The Message | July 2016 | A

A Monthly Newsmagazine of Spokane County Medical Society

THE

JULY | 2016

President’s MessageThe Wisdom of Osler

Aaron E.Wagner, MD

Orcharding and Farming: Creating a Good Work-Life Balance

Medical EducationHappeningsThe Dawn of the Northwest Medical Research Symposium

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The Message | July 2016 | 1

Table of Contents

President’s Message The Wisdom of Osler ..........................................................................................................2

Calendar of Events .......................................................................................................3

Aaron E. Wagner, MD: Orcharding and Farming: Creating a Good Work-Life Balance ............................4

Washington State Medical Association A Risk Worth Taking .............................................................................................................6

SCMS 1st Wednesday Member Mixer ................................................................7

Medical Education Happenings UW School of Medicine Spokane; Thank You Celebration! ...................................8 The Dawn of the Northwest Medical Research Symposium .................................9 University of Washington School of Medicine Spokane Students Don White Coats to Begin Clinical Training ..............................................................10 Washington State University’s Elson S. Floyd College of Medicine Recently Added Two New Administrators to Its Team ............................................................11

New Members and Membership Recognition .........................................12

In The News Catholic Health Association Honors Providence Health Care with Achievement Citation .............................................................................................13

Engage Your Community .......................................................................................14

SCMS Building Expert Media Contact List ................................................14

Weed to Know Preventing Underage Marijuana Use in Spokane County ..................................15

Tell the Tooth: Oral Disease is a Problem We Can Address............................................................16

Tough New Rules on Reporting and Returning Medicare Overpayments ..............................................................18

Asset Protection: Protecting Inheritances ...................................................................................................19

Classified Ads Real Estate, Meetings/Conferences/Events, Positions Available ......................20

2016 Officers and Board of Trustees:

Clinton Hauxwell, MD President

John McCarthy, MD President-Elect

Matthew Hollon, MD Immediate Past President

Carla Smith, MD, PhD Vice President

Mathew Rawlins, MD Secretary-Treasurer

Trustees:

Charles Benage, MD Audrey Brantz, MD Elizabeth Grosen, MD Brenda Houmard, MD, PhD Frank Otto, MD Geraldine Peterdy, MD Darryl Potyk, MD Justin Racht, MD Brian Tryon, MD Robert Wood, PA-C

Newsmagazine Editor:

John McCarthy, MD

Spokane County Medical Society The Message. A monthly newsmagazine published by the Spokane County Medical Society.

Advertising Correspondence: SCMS Publications Attn: Shelly Bonforti 901 E. 2nd Ave., Ste. 301, Spokane, WA 99202 509-325-5010 Fax 509-325-5409 shelly@spcms.org

All rights reserved. This publication, or any part thereof, may not be reproduced without the express written permission of the Spokane County Medical Society. Authors’ opinions do not necessarily reflect the official policies of SCMS nor the Editor or publisher. The Editor reserves the right to edit all contributions for clarity and length, as well as the right not to publish submitted articles and advertisements, for any reason. Acceptance of advertising for this publication in no way constitutes Society approval or endorsement of products or services advertised herein.

“STRENGTH DOESN’T COME FROM WHAT YOU CAN DO. IT COMES FROM OVERCOMING THE

THINGS YOU ONCE THOUGHT YOU COULDN’T.”

— RIKKI ROGERS

2 | Spokane County Medical Society

By Clinton Hauxwell, MD | SCMS President

Born in 1849, Sir William Osler was one of the founding professors of Johns Hopkins Hospital. He has been described as the ‘Father of Modern Medicine,’ and in addition to his medical skills he was recognized as an avid reader, author, and practical joker. He is probably best known for his insistence that medical students and residents learn at the bedside, interacting with patients. He was a particular champion of the clinical

clerkship — having third and fourth year medical students spend time with him on the wards; this was a dramatic change from the traditional lecture style of teaching. He once opined that “He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.” Osler was a prolific writer, and there is much to be learned from his many essays and books — he had the amazing ability to succinctly express ideas which remain today as applicable to the practice of medicine as they were when first written.

“There is no more difficult art to acquire than the art of observation, and for some men it is quite as difficult to record an observation in brief and plain language.”[1] Osler was a vociferous proponent of the physical examination — “ … learn to see, learn to hear, learn to feel, learn to smell ... ” Observation is a skill, he declared, and as such requires dedicated study and practice. “The whole art of medicine is in observation … but to educate the eye to see, the ear to hear and the finger to feel takes time … ” In this era of multi-tasking and ‘time management,’ we frequently neglect to sit, listen, and notice. We ‘look’ but we do not ‘see.’ Too often this is the case; in our rush to move on to the next patient, we run the risk of missing the diagnosis. We must guard against developing ‘inattention blindness’ — failing to recognize that which is in plain sight.

But Osler was not just the philosopher of his day. He also appreciated the need for humor and levity in life. “There is a form of laughter that springs from the heart … bubbling spontaneously from the heart of child or man. Without egotism and full of feeling, laughter is the music of life.” Known for his practical jokes, Osler frequently wrote humorous articles under the pseudonym ‘Egerton Yorrick Davis.’ He encouraged his students to find the humor in medicine. “Varicose veins are the result of an improper selection of grandparents.” He even described the physical exam in jest, suggesting “One finger in the throat and one in the rectum makes a good diagnostician.”

Osler spoke frequently regarding the humanity of his patients. He exhorted his colleagues to view them as individuals, not a collection of symptoms and physical exam findings. “The good physician treats the disease; the great physician treats the patient who has the disease.” He knew the secret of success in medicine – the ability to balance empathy with examination, scientific rigor with compassion. Care more for the individual patient than for the special features of the disease ... Put yourself in his place ... The kindly word, the cheerful greeting, the sympathetic look — these the patient understands.” Osler recognized that, given the choice, most patients would choose the truly caring physician over the brilliant practitioner.

We can take counsel from William Osler. Perhaps we should step back and slow down — take the time to not only look at our patients, but to truly observe them. Avoid inattention blindness and missing the obvious. Can we once again commit to treating the patient and not just the disease? And as we grapple with the often difficult decisions inherent to our profession, we must remember to laugh, for it is ‘the music of life.’ n

References:

[1] “On the Educational Value of the Medical Society” in Yale Medical Journal, Vol. IX, No. 10 (April 1903), p. 325.

