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Primary Care: FM Opportunities
At the end of the day, this is where you want to be. Join the Banner Health Team, in an outdoor paradise where the beautiful Sierra Nevada and Cascade mountains meet the desert of the Great Basin in Susanville, California – where you’ll have the time to connect with your patients, your practice, your family and the great outdoors! We offer dedication to work/life balance unmatched in our industry. Meaning you get to spend more time doing what you love. That’s HEALTH CARE made easier, LIFE made better! • $240K Salary Guarantee • $100K Sign-On Bonus • $100K Educational Loan Repayment • Eligible for $50K from California Health Planning • Eligible for Public Service Loan Forgiveness • Eligible for HRSA Educational Loan Repayment • Retention Bonus • Focus on Patient and Provider Well-Being • Top of Market Compensation and Benefits
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816 21st Street • Sacramento, California 95811 • www.familydocs.org Phone (415) 345-8667 • Fax (415) 345-8668 • E-mail: cafp@familydocs.org
Officers and Board President Lauren Simon, MD, MPH, FAAFP Immediate Past President Shannon Connolly, MD, FAAFP President-elect Raul Ayala, MD, MHCM Speaker Alex McDonald, MD, FAAFP Vice-Speaker Anthony "Fatch" Chong, MD Secretary/Treasurer Brent Sugimoto, MD, MPH, FAAFP Chief Executive Officer Lisa Folberg, MPP Foundation President Ron Labuguen, MD, FAAFP AAFP Delegates Jay Won Lee, MD, MPH, FAAFP Lee Ralph, MD AAFP Alternates Michelle Quiogue, MD Lisa Ward, MD, MPH, FAAFP CMA Delegates Kimberly Buss, MD Felix Nunez, MD Sumana Reddy, MD, FAAFP Kevin Rossi, MD, FAAFP CMA Alternate Delegates Raul Ayala, MD, MCMH Noemi Doohan, MD, PhD Adia Scrubb, MD, MPP David Tran, MD
Staff Lisa Folberg, MPP Chief Executive Officer lfolberg@familydocs.org Anita Charles Program Assistant acharles@familydocs.org Morgan Cleveland Manager of Operations & Governance mcleveland@familydocs.org Jerri Davis, CHCP Vice President, Professional Development, CME/CPD jdavis@familydocs.org Christine Lauryn Manager, Member Communications clauryn@familydocs.org Josh Lunsford Vice President, Membership & Communications jlunsford@familydocs.org Pamela Mann, MPH Executive Director, CAFP Foundation pmann@familydocs.org Catrina Reyes, Esq. Vice President, Policy and Advocacy creyes@familydocs.org Jonathan Rudolph Manager, Finance jrudolph@familydocs.org Tiyesha Watts Legislative & Policy Advocate trwatts@familydocs.org
Brent Sugimoto, MD, Editor Josh Lunsford, Managing Editor The California Family Physician is published quarterly by the California Academy of Family Physicians. Opinions
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EDITION 42 4
California Family Physician Summer 2022
Su mme r 2 0 2 2
features FAMILY MEDICINE RISING: BUILDING ON MOMENTUM 20 From #FMRevolution to #FMRising
Jay W. Lee, MD, MPH, FAAFP
22 CAFP Members In the News • CAFP Welcomes New District Directors • Members Recognized for Achievements in 2022 • John Cheng, MD 28 Passing the Torch – A Farewell Speech from Shannon Connolly, MD, FAAFP
departments 6 Editorial
Spring Awakening
Brent Sugimoto, MD, MPH, FAAFP
8 President’s Message
Family Medicine Connects Us All
10 Political Pulse
Governor’s 2022-23 Proposed Budget Would Expand Access to Health Care in California
Carla Kakutani, MD
14 Legislative Update
Family Physicians Return to Sacramento with Spotlight on Advocacy
Catrina Reyes, Esq.
16 CAFP Foundation
CAFP Foundation Welcomes New President and Members of the Board of Trustees
18 CEO Message
CAFP Sets Strategic Plan for Next Three Years
Shannon Connolly, MD , FAAFP
Pamela Mann Lisa Folberg, MPP
Your Online Resource for Continuing Medical Education. Visit education.familydocs.org
Brent K. Sugimoto, MD, MPH, AAHIVS, FAAFP
editorial
Spring Awakening I recently realized there was something different about my mornings: bird song, lots of it. The singing is frenetic and raucous polyphony, yet those dozens (hundreds?) of voices together are music that is energetic and conveys boundless possibility. During my first waking moments, this literally sets the tone of my day. To me, this is one of the joys of spring. Spring has its own energy, and I think many of us find our own moods lifted by the signs of renewal and regrowth that saturate the senses. This is our literal spring, but figuratively we are also awakening from dormancy in so many ways. This spring has had special resonance for California family doctors. COVID-19 has not disappeared, but its pandemic waves have receded enough that we can tentatively seek the reconnection with colleagues that we have missed over the past two years. Of the many ways the virus was cruel, denying us connection precisely when we needed each other’s support was particularly challenging. At its opening, the All Member Advocacy Meeting in March felt surreal, and I think many in attendance were initially skittish that this long-awaited chance could be snatched back in a moment. Sure, there was some awkwardness as we practiced like social toddlers how to assess personal space in the COVID-era, but the chance to practice was welcome. It did not matter if we interacted with social distance and masks on—we could still feel the realness. Every elbow bump was a salve, and when two felt safe to do so, every deferred hug was a dopamine flood.
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April’s Clinical Forum in San Francisco felt truly celebratory, a reunion that felt like a return home. Dr. Carol Havens, Chair of the Committee on Continuing Professional Development, quipped that she arrived with a no-hugs policy that she had violated many times over by the time she reached the conference ballroom. I think many of us felt uplifted and energized by spring’s events. Hearing and learning from each other were inspiring for envisioning the change we want to see in health care. Trading stories with one another reminded us of our mission. Seeing each other reawakened what we love most about our specialty. In this issue, you will see a sample of what our academy and colleagues are doing in our spring. You will learn about the change in our leadership in the CAFP and CAFP Foundation and the move of our headquarters to Sacramento. You will read about the academy’s plans for shaping the future of medicine with its strategic plan. You will see how much the academy does to advocate for family medicine in the State Capitol. You will also hear about those who move and shape our specialty, such as Dr. Jay W. Lee, who is campaigning to strengthen family medicine nationally as candidate for the AAFP Board of Directors. These snapshots reflect how our nearly 11,000 members are collectively a dynamic force working to advance medicine and our specialty to be better servants to our patients. I think of my morning birds, where each individual voice gives its own color to the composition of a shared musical score. Each family doctor may be singing a different tune, but we are all part of the same song and mission.
