October 2012 - Spokane County Medical Society

Transcription

message
THE
A MON T HLY NE WS M AG A ZINE OF
SPOKANE COUNTY MEDICAL SOCIETY –OCTOBER 2012
THE GROWING ROLE OF
PHYSICIAN ASSISTANTS
IN SPOKANE
By Terri Oskin, MD
SCMS President
Physician Assistants and
the Affordable Care Act
Moving Toward the Future:
Increasing Access to Care
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October SCMS The Message Open2
T a b l e o f C o n t e n ts
2012 Officers and
Board of Trustees
Terri Oskin, MD
President
Anne Oakley, MD
President-Elect
Bradley Pope, MD
Immediate Past President
David Bare, MD
Vice President
William Keyes, MD
Secretary-Treasurer
Trustees:
Robert Benedetti, MD
Audrey Brantz, MD
Michael Cunningham, MD
Karian Dierks, MD
Randi Hart, MD
Louis Koncz, PA-C
Shane McNevin, MD
Gary Newkirk, MD
Fredric Shepard, MD
Carla Smith, MD
Newsletter editor –
Anne Oakley, MD
The Growing Role of Physician Assistants in Spokane . . . . . . . . . . . . . . . . . . . . . . . . . 1
Physician Assistants and the Affordable Care Act . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
The Role of a Physician Assistant at the HIV Clinic at Internal Medicine Residency Spokane . . . . . 4
A Walk-In Clinic That Supports Medical Home--a PA’s Perspective . . . . . . . . . . . . . . . . . . 5
Moving Toward the Future: Increasing Access to Care . . . . . . . . . . . . . . . . . . . . . . . . 5
Physician Assistant Student Involvement in Interprofessional Learning Opportunities . . . . . . . . 7
Physician Assistants in the Rockwood Urgent Care Setting . . . . . . . . . . . . . . . . . . . . . . 9
Physician Assistants in the CHAS Urgent Care Setting . . . . . . . . . . . . . . . . . . . . . . . . 9
Leadership from the Trenches: Local lessons to global applications . . . . . . . . . . . . . . . . . 10
SCMS Delegation to WSMA Annual Meeting and House of Delegates . . . . . . . . . . . . . . . 11
Being a Physician Assistant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Physician Assistants: From Past to the Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Reflections on a PA Career from Two Veterans . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
October 6-12, 2012 Proclaimed as Physician Assistant Week . . . . . . . . . . . . . . . . . . . . 13
In the News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Spokane County
Medical Society Message
A monthly newsletter published by
the Spokane County Medical Society.
The annual subscription rate is $21.74
(this includes the 8.7% tax rate).
Advertising Correspondence
Quisenberry
Marketing & Design
Attn: Lisa Poole
518 S. Maple
Spokane, WA 99204
509-325-0701
Fax 509-325-3889
[email protected]
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.
For Your Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Membership Recognition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Physician Leadership Resource . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Continuing Medical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Meetings, Conferences and Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
New Physicians and Physician Assistants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Positions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Classifieds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
“Autumn,
23
the year ’s last, loveliest smile.”
William Cullen Bryant
October SCMS The Message Open3
The Growing Role of Physician
Assistants in Spokane
By Terri Oskin, MD
SCMS President
As we move from the dog days of summer
and swing into fall, we are all seeing our
lives and schedules ramp up once again.
What better time to dedicate a month to
our partners and colleagues who work by
our sides, our physician assistants.
The profession of physician assistant (PA) was proposed by Dr.
Charles L. Hudson in 1961. The first class of PAs was formed in 1965
at Duke University Medical Center by Dr. Eugene A. Stead, Jr., and
it was comprised of former U.S. Navy hospital corpsmen. It did not
take long for the University of Washington (UW) to recognize the
need and value of physician assistants, and headed by Dr. Richard
Smith, the UW established its physician assistant program in 1969.
Today, 156 accredited PA programs exist in the United States. A
bachelor’s degree and either MCAT or GRE scores are required
admission criteria. Graduates must pass the Physician Assistant
National Certifying Exam (PANCE) to become a PA-C, which is
required by all 50 states for licensure. Similar to physicians, PAs must
obtain 100 hours of CME every two years and recertify every six years.
The Veterans Administration (VA) was the first to employ PAs and
continues to be the largest single employer with nearly 2,000 PAs
working within the VA system across the country. The need for PAs
continues to grow with jobs expected to grow 27 percent between
2006 and 2016. The profession has been listed as the fifth best job in
America according to Money Magazine and Salary.com.
National Physician Assistant Week is celebrated annually from
October 6 through October 12. This week was chosen to honor
the anniversary of the first Physician Assistant graduating class from
Duke University on October 6, 1967.
Recently I spoke with Cindi Shineflew, PA-C, and Robert
Bazzano, PA-C, about their profession and their experiences.
Cindi Shineflew graduated from the University of Osteopathic
Medicine in Des Moines, Iowa, in 1989. She started her career in
emergency medicine and family practice in South Dakota with a stop
in Othello, Washington, before making her way to Spokane. She has
practiced in Spokane for 17 years. Originally with Hillyard Family
Practice with Drs. Vanderbosch and Brown and now with Columbia
Medical Associates, she continues to practice in a family medicine
clinic. She has her own practice and sees some of the doctors’
patients as needed.
How has your role changed during your career?
CS: As I worked with the same doctors for many years their level of
trust grew regarding my abilities. This enabled me to see higheracuity patients. I know I can call on my physician colleagues for
support with some of the more difficult cases, but I do function
relatively independently.
How do you see medicine changing over the next five years?
CS: I am worried. I am already seeing patients that are sicker
and choosing to wait longer before seeking health care. Many of
my patients are losing their jobs and or health insurance. They
are making hard decisions regarding forgoing medications or
procedures due to cost.
Do you see a continued need for a local medical society?
CS: Yes. I will continue to support SCMS because we need to support
our professions and need an organization that will be our voice in this
ever-changing and increasingly complicated health care environment.
Robert Bazzano graduated from St. Louis University in 1985. He
worked with Dr. Tohmeh for 11 years and together they have
been practicing at Northwest Orthopaedic Specialists (NWOS),
specializing in the spine for the past three years.
How do you see your role in your relationship with Dr. Tohmeh?
RB: We built a true partnership based on mutual trust and respect
for one another. We share the practice usually alternating seeing the
patient. Dr. Tohmeh depends on me to access the patient, order the
appropriate tests and get him involved if surgery is expected.
How have you seen your role change during your career?
RB: Due to our close working relationship and respect for one
another I have seen my responsibilities grow. I am responsible for
seeing all our patients when Dr. Tohmeh is away. Of course I have
the other spine surgeons available for consult if needed, and Dr.
Tohmeh trusts my judgment to order the appropriate tests and
treatments whether he is present or away.
How do you see medicine changing over the next several years?
RB: At the present time NWOS is independently owned. I am
concerned with respect to the mergers and acquisitions occurring in
our town and how that will affect our relationships with many of our
local healthcare professionals. Due to our large size we have been
somewhat immune to the recent acquisitions, however if this pattern
continues I believe there will be more of an urgent need to form
tighter alliances.
What do you see as the future role for local medical societies?
RB: We as professionals, independent or employed, need a central
source to go to for information and structure - an entity that will
continue to represent our views and be our voice.
During this month of October let’s all take a moment to honor our
colleagues.
October SCMS The Message 1
The SCMS Strategic Plan was included in the September newsletter for your review. This month I am including a “visual”
interpretation of the Mission, Vision and Strategic Activities. The Mission and Vision serve as the guiding principles for the future
success of the organization. As members, we need your feedback on the relevance of these statements to you as an individual and
as part of the larger community. The physician leadership at SCMS then interprets these statements and creates Strategic Activities
which are also supported by staff. The four areas of Activity translate into initiatives, in some cases, that we carry out with partners
or in collaboration with others in the broader community. Please let us know if this visual interpretation of the work of SCMS
provides value for you as a member of the SCMS. Please feel free to contact me at [email protected] or call me at (509) 325-5010.
Thank you. Keith Baldwin, CEO, SCMS.
Physician Assistants and
the Affordable Care Act
By Louis Koncz, PA-C
President Washington Academy of Physician Assistants and
member of the SCMS Board of Trustees
The Physician Assistant (PA) profession was created in 1965 by
Dr. Eugene Stead at Duke University Medical Center in response
to a shortage of primary care physicians. It was geared toward
military corpsman who had received considerable medical training
during their military service. Today there are over 84,000 nationally
accredited PAs and more than 150 accredited programs. Washington
State has 2,621 licensed PAs. By design, PAs always practice in teams
with physicians to provide high quality, cost effective medical care
in virtually all healthcare settings, and are state-licensed to practice
medicine with the supervision of a physician.
As we all know the Affordable Care Act (ACA) could infuse
potentially 30 million new patients into primary care. That will create
challenges to our current healthcare system. PAs will be a key part
of the solution to the healthcare workforce shortage, but there are
barriers both at the federal and state levels that need to be acted
upon to be able to fully utilize PAs in the primary care workforce.
At the national level we believe that Congress must eliminate
unnecessary federal barriers to the quality medical care provided
by PAs. They must also integrate PAs into all federal programs
designed to promote growth in the primary care workforce.
The America Academy of Physician Assistants (AAPA) is seeking
several changes to update Medicare and to better serve
Medicare beneficiaries; specifically to permit PAs to continue to
serve patients who elect the hospice benefit. For many patients,
especially in rural or other underserved areas where the PA may
be the primary provider, the inability of PAs to provide hospice
care disrupts continuity of care at a time when patients are
most vulnerable, forcing families to seek alternative healthcare
professionals to manage hospice care services.