President’s Message

The Wisdom of Osler

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901 E. 2nd Ave., Ste. 301, Spokane, WA 99202 • Phone: (509) 325-5010 • Fax: (509) 325-5409 • www.spcms.org

Calendar of Events

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If you have any questions regarding an event, please call SCMS at (509) 325-5010 between 9:00 am and 5:00 pm, Monday through Friday, or email shelly@spcms.org

JULYSummer River Cruise July 21, Thursday 6:00 pm — 9:00 pm The Serendipity, Templin’s Marina

AUGUST1st Wed. Member Mixer August 3, Wednesday 5:30 pm — 8:00 pm Marketplace Wineries 39 W. Pacific Ave.

SEPTEMBER1st Wed. Member Mixer September 7, Wednesday 5:30 pm — 8:00 pm Marketplace Wineries 39 W. Pacific Ave. Sponsored by: Incyte Diagnostics

Medical Education Celebration River Cruise September 8, Thursday 6:00 pm — 9:00 pm The Serendipity, Templin’s Marina

OCTOBERWSMA House of Delegates October 1 - 2, Saturday-Sunday SeaTac Hilton, Seattle

1st Wed. Member Mixer October 5, Wednesday 5:30 pm — 8:00 pm Marketplace Wineries 39 W. Pacific Ave. Sponsored by: Inland Imaging

Medicine 2016 October 7, Friday Red Lion Hotel at the Park 7:00 am — 5:00 pm Questions? Contact karen@spcms.org

Senior Physicians Dinner October 20, Thursday, 5:00 pm Manito Golf & Country Club

NOVEMBER1st Wed. Member Mixer November 2, Wednesday 5:30 pm — 8:00 pm Marketplace Wineries 39 W. Pacific Ave. Sponsored by: Inland Imaging

DECEMBER1st Wed. Member Mixer December 7, Wednesday 5:30 pm — 8:00 pm Marketplace Wineries 39 W. Pacific Ave. Sponsored by: Asset Planning & Management, Inc.

4 | Spokane County Medical Society

In-Depth Interview

Orcharding and Farming: Creating a Good Work-Life Balance

By Shelly Bonforti SCMS Development Coordinator

“We shall not cease from exploration, and the end of all our exploring will be to arrive where we started and know the place for the first time.” — T.S. Eliot

I think we all have beliefs or values that our parents try to instill in us at a young age. When we’re young, we generally are forced to follow the leadership of the people who raise us into adulthood, without question. You know, “my house, my rules.” However, once we’re out on our own, we begin to question those beliefs and they become new to us as we make an active choice to incorporate them as our own beliefs, and they truly become part of who we are. It’s at this moment we see them through new eyes and new understanding. As the saying goes, “home is where the heart is” and returning to our true self can be like coming home.

Dr. Aaron Wagner grew up on a farm just outside of Farmington, Washington, with the closest city being Spokane. “I grew up on the farm,” he recollected. “I remember when I was young my dad would pick me up from school and I would ride in the tractor with him all afternoon. I can remember falling asleep almost every time, until I was old enough that he started teaching me to drive. After that I usually stayed awake. When I was younger and working on the farm, though, I took many of the aspects of being outdoors all day

and growing up in this environment for granted,” he confessed.

However, the concept of farming has certainly changed for Wagner over time as he returned to the area following medical school and decided to start a small farm and orchard of his own after deciding with his wife to return to Spokane. “I always appreciated it (farming),” he stated. “However, after I left for medical school, residency, and a career I realized how much I really enjoyed this,” he admitted. “I grew up working on the farm and continued this up through going to medical school. So, although I’ve been involved with farming essentially my whole life on and off, now being back in the area I’m continuing this tradition in more of a hobby format. I started our orchard a couple of years ago, once I knew I’d be back in the area permanently. And there were other aspects that I hadn’t realized, including the peace and beauty of the country, and the emotional well-being became clearer with time,” Wagner declared.

Nowadays, Wagner spends a lot of time back on the farm where he grew up, and has a variety of projects there, including working on the farm, restoring a historic schoolhouse, beekeeping and others, but in particular, he enjoys orcharding. “My wife and I have started an apple orchard with old varieties of both dessert and cider apples, the type that are difficult if not impossible to find anymore, and have tried grafting many of the local trees in the area as well,” he explained. “The area used to have a significant amount of fruit orchards before wheat farming gained prominence, and many of the

Aaron E. Wagner, MD:

The Message | July 2016 | 5

old trees are still present, many of which are of varieties which are difficult to find anymore. I enjoy searching these out and trying to graft them and keep the varieties going. I even started a couple of honey bee hives this spring to assist in pollination,” he expounded. “This allows me to spend time doing farming activities that I grew up with, as I realized with time that I missed this aspect of life, with more of a physical labor component, and spending time outdoors. In addition, growing up in this environment was extremely healthy for me, and with two young daughters I try to have them spend as much time there as possible.”

Wagner feels that growing up in an environment of farming and agriculture has shaped many aspects of who he is today. “It created a work ethic which is ongoing, and spending time working in the fields opened my eyes to the beauty we are constantly surrounded by,” he professed. “Orcharding has been a wonderful way of returning to this environment. An apple harvest in the fall seems to embody some of the characteristics that I have always been drawn to since I was young.”

The contrast with everyday life is what Dr. Wagner enjoys most from farming and orcharding. “It provides an outlet for facets of life that I don’t always get to participate in, and allows for creation of a good work-life balance,” he proclaimed.

Dr. Wagner currently practices at Cancer Care Northwest where a typical work day usually starts around 7 a.m. with tumor board. “I have tumor boards every day of the week, and occasionally a couple per day,” he described. “These are multidisciplinary meetings where we discuss patients newly diagnosed with cancer with all the physicians potentially involved in their care in order to formulate the best treatment plan tailored to their individual case. I will then work on radiation treatment plans until I start seeing patients. Radiation treatment plans typically take up to a week to develop, and involve designing radiation treatments on patient’s CT scans and MRI’s to tailor treatment to areas of known cancer as well as areas at risk for cancer, while avoiding treating the rest of the body as much as possible. This typically requires many planning iterations involving myself as well as a team of planners, including dosimetrists and physicists. I work on treatment planning early in the mornings, any extra time in between patients, and after clinic. There is always treatment planning to be done.”

His workdays are full as he typically see patients in clinic from around 8:30 a.m. to 5:00 p.m., and sees combinations of new patients with a new diagnosis of cancer where he reviews in detail their entire treatment plan, follows up with patients who are being monitored after having completed treatment for cancer, and sees patients currently undergoing treatment with radiation. “Once the clinic day is done, I get caught up on issues that arise during the day, documentation, and then back to treatment planning,” Wagner continued. “Typically I will leave clinic between 6:00 and 7:00 at night, in order to make it home in time to see my daughters before they head to bed.”

