ĹśĹ? ĹšÄžĆŒ KůLJžƉĹ?Ä? Ć?ƚĂLJ͕ Ĺ?ůĞĞŜ ŚĂĚ ĨŽŽÄš ƉŽĹ?Ć?ŽŜĹ?ĹśĹ?Í• ƚŚĞŜ ŚĂĚ Ä‚ Ä?Ä‚Äš Ä?ĆŒŽŜÄ?ĹšĹ?Ć&#x;Ć?͘ dŚĞ Ä?ĹŻĹ?ĹśĹ?Ä? Ç Ä‚Ć? Ć?Ğƚ ƾƉ ĹŻĹ?ĹŹÄž Ä‚Ĺś ŽƉĞŜ ÄžĹľÄžĆŒĹ?ĞŜÄ?LJ ĆŒŽŽžÍ˜ ĚĞŜƚĂů Ä?ĹŻĹ?ĹśĹ?Ä? Ç Ä‚Ć? ĞǀĞŜ ŽƉĞŜ ĨŽĆŒ ƚŚĞ ĂƚŚůĞƚĞĆ?͘ dŚĞ Ä?Ä‚ĆŒÄž Ç Ä‚Ć? ĨĆŒÄžÄžÍ• Ĺ?ĹśÄ?ůƾĚĹ?ĹśĹ? žĞĚĹ?Ä?Ä‚Ć&#x;ŽŜĆ?͘ dÄ‚ĹŹĹ?ĹśĹ? Ä?Ä‚ĆŒÄž ŽĨ Ç Ĺ˝ĆŒĹŻÄš Ä?ĹŻÄ‚Ć?Ć? ĂƚŚůĞƚĞĆ? Ä?Ä‚Ĺś Ä?Äž ĹšÄ‚ĆŒÄšÍ˜ dŚĞLJ ŚĂǀĞ Ĺ?ŜŊƾĆŒĹ?ÄžĆ? ĨĆŒŽž Ç ĹšĹ?Ä?Ĺš ƚŚĞLJ ŜĞĞĚ ƚŽ ĆŒÄžÄ?Ĺ˝Ç€ÄžĆŒ Ć‹ĆľĹ?Ä?ŏůLJ Ĺ˝ĆŒ ƚŚĞLJ Ç Ĺ?ĹŻĹŻ ÄšĆŒĹ˝Ć‰ Ĺ?Ĺś ƚŚĞ ĆŒÄ‚ŜŏĹ?ĹśĹ?Ć? ĂŜĚ ŜŽĆš žĂŏĞ tĹ˝ĆŒĹŻÄš ŚĂžƉĹ?ŽŜĆ?ĹšĹ?ƉĆ?Í• Ĺ˝ĆŒ ƚŚĞ KůLJžƉĹ?Ä?Ć?͘ dĆŒÇ‡Ĺ?ĹśĹ? ƚŽ ĆšĆŒÄžÄ‚Ćš Ä‚ Ć‰ĆŒĹ˝Ä?ůĞž Ä?Ä‚Ĺś Ä?Äž ÄšĹ?ĸÄ?ƾůƚ͕ Ä‚Ć? ƚŚĞLJ Ä‚ĆŒÄž ŇLJĹ?ĹśĹ? ƚŽ ƚŚĞĹ?ĆŒ ŜĞdžƚ ĆšŽƾĆŒĹśÄ‚ĹľÄžĹśĆš ÄžÇ€ÄžĆŒÇ‡ ĆšÇ Ĺ˝ Ç ÄžÄžĹŹĆ?͘ 'ĞƍŜĹ? ƚŚĞž ƚŽ Ä¨Ĺ˝ĹŻĹŻĹ˝Ç Í˛ĆľĆ‰ Ĺ?Ć? ÄšĹ?ĸÄ?ƾůĆš ĂŜĚ žĂŜLJ žĂLJ ŚĂǀĞ Ć?Ĺ?Ĺ?ĹśĹ?ÄŽÄ?ĂŜƚ ƉĆ?LJÄ?ĹšŽůŽĹ?Ĺ?Ä?Ä‚ĹŻ Ć?ĆšĆŒÄžĆ?Ć?Ĺ˝ĆŒĆ? ƚŚĂƚ ƚŚĞLJ Ç Ĺ˝ĹśÍ›Ćš ĂĚžĹ?Ćš Ĺ˝ĆŒ Ä‚Ä?ĹŹĹśĹ˝Ç ĹŻÄžÄšĹ?Ğ͘ ŜĚ Ĺ?ĹŹÄ‚ Ĺ?Ć? Ä‚ ĆŒÄžĹľĹ?ĹśÄšÄžĆŒ ƚŚĂƚ ƚŚĞLJ Ä?Ä‚Ĺś Ä?ŽžÄž Ä?Ä‚Ä?ĹŹ ĨĆŒŽž ĨŽĆŒÄžĹ?Ĺ?Ĺś Ä?ŽƾŜĆšĆŒĹ?ÄžĆ? Ç Ĺ?ƚŚ ÄžĹľÄžĆŒĹ?Ĺ?ĹśĹ?Í• ĞdžŽĆ&#x;Ä? Ĺ?ůůŜĞĆ?Ć?ÄžĆ?͘ ĹŻĹŻÍ• Ĺ?Ĺś Ä‚ĹŻĹŻÍ• Ä‚ ÄšĆŒÄžÄ‚Ĺľ Ä?ŽžÄž ĆšĆŒĆľÄžÍ™ ĨŽĆŒ Ä?ŽƚŚ ŽĨ ĆľĆ?ÍŠ

For Sale: Well-established internal medicine / family practice since 2007 focusing on improving the health and well-being of their patients and the surrounding communities with two clinics in Los Angeles Area and over 6000 active charts. This practice has been on a fast track since day one. Priced at $3,000,000, for the 2 locations, but willing to sell the practices individually. Trained staff will stay and the seller will provide assistance during transition period. For details email: info@DoctorsBroker.com or call (877)955-4447 www.DoctorsBroker.com

At Dignity Health, we lead by example. By always striving to give our personal best-and encouraging our patients and colleagues to do the same-we're able to achieve and do more than we ever imagined. If you're ready to inspire greatness in yourself and others, join us today.

OUTPATIENT FAMILY MEDICINE PHYSICIANS Northern and Southern California (Grass Valley, Inland Empire, Redding, Sacramento, Santa Cruz, Stockton, Ventura & Woodland)

Practice Highlights: • Autonomy with administrative and clinical support

• Salary guarantee period and excellent earning potential based on productivity model

• An established, growing medical group OR an independent single specialty group practice

• Attractive bonus structure

• Full-time and part-time practice options • A Medical Foundation aligned with one of the largest health systems in the nation and the largest hospital system in California

• Sunny California locations with easy access to San Francisco, Napa, Lake Tahoe, Los Angeles and San Diego

Please contact/send your CV to: Physician Recruitment providers@dignityhealth.org | 888-599-7787 www.dignityhealth.org/physician-careers

TM

Hello humankindness

Academic FP Program Director – Las Vegas, NV HCA MountainView Hospital is seeking qualified candidates for our new Family Medicine Residency Program. The Program Director provides leadership and general administration and establishes the strategic direction of the program and is responsible for the standards, quality and reputation of the Family Medicine Residency Program. The Program Director is expected to integrate the Family Medicine Residency Program with physician practices and hospital clinical services in a manner that enhances value and quality, and that promotes an optimal environment for professional practice and graduate medical education.

QUALIFICATIONS t 3FRVJTJUF TQFDJBMUZ FYQFSUJTF BOE EPDVNFOUFE FEVDBUJPOBM BOE administrative expertise acceptable to the review committee. t $VSSFOU DFSUJGJDBUJPO JO UIF TQFDJBMUZ CZ UIF "NFSJDBO #PBSE PG Family Medicine. t $VSSFOU NFEJDBM MJDFOTVSF BOE BQQSPQSJBUF NFEJDBM TUBGG appointment. t "DUJWF JOWPMWFNFOU JO UIF DBSF PG QBUJFOUT 1SJPS UP BTTVNJOH UIJT position, a minimum of two years full-time professional activity in family medicine, as well as teaching experience in a family medicine residency is required.

For more information, please forward your cover letter and CV. Randy Mitchell HCA Physician Services Group 615.943.7854 Randall.Mitchell@HCAHealthcare.com California Family Physician Fall 2016

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ȱ ǰȱ ǰȱ ǰȱBoard Chair, American Academy of Family Physicians ȱ

Commentary for California Family Physician, “ACA: Six Years and Counting. The Good, Bad, and the Promise” Ɛ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͕ ŽƵƌ ƉƌŝŽƌŝƚLJ ŝƐ ĞŶƐƵƌŝŶŐ ƚŚĂƚ ƉĂƚŝĞŶƚƐ ŚĂǀĞ ĂĐĐĞƐƐ ƚŽ ĐĂƌĞ͘ dŽ ƚŚĂƚ ĞŶĚ͕ ƚŚĞ ŵĞƌŝĐĂŶ ĐĂĚĞŵLJ ŽĨ &ĂŵŝůLJ WŚLJƐŝĐŝĂŶƐ ƐƵƉƉŽƌƚĞĚ ƚŚĞ ĨĨŽƌĚĂďůĞ ĂƌĞ Đƚ ; Ϳ͘ EŽƚ ŽŶůLJ ĚŝĚ ƚŚĞ ůĂǁ ĐŽŶƚĂŝŶ Ă WĂƚŝĞŶƚ͛Ɛ ŝůů ŽĨ ZŝŐŚƚƐ͕ ďƵƚ ŝƚ ĂůƐŽ ĞƐƚĂďůŝƐŚĞĚ Ă ƉĂƚŚ ƚŽ ǀĂůƵĞ ƉƌŝŵĂƌLJ ĐĂƌĞ ĂŶĚ ƌĞǁĂƌĚ ŚŝŐŚͲƋƵĂůŝƚLJ ĐĂƌĞ ƌĂƚŚĞƌ ƚŚĂŶ ŚŝŐŚͲǀŽůƵŵĞ ĐĂƌĞ͘ &ƵůůLJ ŵĞĞƚŝŶŐ ƚŚĞƐĞ ŐŽĂůƐ ƌĞƋƵŝƌĞƐ ĐŽŵƉůŝĐĂƚĞĚ͕ ƐŽŵĞƚŝŵĞƐ ƉĂŝŶĨƵů͕ ĐŚĂŶŐĞƐ͘ /Ŷ ƚŚĞ LJĞĂƌƐ ƐŝŶĐĞ ƉĂƐƐĂŐĞ ŽĨ ƚŚĞ ͕ ǁĞ͛ǀĞ ƐĞĞŶ ďŽƚŚ ƐƵĐĐĞƐƐĞƐ ĂŶĚ ĐŚĂůůĞŶŐĞƐ͘ ĞƐƉŝƚĞ ůĞŐŝƐůĂƚŝǀĞ ĐŚĂŶŐĞƐ ĂŶĚ ũƵĚŝĐŝĂů ĐŚĂůůĞŶŐĞƐ͕ ƚŚĞ ĐŽƌĞ ŽĨ ƚŚĞ ƌĞŵĂŝŶƐ͘ /Ŷ ƚŚĞ ĞŶĚ͕ ƚŚĞ ůĂǁ ŝƐ ƚƌĂŶƐĨŽƌŵŝŶŐ Ă ĨŽƌŵĞƌůLJ ĨƌĂŐŵĞŶƚĞĚ͕ ĚƵƉůŝĐĂƚŝǀĞ ĂŶĚ ĞdžƉĞŶƐŝǀĞ ĨĞĞͲĨŽƌͲƐĞƌǀŝĐĞ ƉĂLJŵĞŶƚ ƐLJƐƚĞŵ ŝŶƚŽ Ă ďůĞŶĚĞĚ ƐLJƐƚĞŵ ƚŚĂƚ ƐŚŽƵůĚ ƌĞǁĂƌĚ ƋƵĂůŝƚLJ ĂŶĚ ŽƵƚĐŽŵĞƐ͘ ^ŝŶĐĞ ƚŚĞ ͛Ɛ ƉĂƐƐĂŐĞ͕ ŵŽƌĞ ƚŚĂŶ ϭ͘ϰ ŵŝůůŝŽŶ ĂůŝĨŽƌŶŝĂŶƐ ŐĂŝŶĞĚ ŚĞĂůƚŚ ĐĂƌĞ ĐŽǀĞƌĂŐĞ ƚŚƌŽƵŐŚ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ͘ ŶŽƚŚĞƌ ƚŚƌĞĞ ŵŝůůŝŽŶ ŐĂŝŶĞĚ DĞĚŝĐĂŝĚ Žƌ ŚŝůĚƌĞŶ͛Ɛ ,ĞĂůƚŚ /ŶƐƵƌĂŶĐĞ WƌŽŐƌĂŵ ; ,/WͿ ĐŽǀĞƌĂŐĞ͘ dŚĞ ŶƵŵďĞƌ ŽĨ ƵŶŝŶƐƵƌĞĚ ĂůŝĨŽƌŶŝĂŶƐ ŚĂƐ ĚƌŽƉƉĞĚ ĨƌŽŵ ŶĞĂƌůLJ ϮϮ ƉĞƌĐĞŶƚ ƚŽ ϭϱ ƉĞƌĐĞŶƚ͘ EĞĂƌůLJ ĞŝŐŚƚ ŝŶ ϭϬ ƌĞĐĞŶƚůLJ ŝŶƐƵƌĞĚ ĂůŝĨŽƌŶŝĂŶƐ ĂƌĞ ŵŽƌĞ ůŝŬĞůLJ ƚŽ ƌĞƉŽƌƚ ƚŚĂƚ ƚŚĞŝƌ ŚĞĂůƚŚ ŶĞĞĚƐ ĂƌĞ ďĞŝŶŐ ŵĞƚ ʹ ƵƉ ĨƌŽŵ ŽŶůLJ ŚĂůĨ ŝŶ ϮϬϭϯ͘ dŚĞLJ͛ƌĞ ĂůƐŽ ŵƵĐŚ ůĞƐƐ ǁŽƌƌŝĞĚ ĂďŽƵƚ ƉĂLJŝŶŐ ĨŽƌ Ă ƐĞƌŝŽƵƐ ŝůůŶĞƐƐ Žƌ ĂĐĐŝĚĞŶƚ͘ ^ƚŝůů͕ ĐŽƐƚ ĂŶĚ ĂĐĐĞƐƐ ƌĞŵĂŝŶ ĐŚĂůůĞŶŐŝŶŐ͘ EŽƚ Ăůů ĂůŝĨŽƌŶŝĂŶƐ ŐĞƚ ƚŚĞ ĐĂƌĞ ƚŚĞLJ ŶĞĞĚ͘ dǁŽ ŝŶ ϭϬ ƌĞĐĞŶƚůLJ ĐŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂŶƐ ƐĂŝĚ ƚŚĞLJ ĨĂŝůĞĚ ƚŽ ŐĞƚ ŵĞĚŝĐĂů ĐĂƌĞ ĚƵĞ ƚŽ ĐŽƐƚ Ăƚ ƐŽŵĞ ƉŽŝŶƚ ŝŶ ƚŚĞ ƉĂƐƚ LJĞĂƌ͘ KŶĞ ŝŶ ĨŽƵƌ ŽĨ ƚŚĞ ƌĞĐĞŶƚůLJ ŝŶƐƵƌĞĚ ƐĂŝĚ ƚŚĞLJ ŚĂǀĞ ŚĂĚ ƚŽ ǁĂŝƚ ͞ůŽŶŐĞƌ ƚŚĂŶ Ă ƌĞĂƐŽŶĂďůĞ ƚŝŵĞ͟ ƚŽ ŐĞƚ ĂŶ ĂƉƉŽŝŶƚŵĞŶƚ ĂŶĚ ŵŽƌĞ ƚŚĂŶ ŽŶĞ ŝŶ ϭϬ ǁĞƌĞ ƚŽůĚ ƚŚĞ ƉŚLJƐŝĐŝĂŶ ŽĨĨŝĐĞ ǁĂƐ ŶŽƚ ĂĐĐĞƉƚŝŶŐ ŶĞǁ ƉĂƚŝĞŶƚƐ͘ ^ŽůƵƚŝŽŶƐ ƚŽ ƚŚĞƐĞ ĐŚĂůůĞŶŐĞƐ ůŝĞ ŝŶ ĂƉƉƌŽƉƌŝĂƚĞůLJ ĨƵŶĚŝŶŐ WĂƚŝĞŶƚ ĞŶƚĞƌĞĚ DĞĚŝĐĂů ,ŽŵĞƐ ;W D,Ϳ ǁŚĞƌĞ ƚĞĂŵƐ ĞŶƐƵƌĞ ƉĂƚŝĞŶƚƐ ŐĞƚ ƚŚĞ ƌŝŐŚƚ ĐĂƌĞ Ăƚ ƚŚĞ ƌŝŐŚƚ ƚŝŵĞ ĨƌŽŵ ƚŚĞ ƌŝŐŚƚ ƉƌŽĨĞƐƐŝŽŶĂů͘ ^ĂŵĞͲĚĂLJ ƐĐŚĞĚƵůŝŶŐ͕ ǁĞď ƉŽƌƚĂůƐ ĨŽƌ ƐĞĐƵƌĞ ŵĞƐƐĂŐŝŶŐ͕ ĞdžƚĞŶĚĞĚ ŽĨĨŝĐĞ ŚŽƵƌƐ

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California Family Physician Fall 2016

ĂŶĚ ĞŵĂŝů ĐŽŵŵƵŶŝĐĂƚŝŽŶ Ăůů ŚĞůƉ ƚŽ ĞdžƚĞŶĚ ƉĂƚŝĞŶƚ ĂĐĐĞƐƐ ƚŽ ĐĂƌĞ͘ tĞ ƐĞĞ Ă ŐŽŽĚ ŶĞǁƐͲďĂĚ ŶĞǁƐ ĚŝĐŚŽƚŽŵLJ ŝŶ ƚŚĞ ͛Ɛ ĚĞůŝǀĞƌLJ ƐLJƐƚĞŵ ƌĞĨŽƌŵƐ ĂƐ ǁĞůů͘ dŚĞ ŐŽŽĚ ŶĞǁƐ ŝƐ ƚŚĞ ƐƚĞĚ ŶĂƐĐĞŶƚ ĞĨĨŽƌƚƐ ƚŽ ŵŽǀĞ ƚŚĞ ŚĞĂůƚŚ ĐĂƌĞ ƐLJƐƚĞŵ ƚŽǁĂƌĚ ǀĂůƵĞĚͲ ďĂƐĞĚ ƉĂLJŵĞŶƚ͘ /ŶƐƵƌĂŶĐĞ ĐŽŵƉĂŶŝĞƐ ǁĞƌĞ ĂůƌĞĂĚLJ ĞdžƉĞƌŝŵĞŶƚŝŶŐ ǁŝƚŚ ƚŚĞ ĐŽŶĐĞƉƚ ǁŚĞŶ ƚŚĞ ŝŶƐƚŝƚƵƚĞĚ ƉŽůŝĐŝĞƐ ƚŚĂƚ ĐůĞĂƌůLJ ĞƐƚĂďůŝƐŚĞĚ ǀĂůƵĞͲ ďĂƐĞĚ ĐĂƌĞ ĂƐ ƚŚĞ ŐŽĂů͘ dŚĞ ĐŽŶĐĞƉƚ ŽĨ W D, ŵĞĚŝĐĂů ŚŽŵĞƐ ŚĂĚ ƚĂŬĞŶ ƌŽŽƚ ĂŶĚ Ă ĐĞƌƚŝĨŝĐĂƚŝŽŶ ƉƌŽĐĞƐƐ ŚĂĚ ďĞĞŶ ůĂƵŶĐŚĞĚ͘ dŚĞ ͛Ɛ ĐŚĂůůĞŶŐĞ͕ ƚŚĞŶ͕ ŚĂƐ ďĞĞŶ ƚŽ ƐŵŽŽƚŚ ŽƵƚ ƚŚĞ ĚŝĨĨĞƌĞŶĐĞƐ ĂŵŽŶŐ ƉƌŽŐƌĂŵƐ͕ ŵŽƌĞ ƵŶŝǀĞƌƐĂůůLJ ĚĞĨŝŶĞ ƋƵĂůŝƚLJ ĂŶĚ ĞƐƚĂďůŝƐŚ ŵĞĂƐƵƌĞƐ ƚŚĂƚ ƌĞĨůĞĐƚ ŚŝŐŚ ƋƵĂůŝƚLJ ĐĂƌĞ ĂŶĚ ĚĞǀĞůŽƉ ƉĂLJŵĞŶƚ ƚŚĂƚ ƌĞǁĂƌĚƐ ŽƵƚĐŽŵĞƐ͕ ŶŽƚ ŝŶƚĞƌǀĞŶƚŝŽŶƐ͘ WŝŽŶĞĞƌ ĐĐŽƵŶƚĂďůĞ ĂƌĞ KƌŐĂŶŝnjĂƚŝŽŶƐ ; KƐͿ ĂŶĚ ƚŚĞ DĞĚŝĐĂƌĞ ^ŚĂƌĞĚ ^ĂǀŝŶŐƐ WƌŽŐƌĂŵ ;D^^WͿ ŚĂǀĞ ďŽƚŚ ďĞĞŶ ĞĂƌůLJ ƐƵĐĐĞƐƐĞƐ ŽĨ ƚŚĞ ůĂǁ͘ ŽƚŚ ŚĂǀĞ ĚĞŵŽŶƐƚƌĂƚĞĚ ŝŵƉŽƌƚĂŶƚ ƐĂǀŝŶŐƐ ĂŶĚ ƋƵĂůŝƚLJ ŝŵƉƌŽǀĞŵĞŶƚƐ͘ WŝŽŶĞĞƌ KƐ ŚĂǀĞ ƌĞĐŽƌĚĞĚ ŽǀĞƌĂůů ƋƵĂůŝƚLJ ƐĐŽƌĞƐ ďĞƚǁĞĞŶ ϵϮ ƚŽ ϵϴ ƉĞƌĐĞŶƚ ǁŚŝůĞ ŐĞŶĞƌĂƚŝŶŐ ƐĂǀŝŶŐƐ ŽĨ ŵŽƌĞ ƚŚĂŶ Ψϯϳ ŵŝůůŝŽŶ͘ DĞĚŝĐĂƌĞ ^ŚĂƌĞĚ ^ĂǀŝŶŐƐ ŐĞŶĞƌĂƚĞĚ ƚŽƚĂů ƉƌŽŐƌĂŵ ƐĂǀŝŶŐƐ ŽĨ ΨϰϮϵ ŵŝůůŝŽŶ͘ EƵŵďĞƌ ŽĨ ƚŚĞƐĞ ƉĂƌƚŝĐŝƉĂŶƚƐ ĞĂƌŶĞĚ ƐŚĂƌĞĚ ƐĂǀŝŶŐƐ ďLJ ŵĞĞƚŝŶŐ ďŽƚŚ ƋƵĂůŝƚLJ ƐƚĂŶĚĂƌĚƐ ĂŶĚ ĐŽƐƚ ďĞŶĐŚŵĂƌŬƐ͘ dŚĞ ůĂǁ ŚĂƐ ŶŽ ƉƌŽǀŝƐŝŽŶ ƚŚĂƚ ĞŶƐƵƌĞƐ ƚŚĞ KƐ ƐŚĂƌĞ ƚŚĞ ƐĂǀŝŶŐƐ ǁŝƚŚ ƚŚĞ ƉŚLJƐŝĐŝĂŶƐ ǁŚŽ ĂƌĞ ƚŚĞ ĨŽƵŶĚĂƚŝŽŶ ŽĨ ƚŚĞ K ĂŶĚ ǁŚŽ ĐƌĞĂƚĞĚ ƚŚŝƐ ǀĂůƵĞ͕ ŚŽǁĞǀĞƌ͘ DŽƌĞŽǀĞƌ͕ ƌĞĨŽƌŵŝŶŐ ŚĞĂůƚŚ ĐĂƌĞ ĚĞůŝǀĞƌLJ ĚĞƉĞŶĚƐ ŽŶ ĞůĞĐƚƌŽŶŝĐ ŚĞĂůƚŚ ƌĞĐŽƌĚƐ ; ,ZƐͿ ƚŚĂƚ ŚĂǀĞ ƉƌŽǀĞŶ ƚŽ ďĞ ĐƵŵďĞƌƐŽŵĞ͕ ƚŝŵĞͲĐŽŶƐƵŵŝŶŐ ĂŶĚ ŽĨƚĞŶ ĐůŝŶŝĐĂůůLJ ĂǁŬǁĂƌĚ͘ ĞĨŽƌĞ ƚŚĞ ͛Ɛ ƉĂƐƐĂŐĞ͕ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ůĞĚ ƚŚĞ ŵĞĚŝĐĂů ĐŽŵŵƵŶŝƚLJ ŝŶ ďƵLJŝŶŐ ĂŶĚ ƵƐŝŶŐ ŚĞĂůƚŚ ŝŶĨŽƌŵĂƚŝŽŶ ƚĞĐŚŶŽůŽŐLJ͘ ,Z ĂĚŽƉƚŝŽŶ ĂŵŽŶŐ ĨĂŵŝůLJ