In addition, Medicare needs to allow PAs to order home health
and hospice care. The inability of PAs to order those services
delays access to needed care and disrupts continuity of care.
There have been bipartisan bills introduced recently in the House
and Senate supporting those changes and we are hopeful they
will pass.
Extending Medicaid Electronic Health Record (EHR) incentive
payments to PAs with patient volumes including at least 30%
Medicaid recipients is necessary to treat PAs in the same way
that the law treats other primary healthcare professionals. That
change is essential to meet the needs of the majority of medical
practices and clinics in which PAs provide a high volume of care
to Medicaid beneficiaries.
Building a robust primary care health workforce that recognizes
the value of PAs and increases support for PA students and PA
educational programs is essential. Over the past 45 years PAs have
proven their merit in extending the ability of physicians to provide
quality medical care and must be an integral component of the
nation’s effort to reinvigorate the primary healthcare workforce.
At the state level we are introducing legislation to make some
changes to the laws pertaining to PAs. We would like to see the
number of PAs a physician may supervise be increased. Currently
a physician may supervise three PAs. We believe that hinders
access to care in some practices. In inner-city and remote
practices, for instance, it is becoming increasingly difficult to
recruit physicians. Hiring PAs for those positions could fill a need,
especially with the ACA infusing increased workloads in those
practices. If the supervising physicians were allowed to supervise
more PAs that could help with the workload and allow more
patients access to care.
We also would like to see a change in physician supervision
requirements from a specified amount of time for the supervising
physician to be on-site, which can be a barrier to care in
some circumstances, and allow the practice to determine the
appropriate level of oversight and review. This could be very
helpful, for example, for rural practices where the supervising
physician is at a different practice site. A much more patient
sensitive approach is to allow the physician-PA team to match
supervision to the specific needs of the practice. The physician
must be available for consultation with the PA at all times either
in person or through telecommunication systems or other means.
With EHRs, shared information is now always accessible and
supervision becomes much easier and less cumbersome.
Finally, we would like the practice plan to be created at the
practice site and not be pre-approved by the state prior to the
PA starting to work. A copy would then be sent to the state and
updated every two years with license renewal. Currently, the
practice plan is sent to the state for approval prior to the PA
starting work. The state has approved nearly 100% of all practice
plans that have been submitted. We believe that this is an
unnecessary step that delays when a PA can start working. This is
what most other states are currently doing.
Physician Assistants are now found in many settings, but the role
they play in physician-directed care is identical to the vision of
the physicians who created the profession. The changes at the
state and national levels will improve the efficiency found in the
physician-PA team and address the challenges of healthcare
delivery in the 21st century.
The Role of a Physician Assistant
at the HIV Clinic at Internal
Medicine Residency Spokane
By Debbie Stimpson PA-C, Providence Internal Medicine Residency
I am fortunate to have my passion also be my “work”. I am a
Certified Physician Assistant (PA), HIV Specialist working in the
ambulatory clinic for Providence Internal Medicine Residency
Spokane Program. HIV became my passion in the mid-1990s when
I moved to Spokane and became good friends with someone who
had HIV/AIDS. Through volunteer positions in the HIV field, and
work as research coordinator for a HIV Treatment Adherence Project,
I realized I wanted to further my education. I graduated from the
University of Washington’s MEDEX Northwest Physician Assistant
program seven years ago. Since that time, I have worked as medical
provider with HIV patients. Almost four years ago HIV/AIDS care
was incorporated as a specific discipline into the ambulatory clinic
by opening of The HIV Clinic at Internal Medicine Residency (The
HIV Clinic at IMRS). I was hired to implement the project and have
continued to provide HIV and primary care for the HIV/AIDS patients,
alongside the internal medicine residents and faculty. Dr. John Frlan,
faculty in the residency program, had an interest in HIV and became
my supervising physician and is now also an HIV Specialist. We are
both accredited through the American Academy of HIV Medicine.
New HIV/AIDS patients in our clinic are seen by both a resident and
me during the office visits. Appointments are scheduled with both
of us when possible but sometimes hospital or other electives don’t
allow that coordination. Then the patient will be seen by me and
sometimes a different resident. I provide the “continuity of care” for
the HIV/AIDS patients and allow for overseeing of care and ongoing
education regarding acute and chronic HIV care with the residents.
I enjoy working with the residents who are extremely bright and
eager to learn. I share my knowledge of HIV and they, along with the
faculty, share their enormous wealth of medicine in general. Teaching
of HIV/AIDS is done on one-on-one basis and group settings.
As the only PA-C in the internal medicine residency program, I
believe I am well accepted by the faculty and residents. I am happy
to be a part of this supportive, intellectually stimulating, continuous
education setting.
Background on Debbie Stimpson, PA-C
By Mary Noble MD, Director, Ambulatory Care Clinic, Providence
Internal Medicine Residency
Debbie joined our faculty in 2008 when we opened The HIV Clinic
at IMRS. Our goal remains two-fold: to increase access to expert,
compassionate, comprehensive care for patients with HIV/AIDS and
also to impact the future availability of physicians able to provide care
to this patient population. Most residencies have Infectious Disease
rotations where residents see HIV patients, and residents do see HIV
patients in the hospital. But we know that people living with AIDS
who are adherent to their treatment can live to a near normal life
expectancy. It is important that physicians have familiarity with the
multiple medications, co-morbidities and challenges these individuals
deal with on a daily basis. The HIV Clinic at IMRS helps us achieve
both those goals. Debbie is the consistent presence for each of these
patients. She sees them in conjunction with the residents, interacts
with their case managers and provides education to the entire team
to help us stay abreast of what is current in the HIV/AIDS care.
In addition to The HIV Clinic, she also sees patients who need an
urgent visit if a physician appointment is unavailable and has worked
on some health maintenance projects for our clinic patients. Her
presence has been a positive addition to the Residency program,
allowing our residents to experience working with a non-physician
provider colleague.
As residents graduate from the three year program, their HIV panel
is transferred to incoming interns.
A Walk-In Clinic That
Supports Medical Home
We don’t refill their standard medications. We do, however, have
the ability to consult directly with their doctor and to schedule
appointments so they can see their physician within a reasonable
time. I should mention that one other PA, Jane Whetzel, and a
wonderful group of RNs, LPNs and MAs, make it possible to see the
volume and complexity of patients that we take care of in the ACT.
A PA’s Perspective
By Lester Sloan, MPAS/PA-C
Several weeks ago, an elderly gentleman walked into the clinic
with a productive cough. He’d been running a fever, was a little
short of breath, his pulse oximetry reading was 94. He had a
history of chronic obstructive pulmonary disease, diabetes and
mild hypertension. He had not been to see his doctor for six
months. He had been contacted by his doctor through email that
he needed a series of tests and an appointment.
We diagnosed and treated his bronchitis. He asked me if I
could refill his medications. I was able to access his records
immediately and found that he was low on his medication, but
was not completely out. Although I informed him that his routine
medications needed to be reviewed and refilled by his personal
physician, I would order his labs and schedule an appointment
with his physician to follow-up on his bronchitis, address his
ongoing health issues, take care of his routine refills and evaluate
his labs. He was happy with his treatment and appreciative of the
help getting him in to see his doctor.
A few years ago, the idea of the Medical Home started showing
up in our emails and at our conferences. The idea that each
patient is personally cared for by a physician (or a team led by a
physician) was reviving the concept that medical care is personal
and best done by a core group that know and care about the
patient, very much like the family doctor of old.
We have made a commitment at Group Health Cooperative (GHC)
to utilize the Medical Home concept in all of our primary care
clinics. To the best of our ability, each patient is identified with a
particular doctor and team, so the patient’s care can be consistent.
This can be a particular challenge for people who need to be seen
on an acute basis. We have addressed this through our walk-in
clinic (which is called the Acute Care Team, or ACT).
Over the last several years, it was determined in my clinic that our
patients were over-utilizing the emergency department and urgent
care, partly because they didn’t need to schedule an appointment,
and partly because they were unaware that we were able to take
care of most of their minor problems at the clinic. We decided to
set up a walk-in clinic--not like the standard urgent care, but a clinic
that would actually support the Medical Home process. Before we
started the ACT, we agreed to see patients on an acute care basis
but determined that we would not take over routine care that could
be more effectively handled by their own doctor or team.
We have, over the last year, significantly decreased the number
of patients who go to urgent care or the hospital unnecessarily.
We deal with the patient’s immediate problems but do not try to
manage their hypertension or diabetes. It is our responsibility to take the best medical care of our patients.
I believe that the Medical Home model is an effective way of
promoting continuity of care. The goal of the ACT is to address the
patient’s immediate problems and to support the concept of the
Medical Home by getting the patient back to the physician and
team responsible for their ongoing care. As new problems arise, we
continue to re-evaluate and make changes in how we deliver care
on our Acute Care Team. It has been working well. Other clinics at
GHC are considering the adoption of a similar model.
I was taught in PA school many years ago that our primary
function was to fill gaps in medical delivery. PAs were utilized
wherever they were needed, and over the years we have been
used in every specialty and aspect of medicine. PAs have worked
at Group Health since the late 1960’s. Our profession at that time
was very new, and Group Health was a pioneer in the use of non
physician providers. It is no big surprise that change is the one
constant element for PAs and medicine in general.
Moving Toward the Future:
Increasing Access to Care
By Steve Meltzer, PA-C
As noted by my colleagues Lou Koncz, PA-C and Theresa Schimmels,
PA-C in their articles, the physician assistant (PA) profession continues
to grow in partnership with medicine and provide opportunities
to a wide range of health professionals to enter the profession. It
was reported just this September by the National Commission on
the Certification of Physician Assistants, that the 100,000th PA was
recently certified – a milestone of quality education and access to care.
