California Southern I Governor's Newsletter August 2018

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Mark S. Noah, MD, FACP, ACP Governor

Mark S. Noah, MD, FACP, ACP Governor


Message from the Governor

Dear Colleagues,

It has been about six months since my previous newsletter to you, and ACP has been very active in representing you in both the state and national legislatures.

In February, members from our local chapter went to Sacramento to meet with the our local legislators where we expressed our concerns about several legislative proposals including limitation of a physician's ability to authorize post discharge of opioid prescription to any longer than 3 days regardless of the situation, and a plan that would have developed a single party payer system in the state with minimal physician input. We supported the development of a formal process that would support physicians who have appropriately treated mental health and substance abuse problems to reenter the work force. As we have done for the last 10 years, we invited medical residents and students to become involved in our lobbying process. This educational experience provides our young physicians a real life understanding of the workings of the legislative process, and how physician input is essential in shaping the laws that influence the practice of medicine in our State.

Our regional Governor's Council met at the end of December 2017 and in June 2018. These meetings allow membership input into both California and national resolutions that impact physicians. Topics for this year ranged from the development of strategies to effectively implement aspects of ACP's “Patients Before Paperwork” campaign, to studying the value of a primary care internist versus the growing number of non-internist care providers. The group also discussed policies to increase diversity and representation in our chapter's leadership and various activities. We have approved our ACP chapter's budget for the next business year, and were updated on our next Southern California ACP regional meeting that will take place in the fall.

In late April, the national ACP meeting, Internal Medicine Meeting 2018, was held in New Orleans, LA. The educational content of the meeting was exceptional and included over 200 sessions on the study and management of multiple medical conditions, practice management strategies and extremely well attend groups on physician wellbeing. The keynote speaker was Dr. Karen DeSalvo, former Acting Assistant Secretary of Health and Human Services, and her talk focused on the lessons learned from building a health care system from scratch after the devastation of Hurricane Katrina. The UCLA resident team that won the ACP Southern California Doctors Dilemma® Championship (Medical Jeopardy) participated in the national competition (unfortunately they lost), and we had a wonderful reception for ACP members from California, Hawaii, and Arizona, in the Marriot Hotel that was located in the famous French Quarter of New Orleans. I think everyone had a wonderful time exploring the city of New Orleans, from trips down Bourbon Street to the Garden District, enjoying beignets, chicory coffee, gumbo, fried okra, and po’boys.

At the end of May, California sent the largest state contingent to Washington D.C. to represent the ACP in Congress. Leadership day opened with detailed educational sessions on the process of advocating for our membership and patients with our elected officials. These sessions were followed by presentations on ACP policy regarding many healthcare concerns impacting our patients and members. These sessions were particularly beneficial to the medical residents and students who were receiving their first experience with health care advocacy. The next day the California ACP contingent visited the offices of all 53 California congresspersons and our 2 senators. Topics ranged from discussions on the opioid epidemic, designing more effective and efficient EMRs, the imperative to continue and increase primary care funding in internal medicine, and the challenge to control the rapid rise in medication costs.

Finally, you will receive an announcement and full agenda soon for our ACP Southern California Regional Educational Meeting that will be on Saturday October 27, 2018 at the Hunting Beach Hyatt in Orange County. Plan to join us!

I hope all of you have a phenomenal summer and hope to see you at our meeting in October.




Sacramento Leadership day

California ACP Representatives in Sacramento, CA

California ACP representatives meeting with Jennifer Kent, MPA, the director of the California Department of Health Care Services

Comments from Residents at Sacramento Leadership day

The California-ACP Leadership Day meeting was an enlightening experience for me. In clinical practice, physicians are focused on decision-making on the individual patient level, thus the meeting that took place this past February in Sacramento provided great insight into decision-making for our patients on a much larger scale. It was fascinating to get a window into the intricate process by which legislation is passed, and it was invaluable to get the chance to actually sit down with legislators and their staffers to discuss our views and causes. I would highly recommend this meeting for any student or resident interested in health policy and the processes by which we can benefit our patients on a state-wide level.