ƉŚLJƐŝĐŝĂŶƐ ƐƵƌŐĞĚ͕ ƚŚĞŶ ĨĞůů͘ ^ĂƚŝƐĨĂĐƚŝŽŶ ǁŝƚŚ ,Z ĨƵŶĐƚŝŽŶĂůŝƚLJ ĂŶĚ ŝŶƚĞƌŽƉĞƌĂďŝůŝƚLJ ƉůƵŵŵĞƚĞĚ ĨƌŽŵ ϲϭ ƉĞƌĐĞŶƚ ŝŶ ϮϬϭϬ ƚŽ ϯϰ ƉĞƌĐĞŶƚ ŝŶ ϮϬϭϰ ďĞĐĂƵƐĞ ŽĨ ŝƐƐƵĞƐ ŽĨ ŝŶƚĞƌŽƉĞƌĂďŝůŝƚLJ ĂƐ ƉŚLJƐŝĐŝĂŶƐ ƐƚƌƵŐŐůĞĚ ƚŽ ĐŽŵƉůLJ ǁŝƚŚ ŵĞĂŶŝŶŐĨƵů ƵƐĞ ƌĞŐƵůĂƚŝŽŶƐ͘ ^ƵĐŚ ĐŚĂůůĞŶŐĞƐ ƵŶĚĞƌĐƵƚ ĞĨĨŽƌƚƐ ƚŽ ďƵŝůĚ ƚƌƵůLJ ĐŽŽƌĚŝŶĂƚĞĚ ĐĂƌĞ͕ ĂŶĚ ƚŚĞ &W ĐŽŶƚŝŶƵĞƐ ƚŽ ĂĚǀŽĐĂƚĞ ĨŽƌ ƐŝŐŶŝĨŝĐĂŶƚ ĐŚĂŶŐĞƐ ŝŶ ƌĞŐƵůĂƚŝŽŶƐ ĂŶĚ ǀĞŶĚŽƌ ĂĐĐŽƵŶƚĂďŝůŝƚLJ͘ dŚĞ ƌƵůĞƐ ʹ ĂŶĚ ƚŚĞ ,ZƐ ƚŚĞLJ ŐŽǀĞƌŶ ʹ ŵƵƐƚ ďĞ ĚĞƐŝŐŶĞĚ ƚŽ ŝŵƉƌŽǀĞ ƉĂƚŝĞŶƚ ĐĂƌĞ Žƌ ŝŶĐƌĞĂƐĞ ĞĨĨŝĐŝĞŶĐLJ ŝŶ ǁŽƌŬĨůŽǁ͘ ZĞŐƵůĂƚŽƌƐ ŚĂǀĞ ƚĂŬĞŶ ŶŽƚĞ͘ WƌŽƉŽƐĞĚ ƌƵůĞƐ ƚŽ ŝŵƉůĞŵĞŶƚ ƚŚĞ DĞĚŝĐĂƌĞ ĐĐĞƐƐ ĂŶĚ ,/W ZĞĂƵƚŚŽƌŝnjĂƚŝŽŶ Đƚ ŚĂǀĞ ƚĂŬĞŶ ĂĐĐŽƵŶƚ ŽĨ ƚŚĞ &W͛Ɛ ĐŽŵŵĞŶƚƐ͘ dŚĞ ƉƌŽƉŽƐĂů ĐŽŶƚĂŝŶƐ ƉƌŽǀŝƐŝŽŶƐ ƚŚĂƚ ƐŚŽƌƚĞŶ ƌĞƉŽƌƚŝŶŐ ƉĞƌŝŽĚƐ ĨŽƌ ŵĞĂŶŝŶŐĨƵů ƵƐĞ ͲͲ ŶŽǁ ŬŶŽǁŶ ĂƐ ĂĚǀĂŶĐŝŶŐ ĐĂƌĞ ŝŶĨŽƌŵĂƚŝŽŶ ͲͲ ĂŶĚ ƌĞƋƵŝƌĞ ŝŵƉƌŽǀĞĚ ŝŶƚĞƌŽƉĞƌĂďŝůŝƚLJ ĂŶĚ ĨƵŶĐƚŝŽŶĂůŝƚLJ͘ DƵĐŚ ŵŽƌĞ ŶĞĞĚƐ ƚŽ ďĞ ĚŽŶĞ͘ dŚĞ &W ĐŽŶƚŝŶƵĞƐ ƚŽ ĂĚǀŽĐĂƚĞ ĨŽƌ ĂĚĚŝƚŝŽŶĂů ŝŵƉƌŽǀĞŵĞŶƚƐ ƚŚĂƚ ĞŶƐƵƌĞ Ă ƐƚƌŽŶŐ͕ ĐŽŵƉƌĞŚĞŶƐŝǀĞ ƉƌŝŵĂƌLJ ŵĞĚŝĐĂů ĐĂƌĞ ďĂĐŬďŽŶĞ͘ ŵŽŶŐ ƚŚĞŵ͗ ͻ ŽŶƚŝŶƵĞĚ ĂĚǀŽĐĂĐLJ ĨŽƌ ĞƋƵĂů ƉĂLJŵĞŶƚ ƚŽ ĐŽŵŵƵŶŝƚLJ ƉŚLJƐŝĐŝĂŶ ƉƌĂĐƚŝĐĞƐ ĂŶĚ ŚŽƐƉŝƚĂů ĐŽŵŵƵŶŝƚLJ ŽƵƚƉĂƚŝĞŶƚ ĐůŝŶŝĐƐ͕ ƌĞŐĂƌĚůĞƐƐ ŽĨ ŽǁŶĞƌƐŚŝƉ͘ ͻ ĚŵŝŶŝƐƚƌĂƚŝǀĞ ƐŝŵƉůŝĨŝĐĂƚŝŽŶ ƚŚĂƚ ĞŶƐƵƌĞƐ ƋƵĂůŝƚLJ ŵĞĂƐƵƌĞƐ ƌĞĨůĞĐƚ ƉĂƚŝĞŶƚ ĐĂƌĞ ĂŶĚ ƚŚĂƚ ƌĞĚƵĐĞƐ ƚŚĞ ƉĂƉĞƌǁŽƌŬ ĂƐƐŽĐŝĂƚĞĚ ǁŝƚŚ ŵĞĞƚŝŶŐ ƚŚŽƐĞ ŵĞĂƐƵƌĞƐ͘ ͻ ƐƚĂďůŝƐŚŵĞŶƚ ŽĨ ŶĞǁ ƉĂLJŵĞŶƚ ĐŽĚĞƐ ƚŚĂƚ ƌĞĨůĞĐƚ ƚŚĞ ŝŶƚĞŶƐŝƚLJ ĂŶĚ ĐŽŵƉůĞdžŝƚLJ ŽĨ ĂŵďƵůĂƚŽƌLJ ƉƌŝŵĂƌLJ ĐĂƌĞ ͬD ƐĞƌǀŝĐĞƐ͘ dŚĞ ĞŶŽƌŵŽƵƐ ĂŵŽƵŶƚ ŽĨ ĐŚĂŶŐĞ ŚĂƐ ďĞĞŶ ƉĂŝŶĨƵů ĂŶĚ ĚŝĨĨŝĐƵůƚ͘ /͛ŵ ĐŽŶĨŝĚĞŶƚ ǁĞ ǁŝůů ŵĞĞƚ ƚŚĞ ƵůƚŝŵĂƚĞ ŐŽĂů ŽĨ ďŽƚŚ ŝŵƉƌŽǀŝŶŐ ƉĂLJŵĞŶƚ ĨŽƌ ƉƌŝŵĂƌLJ ŵĞĚŝĐĂů ĐĂƌĞ ĂŶĚ ĂĐĐĞƐƐ ƚŽ ŚŝŐŚ ƋƵĂůŝƚLJ ĐĂƌĞ ĨŽƌ ŽƵƌ ƉĂƚŝĞŶƚƐ͘

Faculty

John Muir Health’s Family Medicine Residency Program, Walnut Creek, CA

John Muir Health is a nationally-recognized healthcare system that offers a full range of outpatient and inpatient services. We are proud to be launching our UCSF-Affiliated John Muir Health Family Medicine Residency Program in the San Francisco East Bay area. We are seeking a faculty member to help develop an innovative, dynamic, 8-8-8 unopposed, community-based program that is attentive to underserved patient populations. The successful candidate must be a board-certified family physician who is committed to educating future family physicians and passionate about excellence in education and clinical services. The selected individual will be responsible for administrative leadership support, direct clinical care and precepting. Contact: Lynn Eddleman, Residency Program Coordinator p: (925) 941-2674 f: (925) 296-9015 lynn.eddleman@johnmuirhealth.com

California Family Physician Fall 2016

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The Affordable Care Act Six Years Later: The Good, Bad, and Promising ^ŝdž LJĞĂƌƐ ĂŌĞƌ ƚŚĞ ĞŶĂĐƚŵĞŶƚ ŽĨ ƚŚĞ īŽƌĚĂďůĞ ĂƌĞ Đƚ ; Ϳ͕ ƚŚĞƌĞ ŝƐ ŵƵĐŚ ƚŽ ĨĞĞů ŐŽŽĚ ĂďŽƵƚ ƚŚĞ ĞdžƉĂŶƐŝŽŶ ŽĨ ŚĞĂůƚŚ ŝŶƐƵƌĂŶĐĞ ĐŽǀĞƌĂŐĞ ĂŶĚ ƉƌŽŐƌĞƐƐ ŽŶ ŚĞĂůƚŚ ĐĂƌĞ ĚĞůŝǀĞƌLJ ƐLJƐƚĞŵ ƌĞĨŽƌŵ͘ dŚĞ ĚĂLJƐ ŽĨ ĞdžĐůƵƐŝŽŶƐ ĨŽƌ ƉƌĞͲĞdžŝƐƟŶŐ ĐŽŶĚŝƟŽŶƐ͕ ůŽƐŝŶŐ ĐŽǀĞƌĂŐĞ ďĞĐĂƵƐĞ ŽĨ ĂŶŶƵĂů Žƌ ůŝĨĞƟŵĞ ůŝŵŝƚƐ ĂŶĚ ĞdžĐĞƐƐŝǀĞ ƉƌĞŵŝƵŵƐ ƐƉĞŶƚ ŽŶ ĂĚŵŝŶŝƐƚƌĂƟǀĞ ĞdžƉĞŶƐĞƐ ĂŶĚ ƉƌŽĮƚƐ ƌĂƚŚĞƌ ƚŚĂŶ ŵĞĚŝĐĂů ĐĂƌĞ ĂƌĞ ĨĂĚŝŶŐ ŝŶƚŽ ƉĂƐƚ ŵĞŵŽƌŝĞƐ͘ ,ĞƌĞ ŝŶ ĂůŝĨŽƌŶŝĂ͕ ϭ͘ϰ ŵŝůůŝŽŶ ĂůŝĨŽƌŶŝĂŶƐ ŚĂǀĞ ŚĞĂůƚŚ ŝŶƐƵƌĂŶĐĞ ƚŚƌŽƵŐŚ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ ĂŶĚ ϭϮ͘ϳ ŵŝůůŝŽŶ ĂůŝĨŽƌŶŝĂŶƐ ŚĂǀĞ ĐŽǀĞƌĂŐĞ ƚŚƌŽƵŐŚ ŽƵƌ ĞdžƉĂŶĚĞĚ DĞĚŝͲ Ăů ƉƌŽŐƌĂŵ͘ ŶĚ ĂůŝĨŽƌŶŝĂ ŚĂƐ ůĞĚ ƚŚĞ ŶĂƟŽŶ ŝŶ ĞdžƉĂŶĚŝŶŐ DĞĚŝĐĂŝĚ ĐŽǀĞƌĂŐĞ ƚŽ ƵŶĚŽĐƵŵĞŶƚĞĚ ŝŵŵŝŐƌĂŶƚ ĐŚŝůĚƌĞŶ ĂŶĚ ŝŶ ƚĂŬŝŶŐ ƐƚĞƉƐ ƚŽ ŽƉĞŶ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ ƚŽ ƵŶĚŽĐƵŵĞŶƚĞĚ ŝŵŵŝŐƌĂŶƚ ĂĚƵůƚƐ͘ /Ŷ ƚĞƌŵƐ ŽĨ ŚĞĂůƚŚ ĐĂƌĞ ĚĞůŝǀĞƌLJ ƐLJƐƚĞŵ ƌĞĨŽƌŵ͕ ƚŚĞ /ŶƚĞŐƌĂƚĞĚ ,ĞĂůƚŚĐĂƌĞ ƐƐŽĐŝĂƟŽŶ ĂŶĚ W' ůĂŝĚ ƐŽŵĞ ŽĨ ƚŚĞ ĨŽƵŶĚĂƟŽŶƐ ĨŽƌ ƉĂLJͲĨŽƌͲƉĞƌĨŽƌŵĂŶĐĞ ŝŶĐĞŶƟǀĞƐ͕ ĂĐĐŽƵŶƚĂďůĞ ĐĂƌĞ ŽƌŐĂŶŝnjĂƟŽŶƐ ĂŶĚ ďƵŶĚůĞĚ ƉĂLJŵĞŶƚƐ ĂƐ ƉĂƌƚ ŽĨ ƚŚĞ ŶĂƟŽŶĂů ŵŽǀĞŵĞŶƚ ĂǁĂLJ ĨƌŽŵ ĨĞĞͲĨŽƌͲ ƐĞƌǀŝĐĞ ƉĂLJŵĞŶƚƐ͘ dŚĞ ĨĞĚĞƌĂů ŐŽǀĞƌŶŵĞŶƚ ĂŶĚ ŵŽƐƚ ŚĞĂůƚŚ ĐĂƌĞ ƚŚŽƵŐŚƚ ĂŶĚ ƉƌĂĐƟĐĞ ůĞĂĚĞƌƐ ŚĂǀĞ ĞŵďƌĂĐĞĚ ƚŚĞ ͞ƚƌŝƉůĞ Ăŝŵ͟ ŽĨ ďĞƩĞƌ ĐĂƌĞ͕ ŝŵƉƌŽǀĞĚ ŚĞĂůƚŚ͕ ĂŶĚ ůŽǁĞƌ ĐŽƐƚƐ͘ WĂƟĞŶƚ ƐĂĨĞƚLJ ŝŶŝƟĂƟǀĞƐ ƐƵĐŚ ĂƐ ƚŚĞ WĂƌƚŶĞƌƐŚŝƉ ĨŽƌ WĂƟĞŶƚƐ͕ ŶŽŶͲƉĂLJŵĞŶƚƐ ĨŽƌ ĂǀŽŝĚĂďůĞ ŚŽƐƉŝƚĂů ƌĞĂĚŵŝƐƐŝŽŶƐ͕ ĂŶĚ ĐĂůůŝŶŐ ŽƵƚ ƚŚĞ ŽǀĞƌͲƵƐĞ ŽĨ ƉƌŽĐĞĚƵƌĞƐ ƚŚƌŽƵŐŚ ŚŽŽƐŝŶŐ tŝƐĞůLJ ŚĂǀĞ ĐŽŶƟŶƵĞĚ ƚŚĞ ŵŽŵĞŶƚƵŵ ĂǁĂLJ ĨƌŽŵ ďƵƐŝŶĞƐƐ ĂƐ ƵƐƵĂů ŝŶ ŚĞĂůƚŚ ĐĂƌĞ͘ DƵĐŚ ǁŽƌŬ ƌĞŵĂŝŶƐ ƚŽ ďĞ ĚŽŶĞ ƚŽ ĂĐŚŝĞǀĞ ƵŶŝǀĞƌƐĂů ŚĞĂůƚŚ ŝŶƐƵƌĂŶĐĞ ĐŽǀĞƌĂŐĞ ĂŶĚ ŵŽƌĞ ƉƌŽŐƌĞƐƐ ƚŽǁĂƌĚƐ ƚŚĞ ƚƌŝƉůĞ Ăŝŵ͕ ŚŽǁĞǀĞƌ͘ tŝƚŚ ƚŚĞ ĂŶŶŽƵŶĐĞŵĞŶƚ ŽĨ ĂŶ ĂǀĞƌĂŐĞ ŽĨ ϭϯ ƉĞƌĐĞŶƚ ŝŶĐƌĞĂƐĞƐ ŝŶ ƉƌĞŵŝƵŵƐ ĨŽƌ ĐŽǀĞƌĂŐĞ ƚŚƌŽƵŐŚ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ ĨŽƌ ϮϬϭϳ͕ ƚŚĞ ͞ĂīŽƌĚĂďůĞ͟ ƉĂƌƚ 20

California Family Physician Fall 2016

ŽĨ ƚŚĞ ǁŝůů ŝŶĐƌĞĂƐŝŶŐůLJ ďĞĐŽŵĞ Ă ĐŚĂůůĞŶŐĞ͘ ZŝƐŝŶŐ ĐŽͲƉĂLJŵĞŶƚƐ ĨŽƌ ƉĂƟĞŶƚƐ ĂůƐŽ ĚŝƐŝŶĐĞŶƟǀŝnjĞƐ ƚŚĞ ƌĞŐƵůĂƌ ĂŶĚ ĐŽŽƌĚŝŶĂƚĞĚ ĐĂƌĞ ďĞŝŶŐ ƉƌŽŵŽƚĞĚ ƚŚƌŽƵŐŚ ŵĞĚŝĐĂů ŚŽŵĞ ĂŶĚ ĂĐĐŽƵŶƚĂďůĞ ĐĂƌĞ ŵŽĚĞůƐ͘ /Ĩ ƉĂƟĞŶƚƐ ŝŶ ƐŝůǀĞƌ ƉůĂŶƐ ĂƌĞ ďĞŝŶŐ ĂƐŬĞĚ ƚŽ ƉĂLJ Ψϯϱ ĨŽƌ Ă ƉƌŝŵĂƌLJ ĐĂƌĞ ŽĸĐĞ ǀŝƐŝƚ͕ ĂŶĚ ƵƉ ƚŽ ΨϮϱϬ Ă LJĞĂƌ ŝŶ ĚĞĚƵĐƟďůĞƐ ĨŽƌ ƉƌĞƐĐƌŝƉƟŽŶ ĚƌƵŐƐ͕ ĂĐŚŝĞǀĞŵĞŶƚ ŽĨ ŐŽĂůƐ ŝŶ ĐĂƌĞ ƉůĂŶƐ ĂŶĚ ŵĞĚŝĐĂƟŽŶ ĂĚŚĞƌĞŶĐĞ ŝƐ ŐŽŝŶŐ ƚŽ ƉůƵŵŵĞƚ͘