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Shannon Connolly, MD, FAAFP CAFP Immediate Past President
Family Medicine Connects Us All *Names have been changed. One of my favorite things about being a family doctor is getting to work on a team with some very special people who teach me so much about how to care for patients. I have a medical assistant, Flor.* She is the secret sauce for a well-run clinic day. She’s 26, a single mom to an 8-year-old and a 4-year-old, still paying off the debt she incurred from going to medical assisting school. She’s bilingual, culturally competent, sharp as a tack, efficient, and kind. She tends to force me to take a lunch break. She has often said to me that had her life circumstances been different, she would have gone to college and pursued nursing or medical school. Instead, she used the resources she had at the time to get to where she is now, and that is why she is my beloved medical assistant. Flor brings a perspective far wiser than her years would suggest. No graduate level coursework on social determinants of health could come close to teaching what Flor understands about our community and the challenges hidden within. We have a patient, Lynn*, a woman in her late 30’s who has been described by other medical professionals as difficult, drugseeking, and borderline. Lynn has neon pink hair, myriad tattoos and piercings, and a penchant for heavy black eyeliner and combat boots. She has been banned from two local ERs and fired from multiple medical practices. Her existence has been punctuated by sexual trauma, abuse, and family dysfunction. Our first encounter was a bit overwhelming…. for me. Somehow, we packed a rambling and sometimes angry narrative about her chaotic life into twenty minutes, along with PTSD, fibromyalgia, pain management, menstrual issues, and the fact that every doctor she had ever had “sucked.” I noted her polypharmacy (15 drugs!) and my long-term plan to simplify her medication regimen. We agreed to meet weekly. At her second visit, Lynn told Flor during triage that no one had ever asked her so many questions about how she was doing and listened so carefully to her answers. Flor pulled up a stool, sat down, and told her, “You can talk to me anytime.” On her third visit with us, Flor–now familiar with the avalanche of problems Lynn would bring up during the triage process, 8
California Family Physician Summer 2022
somehow got on to the topic of birth control. When she brought the chart to me, Flor told me that she wasn’t entirely sure why, but being asked about birth control made Lynn very annoyed, and she thought there was something very important there that I should explore further. Flor’s instinct is always on point, so I dutifully went in and started a conversation with our patient about her reproductive plans. While her narrative was a jumble of angry thoughts and feelings that she had difficulty articulating—despite the use of a lot of expletives and volume, my final understanding of the situation was that her partner was pushing for a pregnancy, but she didn’t have any desire at all to be a mother. She feared abandonment, while also expressing a lot of resentment that he was dismissive of her needs. After confirming that she was in a safe—although perhaps not optimal relationship, I asked Lynn how I could help. Perhaps I overdid it with the open-ended questions. She seemed paralyzed by the prospect of having to sort through her feelings to state a cohesive idea on the topic. She told me I was “getting on her nerves” and instead changed the subject. At the next visit, Flor brought me the chart reporting that Lynn had requested contraception. The patient had interrogated Flor about what would be the “best” birth control for her, and Flor had dutifully provided her with patient information sheets about birth control options. The patient didn’t want to look at them. She wanted to know what Flor thought about birth control. Flor deferred medical questions to me but told Lynn that in her experience, being able to decide the direction of your own life is important. That seemed to resonate with Lynn. By the time I saw her, Lynn seemed pretty clear that she wanted a contraceptive implant. Still, she was very nervous for the insertion. I tried to reassure her, but ultimately, she said, “No offense, doc, but can Flor be there?” So, Flor came back early from her lunch break to sit next to the patient, hold her hand, and chat about music and tattoos. It was an unremarkable procedure, and afterwards, I sent the patient on her way. Halfway down the hall on the way to the check-out desk, Lynn paused, turned around and walked back to Flor, gave her a huge bear hug, and then stomped off without saying anything else.
At the end of the day, I found Flor in the break room, sitting quietly, eyes glistening a bit as though she had been crying recently. I plopped down beside her and asked her if she was okay.
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She smiled and said, “I’m happy, actually. I felt like we made a breakthrough with Lynn today. She asked for me, because she thought I could help her! This was the highlight of my week. It helped me decide I want to go back to school.” Flor felt that being needed by that patient and being able to respond to that need is one of the most healing and rewarding aspects of medicine. She’s right. That patient didn’t need me that day, she needed Flor. My medical assistant was her healer and provided what she needed. In the same way, the patient provided Flor with what she needed, too. This is why I love family medicine, and all the people on the medical team. Our incredible field brings diverse people together and enables connections that heal each of us and give us purpose.
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California Family Physician Summer 2022
9
political pulse
Carla Kakutani, MD Chair, CAFP Legislative Affairs Committee
Governor’s 2022-23 Proposed Budget Would Expand Access to Health Care in California Governor Gavin Newsom released his 2022-23 Budget Proposal on Monday, January 10, 2022. The budget proposal includes key investments to improve access to health care services and to support COVID-19 response efforts. California’s fiscal outlook looks strong for 2022-23 with a $286.4 billion budget and a projected $45.7 billion surplus, which includes $20.6 billion in General Fund for discretionary purposes.
•
Expansion of Medi-Cal Coverage – Provide fullscope Medi-Cal coverage to all income-eligible adults aged 26 through 49 regardless of immigration status by January 1, 2024
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Reproductive Health ○ Increased flexibility for Medi-Cal providers to provide clinically appropriate medication abortion services by removing requirements for in-person follow up visits and ultrasounds, if not clinically indicated
More than 20 percent of the Governor’s proposed budget is dedicated to health-related expenditures.
○ Adding the human papillomavirus vaccine as a covered benefit under the Family PACT program ○ One-time funding of $20 million to the Department of Health Care Access and Information (HCAI) to provide scholarships and loan repayments to a variety of health care provider types that commit to providing reproductive health care services ○ One-time funding of $20 million in grant funding to HCAI to assist reproductive health care facilities in securing their physical and information technology infrastructure and to enhance facility security •
The budget includes: •
COVID-19 Response - $2.7 billion COVID-19 response to bolster testing capacity, accelerate vaccination and booster efforts, support frontline workers, strengthen the health care system and battle misinformation
•
Insulin Affordability - Potential partnership with a contract manufacturer of insulin to make the cost of insulin more affordable and accessible
Behavioral Health ○ $10 million to administer a competitive grant program to prevent and treat depression, as part of the California Initiative to Advance Precision Medicine ○ $26 million to HCAI to support training providers to build out the substance use disorder (SUD) workforce with a focus on opioid treatment ○ $96 million General Fund in 2022-23 and $61 million ongoing General Fund for the Medication Assisted Treatment (MAT) Expansion Project continued on page 12
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California Family Physician Summer 2022
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○ $5 million to the Department of Health Care Services (DHCS) for the distribution of naloxone to homeless service providers •
ACEs Provider Training - One-time $135.1 million over a three-year period to extend Medi-Cal provider training for Adverse Childhood Experience (ACEs) screenings
•
Medi-Cal Community Based Mobile Crisis Services Funding for multi-disciplinary mobile response services for crises related to mental health and substance use disorders as a new Medi-Cal benefit by January 1, 2023
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CalAIM - $2.8 billion for the upcoming fiscal year to implement CalAIM initiatives, which aim to achieve broadbased delivery system, program, and payment reform across the Medi-Cal program. CalAIM will apply a wholeperson care approach that integrates health care and other social determinants of health to this statewide program, with a clear focus on improving health and reducing health disparities and inequities, including improving and expanding behavioral health care.
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Proposition 56 (tobacco tax) Provider Payments $176 million in General Fund to support reduced Proposition 56 revenue caused by the decline in tobacco use.
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Medi-Cal Provider Equity Payments -To promote patientcentered models of care, the Budget includes one-time $400 million ($200 million General Fund) for provider payments focused on advancing equity and improving quality in children’s preventive, maternity, and integrated behavioral health care.
CAFP will work with legislative offices and allies to support the Governor’s proposals to expand and improve health care in California. CAFP will also continue to work with the Administration and the Legislature to ensure California further builds the primary care physician workforce. CAFP’s Key Contacts receive these updates through the weekly Legislative Update. To receive information on what's happening in Sacramento, sign-up to be a Key Contact at www.familydocs.org.