The University of Washington MEDEX Northwest PA Program has
graduated over 1800 PAs since 1970, and has one of the highest
percentages of graduates working in primary care – approximately
54% versus 32% nationally. Part of this success is the result of
students having long exposure to primary care during their clinical
training year and rural/underserved rotation sites.
Three recently awarded federal grants are providing MEDEX the
opportunity to work with select family medicine residencies on
integration of PAs; supporting students with a focus on rural primary
care; and funding development of a new campus in Tacoma that
will be linked to the Joint Lewis-McChord Military Base to increase
opportunities for ex-military medical personnel to transition to the
civilian workforce as PAs.
Continued on page 6
Continued from page 5
This past summer, MEDEX joined the Department of Family
Medicine and is looking at ways to improve PA education and
integration of physician-PA teams at the newly relocated UW Family
Medicine Clinic at Northgate in Seattle. The expectation is that this
will help create a model that can be used throughout the WWAMI
region to encourage integrated practices through physician-PA
teams in support of patient centered medical homes. Participating
PAs will have an expanded role in seeing patients as well as
teaching, team-building and outcomes development.
MEDEX also received a federal grant as part of the initial stimulus
funding to increase emphasis in primary care. Nine entering
students each year are selected to participate in the project
and receive partial tuition payment to offset added expenses of
completing more clinical year rotations in rural communities. They
also participate in several workshops and small discussion groups
during the didactic and clinical years to increase their knowledge of
rural practice and systems.
The most recent grant, just awarded in September, will provide
funding to develop and implement a new MEDEX PA program in
conjunction with the UW Tacoma campus. If accreditation can be
achieved quickly, the MEDEX is striving to have the program up and
running in Fall 2013. There has already been much interest around
the region and MEDEX has been working with the various military
branches and bases in Washington to set the groundwork in place.
The MEDEX program was initiated at the University of Washington
by Dr. Richard Smith, with significant collaboration by WSMA, and
was based on utilizing the advanced skills of ex-military corpsmen
and medics. This new expansion is a tremendous way to “bring it
back home” for the profession and expand the opportunities for
current veteran’s with incredible knowledge and skills. MEDEX is
proud to have this opportunity and looks forward to working with
providers around the entire WWAMI region!
The new 2012 MEDEX Primary Care Scholars. This amazing
group of students recently met to share their personal stories of
what inspired them to become PAs in Primary Care.
Bottom Row: (left to right) Eduardo Garza, Shigone Beighle,
and Matt Loudon.
Center Row: (left to right) Jesus Rosales, Leslie Lewis, Rachel
Ragosta, Teresa Vasicek, Rachel Fisher, and Sam Deblauw.
Back left: Bradley Smith.
Comments from MEDEX Students
As an allied healthcare practitioner living in a small, rural town,
I experienced first-hand that “patient care” doesn’t clock-out
at 5pm. It continues during visits to the post office, market,
local diner, and wherever else one might bump into a patient
throughout the course of a day. After years of developing patient
relationships in a close community, I saw a need to do more.
Becoming a PA answers that need.
Rita Klabacha, 1st year MEDEX student
I decided to become a PA because I have a passion for patient
care. Giving back to my community has always been something I
hold near and dear to my heart and it gives me great joy to know
that I, in some small way, have the potential to make a difference
in somebody else's life. There is no better opportunity to achieve
this right now than in the PA profession.
Gretchen Foley, 1st year MEDEX student
I enjoy the opportunity to work collaboratively with patients while
still maintaining a certain degree of independence. I value the
expectation that continued education and innovation are integral
to the profession. I also appreciate the emphasis on family health
in our rural communities, so essential to our national fabric. That's
why I've chosen to become a Physician Assistant.
Harry Lawrence, 1st year MEDEX student
Back row: (left to right) Daniel Larimer, Randy Robbins, Catherine
Cleveland and Andrew Ashford
Middle row: (left to right) Ken Ferrera and Jeffrey Smith
Front row: Angela Tague
Physician Assistant
Student Involvement
in Interprofessional
Learning Opportunities
Teams receive the initial patient scenario two weeks in advance
of the live event and are instructed to work collaboratively to
formulate a patient-centered plan of care.
By Barbara Richardson, PhD, RN | Interprofessional Education
Washington State University Division of Health Sciences
Students enrolled in the University of Washington’s MEDEX
physician assistant (PA) program on Spokane’s Riverpoint campus
have opportunities to interact with other health professional
students in classroom, extra-curricular and practice settings.
In the simulation lab, PA students may work with nursing and
pharmacy students to practice team work, role clarification, and
improve collaborative communication. This fall, MEDEX students
will engage in small interprofessional (IP) group discussions
reviewing the book, “The Spirit Catches You and You Fall Down”
by Anne Fadiman (1997). This true story, about a Hmong child
that suffers from grand mal seizures, commonly provokes strong
reactions from students when they consider the implications
of cultural barriers that ultimately result in the child living in
a persistent vegetative state. Such opportunities provide PA
students with an opportunity to engage in dialogue around
ethical and moral issues common to all health professionals.
Also lined up for fall semester are extra-curricular opportunities
organized by the Riverpoint Interprofessional Education &
Research student group. These activities include learning with,
from and about other health professions through the “Getting
To Know You” programs, where students and faculty from one
health profession share information about entrance requirements,
a typical course of study, licensure requirements, potential
job placements and current areas of research common in that
profession. Over brown bag lunches, PA students learn from
their peers in the Physical Therapy, Nursing, Speech & Hearing,
Occupational Therapy, Nutrition & Exercise Physiology, dental
hygiene, health policy administration, RIDE dental, and WWAMI
medicine programs. All health professional students are welcome
to attend the viewing of a series of DVDs titled, Unnatural Causes,
that explores social determinants of health that commonly impact
care providers in all professions. PA students can also participate in
the Community Action Poverty Simulation, a simulation experience
that is designed to help participants begin to understand what it
might be like to live in a typical low-income family trying to survive
from week to week. The object is to sensitize students to the
realities faced by clients living in poverty. Every spring, PA students
engage with students from other health professions to participate
in the popular Health Care Team Challenge (HCTC) event. The
HCTC is a clinical case-based competition.
On the day of the event, the teams present their plan in front of a
live audience of faculty, peers and community members. As one
PA student remarked, “It was one of the best experiences of my
educational career because it showed me where I fit in to the big
picture of collaborative health care. It also taught me a lot about
the other fields that I will have contact with once I graduate and
begin working.”
Opportunities for PA students to engage in collaborative
practice opportunities with other students are being developed.
In June, PA student Travis Henderson worked with peers from
the WWAMI medicine, WSU nurse practitioner, pharmacy, and
RIDE dental programs that were all in Othello doing clinical
rotations at Columbia Basin Health Association (CBHA). With
funding support from the Empire Health Foundation, this IP
team of students identified two important community health
issues (teen pregnancy and domestic partner violence) and
collaborated on a project to address those issues with the youth
they encountered on a daily basis in their clinical settings. The
students wanted to reach out to girls aged 15 to 25 to provide
contraception and relationship safety information and deliver it
in a non-confrontational and culturally sensitive way. To attract
young clients, the students created what they called “summer
survival kits.” They purchased recyclable bags and filled them
with items such as Frisbees, beach balls, personal hygiene
products and cards with information about contraception and
healthy relationships. Along with the bags students offered
individualized guidance to their patients. Henderson noted one
tangible benefit of the project was that five girls opted to be
vaccinated for the human papilloma virus (HPV), which is spread
through sexual contact. He also recounted another less concrete
victory, telling a story about how clinic nurses quietly arranged for
one young woman they suspected was a victim of partner abuse
to be pulled away from her boyfriend to talk with Henderson
about potential options for improving her situation. All members
of the team and their preceptors at CBHA were pleased with the
outcome of this collaborative project. The CEO of CBHA noted,
“the interprofessional project was well received by all of the staff
involved. This was a very dynamic group of students, and I think
the fact they were from many different disciplines helped to
create the passion that they put into this project. In the future, we hope to create and offer interprofessional
service learning and collaborative practice opportunities in a wide
variety of settings in order for students in the PA program to work
with peers in other professions in order to be “workforce ready”
members of a collaborative health care team.
COLUMBIA MEDICAL ASSOCIATES
is currently seeking a BC/BE Internist
to join our Northside Internal Medicine
Group in Spokane, Washington to meet
our increased service utilization. We are
a group of over 40 physicians providing
comprehensive medical care to families and
InCyte Pathology
Delivers Answers
individuals of all ages within the Spokane
InCyte Pathology
region. The position offers the following:
Welcomes
Alden Webb, D.O.
•Flexible schedules and outstanding teams
make this opportunity worth exploring.
•Competitive Salary and Generous Benefit
Packages
•Conveniently located only two blocks from
Holy Family Hospital
•Established relationship with local hospitalist
group for admitting, rounding, and discharge
Our physicians are committed to
maintaining the health and well being
of all their patients through preventive
InCyte Pathology welcomes Alden R. Webb,
D.O., to its growing Dermatopathology
Services Department. InCyte Pathology’s
dermatopathologists work closely with area
dermatologists to provide the best treatment
for patients with skin conditions and diseases.
Dr. Webb recently completed his fellowship at
Indiana University School of Medicine in
Indianapolis and will join InCyte Pathology in
early August. Dr. Webb is board certified in
anatomic pathology and clinical pathology and
is board eligible in dermatopathology.
care measures and working closely with
community specialists. Our new partnership
with Group Health and collaborative care
models ensure patients have access to the
You deliver quality healthcare.
InCyte Pathology delivers
quality diagnostics.
best care in Spokane.