ZĞĂƵƚŚŽƌŝnjĂƟŽŶ Đƚ ;D Z Ϳ ǁŝƚŚ Ă :ĂŶƵĂƌLJ ϮϬϭϳ ƐƚĂƌƚ ĚĂƚĞ ĨŽƌ ƉĞƌĨŽƌŵĂŶĐĞ ŵĞĂƐƵƌĞŵĞŶƚ ŵĞĂŶƐ ƚŚĂƚ ĞǀĞŶ ŵŽƌĞ ĚŝƐƌƵƉƟǀĞ ĐŚĂŶŐĞ ŝƐ ŽŶůLJ ŵŽŶƚŚƐ ĂǁĂLJ͘ tŚŝůĞ D Z ĐŽƵůĚ ĂƉƉƌŽƉƌŝĂƚĞůLJ ŝŶĐĞŶƟǀŝnjĞ ͞ĐůŝŶŝĐĂů ƉĞƌĨŽƌŵĂŶĐĞ ŝŵƉƌŽǀĞŵĞŶƚ ĂĐƟǀŝƟĞƐ͟ ĂƐ ǁĞůů ĂƐ ĐŽŶƟŶƵĞĚ ƵƐĞ ŽĨ ,ZƐ ĂŶĚ ƌĞƉŽƌƟŶŐ ŽĨ ƋƵĂůŝƚLJ ŵĞĂƐƵƌĞƐ͕ D^͛ ƉƌŽƉŽƐĂů ĨŽƌ ŚŽǁ DĞĚŝĐĂƌĞ ďŽŶƵƐ ƉĂLJŵĞŶƚƐ ĂŶĚ ƉĞŶĂůƟĞƐ ǁŝůů ďĞ ĐĂůĐƵůĂƚĞĚ ŝƐ ƵŶŶĞĐĞƐƐĂƌŝůLJ ĐŽŵƉůŝĐĂƚĞĚ͘ DŽƌĞ ĂůĂƌŵŝŶŐ͕ D^ ŝƚƐĞůĨ tŚŝůĞ ƚŚĞƌĞ ŝƐ ŐŽŽĚ ŶĞǁƐ ƚŚĂƚ ϳϱ ƉĞƌĐĞŶƚ ŽĨ ĞƐƟŵĂƚĞƐ ƚŚĂƚ ϴϳ ƉĞƌĐĞŶƚ ŽĨ ƐŽůŽ ƉŚLJƐŝĐŝĂŶƐ ŚŽƐƉŝƚĂůƐ ĂŶĚ ϳϰ ƉĞƌĐĞŶƚ ŽĨ ƉŚLJƐŝĐŝĂŶƐ ŚĂǀĞ ĂŶĚ ϳϬ ƉĞƌĐĞŶƚ ŽĨ ƉŚLJƐŝĐŝĂŶƐ ŝŶ ŐƌŽƵƉƐ ŝŵƉůĞŵĞŶƚĞĚ ĨĞĚĞƌĂůůLJͲĐĞƌƟĮĞĚ ĞůĞĐƚƌŽŶŝĐ ŽĨ ƚǁŽͲƚŽͲŶŝŶĞ ƉŚLJƐŝĐŝĂŶƐ ǁŝůů ƌĞĐĞŝǀĞ ŚĞĂůƚŚ ƌĞĐŽƌĚ ; ,ZͿ ƐLJƐƚĞŵƐ͕ ƚŚĞ ďĂĚ ŶĞǁƐ ƉĞŶĂůƟĞƐ ŝŶ ƚŚĞ ĮƌƐƚ ƉĂLJŵĞŶƚ LJĞĂƌ͘ hŶůĞƐƐ ŝƐ ƚŚĂƚ ŽŶůLJ ŵŝŶŝŵĂů ŚĞĂůƚŚ ŝŶĨŽƌŵĂƟŽŶ ƚŚĞƌĞ ĂƌĞ ƐŝŐŶŝĮĐĂŶƚ ĐŚĂŶŐĞƐ ŝŶ ŚŽǁ ĞdžĐŚĂŶŐĞ ĂŶĚ ŝŶƚĞƌŽƉĞƌĂďŝůŝƚLJ ĞdžŝƐƚƐ D Z ŝƐ ŝŵƉůĞŵĞŶƚĞĚ͕ ƉŚLJƐŝĐŝĂŶƐ ǁŝůů ďĞ ĂŵŽŶŐ ,ZƐ͘ ŶĚ ǁŚŝůĞ ƚŚĞƌĞ ĂƌĞ ŵĂŶLJ ĐŽŶĨƵƐĞĚ͕ ĨƌƵƐƚƌĂƚĞĚ ĂŶĚ ƌĞƐĞŶƞƵů͘ ƉƌŽŵŝƐŝŶŐ ŵŽĚĞůƐ ĨŽƌ ŚĞĂůƚŚ ĐĂƌĞ ĚĞůŝǀĞƌLJ ƐLJƐƚĞŵ ƌĞĨŽƌŵ ƐƵĐŚ ĂƐ ƉĂƟĞŶƚͲĐĞŶƚĞƌĞĚ DĞĂŶǁŚŝůĞ͕ ƚŚĞ ŶĂƟŽŶĂů ĞůĞĐƟŽŶ ŝŶ ŵĞĚŝĐĂů ŚŽŵĞƐ͕ ŽŶůLJ Ă ƉĂƚĐŚǁŽƌŬ ŽĨ EŽǀĞŵďĞƌ ŵĞĂŶƐ Ă ĐŚĂŶĐĞ ƚŽ ĞůĞĐƚ Ă ĮŶĂŶĐŝĂů ŝŶĐĞŶƟǀĞƐ ŝƐ ĂǀĂŝůĂďůĞ ƚŽ ƐƵƉƉŽƌƚ ŶĞǁ WƌĞƐŝĚĞŶƚ ĂŶĚ ƉŽƚĞŶƟĂůůLJ ĐŚĂŶŐĞ ƚŚĞ ĐŽƐƚƐ ŽĨ ŵĞĞƟŶŐ ĂŶĚ ŵĂŝŶƚĂŝŶŝŶŐ ƚŚĞ ƚŚĞ ďĂůĂŶĐĞ ŽĨ ƉŽůŝƟĐĂů ƉŽǁĞƌ ŝŶ Ă ƌĞƋƵŝƌĞŵĞŶƚƐ ĨŽƌ ƌĞĐŽŐŶŝƟŽŶ͘ dŚĞ ƋƵĂůŝƚLJ ĚĞĂĚůŽĐŬĞĚ ŽŶŐƌĞƐƐ͘ ZĞŐĂƌĚůĞƐƐ ŽĨ ŵĞĂƐƵƌĞƐ ďĞŝŶŐ ƵƐĞĚ ďLJ ƚŚĞ ĞŶƚĞƌƐ ĨŽƌ ŽƵƚĐŽŵĞ͕ ůĞŐŝƐůĂƟǀĞ ĐĂůůƐ ƚŽ ͞Įdž͟ ƚŚĞ DĞĚŝĐĂƌĞ ĂŶĚ DĞĚŝĐĂŝĚ ^ĞƌǀŝĐĞƐ ; D^Ϳ ĂŶĚ ǁŝůů ĐŽŶƟŶƵĞ͕ ĞǀĞŶ ĂƐ ǁĞ ƚƌLJ ƚŽ ĐŽŶǀŝŶĐĞ ĐŽŵŵĞƌĐŝĂů ŚĞĂůƚŚ ƉůĂŶƐ ĂƌĞ ƐƟůů ƉŽŽƌůLJ ŵŽƌĞ ͞LJŽƵŶŐ ŝŶǀŝŶĐŝďůĞƐ͟ ƚŽ ƐŝŐŶ ƵƉ ĚƵƌŝŶŐ ĂůŝŐŶĞĚ ĂŶĚ ƐƟůů ƚŽŽ ŝŶŇƵĞŶĐĞĚ ďLJ ƐƉĞĐŝĂůƚLJ ƚŚŝƐ ĨĂůů͛Ɛ ĨŽƵƌƚŚ ŽƉĞŶ ĞŶƌŽůůŵĞŶƚ ƉĞƌŝŽĚ ƐŽĐŝĞƟĞƐ ǀĞƐƚĞĚ ŝŶ ƉƌĞƐĞƌǀŝŶŐ ƚŚĞŝƌ ƵŶĚĞƌ ƚŚĞ ƚŽ ƐŵŽŽƚŚ ŽƵƚ ƚŚĞ ĮŶĂŶĐŝĂů ĚŝƐƉƌŽƉŽƌƟŽŶĂƚĞ ƐŚĂƌĞ ŽĨ ĐƵƌƌĞŶƚ ĨĞĞͲĨŽƌͲ ƌŝƐŬƐ ƚŚĂƚ ĂƌĞ ĐĂƵƐŝŶŐ ŵŽƌĞ ŚĞĂůƚŚ ƉůĂŶƐ ƚŽ ƐĞƌǀŝĐĞ ƉĂLJŵĞŶƚƐ͘ &Žƌ ĞdžĂŵƉůĞ͕ ƚŚĞƌĞ ĂƌĞ ǁŝƚŚĚƌĂǁ ĨƌŽŵ ƉĂƌƟĐŝƉĂƟŽŶ ŝŶ ƚŚĞ ŚĞĂůƚŚ ůŽŶŐ ĚĞďĂƚĞƐ ĂďŽƵƚ ǁŚŝĐŚ ĂŵŽŶŐ ĚŽnjĞŶƐ ŝŶƐƵƌĂŶĐĞ ŵĂƌŬĞƚƉůĂĐĞƐ͘ /ŶƚĞƌĞƐƟŶŐůLJ͕ ŝŶ ŽĨ ŝŶĚŝǀŝĚƵĂů ĂŶĚ ĐŽŵƉŽƐŝƚĞ ĚŝĂďĞƚĞƐ ĂŶ ƵŶƉƌĞĐĞĚĞŶƚĞĚ :ŽƵƌŶĂů ŽĨ ƚŚĞ ŵĞƌŝĐĂŶ ŵĞĂƐƵƌĞƐ ƐŚŽƵůĚ ďĞ ƵƐĞĚ ĨŽƌ ǀĂůƵĞͲďĂƐĞĚ DĞĚŝĐĂů ƐƐŽĐŝĂƟŽŶ ĐŽŵŵĞŶƚĂƌLJ͕ WƌĞƐŝĚĞŶƚ ƉĂLJŵĞŶƚ͕ ŝŶĐůƵĚŝŶŐ ŵĞĂƐƵƌĞƐ ŽŶ ĚŝĂďĞƚĞƐͲ ĂƌĂĐŬ KďĂŵĂ ŚŝŵƐĞůĨ ĐĂůůĞĚ ĨŽƌ ƚŚĞ ƌĞůĂƚĞĚ ĂŵƉƵƚĂƟŽŶƐ͕ ƌĂƚŚĞƌ ƚŚĂŶ ĂƐŬŝŶŐ ĚĞǀĞůŽƉŵĞŶƚ ŽĨ Ă ƉƵďůŝĐ ŚĞĂůƚŚ ƉůĂŶ ŽƉƟŽŶ͕ ƚŚĞ ďŝŐŐĞƌ ƉŝĐƚƵƌĞ ƋƵĞƐƟŽŶƐ ĂďŽƵƚ ŚŽǁ ĞdžĂĐƚůLJ ƚŚĞ ŽƉƉŽƐŝƚĞ ŽĨ ƚŚŽƐĞ ǁŚŽ ǁĂŶƚ ƚŽ ƚŽ ƐƵƉƉŽƌƚ ƉƌĂĐƟĐĞƐ ŝŶ ŝĚĞŶƟĨLJŝŶŐ ƉƌĞͲ ͞ƌĞƉĞĂů ĂŶĚ ƌĞƉůĂĐĞ͟ ƚŚĞ ͘ ĚŝĂďĞƚĞƐ͕ ŵĂŬŝŶŐ ƉƌĞǀĞŶƟŽŶ ƉƌŽŐƌĂŵƐ ŵŽƌĞ ĞīĞĐƟǀĞ ĂŶĚ ƐƵƉƉŽƌƟŶŐ ƉĂƟĞŶƚƐ ĂŶĚ dŚĞƌĞ ĂůƐŽ ŝƐ ƚŚĞ ĐŽŶƚĞdžƚ ŽĨ ŽƚŚĞƌ ĐƵƌƌĞŶƚ ĨĂŵŝůŝĞƐ ŝŶ ĚŝĂďĞƚĞƐ ƐĞůĨͲŵĂŶĂŐĞŵĞŶƚ͘ ĞǀĞŶƚƐ͕ ƐĞĞŵŝŶŐůLJ ƵŶƌĞůĂƚĞĚ ƚŽ ŚĞĂůƚŚ ĐĂƌĞ͗ ƚŚĞ ŚŝŐŚůŝŐŚƟŶŐ ŽĨ ƉĞƌƐŝƐƚĞŶƚ ŝŶĐŽŵĞ EĞdžƚ LJĞĂƌ ƉƌĞƐĞŶƚƐ ĂĚĚŝƟŽŶĂů ĐŚĂůůĞŶŐĞƐ͘ ŝŶĞƋƵĂůŝƚLJ ĞǀĞŶ ĂƐ ƚŚĞ ŶĂƟŽŶĂů ĂŶĚ /Ŷ ϮϬϭϳ͕ D^͛ ƉƌŽƉŽƐĂů ƚŽ ďĞŐŝŶ ŐůŽďĂů ĞĐŽŶŽŵŝĞƐ ĐŽŶƟŶƵĞ ƚŽ ƌĞĐŽǀĞƌ ŝŵƉůĞŵĞŶƚĂƟŽŶ ŽĨ ƚŚĞ DĞĚŝĐĂƌĞ ĐĐĞƐƐ ĂŶĚ ŐƌŽǁ͕ ŝŶĐƌĞĂƐĞĚ ĐŽŶƐĐŝŽƵƐŶĞƐƐ ĂďŽƵƚ ĂŶĚ ŚŝůĚƌĞŶ͛Ɛ ,ĞĂůƚŚ /ŶƐƵƌĂŶĐĞ WƌŽŐƌĂŵ ŝŶƐƟƚƵƟŽŶĂů ƌĂĐŝƐŵ ĂƐ η ůĂĐŬ>ŝǀĞƐDĂƩĞƌ

ƐĞĞŬƐ ĂĐĐŽƵŶƚĂďŝůŝƚLJ ĨŽƌ ǀŝŽůĞŶĐĞ ĂŶĚ ŬŝůůŝŶŐƐ ŽĨ ĨƌŝĐĂŶ ŵĞƌŝĐĂŶƐ ďLJ ƉŽůŝĐĞ ŽĸĐĞƌƐ͕ ĂŶĚ ŽŶŐŽŝŶŐ ĚĞďĂƚĞƐ ĂďŽƵƚ ŝŵŵŝŐƌĂƟŽŶ ůĂǁ ĂŶĚ ƉŽůŝĐŝĞƐ͕ ĞƐƉĞĐŝĂůůLJ ĨŽĐƵƐĞĚ ŽŶ DĞdžŝĐĂŶ ĂŶĚ DƵƐůŝŵ ŝŵŵŝŐƌĂŶƚƐ ĂŶĚ ƌĞĨƵŐĞĞƐ͘ ĞĐĂƵƐĞ ůŽǁͲŝŶĐŽŵĞ ĂŶĚ ƵŶĞŵƉůŽLJĞĚ ŝŶĚŝǀŝĚƵĂůƐ͕ ĨƌŝĐĂŶ ŵĞƌŝĐĂŶƐ ĂŶĚ ŽƚŚĞƌ ƉĞŽƉůĞ ŽĨ ĐŽůŽƌ͕ ĂŶĚ DĞdžŝĐĂŶ ŵĞƌŝĐĂŶƐ͕ DƵƐůŝŵ ŵĞƌŝĐĂŶƐ͕ ĂŶĚ ŝŵŵŝŐƌĂŶƚƐ ĂŶĚ ƌĞĨƵŐĞĞƐ ĨƌŽŵ ƚŚƌŽƵŐŚŽƵƚ ƚŚĞ ǁŽƌůĚ Ăůů ŶĞĞĚ ŚĞĂůƚŚ ĐĂƌĞ͕ ƚŚĞƐĞ ŝƐƐƵĞƐ͕ ŝŶ ĨĂĐƚ͕ ĚŽ ŚĂǀĞ ĂŶ ŝŵƉĂĐƚ ŽŶ ŚĞĂůƚŚ ĐĂƌĞ͘ &ŽƌƚƵŶĂƚĞůLJ͕ ŚĞĂůƚŚ ĐĂƌĞ ĚŽĞƐ ĐŽŶƟŶƵĞ ƚŽ ƌĞƐƉŽŶĚ ƚŽ ƚŚĞ ŶĞĞĚƐ ŽĨ ŝŶĐƌĞĂƐŝŶŐůLJ ĚŝǀĞƌƐĞ ƉĂƟĞŶƚƐ͕ ĂŶĚ ƚŚĞƌĞ ĂƌĞ ŝŶĐƌĞĂƐŝŶŐ ĐĂůůƐ ĨŽƌ ĂĚǀĂŶĐŝŶŐ ĞƋƵŝƚLJ͘ D^ ŚĂƐ ŝƐƐƵĞĚ ŝƚƐ ĮƌƐƚ ĞǀĞƌ ƋƵŝƚLJ WůĂŶ ĨŽƌ YƵĂůŝƚLJ /ŵƉƌŽǀĞŵĞŶƚ ŝŶ DĞĚŝĐĂƌĞ͕ ĂŶĚ ƚŚĞ /ŶƐƟƚƵƚĞ ĨŽƌ ,ĞĂůƚŚĐĂƌĞ /ŵƉƌŽǀĞŵĞŶƚ ŚĂƐ ĐĂůůĞĚ ĨŽƌ ŶĂƟŽŶĂů ĂĐƟŽŶ ŽŶ ƚŚĞ ͞ĨŽƌŐŽƩĞŶ͟ ƋƵĂůŝƚLJ ŝŵƉƌŽǀĞŵĞŶƚ Ăŝŵ ŽĨ ĞƋƵŝƚLJ͘ tŚŝůĞ ƚŚĞ ĐŽůůĞĐƟŽŶ ŽĨ ƉĂƟĞŶƚ ƌĂĐĞ͕ ĞƚŚŶŝĐŝƚLJ͕ ĂŶĚ ůĂŶŐƵĂŐĞ ĚĂƚĂ ŝƐ ŝŶĐƌĞĂƐŝŶŐůLJ

ƌŽƵƟŶĞ͕ ŚĞĂůƚŚ ĐĂƌĞ ƐLJƐƚĞŵƐ ĂŶĚ ƉƌŽǀŝĚĞƌƐ ĂƌĞ ƐƟůů ŶŽƚ ĨƵůůLJ ƵƟůŝnjŝŶŐ ƚŚĂƚ ĚĂƚĂ ƚŽ ĞŶƐƵƌĞ ĞƋƵŝƚĂďůĞ ĐĂƌĞ ;ĨŽƌ ĞdžĂŵƉůĞ͕ ƚŚƌŽƵŐŚ ŚĞĂůƚŚ ĐĂƌĞ ŝŶƚĞƌƉƌĞƚĞƌƐͿ ĂŶĚ ƚŽ ŝĚĞŶƟĨLJ ĂŶĚ ƌĞĚƵĐĞ ĚŝƐƉĂƌŝƟĞƐ ĂƐ ƉĂƌƚ ŽĨ ƋƵĂůŝƚLJ ŝŵƉƌŽǀĞŵĞŶƚ͘ /ŶĐƌĞĂƐŝŶŐůLJ͕ ĚĂƚĂ ĂďŽƵƚ ƉĂƟĞŶƚ ĚŝƐĂďŝůŝƚLJ ƐƚĂƚƵƐ͕ ƐĞdžƵĂů ŽƌŝĞŶƚĂƟŽŶ͕ ŐĞŶĚĞƌ ŝĚĞŶƟƚLJ͕ ĂŶĚ ŽƚŚĞƌ ƐŽĐŝĂů ĂŶĚ ďĞŚĂǀŝŽƌĂů ĨĂĐƚŽƌƐ ĂůƐŽ ŝƐ ďĞŝŶŐ ĐŽůůĞĐƚĞĚ͕ ďƵƚ ŵŽƐƚ ŚĞĂůƚŚ ĐĂƌĞ ƉƌŽǀŝĚĞƌƐ ĂƌĞ ĞǀĞŶ ůĞƐƐ ƉƌĞƉĂƌĞĚ ƚŽ ŵĞĞƚ ƚŚĞ ŶĞĞĚƐ ŽĨ ƚŚĞƐĞ ĚŝǀĞƌƐĞ ƉĂƟĞŶƚ ƉŽƉƵůĂƟŽŶƐ͘

/ŐŶĂƟƵƐ ĂƵ ŝƐ Ă ŚĞĂůƚŚ ĐĂƌĞ ƉŽůŝĐLJ consultant based in San Francisco. From ϮϬϬϯͲϮϬϬϵ͕ ĂƐ Ă ƉƌŽŐƌĂŵ ŽĸĐĞƌ ĨŽƌ dŚĞ California Endowment, he supported the California Academy of Family Physicians’ ĐŽŽƌĚŝŶĂƟŽŶ ŽĨ ƚŚĞ DĞĚŝĐĂů >ĞĂĚĞƌƐŚŝƉ ŽƵŶĐŝů ĨŽƌ ƵůƚƵƌĂů WƌŽĮĐŝĞŶĐLJ͕ ǁŚŝĐŚ convened the leadership of 40 of ĂůŝĨŽƌŶŝĂ͛Ɛ ƉŚLJƐŝĐŝĂŶ ŽƌŐĂŶŝnjĂƟŽŶƐ ĂŶĚ health systems to collaborate on improving the quality of care for California’s diverse ƉĂƟĞŶƚ ƉŽƉƵůĂƟŽŶƐ͘

ĞƐƉŝƚĞ Ăůů ƚŚĞ ŐŽŽĚ͕ ďĂĚ͕ ;ĂŶĚ ƵŐůLJͿ ŝŶ ŚĞĂůƚŚ ĐĂƌĞ ƚŽĚĂLJ͕ ƚŚĞ ŽŶůLJ ĐĞƌƚĂŝŶƚLJ ŝƐ ƚŚĂƚ ŵŽƌĞ ĐŚĂŶŐĞƐ ǁŝůů ďĞ ĐŽŵŝŶŐ͘ ĂůŝĨŽƌŶŝĂ͛Ɛ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ŚĂǀĞ Ă ǀŝƚĂů ƌŽůĞ ŝŶ ĞŶƐƵƌŝŶŐ ƚŚĂƚ ƚŚŽƐĞ ĐŚĂŶŐĞƐ ƐƵƉƉŽƌƚ ƚŚĞŝƌ ƉƌĂĐƟĐĞƐ͕ ĂŶĚ ƐƵƉƉŽƌƚ ƚŚĞ ŝŵƉƌŽǀĞŵĞŶƚ ŽĨ ƚŚĞ ŚĞĂůƚŚ ŽĨ ƚŚĞŝƌ ƉĂƟĞŶƚƐ͕ ĨĂŵŝůŝĞƐ͕ ĐĂƌĞŐŝǀĞƌƐ͕ ĂŶĚ ĐŽŵŵƵŶŝƟĞƐ͘

Explore new possibilities Adventist Health offers a variety of employment opportunities with full- and part-time physician careers throughout the West Coast in California, Washington, Oregon and Hawaii .

PHYJOBS AH ORG s s PHYSICIANCAREERS AH ORG California Family Physician Fall 2016

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Covered California Plans to Match Primary Care Physicians with Patients ĂůŝĨŽƌŶŝĂ ŝƐ ŵĂŬŝŶŐ Ă ďŽůĚ ŵŽǀĞ ƚŽǁĂƌĚ ŝŵƉƌŽǀŝŶŐ ƉƌŝŵĂƌLJ ĐĂƌĞ ƵƚŝůŝnjĂƚŝŽŶ ĂŶĚ ĞŶŚĂŶĐŝŶŐ ƚŚĞ ĐŽŶƚŝŶƵŝƚLJ ĂŶĚ ƌĞůŝĂďŝůŝƚLJ ŽĨ ĐĂƌĞ͘ ĞŐŝŶŶŝŶŐ ŝŶ ϮϬϭϳ͕ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ͕ ƚŚĞ ƐƚĂƚĞ͛Ɛ ŚĞĂůƚŚ ŝŶƐƵƌĂŶĐĞ ĞdžĐŚĂŶŐĞ͕ ǁŝůů ƌĞƋƵŝƌĞ Ăůů ŚĞĂůƚŚ ƉůĂŶ ĞŶƌŽůůĞĞƐ ĞŝƚŚĞƌ ƚŽ ƐĞůĞĐƚ Ă ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶ Žƌ ďĞ ŵĂƚĐŚĞĚ ǁŝƚŚ ŽŶĞ ďLJ ƚŚĞŝƌ ŚĞĂůƚŚ ƉůĂŶƐ͘ dŚĞ ĐƌƵdž ŽĨ ƚŚŝƐ ƐƚƌĂƚĞŐLJ ŝƐ ƚŽ ĞŶƐƵƌĞ ĂůŝĨŽƌŶŝĂŶƐ ŚĂǀĞ Ă ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶ ŽĨ ƌĞĐŽƌĚ ƚŽ ŚĞůƉ ƚŚĞŵ ŶĂǀŝŐĂƚĞ ƚŚĞ ŚĞĂůƚŚ ƐLJƐƚĞŵ͕ ŵĂŶĂŐĞ ĐŽŵƉůĞdž ĂŶĚ ĐŚƌŽŶŝĐ ĐŽŶĚŝƚŝŽŶƐ ĂŶĚ ĞŶƐƵƌĞ ƚŚĞ ĐŽŵƉůĞƚĞŶĞƐƐ ŽĨ ƚŚĞŝƌ ŚĞĂůƚŚ ŝŶĨŽƌŵĂƚŝŽŶ͘ dŚĞƐĞ ŵĞĂƐƵƌĞƐ ĂƌĞ ĞdžƉĞĐƚĞĚ ƚŽ ĞŶŚĂŶĐĞ ƚŚĞ ƌĞůĂƚŝŽŶƐŚŝƉ ďĞƚǁĞĞŶ ƉƌŽǀŝĚĞƌ ĂŶĚ ƉĂƚŝĞŶƚ͕ ĂŶĚ ĐŽŶƚƌŝďƵƚĞ ƚŽ ƚŚĞ ŽǀĞƌĂůů ŚĞĂůƚŚ ĂŶĚ ǁĞůůŶĞƐƐ ŽĨ ƚŚĞ ƉĂƚŝĞŶƚ͘ Ɛ Ă ĂŶĂĚŝĂŶ͕ ƚŚĞ ŶŽƚŝŽŶ ŽĨ ƐĞĞŝŶŐ ŵLJ ĨĂŵŝůLJ ĚŽĐƚŽƌ ĂƐ ĂŶ ĞŶƚƌLJ ƉŽŝŶƚ ƚŽ ƚŚĞ ŚĞĂůƚŚ ĐĂƌĞ ƐLJƐƚĞŵ ŝƐ Ă ĨĂŵŝůŝĂƌ ŽŶĞ͘ EŽŶĞƚŚĞůĞƐƐ͕ Ă ƌŽďƵƐƚ ĐŽŶǀĞƌƐĂƚŝŽŶ ĂďŽƵƚ ƚŚĞ ůŽŐŝƐƚŝĐĂů ĂŶĚ ƉŚŝůŽƐŽƉŚŝĐĂů ƌĂŵŝĨŝĐĂƚŝŽŶƐ ŽĨ ƚŚŝƐ ŵŽǀĞ ŝƐ ƌŝŐŚƚĨƵůůLJ ƚĂŬŝŶŐ ƉůĂĐĞ͘ ŚŝĞĨ ĂŵŽŶŐ &W͛Ɛ ƉƌŝŽƌŝƚŝĞƐ ŝƐ ƚŽ ŵĂŝŶƚĂŝŶ ƌĞƐƉĞĐƚ ĨŽƌ ƚŚĞ ĂƵƚŽŶŽŵLJ ŽĨ ƉƌŽǀŝĚĞƌƐ ĂŶĚ ƉĂƚŝĞŶƚƐ͕ ĂŶĚ ƚŽ ĞŶƐƵƌĞ ŵŝŶŝŵĂů ĚŝƐƌƵƉƚŝŽŶƐ ƚŽ ĐĂƌĞ͘ &W ŚĂƐ ĐŽŶǀĞLJĞĚ ƚŚŝƐ ŵĞƐƐĂŐĞ ůŽƵĚ ĂŶĚ ĐůĞĂƌ ƚŽ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ͕ ǁŚŝĐŚ ǁŚŽůĞŚĞĂƌƚĞĚůLJ ĂŐƌĞĞƐ͘ ^ĞĐŽŶĚůLJ͕ ŝƚ ǁŝůů ďĞ ŝŵƉŽƌƚĂŶƚ ƚŽ ĚŝƐƉĞů ĂŶLJ ĨĞĂƌ ĂŵŽŶŐ ƉĂƚŝĞŶƚƐ ƚŚĂƚ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĂƌĞ ďĞŝŶŐ ƵƐĞĚ ĂƐ ďĂƌƌŝĞƌƐ ƚŽ ĐĂƌĞ͕ ƌĂƚŚĞƌ ƚŚĂŶ ĐĂƌĞ ĞŶŚĂŶĐĞƌƐ͕ Žƌ ƚŚĂƚ Ăůů ŚĞĂůƚŚ ƉůĂŶƐ ǁŝůů ďĞĐŽŵĞ ĚĞ ĨĂĐƚŽ ŚĞĂůƚŚ ŵĂŝŶƚĞŶĂŶĐĞ ŽƌŐĂŶŝnjĂƚŝŽŶ ;,DKͿ ƉůĂŶƐ͘ ŶƌŽůůĞĞƐ ŝŶ ĞdžĐůƵƐŝǀĞ ƉƌŽǀŝĚĞƌ ŽƌŐĂŶŝnjĂƚŝŽŶƐ ; WKͿ Žƌ ƉƌĞĨĞƌƌĞĚ ƉƌŽǀŝĚĞƌ ŽƌŐĂŶŝnjĂƚŝŽŶƐ ;WWKͿ ƉůĂŶƐ ǁŝůů ďĞ ŵĂƚĐŚĞĚ ǁŝƚŚ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶƐ͕ ďƵƚ ǁŝůů Ɛƚŝůů ďĞ ĂďůĞ ƚŽ ĂĐĐĞƐƐ ĂŶLJ ŝŶͲŶĞƚǁŽƌŬ ĐĂƌĞ ƉƌŽǀŝĚĞƌƐ ƚŚĞLJ ǁŝƐŚ ĂŶĚ ĐŚĂŶŐĞ ƚŚĞŝƌ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶ ŽĨ ƌĞĐŽƌĚ Ăƚ ƚŚĞŝƌ ĚŝƐĐƌĞƚŝŽŶ ĂƐ ŵĂŶLJ ƚŝŵĞƐ ĂƐ ƚŚĞLJ ǁŝƐŚ͘ ;/Ĩ ƉĂƚŝĞŶƚƐ ǁĂŶƚ Ă ŶƵƌƐĞ ƉƌĂĐƚŝƚŝŽŶĞƌ Žƌ Ă ƉŚLJƐŝĐŝĂŶ ĂƐƐŝƐƚĂŶƚ ĂƐ ƚŚĞ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉƌŽǀŝĚĞƌ͕ ŚŽǁĞǀĞƌ͕ ƚŚĞLJ ǁŝůů Ɛƚŝůů ŶĞĞĚ ƚŽ ƐĞůĞĐƚ ƚŚĞ ƉŚLJƐŝĐŝĂŶ ŵĞŵďĞƌ ŽŶ ƚŚĂƚ ĐůŝŶŝĐŝĂŶ͛Ɛ ƚĞĂŵ ĂƐ ƚŚĞŝƌ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉƌŽǀŝĚĞƌ͘Ϳ WĂƚŝĞŶƚƐ ŶŽƚ ŝŶ ŵĂŶĂŐĞĚ ĐĂƌĞ ƉůĂŶƐ ǁŝůů ŶŽƚ ďĞ ƌĞƋƵŝƌĞĚ ƚŽ ƐĞĞ ƚŚĞ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶ ƚŽ ŽďƚĂŝŶ ĂƵƚŚŽƌŝnjĂƚŝŽŶ ďĞĨŽƌĞ ƐĞĞŝŶŐ Ă ƐƉĞĐŝĂůŝƐƚ͕ ĂŶĚ ĞĂĐŚ ĞŶƌŽůůĞĚ ĨĂŵŝůLJ ŵĞŵďĞƌ ĐĂŶ ŚĂǀĞ ŚŝƐ Žƌ ŚĞƌ ŽǁŶ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶ͘ ĂƌĞ ŝƐ ďĞŝŶŐ ƚĂŬĞŶ ƚŽ ĞŶƐƵƌĞ ƚŚĂƚ ƉĂƚŝĞŶƚƐ ǁŚŽ ƉĂLJ ĨŽƌ Ă ĐŚŽŝĐĞ ĐŽŶƚŝŶƵĞ ƚŽ ĞŶũŽLJ ƚŚĞ ůĞǀĞů ŽĨ ĂĐĐĞƐƐ ƚŽ ǁŚŝĐŚ ƚŚĞLJ͛ƌĞ ĂĐĐƵƐƚŽŵĞĚ͘ 22