Jeffrey Ko, MD
PGY-3, Internal Medicine
Cedars-Sinai Medical Center

ACP-Sacramento Leadership Day was a wonderful learning experience which I felt added a great deal to my training in becoming a better health advocate for my patients, my community and my state. As physicians it is our responsibility to know about the legislative issues being considered that will affect our patients and undoubtedly our own experience in being able to provide appropriate care to all. I enjoyed learning about the complexities and nuances of the whole process. What I found most surprising was how easy it is to set up an appointment with my representative to discuss the topics that concern both me and them! The actual face-to-face discussion proved to be more challenging but it did provoke me to consider how I might gather more appealing support the next time to mount a more persuasive argument. Conclusion: numbers matter and putting a face to the name of your organization and the constituents you represent matter! It also taught me the importance of coming to the table willing to hear out the other side and consider how we might find a way to meet in the middle in order to come to a meaningful outcome for all parties involved. In short, to advocate means to be intentional in educating yourself, your patients, your communities and your elected officials. It means being intentional in finding creative ways to bring awareness and create opportunities for the solutions you seek. ACP Leadership Day is a great way to learn more and practice just that! I highly recommend it.

Maria Marian
PGY-2 Resident
UCLA-Olive View IM Program

Although as medical residents we are closely involved in direct patient care, oftentimes it can be difficult to step back and evaluate the legislative processes which allow us to deliver that care. This year I had the privilege of participating in Cal-ACP's Sacramento Leadership Day at the State Capitol. Leadership Day provided a unique look into the intricacies of policy-making, including the passage of laws and regulations that ultimately affect physicians and their patients. We had the opportunity to sit down with State Senator Ed Hernandez and California Department of Health Care Services Director Jennifer Kent to discuss multiple challenges facing California's patient population. Additionally, we met with several state assembly members to discuss a range of important topics including access to affordable care, physician wellness, and the opioid addiction crisis. It was very rewarding to provide legislators with a personal look into the difficulties facing patients and physicians alike, and see their eagerness to bring about change. The experience highlighted the importance of advocacy work at the State and local level in order to pursue policies that positively impact our growing patient population. It was overall a highly informative and enriching experience. A special thank you to CA ACP for hosting the event.

Kirollos Zaki, DO
PGY-2 Resident
UCLA-Olive View IM Program

Before having had the wonderful opportunity of attending ACP Leadership days, I had no idea what “advocacy” meant as a physician on the large scale. So often we are focused and engaged on how to advocate, discuss, and assess on a smaller scale, an individual scale, that we tend to forget, or not even realize how powerful are voices can be. Not just for ourselves, but for those we take care of, and care about. It might be seen as cliché to say that having this opportunity changed me, but it has changed me, for I'm now aware of the process. I've been extremely fortunate to get to scratch the surface of what it takes to enable a great deal of good for this country, and I look forward to joining my colleagues in ensuring this happens. For anyone that has skepticism about the system or doesn't know what advocacy is, I highly encourage you to ask those close to you and to these various processes, because it could ignite your passion

Niv Hakami-Majd, MD
Internal Medicine Categorical Resident, PGY-2
Cedars Sinai Medical Center / West Los Angeles Veteran's Affairs

Left to right: Marin McCutcheon, MD, Soma Wali, MD, FACP, Maria Marian, MD, Jose Escobar, MD, Peter Nguyen, MD, Kirollos Zaki, DO, Niv Hakami-Majd, MD, Jeffrey Ko, MD, and Governor, Mark Noah, MD, FACP
Left to right: Governor Mark Noah, MD, FACP, Niv Hakami-Majd, MD and Elad Neeman, MD at Leadership Day Orientation
Left to right: Brendan Kim, Medical Student, Soma Wali, MD, FACP, Congressman Ami Bera, MD, ACP Northern California Chapter Governor Raminder Gill, MD, FACP, and Stephanie Wang, MD

2018 Washington Leadership Day

Back row, left to right: Robert Thomas, MD, UCSD, Johnathan Harrison, MD, Scrips Mercy, Elad Neeman, MD, Noah Duncan, MD, Isuare Hostetter, Medical Student, Junya Kayano, MD, Niv Hakami-Majd, MD, Brendan Kim, Medical Student, Jarod DuVall, MD, Stephanie Wang, MD, and Joe Torres, MD
Front Row, left to right: Charles Hamori, MD, FACP, Governor, ACP Southern CA Region II, Mark Noah, MD, FACP, ACP, Governor, Southern CA Region I, Soma Wali, MD, FACP, Paul Speckart, MD, MACP, Chester Choi, MD, MACP, and Raminder Gill, MD, FACP, Governor, ACP Northern California Chapter
Left to right: Niv Hakami-Majd, MD, Governor Mark Noah, MD, FACP, Noah Duncan, MD, Elad Neeman, MD, Isuare Hostetter, Medical Student, Stephanie Wang, MD, Junya Kayano, MD, Joe Torres, MD, and Soma Wali, MD, FACP
Left to right: Junya Kayano, MD, Stephanie Wang, MD, Soma Wali, MD, FACP, Jarod DuVall, MD, Noah Duncan, MD, and Joe Torres, MD