To apply or inquire for further information
Learn more by calling us at 509.892.2700 or
visit www.incytepathology.com.
please contact:
Nancy Longcoy, Physician Recruiter
[email protected]; Ph: 206-448-6132
Proudly serving SCMS physicians
and their patients since 1957
Physician Assistants in
the Rockwood Urgent
Care Setting
The first PAs were veterans, but as the usefulness of non-physician
providers became apparent, programs opened up in universities
all over the country to train candidates to meet the growing
demand. We are fortunate to have MEDEX, one of the oldest
and best PA programs in the nation right here in Washington
providing us with well-trained practitioners.
By Jana Tritto, PA-C
Washington State Physician Assistants (PA) are licensed by
the State Board of Medicine and have a relationship with a
sponsoring physician. In most instances, especially in urgent care
clinics, the PA works quite independently alongside the physician.
The relationship is one of trust and respect.
The most important thing for a PA to know is “to know what
they don't know". We want and need the support of our doctor
partners. We are pleased and grateful for the trust and respect
we have worked hard to earn. We are proud of our profession
and our abilities. A mutually comfortable and trusting relationship
with a physician is built over time as we work together; both
independently and collaboratively.
The MD-PA relationship in Urgent Care is satisfying for both
parties. The PA may work independently, but has a doctor
there who can provide insight or answer specific questions. The
physician, too, will collaborate with a PA on patient concerns or
an X-ray. Each provider has his/her areas of expertise, such as
training in joint injections or trauma, and each is respected for it.
Knowing each other’s' strengths, and relying on them provides
better patient care. It has the added benefit of a more productive
and less stressful work environment for the staff.
Urgent care medicine has been recognized as a specialty and
has much in common with emergency medicine. Therefore, there
is a need for specific training and ongoing education. PAs are
board certified in general medicine and/or surgical assist, and
maintain that certification with 50 Category 1 CME credits a year
and a retest every seven years. In the urgent care setting, both
the physicians and PAs are usually required to maintain Advanced
Cardiac Life Support (ACLS) and Pediatric Advanced Life Support
(PALS) certification and to take part in or lead monthly drills for
the other staff members.
Urgent care demands practitioners with a broad knowledge
base to meet the needs of the young and old and everything
in between. We see patients of all ages, with every injury and
illness; from the worried well to an evolving myocardial infarction.
It is vital to stay alert, keeping an open differential diagnosis
with each patient. PAs in the urgent care need to have training
and skills to perform minor procedures and suturing, splint
sprains and fractures, counsel the anxious and depressed and
differentiate between the patient in pain and a drug seeker.
PAs have seen increased acceptance since the profession was
established to legitimize and use the skills of the combat medics
from the Vietnam War.
Patients, too, have accepted mid-level practitioners both in
primary care and in the urgent care setting. Many patients think
that they are given more time and attention from their PA and
will actually request a PA at their visit. Gone are the days that
physician assistants were seen as a glorified "coat holder" for the
doctor. Patients, physicians, and other ancillary staff now view
PAs correctly as physician extenders, with abilities and knowledge
to effectively diagnose and treat, within their scope of practice.
PAs in urgent care medicine are able to provide excellent patient
care, and are also able to fill a growing need as this specialty area
increases in popularity. It is a winning combination.
Physician Assistants in the
CHAS Urgent Care Setting
By John Colver, MSPAS, PA-C
I have been with Community Health Association of Spokane
(CHAS) for a few years now working as a primary care provider
for approximately 2000 patients in our community. Recently I
have found interest in working with our newly opened urgent
care team on an as-needed basis. It has been an adjustment to
shift my mental paradigm from a ‘preventative first’ approach to
a more emergent ‘what-is-most-critical-now’ approach. Adding
this new dimension to my skill-set has been both advantageous
to me as a clinician as well as a benefit to the patients I treat.
Whether in the urgent care or a family practice clinic, it’s my belief
that knowledge from experience, understanding limitations and
effective use of resources build the foundation of a well-qualified
physician assistant (PA).
It is essential that as an urgent care PA I am able to recognize
the acuity of the patient’s condition and then set in motion
a treatment plan to address these needs. Often I find myself
consulting other providers or resources to meet this end. I am
not embarrassed when I don’t know the answer to a particular
situation so long as I keep the patient’s best interest in mind. In
fact, as PAs we are trained to work as a team with supervising
physicians with whom we can consult when needed. It is a model
that has proven effective in every medical specialty–urgent care
without exception. Similarly, physicians are required to identify
their own limitations in practice and will often consult when
needed for the patient’s best interest. I have found that my efforts
to provide quality care through this team-centered approach have
been met, in most instances, with respect.
Continued on page 10
Continued from page 9
As time develops experience and knowledge, PAs are relied on to
give educated and quality care. In the urgent care setting I am able
to diagnose and treat independently with delegated autonomy
in a way that has generated respect from my patients and other
providers. Additionally, I have found that my background in family
practice has given me an advantage over some of my peers. I am
familiar with chronic disease management and can troubleshoot
the acute patient with much comorbidity. I can also better guide
the acute patient through the aftercare process, understanding
many of the turns in long-term management. Because of this I am
an asset and resource to the urgent care team.
As I grow in experience
in urgent care medicine
I find that it carries over
to my day job in family
practice. I am increasingly
able to recognize acutely
‘sick’ from ‘not sick’ and
able to perform more of
the simple procedures
in-clinic rather than sending out referrals. This is a huge benefit
in my practice as many of our patients are without insurance
and would not be able to afford a specialist visit. I enjoy my role
in both urgent care and family practice settings, each with its
challenges and successes. I anticipate further growth and look
forward to helping others as part of a complete healthcare team.
Leadership from the
Trenches: Local lessons
to global applications
that occurred at the volunteer direction of a number of attorneys
in the state. They also clarified that entities would have to have
certified Electronic Health Records (EHRs) in order to connect to
the network. The next patient centered steps in development
will include, in this order, transitions of care; patient engagement;
population-based care model and clinical integration/accountable
care organization (ACO) in the stages of development.
Dr. McCrary stressed the fact that there are many challenges to HIE
development but that there are as many solutions if providers lead
the process to overcoming the challenges. She also advocated
for all providers joining the health information sharing process to
provide the necessary leadership for a successful initiative. The
required minimum data set in the systems will include demographics,
procedures, medication lists, diagnostic test results, problem lists/
diagnosis, allergies and immunizations. She is also advocating for full
HIE-Query functionality, a national information exchange capability
with direct secure clinical messaging and state level interfaces.
In addition, a panel of presenters from Group Health, MultiCare
Health System and the Franciscans updated the audience on the
progress toward implementation and use of the EPIC system. All
the systems will be using the same electronic medical record (EMR)
in the near future so they all addressed the ability to share patient
information across the community of providers as a result. Geoff
Ling, MD, Ph.D., spoke about the truly innovative work being done
in the military in his talk about “Developing Medical Innovations the
DARPA Way” to support our soldiers in the military, especially those
that are injured and with loss of limbs. He was most poignant about
the ability to develop sophisticated mechanical limbs driven by the
individuals own thoughts. Truly incredible advances!
By Keith Baldwin, CEO, SCMS
The Pierce County Medical Society organized the Leadership
from the Trenches: Local lessons to global applications
conference held on Friday, September 14, 2012, prior to the
WSMA Annual Meeting in Tacoma. It was well-attended,
addressed valuable topics and included a number of top notch
speakers. Spokane physicians who attended included Terri Oskin,
MD, SCMS President; Jeff O’Connor, Chair, SCMS Informatics
Committee and Jeff Collins, CMO, Providence Health.
Laura McCrary, Ed.D, Executive Director of the Kansas Health
Information Network (KHIN), was a great segue into the topic of
Health Information Exchange (HIE) and the purpose for sharing
patient information. She noted that the KHIN is in the formative
stages of development and is focused on developing Data
Exchange and HIE Services or data portability. The KHIN was
legislatively authorized to be the statewide HIE in Kansas. They
spent a number of years normalizing all the patient privacy issues
with HIPPA prior to beginning their development process and
Additional presentations included Pierce County’s Community
Transformation Grant: Lessons for Transformational Leadership,
Understanding the Hospital’s Bottom Line: A CFO’s Perspective
and Quantifying Quality in Healthcare Systems: Pay for Performance
– The ABCs of Value Based Purchasing. I applaud Pierce County
Medical Society’s efforts to bring relevant content to their CME
offering and look forward to a possible collaboration in the future.
(The slides of individual presentations are available on request.
Contact Keith Baldwin at [email protected] or (509) 325-5010.)
SCMS Delegation to
WSMA Annual Meeting
and House of Delegates
A number of physicians represented you, the SCMS membership,
at the recent WSMA Annual Meeting and House of Delegates
(HOD) that occurred in Tacoma on Saturday and Sunday,
September 15 and16. Preparation for the Annual Meeting
and HOD occurred in Spokane first with the SCMS Executive
Committee and then with the Caucus on September 12 to discuss
and prepare for the recommendations to the HOD on September
16. The process involved the submission of resolutions and
WSMA bylaw amendments prior to the HOD. Significant topics
included marijuana; peer review; Joint Commission regulations
and bylaws amendments related to WSMA/County relationships,
WSMA Board composition, nominating committee and AMA
delegation standing. The process started with a presentation
of the reports, resolutions and amendments to the reference
committees. And, a lot of testimony was given on all sides
of the issues. The reference committees then make changes
based on the testimony for final submission to the HOD. Dr.
Brad Pope chaired one of the reference committees this year.
It is challenging but rewarding work on behalf of the physician
community. The HOD voted not to de-unify the nine remaining
WSMA unified county medical societies. They did vote to
change the representation of the WSMA Board but retained AMA
delegates as voting board members.