Wagner acknowledges that there is some correlation between his career and farming and orcharding. “It has created a strong work ethic which has lasted and stayed with me,” he upheld. “And there are always a variety of challenges,” he stated. “Working on the orchard, for instance, brings up questions of crop diseases and nutritional deficiencies. In many ways this parallels medicine, where we are looking at human diseases and deficiencies, but this is a body of knowledge that is a new frontier for me and one which is fun to research and learn on my own.”

Land and equipment are obviously required for farming and orcharding, which Wagner recognizes he is lucky to have. “My father and uncle still are actively farming around 6,000 acres, and as such I am lucky to be able to tag along on this activity as well as utilize farm equipment,” he said. “Exactly what equipment would take a long time to detail, but again, I am lucky to have access to a

large variety of tools and equipment. The equipment I don’t have, I try to build, like a cider press, sprayers, apple ladders, etc…”

In Family Values, Not Money, Is Best Legacy, Philip Moeller writes that despite financial upheavals in recent years “people thinking about their estates and inheritances continue to believe that passing along personal and family values is the most important legacy they can leave for their heirs.” With that said, Dr. Wagner is passing along the values he learned as a child to his children as well. “My family, including my wife (Sarah) and two daughters ages five and two years old, are with me all the time,” he maintained. “It’s a great environment for the kids, and both of them love to go there. There’s open space to run, they get to go on tractor rides which they love, and see their grandparents. In addition, they love riding on the combines and trucks during harvest, and being able to see the farm at work. My oldest daughter is even enjoying beekeeping, and has her own bee suit.”

Dr. Wagner has many hobbies, and also enjoys fly-fishing, skiing and woodworking. “I love to fly-fish as well as ski and I do both of these activities as much as time allows,” he added. “However, given my children’s ages and a desire to spend time with them, these activities have taken a bit of a backseat until my daughters are older and can participate more in these activities themselves. We have started skiing with my oldest daughter, and she can bomb down the hill already.”

“I also enjoy reading, and spend many evenings reading old classics, which are generally my favorite genres,” he continued. “In addition, I love to woodwork, which is another very time consuming hobby, but I spend time in my woodshop as much as possible. My wife usually has a list of projects and furniture that she wants me to build, and in fact, I’ve built much of the furniture in our house,” he shared.

“I love the region,” Wagner asserted. “This is home to me, having grown up in the area, and the longer I was away the more I realized I missed the geography and outdoor opportunities. That still wouldn’t have been possible without a good job opportunity, though, and I’m lucky enough that I have a fantastic practice to work for, Cancer Care Northwest, without which I wouldn’t have been able to come back to this region.” n

Dr. Wagner graduated magna cum laude in Chemical Engineering from the University of Idaho in 2005. He subsequently attended Loma Linda University School of Medicine where he received his MD and was granted various scholarships of distinction. He has completed four additional years of specialty training in Radiation Oncology at the Huntsman Cancer Hospital and University of Utah Medical Center where he was named Chief Resident after early advancement, in Radiation Oncology.

Dr. Wagner has actively pursued clinical research throughout his career. He has authored multiple scientific articles in top medical publications, including the Journal of Thoracic Cardiovascular Surgery and Gynecologic Oncology. Additionally, he has given various presentations and written a number of book chapters on modern radiation treatment and the use of radiotherapy in the care of patients with gynecologic, skin, central nervous system, and other bodily malignancies.

6 | Spokane County Medical Society

Washington State Medical Association

By Ray Hsiao, MD | WSMA PresidentOver a century after being launched by

pioneering Washington state physicians, the WSMA continues to enjoy remarkable health (over 10,000 members and growing) in an era of unprecedented change in healthcare. Today, our members stand where the paths of change and opportunity converge, ready to take the historic step of introducing to this venerable organization a new

way to govern and to serve its members, their patients and profession.

This momentous occasion did not appear out of nowhere. Preceding this moment were years of collaboration and conversation among our members, driven by a collective desire to increase the value and effectiveness of membership by adapting to a new healthcare environment, honoring a diversifying demographic and becoming more responsive to a fast-changing industry.

The path forward became clearer last year after the WSMA Board of Trustees introduced a preliminary proposal for an alternate policy-making process, inspired by new models of governance being adopted by other medical associations around the country.

What ensued, as our members spent the better part of a year considering these changes, was one of the most robust and exciting discussions I have been a part of since joining the association. It was heartwarming to see so many of our members involved and invested in the future of the WSMA.

Out of these discussions, the message from our members became clear: Changes to the WSMA must strike a balance between updating and modernizing our policy-making structure and respecting those elements that our members still value.

Honoring our physician-driven mission, the WSMA Executive Committee has built on that message to craft a new proposal for consideration at the 2016 Annual Meeting of the House of Delegates. The proposal creates a more modern, efficient system of governance while preserving WSMA’s long-standing traditions of democratic participation and representative governance.

I encourage you to go to wsma.org/reference-committees today and review the proposal. Share your thoughts and see what your colleagues are saying. Engage in a discussion. You helped to create this proposal, and we need your help to make it work.

Embracing change doesn’t mean repudiating the past; rather, it reflects our desire to be better versions of ourselves. We recognize that with change comes risk; yet we also know, through our experiences as physicians, that without risk, there truly is no reward.

I believe WSMA members are ready to lead the way forward—and into history. Our reward is the assurance we have done everything we can to help make Washington the best place to practice medicine and to receive care. And that’s a risk well worth taking.

Join us at the WSMA annual meeting, Oct. 1-2 in Seattle. I look forward to seeing you there. n

A Risk Worth Taking

The Message | July 2016 | 7

A special thanks to our sponsor for the evening!

SCMS 1st Wednesday Member Mixer

Spokane County Medical Society’s 1st Wednesday Member Mixer was held on June 1, 2016, at Marketplace Wineries. Guests enjoyed appetizers and drinks, as well as great conversation with colleagues in a relaxed atmosphere. A great time was had by all!

8 | Spokane County Medical Society

Medical Education Happenings

UW School of Medicine Spokane; Thank You Celebration!

By Darryl Potyk, MD, FACP University of Washington School of Medicine Assistant Dean for Regional Affairs & Clinical Professor Providence Internal Medicine Residency Spokane Associate Program Director

Thank you. Two words that need to be used more often, not only in our everyday life, but also in a heart-felt manner to those who make a big difference in what we do. On May 19, 2016, UW School of Medicine-Spokane did just that. We wanted to say thank you to those who are engaged in medical education, whether it be in the Foundations phase (flipped classroom, anatomy, Primary care practicum) or in the Patient care phase (required and elective clerkships). There are over 750 clinical faculty members teaching UWSOM-Spokane medical students in Spokane and Eastern Washington; of those 175 were able to attend the “Thank You” event at the Davenport Hotel to recognize educators who share our

mission of increasing the physician workforce and committing their time, energy and talents to do so.