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Apply online at: www.governmentjobs.com/careers/tulare 12
California Family Physician Summer 2022
Department of Veterans Affairs
Redding VA Outpatient Clinic, Redding, CA Chico VA Outpatient Clinic, Chico, CA
Supervisory and Staff Physician Positions Available These Northern California locations have a lot to offer to those seeking good weather and an abundance of outdoor activities such as hiking, snow skiing, boating and fishing. Enjoy the area’s beautiful rural settings with access to many national parks, rivers, and lakes. Whether you’re interested in work/life balance, research or academics you will find that working for the VA offers many benefits.
the Best Mission in all Healthcare Redding — TakingVACare of Veterans! Department ofJoin Veterans Affairs Outpatient Clinic, Redding, CA Eligible applicants should be able to provide comprehensive primary care, including gender specific care (e.g. Women’s Health). Our practice has earned national Outpatient Chico, CA and international recognition as the best care delivered anywhere. Outstanding working conditionsChico allow forVA a satisfying career withClinic, a high quality of life along with a competitive salary and excellent benefits including malpractice insurance.
Supervisory &beStaff Physician Positions Available Candidates must: 1) be a US citizen or PRA (Non-citizens may appointed when it is not possible to recruit qualified citizens in accordance with [38 U.S.C. § 7407(a)]; 2) possess a current, full, unrestricted medical license in any state, and 3) board prepared/certified in Internal or Family Medicine, 4) Supervisor candidates These Northern California locations have a lot to offer to those seeking goodvaccination weather and for an abundance of outdoor and activities such as hiking, snow2019 skiing,(COVID-19), boating and which fishing. are Enjoy should have demonstrated leadership experience, and 5) confirm seasonal influenza Coronavirus Disease both requirements for all Health Care Personnel employed byrivers, Department Veteransyou’re Affairs. the area’s beautiful rural settings with access to (HCP) many national parks, and lakes.ofWhether interested in work/life balance, research or academics you will find that working for the VA offers many benefits. Education Debt Reduction Program (up to $200,000/tax free over 5-years) and/or Recruitment Incentive authorized.
Join the best mission in all of healthcare - taking care of Veterans!
Eligible applicants should be able to provide comprehensive primaryTo care, including gender specific care (e.g. Women's Health). Our practice has earned national and international apply, forward current CV to VA Healthcare Recruiter: Crystal.Keeler@va.gov recognition as the best care delivered anywhere. Outstanding working conditions allow for a satisfying career with a high quality of life along with a competitive salary and excellent benefits including malpractice insurance. Candidates must: 1) be a US citizen or PRA (Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with [38 U.S.C. § 7407(a)]; 2) possess a current, full, unrestricted medical license in any state, and 3) board prepared/certified in Internal or Family Medicine, 4) Supervisor candidates should have demonstrated leadership experience, and 5) confirm vaccination for seasonal influenza and Coronavirus Disease 2019 (COVID-19), which are both requirements for all Health Care Personnel (HCP) employed by Department of Veterans Affairs. To apply, forward a current CV to VA Healthcare Recruiter: Crystal.Keeler@va.gov Education Debt Reduction Program (up to $200,000/tax-free over 5-years) and/or Recruitment Incentive authorized.
California Family Physician Summer 2022
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legislative update
Catrina Reyes, Esq.
Vice President of Advocacy and Policy
Family Physicians Return to Sacramento with Spotlight on Advocacy In mid-March, more than 150 family physicians, residents, and medical students from across the state met in Sacramento for CAFP’s All Member Advocacy Meeting (AMAM). AMAM gives members the opportunity to bring policy issues to the Academy for its consideration. This year, attendees provided testimony on nine resolutions submitted to the Board of Directors for consideration. Also during AMAM, the Academy’s leaders for the coming year were elected and we celebrated the efforts and achievements of those who worked to advance issues important to family physicians. Alex McDonald, MD, FAAFP was awarded the Hero of Family Medicine award for his relentless advocacy for patients, colleagues, and the family medicine specialty. Assemblymember Cecilia Aguiar-Curry was named CAFP’s 2022 Champion of Family Medicine for her work in expanding access to care through telehealth and for authoring the Family Physician Week resolution. AMAM develops successive waves of family physicians trained and dedicated to being the most effective advocates possible for their patients and specialty – whether in their own communities, in Sacramento, or even Washington, D.C. Through advocacy training and education on priority issues, AMAM ensures our family physician advocates are conversant and comfortable with the key issues confronting family medicine and health care. This year, the keynote speaker was Mike Madrid, who is most recently known for co-founding the influential national movement, the Lincoln Project. Mr. Madrid discussed the upcoming elections and the changing voter profile. We were also honored to be joined by State Senator Richard Pan, MD, and CAFP’s very own Jasmeet Bains, MD, who is currently running for State Assembly in the Central Valley. Dr. Pan and Dr. Bains shared their journeys to their leadership roles and insights on how to take on these leadership roles. Following the panel of physician leaders was another stellar panel of health policy experts - Christopher Koller, president of the Milbank Memorial Fund, and Diane Rittenhouse, MD, senior fellow at Mathematica and Professor of Family Medicine and Health Policy at UCSF. Mr. Koller and Dr. Rittenhouse went over the National Academies of Sciences, Engineering,
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California Family Physician Summer 2022
and Medicine’s report on implementing high-quality primary care and how California can invest in primary care. Advocacy training is a key component of AMAM so attendees received a legislative briefing of CAFP’s advocacy priorities from CAFP’s advocacy team. Attendees were also provided with insights from legislative staffers - Brett Williams, Chief of Staff for Assembly Member Jacqui Irwin, Katie Phillips, Senior Advisor to Assembly Member James Gallagher, and Israel Landa, Legislative Director for Assembly Member Carlos Villapudua - on how to craft a message and meet with legislators. Attendees were able to practice what they learned through a role playing exercise. The Family Physicians Political Action Committee (FP-PAC) exceeded the goal set for the weekend and almost doubled the amounts raised in previous years. FP-PAC is the only political action committee in California that has the sole mission of promoting family physicians and family medicine. At the end of the first day of AMAM, FP-PAC contributors attended a donor reception at Smic’s Sip & Quip with legislative guests Assemblymember Adam Gray (District 21, Merced & Stanislaus), Assemblymember Kevin McCarty (District 7, Sacramento, Yolo), and Dave Jones (Candidate for State Senate). The week following AMAM was Family Physician Week. Assemblymember Aguiar-Curry authored a resolution designating the week of March 13, 2022, to March 19, 2022 as Family Physician Week. Assemblymember Aguiar-Curry presented the resolution on the Assembly Floor on March 14th with CAFP’s Executive Committee as guests in the gallery. CAFP’s Lobby Days were held during this week, which allowed CAFP family physician advocates to educate legislators and their staffers on the breadth of family physician training and the diverse populations family physicians serve. Over the course of 66 legislative meetings, advocates also asked legislators to support an additional General Fund expenditure of $60 million dollars allocated over three years to the Song-Brown program for primary care graduate medical education (GME) programs. Make sure to join us next year! Save the date for the 2023 All Member Advocacy Meeting - March 25-26, 2023. To stay in the loop on CAFP's advocacy efforts, sign up to be a Key Contact at www.familydocs.org.