California Family Physician Fall 2016

ǀĞŶ ǁŝƚŚ ƚŚŝƐ ĐŚŽŝĐĞ ŝŶƚĂĐƚ͕ ŚŽǁĞǀĞƌ͕ ŝŶ ƚŚĞ ĨŝƌƐƚ LJĞĂƌ ŽĨ ƚŚŝƐ ŝŶŝƚŝĂƚŝǀĞ͕ ŚĞĂůƚŚ ƉůĂŶƐ ǁŝůů ĂƐƐŝŐŶ Ă ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶ ƚŽ Ăůů ĞŶƌŽůůĞĞƐ͘ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ ŝƐ ƉƌĞƉĂƌŝŶŐ ĨŽƌ ƉŽƐƐŝďůĞ ŝƐƐƵĞƐ ǁŝƚŚ ƚŚŝƐ ŵĂƚĐŚŝŶŐ͕ ƐƵĐŚ ĂƐ ŵĂƚĐŚŝŶŐ Ă ƉĂƚŝĞŶƚ ǁŚŽ ŚĂƐ Ă ƉƌĞĞdžŝƐƚŝŶŐ ƌĞůĂƚŝŽŶƐŚŝƉ ǁŝƚŚ ŽŶĞ ƉŚLJƐŝĐŝĂŶ ƚŽ Ă ĚŝĨĨĞƌĞŶƚ ƉŚLJƐŝĐŝĂŶ͕ ĂŶĚ ĂŶƚŝĐŝƉĂƚĞƐ ƚŚĂƚ ƚŚĞƐĞ ŵŝƐƚĂŬĞƐ ǁŝůů ďĞ ĞĂƐŝůLJ ĐŽƌƌĞĐƚĂďůĞ͘ Ɛ Ă ƌĞƐƵůƚ ŽĨ ƚŚŝƐ ŵĂƚĐŚŝŶŐ͕ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶƐ ŵĂLJ ĨŝŶĚ ƚŚĞŵƐĞůǀĞƐ ǁŝƚŚ Ă ďƌŽĂĚĞŶĞĚ ƐĞƚ ŽĨ ĞdžƉĞĐƚĂƚŝŽŶƐ͘ &Žƌ ŽŶĞ ƚŚŝŶŐ͕ ƚŚĞLJ ǁŝůů ŚĂǀĞ ƚŽ ĚĞĂů ŵŽƌĞ ĚŝƌĞĐƚůLJ ǁŝƚŚ ƚŚĞ ƚƌĂŶƐŝƚŝŽŶƐ ŝŶ ĐĂƌĞ ŝŶ ǁŚŝĐŚ ŝŶĨŽƌŵĂƚŝŽŶ ĂďŽƵƚ Ă ƉĂƚŝĞŶƚ͛Ɛ ŚĞĂůƚŚ ƚĞŶĚƐ ƚŽ ĨƌĂĐƚƵƌĞ͘ tŚŝůĞ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶƐ ĐĂŶ ƌĞĂƐŽŶĂďůLJ ƉƌĞƉĂƌĞ ƚŽ ďĞ ŵĂƚĐŚĞĚ ǁŝƚŚ ƉĂƚŝĞŶƚƐ͕ ƚŚĞLJ ĐĂŶŶŽƚ ĞŶƐƵƌĞ ƚŚĂƚ ƐƵďƐƉĞĐŝĂůŝƐƚƐ ƐŽƵŐŚƚ ŽƵƚ ďLJ ƉĂƚŝĞŶƚƐ ĞŶƌŽůůĞĚ ŝŶ WK ĂŶĚ WWK ƉůĂŶƐ ǁŝůů ĚŽ ƚŚĞŝƌ ƉĂƌƚ ƚŽ ƌĞƉŽƌƚ ƉĂƚŝĞŶƚ ĞŶĐŽƵŶƚĞƌƐ ďĂĐŬ ƚŽ ƚŚĞŵ͘ dŚŝƐ ŵŝŐŚƚ ďĞ ĂŶ ĞƐƉĞĐŝĂůůLJ ĂĐƵƚĞ ŝƐƐƵĞ ŐŝǀĞŶ ƚŚĞ ŽŶŐŽŝŶŐ ŝƐƐƵĞƐ ǁŝƚŚ ƚŚĞ ŝŶƚĞƌŽƉĞƌĂďŝůŝƚLJ ŽĨ ĞůĞĐƚƌŽŶŝĐ ŵĞĚŝĐĂů ƌĞĐŽƌĚƐ ; DZƐͿ͘ &W ŝƐ ǁŽƌŬŝŶŐ ǁŝƚŚ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ ƚŽ ĐůĂƌŝĨLJ ƌŽůĞƐ ĂŶĚ ƌĞƐƉŽŶƐŝďŝůŝƚŝĞƐ ƌĞŐĂƌĚŝŶŐ ƚŚĞ ĐŽŵƉůĞƚĞŶĞƐƐ ŽĨ ƉĂƚŝĞŶƚƐ͛ ŵĞĚŝĐĂů ƌĞĐŽƌĚƐ͘ dŚƌŽƵŐŚŽƵƚ ƚŚŝƐ ƉƌŽĐĞƐƐ͕ &W ǁŝůů ŵŽŶŝƚŽƌ ĚŝƐĐƵƐƐŝŽŶƐ ĂŶĚ ĐŽůůĂďŽƌĂƚĞ ǁŝƚŚ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ ƚŽ ĐƌĞĂƚĞ ĐůĂƌŝƚLJ ĂŶĚ ŐƵŝĚĂŶĐĞ ĨŽƌ ŽƵƌ ŵĞŵďĞƌƐ͘ tĞ ƌĞŵĂŝŶ ƉĂƌƚŝĐƵůĂƌůLJ ŝŶƚĞƌĞƐƚĞĚ ŝŶ ƚŚĞ ĐƌŝƚĞƌŝĂ ƚŚĂƚ ŚĞĂůƚŚ ƉůĂŶƐ ǁŝůů ƵƐĞ ƚŽ ŵĂƚĐŚ ƉŚLJƐŝĐŝĂŶƐ ĂŶĚ ĞŶƌŽůůĞĞƐ͕ ĂŶĚ ǁŚĞƚŚĞƌ Žƌ ŶŽƚ ŝƚ ǁŝůů ďĞ ƉŽƐƐŝďůĞ ƚŽ ƚƌĂĐŬ ƚŚĞ ƉĞƌĐĞŶƚĂŐĞ ŽĨ ĞŶƌŽůůĞĞƐ ǁŚŽ ƌĞƉŽƌƚ ƚŽ ƚŚĞŝƌ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶƐ ĂĨƚĞƌ ƚŚĞ ŵĂƚĐŚ͘ &ĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ƐŚŽƵůĚ ďĞ ĂǁĂƌĞ ƚŚĂƚ ƉĂƚŝĞŶƚƐ ǁŚŽ ŚĂǀĞ ďĞĞŶ ŵĂƚĐŚĞĚ ǁŝƚŚ ƚŚĞŵ͕ Žƌ ƉĂƚŝĞŶƚƐ ǁŚŽ ƐǁŝƚĐŚ ƚŽ ƚŚĞŵ ĂĨƚĞƌ ƚŚĞ ŵĂƚĐŚ͕ ŵĂLJ ĐŽŶƚĂĐƚ ƚŚĞŝƌ ŽĨĨŝĐĞƐ ƚŽ ƐĐŚĞĚƵůĞ ǀŝƐŝƚƐ͘ /ƚ ŝƐ ĂůƐŽ ŝŵƉŽƌƚĂŶƚ ƚŚĂƚ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ŶŽƚŝĨLJ ŚĞĂůƚŚ ƉůĂŶƐ ŽĨ ĂŶLJ ĐŚĂŶŐĞƐ Ăƚ ƚŚĞŝƌ ƉƌĂĐƚŝĐĞƐ͕ ĞƐƉĞĐŝĂůůLJ ŝĨ ƚŚĞŝƌ ƉƌĂĐƚŝĐĞƐ ŶŽ ůŽŶŐĞƌ ĂĐĐĞƉƚ ŶĞǁ ƉĂƚŝĞŶƚƐ͘ ŽŝŶŐ ƐŽ ǁŝůů ĂůůŽǁ ƚŚĞ ŚĞĂůƚŚ ƉůĂŶƐ ƚŽ ĂĚĚ Žƌ ƌĞŵŽǀĞ ŶĂŵĞƐ ĨƌŽŵ ƚŚĞ ůŝƐƚ ŽĨ ĂǀĂŝůĂďůĞ ƉƌŽǀŝĚĞƌƐ͘ dŚĞ ƚƌĂŶƐŝƚŝŽŶ ĂŚĞĂĚ ŵĂLJ ďĞ Ă ůŝƚƚůĞ ďƵŵƉLJ͕ ďƵƚ ŵĂƚĐŚŝŶŐ ƉĂƚŝĞŶƚƐ ƚŽ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĂŶĚ ŽƚŚĞƌ ƉƌŝŵĂƌLJ ĐĂƌĞ ƉŚLJƐŝĐŝĂŶƐ ŝƐ ĂŶ ŝŵƉŽƌƚĂŶƚ ƐƚĞƉ ŝŶ ƚŚĞ ŚŝƐƚŽƌLJ ŽĨ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ŝŶ ĂůŝĨŽƌŶŝĂ͘ /ƚ ǁŝůů ŚĞůƉ ƚŽ ƐŽůŝĚŝĨLJ ƚŚĞ ĐĞŶƚƌĂůŝƚLJ ĂŶĚ ǀĂůƵĞ ŽĨ ƚŚĞ WĂƚŝĞŶƚ ĞŶƚĞƌĞĚ DĞĚŝĐĂů ,ŽŵĞ ĂƐ Ă ŵŽĚĞů ŽĨ ĐĂƌĞ͕ ĂŶĚ͕ ƚŚĞƌĞĨŽƌĞ͕ ŽĨ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ƚŚĞŵƐĞůǀĞƐ͘ Conrad Amenta is CAFP’s new Director of Health Policy.

PARTNERS IN HEALTH Career Opportunity OUTPATIENT FAMILY MEDICINE PHYSICIANS ARE INVITED TO JOIN OMNI

ABOUT OMNI FAMILY HEALTH National-award winning Omni Family Health was founded in 1978 in rural Kern County, California. Today, the organization operates 18 state-of-the-art health centers throughout 9 communities, providing medical, dental, behavioral health, chiropractic, OB/GYN, pediatrics and specialty services. Our mission is to improve the health of our communities by providing the highest quality healthcare to everyone.

Competitive compensation and benefits package including choice of two retirement plans, 18 days vacation, education leave and paid CME benefits Generous Sign-On Bonus Relocation Package Incentives And more!

Call Arlana Lynn at (661) 630-7048 or Valentina Chavez at (661) 630-4049 for more information. Visit our website for details: www.OmniFamilyHealth.org

Department of Family

and Community Medicine Academic Recruitment The University of California, Davis, Department of Family and Community Medicine seeks a Health Sciences Assistant Clinical Professor. The position will be expected to contribute with distinction in the areas of clinical care, teaching, mentoring of trainees, and University and public service. Positioned in the heart of Northern California, Sacramento is a diverse farm-to-fork foodie and coffee town with a vibrant art scene, and is an easy drive from San Francisco, the Napa Valley, Tahoe, and Yosemite. We have everything—but you! Candidates wishing to learn more about this academic opportunity should review the full recruitment description at https:// recruit.ucdavis.edu/apply/JPF01151 If interested, candidates should submit their application, including a current CV and a cover letter with full contact information, and they should apply online using the above URL. Inquiries regarding this position may be directed to Search Committee Chair, Dr. Sarah Marshall at smarshall@ucdavis.edu or by calling (916) 734-6226. The position opens on August 1, 2016. For full consideration, applications should be received by December 1, 2016. The position will remain open until filled through June 30, 2018. The University of California is an Affirmative Action/Equal Opportunity Employer with a strong institutional commitment to the achievement of diversity among its faculty, staff, and students.

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MACRA 101: Ready, Set, Go! Background dŚĞ DĞĚŝĐĂƌĞ ĐĐĞƐƐ ĂŶĚ ,/W ZĞĂƵƚŚŽƌŝnjĂƟŽŶ Đƚ ;D Z Ϳ ƌĞĚĞƐŝŐŶƐ ƉĂLJŵĞŶƚ ŝŶ ƚŚĞ DĞĚŝĐĂƌĞ ƉƌŽŐƌĂŵ ďĞŐŝŶŶŝŶŐ ŝŶ ϮϬϭϵ͘ ŶĚ ŝƚ ŝƐ ŶŽƚ ũƵƐƚ ƉĂLJŵĞŶƚ ƚŚĂƚ ĐŚĂŶŐĞƐ͕ ďƵƚ ĂůƐŽ ƚŚĞ ǁĂLJ ƚŚĞ ĞŶƚĞƌƐ ĨŽƌ DĞĚŝĐĂƌĞ ĂŶĚ DĞĚŝĐĂŝĚ ^ĞƌǀŝĐĞƐ ; D^Ϳ ŵĞĂƐƵƌĞƐ ĂŶĚ ƉƵďůŝĐůLJ ƌĞƉŽƌƚƐ ŽŶ ƉŚLJƐŝĐŝĂŶ ƉĞƌĨŽƌŵĂŶĐĞ͘ dŚĞ ƉĂLJŵĞŶƚ ĐŚĂŶŐĞƐ ĂŶĚ ƌĞƉŽƌƟŶŐ ƚŚĂƚ ƐƚĂƌƚ ŝŶ ϮϬϭϵ ǁŝůů ďĞ ďĂƐĞĚ ŽŶ ĚĂƚĂ ƐƵďŵŝƩĞĚ ďLJ ƉŚLJƐŝĐŝĂŶƐ ŝŶ ϮϬϭϳ͘ /Ŷ ^ĞƉƚĞŵďĞƌ͕ ŶĚLJ ^ůĂǀŝƩ͕ ĐƟŶŐ ĚŵŝŶŝƐƚƌĂƚŽƌ ŽĨ D^͕ ĂŶŶŽƵŶĐĞĚ ĐŚĂŶŐĞƐ ƚŽ ƚŚĞ ƌŽůůͲŽƵƚ ŽĨ D Z ͘ D^ ŚĂĚ ƉƌŽƉŽƐĞĚ ƚŚĂƚ ƉŚLJƐŝĐŝĂŶƐ͛ DĞĚŝĐĂƌĞ ƉĂLJŵĞŶƚ ǁŽƵůĚ ďĞ ƉŽƐŝƟǀĞůLJ Žƌ ŶĞŐĂƟǀĞůLJ ĂĚũƵƐƚĞĚ ďĂƐĞĚ ŽŶ ƉĞƌĨŽƌŵĂŶĐĞ ĂŶĚ ƵƟůŝnjĂƟŽŶ ĚĂƚĂ ĨŽƌ ƚŚĞ ĞŶƟƌĞ LJĞĂƌ ŽĨ ϮϬϭϳ͘ ĐƟŶŐ ĚŵŝŶŝƐƚƌĂƚŽƌ ^ůĂǀŝƩ͛Ɛ ĂŶŶŽƵŶĐĞŵĞŶƚ ĂƉƉĞĂƌƐ ƚŽ ĐƌĞĂƚĞ Ă ŵŽƌĞ ŇĞdžŝďůĞ ƐĐŚĞŵĂ͗ ƉŚLJƐŝĐŝĂŶƐ ǁŚŽ ƐƵďŵŝƚ Ez ĚĂƚĂ ŝŶ ϮϬϭϳ ĐĂŶ ĂǀŽŝĚ Ă ŶĞŐĂƟǀĞ ĂĚũƵƐƚŵĞŶƚ͘ WŚLJƐŝĐŝĂŶƐ ǁŚŽ ƐƵďŵŝƚ ŵŽƌĞ ĚĂƚĂ ŵĂLJ ŐĞƚ Ă ƉŽƐŝƟǀĞ ƉĂLJŵĞŶƚ ĂĚũƵƐƚŵĞŶƚ͘ ĐƟŶŐ ĚŵŝŶŝƐƚƌĂƚŽƌ ^ůĂǀŝƩ ĂůƐŽ ƉƌŽŵŝƐĞĚ ĮŶĂů D Z ƌĞŐƵůĂƟŽŶƐ ďLJ EŽǀĞŵďĞƌ ϭ ĂŶĚ ŝŶĨĞƌƌĞĚ ƚŚĞƌĞ ǁŽƵůĚ ďĞ ŶŽ ĚĞůĂLJ ƚŽ ƚŚĞ ƐƚĂƌƚ ŽĨ ƚŚĞ ĮƌƐƚ ŵĞĂƐƵƌĞŵĞŶƚ ƉĞƌŝŽĚ ŽŶ :ĂŶƵĂƌLJ ϭ͕ ϮϬϭϳ͘ DĞĚŝĐĂů ŽƌŐĂŶŝnjĂƟŽŶƐ͕ ŝŶĐůƵĚŝŶŐ ƚŚĞ &W ĂŶĚ ƚŚĞ ŵĞƌŝĐĂŶ ĐĂĚĞŵLJ ŽĨ &ĂŵŝůLJ WŚLJƐŝĐŝĂŶƐ͕ ŚĂĚ ƌĞƋƵĞƐƚĞĚ Ă ĚĞůĂLJ ƵŶƟů Ăƚ ůĞĂƐƚ :ƵůLJ ϮϬϭϳ͘ Ɛ ϮϬϭϳ ʹ ƚŚĞ ƟŵĞ ƚŽ ƐƵďŵŝƚ ĚĂƚĂ ĂŶĚ ĂǀŽŝĚ Ă ŶĞŐĂƟǀĞ ƉĂLJŵĞŶƚ ĂĚũƵƐƚŵĞŶƚ ʹ ĚƌĂǁƐ ĐůŽƐĞƌ͕ &W ƵƌŐĞƐ ĂůŝĨŽƌŶŝĂ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ƚŽ ƉƌĞƉĂƌĞ ĨŽƌ D Z ͘ dŚĞ ĮƌƐƚ ƐƚĞƉ ŝƐ ƚŽ ďĞĐŽŵĞ ĨĂŵŝůŝĂƌ ǁŝƚŚ ƚŚĞ ůĂǁ͕ ƵŶĚĞƌƐƚĂŶĚ ŝƚƐ ƐƚƌƵĐƚƵƌĞ ĂŶĚ ƚŚĞ ŶĞǁ ǁĂLJƐ ƉŚLJƐŝĐŝĂŶƐ ǁŝůů ďĞ ŵĞĂƐƵƌĞĚ ĂŶĚ ƉĂŝĚ͘ D Z ĐƌĞĂƚĞƐ ƚŚĞ YƵĂůŝƚLJ WĂLJŵĞŶƚ WƌŽŐƌĂŵ͕ Ă ƚǁŽͲƚƌĂĐŬ ƐLJƐƚĞŵ ƚŚĂƚ ŝŶĐůƵĚĞƐ͗ ;ϭͿ Ă DĞƌŝƚͲ ĂƐĞĚ /ŶĐĞŶƟǀĞ WĂLJŵĞŶƚ ^LJƐƚĞŵ ;D/W^Ϳ ĂŶĚ ;ϮͿ ĚǀĂŶĐĞĚ ůƚĞƌŶĂƟǀĞ WĂLJŵĞŶƚ ŵŽĚĞůƐ ; WDƐͿ͘ DŽƐƚ ĂůŝĨŽƌŶŝĂ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ǁŝůů ƉĂƌƟĐŝƉĂƚĞ ŝŶ ƚŚĞ D/W^ ƉƌŽŐƌĂŵ͘ dŚŝƐ ŝƐ ŶŽƚ Ă ĐŚŽŝĐĞ Žƌ ƚŚĞ ƌĞƐƵůƚ ŽĨ ĂŶLJ ĂĐƟŽŶ͘ /Ŷ ƉƌŽƉŽƐĞĚ ƌĞŐƵůĂƟŽŶƐ͕ D^ ĚĞĮŶĞĚ WDƐ ŶĂƌƌŽǁůLJ͕ ĂŶĚ ǀĞƌLJ ĨĞǁ ĂůŝĨŽƌŶŝĂ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĂƌĞ ŝŶ ƋƵĂůŝĨLJŝŶŐ ƉƌŽŐƌĂŵƐ͘ ĂƐĞĚ ŽŶ ƉƌŽƉŽƐĞĚ ĐƌŝƚĞƌŝĂ͕ ŽŶůLJ ƚŚĞ ĨŽůůŽǁŝŶŐ ǁŝůů ďĞ ĚĞĞŵĞĚ ĚǀĂŶĐĞĚ WDƐ ŝŶ ϮϬϭϳ͗ ͻ DĞĚŝĐĂƌĞ ^ŚĂƌĞĚ ^ĂǀŝŶŐƐ WƌŽŐƌĂŵ ;dƌĂĐŬ Ϯ ĂŶĚ ϯͿ ͻ EĞdžƚ 'ĞŶĞƌĂƟŽŶ ĐĐŽƵŶƚĂďůĞ ĂƌĞ KƌŐĂŶŝnjĂƟŽŶ DŽĚĞů ͻ ŽŵƉƌĞŚĞŶƐŝǀĞ ŶĚ ^ƚĂŐĞ ZĞŶĂů ŝƐĞĂƐĞ ĂƌĞ ʹ ƚǁŽͲƐŝĚĞĚ ƚƌĂĐŬ ͻ ŽŵƉƌĞŚĞŶƐŝǀĞ WƌŝŵĂƌLJ ĂƌĞ WůƵƐ ͻ KŶĐŽůŽŐLJ ĂƌĞ DŽĚĞů ;ƚǁŽͲƐŝĚĞĚ ƌŝƐŬ ƚƌĂĐŬ ĂǀĂŝůĂďůĞ ŝŶ ϮϬϭϴͿ DĞƌŝƚͲ ĂƐĞĚ /ŶĐĞŶƟǀĞ WĂLJŵĞŶƚ ^LJƐƚĞŵ D/W^ ĞǀĂůƵĂƚĞƐ ƉŚLJƐŝĐŝĂŶƐ ŝŶ ĨŽƵƌ ƉĞƌĨŽƌŵĂŶĐĞ ĐĂƚĞŐŽƌŝĞƐ͗ YƵĂůŝƚLJ͕ ZĞƐŽƵƌĐĞ hƐĞ͕ ůŝŶŝĐĂů WƌĂĐƟĐĞ /ŵƉƌŽǀĞŵĞŶƚ ĐƟǀŝƟĞƐ ; W/ ƐͿ ĂŶĚ ĚǀĂŶĐŝŶŐ ĂƌĞ /ŶĨŽƌŵĂƟŽŶ ; /Ϳ͘ D/W^ ĐŽŵďŝŶĞƐ 24

