Leadership

Colton and Redlands Family Practice/Geriatrics specialist Frank Randolph, M.D. became the 110th president of the San Bernardino County Medical Society on July 1, 2002. Executive Officers for 2002/2003 include President-Elect Samuel Wilson, M.D., Vice-President Edward Hess, M.D., Secretary Lisa Perry-Gilkes, M.D., Treasurer Burton Briggs, M.D., and Past-President Jay Shankar, M.D. In December, Dr. Lisa Perry-Gilkes relocated to Atlanta, Georgia. The Nominating Committee appointed Dr. Briggs to fill her vacant position and Ruchir Sehra, M.D. to the office of Treasurer for the remaining term. Board members presented a special resolution to Dr. Lisa Perry-Gilkes in recognition of her contributions to the Medical Society and expressed their regrets on her leaving and their best wishes for her future.

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SBCMS leaders joined over 600 physicians at the Fifth Annual CMA Leadership Academy held November 22-24, 2002 at the La Quinta Resort & Club. The conference provided an excellent opportunity to interact with other physician leaders.

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Medical Society leaders attended the Annual Session of the CMA House of Delegates March 22-25, 2003 in San Francisco. Dr. Ron Bangasser was installed President of the CMA on March 24, 2003 at the House of Delegates. He is the first Inland Empire physician to head the CMA since the late Dr. Nicholas Krikes was elected in 1978. An outspoken advocate for medical quality and access issues, he will speak on behalf of 35,000 California doctors.

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Physician Advocacy

Inland Global Medical Group (IGMG) closed its doors in October 2002, leaving $5 million owed to providers. 48,000 covered lives were involved. SBCMS provided affected physicians legal information, a contact list for each of the health plans, and a payment assistance form so that CMA could assess how much money physicians are owed by IGMG. SBCMS and CMA's Elizabeth McNeil aggressively worked to seek payment for the physicians, find ways to make available to physicians the $800,000 in reserve monies that the health plans were holding that should have been distributed to physicians for their unreimbursed claims, and to help them maintain their patients as the health plans reassigned patients to new physician groups. SBCMS hosted a Town Hall meeting on January 14 at San Antonio Community Hospital. 55 physicians met with CMA Legal Counsel Catherine Hansen, Elizabeth McNeil and Joy Higa from the Department of Managed Health Care in regard to the Inland Global Medical Group closure. The physicians were very appreciative. CMA is working with Senator Jackie Speier on legislation that would ensure that health plans take back the responsibility of reimbursing physician claims.

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Due to the monumental efforts of CMA, AMA, and Dr. Ron Bangasser, who made eleven trips to Washington during the year, President Bush signed the Omnibus Appropriations bill (H.J. 2), authorizing the Department of Health and Human Services to correct the 1998 and 1999 Medicare physician payment projection errors. This action secured an important victory in the fight against Medicare cuts. It averted a 4.4% cut in Medicare physician payments that was scheduled to go into effect on March 1, 2003 and, as a result of this legislation,physicians received a 1.6% increase in 2003 spending. Over the next 10 years, $54 billion will be added to physicians' incomes by this legislation. This averages more than $3,800 per physician per year. This victory has given the more than 40 million Americans now enrolled in the Medicare program - and the millions more who eventually will be - the good news that their access to care won't be jeopardized by an accounting error.

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On July 1, 2002, under the transition plan approved by the Board of Supervisors, the responsibility for managing AB 75/SB 612 claims was transferred to the County's Risk Management Division. The SBCMS Emergency Medical Services Funds (AB 75/SB 612) Committee continues to provide advice to the new administrator on the payment of the claims for physicians. The county provides SBCMS monthly reports on the funds' status and meets with the SBCMS EMS Funds Committee quarterly.

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On August 14-15, 2002 SBCMS and CMA conducted free 45-minute mini-consultations to address reimbursement problems for physician members and their office staff. The consultations were for members-only.