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California Family Physician Summer 2022
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CAFP Foundation
CAFP Foundation Welcomes New President and Members of the 2022 is already off to an eventful and exciting start for the CAFP Foundation! As the year kicked-off, the CAFP Foundation Board of Trustees (BoT) and the CAFP Board of Directors affirmed a new President and slate of candidates. We are grateful for the generous support, perspective and expertise from our outgoing Trustees and are thrilled to welcome a new group of leaders. Continue reading for a message from the immediate past President, incoming President, and to see a list of the current Trustees. A Message from our Outgoing President, Dr. Marianne McKennett I must say, it has been a wonderful journey and experience leading the CAFP Foundation. With a career spent in Medical Education, I was drawn to the mission of the CAFP Foundation to support medical students and family medicine residents. Over the past four years, I have watched our work take root - we’ve reached more student-resident members, sustained meaningful programs, implemented successful events and launched new activities that include poster presentations, leadership programs, clinical workshops, and mentorship. With student and resident input, we have renewed our mission statement to reflect the goals of the CAFP Foundation. I am so pleased to have served during such a dynamic time of growth, innovation and transition. It has been a joy to welcome Pamela Mann as the new CAFP Foundation Executive Director. She has already led us forward in our mission. I am also humbled by the generosity and grit of our CAFP community. Together, we have supported critical development opportunities for our future family physicians through scholarships, fellowships, and research grants. Even when the world felt a bit on hold, we continued our efforts to support medical students and residents in their academic and professional journeys. This makes me reflect on what it means to carry out the Foundation’s mission. Philanthropy is at the heart of what the organization does. In fact, it's even how we begin our mission statement: through philanthropy. This potential of giving to build up the next generation of family physicians is so profound - so it must be nurtured and promoted, even during these extraordinary times. This year the CAFP Foundation engaged in a robust process to select Board members that reflect our mission and the diversity of Family Medicine in California. I look forward to seeing what the next year brings, as Dr. Ron Labuguen steps into his new role as President and leads initiatives to invest in the bright future of family medicine in California.
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California Family Physician Summer 2022
Board of Trustees A Message from our Incoming President, Dr. Ronald Labuguen Let me begin by expressing a deep appreciation for Dr. McKennett’s long standing leadership and unwavering dedication to supporting students and residents. I am truly honored by the opportunity to step into this role and continue this work as your next CAFP Foundation President. Because of the pandemic, our terms on the Board of Trustees were extended an extra year. So, with this year, we had the opportunity to recruit quite a few new Trustees this past fall. I was thrilled to see several excellent candidates putting their names forward — what a positive indication of interest in our organization, the desire to shape our work, and the opportunity to enhance diverse views and fresh ideas, which are vitally important to realizing our vision and mission. As we look ahead to this year, I’m excited about the development of a new strategic plan that will carry the Foundation into the future with a clear vision of who we are and the role we wish to play in our field. I’m also looking forward to reflecting and learning, with a conviction that our investment in medical students, family medicine residents and early career physicians will continue to lead to impactful opportunities and program offerings that build a strong, capable, and vibrant workforce. More than ever, we will strive to inspire and be inspired by a new generation of family physicians.
CAFP Foundation Board of Trustees Ronald Labuguen, MD
Scott Kessenick, Esq
Marianne McKennett, MD
Wendy Lee, MBA
Irina de Fischer, MD
Nadine Grace-Abraham, MD
Tom Bent, MD
Christina Spandler, MD
Anna Askari, MD, MSBS
Mohammed Rafae
Lalita Abhyankar, MD, MHS
Pranshul Goel
Parastou Farhadian, MD, CPE
California Family Physician Summer 2022
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ceo message
By Lisa Folberg, MPP, CAFP CEO
CAFP Sets Strategic Plan for Next Three Years The last two years were full of tumult. We had to pivot, bob and weave through two years of the unexpected. Your CAFP staff and physician leadership were able to navigate the disruptions that resulted from COVID, in part, because our strategic plan helped us stay focused on big picture goals even in the midst of unpredictable events. COVID-19 required reaction, it required flexibility. Our strategic plan objectives, the specific milestones identified for achieving the larger strategic goals had to shift. However, our strategic goals, the broad longer term outcomes CAFP wanted to achieve, remained our North Star. I believe our strategic plan helped us avoid the pitfall of focusing too much on immediate goals and losing sight of the big picture, even as we were riding the wave of unpredictable events. The strategic plan helped senior staff and physician leadership make shorter term decisions based on longer term goals. It is appropriate that 2022 marks the beginning of a new CAFP three-year strategic plan. It finally seems that we can dare to be hopeful and ambitious. We were also able to apply some of what we learned from living and working through the pandemic. I am a reformed strategic planning skeptic. I have lived through some painful strategic planning processes and even worse, seen valuable process translate to an abandoned, dusty binder of goals and objectives. Of course, the strategic plan is much more than goals and objectives. A big part of the value of a strategic plan is taking
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the time to review and evaluate our organizational mission and vision, and to be very purposeful in thinking about how we prioritize our CAFP staff time, our physician leaders’ time and our members’ resources. The new CAFP strategic plan began on January 1, 2022, and will take us through December 2024. Our intent was to
develop goals and objectives that were achievable and ambitious. In developing our strategic goals, we asked the questions: does this disproportionately affect family physicians? And can CAFP have an impact on the issue in the next three years? The biggest challenge in developing CAFP’s strategic plan was not finding things to do, it was not including everything! As family
physicians, your holistic approach to patient care means every issue that impacts a community, a patient, the health care system and the practice of medicine is relevant to family physicians.
‐ Strategic goals: the broad outcomes CAFP wants to achieve ‐ Objectives: the more specific milestones for achieving the goals The strategic plan goals and objectives were borne of months of work by the Board and staff with the help of our amazing strategic planner, Karin Bloomer. The work really began over a year before with our member survey. Many of you participated in a random sample survey of member priorities and expectations. This survey was one of the ways we were able to incorporate a larger cross-section of member input. Using this knowledge foundation, the Board identified major issues CAFP should address in the next three years. Staff weighed in, as did CAFP Chapter leaders, and general membership to develop four broad strategic goals. These are the broad outcomes CAFP wants to achieve. CAFP’s Four Strategic Goals are: 1. Advance Payment Reform and System Transformation 2. Raise the Profile of Family Medicine 3. Prioritize Justice Through Diversity, Equity and Inclusion 4. Alleviate Burnout and Support Member Wellness and Joy in Medicine The Board also developed a supporting set of objectives. The objectives are more specific milestones for achieving the goals. Your CAFP Board also developed and refined our organizational mission, vision, and values. These elements represent CAFP’s organizational DNA: tapping into
our individual and collective purpose; articulating what CAFP does, why it does it, and for whom; imagining an optimal future for our communities and your specialty; and describing the attributes that CAFP must demonstrate to successfully serve family physicians. Your Board stepped up with creative thinking, pragmatism and a lot of hard work. Our mission defines what CAFP does, for whom, and why and our vision describes the optimal future that CAFP will work to achieve. The vision statement is about where we are going. Our strategic plan guides us closer to our vision. The Board’s work gave me the direction I need as CEO to lead the organization on the “how”—by developing and operationalizing a 2022 work plan with strategies that
Mission: CAFP empowers, educates, and connects current and future family physicians to optimize health for all. Vision: Thriving communities where every individual has the knowledge, power, and resources to achieve their optimal health and fullest potential. advance CAFP’s goals and objectives. Health care policy, advocacy and the practice of medicine never sit idle and are rarely completely predictable. The strategic plan will help your CAFP staff and physician leaders to stay focused and use our organizational resources most efficiently.