Please thank all of your hard working delegates to the WSMA
Annual Meeting and HOD who gave their weekend time to
represent Spokane physicians at this annual meeting and delegate
gathering. Those attending included Drs. Brad Pope, Anne
Oakley, Beth Peterson, Terri Oskin, Deb Harper, Rick Shepard,
Brian Seppi, Anne Montgomery, Gary Knox, Rob Benedetti, Rod
Trytko Dean Martz, Melanie Lang and Lou Koncz, PA-C.
Being a Physician Assistant
By Dean W. Crosgrove, PA-C
Providence Hawthorne Urgent Care
"Call me Dean." With apologies to the fans of Herman Melville,
this is my standard response to the inevitable question, "What
should I call you?"
Physician assistants (PA) have a unique role in the hierarchy of
medicine. We are in the gray area called "mid-levels." For the uninitiated, a physician assistant, (not physician's assistant), is a master's level trained medical professional who has the skill set to perform about 80 percent of what a family medical
doctor can provide. This obviously varies due to specialty
training and experience.
In urgent care, for example, our backgrounds lean more toward
emergency medicine and urgent care. We are licensed to
practice medicine in conjunction with a licensed medical
doctor. I believe that this preceptor relationship is what helps
PAs be accepted as a professional healthcare provider and not
a physician replacement like some have suggested. We are not
referred to as "doctor" (unless we have a PhD or some other
doctorate) and “Mister Crosgrove” makes me want to look around
for my father. So I have found that the informality of using my first
name is the approach that works for me.
I have spent my career as a PA working in rural emergency
departments (ED) and have now landed in the perfect blend for
a job at Providence Hawthorne Urgent Care. Urgent care is the
best of ED and family practice medicine combined. The medical
team can make a rapid and significant impact on patient care
and every member, from the front desk to medical assistants and
nurses, has valuable input and is encouraged to share insights
into a patient. This creates an information base on a patient that
allows for rapid evaluation, treatment and final disposition in an
efficient manner. Whoever is assigned the patient is in charge
of the patient’s care, with input from the rest of the team. A
typical day can consist of all aspects of acute family medicine and
a liberal serving of lacerations, abscesses, sprains and broken
bones. We fill the niche as a place where family practice clinics
can refer their patients, knowing we are not taking over the
care of their patients but acting as a support facility for better
treatment of their patients. The patients seem uniformly pleased
with the rapid care and the knowledge that we send prompt
reports to their doctors while encouraging close follow-up with
the primary care providers.
I have found that, in general, the newer physicians accept PAs
as peers rather than subordinates. In urgent care, physicians
and PAs routinely run patient concerns by each other to make
sure they are on the right track since this is the first time they
have seen the patient and maybe the last. This may be a unique
setting, but in my 15 years as a PA, this has been the norm rather
than the exception.
The enjoyment of urgent care comes from the daily variety of
patients, everything from chest pain and dehydration to fishhooks
and pinkeye. We are jacks-of-all-trades (hopefully masters of
some). I am fortunate to work with a very experienced group
who are willing to share information and techniques. Andrea
Johnson, MD has a very compassionate approach to patient care.
She actively listens to patients and has demeanor that makes you
want her as your own provider. Joshua Beers, MD and Mitchell
Tippets, MD bring an energy and knowledge base that stimulates
me as a practitioner to learn more. Connie Langford, PA-C has
an experience base that makes my background experience a mere
shadow. She is the PA I try to emulate. With 17 years as a King
County Medic One paramedic, I would not change my second
career as a PA. I am very fortunate to be working with this group.
Physician Assistants: From
Past to the Future
By Theresa Schimmels, PA-C
It was over 40 years ago that a group of physicians looked at
America’s healthcare system and realized there was a critical need
for healthcare delivery in underserved areas. They envisioned
a new type of health professional, one that would be able to
enhance their practice, freeing them to see more patients, utilize
their time and talents more efficiently and provide better care
to their communities. They would train the new “assistants” in
medicine just as they had been taught, yet in a shorter amount of
time, requiring physician supervision. Dr. Eugene Stead at Duke
University, followed a few months later by Dr Richard Smith of the
University of Washington, created what would be known as the
Physician Assistant (PA).
Those doctors were visionaries. Their dream of a physicianphysician assistant team was realized and has taken healthcare
in America to a better place. The efficiency of this team has led
to utilization in all medical and surgical specialties, from primary
care to orthopedics, infectious disease to cardio-thoracic surgery.
The team is effective because of similarities in training and the PA
profession’s commitment to maintaining practice with physician
supervision; utilizing the strengths of each member of the team.
According to the Bureau of Labor and Statistics Occupational
Outlook Handbook, 2012-13 Edition, “Employment of physician
assistants is expected to increase 30 percent from 2010 to
2020, much faster than the average for all occupations. As more
physicians enter specialty areas of medicine, there will be a
greater need for primary healthcare providers, such as physician
assistants.” Health and Human Services Secretary Kathleen
Sebelius recently announced $2.3 million in grants to train
primary care PAs and help veterans transition from the military to
civilian PA careers when they return home.
So, you ask, what is going to happen with the PAs in the future?
How does this make a difference in how I practice? I can honestly
answer you in one short phrase: The PA profession remains
committed to the concept of the supervising physician and
highly values the physician-PA relationship. PAs are geared
to step in to help physicians fill the need for more primary
care providers. We will continue to evolve to provide patientcentered care whether it is in a medical home environment or
providing postoperative care in a hospital. We are here for one
reason: because physicians believe the need to establish a new
healthcare entity to practice medicine under the direction of
physicians and surgeons, formally training us to examine patients,
diagnose injuries and illnesses and provide treatment. We are
here to serve.
In the past 15 years, since I entered and completed my training,
the role of the PA in medicine has changed. The physician
shortage has created an opportunity for a physician’s practice to
utilize a PA’s skills to augment their practice, increase their income
and patient volume, and provide quality care in a timely manner.
The American Academy of Physician Assistants’ (AAPA) 2010
census states approximately 32% still practice in primary care
medicine, down from the approximately 55% that did so in 1997.
Being able to branch out into surgical and medical subspecialties
closely follows the direction of physicians moving out of primary
care medicine.
With lack of incentives and increasing costs of medical school
training, the waning number of training for primary care doctors
is disturbing. A projection from the Association of American
Medical Colleges suggests the U.S. could have nearly 63,000
fewer doctors than needed by 2015. Physician training takes
two or more years after medical school, depending on specialty.
Unlike physicians, PAs are trained as generalists. Those of us
who choose to go into a medical subspecialty have the flexibility
to move into another specialty without additional training or
residency requirements.
Reflections on a PA Career
from Two Veterans
This month we asked two seasoned Group Health physician
assistants (PA) to look back on their careers and discuss where
the profession is headed. Our guests are Dan Myhre, PA-C, of
Veradale Medical Center and Tom Charles, PA-C, of Riverfront
Medical Center.
How did you first decide to become a physician assistant?
Dan Myhre: I served as a medic in Vietnam, and then I attended
the University of Washington in its third class of PAs between
1971 and 1972. When I started at Group Health, I was the first PA
at its Lynnwood Medical Center. After that I bounced between
family practice, surgery and emergency medicine. I’ve been at
Group Health most recently for 15 years.
Tom Charles: I was a math and physics major and went into
military service after college in 1968. I lived overseas and went to
PA school at Hahnemann University in Pennsylvania between 1975
and 1977. After practicing in North Dakota for a year, I moved to
Spokane and have worked for Group Health for 33 years.
My military experience triggered my interest in medicine. I
accompanied physicians into orphanages and worked as a
Vietnamese-language interpreter. The dramatic things I saw chisel
an impression on a person. I could see how medical care helped
kids do well, which prompted me to work in health care. I’ve
always worked in family practice.
What was it like being the new guy in a new profession?
DM: Early on, it was a struggle. Some physicians didn’t want
to work with us and didn’t appreciate that PAs could prescribe
medications. I remember caring for a patient with a fracture
and I called the on-call orthopedist for a consult. The doctor
said he didn’t talk to PAs so I had to ask a family physician to
make the referral. We took care of the patient. Of course now
it’s completely the opposite working with physicians. And family
medicine doctors have always seemed to welcome us with open
arms and have been great teachers and mentors.
TC: It was a new profession. By the time I started the doctors
were familiar with it, but the patients weren’t. We had to carve out
a niche in patient teaching and our distinct skills.
DM: That’s true about creating a niche. The health care team learns
what you are good at. At our clinic, because I’ve been able to do
the mechanical things, our doctors don’t do a lot of casting and
splinting. Our other PA at Veradale handles a lot of women’s health
care, freeing up doctors to practice more internal medicine.
Where do you think the profession is headed?
TC: At Group Health, PAs were geared to go into pediatrics, OB/
GYN and family practice. But the vast majority of new graduates
today are going into a specialty and they are in demand. Here in
Spokane, virtually all specialists employ PAs, which improves their
patients’ access to care. In the future I predict that demand will
swing back to family practice and general medicine as we gear up
for baby boomers and new patients entering primary care. Family
practice needs to ramp it up to be ready for them all.
DM: The future is unlimited for PAs. Studies predict a looming
shortage of primary care physicians and PAs can fill part of that
role. We need the family doctors, of course, but some studies
suggest that PAs can see 60 percent or more of the patients
who come through the door and deal with their medical issues
competently.
Both of you are edging toward retirement. What advice
do you have for PAs just starting out?
DM: The profession has evolved but the important thing to always
remember is to be intellectually honest about your capabilities.
Know your limits, know when you need help and stay out of trouble
for the patient’s sake. When you don’t know what you are facing,
go to the physician and ask “What am I seeing here?”
TC: Medicine is unpredictable and chaotic. My advice for all
medical professionals, not just PAs, is to give every patient your
absolute best. When you see them, go over in your mind, “What
more can I do to help?” You can’t have a bad day or just get by
because the stakes are too high. Human beings are unpredictable
and they can get hurt quickly. At the end of the day you want to
know you’ve given your best.