The highlights of the evening included a graduating UWSOM-Spokane medical student (Lauren Benson) and a UWSOM-Spokane alumna (Rachel Safran) sharing their experiences as students here. Both shared their gratitude for having been able to train in the supportive yet rigorous environment that has been created in Spokane. Their firsthand accounts of the quality of their education

together with the relationships they had with their faculty contributed to both of these graduates choosing to stay in Spokane. While teachers and administrators can say “thank you”, the words are much more meaningful when they come from students and recent graduates.

In addition to saying thank you, this evening was also an opportunity to celebrate the future. Those in attendance heard from Gonzaga University President, Thayne McCulloh. Dr. McCulloh’s remarks emphasized that the partnership between Gonzaga University and UW School of Medicine-Spokane will build on the educational excellence at both institutions, that the GU faculty are enthusiastic about participating in medical education and ultimately that this partnership will be good for the health and prosperity of Spokane and Eastern Washington. The shared mission and commitment to excellence on the part of these two universities speaks to great opportunities ahead!

Another speaker summed things up this way: “Teaching is a higher calling — it’s important to pay forward the training we received [as medical students]. Being a teacher really can make a profound difference in the lives of medical students and residents, and, the older I get, I often think of the pragmatic side: we’re here helping to “make” the best possible doctors to take care of us and our families. But, at the end of the day, what I hear from most of you is that teaching reminds us all of why we went into medicine. It reminds us of the joy in becoming and being physicians.”

The UW School of Medicine-Spokane, thanks you for your commitment to our students, for your professional excellence and for your collaboration and support of Spokane’s growing and leading medical education program. n

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SCMS is hosting an evening cruise celebrating medical education in Spokane held aboard COP member Travis Prewitt’s (UBS Bank) boat “The Serendipity”. Due to

limited space capacity on the boat and the nature of the event, invites to participate are limited to practicing physicians and physician assistants only and does not include spouses, significant others or staff.

MEDICAL EDUCATION CELEBRATION CRUISEThursday, September 8, 2016

Visit our website, spcms.org for details and event registration.

The Message | July 2016 | 9

Medical Education Happenings

By Danielle Wolff, MD, MPH Program Director, Transitional Year Residency

For years, the medical residents in Spokane have been involved in remarkable research that has been accepted to be presented at national conferences or published in well recognized medical journals, but they have never had the opportunity to showcase their hard work locally, until now. On May 11, 2016, the first annual Northwest Medical Research Symposium was held at Providence Sacred Heart Medical Center. This was an opportunity for residents and fellows to present their research or case studies to attending faculty, community physicians, and guests. In total, their were 23 poster and 9 oral presentations, representing residents and fellows from the Internal Medicine, Family Medicine, Radiology, Transitional Year, OB Fellowship, and Sports Medicine Fellowship programs in Spokane.

The afternoon consisted of two poster sessions, where residents had the opportunity to discuss their research and answer questions. In addition, there were three oral presentation sessions that allowed presenters to speak about their research topic and then answer questions. Guest and participants could also take part in trivia and a raffle for door prizes. The event concluded with a cocktail party.

Prize money was awarded to what judges deemed the best oral and poster presentations. While there were many outstanding presentations, the 2016 Northwest Medical Research Symposium winners were:

Best Oral Presentation:

Peter Wehr, MD; Family Medicine Residency Early Analysis of Concussion Prevention in NCAA Football: Changes in Lower Extremity Injury Rates Across the 2009/10 – 2014/15 Seasons

Best Poster Presentation:

Sam Braden, MD; Transitional Year Residency A Randomized, Single-Blind Comparison of Three Commercially Available Botulinum Toxins in the Treatment of Facial Synkinesis

A warm thank you to our judges, who volunteered time out of their busy schedules to join us for the afternoon:

• Brent Albertson, PharmD • Radica Alicic, MD • Jerico Cairns, MD • Karina Dierks, MD • Travis Dierks, MD • Kiran Gill, DO • Ken Isaacs, MD • Diane Lefcort, MD • Dinesh Ratti, MD • Hormoz Solomon, MD • Katherine Tuttle, MD

As well, thanks to Central Food, Horizon Credit Union, Liberty Ciderworks, and Washington Trust Bank, who donated amazing door and trivia prizes.

The symposium sparked a lot of interest from the local medical community. Plans are already underway for next year’s research symposium, with the hope of expanding to allow medical students, pharmacy residents, and community physicians the opportunity to showcase their research. As this annual event continues to grow, it would be wonderful to get more community physician involvement, both in attending the event, presenting research, as well as getting residents, fellows, or students involved in local research. If you are interested in any of these prospects, please contact me at: danielle.wolff@providence.org. n

The Dawn of the Northwest Medical Research Symposium

10 | Spokane County Medical Society

Medical Education Happenings

University of Washington School of Medicine Spokane Students Don White Coats to Begin Clinical Training

UW School of Medicine Spokane students, faculty, family members and friends gathered on Saturday, May 14, for a ceremony in which 18 second-year medical students transitioning to their third year of training received their white coats. The “White Coat Ceremony” represents the transition into clerkship training—the third and fourth years of medical school that involve increasingly intensive patient-care training.

The intimate ceremony took place at the rural Palouse home of William G. Sayres, Jr. M.D., UW School of Medicine Assistant Dean. Dr. Sayres gave the opening remarks before the white coats were presented to the students by Spokane faculty Matt Hollon, M.D., Geoff Jones, M.D., Karen Wildman, M.D. and Janelle Clauser, M.D. During the event, the students reflected on the past year, and looked ahead to the world of clinical medicine.

“This is an exciting milestone for these outstanding students,” said Dr. Sayres. “They are learning and gaining experience through the most innovative curriculum, collaboration and support of local clinical experts, all guided by faculty in a nationally top ranked program.”

The third year of medical school consists of required clinical clerkships in Family Medicine, Internal Medicine, Obstetrics and Gynecology, Pediatrics, Psychiatry, and Surgery. Students can opt into a Track Program in one location in the WWAMI region (Washington, Wyoming, Alaska, Montana and Idaho) that allows

them to complete at least five of the six clerkships and/or all of the fourth year required clerkships in same location. The Spokane Track is recognized for the quality of clinical teaching and is popular with students who are seeking to immerse themselves in a community during their clinical training.