Help Your Patients Make Better Informed Decisions About Their Care The California Prostate Cancer Coalition, founded in 1997 as a 501(c)(3) not-for-profit organization, is dedicated to savings men’s lives www.prostatecalif.org https://naspcc.org/docs/informed-decision-9-11-17.pdf www.naspcc.org California Family Physician Summer 2022
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Family Medicine Rising: Building on Momentum Jay W. Lee, MD, MPH, FAAFP
From #FMRevolution to #FMRising
Family Medicine rising (#FMRising)? Yes, absolutely. Failure is not an option. The brokenness of today’s health care system needs our collective healing minds and hearts. The COVID-19 pandemic has created an urgency for systemic transformation unlike any period I’ve experienced in my career of 20-plus years. The pandemic has opened a historic window to rise up and become the leaders our health care system needs us to be. We will rise up: Family Medicine strong. In the spring of 2011 (what is it about spring and revolutions by the way?), then-AAFP President Roland Goertz, MD, delivered a simple, but powerful, message: “Our Time is now.” America’s family physicians seized the moment. How? By utilizing social media to do what we do best: communicate. Our vision was two-fold: 1) that family physicians and other primary care providers embrace this idea that we are better
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than how the status quo values us, and that we need to “revolt” against the fragmented health care delivery machine to shift away from volume-based fee-for-service and toward value-based care; 2) that the general public engages with #FMRevolution-aries and embraces the movement. In the spring of 2011, Family Medicine Revolution was re-born as #FMRevolution. Our collective family medicine consciousness, like the mythical phoenix, arose from the ashes to become “Strong Medicine for America.” We have new tools for engaging strong warriors (or awakening long dormant ones) and for stoking the fire within our souls. Since the birth of #FMRevolution, we have witnessed a surge in activity on various social media platforms highlighting the importance of family physicians in America’s communities and making a strong case for re-engineering (let’s call it “physician-eering”) the foundation of our health care system with a robust, dynamic primary care workforce.
A salubrious side effect of this social media movement has been a realization that there is a growing community of family physicians, medical students, patients, and others who understand the myriad messages about our specialty and who help amplify our voice. Since 2011, we have experienced well over 100,000 tweets worldwide. #FMRevolution has become integrated into our collective consciousness. While we have come a long way in the past decade, we still have a long way to go. Whereas $13 in savings are realized for every $1 spent on primary care, only 5 to 8% of total health care spending in the United States is for primary care. Investing a paltry 5 to 8 cents per dollar in primary care is a nutritional deficiency for health care. It is no surprise that the robust system our patients deserve shows signs of anemia, with inequitable access and outcomes, and declining physician wellbeing. Patients who suffer from anemia deserve to have the root cause determined and their ailment corrected. In the same vein, our nation must commit to addressing the root cause afflicting health care with a strong primary care infrastructure so we can make health primary and live our best lives.
Family physicians know the answer to this problem, and through our #FMRevolution journey, we have learned to see the power of our leadership. Now we must show ourselves to be Family Medicine strong. Our progress as a specialty, notwithstanding, with the cracks opened by the COVID-19 pandemic in an already fragile health care system, it is time to build on the #FMRevolution. It is time to build a system based on primary care that works for patients and for family physicians. It is time to build this moment into a movement. And I believe this movement will see #FMRising. I believe in the transformational, healing power of Family Medicine even more now as a PGY-20 than I did as a PGY-1. As Dr. Goertz beseeched us, our time is now. Let’s rise up, Family Medicine. Let’s build the future together. Let’s seize the day and heal the brokenness of the system. Let’s do it for our patients and let’s do it for each other! My name is Dr. Jay W. Lee. I am proud to be a family physician and I look forward to running as your #FMRising candidate for the AAFP Board of Directors in Washington, DC this September.
We Too Believe... Healthcare is a Fundamental Human Right! Join our team! Visit our Careers page at srhealth.org
phone: 707.303.3600 ext. 2587 California Family Physician Summer 2022
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In the News
CAFP Welcomes New District Directors
Congratulations to Maria Carriedo-Ceniceros, MD (District I, San Diego-Imperial counties) and Shayne Poulin, MD (District V, RiversideSan Bernardino, Kern, Tulare counties) who were recently elected to serve on CAFP’s Board of Directors. Maria Carriedo-Ceniceros, MD is a family physician from San Ysidro Health Center,
a Federally Qualified Community Health Center serving over 109,000 of the culturally diverse population throughout San Diego County. She has been the VP and Chief Medical Officer for San Ysidro Health Center since 2012. Her goals at CAFP include not only providing the perspective of a physician working in Southern California with an underserved and culturally diverse population, but in addition, working together with physicians from throughout the state to build a healthier community and address the many important issues facing healthcare including health equity, physician workforce shortage, physician wellness, and practice transformation. Dr. Carriedo-Ceniceros also holds a seat on the board of the San Diego
PRIMARY CARE PHYSICIANS San Francisco Bay Area
Contra Costa Health Services is seeking full-time BC/BE FM, Peds or IM Primary Care Physicians. Our health centers across Contra Costa County are integrated with specialty care services and the public hospital. We are looking for providers from diverse backgrounds and lived experiences who share our vision of providing equitable and quality health care to all members of our Contra Costa community. Desired applicants would work with a motivated practitioner group to provide innovative community medicine that empowers patients by fostering an environment of belonging and well-being. We offer: • Modern facilities serving the needs of ethnically and culturally diverse populations • Opportunity to be involved in resident teaching with our nationally recognized Family Medicine Residency Program • Comprehensive compensation package • 4 hours of paid administrative time a week for full-time providers and No Call • Favorable HPSA score for national and state loan repayment programs • EPIC medical record system
For more information, please contact: Recruit@cchealth.org 22
California Family Physician Summer 2022
County Medical Society and enjoys “working with a broad spectrum of physicians and specialties to work towards a common goal of meeting the needs of our patients and honoring our profession.” Shayne Poulin, MD has served as the Community Director for the Riverside-San Bernardino Chapter for the past two years, bringing together the diverse and robust community of family physicians in the Inland Empire. In her current role providing primary care at Planned Parenthood in San Bernardino she enjoys the opportunity to care for underserved patients from all over Southern California. “The transition from my previous experience in academics surrounded by other family physicians to being the only doctor at my current health center has been isolating at times. This is a sentiment I know is shared with others, particularly those working in rural areas. That feeling of isolation and quest for community drew me to CAFP. What I found at CAFP and our local chapter is a rich source of community, friendship and support. It is truly an honor to continue to cultivate our vibrant community and serve as the District V Director for CAFP.” Shani Muhammad, MD, FAAFP is an active member of the Riverside-San Bernardino chapter and prior District VIII Director, was also elected to serve as District V Alternate. Congratulations, Drs. Carriedo-Ceniceros, Poulin, and Muhammad. Thank you for your commitment to serve!