October 6-12, 2012
Proclaimed as Physician
Assistant Week
On September 5, 2012 Governor Christine O. Gregoire
proclaimed October 6-12, 2012 as Physician Assistant Week. In
her proclamation she stated that “PAs are often the first point
of contact for patients and serve a vital role in helping them
understand their medical needs and empowering them to
become their own advocates.” The entire proclamation can be
read at http://www.washington.edu/medicine/som/depts/medex/.
In The News
Jon Boyum, MD Joins Surgical Specialists of Spokane
Dr. Boyum has roots in Spokane as a graduate
from Gonzaga University. He is a board
certified general surgeon with advanced
training in thoracic surgery. Dr. Boyum
received his medical degree from University
of Washington Medical School and completed
his general surgery residency at University
of Vermont/ Fletcher Allen Health Care,
Burlington, Vermont. Dr. Boyum completed
his thoracic training at Oregon Health Sciences
University, Portland, Oregon.
The Physicians of Cancer Care Northwest are pleased to
announce the addition of Jason Call, MD; Mei Dong, MD,
PhD and Srivalli Gopaluni, MD
Dr. Jason Call, Radiation Oncologist,
graduated cum laude with a double major
in Zoology and Russian from Brigham Young
University. He pursued his medical school
training at the Medical College of Wisconsin,
Wauwatosa, Wisconsin and his residency
training in Radiation Oncology at the Mayo
Clinic in Rochester, Minnesota. He has been
active in research throughout his career,
publishing his works in several scientific journals.
Dr. Mei Dong, Medical Oncologist, completed
her Internal Medicine residency at Norwalk
Hospital, Yale University. She successfully
pursued her fellowship in Hematology/
Oncology at Duke University, Durham, North
Carolina and MD Anderson Cancer Center,
Houston, Texas. Dr. Dong conferred her
Ph.D. in Biomedical Science at the University
of Connecticut and her MD was achieved at
Harbin Medical University, Harbin, China. Dr.
Dong is an advocate of patient-centered care.
Dr. Srivalli Gopaluni, Medical Oncologist,
completed her residency at Internal Medicine
SUNY Upstate Medical University; Syracuse,
New York and her internship was completed at
Gandhi Medical College, India. She pursued
her Hematology/Oncology Fellowship at SUNY
Upstate Medical University; Syracuse, New
York. She is very enthused about the new
treatments in Melanoma and GU Oncology
and has a special interest in enrolling patients
to clinical trials.
Inland Northwest Health Services names Deb Harper,
MD to the Board
Dr. Deb Harper has been named a new
member of the Inland Northwest Health
Services board of directors. Dr. Harper is a
part-time general pediatrician at Group Health
and a clinical assistant dean for the University
of Washington School of Medicine.
CHAS Appoints New Medical Director
Dr. William Lockwood to oversee CHAS clinics
Community Health Association of Spokane (CHAS) is proud to
announce a visionary new leader at the helm. As of September
1, 2012, Dr. David Bare will hand over Medical Director
responsibilities to Dr. William Lockwood.
After graduating Summa Cum Laude with a B.S. in Medical Physics
from Oakland University in Rochester, Michigan, Dr. Lockwood
continued on at the University of Michigan’s Medical School where
he completed his M.D. in 1987. He completed his Emergency
Medicine residency at Wright State University School of Medicine
in 1990. Dr. Lockwood has worked in emergency medicine for
over 20 years and has worked as a volunteer EMS medical director,
attending physician, and provided a year of service in Australia.
Dr. Lockwood joined CHAS in 2010 to help build and grow
Spokane Urgent Care and is excited about his upcoming move
to the Medical Director position. In his words, “I’m prepared to
work hard and do my best.” And in a wonderful ode he recently
recited to the providers of CHAS he said, “I’m happy, thankful,
and honored to be a piece of CHAS’ great mission –bringing
healthcare to people, regardless of social condition.” Dr. Bare’s
career includes 35 years of exceptional service to patients
and communities in Washington State, including the role of
Medical Director at CHAS since 2003. He will continue to work
for CHAS as an urgent care provider. Dr. Bare jokingly states,
“I made the switch from private practice when I started to get
grumpy with the 2 a.m. phone calls. I am switching from Medical
Director to provider before people start getting grumpy with
me.”accountability for quality and value.
For Your Information
The membership overwhelming voted to pass the suggested
changes to Section 6.2 (h) Membership Classes. The updated bylaw now reads as follows:
WA DOH has implemented a $2 convenience fee. “While the
online renewal process is more convenient for our customers, it
does not reduce agency costs. We will continue to mail renewal
notices and licenses to our credential holders. Our current
renewal process is already mostly automated; therefore, this
new optional system will not decrease staff time. The purpose
of convenience fee is to help cover costs of making the online
system available and credit card processing.” 6.2 (h) Membership Classes
Renew Online at http://www.doh.wa.gov/hsqa/Renewals.htm
Physician Assistant members shall consist of physician assistants
who are licensed, and in good standing, by the State Board of
Medical Examiners. They shall pay annual dues as established by
the Board of Trustees, but such membership does not entitle the
member to vote. One seat on the Board of Trustees may be filled
by a physician assistant.
NOTE: You will not be able to renew online if:
Changes to SCMS By-Laws Passes
»» Your credential has already expired.
»» You are currently in any other status such as military,
inactive, or retired.
»» You want to change your status from active to military,
inactive, or retired.
Online License Renewal - Six new
professions available
»» You have an address change.
»» You have a name change.
On September 17th, 2012 six additional professions were released
for online renewal. Physicians and Physician Assistants are two of
the newly added professions. Please contact WA DOH Customer Service Office at (360) 2362750 for assistance.
Some of the Professions That Can Renew Online:
Is your contact information current?
Osteopathic Physician & Surgeon
DOH must have your current mailing address in ITS system for
you to renew online. They will mail your updated credential to
the address on file. The United States Postal Service will not send
your credential to a forwarding address.
Osteopathic Physician & Surgeon Limited
Pharmacist
Pharmacy Technicians
Physician and Surgeon
Physician Assistant
Podiatric Physician and Surgeon
If your contact information is not current in the DOH system,
please complete and submit the address change form. Please
include a valid email address. Contact DOH prior to online
renewal to make sure your contact information has been updated.
Podiatric Physician and Surgeon Limited
Surgical Technologists
Membership Recognition
for October 2012
UPCOMING SCMS EVENTS
Thank you to the members listed below. Their contribution of time
and talent has helped to make the Spokane County Medical Society
the strong organization it is today.
30 Years
OCTOBER
Senior Physicians’ Dinner – 18
DECEMBER
Michael J. Kraemer, MD
10/26/1982
Curtis G. Wickre, MD
10/26/1982
Steven Wolf, MD
10/26/1982
Board of Trustees’ Meeting – 12
20 Years
Stephen J. Darling, MD
10/28/1992
David Sandler, MD
10/28/1992
David R. Greeley, MD
10/27/1992
10 Years
Erik D. Skoog, MD
10/7/2002
Stephanie R. Moline, MD
10/28/2002
Physician Leadership Resources
A link for any of the resources listed can be found at the SCMS website (www.spcms.org) Leadership Resources tab.
Online Journal
New Journal Prepares Young Physicians for Medical Management, Leadership
A free online journal created by the American College of Physician Executives (ACPE) equips the next generation of physicians with the
knowledge they need to succeed in the business side of medicine.
This bi-weekly publication, called LeadDoc, is designed to help medical students, residents and young physicians develop leadership
and management skills that will advance their careers. Each issue features a physician profile and advice from established physicians.
“In essence, every physician is a leader at some level,” ACPE CEO Peter Angood said in a news release. “Our goal is to inform and guide
young physicians as they launch their careers in health care—regardless of where their professional paths may eventually lead.”
Visit http://net.acpe.org/iimgs/newsroom/Press- releases/2012/06-05_LeadDoc.pdf to read more in an ACPE news release.
Book
Clinical Integration: A Roadmap to Accountable Care, By Ken Yale Second Edition offers timely updates on key changes affecting the
industry as clinically integrated networks (CIN) and accountable care organizations (ACO) emerge. This second edition expands the
discussion of key issues affecting hospitals, physicians, insurers, government agencies, and legal professionals on efforts to establish
organizations with greater accountability for quality and value.
Continuing Medical Education
Promoting Healthy Families (Practice Management Alerts from
the American Medical Association) is designed to help physicians
successfully talk about healthy behaviors with their adult patients in
a way that may spark—and help sustain—positive changes for the
whole family. The continuing medical education activity includes a
video module, a detailed monograph and patient handout. These
activities have been certified for AMA PRA Category 1 CreditTM.
For more information www.ama-assn.org.
Medical and Therapeutic Management of Chronic Pain: This
seminar is jointly sponsored by the St. Luke’s Rehabilitation and the
Spokane County Medical Society. 4.5 AMA Category 1 Credits.
Conference will be held on November 9, 2012 from 8:00 AM –
3:30 PM at the Davenport Hotel. Additional information & online
register available at www.cherspokane.org.
Yin of Medicine - Past, Present and Future October 10-13, 2012
21.25 hours of Category 1 credit Brochure, Tuition & Registration
http://cmetracker.net/GHC/Login?FormName=RegLoginLive&Event
id=1572 For twenty years, Yin of Medicine has served as a consistent
gathering place for women in health care. This year's program
celebrates the past successes of women in health care, the current
state of health care, and a look forward to the roles women will play
in its future. Alongside this content, we will continue to explore hot
clinical topics and how each of us can participate in shaping the
future of health care through our contributions as practitioners,
leaders, and team members. Location: Alderbrook Resort 7101 E
State Highway 106 Union, WA 98592 (360) 898-2200 http://www.
alderbrookresort.com/ All reservations must be made by the cut-off
date of 9/11/2012. Contact Maria Cárdenas-Anson at (206) 326-2084
for more information or at [email protected].