For 25 consecutive years, UWSOM has maintained the No. 1 ranking in the nation in family medicine and rural medicine training, and for 22 out of 23 years has earned the No. 1 ranking in primary care training in U.S. News & World Report’s lists of the nation’s top graduate and professional-school programs in the country. In addition to leadership in primary care, family medicine and rural medicine, UWSOM faculty also compete for more than $1 billion of research funding per year and their research is devoted to improving the communities they serve.

The UW School of Medicine has provided medical education in Spokane and eastern Washington for 45 years through a five-state, community-based medical education program called WWAMI, an acronym for the states it serves: Washington, Wyoming, Alaska, Montana and Idaho. Today, more than 500 faculty in 18 communities throughout eastern Washington serve as educators and mentors for UW medical students. This year, the UW was selected by the American Medical Association as one of 20 medical schools to join a national consortium to create the medical school of the future. n

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Spokane County Medical Society 901 E 2nd Ave, Ste 301, Spokane, WA 99202 (509)325-5010 Fax: (509)325-5409

The Message | July 2016 | 11

Washington State University’s Elson S. Floyd College of Medicine Recently Added

Two New Administrators to Its TeamBy Doug Nadvornick, Elson S. Floyd College of Medicine

Dawn DeWitt, MD, is vice dean for student and faculty experience, and Luisita Francis, MD, is assistant dean for community engagement.

DeWitt will provide strategic leadership for the college and has been active in medical education innovation and leadership for more than 20 years in the U.S., Australia and Canada. She is a general internist with an interest in diabetes and has worked with underserved, rural and indigenous populations.

“It is beyond exciting to help create a new College of Medicine that will train doctors for Washington State,” DeWitt said. “I’m also looking forward to doing some clinical work and teaching here in general medicine and diabetes.”

Francis will help the college develop relationships with campus and clinical partners around Washington. She is a pediatrician by training, and was in private practice in Los Angeles and Bakersfield, California. Most recently, she was executive director of Excelerate Success, a Spokane County educational attainment partnership for children, where she developed skills in collaboration and partnership building across a range of industries.

“I’m excited to help the Elson S. Floyd College of Medicine find the places and develop the programs where our students will have great learning experiences,” Francis said.

DeWitt obtained a bachelor’s degree from Mount Holyoke College (South Hadley, MA), a master’s degree from Trinity College, Cambridge University (England), and an M.D. at Harvard Medical School (Boston). She then did a residency in Internal Medicine through University of Washington affiliated hospitals and was the first woman chief resident at the UW Medical Center. She was a clinician educator at UW with a focus on WWAMI-related education and faculty development for 10 years. In 2003, she moved to Australia as professor and foundation chair of rural medical education at the University of Melbourne, and in 2012, she moved to the University of British Columbia where she served as associate dean for

undergraduate medical education and was a tenured professor as well as an attending physician at Vancouver General Hospital.

Francis did her undergraduate work at Princeton University in New Jersey, obtained her medical degree from Northwestern University in Chicago, and was a medical resident at The Children’s Hospital in Los Angeles. In the 11 years she spent in private practice in California after her residency, she worked with children from underserved areas as well as high-end pediatric patients in North Hollywood.

Prior to medical school, Francis spent a year in marketing communications, and later, while practicing medicine, she was involved in marketing and building collaborative partnerships by participating in various organizations. She also spent two years during that time as a medical/technical advisor to the television program “All Saints” in Sydney, Australia. Francis moved to Spokane four years ago. n

Medical Education Happenings

Dawn DeWitt, MD Luisita Francis, MD

12 | Spokane County Medical Society

to the members listed here. Their contribution of time and talent has helped to make the Spokane County Medical Society the strong organization it is today.

70 YEARSRobert A. Stier, MD 07/15/194660 YEARSGeorge W. Bagby, MD 07/09/1956James McAllister, MD 07/20/195650 YEARSGeorge M. Pavey, MD 07/01/196630 YEARSRobert G. Benedetti, MD 07/17/1986

10 YEARSJulie R. Kaczmark, MD 07/01/2006Christopher D. Yarber, DO 07/17/2006Robert S. Wirthlin, MD 07/24/2006Pamela S. Kohlmeier, MD 07/31/2006

thank you

New Members

Welcome, New MembersPHYSICIANS:

Lambert, Allison A., MD

Internal Medicine/Pulmonary Medicine/Critical Care Medicine

Medical School: Mount Sinai School of Medicine (2008)

Internal Medicine Internship & Residency: Mount Sinai Hospital (2008-2011)

Pulmonary & Critical Care Medicine Fellowship: Johns Hopkins Hospital (2011-2015)

Joining Spokane Critical Care Associates 9/1/2016

Parkinson, Erin G., DO

Internal Medicine

Medical School: Arizona College of Osteopathic Medicine (2013)

Internal Medicine Internship & Residency: Providence Internal Medicine Residency Spokane (2013-2016)

Joining Spokane Critical Care Associates 7/2016

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The Message | July 2016 | 13

In The News

CATHOLIC HEALTH ASSOCIATION HONORS PROVIDENCE HEALTH CARE WITH ACHIEVEMENT CITATION

Providence Health Care’s Transitional Respite Care for the Homeless Program was presented with the Catholic Health Association’s (CHA) Achievement Citation this week. The Achievement Citation is one of CHA’s highest honors reserved for outstanding programs that transform lives.

The Transitional Respite Care for the Homeless Program provides a post-discharge environment for people who are homeless to recuperate, and would otherwise return to life of the streets before they are fully healed. It received this premier award for original, bold, innovative programming that delivers measurable results for communities it serves in Spokane. The program is reducing the demand on emergency services, saving resources that are being redistributed for important services, and helping improve the overall health of the community.

The award was presented June 6 during the annual CHA Assembly in Orlando, Florida. Elaine Couture, regional chief executive of Providence Health Care, accepted the award, saying “At its core, this program is a testament to the connection between health and home, and the value of human dignity in every person’s life. Our hope is to share this story, and that other communities will develop similar programs.” The award includes a $10,000 grant from CHA to support the program.

Learn more about the program. www.chausa.org/assembly2016/about/Awards/achievement-citation n

Elaine Couture (center), regional chief executive of Providence Health Care, accepts the Catholic Health Association Achievement Citation during ceremonies in Orlando, Florida, this week. Presenting were Robert Henkel (left), CEO of Ascension Health and chairman of the CHA Board of Trustees; and Sister Carol Keehan (right), CHA president.

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14 | Spokane County Medical Society

Family Medicine Physician with ObstetricsWith three clinics in beautiful Spokane, Washington, Unify Community Health has grown. We currently have an opening for a Family Medicine physician with OB to work alongside our dedicated, mission-driven providers. Our providers are supported by teams of nurses, medical assistants, dietitians, and a behavioral health consultant.