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RCMA and SBCMS hosted the 15th Annual Western States Regional Conference on Physicians' Well-Being on Tuesday, May 13at the University of California Riverside's Extension Center in Riverside. The event was co-sponsored by the California Society of Addiction Medicine, the University of California Riverside Continuing Medical Education Program, and endorsed by the CMA. The annual course assists in recognition and identification of the impaired physician, the role and functions of the Physicians' Well-Being Committee, methods of investigations, interventions, recovery and monitoring, and legal issues. Over 200 attended.

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SBCMS accepted RCMA's invitation to participate on the University of California Riverside Task Force to explore a four-year medical school at UCR. Drs. Ernest Levister, Guillermo Valenzuela and Clifford Walters agreed to serve on the Task Force. Funds have been committed for a feasibility study, and further discussion will take place with the two county hospitals and Eisenhower Medical Center. CMA will support both a four-year medical school at UC Riverside and a second medical school in the central valley.

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Communications

The August Southern California Physician featured the recipients of the Medical Society's 2002 Outstanding Physician and Citizen awards: Rodney Willard, M.D., the Nicholas Krikes Award for Outstanding Contribution to the Medical Society; Thelma Korpman, M.D. and Lisa Perry-Gilkes, M.D., co-recipients of the Outstanding Contribution to the Community Award; and G. Gordon Hadley, M.D., the William L. Cover Award for Outstanding Contribution to Medicine. Dr. Kenneth Jordan accepted the Outstanding Citizen Award for his late wife, Hannah "Honey" Jordan. Executive Director Linda Stratton was also honored for her 25 years of service to the Medical Society.

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The Messenger, SBCMS' section in the Southern California Physician magazine, continued to provide local news for San Bernardino County's physician leaders. Feature articles included Inside the Current Med Mal Market: Understanding Chaos, by David Ruvalcaba, Senior Market Researcher/Analyst for NORCAL Mutual Insurance Company; Elder Abuse- The Role of the Physician, by Dr. Randolph and Tristan Svare, San Bernardino County Deputy District Attorney; Beating the Odds: Reducing the Risk of Not Being Paid by HMOs and IPAs, authored by Los Angeles health care attorney Jeremy Miller, J.D., and information for physicians on HIPAA. The Southern California Physician magazine (SCP) is published monthly by the Los Angeles County Medical Association and is mailed at no cost to all SBCMS members. The magazine is the official publication of six Southern California county medical associations: San Bernardino, Riverside, Imperial, Orange, Los Angeles and Ventura. Drs. Rodney Willard, Ronald Bangasser and Thelma Korpman represent SBCMS on the SCP Editorial Advisory Board.

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Members of the Communication Committee, Board of Directors and other SBCMS members were interviewed by local media on various topics. SBCMS endorsed KVCR-TV Channel 24's new live call-in health education program, "Doctors on Call." SBCMS physicians voluntarily appear on the program to discuss various medical topics and answer questions from callers.

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SBCMS continues to communicate bi-monthly with our members through our broadcast fax newsletter, "FaxFacts," which includes up-to-the-minute legislative and organizational events and issues. SBCMS members' office personnel receive our quarterly Medical Office Managers newsletter.

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SBCMS members and their staffs were invited to attend several programs and seminars on the following dates: August 14-15, 2002, CMA Mini Consultations "Hands On Help With Your Payment Hassles"; October 8, 2002, CMA MBA Seminar "MBA in a Day for Physicians & Office Managers"; October 23, 2002, SBCMS/RCMA/CMA Seminar "Total HIPAA"; March 5, 2003, CMA/SBCMS/RCMA "Coding, Documentation & Compliance"; March 12, 2003, SBCMS/RCMA/CMA Seminar "Total HIPAA." The meetings were held in the SBCMS Conference Center.

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On September 18, 100 attorneys, judges, physicians & other health professionals met at SBCMS for dinner and an informative seminar, "What You Don't Know About Elder Abuse," that explored the problem in depth. SBCMS and the San Bernardino County Bar Association's joint Medical Legal Committee hosted the seminar in collaboration with the Elder Abuse Unit of the San Bernardino Office of the District Attorney. A panel of experts included Diana Koin, M.D., Assoc. Clinical Professor Medicine, University of California San Francisco; Tristan Svare, San Bernardino Deputy District Attorney, Elder Abuse Prosecution Unit; and Bryan Reid, Esq., a partner with the Southern California litigation firm of Elliot, Snyder & Reid.

