Marin Medical Society

MMS News Briefs


October 2013

• Legislative update: Year of challenges, victories for CMA

• Chief CMA federal lobbyist to speak at Oct. 23 dinner in Santa Rosa

• Top stories from CMA Alert






Legislative update: Year of challenges, victories for CMA 


 Juan Torres

[Mr. Torres is vice president of government relations for the California Medical Association.]

This year turned out to be a challenging one for the California Medical Association. We knew it would be a historic year with the implementation of the Affordable Care Act and the wave of legislative freshmen. We anticipated that many challenges would arise as we helped educate new legislators not only about the ACA, but also about the many issues important to the physician community in California.

CMA faced an unprecedented number of scope-of-practice expansion bills introduced in the Legislature. These bills were painted with a broad brush as necessary reforms to help implement the ACA. Those who wanted to expand scope had a key message: we need allied health professionals--including nurse practitioners, optometrists and pharmacists--to do more in order to prepare for the many Californians who would be new to the healthcare infrastructure in California. Our message was simple: we will not jeopardize patient safety and we need to promote integration of allied health professionals--not fragment them as these proposals suggested.

We faced a concerted effort by the nurse practitioners, optometrists and pharmacists who joined together to push their agenda collectively. They put in significant resources to mount a public relations campaign and were actively pursuing newspaper editorial boards across the state to promote their agenda. With help from our specialty partners and our local medical societies, CMA won the argument in the Capitol. We successfully defeated the attempt by nurse practitioners to gain independent practice in California, as well as efforts by optometrists seeking to diagnose and treat diseases in patients. CMA significantly narrowed the pharmacists’ proposal to ensure that they could provide reasonable services in an integrated and safe manner that promoted collaboration with physicians.

CMA also tackled the incorrect perception that physicians are at the center of the opioids overdose crisis occurring in California. Physicians recognize the need to help ensure appropriate prescribing and the need to tackle abuse and diversion of prescription drugs. We helped craft a proposal that will ensure that our state’s prescription monitoring program, CURES, will be upgraded and funded. CMA also secured a streamlined application process for CURES, a requirement that a stakeholders group be consulted as the upgrade and maintenance occurs, and a reduced fee impact on physicians. Most importantly, there will be no mandated participation required of physicians.

A proposal that would have given the medical board overly broad power to discipline physicians for inappropriate prescribing was soundly defeated by CMA in an overwhelming fashion on the Assembly floor. CMA was also able to make certain that any reports initiated by coroners involving overdose deaths would remain confidential. In addition, an effort to shift the investigative authority from the medical board to the Department of Justice was defeated.

The trial attorneys’ campaign to eviscerate MICRA was also in full gear this year. Trial attorneys invested heavily in three additional lobbyists and launched a public relations campaign titled “38 is Too Late,” and made several attempts to push a legislative bill in the Capitol. All these efforts resulted in no action in the Capitol, a major victory for CMA.

While CMA is proud of our legislative victories this year, we understand that these battles will continue next year. We know that that the trial attorneys are initiating a ballot fight and we know that some allied health professionals will continue to erroneously call for scope expansion. CMA will continue to be the voice of the physician community and is prepared to take on these challenges.

Chief CMA federal lobbyist to speak at Oct. 23 dinner in Santa Rosa


Elizabeth McNeil, CMA’s chief lobbyist in Washington, DC, is the featured speaker at a special dinner in Santa Rosa on Wednesday evening, Oct. 23. Topics include pending changes in healthcare reform, deficit reduction, Medicare and Medi-Cal.

The special dinner, to be held at the Fountaingrove Inn in Santa Rosa, is free for MMS members. Spouses, guests and nonmembers are $40 each. The evening begins with a wine reception at 6 p.m., followed by dinner and program at 6:30. Dinner choices include grilled salmon, pesto penne and grilled chicken.

To RSVP, contact Rachel Pandolfi at 415-924-3891 or You can also fax the attached order form to MMS at 415-924-2749. Be sure to indicate dinner choice.

Oct. 23 Dinner flyer

Top stories from CMA Alert


Here are the top stories from the latest CMA Alert, the California Medical Association’s biweekly email newsletter. For a free subscription, visit

CMA pilots online reference committee for 2013 House of Delegates

CMA files a petition with the Supreme Court to block the 10 percent Medi-Cal physician reimbursement cut

Study finds that ACA Medi-Cal expansion could fuel ER use

Federal, state regulators weigh in on novel grace period proposal

PQRS administrative claims-based reporting deadline is October 15


Dr. Irina deFischer and Dr. Jeffrey Stevenson will be representing Marin County physicians at this year’s CMA House of Delegates, set for Oct. 11-13 in Anaheim. The HOD is an annual meeting that sets CMA policy and priorities for the coming year.



The Dutton-Goldfield Winery is donating 5% of the proceeds of its wine sales from Oct. 26 to Nov. 3 to Operation Access, which arranges donated surgical and specialty care for underserved local residents. Wines can be purchased at or at the winery, 3100 Gravenstein Hwy. North in Sebastopol. Remember to use the promotion code DGACCESS at checkout. Operation Access will also be hosting an open house at the winery from 3 to 4:30 p.m. on Saturday, Oct. 26.