A few of our benefits include:

• Market-competitive compensation

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• 1 in 4 call

• Hiring bonus and relocation package

• EMR: Epic

Unify Community Health

providerjobs@yvfwc.org | 1-877-983-9247 | www.yvfwc.org

Make a Meal for Many! On September 16, 2016, Spokane County United Way will gather over 300 volunteers to assemble 100,000 meal packages in three hours. Through collaboration with 2nd Harvest and Communities in Schools these meals will be distributed throughout our community.

This event makes direct impact on Vision 2020 - a more educated, prosperous, and healthy community. Please contact Blake Pang with immediate questions or sponsorship inquiries or call (509) 838-6581. n

SCMS has a monthly column highlighting community engagement opportunities that you can support. If you have a special program you would like to bring awareness to, please email shelly@spcms.org.

Engage Your Community

From time to time, the Spokane County Medical Society (SCMS) is called upon by the media to provide expert medical opinion or commentary on specific subject matter, usually as background for an article or news story. In response to that need, we are building a SCMS Media Contact List and are seeking SCMS members who would be willing to be called upon to provide expert insight on specific procedures, diseases, treatments or even basic anatomy.

SCMS Building Expert Media Contact ListIf you are willing to be included on this list, please

email shelly@spcms.org with your name, your preferred contact information and the areas you would be willing to speak about should the need arise. This is one more way that SCMS is helping to reconnect our members with the community. We thank you for your willingness to participate.

The Message | July 2016 | 15

Weed to KnowBy now, you might be used to seeing retail marijuana stores, ads

marketing associated products in the local papers, and you may have even been exposed to public use of marijuana. This is the post-I-502 world we now live, work, and play in — it’s a world adults share with teens and adolescents who are more susceptible to the negative effects of marijuana use. Thus, this green era ushers in a new responsibility for the Spokane community to protect youth, and educate them, specific to the harms of associated with their marijuana use.

Adding complexity to this urgency to educate, the cannabis industry grew quickly, making it difficult for communities to respond with adequate training, resources and messaging. As prevention materials and data emerges, providers will be crucial in directing patients to reliable information, particularly when it comes to providing information to parents and youth.

Locally, Spokane Regional Health District (SRHD) recently released materials and messaging under the banner of Weed to Know, which targets existing and potential adult marijuana users and implores them to help prevent underage marijuana use. The campaign features six key messages including:• laws about driving under the influence and restrictions on marijuana use in public places• specificity on marijuana not being legal for people under 21• safe and secure storage of edibles• talking to youth about marijuana use • promotion of a free addiction and recovery hotline available 24/7 for anonymous support

The messages largely appear in the form of print and digital ads in popular media outlets like Spokesman Review, Inlander, Black Lens News and others. Clinics interested in participating in the campaign can use posters and other resources provided by SRHD. Providers can also direct patients to visit the website, www.srhd.org/WeedToKnow.asp, where individuals can read information about each of the campaign messages and be linked to many other helpful resources.

Beyond Spokane County, there are a variety of resources available to learn about marijuana including the University of Washington’s Learn About Marijuana site, learnaboutmarijuanawa.org, where visitors can find scientific information on what marijuana use, how it is used and impacts

on health. Among the many resources on this site, there is also information for pregnant women and parents.

The Washington State Department of Health also recently launched a campaign just for youth. The campaign is titled Listen 2 Your Selfie and encourages youth to think about what is important to them and to forget about marijuana. Youth can visit the site, listen2yourselfie.org, to learn more about health impacts of using marijuana, consequences of underage use, and resources.

To provide parents with resources to talk to their children about marijuana starttalkingnow.org has a wealth of information, including short “how to” videos.

For more information on resources or program activities specific to preventing underage marijuana use, contact SRHD’s Tobacco, Vaping Device, and Marijuana Prevention program via Paige McGowan at pmcgowan@srhd.org or (509) 324-1504. n

Preventing Underage Marijuana Use in Spokane County

16 | Spokane County Medical Society

Tell the Tooth: Oral Disease is a Problem We Can Address

By Deb Harper, MD, FAAPAs a practicing Pediatrician in Spokane for over thirty years, I

have seen my share of painful dental problems among my young patients. I trained in Chicago at Cook County Hospital. My patients were the poorest of the poor. But I didn’t see teeth rotted to the gumline until I moved to Spokane. Honest, the first kid I saw with horrible dental caries I thought had ectodermal dysplasia. I’d seen THAT in Chicago. Twice.

Instinctively, most of us recognize that good oral health is important. Painful teeth affect a child’s ability to focus and learn and prevent seniors from eating nutritious foods. [1] What many may not know is that early childhood caries (cavities or tooth decay) is the most common chronic disease affecting young children. It is five times more common than asthma and seven times more common than hay fever.[2] Poor dental health affects cardiovascular health too.

Unfortunately, one of every four Spokane children has experienced dental decay by kindergarten.[3] Unsurprisingly, one of every three Spokane County adults has lost at least one tooth due to decay.[4] I remember volunteering in my sons’ elementary classrooms and helping on field trips. One group of six kids I took to the Fair were amazed that I had my own home grown teeth.

None of their mother’s had any teeth left (other than their dentures). And, come to think of it, those mothers were all ten years and more younger than me. This is why there is growing momentum for physicians to address oral health.[5]

Our local dentists pioneered the ABCD program (a precursor to our Project Access) so all children would have access to dental care. Then they expanded the ages served with the ABCDE

program, now called Mighty Mouth in Primary Care, to encourage physicians to do fluoride varnishes. Together we showed everyone how well this worked

for our kids. Now statewide, 45 percent of pediatricians and family physicians have been trained to deliver oral health preventive services during well child visits

Signing up for a free ninety minute training is as simple as contacting The Washington Dental Service Foundation – and

NOWHIRING

Primary CareProviders

ONE OF EVERY FOUR SPOKANE CHILDREN HAS EXPERIENCED DENTAL DECAY BY KINDERGARTEN

The Message | July 2016 | 17

they do refresher courses. Addressing oral health in your practice is reimbursable.

We have a role in promoting strategies that will prevent cavities. The re-mineralizing effects of community water fluoridation and fluoride varnish along with proper brushing and flossing on tooth enamel are effective for both children and adults. Working together, one conversation at time, we have the opportunity to inoculate our patients from the questionable information found on the web and help them make the right decisions for their overall health and the community. Oral Health is one of the great interventions we make that can have lasting effect. n

The SCMS is partnering with Smile Spokane to improve oral health for all Spokane residents. For more information on trainings or to get involved, please contact Jerrie Allard, info@smilespokane.org.