Members Recognized for Achievements in 2022 2022 Family Physician of the Year – Erika Roshanravan, MD, FAAFP The California Academy of Family Physicians presents this prestigious award to an individual who exhibits the finest qualities of family physicians, and who goes above and beyond in service to patients and community. This year, CAFP is proud to honor Erika Roshanravan, MD, FAAFP as our 2022 Family Physician of the Year. Dr. Roshanravan is a continued source of inspiration for colleagues both locally within the re-invigorated Sacramento Valley Chapter of the CAFP, and state-wide as the Alternate District X Director to the CAFP, as a contributing member of the CAFP Finance Committee, Scope of Practice Committee, as a member of the Family Medicine Initiative on Trauma Informed Care Expert Advisory Panel, and currently as the District X Director to the CAFP. She serves as UC Davis preceptor/faculty for family medicine residents with continuity clinic at the FQHC – Communicare, as volunteer faculty for primary care immersion RURAL PRIME medical students, and as the Diversity, Equity, and Inclusion Officer within the Communicare Health Center. Dr. Roshanravan is a selfless advocate for her patients. She works tirelessly to care for the underserved, rural population within Woodland, CA and the surrounding areas, providing full-spectrum trauma-informed care within the FQHC environment. Dr. Roshanravan is a transformational leader _she motivates her colleagues, peers, and
mentees to get involved in the community, and in the CAFP. She has led multiple advocacy events over the past three years, and was a leader in reinvigorating the Sacramento Valley Chapter of the CAFP. Outside of her work within the CAFP, and her FQHC, she volunteers at her childrens’ school as facilitator and chaperone for the classroom, organizer for fundraising events, and leader for the science fairs. Dr. Roshanravan is a superb representative of the field of family medicine. She is optimistic, creative, and an empathetic listener who is dedicated to advancing the specialty of family medicine, and advocating for health policy and legislation that supports the health and wellness of all Californians. Through the strength of her vision, and communication skills, she inspires students, residents, and colleagues to do more and be more for family medicine. 2022 CAFP Foundation Barbara Harris Award for Excellence in Education – Ecler E. Jaqua, MD, FAAFP The Barbara Harris Award for Excellence in Education list of winners is long and noteworthy! In 2022, we welcomed Dr. Ecler Jaqua to this group. Dr. Jaqua is an Assistant Professor in the Department of Family Medicine at Loma Linda University and President of the San Bernardino-Riverside Chapter. She has completed fellowships in Geriatric Medicine, Primary Care Psychiatry, and Primary Care Pain Management. She is widely recognized for her vast medical knowledge, love of
teaching and commitment to the medical profession. She mentors students and residents to develop their medical knowledge and empowers them to grow professionally through scholarly activities. Congratulations, Dr. Jaqua, our 2022 Barbara Harris Award winner! 2022 CAFP Foundation Preceptor of the Year – Louise Huang, MD In 2013, the CAFP Foundation founded the Preceptor of the Year award to celebrate the many family physicians who take medical students and residents into their practices, and into their lives. This award honors more than the “rotation” encounter; it celebrates the time and commitment our preceptors and mentors give to the future of our specialty. This year, we are excited to recognize, Dr. Louise Huang for this Award. Dr. Huang is a part-time Attending at the RUHS/UCR Family Medicine Residency Program. She is retired from her long career in primary care, but still volunteers as a preceptor in an FQHC in a HRSA medically under-served area in Moreno Valley. She exemplifies the best qualities of a thoughtful teacher: patience, humility, kindness. Dr. Huang completed her own residency training at a time when family physicians performed full-spectrum care; she uses this experience to encourage current learners to reach to the highest level of their training and degrees.
continued on page 24 California Family Physician Summer 2022
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In the News continued from page 23
2022 CAFP Foundation Residents of the Year – Nadine Grace-Abraham, MD & Juliana Jones, MD
Drs. Juliana Jones, a 2nd year resident at Dignity Health CHMC, and Nadine Grace-Abraham, a 2nd year resident at Emanate Health, are the recipients of the 2022 Family Medicine Resident of the Year award. Nadine and Juliana are enthusiastic leaders in both their residency programs and in the Academy. Since 2018, they have served as members of the CAFP StudentResident Council, a statewide group that works to promote and advocate for student and resident interests. Nadine and Juliana have been the primary organizers of the Procedures Workshop since 2019. Their long hours spent on planning, writing grants, procuring supplies, and recruiting volunteer faculty are definitely worth celebrating. They are not only deeply committed to helping their peers gain confidence and competence in procedural skills, but also especially excited about promoting the FM specialty. We couldn’t imagine two residents more deserving of this award. Congratulations, both Juliana and Nadine!
2022 CAFP Foundation Excellence in Family Medicine Research – Michael B. Potter, MD, FAAFP We are thrilled to honor Dr. Michael Potter, who has spent his career promoting community engaged research to advance family medicine. Dr. Potter’s years of experience is demonstrated by his vast network of professional partners and numerous publications. Leading the San Francisco Bay Collaborative Research Network for more than 15 years, Dr. Potter has created a network of over 5,000 physicians dedicated to improving research practices and clinical outcomes. Dr. Michael Potter is a professor in the Department of Family and Community Medicine at UCSF, where he is involved in patient care, teaching and practice-based research. He is the Director of the SF Bay CRN, UCSF's primary care practice-based research network which supports research partnerships between UCSF faculty and community-based health centers and health systems. His own research interests include cancer screening and self-management support interventions in primary care and in the community. 2022 Hero of Family Medicine – Alex McDonald, MD, FAAFP At the 2022 All Member Advocacy Meeting (AMAM), CAFP announced the 2022 Hero of Family Medicine award winner. The award is presented annually
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to a CAFP member who has gone above and beyond the call of duty to advocate for patients, colleagues and the family medicine specialty. The winner of the CAFP’s 2022 Hero of Family Medicine Award is Alex McDonald, MD, FAAFP (RiversideSan Bernardino)! It is hard to know where to start when talking about what Dr. McDonald has done to advocate for family medicine this year. Many of you are aware that he co-founded “This is Our Shot”, a physician-led effort to elevate voices of healthcare heroes to build vaccine trust towards a COVID-free world. Alex has been our hero for a long time. He has helped all of us use social media to elevate family physicians and the issues we care about. He is usually the first to volunteer when CAFP calls. He leads the CAFP Member Engagement Committee and recently ended his tenure as New Physician Director where he advocated for residents and new physicians to be involved and included at all levels of CAFP. Alex is also spreading the family physician gospel to the larger house of medicine. He sits on the CMA Board, where we hear he is getting into all kinds of good trouble. 2022 Champion of Family Medicine – Assemblymember Cecilia Aguiar-Curry CAFP was honored to award Assembly Member, Cecilia Aguiar-Curry with 2022 Champion of Family Medicine. Assembly Aguiar-Curry has been a champion of many issues important to family physicians and our patients including improving access to care for patients through telehealth services. She understands the importance of family physicians in their communities. Appreciating the importance
Join a team that’s been helping to redefine what it means to be a community clinic for 50 years. of family physicians, Assembly Member Aguiar-Curry introduced a resolution in the Legislature designating the week of March 13-19, 2022 as Family Physician Week. That is why, in recognition of her courage and empathy for patients and her dedication to advocating for family medicine and primary care, we’re thrilled to name Assembly Member Aguiar-Curry as our 2022 Champion of Family Medicine award winner.