California Family Physician Fall 2016

ƚŚĞƐĞ ĨŽƵƌ ĞǀĂůƵĂƟŽŶƐ ƚŽ ĐƌĞĂƚĞ Ă ŽŵƉŽƐŝƚĞ WĞƌĨŽƌŵĂŶĐĞ ^ĐŽƌĞ͘ D^ ƉƌŽƉŽƐĞƐ ƚŽ ǁĞŝŐŚƚ ƚŚĞ ĨŽƵƌ ĐĂƚĞŐŽƌŝĞƐ͕ ĂƐ ŝůůƵƐƚƌĂƚĞĚ ŝŶ ƚŚĞ ĐŚĂƌƚ ďĞůŽǁ͕ ǁŝƚŚ Ă ŐƌĞĂƚĞƌ ĞŵƉŚĂƐŝƐ ŽŶ ƋƵĂůŝƚLJ ŝŶ ƚŚĞ ĮƌƐƚ LJĞĂƌ͘ Ɛ Ă ƐƚĂƌƟŶŐ ƉŽŝŶƚ ƚŽ ƵŶĚĞƌƐƚĂŶĚŝŶŐ ƚŚĞƐĞ ƉĞƌĨŽƌŵĂŶĐĞ ĐĂƚĞŐŽƌŝĞƐ͕ ƌĞĐŽŐŶŝnjĞ ƚŚĂƚ ƚŚƌĞĞ ŽĨ ƚŚĞŵ ĚƌĂǁ ĨƌŽŵ ĞdžŝƐƟŶŐ D^ ƉƌŽŐƌĂŵƐ͕ ĂƐ ŶŽƚĞĚ ŝŶ ƚŚŝƐ ƚĂďůĞ͗

Performance Category

Weight

ƌĂǁƐ ŽŶ džŝƐƟŶŐ Program

YƵĂůŝƚLJ

ϱϬ ƉĞƌĐĞŶƚ WŚLJƐŝĐŝĂŶ YƵĂůŝƚLJ ZĞƉŽƌƟŶŐ ^LJƐƚĞŵ ;WYZ^Ϳ

ZĞƐŽƵƌĐĞ hƐĞ

ϭϬ ƉĞƌĐĞŶƚ sĂůƵĞͲďĂƐĞĚ WĂLJŵĞŶƚ DŽĚŝĮĞƌ ;sDͿ

ůŝŶŝĐĂů WƌĂĐƟĐĞ ϭϱ ƉĞƌĐĞŶƚ /ŵƉƌŽǀĞŵĞŶƚ ĐƟǀŝƟĞƐ ĚǀĂŶĐŝŶŐ ĂƌĞ /ŶĨŽƌŵĂƟŽŶ

Ϯϱ ƉĞƌĐĞŶƚ DĞĂŶŝŶŐĨƵů hƐĞ

D/W^ ĞǀĂůƵĂƚĞƐ ͞ ůŝŐŝďůĞ ůŝŶŝĐŝĂŶƐ͟ ; ƐͿ͘ Ɛ ŝŶĐůƵĚĞ ƉŚLJƐŝĐŝĂŶƐ ;D ͬ Kͬ D ͬ ^Ϳ͕ ƉŚLJƐŝĐŝĂŶ ĂƐƐŝƐƚĂŶƚƐ͕ ŶƵƌƐĞ ƉƌĂĐƟƟŽŶĞƌƐ͕ ĐůŝŶŝĐĂů ŶƵƌƐĞ ƐƉĞĐŝĂůŝƐƚƐ ĂŶĚ ĐĞƌƟĮĞĚ ƌĞŐŝƐƚĞƌĞĚ ŶƵƌƐĞ ĂŶĞƐƚŚĞƟƐƚƐ͘ ^ŽŵĞ ƉŚLJƐŝĐŝĂŶƐ ĂƌĞ ĞdžĐůƵĚĞĚ ĨƌŽŵ D/W^͕ ŝŶĐůƵĚŝŶŐ ŶĞǁůLJ ĞŶƌŽůůĞĚ ƉŚLJƐŝĐŝĂŶƐ͕ ƉŚLJƐŝĐŝĂŶƐ ƉĂƌƟĐŝƉĂƟŶŐ ŝŶ WDƐ ĂŶĚ ƉŚLJƐŝĐŝĂŶƐ ďĞůŽǁ Ă ůŽǁͲǀŽůƵŵĞ ƚŚƌĞƐŚŽůĚ ;ƉƌŽƉŽƐĞĚ ƚŽ ďĞ Ă ƉƌŽǀŝĚĞƌ ǁŚŽ ďŝůůƐ ĐŚĂƌŐĞƐ ůĞƐƐ ƚŚĂŶ ΨϭϬ͕ϬϬϬ ĂŶĚ ǁŚŽ ƉƌŽǀŝĚĞƐ ĐĂƌĞ ĨŽƌ ϭϬϬ Žƌ ĨĞǁĞƌ WĂƌƚ ͲĞŶƌŽůůĞĚ DĞĚŝĐĂƌĞ ďĞŶĞĮĐŝĂƌŝĞƐ ĂŶŶƵĂůůLJͿ͘ Ɛ ĐĂŶ ŚĂǀĞ ƚŚĞŝƌ ƉĞƌĨŽƌŵĂŶĐĞ ĂƐƐĞƐƐĞĚ ĂƐ Ă ŐƌŽƵƉ ŝĨ ƚŚĞLJ ŵĞĞƚ Ă ƉƌŽƉŽƐĞĚ ĚĞĮŶŝƟŽŶ͘ 'ƌŽƵƉƐ ǁŝůů ŚĂǀĞ ƚŚĞŝƌ ƉĞƌĨŽƌŵĂŶĐĞ ĂƐƐĞƐƐĞĚ ĂƐ Ă ŐƌŽƵƉ ĂĐƌŽƐƐ Ăůů ĨŽƵƌ ƉĞƌĨŽƌŵĂŶĐĞ ĐĂƚĞŐŽƌŝĞƐ͘ &Žƌ Ɛ ǁŚŽ ƉƌĂĐƟĐĞ ŝŶ ƌƵƌĂů ŚĞĂůƚŚ ĐůŝŶŝĐƐ Žƌ &ĞĚĞƌĂůůLJ YƵĂůŝĮĞĚ ,ĞĂůƚŚ ĞŶƚĞƌƐ͕ ǁŚŽ ďŝůů ĨŽƌ ƐĞƌǀŝĐĞƐ ƵŶĚĞƌ ƚŚĞ Z, ͬ&Y, ĂůůͲ ŝŶĐůƵƐŝǀĞ ƌĂƚĞ͕ ƚŚĞ D/W^ ĂĚũƵƐƚŵĞŶƚ ǁŽƵůĚ ŶŽƚ ĂƉƉůLJ͘ YƵĂůŝƚLJ &Žƌ ĞĂĐŚ ƉĞƌĨŽƌŵĂŶĐĞ ƉĞƌŝŽĚ͕ Ɛ Žƌ ŐƌŽƵƉƐ ǁŝůů ƌĞƉŽƌƚ Ăƚ ůĞĂƐƚ Ɛŝdž ƋƵĂůŝƚLJ ŵĞĂƐƵƌĞƐ͕ ŝŶĐůƵĚŝŶŐ ŽŶĞ ͞ĐƌŽƐƐͲĐƵƫŶŐ͟ ŵĞĂƐƵƌĞ ĂŶĚ ŽŶĞ ŽƵƚĐŽŵĞ ŵĞĂƐƵƌĞ͘ Ɛ ǁŝůů ĐŚŽŽƐĞ ŵĞĂƐƵƌĞƐ ĨƌŽŵ Ă ůŽŶŐ ůŝƐƚ ƉƌŽǀŝĚĞĚ ďLJ D^͘ Ŷ ǁŚŽ ƌĞƉŽƌƚƐ ŽŶ ĨĞǁĞƌ ƚŚĂŶ Ɛŝdž ŵĞĂƐƵƌĞƐ ǁŝůů ďĞ ƚƌĞĂƚĞĚ ĂƐ ĂĐŚŝĞǀŝŶŐ ƚŚĞ ůŽǁĞƐƚ ƉŽƐƐŝďůĞ ƐĐŽƌĞ ĨŽƌ ĞĂĐŚ ŵĞĂƐƵƌĞ ƵŶĚĞƌ Ɛŝdž͘ ZĞƐŽƵƌĐĞ hƐĞ ZĞƐŽƵƌĐĞ hƐĞ ŝƐ D^͛Ɛ ǁĂLJ ŽĨ ŵĞĂƐƵƌŝŶŐ ƉŚLJƐŝĐŝĂŶ ĐŽƐƚƐ ĂŶĚ ǁŝůů ĐŽŵƉĂƌĞ ĂƉƉůŝĐĂďůĞ ƌĞƐŽƵƌĐĞƐ ƵƐĞĚ ƚŽ ƚƌĞĂƚ ƐŝŵŝůĂƌ ĐĂƌĞ

ĞƉŝƐŽĚĞƐ ĂĐƌŽƐƐ ƉƌĂĐƟĐĞƐ͘ /Ŷ ƚŚĞ ĮƌƐƚ LJĞĂƌ͕ D^ ƉƌŽƉŽƐĞĚ ƚŽ ƵƐĞ ƚŚĞ ĨŽůůŽǁŝŶŐ ŵĞĂƐƵƌĞƐ͗ dŽƚĂů ƉĞƌ ĐĂƉŝƚĂ ĐŽƐƚ͕ DĞĚŝĐĂƌĞ ƐƉĞŶĚŝŶŐ ƉĞƌ ďĞŶĞĮĐŝĂƌLJ ĂŶĚ ƐĞǀĞƌĂů ĞƉŝƐŽĚĞͲďĂƐĞĚ ŵĞĂƐƵƌĞƐ͘ D^ ƉƌŽƉŽƐĞƐ ϰϭ ĐůŝŶŝĐĂů ĐŽŶĚŝƟŽŶƐ ĂŶĚ ƚƌĞĂƚŵĞŶƚ ĞƉŝƐŽĚĞͲ ďĂƐĞĚ ŵĞĂƐƵƌĞƐ ĨŽƌ ƚŚĞ ƚŚŝƌĚ ĐƌŝƚĞƌŝŽŶ͕ ĂůƚŚŽƵŐŚ ƚŚŝƐ ůŝƐƚ ŝƐ ƐƵďũĞĐƚ ƚŽ ĐŚĂŶŐĞ ŝŶ ƚŚĞ ĮŶĂů ƌƵůĞ͘ D^ ƉƌŽƉŽƐĞƐ ƚŽ ǁĞŝŐŚ Ăůů ŽĨ ƚŚĞ ŵĞĂƐƵƌĞƐ ĞƋƵĂůůLJ ĂŶĚ Ăůů ŽĨ ƚŚĞ ŵĞĂƐƵƌĞ ǁŽƵůĚ ďĞ ĂĚũƵƐƚĞĚ ĨŽƌ ŐĞŽŐƌĂƉŚŝĐ ƉĂLJŵĞŶƚ ƌĂƚĞ ĂĚũƵƐƚŵĞŶƚƐ ĂŶĚ ďĞŶĞĮĐŝĂƌLJ ƌŝƐŬ ĨĂĐƚŽƌƐ͘ ůŝŶŝĐĂů WƌĂĐƟĐĞ /ŵƉƌŽǀĞŵĞŶƚ ĐƟǀŝƟĞƐ W/ ŵĞĂƐƵƌĞƐ ƉĂƌƟĐŝƉĂƟŽŶ ŝŶ ƋƵĂůŝƚLJ ŝŵƉƌŽǀĞŵĞŶƚ ĂĐƟǀŝƟĞƐ͘ dŚĞƌĞ ĂƌĞ ϵϬ ƉƌŽƉŽƐĞĚ ĂĐƟǀŝƟĞƐ͕ ĂŶĚ ƉŚLJƐŝĐŝĂŶƐ ŵƵƐƚ ƉĂƌƟĐŝƉĂƚĞ ĨŽƌ Ăƚ ůĞĂƐƚ ϵϬ ĚĂLJƐ ĚƵƌŝŶŐ ƚŚĞ ŵĞĂƐƵƌĞŵĞŶƚ LJĞĂƌ͘ dŚĞ ŚŝŐŚĞƐƚ W/ ƐĐŽƌĞ ǁŝůů ďĞ ŐŝǀĞŶ ƚŽ ƚŚŽƐĞ ƉĂƌƟĐŝƉĂƟŶŐ ŝŶ ŶĂƟŽŶĂůůLJ ƌĞĐŽŐŶŝnjĞĚ ĂĐĐƌĞĚŝƚĞĚ WĂƟĞŶƚ ĞŶƚĞƌĞĚ DĞĚŝĐĂů ,ŽŵĞƐ ;W D,Ϳ͘ Ɛ ǁŚŽ ƉĂƌƟĐŝƉĂƚĞ ŝŶ ĂŶ WD ƚŚĂƚ ĚŽĞƐ ŶŽƚ ƋƵĂůŝĨLJ ĂƐ ĂŶ ĚǀĂŶĐĞĚ WD ƌĞĐĞŝǀĞ Ăƚ ůĞĂƐƚ ŚĂůĨ ŽĨ ƚŚĞ ŚŝŐŚĞƐƚ ƉŽƚĞŶƟĂů ƐĐŽƌĞ ƐŝŵƉůLJ ĨŽƌ ƉĂƌƟĐŝƉĂƟŶŐ͘ KƚŚĞƌ Ɛ ĐĂŶ ƌĞĐĞŝǀĞ ƚŚĞ ŵĂdžŝŵƵŵ ƐĐŽƌĞ ďLJ ƉĂƌƟĐŝƉĂƟŶŐ ŝŶ ƚŚƌĞĞ ŚŝŐŚͲǁĞŝŐŚƚĞĚ W/ Ɛ Žƌ Ɛŝdž ŵĞĚŝƵŵͲǁĞŝŐŚƚĞĚ W/ Ɛ͘ 'ƌŽƵƉƐ ĐŚŽŽƐĞ ǁŚŝĐŚ W/ Ɛ ƚŽ ƌĞƉŽƌƚ ƚŽ D^͘ ĚǀĂŶĐŝŶŐ ĂƌĞ /ŶĨŽƌŵĂƟŽŶ dŚŝƐ ĐĂƚĞŐŽƌLJ ƐƚƌĞĂŵůŝŶĞƐ ƚŚĞ ĐƵƌƌĞŶƚ ,Z DĞĂŶŝŶŐĨƵů hƐĞ ƉƌŽŐƌĂŵ ǁŝƚŚ Ă ŶĞǁ ƐĐŽƌŝŶŐ ŵĞƚŚŽĚŽůŽŐLJ͘ dŚĞ / ƌĞƋƵŝƌĞŵĞŶƚ ŚĂƐ ƚŚƌĞĞ ƉĂƌƚƐ͗ Ă ƚŚƌĞƐŚŽůĚ ƌĞƋƵŝƌĞŵĞŶƚ ƚŽ ƉƌŽƚĞĐƚ ŚĞĂůƚŚ ŝŶĨŽƌŵĂƟŽŶ͖ Ă ďĂƐĞ ƐĐŽƌĞ͕ ŝŶĐůƵĚŝŶŐ ĞͲƉƌĞƐĐƌŝďŝŶŐ͕ ĞůĞĐƚƌŽŶŝĐ ƉĂƟĞŶƚ ĂĐĐĞƐƐ͕ ƉĂƟĞŶƚ ĞŶŐĂŐĞŵĞŶƚ͕ ŚĞĂůƚŚ ŝŶĨŽƌŵĂƟŽŶ ĞdžĐŚĂŶŐĞ ĂŶĚ ĚĂƚĂ ƌĞŐŝƐƚƌLJ ƌĞƉŽƌƟŶŐ͖ ĂŶĚ ĂŶ ĂĚĚŝƟŽŶĂů ƐĞƚ ŽĨ ĞŝŐŚƚ ŵĞĂƐƵƌĞƐ ƚŚĂƚ ĐĂŶ ĂĚĚ ƚŽ ƚŚĞ ŽǀĞƌĂůů ƉĞƌĨŽƌŵĂŶĐĞ ƐĐŽƌĞ͘ ZĞƉŽƌƟŶŐ ZĞƐŽƵƌĐĞ hƐĞ ǁŝůů ďĞ ŵĞĂƐƵƌĞĚ ƵƐŝŶŐ DĞĚŝĐĂƌĞ ĐůĂŝŵƐ ĚĂƚĂ͕ ĂŶĚ ƚŚĞƌĞ ŝƐ ŶŽ ƐĞƉĂƌĂƚĞ ƌĞƉŽƌƟŶŐ ďLJ Ɛ ŝŶ ƚŚĂƚ ĐĂƚĞŐŽƌLJ͘ /Ŷ ƚŚĞ ŽƚŚĞƌ ƚŚƌĞĞ ƉĞƌĨŽƌŵĂŶĐĞ ĐĂƚĞŐŽƌŝĞƐ͕ D/W^ ĚĂƚĂ ŵĂLJ ďĞ ƐƵďŵŝƩĞĚ ƚŚƌŽƵŐŚ Ă ƋƵĂůŝĮĞĚ ƌĞŐŝƐƚƌLJ͕ Ă YƵĂůŝĮĞĚ ůŝŶŝĐĂů ĂƚĂ ZĞŐŝƐƚƌLJ͕ Ă ŚĞĂůƚŚ /d ǀĞŶĚŽƌ ƚŚĂƚ ŽďƚĂŝŶƐ ĚĂƚĂ ĨƌŽŵ ƚŚĞ ͛Ɛ

ĐĞƌƟĮĞĚ ,Z ƚĞĐŚŶŽůŽŐLJ ; ,ZdͿ Žƌ Ă D^ͲĂƉƉƌŽǀĞĚ ƐƵƌǀĞLJ ǀĞŶĚŽƌ͘ dŚĞ D/W^ ŽŵƉŽƐŝƚĞ WĞƌĨŽƌŵĂŶĐĞ ^ĐŽƌĞ ŵĞƚŚŽĚŽůŽŐLJ ŝƐ ĐŽŵƉůŝĐĂƚĞĚ͘ ^ƵĸĐĞ ŝƚ ƚŽ ƐĂLJ͕ ƉĂLJŵĞŶƚ ŵĂLJ ďĞ ĂĚũƵƐƚĞĚ ;ƉŽƐŝƟǀĞůLJ Žƌ ŶĞŐĂƟǀĞůLJͿ ďĂƐĞĚ ŽŶ ǁŚĞƚŚĞƌ ĂŶ ƐĐŽƌĞƐ ĂďŽǀĞ Žƌ ďĞůŽǁ Ă ƉĞƌĨŽƌŵĂŶĐĞ ƚŚƌĞƐŚŽůĚ͘ D^ ǁŝůů ƵƐĞ Ă ƐĞŶƐŝƟǀŝƚLJ ĂŶĂůLJƐŝƐ ƚŽ ĚĞƚĞƌŵŝŶĞ ǁŚĞƌĞ ƚŚĞ ƉĞƌĨŽƌŵĂŶĐĞ ƚŚƌĞƐŚŽůĚ ŝƐ ƐĞƚ ĂŶŶƵĂůůLJ͕ ǁŝƚŚ ĂƉƉƌŽdžŝŵĂƚĞůLJ ϱϬ ƉĞƌĐĞŶƚ ŽĨ Ɛ ĂďŽǀĞ ƚŚĂƚ ƚŚƌĞƐŚŽůĚ ĂŶĚ ϱϬ ƉĞƌĐĞŶƚ ďĞůŽǁ͘ &Žƌ ƉĂLJŵĞŶƚ LJĞĂƌƐ ϮϬϭϵ ƚŚƌŽƵŐŚ ϮϬϮϰ͕ ĂŶ ĂĚĚŝƟŽŶĂů ƉŽƐŝƟǀĞ ĂĚũƵƐƚŵĞŶƚ ŽĨ ΨϱϬϬ ŵŝůůŝŽŶ ǁŝůů ďĞ ĚŝƐƚƌŝďƵƚĞĚ ĞĂĐŚ LJĞĂƌ ƚŽ ƚŚŽƐĞ Ɛ ǁŚŽ ŵĞĞƚ ƚŚĞ ͞ĞdžĐĞƉƟŽŶĂů ƉĞƌĨŽƌŵĂŶĐĞ͟ ƚŚƌĞƐŚŽůĚ͘ D^ ƉƌŽƉŽƐĞƐ ƚŚĂƚ ĐŽŵƉŽƐŝƚĞ ƐĐŽƌĞƐ ĂŶĚ ƉĞƌĨŽƌŵĂŶĐĞ ƐĐŽƌĞƐ ďĞ ŝŶĐůƵĚĞĚ ŽŶ ƚŚĞ WŚLJƐŝĐŝĂŶ ŽŵƉĂƌĞ ǁĞďƐŝƚĞ͕ ĂƐ ǁĞůů ĂƐ ĂŐŐƌĞŐĂƚĞ ŝŶĨŽƌŵĂƟŽŶ ŽŶ ƚŚĞ ƌĂŶŐĞ ŽĨ D/W^ ĐŽŵƉŽƐŝƚĞ ƐĐŽƌĞƐ ĂŶĚ ƌĂŶŐĞ ŽĨ ƉĞƌĨŽƌŵĂŶĐĞ ďLJ ĐĂƚĞŐŽƌLJ͘ ůƚĞƌŶĂƟǀĞ WĂLJŵĞŶƚ DŽĚĞůƐ ĞƚǁĞĞŶ ϮϬϭϵ ĂŶĚ ϮϬϮϱ͕ ƋƵĂůŝĨLJŝŶŐ ƉĂƌƟĐŝƉĂŶƚƐ ;YWƐͿ ǁŚŽ ƉĂƌƟĐŝƉĂƚĞ ŝŶ ƚŚĞ ĚǀĂŶĐĞĚ WDƐ ĚĞƐĐƌŝďĞĚ ĂďŽǀĞ ǁŝůů ďĞ ĞdžĐůƵĚĞĚ ĨƌŽŵ ƚŚĞ D/W^ ƉƌŽŐƌĂŵ ĂŶĚ ǁŝůů ďĞ ĞůŝŐŝďůĞ ƚŽ ƌĞĐĞŝǀĞ ĂŶ ĂŶŶƵĂů ůƵŵƉ ƐƵŵ ŝŶĐĞŶƟǀĞ ƉĂLJŵĞŶƚ ĞƋƵĂů ƚŽ ĮǀĞ ƉĞƌĐĞŶƚ ŽĨ ƚŚĞŝƌ ƉƌŝŽƌ LJĞĂƌ͛Ɛ ƉĂLJŵĞŶƚƐ ĨŽƌ WĂƌƚ ͲĐŽǀĞƌĞĚ ƉƌŽĨĞƐƐŝŽŶĂů ƐĞƌǀŝĐĞƐ͘ ^ƚĂƌƟŶŐ ŝŶ ϮϬϮϲ͕ ƋƵĂůŝĮĞĚ ƉĂƌƟĐŝƉĂŶƚƐ ǁŝůů ƌĞĐĞŝǀĞ Ă ŚŝŐŚĞƌ ĂŶŶƵĂů ĨĞĞ ƐĐŚĞĚƵůĞ ƵƉĚĂƚĞ ƚŚĂŶ Ɛ ƉĂƌƟĐŝƉĂƟŶŐ ŝŶ ƚŚĞ D/W^ ƉƌŽŐƌĂŵ ʹ Ă ͘ϳϱ ƉĞƌĐĞŶƚ ŝŶĐƌĞĂƐĞ ƌĂƚŚĞƌ ƚŚĂŶ ƚŚĞ ƐƚĂŶĚĂƌĚ ͘Ϯϱ ƉĞƌĐĞŶƚ ŝŶĐƌĞĂƐĞ͘ D^ ŚĂƐ ĞƐƚĂďůŝƐŚĞĚ ĐƌŝƚĞƌŝĂ ĨŽƌ WDƐ ĂŶĚ ƚŚĞŶ Ă ƚŚƌĞƐŚŽůĚ ĂŵŽƵŶƚ ƚŽ ďĞ ĂŶ ĚǀĂŶĐĞĚ WD͘ >ŽŽŬ ĨŽƌ ĂŶ ĂůůͲŵĞŵďĞƌ ĞŵĂŝů ďůĂƐƚ ĂŶŶŽƵŶĐŝŶŐ ƚŚĞ ĂǀĂŝůĂďŝůŝƚLJ ŽĨ &W ƌĞƐŽƵƌĐĞƐ͘ ŶLJ ƋƵĞƐƟŽŶƐ͍ ŽŶƚĂĐƚ &W͛Ɛ ŝƌĞĐƚŽƌ ŽĨ ,ĞĂůƚŚ WŽůŝĐLJ͕ ŽŶƌĂĚ ŵĞŶƚĂ͘ >ĞĂŚ EĞǁŬŝƌŬ͕ ĨŽƌŵĞƌůLJ &W͛Ɛ ŝƌĞĐƚŽƌ ŽĨ ,ĞĂůƚŚ WŽůŝĐLJ͕ ŝƐ Ă ĨŽƵŶĚĞƌ ĂŶĚ ƉƌŝŶĐŝƉůĞ ŽĨ >^E ,ĞĂůƚŚ ^ƚƌĂƚĞŐŝĞƐ͕ Ă ĐŽŶƐƵůƟŶŐ Įƌŵ ŝŶ ^ĂŶ &ƌĂŶĐŝƐĐŽ͘