[1] Dental Problems Affect School Performance. PEW Dental Campaign. August 15, 2012. Accessed at www.pewtrusts.org/en/about/news-room/press-releases/2012/08/15/dental-problems-affect-school-performance June 7, 2016.

[2] US Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health: 2000. Available at: www.nidcr.nih.gov/DataStatistics/SurgeonGeneral/Report/ExecutiveSummary.htm. Accessed June 07,2016

[3] Spokane Regional health District. Smile Survey 2010, Oral Health Disparities Evident. April 18, 2011. Accessed at www.srhd.org/news.asp?id=212 June 7, 2016

[4] Spokane Regional Health District. Ten Things You Need to Know About Oral Health in Spokane County: 2010. Assessed at www.srhd.org/documents/PublicHealthData/OralHealthFS-2010.pdf June 7th, 2016

[5] U.S. Department of Health and Human Services Health Resources and Services Administration. Integration of Oral Health and Primary Care Practice. 2014. Accessed at www.hrsa.gov/publichealth/clinical/oralhealth/primarycare/integrationoforalhealth.pdf June 7, 2016

18 | Spokane County Medical Society

Tough New Rules on Reporting and Returning Medicare Overpayments

By Richard D. Wagner, FHFMA, CPAOn February 12, 2016 Centers for Medicare & Medicaid Services

(CMS) issued final rules on the reporting and returning of Medicare overpayments. These new rules were issued as part of the Affordable Care Act enacted on March 23, 2010. The penalties for not following this new rule could be a violation of the False Claims Act (FCA). The FCA fines range from $5,500 to $11,000 per claim and a payment up to three times the amount of damages. It also imposes a look back period of six years of the date the overpayment was received.

What is an overpayment? It could come in two ways, the first is simply an amount paid in excess of what was claimed also known as a credit balance. This can occur just through a payment error or more often when a Medicare beneficiary has other insurance and there is confusion over which should pay in which case Medicare may pay more than their share, result is a credit balance. The other way is more common where claims may have been miss-coded and the claim for payment was overstated, i. e. maybe a modifier 25 was used on an E & M code where it should not have been resulting in an overpayment.

This means that you need to be more active in the billing part of your practice and make sure there are procedures in place to be “proactive” in following up on any possible issues. Once an issue is found you have triggered a 6 month investigation period

to find the overpayment amount for the last 6 years and refund the money. This would indicate each practice needs to have an internal process in place to periodically review the billing and coding for any potential issues. There is an expectation now that you will be actively looking for issues on an ongoing basis.

You can do one of two things to comply with this new rule. Stick your head in the sand and hope no problems exist in which case if a problem is found by CMS then expect a bigger stick to be used in the way of penalties and potentially suspension from the Medicare program. The second and one we recommend is to put in place a periodic review of your billing and coding to proactively look for problems and when found follow the rules set out in this new rule to repay any overpaid amounts. If you have a proactive process in place and a problem slips through the process and is reported to you by CMS you are much less likely to suffer the full extent of the penalties.

Some would say this places an undue hardship upon medical practices but it should be noted you were always required to report and repay any overpayments when found. This rules simply formalizes and clarifies the process to be used. n

Rick is a CPA, partner, and Director of the Medical Professionals practice at Eide Bailly, a top 25 CPA and business advisory firm. Our health care services go beyond cost reports, audit and tax, to help you drive results and plan for a strong future. For more information contact Rick at rwagner@eidebailly.com.

The Eastern Washington AREA HEALTH EDUCATION CENTER is at Eastern Washington University!

• Experiential learning for health professions students

• Creation of a youth pipeline into health care careers

• Continuing education for health providers

• Internships for future health professions students

Learn more at

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WHAT THE HECK IS ANAHEC

The Message | July 2016 | 19

Asset Protection: Protecting Inheritances

By Greer Gibson Bacon, CFP®In many years of professional practice, I’ve never met a physician

who didn’t fear a malpractice lawsuit. Most don’t result in an award to the plaintiff, but the potential for financial loss is stunning. That said; litigious patients may be the least of your worries. There’s the soon-to-be ex-spouse. There’s the teenage driver who causes a wreck while texting. There’s the mailman who’s been bitten by your dog. You have plenty of potential creditors and it’s important to build asset protection into your financial plan.

Now, let’s consider the greatest wealth transfer in history. In the coming years, baby boomers will inherit $12 trillion from their parents. However, that pales compared to the $30 trillion boomers will leave to their children. For most of us, it’s important to protect these assets for ourselves, our children and grandchildren.

Properly drafted, testamentary trusts are a great way to protect family assets from creditors while providing many (but not all) advantages of outright ownership. For example, you can be your own trustee. You can receive all trust income. You can receive trust principal, but only if limited by an ascertainable standard, like the MESH standard (maintenance, education, support and health). Also, you can be granted a limited power-of-appointment to direct trust income or principal to someone else.

Here are two examples of how you might use testamentary trusts in your financial plan.

• If you’re a high net worth boomer and likely to receive an inheritance from your parents, ask them to leave it in trust naming you as “income beneficiary” and your children as “principal beneficiaries”. In addition to creditor protection, this provides a valuable estate tax advantage. This is because trust assets are excluded from your estate if you don’t have a general power-of-appointment. It blows the estate tax advantage and creditor protection if you can give them to yourself at-will.

• If you’re a high net worth boomer and likely to leave an inheritance to your children, leave it in trust naming them as income beneficiaries and your grandchildren as principal beneficiaries. Again, this provides creditor protection and potential estate tax advantages. But, importantly, it assures family assets pass to your grandchildren should your child die and his surviving spouse remarry.

Although these examples don’t provide for spouses, you can. For example, your parents might grant you a limited power-of-appointment to direct trust income to your spouse for her lifetime if you die first. Thereafter, trust principal passes to your children. You can provide for multiple generations, too.

For generations, ultra-wealthy families (think Rockefeller, Guggenheim and Morgan) have used these and similar strategies to protect their wealth from potential creditors and continual erosion by estate and gift taxes as it passes from generation-to-generation. Fortunately, they can be used effectively by the rest of us, too.

If you’d like to learn more about this and similar strategies, you should contact your estate planning professional. If you don’t have one, try visiting the Spokane Estate Planning Council website at spokaneepc.org.

Bacon is a Certified Financial Planner™ and President of Asset Planning & Management, Inc. A fee-only firm, it provides comprehensive wealth management services for individuals, their families and professional practices.

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20 | Spokane County Medical Society

Interested in placing a classified ad?