Vista Community Clinic has outstanding opportunities for Full-Time and Part-Time Physicians. We are looking for dedicated, motivated and enthusiastic team players who want to make a difference in the community. Vista Community Clinic is a federally qualified, not-for-profit healthcare clinic with more than 800 employees and nine state-of-the-art clinics treating more than 69,000 patients every year. We provide healthcare throughout the Southern California regions of North San Diego, Orange and Riverside Counties. Our compensation and benefits program includes: Competitive compensation, sign-on bonus, relocation bonus, health, dental, vision, company-paid life, longterm disability, flexible spending accounts , 403(b) retirement plan, malpractice coverage, NHSC loan repayment eligible organization, CME allowance, and no oncall hours For more information visit www.vcc.org or email hr@vcc.org EEO/AA/M/F/Vet/Disabled
50 years
1972-2022
A G A T H E R I N G O F F A M I LY M E D I C I N E RESIDENTS AND MEDICAL STUDENTS
AUGUST 27, 2022 | LOS ANGELES, CA WWW.FAMILYDOCS.ORG/SUMMIT Brought to you by the California Academy of Family Physicians Foundation
California Family Physician Summer 2022
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In the News
Lauren Simon, MD, MPH, FAAFP
CAFP Honors the Life of Family Physician Hero John Cheng, MD
John Cheng, MD
As family physicians, we work tirelessly to preserve human life and health. Your CAFP has worked to support legislation that prevents gun violence, including AB 1669 (Bonta) which requires ammunition sales at gun shows in California be regulated with the same rigor as firearms. CAFP backed SB 172 (Portantino) that requires firearms to be stored in a gun safe or by using a firearm safety device when outside of the home. Additionally, CAFP supported SB 536 (Pan) which would require the Department of Justice
Like all Californians, CAFP was devastated to learn of another mass casualty when a gunman opened fire at a church in Orange County. We grieve for the latest victims in Laguna Woods, Houston, Milwaukee, and Buffalo over the weekend. Our hearts are broken at the loss of Dr. John Cheng, a family physician in Orange County as we mourn his tragic death. Dr. Cheng’s dedication to serving his community was demonstrated in his final heroic act to stop the shooter, that likely helped save many more lives. Dr. Cheng is described as having an especially caring and attentive way with patients and colleagues. His practice partners noted that he was well-respected for his knowledge of nutrition and sports medicine. He brought the same high level of enthusiasm and expertise when giving advice to a second-grade aspiring soccer star, and a cancer survivor training for their first triathlon. I always appreciated John for his enthusiasm, kind heart, and calm demeanor as he cared for studentathletes on the sports sidelines and so many others in the community. 26
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to make information relating to gun violence restraining orders available to researchers affiliated with the Firearm Violence Research Center or to any other entity that is concerned with the study and prevention of violence. In honor of Dr. Cheng and all the other victims and communities affected by gun violence, CAFP will continue to fight for laws that help protect communities from gun violence, including gun safety measures and access to mental and behavioral health services.
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MICHELLE GILBERT
501-725-3561 mgilbert@pcipublishing.com
John Cheng, MD
Family Medicine Physician Job Opening Position Summary:
UCI Family Medicine, a Department of the University of California-Irvine School of Medicine, is committed to upholding the highest professional and institutional standards. We thrive by promoting optimal health for patients, staff, trainees, and faculty. UCI Family Medicine provides clinical services for patients of all ages in a variety of settings as follows: Family Health Centers (federally qualified health centers or FQHC’s) in Santa Ana and Anaheim; Gottschalk Plaza; Senior Health Center; skilled nursing facilities; inpatient services and obstetric deliveries at the UCI Douglas Hospital in Orange. UCI Family Medicine provides education across a variety of programs including undergraduates; medical students; family medicine residents; fellows in geriatrics and sports medicine; and outreach to the community. We are seeking a qualified individual who is an excellent clinician with a strong commitment to clinical leadership, quality improvement and teambased patient care. The incumbent in collaboration with the Executive Medical Director (EMD) of the Federally Qualified Health Center (FQHC), will direct, coordinate, and implement the QI Program for the Federally Qualified Health Center and function as the Anaheim Site Medical Director. The incumbent will collect, manage, and analyze FQHC quality data and prepare quality reports for review. Incumbent will have practical knowledge and skills in Continuous Quality Improvement, including analysis and interpretation of data using computer based disease registries or similar data collection systems is essential. The incumbent reports directly to the EMD and to the Department Chair.
Essential Job Functions:
• Provides clinical expertise and leadership while assisting in the development, monitoring, and presentation of internal quality measures and initiatives. Disseminates QI performance to clinical staff team on a regular basis. Adheres to all UCI FQHC Policies and Procedures. • Leads and participates in Quality, and ad hoc meetings as directed by the EMD. Assists with coordination of monthly QI Meetings. Communicates FQHC initiatives to department members to ensure adequate understanding. Assists department medical directors to prepare QI reports and statistics. • Provides leadership by focusing teams and organization units on visions and distinctive strategies that result in excellent short and long-term performance. This includes coordinating, tracking, and reporting of clinical outcomes. Assist with annual UDS and HRSA reports and ensures timely completion of corrective action plans related to quality. • Reviews incident reports from the Safety and Quality Information System (SQIS) as well as patient grievances and conducts follow up investigations as warranted. • Collaborates with the FQHC Executive Medical Director in the investigation of clinical events including sentinel events, sentinel event near misses, and significant adverse events; leads and/or participates in the development of root cause analyses. • Oversee all aspects of patient care services at FHC Anaheim with the site Practice Manager to assure that the medical care provided is of highest quality and standards and consistent with all accreditation and licensure requirements. • Provide leadership, oversight, and supervision of all physicians and allied health care providers working at the site. • Serve as the medical liaison with outside referring physicians to facilitate inter-institutional transfers.
Requirements:
• Family physician; board-certified, full-scope ambulatory health care services including care of children, adults and the elderly. • Experienced in providing and/or oversight of pre-natal care. • Demonstrated experience in quality improvement to improve patient outcomes • Leadership skills; ability to motivate, inspire, communicate with faculty, residents, staff, and peers to maintain a professional, team-based approach in the care of patients. • Proficiency in Spanish
Compensation Range:
Commensurate with Experience
Link to Apply:https://careersucirvine.ttcportals. com/jobs/7529484-staff-physician Note: Applicant may be eligible to apply for loan repayment.
Family Medicine Rising: Building on Momentum
Passing the Torch –
A Farewell Speech from Shannon Connolly, MD, FAAFP The following includes excerpts from Dr. Connolly’s farewell speech given at the 2022 All Member Advocacy Meeting. Dr. Connolly’s full speech is available on www.familydocs.org. The 20th century artist, Norman Rockwell, depicted the iconic family doctor in his paintings as a beloved, steadfast soul who used some magical mix of compassion and brilliant clinical acumen to heal each patient. Rockwell’s family doctor was an avuncular, unhurried man who arrived on your doorstep with his black doctor’s bag which somehow contained everything he needed, as American and nostalgic as quilts, apple pie, and baseball. I think the good doctor would recoil in horror if he were a fly on the wall observing the chaos that is my typical day in clinic. A while ago I was with a residency buddy of mine, and she was trying to explain to our other friend— who is a project manager for a tech company, what it is like. She said, “Let me explain clinic. Imagine your team has to run 25 back-to-back meetings in a day— each one 15 or 20 minutes. None of those meetings have set agendas,
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but they all must start and end on time—sometimes simultaneously. The meeting participants may bring up any issue at all for discussion during the meeting, and you must try to figure out
a solution. Meetings can be stressful. Often the meeting attendees show up late or at the wrong time, other times, they try to die during the meeting, and on at least one occasion, they tried to
have a baby during the meeting." "In addition to whatever comes up in the nonexistent agenda, you as the meeting chair have to take care of all of the meeting participants’ organ systems and emotional needs and screen for diseases and give them their flu shots and beg them to quit smoking."