ACP Leadership Day on Capitol Hill – A Medical Student/Resident Perspective

As a fourth year medical student with a Masters in Public Policy, having the opportunity to be at the table and represent ACP's patient centered policy actions was instrumental in my development as a future leader. The experience provided me with a firsthand experience on the inner workings of Washington, and how to engage with our representatives to improve access for our patients. I am grateful to the Southern ACP Chapters, Dr. Wali, and Olive View for allowing me to have such a wonderful experience. It was an amazing experience and the food was delicious in DC!!!

Joe Torres, MD, MPP
PGY-1 Resident
UCLA-Olive View Internal Medicine Program

Participating in the ACP Leadership Days in Washington D.C. was a wonderful educational and personal experience for me. We started off with some very informative lectures on the process of policy making at ACP, the legislative process in Congress, previous successes of ACP Leadership Days, and a review of the current policies we would advocate for on behalf of the ACP. The second day is spent mostly in Congress, meeting with representatives and their staffers and discussing ACP agenda, as well as potential barriers for implementation. Despite a pretty busy schedule, we were also able to explore the beautiful city's hallmarks during the first and second evenings.

Elad Neeman, MD
PGY-2 Resident
Cedars-Sinai Medical Center/West-LA VA Medical Center



National ACP Scientific Meeting in New Orleans and Convocation Ceremony

Governor Mark Noah, MD, FACP with New Fellows of ACP

New ACP Southern California Region 1 Fellows Over the last 6 months:

Olivia A. Arreola-Owens, MD, FACP, Toluca Lake

Emily Cantor, MD, FACP, Los Angeles

Michael Estes, MD, FACP, Los Angeles

Ma Ai Thanda Han, MBBS, FACP, West Hollywood

Babji P Mesipam, MD, FACP, Santa Barbara

Vinhfield X. Ta, MD, FACP, Sherman Oaks

Ivaylo Vagliarsky, MD, FACP, Bakersfield

The Governors of California, Hawaii and Arizona ACP Chapters at the New Orleans Reception
The California, Hawaii, Arizona Chapter reception at the Annual Meeting of the ACP in New Orleans
Chicory, Coffee and Beignets are a must in this New Orleans French Quarter Historical Cafe


Louisiana Swamp Tour and a visit from their favorite reptile, “Alligator Bob”



ACP Medical Student Award Winners

Each year ACP honors a medical student from the DGSOM at UCLA and one from Keck SOM at USC with an award as the top student going into Internal Medicine residency training. This year the recipient from UCLA was Jessica L. Lucier, MD and from USC was Christina S. Gainey, MD. These two students demonstrated the clinical and interpersonal skills that we hope all of our future physicians would possess.

Mark Noah, MD, FACP presenting Jessica Lucier, MD with the ACP Student Internist of the Year Award at UCLA




Mark Your Calendars! The Southern California ACP Scientific Meeting moves to Huntington Beach, CA this October

You should all soon be getting an announcement on the full agenda of our ACP Southern California Scientific meeting that will be held on Saturday, October 27, 2018 at the Hyatt Regency Huntington Beach Resort and Spa in Orange County. We have an outstanding program that will focus on updates in medical care and physician wellbeing. There will great workshops on common office procedures like joint injections, as well an opportunity for physicians to learn new skills to help prevent burn out ranging from mindfulness training to meditation, and Tai Chi. There will be Maintenance of Certification educational sessions in Ambulatory Internal Medicine, and Hospital Medicine and as always we will have special sessions for residents and students, a Scientific poster sessions, as well as the friendly Doctor's Dilemma® competition between our Southern Californian residency programs.

Registration and lodging information will be forthcoming in the next few weeks. We hope to see you there!