Engaging Patients – The ABIM Foundation Choosing Wisely®
Campaign CPIN Lunchtime Webinar: Tuesday, October 23, 2012 –
from 12:15 until 1:15 PM Evidence-based medicine is more than just
using clinically-proven procedures; equally important is using the
evidence to decide what not to do. Choosing Wisely® is part of a
multi-year effort by the ABIM Foundation, along with many national
specialty society partners, to help physicians become better
stewards of our limited health care resources. Twenty national
organizations representing medical specialists, as well as Consumer
Reports, joined with the ABIM Foundation to help physicians,
patients and other health care stakeholders think and talk about the
overuse of health care resources. Each specialist organization has
identified five tests or procedures commonly used in their field for
which the necessity should usually be questioned and discussed.
The resulting lists of "Five Things Physicians and Patients Should
Question" are intended to “spark discussion about the need—or
lack thereof—for many frequently ordered tests or treatments”.
This webinar will present an overview of this campaign. This activity
has been approved for AMA PRA Category 1 Credit™; AAFP
Prescribed credit is pending application.
Physicians can register online at http://www.wsma.org/clinicalperformance-improvement-network and anyone can register by
sending an e-mail titled CPIN Oct 23 to [email protected], with the
following info: Name, Phone, Clinic/Group Name and Number of
Participants. Free for all physicians, medical group staff, or other
care providers. $75 for non-clinical participants. Questions contact
Kesley Howard at (206) 956-3620 or [email protected].
Rockwood Health Systems Breast and General Tumor
Boards: These tumor boards are jointly sponsored by
Rockwood Health Systems and the Spokane County Medical
Society. Tumor Boards will be held weekly September –
December 2012. Each Tumor Board is worth 1.0 Category I
CME credits. For more information please contact Sharlynn
M. Rima CME Coordinator at [email protected].
Meetings/Conferences/Events
Institutional Review Board (IRB) - Meets the second Thursday of
every month at noon at the Heart Institute, classroom B. Should
you have any questions regarding this process, please contact the
IRB office at 509.358.7631.
WSMA & UW Physician Leadership Course Offered in Spokane
Spring 2013 Terri Oskin, MD, SCMS President wrote in the August
Newsletter, “Through Leadership Spokane I developed a new
and deeper understanding and appreciation of Spokane, both
its strengths as well as its weaknesses. The program stresses the
role of the servant leader and active participation.” The SCMS
has and continues to stress the importance of physician leadership
through its publications and activities in the community. If you are
in a position of leadership or are contemplating it, read the many
physician authored articles in the August Newsletter and consider
advancing your leadership skills. The following announcement
outlines an excellent leadership program that you should consider.
Physicians who lead are in a remarkable position - they know the
culture of patient care as well as the culture of business. Safe and
cost-effective care can only be achieved if more physicians take
leadership roles in health care or form strong partnerships with
administrators. Nevertheless, many physicians do not feel confident
in their skills and need an opportunity to see what their future might
be as leaders.
The WSMA/UW Physician Leadership course is a comprehensive
leadership skills development program that offers 10 weeks of
interactive hybrid distance learning specifically designed for
physicians. The course is based on UW MHA and Certificate of
Medical Management curriculum. The course offers 8 weeks of
online assignments and group work bookended by two in-person
weekend meetings, allowing physicians to develop and hone their
leadership skills in a convenient manner without needing to take
significant time away from their practice or personal lives. The 40hour course (CME and AAFP credit apply) focuses on: leadership and
conflict management, strategic planning and management, safety
and quality management, finance and communication and advocacy.
The Second Annual James McClellan Lecture Humanity In
Clinical Care The Marcus Whitman Hotel and Conference Center,
2nd and Rose Street, Walla Walla, WA. Parking is available on site.
Friday, 9 November 2012 Welcome 12:00pm. Lecture 12:30pm
Luncheon 1:30pm: FREE, with Symposium (1:30-4:00 PM) CME II,
2 hours Cost: None. The Lectureship is funded through donations
from the medical community of Walla Walla as a loving memorial to
Dr. James E. McClellan. Pre-registration is required. Space is limited:
reservations will not be accepted after 4 November. Register by email:
Carole Alexander at: [email protected]; include full name,
occupation (physician, nurse, student, etc.), and mailing address.
The following physicians and physician assistants have applied for
membership and notice of application is presented. Any member
who has information of a derogatory nature concerning an applicant’s
moral or ethical conduct, medical qualifications or such requisites
shall convey this to our Credentials Committee in writing 104 S Freya
St., Orange Flag Bldg #114, Spokane, Washington, 99202.
PHYSICIAN ASSISTANT PRESENTED A SECOND TIME
Perius, Nicholas J., PA-C
Physician Assistant
School: U of North Dakota
Practicing with Valley Hospital and Medical Center 06/2012
PHYSICIANS
IN MEMORIAM
Dunsmoor Su, Rebecca F., MD
OBGYN
Med School: U of Pennsylvania (2001)
Internship & Residency: Hospital of the U of Pennsylvania (2005)
Practicing with Obstetrix Medical Group of Washington 09/2012
Laselle, Brooks T., MD
Emergency Medicine
Med School: Feinberg School of Medicine (2004)
Internship & Residency: Madigan Army Medical Center (2007)
Fellowship: Denver Health Medical Center (2009)
Practicing with Spokane Emergency Physicians 01/2013
Lowe, Gloria V., MD
Family Medicine
Med School: U of Washington (2008)
Internship & Residency: Family Medicine Spokane (2012)
Practicing with South Hill Family Medicine 09/2012
PHYSICIANS PRESENTED A SECOND TIME
Kilaru, Ravi K., MD
Cardiovascular Disease/ Electrophysiology
Med School: Guntur Medical College (1998)
Practicing with Rockwood Clinic 08/2012
Le, Steven K., MD
Cardiovascular Disease
Med School: UCLA School of Medicine (2006)
Practicing with Providence Spokane Cardiology 09/2012
Bert Pedersen Jacobson, MD
Bert Jacobson was born on January 23, 1918 in Spokane,
Washington and passed away on September 3, 2012 at
Providence Sacred Heart Medical Center where he had
served as president of the medical staff from 1980-81. Bert
was raised in Mead, graduated from Mead High School
and Gonzaga University. He received his medical degree
from Jefferson Medical College in Philadelphia in 1943 and
joined the U.S. Navy as a medical officer on the battleship,
U.S.S. Stringham, in the Pacific Ocean during World War
II. He married his wife Helen, a nurse anesthetist, in 1944.
He began practicing medicine in Poulsbo, Washington
(1946-50) before moving to Spokane and establishing a
private practice as a general practitioner and surgeon
from 1950-84. He served as a doctor for the Spokane Fire
Department, the Northern Pacific (Burlington Northern)
Railroad and the North Central High School football team.
He and Helen raised three daughters and shared many
happy days at Priest Lake, Idaho. He was preceded in
death by his wife Helen and sister, Lina Ryan. He is survived
by his daughters, Patsy (Frank) Etter, Nancy Bettesworth
and Judy (Dave) Nail all of Spokane; nine grandchildren
and ten great-grandchildren, and sister, Frances (Bill)
Holcomb of Spokane.
Reveron, Ivan J., MD
Family Practice
Med School: Eastern Central U (1984)
Practicing with Community Health Association of Spokane 08/2012
Schomberg, Paula J., MD
Radiation Oncology
Med School: Medical College of Wisconsin (1979)
Practicing with Cancer Care Northwest 11/2012
Zimmerman, Colleen E., MD
Family Medicine
Med School: Sanford School of Medicine (2009)
Practicing with Family Medicine Spokane 09/2012
PHYSICIAN ASSISTANT
Lipps, Deanna R., PA-C
Physician Assistant
School: U of Washington (2012)
Practicing with Rockwood Clinic 10/2012
POSITIONS AVAILABLE
PHYSICIAN OPPORTUNITIES AT COMMUNITY HEALTH
ASSOCIATION OF SPOKANE (CHAS) Enjoy a quality life/work
balance and excellent benefits including competitive pay, generous
personal time off, no hospital call, CME reimbursement, 401(k), full
medical and dental, NHSC loan repayment and more. To learn more
about physician employment opportunities, contact Toni Weatherwax
at (509) 444-8888 or [email protected].
QTC MEDICAL GROUP is one of the nation’s largest private providers
of medical disability evaluations. We are contracted through the
Department of Veterans Affairs to manage their compensation and
pension programs. We are currently expanding our network of Family
Practice, Internal Medicine and General Medicine providers for our
Washington Clinics. We offer excellent hours and we work with your
availability. We pay on a per exam basis and you can be covered on
our malpractice insurance policy. The exams require NO treatment,
adjudication, prescriptions to write, on-call shifts, overhead and case
file administration. Please contact Gia Melkus at (800) 260-1515 x5366
or email [email protected] or visit our website www.qtcm.com to
learn more about our company.
PRIMARY CARE INTERNIST WANTED (Pullman) - Immediate
opportunity for BE/BC primary care internist to join a privately
owned, multi-specialty, physician practice. Palouse Medical offers
a competitive employment package, guaranteed first year salary,
comprehensive benefits and partnership potential. Dedicated to
delivering quality care, we are proud to offer an extensive array of
patient services and on-site laboratory and imaging departments.
We can’t wait to introduce you to the communities that we love and
serve. Call Theresa Kwate at (509) 332-2517 ext. 20 or email tkwate@
palousemedical.com. Contact us today and discuss your future at
Palouse Medical!