&W ƵƌŐĞƐ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ƚŽ ďĞĐŽŵĞ ĨĂŵŝůŝĂƌ ǁŝƚŚ D Z ƚŚŝƐ ĨĂůů ŝŶ ĂŶƟĐŝƉĂƟŽŶ ŽĨ ĚĂƚĂ ĐŽůůĞĐƟŽŶ ƚŚĂƚ ǁŝůů ďĞŐŝŶ ŝŶ ϮϬϭϳ͘ dŽ ĂƐƐŝƐƚ LJŽƵ͕ &W ǁŝůů ĚĞůŝǀĞƌ Ă ƐĞƌŝĞƐ ŽĨ ƌĞƐŽƵƌĐĞƐ͗ ͻ D Z ϭϬϭ͗ 'Ğƚ ZĞĂĚLJ͘ dŚŝƐ ĨĂůů͕ &W ǁŝůů ƉƵďůŝƐŚ ƐƵŵŵĂƌLJ ŵĂƚĞƌŝĂůƐ ĂŶĚ ůĂƵŶĐŚ ŶĞǁ͕ ǁĞďͲďĂƐĞĚ ƌĞƐŽƵƌĐĞƐ ŽŶ ĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ͘ ͻ D Z ĨŽƌ ^ŵĂůů ĂŶĚ ZƵƌĂů &ĂŵŝůLJ WŚLJƐŝĐŝĂŶƐ͗ 'Ğƚ ^Ğƚ͘ ^ŵĂůů ĂŶĚ ƌƵƌĂů ƉƌĂĐƟĐĞƐ ĨĂĐĞ ƵŶŝƋƵĞ ĐŚĂůůĞŶŐĞƐ ǁŝƚŚ D Z ͕ ďƵƚ ǁŝůů ŚĂǀĞ ƵŶŝƋƵĞ ŽƉƉŽƌƚƵŶŝƟĞƐ ŝŶ ƚĞƌŵƐ ŽĨ ƚĞĐŚŶŝĐĂů ĂƐƐŝƐƚĂŶĐĞ ĂŶĚ ĂŶƟĐŝƉĂƚĞĚ ĂĐĐŽŵŵŽĚĂƟŽŶƐ ŝŶ ƚŚĞ ƌĞŐƵůĂƟŽŶƐ͘ &W ǁŝůů ĚĞǀĞůŽƉ ŽƵƚƌĞĂĐŚ ĂŶĚ ĞĚƵĐĂƟŽŶĂů ŵĂƚĞƌŝĂůƐ ĂƐƐŝƐƟŶŐ ƚŚŝƐ ŐƌŽƵƉ͘ ͻ D Z ϮϬϭ͗ 'Ž͊ &ŽůůŽǁŝŶŐ ƉƵďůŝĐĂƟŽŶ ŽĨ ƚŚĞ ĮŶĂů ƌĞŐƵůĂƟŽŶƐ͕ &W ǁŝůů ŽīĞƌ ƉƌŽŐƌĂŵŵŝŶŐ ƚŽ ŚĞůƉ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĚĞǀĞůŽƉ Ă ƐƚƌĂƚĞŐLJ ĨŽƌ ƚŚĞŝƌ ƉƌĂĐƟĐĞ͘ >ĞĂƌŶ ŚŽǁ ƚŽ ƐĞůĞĐƚ ĂŶĚ ƌĞƉŽƌƚ ŽŶ ŵĞĂƐƵƌĞƐ ƚŚĂƚ ďĞŶĞĮƚ LJŽƵƌ ƉƌĂĐƟĐĞ͕ ƉĂƟĞŶƚƐ ĂŶĚ ďŽƩŽŵ ůŝŶĞ͘ California Family Physician Fall 2016

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¢ȱ ǰȱ ǰȱ ǰȱ

CAFP Goes to Orlando! DŽƌĞ ƚŚĂŶ ϮϬϬ &W ŵĞŵďĞƌƐ ĂƩĞŶĚĞĚ ƚŚĞ ƌĞĐĞŶƚ &W ŽŶŐƌĞƐƐ ŽĨ ĞůĞŐĂƚĞƐ ĂŶĚ &ĂŵŝůLJ DĞĚŝĐŝŶĞ džƉĞƌŝĞŶĐĞ ;&DyͿ ŵĞĞƟŶŐ ŝŶ KƌůĂŶĚŽ͕ &> ŽŶ ^ĞƉƚĞŵďĞƌ ϭϴͲϮϰ͘ zŽƵƌ ĚĞůĞŐĂƟŽŶ ƚŽ ƚŚĞ &W ŽŶŐƌĞƐƐ ďĞŐĂŶ ŝƚƐ ǁŽƌŬ ŽŶ ^ƵŶĚĂLJ ǁŝƚŚ ƚŚĞ tĞƐƚĞƌŶ ^ƚĂƚĞƐ &ŽƌƵŵ ŵĞĞƟŶŐ ĂŶĚ dŽǁŶ ,Ăůů͘ dŚĞ ϭϮ ǁĞƐƚĞƌŶ ƐƚĂƚĞ ĐŚĂƉƚĞƌ ƉĂƌƟĐŝƉĂŶƚƐ ʹ ϳϬ ŝŶ Ăůů ʹ ŵĞƚ ĨŽƌ Ă ĐĂƐƵĂů ĚŝŶŶĞƌ ĂŶĚ ĐŽŶǀĞƌƐĂƟŽŶ ĂďŽƵƚ ƌĞƐŽůƵƟŽŶƐ ƐƵďŵŝƩĞĚ ďLJ ƚŚĞŝƌ ĐŚĂƉƚĞƌƐ͘ dŚĞ dŽǁŶ ,Ăůů͕ ĨĞĂƚƵƌŝŶŐ &W ŽĸĐĞƌƐ ĂŶĚ džĞĐƵƟǀĞ sŝĐĞ WƌĞƐŝĚĞŶƚ ŽƵŐůĂƐ ,ĞŶůĞLJ͕ D ͕ ŚŝŐŚůŝŐŚƚĞĚ ƚŚĞ ĐĂĚĞŵLJ͛Ɛ ƌĞĐŽŵŵĞŶĚĂƟŽŶƐ ƚŽ ĂĚĚƌĞƐƐ ƉŚLJƐŝĐŝĂŶ ǁĞůůŶĞƐƐ ĂŶĚ ďƵƌŶŽƵƚ͕ ƚŚĞ ŽƉŝŽŝĚ ĐƌŝƐŝƐ͕ ƚŚĞ DĞĚŝĐĂƌĞ ĐĐĞƐƐ ĂŶĚ ,/W ZĞĂƵƚŚŽƌŝnjĂƟŽŶ Đƚ ;D Z Ϳ ĂŶĚ ,ĞĂůƚŚ ŝƐ WƌŝŵĂƌLJͬ&ĂŵŝůLJ DĞĚŝĐŝŶĞ ĨŽƌ ŵĞƌŝĐĂ͛Ɛ ,ĞĂůƚŚ͘ DŽŶĚĂLJ ǁĂƐ ƚŚĞ ŽŶŐƌĞƐƐ ŽƉĞŶŝŶŐ͕ ƌĞĨĞƌĞŶĐĞ ĐŽŵŵŝƩĞĞ ŵĞĞƟŶŐ͕ ĂŶĚ ĐĂŶĚŝĚĂƚĞ ŚŽƐƉŝƚĂůŝƚLJ ĞǀĞŶƚ͘ dŚĞ &W ĚĞůĞŐĂƟŽŶ͕ ŽĸĐĞƌƐ ĂŶĚ ŽƚŚĞƌ ŵĞŵďĞƌƐ ƐƉŽŬĞ ŝŶ ĞĂĐŚ ŽĨ ƚŚĞ ƌĞĨĞƌĞŶĐĞ ĐŽŵŵŝƩĞĞƐ͕ ƚĂŬŝŶŐ ƐƵƉƉŽƌƚ Žƌ ŽƉƉŽƐĞ ƉŽƐŝƟŽŶƐ ŽŶ Ă ǀĂƌŝĞƚLJ ŽĨ ƌĞƐŽůƵƟŽŶƐ͕ ŝŶĐůƵĚŝŶŐ ƚǁŽ ŽĨ ŽƵƌ ŽǁŶ ŽŶ ƌĞƉƌŽĚƵĐƟǀĞ ŚĞĂůƚŚ ;ǁŚŝĐŚ ƐƵďƐĞƋƵĞŶƚůLJ ƉĂƐƐĞĚ ƐƵĐĐĞƐƐĨƵůůLJͿ͘ DŽŶĚĂLJ ĞǀĞŶŝŶŐ͕ ƚŚĞ &W ƚĞĂŵ ŚŽƐƚĞĚ Ă ŐƌĞĂƚ ĞǀĞŶƚ ĨŽƌ :ĂĐŬ ŚŽƵ͕ ŽƵƌ ĐĂŶĚŝĚĂƚĞ ĨŽƌ WƌĞƐŝĚĞŶƚͲĞůĞĐƚ͘ DŽƌĞ ƚŚĂŶ ϮϬ &WĞƌƐ ƐƉŽƌƚĞĚ :ĂĐŬ ŚŽƵ ͞^Ɵůů >ĞĂĚŝŶŐ ĨƌŽŵ ƚŚĞ ,ĞĂƌƚ͟ ƐŚŝƌƚƐ ĂŶĚ ŐƌĞĞƚĞĚ ƐĞǀĞƌĂů ŚƵŶĚƌĞĚ ŐƵĞƐƚƐ ŝŶ ƚŚĞ ŚŽƐƉŝƚĂůŝƚLJ ďĂůůƌŽŽŵ͘ ĂůůŽŽŶƐ͕ ďƵƩŽŶƐ͕ ĨŽƌƚƵŶĞ ĐŽŽŬŝĞƐ͕ :ĂĐŬ ďŽďďůĞ ŚĞĂĚƐ ĂŶĚ ĐŽŶǀĞƌƐĂƟŽŶƐ ŐĂůŽƌĞ ĂĚĚĞĚ ƚŽ ƚŚĞ ĨƵŶ ŽĨ ƚŚĞ ĞǀĞŶŝŶŐ͘

ĚƵĐĂƟŽŶ͘ dŚĞ ĞůĞŐĂƚĞƐ ĚŝŶŶĞƌ ƚŚĂƚ ĞǀĞŶŝŶŐ ĐĂƉƉĞĚ Žī ƚŚĞ ŽŶŐƌĞƐƐ͘ ĚƵĐĂƟŽŶĂů ƐĞƐƐŝŽŶƐ ďĞŐĂŶ ŽŶ tĞĚŶĞƐĚĂLJ ǁŝƚŚ ƚŚĞ ŽƉĞŶŝŶŐ ŽĨ &Dy ĂŶĚ ƚŚĞ &W ĐƌŽǁĚ ǁĂƐ ŝŶƐƉŝƌĞĚ ďLJ ŬĞLJŶŽƚĞƌ ƚƵů 'ĂǁĂŶĚĞ͕ D ͕ ǁŚŽ ƐƉŽŬĞ ƚŽ ŽƵƌ ŚĞĂƌƚƐ ĂŶĚ ŚĞĂĚƐ ĂƐ ŚĞ ƉƵƐŚĞĚ ĨŽƌ ƐƚƌŽŶŐĞƌ ƐLJƐƚĞŵƐ ƚŽ ƐƵƌƌŽƵŶĚ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĂŶĚ ƚŚĞŝƌ ƚĞĂŵƐ ĂƐ ƚŚĞLJ ƉƌŽǀŝĚĞ ƚŚĞ ƉƌŝŵĂƌLJ ĐĂƌĞ ŵĞƌŝĐĂ͛Ɛ ƉĂƟĞŶƚƐ ŶĞĞĚ ĂŶĚ ĚĞƐĞƌǀĞ͘ ^ĞǀĞƌĂů &WĞƌƐ ƐĞƌǀĞĚ ĂƐ ĨĂĐƵůƚLJ ĨŽƌ &Dy͕ ŝŶĐůƵĚŝŶŐ &W ŽŵŵŝƩĞĞ ŽŶ ŽŶƟŶƵŝŶŐ WƌŽĨĞƐƐŝŽŶĂů ĞǀĞůŽƉŵĞŶƚ ŵĞŵďĞƌƐ ^ĂƌĂŚ DĐEĞŝů ĂŶĚ <ĂƌĞŶ DƵĐŚŽǁƐŬŝ ĂƐ ǁĞůů ĂƐ ŽĂƌĚ ŵĞŵďĞƌ ƐŚďLJ tŽůĨĞ͕ D ͕ DW,͕ DWW ͘ KŶ dŚƵƌƐĚĂLJ͕ &W ƌĞƐŝĚĞŶƚ ŵĞŵďĞƌƐ ĂǀŝĚ dƌĂŶ ;>ŽŶŐ ĞĂĐŚ DĞŵŽƌŝĂůͿ͕ DĂƌŐŽƚ ƌŽǁŶĞ ;^ƵƩĞƌͲ^ĂŶƚĂ ZŽƐĂͿ͕ :ĞƌƌLJ ďƌĂŚĂŵ ;h^ Ϳ ĂŶĚ ŚƌŝƐƟŶĞ <ŝŶŶĞǀĞLJ ;h ^ Ϳ͕ ǁĞƌĞ ŚŽŶŽƌĞĚ ǁŝƚŚ ĨŽƵƌ ŽĨ ƚŚĞ ϭϮ 'D ǁĂƌĚƐ ĨŽƌ džĐĞůůĞŶĐĞ ŝŶ 'ƌĂĚƵĂƚĞ DĞĚŝĐĂů ĚƵĐĂƟŽŶ͘ KƵƌ ĨƵƚƵƌĞ ŝƐ ŝŶĚĞĞĚ ďƌŝŐŚƚ͘ dŚĞ ĞǀĞŶƚƐ ǁŽƵŶĚ ĚŽǁŶ ǁŝƚŚ ƚŚĞ ĮŶĂů ƐĞƐƐŝŽŶƐ͕ ĂŶĚ &ƌŝĚĂLJ͛Ɛ Ăůů ŵĞŵďĞƌ ĞǀĞŶƚ Ăƚ hŶŝǀĞƌƐĂů ^ƚƵĚŝŽƐ͘ dŚĂŶŬƐ ƚŽ ƚŚĞ ĂůŝĨŽƌŶŝĂŶƐ ǁŚŽ ĚĞƐĐĞŶĚĞĚ ŽŶ KƌůĂŶĚŽ ʹ ǁĞ͛ůů ƐĞĞ LJŽƵ Ăůů ĂŐĂŝŶ ŶĞdžƚ LJĞĂƌ ŝŶ ^ĂŶ ŶƚŽŶŝŽ͕ dy͘ ^ŚĞůůLJ ZŽĚƌŝŐƵĞƐ ŝƐ &W͛Ɛ ĞƉƵƚLJ džĞĐƵƟǀĞ sŝĐĞ WƌĞƐŝĚĞŶƚ͘

dƵĞƐĚĂLJ ǁĂƐ ZĞĨĞƌĞŶĐĞ ŽŵŵŝƩĞĞ ƌĞƉŽƌƚƐ ĂŶĚ ĐĂŶĚŝĚĂƚĞ ƐƉĞĞĐŚĞƐͬYƵĞƐƟŽŶ ĂŶĚ ŶƐǁĞƌ ;Y Θ Ϳ ĚĂLJ͘ :ĂĐŬ ĚŝĚ ƵƐ ƉƌŽƵĚ ǁŝƚŚ Ă ƚĞƌƌŝĮĐ ƐƉĞĞĐŚ ĂŶĚ Y Θ ƐĞƐƐŝŽŶ͘ &W͛Ɛ ƚǁŽ ƌĞƐŽůƵƟŽŶƐ͕ ŶĚŽƌƐĞ ĐĐĞƐƐ ǁŝƚŚŽƵƚ ŐĞ ZĞƐƚƌŝĐƟŽŶƐ ƚŽ KǀĞƌͲ ƚŚĞͲ ŽƵŶƚĞƌ KƌĂů ŽŶƚƌĂĐĞƉƟǀĞƐ ĂŶĚ DĞĚŝĐĂŝĚ ŽǀĞƌĂŐĞ ŽĨ KǀĞƌͲƚŚĞͲ ŽƵŶƚĞƌ ŵĞƌŐĞŶĐLJ ŽŶƚƌĂĐĞƉƟŽŶ͕ ǁĞƌĞ ďŽƚŚ ƉĂƐƐĞĚ ŽŶ ƚŚĞ ĐŽŶƐĞŶƚ ĐĂůĞŶĚĂƌ ŽŶ ƌĞĐŽŵŵĞŶĚĂƟŽŶ ŽĨ ƚŚĞ ƌĞĨĞƌĞŶĐĞ ĐŽŵŵŝƩĞĞ͘ tĞĚŶĞƐĚĂLJ ǁĂƐ ĞůĞĐƟŽŶ ƌĞƐƵůƚƐ ĚĂLJ͕ ĂŶĚ ŵƵĐŚ ƚŽ ŽƵƌ ĚŝƐŵĂLJ͕ :ĂĐŬ ǁĂƐ ŶŽƚ ƐƵĐĐĞƐƐĨƵů ŝŶ ŚŝƐ ďŝĚ ĨŽƌ WƌĞƐŝĚĞŶƚͲĞůĞĐƚ͘ :ĂĐŬ͕ ZŽď >ĞĞ ŽĨ /ŽǁĂ ĂŶĚ DŝŬĞ DƵŶŐĞƌ ŽĨ <ĂŶƐĂƐ ƌĂŶ Ă ŐƌĞĂƚ ƌĂĐĞ ĂŶĚ ƌ͘ DƵŶŐĞƌ ǁŝůů ďĞ &W͛Ɛ ϮϬϭϳͲϭϴ WƌĞƐŝĚĞŶƚ͘ ĂƌůĂ <ĂŬƵƚĂŶŝ͕ &W͛Ɛ ƐĞŶŝŽƌ ĚĞůĞŐĂƚĞ͕ ĂŶŶŽƵŶĐĞĚ ŚĞƌ ƌĞƟƌĞŵĞŶƚ ĨƌŽŵ ƚŚĞ ĚĞůĞŐĂƟŽŶ ĂŶĚ ƌĞĐĞŝǀĞĚ Ă ŚƵŐĞ ƌŽƵŶĚ ŽĨ ĂƉƉůĂƵƐĞ͘ ŶĚ ŽƵƌ ŽǁŶ ŶŶĞ DŽŶƚŐŽŵĞƌLJ ǁĂƐ ŶĂŵĞĚ ĐŚĂŝƌ ŽĨ ƚŚĞ ŽŵŵŝƐƐŝŽŶ ŽŶ

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California Family Physician Fall 2016

dŚĂŶŬƐ ƚŽ Ăůů ƚŚĞ &WĞƌƐ ǁŚŽ ĐĂŵĞ ŽƵƚ ƚŽ ŚĞůƉ ŝŶ :ĂĐŬ͛Ɛ ĐĂŵƉĂŝŐŶ͊

ŽŶƟŶƵĞĚ ŽŶ ƉĂŐĞ Ϯϴ ххх

NORTHERN CALIFORNIA, NAPA Independent Medical Group is seeking qualified candidates to staff their minor emergency department.

Candidates include: Near retirement Emergency Physicians Family Practice physicians Urgent care Physicians Emergency department Nurse Practitioners.

Like a dose of good medicine for an ailing industry, Petaluma Health Center is leading the way in changing healthcare for the better. For medical professional and practitioners inspired to improve the health of people and communities, that makes PHC the ideal place to work. Not only has PHC established itself as a model for integrative medicine, there’s a spirit of innovation that empowers everyone to find new and better ways to do things. So, if you’re looking for a place to practice what you’re passionate about, there’s a place for you at Petaluma Health Center.