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SBCMS' nominee, Gerald R. Greene, M.D., a Pediatric Infectious Disease Specialist at Arrowhead Regional Medical Center, received the "Top Doctor Award" from the Unforgettables Foundation on December 31, 2002 at the Third Annual Lights for Little Lives March.

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The SBCMS and IWIN web sites (www.sbcms.org and inlandwellness.org) continue to provide both physicians and the general public with local information and links to CMA and other important medical web sites under the direction of the Electronic Communications Committee. Webmaster Jay Razzouk is responsible for updating and improving the SBCMS and IWIN web sites, and this year he created a new, easy to navigate layout for the SBCMS web site. The Electronic Communication Committee's goals are to update the IWIN website, www.inlandwellness.org, prepare a press kit for the media including a possible media blitz in January 2004 in preparation for February Black History Month, and establish a separate website for the Physicians Memorial, Gift and Benevolence Fund (PMGBF).

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SBCMS embarked on a joint collaboration with the San Bernardino County Health Department to disseminate information to physicians through broadcast fax announcements, the SBCMS section of the Southern California Physician magazine, and the Medical Society's website, www.sbcms.org. The SBCMS Electronic Communication Committee added to the SBCMS main web page a link to a DPH announcement page.

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SBCMS published a 2003 Physician Directory that includes complete office information on nearly 1800 physicians, Inland Empire hospitals, useful websites for physicians, legislative contacts, and valuable community resources. A copy of the directory was mailed to SBCMS members as a free benefit of membership. Nonmembers and the public pay $70 per copy.

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Sue Bradshaw, SBCMS Director of Communications, retired on March 31 after nearly 22 years of service. She continues to work with SBCMS as an independent contractor from her home office. One of her duties was the Public Service Committee, which reviews complaints from patients of SBCMS members. The Executive Committee evaluated the need for the committee and Board members agreed to place the committee on inactive status and appoint the Chair as a consultant. Patient complaints are referred to other appropriate agencies.

The Medical Review Advisory Committee, under the leadership of Dennis Flynn, M.D., reviewed 20 cases. Committee members represent various medical specialties necessary to conduct case reviews of NORCAL insureds. Representatives from NORCAL Claims Department as well as attorneys representing cases for the insured physician(s) attend our meetings to determine from the medical community if the standard of care has been met in each case.

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Legislative Advocacy
On April 30, 48 enthusiastic SBCMS and RCMA members attended the annual CMA Legislative Day in Sacramento, including 11 Loma Linda University Medical School students whose attendance was sponsored in part by SBCMS Board members. The conference included briefings on legislative issues by CMA government relations' staff and appointments with our legislators. Led by a fire truck and ambulance, over 600 physicians donned their white coats and marched to the State Capitol to advocate for passage of health-care related bills concerning access to care and to encourage legislators to prevent further cuts to Medi-Cal. For the first time, state legislators, firefighters and paramedics, as well as community-based health care advocates - some using wheelchairs and sign-language interpreters - joined the physicians in speaking out for healthcare funding at the rally. The rallying cry - Governor, don't balance the budget on the backs of patients and doctors. Eleven specialty organizations attended the conference.

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SBCMS members called and wrote their legislative representatives urging them to support HR 4600. A federal professional liability reform measure that includes the major provisions of California's Medical Injury Compensation Reform Act (MICRA), HR 4600 passed the U.S. House of Representatives on September 26 by a vote of 217-203 with 12 members not voting. HR 4600 would safeguard patients' access to care by enacting reforms that provide a $250,000 cap on non-economic damages and place a reasonable limit on punitive damages without preempting existing state law. The legislation faces stiff opposition in the Senate. Conversation will be kept open in the Senate regarding tort reform, until a measure that can be supported can gain requisite support of more Democratic Senators.