The October issue of CMA Practice Resources (CPR) is now available at Each issue includes tips on reimbursement and contracting-related issues, along with the latest practice-management news.

An FAQ on the HIPAA Omnibus Final Rule, which went into effect on Sept. 23, is available in the Privacy and Security section of The FAQ includes answers to questions such as “Do I need to conduct a risk analysis” and “Do I need to update my business associate agreements?” (The answers are yes and yes.) More details on HIPAA, including sample forms and policies, can be found throughout the Privacy and Security section.

MMS members can get registration discounts for the Napa Primary Care Conference: Caring for the Active and Athletic Patient, to be held at the Napa Valley Marriott from Nov. 6 to 10. The conference is designed for physicians and medical professionals who care for active and athletic patients or who themselves lead such a lifestyle. Topics include common medical and musculoskeletal problems, healthy lifestyles and personal wellness. The conference offers up to 16 hours of CME. To register, visit the conference website.

CMA’s Institute for Medical Quality and the PACE program at UC San Diego are cosponsoring a Stepping Up to Leadership conference in San Antonio, Texas, on Nov. 7-9. The conference trains medical staff leaders in issues of communication, problem solving, and improving outcomes for patients and staff. Because of a grant from the Physicians Foundation, cost is as low as $595 for all three days. To register, visit

The following CMA webinars are scheduled for October. Webinars, which are typically worth one CEU credit, begin at 12:15 p.m. and run until 1:15 or later. To register, visit Seminars are free for CMA members and their staff; cost for nonmembers is $99 per person.

Successful Medi-Cal Provider Enrollment for Physician Providers (Oct. 2)

Benefits of Financing your Electronic Medical Records Project (Oct. 9)

Utilizing Technology to Increase Patient Engagement and Meet the Requirements of Meaningful Use (Oct. 16)

CMS Quality Reporting Programs: What Physicians Need to Know and Do Now to Improve Care and Avoid Penalties (Oct. 30)



For Sale: SF family and urgent care practice

Average revenue $407,000; very high profit margin. No third-party plans; all cash. Strong growth potential. The practice is approximately half urgent care and half primary care. Real estate also available. Practice Consultants: or 800-576-6935.

Psychiatrist wanted

A staff psychiatrist at Sonoma Developmental Center participates in the multidisciplinary team process for the management of individuals with intellectual disabilities. Sonoma Developmental Center is operated by the State of California, Department of Developmental Services, and provides long-term residential services for individuals with intellectual disabilities. The psychiatrist performs psychiatric evaluations, participates in the multidisciplinary team meetings and provides recommendations to the primary care physicians in the psychiatric medication management of complex behavioral problems. The psychiatrist is also available via email and pager for consultation with primary care physicians for urgent clinical issues.

SALARY RANGE:$18,146–$22,377 per month

Applications may be downloaded from the California Department of Human Resources website at Applications MUST be filed in person or by mail with:

Sonoma Developmental Ctr., Human Resources Exam Dept., 15000 Arnold Dr., PO Box 1493, Eldridge, CA 95431. For more details, call Dr. Michael Wymore at 707-938-6566.

Staff physicians wanted

Sonoma Developmental Center is a long-term care facility operated by the State of California near Glen Ellen, California. The Center provides comprehensive health services to approximately 500 individuals with intellectual disabilities. We currently have four openings for primary care staff physicians in the fields of Family Practice, Internal Medicine or Pediatrics. The compensation and benefit package is competitive. Sonoma Developmental Center is an Equal Opportunity Employer.

Applications may be downloaded from the California Department of Human Resources website at Applications (Form 678) MUST be filed in person or by mail with: Sonoma Developmental Center, Human Resources–Examination Unit, 15000 Arnold Drive, PO Box 1493, Eldridge, CA 95431. For more information, call Dr. Michael Wymore, medical director, at 707-938-6566.

MMS members get free classifieds!

MMS members can place free classified ads in News Briefs or Marin Medicine. Cost for nonmember physicians and the general public is $1 per word. To place a classified ad, contact Linda McLaughlin at or 707-525-4359.



Sujoya Dey, MD, Clinical Cardiac Electrophysiology*, Cardiovascular Disease*, Internal Medicine*, 2 Bon Air Rd. #100, Larkspur 94939, Stanford Univ 2000

Kenneth Etefia, MD, Psychiatry*, 1036 Sir Francis Drake Blvd., Kentfield 94904, New York Univ 2006

David Goodman, MD, Public Health & General Preventive Medicine, 6 Parkside Way, Greenbrae 94904, Harvard Med Sch 1993

Ruben Kalra, MD, Anesthesiology*, Pain Medicine*, 100 Rowland Way #200, Novato 94945, Univ Southern California 2002

Kabir Singh, MD, Cardiovascular Disease, Internal Medicine*, 2 Bon Air Rd. #100, Larkspur 94939, UC San Francisco 2006

* = board certified; italics = special medical interest



The Marin Medical Society, a 501(c)(6) nonprofit association, supports local physicians and their efforts to enhance the health of the community. We are affiliated with the California Medical Association and the American Medical Association.

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