It’s in the effort that a patient made to get to your clinic, running as fast as they could, waving their arms and chasing a bus they just barely missed down the street on a scorching hot
But you know what? It’s not terrible at all. It’s an amazing adventure filled with love, and gratitude and grit. And you all, my incredible meeting leaders, are the people who make family medicine a practice in fostering human connection. Despite all the challenges, sometimes we do heal our patients. And sometimes, our patients heal us. Sometimes we heal each other. A lot of the time, we learn that we have been doing things wrong, and that we could do them in better, kinder, more effective ways. We learn to recognize the problems in the ways we had been thinking and we are given countless opportunities to correct the shortcomings of our experience as humans. And you can see it, if you look carefully through the smoke of all the chaos, there are a million moments of beauty in that day full of meetings.
continued on page 30
A PHYSICIAN DRIVEN
"Oh, and you have to take meeting minutes during the meeting. Somehow by the end of the meeting the meeting participants have to leave feeling that you care about them and have things under control. Also, the team, has to still be alive and able to come back for more meetings tomorrow.” Our non-medical friend looked at us incredulously. “That sounds terrible!” She said.
day so they could catch their ride. They showed up in clinic, only just a few minutes late because they
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California Family Physician Summer 2022
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promised you last time that they were going to take their diabetes seriously this time. It’s the patient—a man who based upon past behavior is not exactly a favorite of your staff, who shows up as a “walk-in,” unannounced on the worst day. But you squeeze them into your schedule only to find that their sole reason for requesting an appointment was so they could tell you personally that they had gotten sober. It’s your colleague, who has wrapped up their day early but they see you’re still underwater so they take a chart off your pile and see another patient so you can get home in time for bedtime stories with your kiddos. These are the healing moments of family medicine—the moments we must carefully collect like beautiful glass marbles that we place in a jar for safekeeping. And in those moments when we need healing, we pull that jar of marbles out and hold each one up, rotating it slowly and letting it reflect the light that is our connection to each other. It is this simple practice of gratitude that protects us. That’s family medicine. This past year, it has been my honor to serve as your CAFP President. Like the year before it, this year wasn’t exactly as I had imagined it. The irony is not lost on me that the first time I’ve had the privilege of addressing you in person happens to be in my last month of presidency. That’s okay. Flexibility is a family medicine superpower! My favorite part of this year was the board of directors strategic planning retreat, where we made our strategic plan. Out of that weekend came a document—our new 3-year strategic plan. It’s because of this work plan, that our activities will include several things, including the appointment of a 30
California Family Physician Summer 2022
taskforce to develop a framework on how to promote and measure justice, diversity, equity, and inclusion work. All the work is very important, but it is this piece that I must confess I am most excited about. The soon to be developed task force will center the work of diversity, equity, and inclusion, and ensure that we find ways to bake these priorities into the very structure of our organization in ways that make it permanent and of primary importance, and not just a nice afterthought that happens in addition to the other work that we do. The CAFP will lead in this work and change the culture of our specialty such that future generations will consider health equity work to be as vital as anything else we do in medicine. And studying the root causes of the malignancy that is racism in medicine will be as important as understanding the pathophysiology of diabetes or any other disease. But to do this good work, we need to ensure that our doctors and learners are healthy and have the resources they need. That is why the other three strategic goals are so important. We must redesign our healthcare system in ways that prioritize the health of patients above all else, dismantling perverse incentive structures that only serve to create barriers. We must educate our communities and legislators about what family doctors do so it makes sense to them to support our work. And we must regain our joy. We must reject working conditions that cause moral injury, but that is not enough, we must also redefine our profession to be one that is considered a privilege to participate in because it is so rewarding and inspiring. Let me be clear, we are not asking to make
the practice of medicine easy—it will never be easy. It will always be challenging, and require tremendous skill, emotional fortitude, and dedication. But we are looking to make the practice of medicine sustainable and safe for its professionals. If we don’t heal our own wounds, we will bleed on those who didn’t cut us. We must stop the hemorrhage of bright young people from our field. We must do this if we are to have a next generation of leaders. That is why this is a strategic goal for us. I believe this organization is on the right track. I believe we have members who are, as my friend Jay Lee would say, “brave enough to become the physicians we wrote about in our personal statements.” I believe we have the brightest, most talented staff— people who can transform great ideas into action, who can turn noes into yesses, and who are honorary family physicians. I believe our CAFP Board and committee members are spirited and passionate leaders who collect marbles in glass jars and have the drive to create something bigger, better, and more aspirational than what we have now. The four goals in our strategic plan reflect who we are, and will serve as our North star for the next three years and beyond. I continue to believe that this organization is a national thought leader for our profession. We have among us, leaders who will change the very culture of medicine and society. We are proud of people like Jay Lee, and Jasmeet Bains, who grew up in the California Academy and are now answering the leadership call. Each of us here has that ability. The CAFP is an organization full of leaders. Let’s all answer that call. We have a lot of work to do, so let’s get to it.
Leading the future of health care A FEW REASONS TO CONSIDER A PRACTICE WITH TPMG: • Work-life balance focused practice, including flexible schedules and unmatched practice support.
Adult & Family Medicine Physician Opportunities Northern & Central California The Permanente Medical Group, Inc. (TPMG - Kaiser Permanente Northern California) is one of the largest medical groups in the nation with over 9,000 physicians, 22 medical centers, numerous clinics throughout Northern and Central California, and a 75-year tradition of providing quality medical care. We currently have openings for BC/BE Family Medicine or Internal Medicine Physicians to join us throughout Northern & Central California. When you join Kaiser Permanente in Northern or Central California, you'll enjoy the best of both big city and small town amenities. Our locations offer family-oriented communities, spacious parks, tree-lined streets, excellent schools, great shopping, outstanding restaurants, and a multitude of cultural activities. You’ll also enjoy nearby destinations such as the Napa Valley wine country, San Francisco, Lake Tahoe, and the stunning shoreline of the Pacific Coast. To learn more and to apply, please visit: https://tpmg.permanente.org
We are an EOE/AA/M/F/D/V Employer. VEVRAA Federal Contractor
• We can focus on providing excellent patient care without managing overhead and billing. • We demonstrate our commitment to a culture of equity, inclusion, and diversity by hiring physicians that reflect and celebrate the diversity of people and cultures. We practice in an environment with patients at the center and deliver culturally responsive and compassionate care to our member populations.
FORGIVABLE LOAN PROGRAM $125,000 - $275,000 (based on location and experience)
Available exclusively to Internal Medicine and Family Medicine Physicians, the Forgivable Loan Program is just one of many incentives we offer in exchange for our Primary care Physician’s dedication and expertise. Ask us about our enhanced compensation for AFM Physicians! FAMILY MEDICINE: Contact Bianca Canales at: Bianca.Canales@kp.org or 510-421-2183 INTERNAL MEDICINE: Contact Harjit Singh at: Harjit.X.Singh@kp.org or 510-295-7857
CONNECT WITH US:
CALIFORNIA ACADEMY OF FAMILY PHYSICIANS 816 21st Street Sacramento, California 95811
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