707.559.7500 phealthcenter.org

1179 North McDowell Blvd. Petaluma, CA 94954

If interested, forward C.V. to Tony Mottalei M.D. mottalei@gmail.com

Mayo School of Continuous Professional Development

UPDATES IN FAMILY MEDICINE Relevant information for the practicing primary care clinician

Disney’s Grand Californian Hotel Anaheim, CA REGISTER NOW! MARCH 2-4, 2017 ce.mayo.edu/familymedupdate2017 In collaboration with

California Family Physician Fall 2016

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ȱ ǰȱ

#NeverStop Being Heroic tŽǁ͕ ǁŚĂƚ Ă ƌŝĚĞ͊ ^ĞƌǀŝŶŐ ŽŶ ƚŚĞ &W ŽĂƌĚ ŽĨ ŝƌĞĐƚŽƌƐ ŚĂƐ ďĞĞŶ Ă ďůĂƐƚ ĂŶĚ ŚĂǀŝŶŐ ƚŚĞ ŽƉƉŽƌƚƵŶŝƚLJ ƚŽ ƌƵŶ ĨŽƌ &W WƌĞƐŝĚĞŶƚͲĞůĞĐƚ ǁĂƐ ƚŚĞ ĞdžƉĞƌŝĞŶĐĞ ŽĨ Ă ůŝĨĞƚŝŵĞ͘ /Ŷ ƚŚĞ ĐŽƵƌƐĞ ŽĨ ƚŚƌĞĞ ƐŚŽƌƚ LJĞĂƌƐ͕ /͛ǀĞ ŚĂĚ ƚŚĞ ƉƌŝǀŝůĞŐĞ ŽĨ ƚƌĂǀĞůŝŶŐ ĂĐƌŽƐƐ ŽƵƌ ŐƌĞĂƚ ŶĂƚŝŽŶ͕ ĨƌŽŵ ^ĞĂƚƚůĞ͕ tĂƐŚŝŶŐƚŽŶ ƚŽ tĂƐŚŝŶŐƚŽŶ ͕ ŽŝƐĞ͕ /ĚĂŚŽ ƚŽ ŽůƵŵďƵƐ͕ KŚŝŽ ZĞŶŽ͕ EĞǀĂĚĂ ƚŽ ,ŽƵƐƚŽŶ͕ dĞdžĂƐ͕ ĂŶĚ ĨƌŽŵ ƚŚĞ ǀĂƐƚ ƐƚĂƚĞ ŽĨ ůĂƐŬĂ ƚŽ ƚŚĞ ŐƌĞĂƚ ĨŽŽƚďĂůů ƐƚĂƚĞ ŽĨ ůĂďĂŵĂ͘ / ĞǀĞŶ ǀŝƐŝƚĞĚ ƚŚĞ ĂƌŝďďĞĂŶ ʹWƵĞƌƚŽ ZŝĐŽ ĂŶĚ h͘^͘ sŝƌŐŝŶ /ƐůĂŶĚƐ ĂƐ ǁĞůů ĂƐ ƚŚĞ WĂĐŝĨŝĐ ŝƐůĂŶĚƐ ŽĨ 'ƵĂŵ ĂŶĚ ,ĂǁĂŝŝ͘ / ůĞĂƌŶĞĚ ƚŚĂƚ ƚŚƌŽƵŐŚŽƵƚ ƚŚŝƐ ĚŝǀĞƌƐĞ ĐŽƵŶƚƌLJ͕ ǁĞ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĂƌĞ ƚŚĞ ĐŽŵŵŽŶ ƚŚƌĞĂĚ ƌƵŶŶŝŶŐ ƚŚƌŽƵŐŚ ƚŚĞƐĞ ĚŝǀĞƌƐĞ ĐŽŵŵƵŶŝƚŝĞƐ͘ &ĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĂƌĞ ŝŵƉƌŽǀŝŶŐ ƚŚĞ ŚĞĂůƚŚ ĂŶĚ ůŝǀĞƐ ŽĨ ƚŚĞŝƌ ƉĂƚŝĞŶƚƐ ŝŶ ƚŚĞŝƌ ĐŽŵŵƵŶŝƚŝĞƐ͕ ĨƌŽŵ ŶŐŝĞ ^ƉĂƌŬƐ ǁŽƌŬŝŶŐ ƚŽ ŝŶƚĞŐƌĂƚĞ ƚĞĂŵƐ ŝŶ ƚŚĞ 'ƌŽƵƉ ,ĞĂůƚŚ ŽŽƉĞƌĂƚŝǀĞ ŝŶ ^ĞĂƚƚůĞ ƚŽ dŽďŝĞ >LJŶŶ ^ŵŝƚŚ ƐĞƌǀŝŶŐ ƚŚĞ ŚŽŵĞůĞƐƐ ĂŶĚ ƚŚĞ ƵŶĚĞƌƐĞƌǀĞĚ ŝŶ tĂƐŚŝŶŐƚŽŶ͕ ͘ ^ƚĂƚĞ ĐŚĂƉƚĞƌƐ ĂƌĞ ĞŶŐĂŐĞĚ ŝŶ ďƌŝŶŐŝŶŐ ďĞƚƚĞƌ ŚĞĂůƚŚ ƚŽ ƚŚĞŝƌ ƐƚĂƚĞƐ͕ ĨƌŽŵ /ĚĂŚŽ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĐĂƌƌLJŝŶŐ ůĞŐŝƐůĂƚŝŽŶ ƚŽ ƚŚĞ ŽŝƐĞ ƐƚĂƚĞŚŽƵƐĞ ƚŽ ĐůŽƐĞ ƚŚĞ ŐĂƉ ŽĨ ŚĞĂůƚŚ ĐĂƌĞ ĐŽǀĞƌĂŐĞ ƚŽ KŚŝŽ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĨŝŐŚƚŝŶŐ Ăƚ ƚŚĞ ŽůƵŵďƵƐ ƐƚĂƚĞŚŽƵƐĞ ŝŶ ƚŚĞ ďĂƚƚůĞ ĂŐĂŝŶƐƚ ŝŶĂƉƉƌŽƉƌŝĂƚĞ ŽƉŝŽŝĚ ƵƐĞ͘ &ĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĐŽŶƚŝŶƵĞ ƚŽ ŵĂŝŶƚĂŝŶ ƚŚĞ ĨĂďƌŝĐ ŽĨ ŽƵƌ ƚŝŐŚƚůLJͲŬŶŝƚ ĐŽŵŵƵŶŝƚŝĞƐ͕ ĨƌŽŵ :ŽŚŶ ƵůůĞŶ͕ Ă ĨƵůůͲƐĐŽƉĞ ƉŚLJƐŝĐŝĂŶ ƐĞƌǀŝŶŐ ŚŝƐ ƌƵƌĂů ĐŽŵŵƵŶŝƚLJ ŝŶ sĂůĚĞnj͕ ůĂƐŬĂ ǁŝƚŚ ƚĞůĞŵĞĚŝĐŝŶĞ ƚŽ ĞǀĞƌůLJ :ŽƌĚĂŶ͕ Ă ƐƉŽƌƚƐ ŵĞĚŝĐŝŶĞ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶ ƐĞƌǀŝŶŐ ŚĞƌ ƐŵĂůů ĐŽŵŵƵŶŝƚLJ ŽĨ ŶƚĞƌƉƌŝƐĞ͕ ůĂďĂŵĂ͘ KƵƌ ĐŽůůĞĂŐƵĞƐ ĂƌĞ ĂůƐŽ ŝŶŶŽǀĂƚŝǀĞ ůĞĂĚĞƌƐ͕ ĨƌŽŵ ĂŶ ^ƉŽŐĞŶ͕ ǁŽƌŬŝŶŐ ƚŽ ƌĞŵĂŬĞ Ă ƵŶŝǀĞƌƐŝƚLJͲďĂƐĞĚ ŚĞĂůƚŚ ƐLJƐƚĞŵ ŝŶ ZĞŶŽ͕ ƚŽ dƌŽLJ &ŝĞƐŝŶŐĞƌ͕ ĐƌĞĂƚŝŶŐ Ă ŶĞǁ ŝŶƚĞŐƌĂƚĞĚ ŚĞĂůƚŚ ƐLJƐƚĞŵ ŝŶ ,ŽƵƐƚŽŶ͘ &ĂŵŝůLJ ŵĞĚŝĐŝŶĞ ůĞĂĚĞƌƐ ĐŽŶƚŝŶƵĞ ƚŽ ƚĂĐŬůĞ ĚŝĨĨŝĐƵůƚ ŝƐƐƵĞƐ ƚŚƌĞĂƚĞŶŝŶŐ ƚŽ ƵŶĚĞƌŵŝŶĞ ƚŚĞ ŚĞĂůƚŚ ŽĨ ƚŚĞŝƌ ĐŽŵŵƵŶŝƚŝĞƐ͕ ĂĚĚƌĞƐƐŝŶŐ ƚŚĞ ƉƌŝŵĂƌLJ ĐĂƌĞ ďƌĂŝŶ ĚƌĂŝŶ ŝŶ WƵĞƌƚŽ ZŝĐŽ ĂŶĚ ƚŚĞ ĐŚĂůůĞŶŐĞ ŽĨ ƚƌĂƵŵĂ ƐĞƌǀŝĐĞƐ ŝŶ ƚŚĞ h͘^͘ sŝƌŐŝŶ /ƐůĂŶĚƐ͕ ƚŚĞ ůĂĐŬ ŽĨ ƐƵďƐƉĞĐŝĂůƚLJ ƐƵƉƉŽƌƚ ŝŶ 'ƵĂŵ ĂŶĚ ŵĂůĚŝƐƚƌŝďƵƚŝŽŶ ŽĨ ƌƵƌĂů ƉŚLJƐŝĐŝĂŶƐ ŝŶ ,ĂǁĂŝŝ͘ / Ăŵ ƉƌŽƵĚ ƚŽ ŚĂǀĞ ƐĞƌǀĞĚ ĂůŽŶŐƐŝĚĞ Ăůů ŽĨ LJŽƵ͕ ĂŶĚ ĐŽƵŶƚůĞƐƐ ŽƚŚĞƌ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ĂƌŽƵŶĚ ŽƵƌ ĐŽƵŶƚƌLJ͕ ŝŶ ƉƵƌƐƵŝŶŐ ďĞƚƚĞƌ ŚĞĂůƚŚ ĂŶĚ ďĞƚƚĞƌ ĐĂƌĞ ĨŽƌ ŽƵƌ ĐŽŵŵƵŶŝƚŝĞƐ͘ / ǁĂŶƚ ƚŽ ĞdžƚĞŶĚ ŵLJ ŐƌĂƚŝƚƵĚĞ ƚŽ ƚŚĞ ŵŽƐƚ ĂǁĞƐŽŵĞ ĐĂŵƉĂŝŐŶ ƚĞĂŵ͕ ůĞĚ ďLJ :ĂLJ >ĞĞ ĂŶĚ ĂƌůĂ <ĂŬƵƚĂŶŝ͕ ƚĞĂŵ ŵĞŵďĞƌƐ :ĞĨĨ >ƵƚŚĞƌ͕ ĂƌŽů ,ĂǀĞŶƐ͕ >ĞĞ ZĂůƉŚ ĂŶĚ DŝĐŚĞůůĞ YƵŝŽŐƵĞ ĂŶĚ Ăůů ŽĨ LJŽƵ ƐĞƌǀŝŶŐ ŽŶ ƚŚĞ &W ŽĂƌĚ ŽĨ 28

California Family Physician Fall 2016

:ĂĐŬ ǁĂƐ ũŽŝŶĞĚ ŝŶ KƌůĂŶĚŽ ďLJ ŚŝƐ ǁŝĨĞ <ĂƚŚLJ ĂŶĚ ĐŚŝůĚƌĞŶ͕ ^ĂƌĂŚ͕ ^ĂŵĂŶƚŚĂ ĂŶĚ EĂƚŚĂŶ͘

ŝƌĞĐƚŽƌƐ͕ &W džĞĐƵƚŝǀĞ sŝĐĞ WƌĞƐŝĚĞŶƚ ^ƵƐĂŶ ,ŽŐĞůĂŶĚ͕ ĞƉƵƚLJ džĞĐƵƚŝǀĞ sŝĐĞ WƌĞƐŝĚĞŶƚ ^ŚĞůůLJ ZŽĚƌŝŐƵĞƐ͕ ĂŶĚ ŽƵƌ &W ƐƚĂĨĨ ŵĞŵďĞƌƐ͘ /Ŷ ĂĚĚŝƚŝŽŶ͕ / ǁĂŶƚ ƚŽ ƚŚĂŶŬ Ăůů ŽĨ ŵLJ ƐƵƉƉŽƌƚĞƌƐ ĨƌŽŵ ĂůŝĨŽƌŶŝĂ ĂŶĚ ĞůƐĞǁŚĞƌĞ ǁŚŽ ƚƌĂǀĞůĞĚ ƚŽ KƌůĂŶĚŽ ĂŶĚ ƉĂƌƚŝĐŝƉĂƚĞĚ ŝŶ ƚŚĞ ŚŽƐƉŝƚĂůŝƚLJ ŶŝŐŚƚ ĞǀĞŶƚ͘ dŽ ƚŚŽƐĞ ǁŚŽ ŚĞůƉĞĚ ĐŽŶƚĂĐƚ ĚĞůĞŐĂƚĞƐ ĂŶĚ ĂůƚĞƌŶĂƚĞƐ ŽŶ ŵLJ ďĞŚĂůĨ͕ ĞŝƚŚĞƌ ďLJ ĐĂůůŝŶŐ Žƌ ǁƌŝƚŝŶŐ͕ ĂŶĚ ƚŽ ƚŚŽƐĞ ǁŚŽ ƐĞŶƚ ŵĞ LJŽƵƌ ǁĞůůͲǁŝƐŚĞƐ͕ / ĚĞĞƉůLJ ĂƉƉƌĞĐŝĂƚĞ LJŽƵƌ ƉŽƐŝƚŝǀĞ ĞŶĞƌŐLJ͖ ŝƚ ŝŶǀŝŐŽƌĂƚĞĚ ŵLJ ƐƉŝƌŝƚ ĚƵƌŝŶŐ ƚŚŝƐ ŐƌƵĞůŝŶŐ͕ LJĞĂƌͲůŽŶŐ ƉƌŽĐĞƐƐ͘ / ǁŽƵůĚ ŶŽƚ ŚĂǀĞ ďĞĞŶ ĂďůĞ ƚŽ ĂĐŚŝĞǀĞ ƚŚŝƐ ůĞǀĞů ŽĨ ĞdžĐĞůůĞŶĐĞ ĂůŽŶĞ ĂŶĚ / Ăŵ ƚƌƵůLJ ďůĞƐƐĞĚ ƚŽ ŚĂǀĞ ĨƌŝĞŶĚƐ ĂŶĚ ĐŽůůĞĂŐƵĞƐ ůŝŬĞ LJŽƵ͘

ĐĂƵƚŝŽŶĞĚ ƚŚĞ ĐƌŽǁĚ ĂƚƚĞŶĚŝŶŐ ƚŚĞ hŶŝƚĂƌŝĂŶ hŶŝǀĞƌƐĂůŝƐƚ ƐƐŽĐŝĂƚŝŽŶ͛Ɛ ĂŶŶƵĂů tĂƌĞ >ĞĐƚƵƌĞ͕ ƚŚĂƚ ͚KŶĞ ŽĨ ƚŚĞ ŐƌĞĂƚ ŵŝƐĨŽƌƚƵŶĞƐ ŽĨ ŚŝƐƚŽƌLJ ŝƐ ƚŚĂƚ Ăůů ƚŽŽ ŵĂŶLJ ŝŶĚŝǀŝĚƵĂůƐ ĂŶĚ ŝŶƐƚŝƚƵƚŝŽŶƐ ĨŝŶĚ ƚŚĞŵƐĞůǀĞƐ ŝŶ Ă ŐƌĞĂƚ ƉĞƌŝŽĚ ŽĨ ĐŚĂŶŐĞ ĂŶĚ LJĞƚ ĨĂŝů ƚŽ ĂĐŚŝĞǀĞ ƚŚĞ ŶĞǁ ĂƚƚŝƚƵĚĞƐ ĂŶĚ ŽƵƚůŽŽŬƐ ƚŚĂƚ ƚŚĞ ŶĞǁ ƐŝƚƵĂƚŝŽŶ ĚĞŵĂŶĚƐ͘ dŚĞƌĞ ŝƐ ŶŽƚŚŝŶŐ ŵŽƌĞ ƚƌĂŐŝĐ ƚŚĂŶ ƚŽ ƐůĞĞƉ ƚŚƌŽƵŐŚ Ă ƌĞǀŽůƵƚŝŽŶ͛͘ Ɛ ŵĞŵďĞƌƐ ŽĨ ƚŚŝƐ ŽƵƚƐƚĂŶĚŝŶŐ ŽƌŐĂŶŝnjĂƚŝŽŶ͕ ǁĞ ƐŚĂůů ĐŽŶƚŝŶƵĞ ƚŚĞ ƉƌŽŐƌĞƐƐ ǁĞ ŚĂǀĞ ŵĂĚĞ ƐŽ ĨĂƌ ŝŶ ƉƵƐŚŝŶŐ ĨŽƌǁĂƌĚ ƚŚĞ &ĂŵŝůLJ DĞĚŝĐŝŶĞ ZĞǀŽůƵƚŝŽŶ͘ tĞ ƐŚĂůů ŚĞĞĚ ƚŚĞ ƐĂŐĞ ǁŽƌĚƐ ŽĨ ƌ͘ <ŝŶŐ ĂŶĚ ŶĞǀĞƌ ƐƚŽƉ ďĞŝŶŐ ŚĞƌŽŝĐ͕ ĂŶĚ ǁĞ ƐŚĂůů ĐŽŶƚŝŶƵĞ ƚŽ ĚŽ ǁŚĂƚ ŝƐ ƌŝŐŚƚ ďLJ ŽƵƌ ƉĂƚŝĞŶƚƐ ĂŶĚ ŽƵƌ ĐŽŵŵƵŶŝƚŝĞƐ͘

Ɛ / ĐůŽƐĞ ĂŶŽƚŚĞƌ ĐŚĂƉƚĞƌ ŝŶ ŵLJ &W ůĞĂĚĞƌƐŚŝƉ ũŽƵƌŶĞLJ͕ / ǁĂŶƚ ƚŽ ƐŚĂƌĞ ǁŝƚŚ LJŽƵ ŵLJ ĐůŽƐŝŶŐ ƌĞŵĂƌŬƐ Ăƚ ƚŚĞ &W ŽŶŐƌĞƐƐ ŽĨ ĞůĞŐĂƚĞƐ ; K Ϳ͘

&ŝŶĂůůLJ͕ / ƐŚĂůů ĞĐŚŽ ƌ͘ <ŝŶŐ͛Ɛ ǁŽƌĚƐ Ăƚ ƚŚĞ ĞŶĚ ŽĨ ŚŝƐ ŚŝƐƚŽƌŝĐ tĂƌĞ >ĞĐƚƵƌĞ ƐƉĞĞĐŚ͕ ƚŚĂƚ ͚ǁŝƚŚ ƚŚŝƐ ĨĂŝƚŚ ǁĞ ǁŝůů ďĞ ĂďůĞ ƚŽ ŚĞǁ ŽƵƚ ŽĨ ƚŚĞ ŵŽƵŶƚĂŝŶ ŽĨ ĚĞƐƉĂŝƌ Ă ƐƚŽŶĞ ŽĨ ŚŽƉĞ͘ tĞ ǁŝůů ďĞ ĂďůĞ ƚŽ ƚƌĂŶƐĨŽƌŵ ƚŚĞ ũĂŶŐůŝŶŐ ĚŝƐĐŽƌĚƐ ŽĨ ŽƵƌ ŶĂƚŝŽŶ ŝŶƚŽ Ă ďĞĂƵƚŝĨƵů ƐLJŵƉŚŽŶLJ ŽĨ ďƌŽƚŚĞƌŚŽŽĚ͕ ĂŶĚ ƐƉĞĞĚ ƵƉ ƚŚĂƚ ĚĂLJ ǁŚĞŶ Ăůů ŽĨ 'ŽĚ͛Ɛ ĐŚŝůĚƌĞŶ Ăůů ŽǀĞƌ ŽƵƌ ŶĂƚŝŽŶ ĂŶĚ ƚŚĞ ǁŽƌůĚ ǁŝůů ďĞ ĂďůĞ ƚŽ ǁĂůŬ ƚŚĞ ĞĂƌƚŚ ĂƐ ďƌŽƚŚĞƌƐ ĂŶĚ ƐŝƐƚĞƌƐ͕ ĂŶĚ ƚŚĞŶ ǁĞ ĐĂŶ ƐŝŶŐ ŝŶ ƚŚĞ ǁŽƌĚƐ ŽĨ ƚŚĞ ŽůĚ EĞŐƌŽ ƐƉŝƌŝƚƵĂů ʹ&ƌĞĞ Ăƚ ůĂƐƚ͕ ĨƌĞĞ Ăƚ ůĂƐƚ͕ ƚŚĂŶŬ 'ŽĚ ĂůŵŝŐŚƚLJ ǁĞ ĂƌĞ ĨƌĞĞ Ăƚ ůĂƐƚ͛͘ dŚĂŶŬ LJŽƵ ĨŽƌ LJŽƵƌ ƐƵƉƉŽƌƚ ĂŶĚ ĞŶĐŽƵƌĂŐĞŵĞŶƚ ƚŚƌŽƵŐŚŽƵƚ ƚŚĞƐĞ LJĞĂƌƐ͘ sŝǀĂ η&DZĞǀŽůƵƚŝŽŶ ĂŶĚ /͛ůů ƐĞĞ LJŽƵ ŽŶ ƚŚĞ ďĂƚƚůĞĨŝĞůĚ͊͟

͞ ƌ͘ :ŽŚŶ DĞŝŐƐ͕ ĐƵƌƌĞŶƚ &W WƌĞƐŝĚĞŶƚ͕ ƌĞŵŝŶĚĞĚ ƚŚĞ ĂƚƚĞŶĚĞĞƐ ƚŚĂƚ ƚŚŝƐ LJĞĂƌ ŝƐ ƚŚĞ ϱϬƚŚ ĂŶŶŝǀĞƌƐĂƌLJ ĨŽƌ ƚŚĞ ƐƉĞĐŝĂůƚLJ ŽĨ &ĂŵŝůLJ DĞĚŝĐŝŶĞ͘ /Ŷ ƚŚĞ ƉĂƐƚ ŚĂůĨ ĐĞŶƚƵƌLJ͕ ǁĞ ŚĂǀĞ ĐŽŵĞ ƐŽ ĨĂƌ ĂƐ Ă ƐƉĞĐŝĂůƚLJ͖ LJĞƚ͕ ǁĞ ŚĂǀĞ ŵƵĐŚ ƚŽ ůŽŽŬ ĨŽƌǁĂƌĚ ƚŽ ĂƐ ǁĞ ĐŽŶƚŝŶƵĞ ƚŽ ƌĞƐŚĂƉĞ ŚĞĂůƚŚ ůĂŶĚƐĐĂƉĞƐ ĂƌŽƵŶĚ ŽƵƌ ĐŽŵŵƵŶŝƚŝĞƐ͘ /Ŷ ϭϵϲϲ͕ ƚŚĞ ƐĂŵĞ LJĞĂƌ ĂƐ ƚŚĞ ĨŽƵŶĚŝŶŐ ŽĨ &ĂŵŝůLJ DĞĚŝĐŝŶĞ ĂƐ Ă ŵĞĚŝĐĂů ƐƉĞĐŝĂůƚLJ͕ ZĞǀ͘ DĂƌƚŝŶ >ƵƚŚĞƌ <ŝŶŐ͕ :ƌ͘

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California Family Physician Fall 2016

29

EXECUTIVE VICE PRESIDENT’S FORUM

ȱ ǰȱ

Verdict on the ACA? Good, Overall. WĞƚĞƌ Z͘ KƌƐnjĂŐ͕ WŚ ͕ ƉŽŝŶƚƐ ŽƵƚ ŝŶ ĂŶ ĞĚŝƚŽƌŝĂů ŝŶ ƚŚĞ :ƵůLJ ϭϭ ŝƐƐƵĞ ŽĨ dŚĞ :ŽƵƌŶĂů ŽĨ ƚŚĞ ŵĞƌŝĐĂŶ DĞĚŝĐĂů ƐƐŽĐŝĂƟŽŶ ƚŚĂƚ ͞WƌĞƐŝĚĞŶƚ KďĂŵĂ ŝƐ ƚŚĞ ŽŶůLJ ƐŝƫŶŐ ƉƌĞƐŝĚĞŶƚ ŽĨ ƚŚĞ hŶŝƚĞĚ ^ƚĂƚĞƐ ŝŶ ŵŽĚĞƌŶ ŚŝƐƚŽƌLJ ƚŽ ƉƵďůŝƐŚ ĂŶ ĂƌƟĐůĞ ŝŶ : D ͘͟ ƌ͘ KƌnjĂŐ ƐƵŐŐĞƐƚƐ ƚŚĂƚ ŝƐ ĂƉƉƌŽƉƌŝĂƚĞ ŝŶ ůŝŐŚƚ ŽĨ ƚŚĞ ĨĂĐƚ ƚŚĂƚ ŚĞ ŝƐ ͞ĂůƐŽ ƚŚĞ ŽŶůLJ ƌĞĐĞŶƚ ƉƌĞƐŝĚĞŶƚ ƚŽ ƐŝŐŶ ĐŽŵƉƌĞŚĞŶƐŝǀĞ ŚĞĂůƚŚ ƌĞĨŽƌŵ ůĞŐŝƐůĂƟŽŶ͕ ƚŚĞ īŽƌĚĂďůĞ ĂƌĞ Đƚ ; Ϳ͕ ůĞŐŝƐůĂƟŽŶ ǁŝƚŚ ƚŚĞ ĞdžƉƌĞƐƐ ƉƵƌƉŽƐĞ ŶŽƚ ŽŶůLJ ŽĨ ĞdžƉĂŶĚŝŶŐ ĐŽǀĞƌĂŐĞ ďƵƚ ĂůƐŽ ĐŽŶƚĂŝŶŝŶŐ ĐŽƐƚ ĂŶĚ ŝŵƉƌŽǀŝŶŐ ƋƵĂůŝƚLJ͘͟