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After proposing cuts to Medi-Cal provider rates, Governor Gray Davis on September 30th reversed his stance and signed AB 3006, legislation ensuring that already low reimbursement rates would not be lowered. SBCMS/CMA worked throughout the budget battle to ensure that California legislators and the administration understood the impact cutting Medi-Cal reimbursements and eligibility would have on patients and the state's already fragile emergency care system. SBCMS members joined the scores of physicians who wrote letters, telling Governor Davis that trimming Medi-Cal payments would force them to choose between seeing Medi-Cal patients and staying in business. Also good news, the governor signed CMA-supported AB 442, which maintained current Medi-Cal eligibility rules and kept nearly $1 million in the health care system for the working poor and their children.

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Save Our Seniors (SOS) representatives flew to Washington on September 9-12 to meet with the Senate Finance Committee and work with the combined Senate/House Conference Committee to finalize how much money will go into the Medicare increases and Medicare Plus Choice increases. The committee was initiated by SBCMS and the Riverside County Medical Association to work on a local solution to the senior health plans' withdrawal from certain areas and/or the significant changes to the benefit structures which are adversely affecting seniors' abilities to either pay or remain in the program. Drs. Ron Bangasser and Steve Larson (RCMA) chair the committee.

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SBCMS was one of the first county medical societies to participate in a pilot project to raise funds for the MICRA Defense Fund by including a $50 stipend in the members' dues statements, which were mailed the first week of October. The purpose of this effort was to increase physician participation in organized medicine's political activities and increase CALPAC contributions. Each of the participating counties (Fresno, Orange, Riverside, San Bernardino, and San Diego) increased both contributions and physician participation dramatically.

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The Legislative Commission/LOPAC Committee, under the leadership of Dr. Dev Gnanadev, participated in nine fund raising events for local legislative representatives. Participation in the fundraisers ensures that SBCMS maintains personal contact with the legislators and provides us opportunities to express medicine's views.

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Community Involvement

The SBCMS and its public service arm, Inland Wellness Information Network (IWIN), continue with initiatives that contribute significantly to the quality of life in the Inland Empire.

The African American Health Initiative, a comprehensive community health collaborative aimed at reducing and eliminating health risks and improving overall health quality among the African American population in San Bernardino County, received grants that will enable the Initiative to make significant progress:

• A two-year $268,620 grant from The California Endowment addresses the health disparities of African Americans in San Bernardino County by engaging in a participatory planning process that will identify, assess, and implement culturally specific strategies for the prevention and treatment of hypertension and heart disease, HIV/AIDS, prostate and breast cancer. The grant will concentrate on three geographic areas - Victorville, the Rialto/Fontana area, and metropolitan San Bernardino.
• Second-year funding of $50,000 for hypertension and heart disease and HIV/AIDS from the Office of Minority Health. The objective is to reduce the incidence of heart disease, stroke and hypertension among African Americans and improve access for communities of color and for those who know their HIV status but are not in health care.

Major activities of AAHI during the 2002-2003 year:

• Sponsored medical screenings and referrals, community walks and participated in numerous health education and prevention venues.
  
• Held a series of community gatherings "Breaking Bread & Building Bridges" of Inland Empire and High Desert groups involved in African American health issues. They allowed community groups to come together to increase solidarity among key community leaders and individuals and to share information about goals, objectives and missions and also to strategize about effective approaches to improve the health of African Americans in San Bernardino County.
  
• AAHI Resource Directory - Developed by Dr. Sam Wilson is located on the Internet at http://www.chemgonline.web66.com. The directory will include: offices and clinics for primary and specialty care, hospitals and health care facilities, nursing and convalescent homes for residential care, dentists, outpatient mental health and drug rehabilitation clinics, inpatient hospitals for mental health care, child care facilities and the location of pharmacies.
  
• A Prostate Cancer Screening Van Committee is working to bring a mobile van to San Bernardino during the summer of 2003 that will conduct free prostate screenings. African American men are at high risk for prostate cancer.
  
• Triumph of the Spirit, A Celebration of Wholeness and Wellness in Communities of Color (a drama and lecture with a message dealing with HIV/AIDS) was co-sponsored by AAHI and held February 23 at New Hope Missionary Baptist Church.
  