CONTRACT BACK-UP PHYSICIAN 4 + HOURS/MONTH Octapharma Plasma is hiring a Contract Back-Up Physician in our
Spokane, WA Donor Center! This position requires just 4 hours per
month. GENERAL DESCRIPTION Provide independent medical
judgment for issues relating to donor safety, health and suitability for
plasmapheresis and immunization. Provide federal and international
mandated training and supervision of donor center medical staff
to assure compliance with applicable laws. We provide on-the-job
training. WHO IS OCTAPHARMA PLASMA? Octapharma Plasma, Inc.
is dedicated to improving the health and lives of people worldwide.
OPI owns and operates plasma collection centers critical to the
development of life-saving patient therapies utilized by thousands
of patients globally. Learn more at www.OctapharmaPlasma.
com. Apply today by sending your resume/CV to Careers@
OctapharmaPlasma.com!
PREMIER CLINICAL RESEARCH, an independent dedicated
research facility here in Spokane with 20 years of research experience
is looking for a Pediatrician to be a part of our physician network
for future studies. For more information please contact: April
Gleason, Director of Business Development, (509) 390-6768,
[email protected].
FAMILY MEDICINE SPOKANE Immediate opening with Family
Medicine Spokane (FMS) for a full time BC/BE FP physician who
has a passion for teaching. FMS is affiliated with the University of
Washington School of Medicine. We have seven residents per year in
our traditional program, one per year in our Rural Training Track and
also administer OB and Sports Medicine Fellowships. This diversity
benefits our educational mission and prepares our residents for urban
& rural underserved practices. We offer a competitive salary, benefit
package and gratifying lifestyle. Please contact Diane Borgwardt,
Administrative Director at (509) 459-0688 or e-mail at BorgwaD@
fammedspokane.org. PROVIDENCE HEALTH & SERVICES is building its Urgent
Care presence in Spokane. We are recruiting for BE/BC Urgent/
Immediate Care physicians and advanced practice providers (nurse
practitioners and physician assistants welcome to apply). This is
a great opportunity to join a growing employed medical group in
beautiful eastern Washington. The exceptional Providence care team
is implementing a system-wide standardized EHR and providers
benefit from shared best practices and robust clinical and business
support. Providence already operates hospitals, residency programs
and numerous primary care and specialty clinics in Spokane.
Competitive compensation and excellent benefits package, including
relocation. Learn more: Mark Rearrick, Providence physician recruiter
(509) 474-6605, [email protected], www.providence.org/
physicianopportunities.
SPRINGDALE COMMUNITY HEALTH CENTER ARNP or PAC N.E. Washington Health Programs (NEWHP) has an immediate
opportunity for an excellent Physician Assistant (certified) or Nurse
Practitioner with Family Practice experience to join our Springdale
Community Health Center located in rural Springdale, WA. This
position is for Family Practice outpatient care; urgent care experience
is a plus but not required. NEWHP offers competitive compensation,
comprehensive benefits. . NHSC eligible site. EOE and provider.
Application Deadline: Until filled. Send resume to: N.E. Washington
Health Programs Attn: Human Resources PO Box 808 Chewelah,
WA. 99109 or electronically to [email protected].
PHYSICIANS NEEDED FOR WORKERS COMPENSATION EXAMS
Let us help you get started in earning additional professional income!
We are an established I.M.E. practice currently looking for Active
Practice and Board Certified Orthopedic and Neurological Doctors,
to perform Workers Compensation Exams. Located just minutes away
from Rockwood Clinic in North Spokane, we offer a flexible schedule
in a helpful, working environment. Previous experience performing
Workers Compensation Exams is not required. Please contact Lorraine
Stephens for further information at (509) 484-0380.
EASTERN STATE HOSPITAL PSYCHIATRIST - ESH is recruiting
for a psychiatrist. Joint Commission accredited, CMS certified,
state psychiatric hospital. 287 beds. Salary $161,472 annually with
competitive benefits and opportunity for paid on-call duty. Join a
stable Medical Staff of 30+ psychiatrists, physicians and physician
assistants. Contact Shirley Maike, (509) 565-4352, email maikeshi@
dshs.wa.gov. PO Box 800, Medical Lake, WA 99022-0800.
PARTNERING FOR PROGRESS is a humanitarian Spokane-based
nonprofit that is committed to ensuring that residents of the Kopanga,
Kenya community have improved access to healthcare, clean water,
sanitation and education. Through generous donors, P4P built a
clinic for the Comprehensive Rural Health Project that is run by Alice
Wasilwa RN with two other Kenyan nurses and provides primary care.
Some of the common diseases include malaria, water borne illness as
well as the diagnosis and treatment of HIV. There are approximately
12 deliveries per month and the clinic staff treats 900-1000 patients
monthly. We are in need of medical providers, optometrists and
dentists to travel to Kopanga to provide primary care on Oct. 18 – 28,
2012. If you would like to volunteer please contact Stacey Mainer at
[email protected].
MEDICAL DOCTOR (MD/DO) (PRN openings in Spokane, WA)
Physicians needed to perform physicals and health screenings at a
non-commercial medical facility. MD/DO must have a current active,
license from any state, available 1 to 3 mornings a week.
Send CV to or call: Gil: (210) 424-4008
[email protected]
EOE
REAL ESTATE
Luxury Condos for Rent/Purchase near Hospitals. 2 Bedroom
Luxury Condos at the City View Terrace Condominiums are available
for rent or purchase. These beautiful condos are literally within
walking distance to the Spokane Hospitals (1/4 mile from Sacred
Heart, 1 mile from Deaconess). Security gate, covered carports, very
secure and quiet. Newly Remodeled. Full appliances, including fullsized washer and dryer. Wired for cable and phone. For Rent $ 850/
month. For Sale: Seller Financing Available. Rent-to-Own Option
Available: $400 of your monthly rent will credit towards your purchase
price. Please Contact Dr. Taff (888) 930-3686 or [email protected].
North Spokane Professional Building has several medical office
suites for lease. This 60,000 sf professional medical office building is
located at N. 5901 Lidgerwood directly north of Holy Family Hospital
at the NWC of Lidgerwood and Central Avenue. The building has
various spaces available for lease from 635 to 6,306 usable square
feet available. The building has undergone extensive remodeling,
including two new elevators, lighted pylon sign, refurbished lobbies,
corridors and stairways. Other tenants in the building include
pediatricians, dermatology, dentistry, pathology and pharmacy.
Floor plans and marketing materials can be emailed upon request. A
Tenant Improvement Allowance is Available, subject to terms of lease. Please contact Patrick O’Rourke, CCIM, with O’Rourke Realty, Inc. at
(509) 624-6522 or cell (509) 999-2720. Email: [email protected].
Clinical Space for Lease - Built in January 2011. 1128 sq ft, four
exams rooms, two administrative offices, one office with a counter
(electronic bar for laptops, etc.), restroom, reception area and
waiting room. Rates are negotiable. Interested parties contact
Sharon Stephens at Bates Drug Stores, Inc. 3704 N. Nevada, (509)
489-4500 Ext. 213 or [email protected].
FOR SALE: 16909 N Triple Butte Court, Colbert, WA $789,000
Beautiful home, custom built in 1996 by Copeland Design and
Construction. Situated on five wooded acres with two seasonal ponds
and 220 feet of river frontage along the Little Spokane River. Idyllic
country living but only 5 minutes from the Wandermere Shopping
Center and only 10 - 15 minutes from Holy Family Hospital. There are
4 bedrooms, a library, a formal dining room, an open kitchen with
eating area, great room, rec room, sun room, 2 full baths, a guest bath,
mud room, laundry room, a 3-car attached garage and a greenhouse
with fenced-in garden, covered front porch, large back deck with hot
tub and a patio of cobblestones. Views from the back deck look over
the Little Spokane River wetlands. Call Dr. Edward Petruzzello at (509)
879-3770. No realtors please.
Office space located at 1315 North Division. This location is
two miles north of downtown Spokane and just west of Gonzaga and
the university district. It consists of 902 sq. ft. and rents for $1015
per month plus 20% of the building Avista and City of Spokane
bills. The rest of the building is occupied by a physiatry and pain
management medical practice. The space would be ideal for an
ancillary medical, chiropractic or therapeutic clinic. Parking is ample
and convenient. The space has a nice waiting area and receptionistenclosed area, with several office, storage or exam rooms. Call
(509) 321-2276 for more information or for a showing of your ideal
location.
MEDICAL OFFICES/BUILDINGS
OTHER
South Hill – on 29th Avenue near Southeast Boulevard - Two
offices now available in a beautifully landscaped setting. Building
designed by nationally recognized architects. Both offices are
corner suites with windows down six feet from the ceiling. Generous
parking. Ten minutes from Sacred Heart or Deaconess Hospitals.
Phone (509) 535-1455 or (509) 768-5860.
Ten (10) adjustable rolling physician stools, teal - $35.00 each, all
in great condition. For more information contact Colleen Kins at
Internal Medicine Residency (509) 744-3965 or email Colleen.Kins@
Providence .org.
PRSRT STD
SPOKANE COUNTY MEDICAL SOCIETY - ORANGE FLAG BUILDING
104 S FREYA ST STE 114
SPOKANE, WA 99202
U.S. Postage
PAID
Spokane, WA
Permit No. 512
ADDRESS SERVICE REQUESTED
Printed on GP Spectrum® Paper: Certified by the Sustainable Forestry Initiative. Please recycle.
G lf
Cure
for the
1 800 523-2464 | CI R C L I N G R AV E N .COM |
/ C I R C L I N G . R AV E N

October 2012 - Spokane County Medical Society

Transcription

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