ƉŽŝŶƚ ŽƵƚ ƚŚĂƚ ƚŚĞ ĂǀĞƌĂŐĞ ŝŶĐƌĞĂƐĞ ŽǀĞƌ ƚŚƌĞĞ LJĞĂƌƐ ŝƐ ƐĞǀĞŶ ƉĞƌĐĞŶƚ͖ &W͛Ɛ ŽǁŶ ƉƌĞŵŝƵŵ ĨŽƌ ĞŵƉůŽLJĞĞ ƉůĂŶ ĐŽǀĞƌĂŐĞ ŝŶĐƌĞĂƐĞĚ ϭϬ ƉĞƌĐĞŶƚ ƚŚŝƐ LJĞĂƌ͕ ďLJ ĐŽŵƉĂƌŝƐŽŶ͘ ĚĚŝƟŽŶĂůůLJ͕ ƐŽŵĞ ƉůĂŶƐ ƉƌŽǀŝĚŝŶŐ ĐŽǀĞƌĂŐĞ ƚŚƌŽƵŐŚ ŝŶƐƵƌĂŶĐĞ ĞdžĐŚĂŶŐĞƐ ;hŶŝƚĞĚ,ĞĂůƚŚ 'ƌŽƵƉ͕ ĞƚŶĂ ĂŶĚ ,ƵŵĂŶĂͿ ŚĂǀĞ ĚƌŽƉƉĞĚ ŽƵƚ͕ Žƌ ǁŝůů͕ ĂŶĚ ŽƚŚĞƌƐ ŚĂǀĞ ĞdžƉĞƌŝĞŶĐĞĚ ůŽƐƐĞƐ ; ůƵĞ ^ŚŝĞůĚ ĂŶŶŽƵŶĐĞĚ ŝƚ ǁŽƵůĚ ƐŚƵƚ ĚŽǁŶ ĨŽƌ ĨŽƵƌ ĚĂLJƐ ŝŶ ^ĞƉƚĞŵďĞƌ ƚŽ ƌĞĚƵĐĞ ůŝĂďŝůŝƟĞƐ ĨŽƌ ƉĂŝĚ ƟŵĞ Žī ŝŶ ƌĞƐƉŽŶƐĞ ƚŽ ůŽƐƐĞƐ ŝƚ ŚĂƐ ŝŶĐƵƌƌĞĚ ŝŶ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ͘ /ƚ ǁŝůů ƌĂŝƐĞ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ ƌĂƚĞƐ ďLJ ŶĞĂƌůLJ ϮϬ ƉĞƌĐĞŶƚ ŶĞdžƚ LJĞĂƌ͘Ϳ dŚĞƐĞ ĞǀĞŶƚƐ ƉŽƌƚĞŶĚ ƉŽƚĞŶƟĂů ĂĚĚŝƟŽŶĂů ŽƚŚ ƚŚĞ WƌĞƐŝĚĞŶƚ ĂŶĚ ƌ͘ KƌnjĂŐ ĞdžƚŽů ƚŚĞ ŵĂŶLJ ƐƵĐĐĞƐƐĞƐ ƉƌĞŵŝƵŵ ŝŶĐƌĞĂƐĞƐ ŝŶ Ă ǀĞƌLJ ƉƌŝĐĞͲƐĞŶƐŝƟǀĞ ƉŽƉƵůĂƟŽŶ ĂŶĚ ŽĨ ƚŚĞ ͗ ϭͿ ϮϬ ŵŝůůŝŽŶ ĨĞǁĞƌ ƵŶŝŶƐƵƌĞĚ ʹ Ă ĚĞĐůŝŶĞ ŝŶ ƚŚĞ ŝŶĚŝĐĂƚĞ ďƵŵƉƐ ĂŚĞĂĚ͕ ĂƐ ĚŽĞƐ ƐŽŵĞ ƉůĂŶƐ ďĂĐŬŝŶŐ ŽƵƚ ŽĨ ƚŚĞ ƵŶŝŶƐƵƌĞĚ ŽĨ ϰϯ ƉĞƌĐĞŶƚ ĨƌŽŵ ϭϲ ƉĞƌĐĞŶƚ ƚŽ ϵ͘ϭ ƉĞƌĐĞŶƚ ďĞƚǁĞĞŶ Ăůů ƚŽŐĞƚŚĞƌ͕ ůĞĂǀŝŶŐ ŽŶůLJ ŽŶĞ ŚĞĂůƚŚ ƉůĂŶ ĐŚŽŝĐĞ ŝŶ ƐŽŵĞ ϮϬϭϬ ĂŶĚ ϮϬϭϱ͖ ϮͿ Ă ĚĞĐůŝŶĞ ŝŶ ŚĞĂůƚŚ ĐĂƌĞ ĐŽƐƚƐ͖ ϯͿ ŝŵƉƌŽǀĞŵĞŶƚ ĂƌĞĂƐ ŽĨ ƚŚĞ ĐŽƵŶƚƌLJ͘ ŝŶ ƋƵĂůŝƚLJ ŽĨ ĐĂƌĞ͖ ĂŶĚ ϰͿ Ă ƌĞĚƵĐƟŽŶ ŝŶ ĮŶĂŶĐŝĂů ŝŶƐĞĐƵƌŝƚLJ ĂƐ Ă ƌĞƐƵůƚ ŽĨ ĞdžƉĂŶĚĞĚ ĐŽǀĞƌĂŐĞ ĂŶĚ ĂĐĐĞƐƐ͘ ĚĚŝƟŽŶĂůůLJ͕ ŶĚ͕ ĮŶĂůůLJ͕ ƚŚĞ ĂůŝĨŽƌŶŝĂ ,ĞĂůƚŚ ĂƌĞ &ŽƵŶĚĂƟŽŶ ƌĞƉŽƌƚƐ ƚŚĂƚ ŽƉƉŽŶĞŶƚƐ͛ ƉƌĞĚŝĐƚĞĚ ŵĂƐƐŝǀĞ ũŽď ůŽƐƐĞƐ ĂƐ ĞŵƉůŽLJĞƌƐ ƐŽƵŐŚƚ ǁŚŝůĞ ĞŵƉůŽLJĞƌͲƐƉŽŶƐŽƌĞĚ ŝŶƐƵƌĂŶĐĞ ; ^/Ϳ ĂǀĂŝůĂďŝůŝƚLJ ŚĂƐ ďĞĞŶ ƚŽ ĂǀŽŝĚ ƉƌŽǀŝĚŝŶŐ ǁŽƌŬĞƌƐ ǁŝƚŚ ŚĞĂůƚŚ ĐŽǀĞƌĂŐĞ ŚĂƐ ŶŽƚ LJĞƚ ŽŶ ƚŚĞ ĚĞĐůŝŶĞ ƐŝŶĐĞ ϮϬϬϵ͕ ƚŚĞ ƋƵĞƐƟŽŶ ŽĨ ǁŚĞƚŚĞƌ ƚŚĞ ŵĂƚĞƌŝĂůŝnjĞĚ͘ ŽƚŚ ƚŚĞ WƌĞƐŝĚĞŶƚ ĂŶĚ ƌ͘ KƌnjĂŐ ĂĐŬŶŽǁůĞĚŐĞ ƌĞĨŽƌŵƐ ǁŽƵůĚ ĨƵƌƚŚĞƌ ĞƌŽĚĞ ^/ ƐĞĞŵƐ ƚŽ ŚĂǀĞ ďĞĞŶ ĂŶƐǁĞƌĞĚ͗ ŇĂǁƐ ƚŚĂƚ ĐŽƵůĚ ĂŶĚ ƐŚŽƵůĚ ďĞ ĮdžĞĚ͕ ƉŽůŝƟĐƐ ƉĞƌŵŝƫŶŐ͕ ĂŶĚ ƚŚĞ ƚŚĞ ϮϬϭϱ ĂůŝĨŽƌŶŝĂ ŵƉůŽLJĞƌ ,ĞĂůƚŚ ĞŶĞĮƚƐ ^ƵƌǀĞLJ ŝŶĚŝĐĂƚĞƐ WƌĞƐŝĚĞŶƚ ŶŽǁ ŝƐ ĂĚǀŽĐĂƟŶŐ ĨŽƌ Ă ƉƵďůŝĐ ƉůĂŶ ŽƉƟŽŶ ƚŚƌŽƵŐŚ ƚŚĞ ĂǀĂŝůĂďŝůŝƚLJ ŽĨ ^/ ƌĞŵĂŝŶĞĚ ƐƚĂďůĞ ŝŶ ƚŚĞ ƐƚĂƚĞ ĨŽůůŽǁŝŶŐ ƚŚĞ ĞdžĐŚĂŶŐĞƐ͘ dŚĞ ŚĞĂůƚŚ ďĞŶĞĮƚƐ ŽĨ ĐŽǀĞƌŝŶŐ ϮϬ ŵŝůůŝŽŶ ŵŽƌĞ ŝŵƉůĞŵĞŶƚĂƟŽŶ͘ ŽƚŚ ƚŚĞ ƐŚĂƌĞ ŽĨ ĮƌŵƐ ŽīĞƌŝŶŐ ĐŽǀĞƌĂŐĞ ŝŶĚŝǀŝĚƵĂůƐ ŚĂǀĞ LJĞƚ ƚŽ ďĞ ƉƌŽǀĞŶ͖ ƐƟůů͕ Ă ƌĞĐĞŶƚ ƐƚƵĚLJ ĐŽŵƉĂƌŝŶŐ ďĞƚǁĞĞŶ ϮϬϭϯ ĂŶĚ ϮϬϭϱ ĂŶĚ ƚŚĞ ƐŚĂƌĞ ŽĨ ĞŵƉůŽLJĞĞƐ ǁŽƌŬŝŶŐ ĨŽƌŵĞƌůLJ ƵŶŝŶƐƵƌĞĚ ŝŶĚŝǀŝĚƵĂůƐ ŝŶ ŽŶĞ ƐƚĂƚĞ ƚŚĂƚ ĞdžƉĂŶĚĞĚ Ăƚ ĮƌŵƐ ŽīĞƌŝŶŐ ƐƵĐŚ ĐŽǀĞƌĂŐĞ ƌĞŵĂŝŶĞĚ ƐƚĂďůĞ͘ EĞŝƚŚĞƌ ĚŽĞƐ DĞĚŝĐĂŝĚ ĐŽǀĞƌĂŐĞ ǁŝƚŚ ĂŶŽƚŚĞƌ ƐƚĂƚĞ ƚŚĂƚ ĚŝĚ ŶŽƚ ŝŶĚŝĐĂƚĞƐ ƚŚĞƌĞ ĂƉƉĞĂƌ ƚŽ ďĞ Ă ƐŚŝŌ ďLJ ĞŵƉůŽLJĞƌƐ ĨƌŽŵ ĨƵůůͲƟŵĞ ǁŽƌŬ ƐŽŵĞ ƉŽƐŝƟǀĞ ĐŚĂŶŐĞ ĂŵŽŶŐ ŝŶƐƵƌĞĚƐ ŝŶ ǁŚĂƚ ƚŚĞ ĂƵƚŚŽƌƐ ƚĞƌŵ ƚŽ ƉĂƌƚͲƟŵĞ ǁŽƌŬĞƌƐ ƚŽ ĂǀŽŝĚ ĞůŝŐŝďŝůŝƚLJ ĨŽƌ ^/ ƉůĂŶƐ͘ /Ŷ ĨĂĐƚ͕ Ă ŵĂƐƐŝǀĞ ŶĂƚƵƌĂů ĞdžƉĞƌŝŵĞŶƚ͘ ĂĐĐŽƌĚŝŶŐ ƚŽ ƚŚĞ ƌĞƐĞĂƌĐŚ͕ ĮƌŵƐ ǁŝƚŚ Ă ůĂƌŐĞƌ ƐŚĂƌĞ ŽĨ ůŽǁͲǁĂŐĞ ĞŵƉůŽLJĞĞƐ ;ŵŽƌĞ ƚŚĂŶ ϯϱ ƉĞƌĐĞŶƚ ŽĨ ǁŽƌŬĞƌƐ ĞĂƌŶŝŶŐ ůĞƐƐ ƚŚĂŶ KƚŚĞƌ ďĞŶĞĮƚƐ ŽĨ ƚŚĞ ŵĞŶƟŽŶĞĚ ďLJ WƌĞƐŝĚĞŶƚ KďĂŵĂ ΨϮϯ͕ϬϬϬ ƉĞƌ LJĞĂƌͿ͕ ͞ƚŚĞ ƉƌŽƉŽƌƟŽŶ ŽĨ ǁŽƌŬĞƌƐ ǁŚŽ ǁĞƌĞ ĞůŝŐŝďůĞ ŝŶĐůƵĚĞ ĂĐĐĞƐƐ ƚŽ Ă ĐŽƌĞ ƐĞƚ ŽĨ ŚĞĂůƚŚ ƐĞƌǀŝĐĞƐ ;ŝŶĐůƵĚŝŶŐ ĨŽƌ ĐŽǀĞƌĂŐĞ ĂĐƚƵĂůůLJ ŝŶĐƌĞĂƐĞĚ ƐŝŐŶŝĮĐĂŶƚůLJ ĨƌŽŵ ϲϮ͘ϯ ƉĞƌĐĞŶƚ ŵĂƚĞƌŶŝƚLJ ĐĂƌĞ ĂŶĚ ƚƌĞĂƚŵĞŶƚ ĨŽƌ ŵĞŶƚĂů ŚĞĂůƚŚ ĂŶĚ ƐƵďƐƚĂŶĐĞ ƚŽ ϳϲ͘ϳ ƉĞƌĐĞŶƚ͟ ĚƵƌŝŶŐ ƚŚŽƐĞ LJĞĂƌƐ͕ ĂůƚŚŽƵŐŚ ƚŚĞ ŽǀĞƌĂůů ƐŚĂƌĞ ƵƐĞ ĚŝƐŽƌĚĞƌƐͿ͕ ĐŽǀĞƌĂŐĞ ŽĨ ƌĞĐŽŵŵĞŶĚĞĚ ƉƌĞǀĞŶƟǀĞ ƐĞƌǀŝĐĞƐ ŽĨ ĞůŝŐŝďůĞ ĞŵƉůŽLJĞĞƐ ǁŚŽ ĂĐƚƵĂůůLJ ĞŶƌŽůůĞĚ ŝŶ ^/ ĐŽǀĞƌĂŐĞ ǁŝƚŚŽƵƚ ĐŽƐƚͲƐŚĂƌŝŶŐ͕ ŝŶĐůƵĚŝŶŐ ǁŽŵĞŶ͛Ɛ ƉƌĞǀĞŶƟǀĞ ƐĞƌǀŝĐĞƐ ĚĞĐůŝŶĞĚ ĨƌŽŵ ϴϲ͘ϰ ƉĞƌĐĞŶƚ ƚŽ ϴϬ͘Ϯ ƉĞƌĐĞŶƚ ŝŶ ƚŚĂƚ ƉĞƌŝŽĚ͕ ĐůŽƐĞƌ ƐƵĐŚ ĂƐ ĐŽŶƚƌĂĐĞƉƟǀĞ ĐŽǀĞƌĂŐĞ ĂŶĚ ƐĐƌĞĞŶŝŶŐ ĂŶĚ ĐŽƵŶƐĞůŝŶŐ ƚŽ ƚŚĞ ŶĂƟŽŶĂů͕ ƵŶĐŚĂŶŐĞĚ ĂǀĞƌĂŐĞ ŽĨ ϳϵ ƉĞƌĐĞŶƚ͘ ĨŽƌ ĚŽŵĞƐƟĐ ĂŶĚ ŝŶƚĞƌƉĞƌƐŽŶĂů ǀŝŽůĞŶĐĞ͕ ƉƌŽƚĞĐƟŽŶ ĂŐĂŝŶƐƚ ĐĂƚĂƐƚƌŽƉŚŝĐ ĐŽƐƚƐ͕ ĞůŝŵŝŶĂƟŽŶ ŽĨ ůŝĨĞƟŵĞ ůŝŵŝƚƐ ŽŶ ĐŽǀĞƌĂŐĞ ĂŶĚ ŵŽŶŐ ƚŚĞ ƉŽƚĞŶƟĂů ƌĞĂƐŽŶƐ ĨŽƌ ƚŚĞ ůŽǁĞƌ ƚŚĂŶ ĞdžƉĞĐƚĞĚ ĐĂƉƐ ŝŶ ŵŽƐƚ ƉůĂŶƐ ŽŶ ĞŶƌŽůůĞĞƐ͛ ĂŶŶƵĂů ŽƵƚͲŽĨͲƉŽĐŬĞƚ ĞdžƉĞŶƐĞƐ͘ ĐŽƐƚƐ ĂƌĞ ĚŽǁŶƚƵƌŶƐ ŝŶ ƚŚĞ ďƵƐŝŶĞƐƐ ĐLJĐůĞƐ͕ ďĞŚĂǀŝŽƌ ĐŚĂŶŐĞƐ ƚŚĂƚ ĂŶƟĐŝƉĂƚĞĚ ĐŽƐƚ ƐĂǀŝŶŐƐ ŝŶŝƟĂƟǀĞƐ͕ ŝŶĐůƵĚŝŶŐ ƌĞĚƵĐĞĚ ƌ͘ KƌnjĂŐ ĞdžĂŵŝŶĞƐ ƐŽŵĞ ƵŶĂŶƟĐŝƉĂƚĞĚ ƌĞƐƵůƚƐ͗ ƐƵƌƉƌŝƐŝŶŐ ŚŽƐƉŝƚĂů ƌĞĂĚŵŝƐƐŝŽŶƐ ;ƌĞƐƵůƟŶŐ ĨƌŽŵ ĞīŽƌƚƐ ƵŶĚĞƌƚĂŬĞŶ ďLJ ƌĞĚƵĐƟŽŶ ŝŶ DĞĚŝĐĂƌĞ ƐƉĞŶĚŝŶŐ ƉĞƌ ďĞŶĞĮĐŝĂƌLJ ƚŚƌŽƵŐŚ ŚŽƐƉŝƚĂůƐ ĞǀĞŶ ďĞĨŽƌĞ ƉĞŶĂůƟĞƐ ǁĞŶƚ ŝŶƚŽ ĞīĞĐƚ͊Ϳ ĂŶĚ ůŽǁĞƌ ϮϬϭϰ ĂŶĚ Ă ĚĞĐůŝŶĞ ŝŶ ŽǀĞƌĂůů ŚĞĂůƚŚ ĐĂƌĞ ƐƉĞŶĚŝŶŐ͘ ,Ğ ĐŝƚĞƐ ƌĂƚĞƐ ŽĨ ŚŽƐƉŝƚĂůͲĂĐƋƵŝƌĞĚ ŝŶĨĞĐƟŽŶƐ͘ KƚŚĞƌ ƐƵƌƉƌŝƐŝŶŐ ŽƵƚĐŽŵĞƐ͗ Ă ZŽďĞƌƚ tŽŽĚ :ŽŚŶƐŽŶ &ŽƵŶĚĂƟŽŶͲhƌďĂŶ /ŶƐƟƚƵƚĞ ĂŶĂůLJƐŝƐ ĂŶ ŝŶĐƌĞĂƐĞ ŽĨ ŽŶĞ ƚŚŝƌĚ ŝŶ DĞĚŝĐĂƌĞ ĚǀĂŶƚĂŐĞ ĞŶƌŽůůŵĞŶƚ ƐƵŐŐĞƐƟŶŐ ŶĂƟŽŶĂů ŚĞĂůƚŚ ĞdžƉĞŶĚŝƚƵƌĞƐ ǁŝůů ďĞ ϭϭ ƉĞƌĐĞŶƚ ůŽǁĞƌ ĚĞƐƉŝƚĞ Ă ƐŝŐŶŝĮĐĂŶƚ ƉĂLJŵĞŶƚ ƌĞĚƵĐƟŽŶ ĨŽƌ ƚŚĂƚ ƉƌŽŐƌĂŵ ĂŶĚ ƚŚĂŶ ƉƌŽũĞĐƚĞĚ ĨƌŽŵ ϮϬϭϰͲϭϵ͘ KĨ ĐŽŶĐĞƌŶ ŝŶ ŽƵƌ ŽǁŶ ƐƚĂƚĞ͕ ƐƚĂďŝůŝƚLJ ŝŶ ĞŵƉůŽLJŵĞŶƚ ŽīĞƌĞĚ ŝŶƐƵƌĂŶĐĞ ĚĞƐƉŝƚĞ ƉƌĞĚŝĐƟŽŶƐ ŚŽǁĞǀĞƌ͕ ŝƐ Ă ϭϯ ƉĞƌĐĞŶƚ ĂǀĞƌĂŐĞ ŝŶĐƌĞĂƐĞ ŝŶ ƉƌĞŵŝƵŵƐ ĨŽƌ ƉůĂŶƐ ƚŚĂƚ ĞŵƉůŽLJĞƌƐ ǁŽƵůĚ ĞŶĚ ƐƵĐŚ ƉůĂŶƐ͕ ƉŽƚĞŶƟĂůůLJ ƐĞŶĚŝŶŐ ƉƵƌĐŚĂƐĞĚ ƚŚƌŽƵŐŚ ŽǀĞƌĞĚ ĂůŝĨŽƌŶŝĂ ; Ϳ͕ ĂůƚŚŽƵŐŚ ŽĸĐŝĂůƐ ĞŵƉůŽLJĞĞƐ ƚŽ ƚŚĞ ŝŶƐƵƌĂŶĐĞ ĞdžĐŚĂŶŐĞƐ ŝŶƐƚĞĂĚ͘

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California Family Physician Fall 2016

Excellent Physician Opportunities Enjoy Work - Life Balance in the Gateway to the Sierras

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• Short distance to hiking in 2 National Parks • Numerous lakes • Biking, Fishing, Hunting, Golf, as well as other outdoor activities available

• Close to International airport • Excellent schools • Low cost of living • High Quality Medical Care

Now Seeking: Family Medicine • Internal Medicine Competitive compensation, signing bonus, annual physician bonus, malpractice coverage.

Please send CV to CVIH HR: 2740 Herndon Ave., Clovis, CA 93611 or email to hr@cvih.org

Central Valley Indian Health, Inc.

Hiring in accordance with Indian Pref. Act.

NAPA VALLEY WINE COUNTRY OUTPATIENT FP POSITIONS Hospital supported outpatient FP positions in desirable growing community of 135,000 nestled in the Napa Wine Country 45 minutes to San Francisco associated with award winning 200 bed health system. Refer inpatients to Hospitalist program. New and modern clinic facilities. Excellent 5 year salary guarantee, signing bonus, production bonus, benefits and relocation. High income projection.

314-984-0624 donohueandassoc@aol.com

FAMILY MEDICINE/PEDIATRIC MEDICINE

Vista Community Clinic With locations in Vista/No San Diego County, Lake Elsinore/So Riverside County and La Habra/Orange County Seeking: Full-time, part-time and per diem Family Medicine Physicians and Pediatricians. Requirements: California license, DEA license, CPR certification and board certified in family medicine. Bilingual English/Spanish preferred.

Contact c Us: Visitt our website at a ww www.vistacommunityclinic.org r Forward resume to hr@vistacommunityc t linic.org r or fax resume to 760-414-3702

UCSF FRESNO FAMILY MEDICINE FACULTY POSITION The UCSF Fresno Medical Education Program and Central California Faculty Medical Group (CCFMG) are recruiting for a physician to join the teaching faculty. The successful applicant should be board certified or board eligible in Family Medicine, have a license to practice medicine in the United States, and be eligible to obtain a California medical license. This position provides an opportunity for teaching, clinical research, and community practice. Proficiency in OB optional. Administrative/leadership opportunities are available. A competitive salary is offered. The program is based in Fresno, California, which offers a high standard of living combined with a low cost of living. The result is a quality of life uniquely Californian, yet surprisingly affordable. Fresno is a vibrant, growing city located in Central California. There is much to see and do in Fresno and the city is ideally located for fast, convenient getaways to the scenic Central Coast as well as the majestic Sierra Nevada mountains. Fresno is the only major city in the country with close proximity to three national parks, including renowned Yosemite National Park.

INTERESTED APPLICANTS PLEASE SEND CV AND 5 REFERENCES TO: Diane O’Connor • Diane.oconnor@ccfmg.org

California Family Physician Fall Fall2016 2016

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CALIFORNIA ACADEMY OF FAMILY PHYSICIANS FOUNDATION 1520 PACIFIC AVE SAN FRANCISCO, CA 94109 -2627

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MIEC Belongs to Our Policyholders!

Toni Brayer, MD Board of Governors

Over the last 20 years California policyholders have saved an average of 25% on premiums with MIEC’s Dividend Program*

Keeping true to our mission MIEC has never lost sight of its original mission, always putting policyholders (doctors like you) first. For over 40 years, MIEC has been steadfast in our protection of California physicians with conscientious Underwriting, excellent Claims management and hands-on California Dividends as % of premiums Loss Prevention services; we’ve partnered with policyholders ($1m/$3m limits) to keep premiums low. 60%

Added value: Q No profit motive and low overhead Q Supports Organized medicine in Califonria For more information or to apply: Q www.miec.com Q Call 800.227.4527 Q Email questions to underwriting@miec.com

50%

MIEC Average Dividend MPL Industry Average Dividend

40% 30% 20% 10%

No Profits No Dividends

0% * On premiums at $1/3 million limits. Future dividends cannot be guaranteed.

MIEC 6250 Claremont Avenue, Oakland, California 94618 s 800-227-4527 s www.miec.com CalFamPhy_ad_09.09.16

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MIEC Owned by the policyholders we protect.

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