Contact Shelly Bonforti, SCMS Publications Phone: (509) 325-5010, Fax (509) 325-5409

or Email: shelly@spcms.org

Classified Ads

AL-ANON FAMILY GROUPS AND ALATEEN REFERRALS: Al-Anon and Alateen support groups are available in Spokane County for family members and friends of alcoholics at which men and women share experiences of solving common problems arising from living with or loving a problem drinker. Alateen meetings are for teenage family members and friends of alcoholics and are not suitable for teens with current drinking problems. For further information and meeting schedules contact District2AlAnonOutreach@yahoo.com or (509) 456-2125. Al-Anon and Alateen support groups can supplement medical treatment and counseling therapy. Information provided by Al-Anon District 2 Public Outreach Committee.

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MEDICINAL CANNABIS AND CHRONIC PAIN PROJECT- A SCIENCE-BASED ONLINE TRAINING FOR CLINICIANS IN TIMES OF LEGALIZATION. CME Webinar Expires 12/31/16. Legalization has brought increased public attention to cannabis and its medicinal properties. This training provides you with up-to-date information on the use of medicinal cannabis for the treatment of chronic pain in two online modules. The first is a basic primer on the mechanism of action of medicinal cannabis, its medical uses, and Washington State law. The second focuses on the best clinical practices associated with the recommendation of medicinal cannabis. This training provides useful tools for healthcare providers in their discussion with patients about the use of medicinal cannabis in the treatment of chronic pain. Up to 2.0 AMA PRA Category 1 Credits™ are available upon completion. Click here for more information and to begin the training: adai.uw.edu/mcacp

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POSITIONS AVAILABLEPSYCHIATRISTS Providence Medical Group is seeking several Psychiatrists to join our team in scenic Spokane. Flexible full-time practice opportunities with various schedules: inpatient, faculty (Psychiatry Residency program), or split. Schedule will be 7 days on / 7 days off, with 12 hour “on” days. Whichever you choose, the positions offer exceptional compensation and benefits, and great quality of life. To apply, contact Jackie Sill; Jacqueline.Sill@providence.org; (509) 474-2076.

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REAL ESTATECHARMING A-FRAME LAKEFRONT HAYDEN LAKE CABIN with Additional Guest Quarter Cabin Enjoy fabulous views from multiple decks and large picture windows from this charming waterfront A-frame cabin located on the west side of Hayden Lake in Idaho. Stay in the A-frame alone or if your group is larger, add the guest quarters for more room, another kitchen and an additional bath. Deep water frontage with boat slip. Sleeps 9. For rates and the availability contact Pam Sturbaum (509) 939-3452.

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DAYLITE RANCHER 3,200 sq. ft. on Pend O’Reille River with boatable access to P.O.R. Lake. Entertainer’s delite! Gorgeous landscaping. Hot tub overlooks river. 3 bdrm, 3 bath, w/room for several families. Remote/private feel, but only 10 minutes to groceries, bank, post office, golf course; 45 minutes to two ski resorts. One block to community boat launch. See online: 109 W Cedar Ln, Priest River, ID 83856 - contact: realtor Katie Stolebarger W: (208) 664-9221; C: (208) 640-9295; cdawaterfront@aol.com

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LAKE FRONT CONDO with desired southern exposure on Pend Oreille Lake. 3 levels. Sleeps 8. 2 bathrooms, fully furnished. Boat slip and garage included. Sandy beach. Multiple decks, close to Sandpoint. Rent by the month or for the summer. $4,500 per month. Call (509) 993-8547.

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LEGACY RIDGE GATED COMMUNITY IN LIBERTY LAKE is filling up fast with homes ranging from $410,000 through the first gate, to $474,900 through the second gate. Preview the best value available at 780 N Holiday Hills Dr, featuring over 2,300 finished main floor sq. ft., MLS#201616420. This 3 bedroom, 2 bath home is vacant, easy to preview, and it’s move-in ready. Offered @ $474,900. Call Jake Turley and let 17 years of full-time Spokane real estate experience work for you. Tamarack Realty (509) 230-7856.

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LIBERTY LAKE GATED, 3/2.5 bath mfd home. Att. 24’x60’ shop/lean-10 acres MOL, woodstove, mudrm, in-line water, grid interactive solar/batt. backup/wind turbine incl., propane, util. to building pad. Saltese/Mica views. Survey/fence, lg. animals. Poss. free elec./DOR credits. Poss. equestrian/bike/hiking/hunting fenced priv. Mica Conservation area access. Buyer assumes farm/ag tax. $299,900/201612516. (509) 220-7512, 23215 E. Henry. Seller is Broker w/poss. owner financing. Poss. off grid, preppers.

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MEETINGS/CONFERENCES/EVENTSSpokane County Medical Society presents MEDICINE 2016: 7.0 Hours of Category 1 CME credit, sponsored by the Spokane County Medical Society. The program will focus on the more challenging management issues that clinicians encounter. The conference will be held on Friday, October 7, 2016, at the Red Lion Hotel at the Park. Visit the Spokane County Medical Society website at www.spcms.org for more information and to register online, or contact Karen Hagensen at (509) 325-5010 or karen@spcms.org.

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Call our 24-hour dedicated hotline at

(509) 720-6000sta ed by a professional

in behavioral health for medical professionals.

To make a tax deductible donation to support this program, contact Karen Hagensen at (509) 325-5010 or karen@spcms.org,

or mail to: Spokane County Medical Society Foundation

Attn: Wellness Program 901 E. 2nd Ave., Ste. 301

Spokane, WA 99202-2257

SCMS Foundation

Wellness Program

It’s okay to ask for help!

• No such thing as a too small problem, professional or personal. • Anonymous.• Care and counseling provided by an independent professional, focused on medical professionals. • First 8 sessions free to SCMS members (available at contracted rate to non-members).• 24/7 anonymous phone referral through third party service. Appointments set within 24 hours of request, including before or after o�ce hours. • Private setting in an independent provider’s o�ce or if preferred in a dedicated, private entrance, soundproofed room within the Spokane County Medical Society o�ces.• No information disclosed to others by provider without the physician's written consent (imminent risk of danger to self or others excepted, or where otherwise restricted by law).• No role in disciplinary or fitness-for-duty evaluations.• Coordinated referrals to other programs and agencies as applicable, indicated or desired.

We want to make that ask as easy as possible.

ADDITIONAL RESOURCES INCLUDE: WELLNESS • EDUCATION & TRAINING • BUSINESS • LITIGATION

SPOKANE COUNTY MEDICAL SOCIETY

901 E. 2ND AVE., STE. 301 SPOKANE, WA 99202

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