• AAHI was a co-sponsor of the Jumpstart Series that began on March 18 with the Cultural Competency Training, April 16 Women and HIV, June 18 Youth and HIV, July 12 Men of Color and HIV. The goal of the Jumpstart Series was to respond to the dramatic shifts of HIV infection, influx of new diverse populations and the current economic climate by maximizing cultural competence in service delivery.

Healthy Lifestyles Program is a community partnership initiative of the Medical Society, its Alliance, and IWIN. This year we designed a new color brochure and promoted the program more aggressively. We partnered with the Dole Food Company and now use Dole's "5 A Day Friends" artwork on all our brochures. The Healthy Lifestyles program encourages school children early in their formative years to learn about and develop healthy lifestyles. During the 2002-2003 year this program received a $3,000 grant from NORCAP and a $5,000 grant from GlaxoSmithKline. These grants enabled IWIN to increase the cash awards to the winning classes from $100 to $300 and to offer the program to more schools.

Live and Then Give, our organ and tissue donor awareness program is a partnership of IWIN, SBCMS and the RCMA. The project is designed to improve health and save lives by making more donated organs and tissue available in the Inland Empire. The month of April was National Donate Life Month. In recognition of this, Live & Then Give placed organ donor displays in four Inland Empire hospitals. Other activities include:

• April, May and June collaborated with OneLegacy and Cassie's Friends and deployed our second 3-month cinema advertising campaign at seven Krikorian Theatres throughout Southern California. Our campaign reached nearly 2 million moviegoers. The "Live & Then Give" designs were similar to the 2002 campaign. The families' tributes to the donors were positive and inspiring, and the photos were of high quality. "Live & Then Give" organ donor cards and holders were at the theater snack bar.
  
• On April 27 Live & Then Give promoted organ donor awareness at the Rancho Cucamonga Epicenter - home of Quakes baseball. This was our third consecutive year to participate. Nearly 3,500 organ donor cards, hundreds of balloons and brochures and organ donor cards were distributed.
  
• Appeared on local cable TV shows and had good media coverage in local newspapers, and participated in numerous health fairs and education venues.
  

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A full house of approximately 200 physicians and members of the public attended the sixth annual Medical Museum and Library's Open House celebration on Sunday, February 2, 2003. It was a tremendous success and it gave everyone an opportunity to stop and appreciate the efforts of our Historical Committee in preserving the history of the development of medicine. Dr. David Peck gave an interesting account of "The Lewis and Clark Expedition - Wilderness Medicine in Early America." A San Diego urgent-care physician, Dr. Peck is an expert speaker on wilderness medicine and is the author of "Or Perish in the Attempt-Wilderness Medicine in the Lewis and Clark Expedition." He related the medical mysteries and mishaps encountered during the expedition and spiced his narrative with an informative and sometimes graphic slide presentation. Visitors also had the opportunity to tour the museum with docents who explained the medical devices, instruments and old books on display. The SBCMS Alliance served as greeters and graciously served refreshments.

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Public Health

SBCMS volunteered to participate in the San Bernardino County Public Health Department's Bioterrorism Advisory Committee and to assist in the development of communication strategies to increase the effectiveness of the county's bioterrorism response. Dr. Frank Randolph was named as SBCMS' representative on the advisory committee.

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On April 8, 2003 The Board of Supervisors of the County of San Bernardino formally recognized SBCMS past-president Dr. Kenneth Lane for his contributions to public health efforts in this County, commended his contributions to multiple areas of public health intervention efforts and honored him for his past, present and future efforts to coordinate the Medical Society, hospitals and others in improving public health in this county.

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Membership
Board members pledged $1,800 to sponsor house officer memberships. As a result of the sponsorships, SBCMS submitted 24 house officers' memberships to CMA.

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94 new members joined SBCMS since July 2002, including four new groups: California Emergency Physicians, La Salle Medical Associates, Loma Linda University Department of Pediatrics, and St. Mary Choice Medical Group. 76 new medical students were recruited.