District IX March 2006.qxp - American College of Obstetricians and

district
news
Serving ACOG members in California
March 2006
News from the District IX chair
Frank R. Gamberdella, MD
s I begin my
term as
District IX
chair, I would like to
take this opportunity
to thank you for electing me to serve you.
I greatly appreciate your trust and confidence.
Immediate Past Chair James A. Macer,
MD, ended his term as chair with a great
legacy. He worked tirelessly for our
Fellows and their patients. Dr. Macer’s
term culminated at last year’s ADM in
Cabo San Lucas, which was a remarkable
success. He envisioned a tremendous
scientific program with social events at
an outstanding venue. Fortunately, Dr.
Macer will continue on the Advisory
Council as immediate past chair. His
experience and wealth of knowledge will
ensure a smooth transition.
I would also like to thank Betty K. Tu,
MD, former secretary for District IX. Dr.
Tu contributed greatly to the district. She
created the Committee on the Business of
Medicine, which has been remarkably
helpful to our Fellows. Josephine L. Von
Herzen, MD, has also finished her term as
immediate past chair. She will be greatly
missed for the 18 years she has represented ACOG in California.
A
District IX officers and staff
Laurie C. Gregg, MD, will be the new
secretary. Dr. Gregg has been a Section 1
officer and currently serves on the
Medical Board of California. Her position
on the board will be immensely helpful to
the College.
Jeanne A. Conry, MD, is the new vice
chair. Dr. Conry has been our treasurer for
the last six years and has done a remark-
able job of managing the district’s financial health. She is also extremely knowledgeable in all aspects of ACOG and has
already proven to be a great resource to
me.
We are very fortunate to have Jeffrey R.
Richardson Jr, MD, as the new treasurer.
Dr. Richardson has served the district for
many years as the Section 4 vice chair
and chair and has been a representative to
the California Medical Association.
Shannon Smith-Crowley, JD, will con-
The strength of our
district ultimately lies with
our Fellows throughout
the state who are using
their clinical skills and
compassion daily to care for
their patients.
tinue as our legislative lobbyist, and Ruth
E. Haskins, MD, will continue as the
chair of the Committee on State
Legislation. Both Shannon and Ruth
have done an outstanding job representing
us on legislative issues related to our
specialty.
Rene B. Allen, MD, is the new Junior
Fellow chair. Dr. Allen is currently a
fellow in reproductive endocrinology and
infertility at the University of Southern
California.
We are very fortunate to have recently
hired Margaret Merritt as our new executive director for District IX. She brings a
wealth of knowledge on health care and
legislative issues, having worked in these
areas for many years in Sacramento. We
would also like to welcome Diana Cowan
to our District IX staff. Her professional
experience will surely serve us well.
Top issues for ACOG
The College is, as you know, currently
dealing with several significant issues in
our specialty. Professional liability, tort
reform, medical reimbursement, and
Medicare issues remain in the forefront.
Pay-for-performance will be an intensely
debated issue for Medicare reimbursement.
Ultrasound imaging by our specialty
has been challenged by the American
College of Radiology. ACOG has been
proactive to ensure that our specialty is
reimbursed by Medicare for ultrasound
imaging for ob-gyn patients.
The College is making every attempt to
stimulate interest in our specialty to medical students. District IX has held several
medical student mixers with Fellows at
various medical schools in California.
We believe this is essential to improve
the quality and number of applicants for
ob-gyn. If you would like to contribute,
please contact your section officers.
As leaders in health care for women,
your Executive Board and Advisory
Council will do everything possible to
maintain the highest standard of care for
our patients. The Board and I will do our
best to ensure that each of you and your
patients will be well represented from
both a clinical and legislative perspective.
Please do not hesitate to contact me or
our district or section officers if you have
any questions or recommendations.
The strength of our district ultimately
lies with our Fellows throughout the state
who are using their clinical skills and compassion daily to care for their patients. From the Junior Fellow chair
Rene B. Allen, MD
reetings and happy new year to all
District IX Junior Fellows and
Fellows. This year promises to be
an exciting year with lots of great meetings
G
and activities.
Annual District Meeting
Last year certainly was not disappointing as we capped off a
productive year with a fantastic ADM in Cabo San Lucas,
Mexico, which was a combined meeting with District III and IV.
ABOG Executive Director Norman F. Gant, MD, was gracious
enough to represent ABOG and attend a Q&A session for all
Junior Fellows concerning the oral boards and their recent
changes. I am already looking forward to the next ADM in
Kohala Coast, HI. I encourage as many Junior Fellows to attend,
especially if you have never been to an ADM, which are a great
balance of education and relaxation.
district
Annual Clinical Meeting
The upcoming Annual Clinical Meeting will be held May 6–10
in ACOG’s hometown, Washington, DC. There have been
opportunities for Junior Fellows to receive stipends to attend
this meeting, either by being selected for Stump the Professors
or by winning the annual essay contest. The essay theme for this
year was “How My Ob-Gyn Mentor Influenced Me.” Once
again, we had some outstanding essays submitted from District
IX.
In addition to these two opportunities, six residencies will
have the opportunity each year to send a resident to the ACM
through the Wyeth Resident Reporter Program. Because there
are 18 residencies in District IX, we decided that we will rotate
programs. This year, University of California-San Diego,
news
Dane M. Shipp, MD Editor
Joni E. Weber Editorial Manager
Margaret Merritt District IX Executive Director
District IX News is produced and distributed by
the ACOG Office of Communications.
Copyright 2006 by American College of
Obstetricians and Gynecologists
409 12th Street, SW, Washington, DC 20024
Send letters to:
Dane M. Shipp, MD
dshipp100@earthlink.net
2
March 2006
University of Southern California, Kern, Kaiser Oakland, Loma
Linda, and White Memorial will each nominate a resident
reporter. ACOG also has the John Burch Endowment Fund,
which provides each district $1,000 to sponsor a Junior Fellow
to attend the ACM. Veronique Tache, MD, Junior Fellow chair
from Section 1, has been selected as the recipient of this year’s
award.
Medical student recruitment
Through ACOG’s John Gibbons Medical Student Award, three
medical students in District IX were able to attend the ADM in
Cabo San Lucas, Mexico. The medical students who attended
were Lisa Rogo, University of Southern California; Michael
Nystrom, University of California-Los Angeles; and Laetitia
Poisson de Souzy, University of California-Davis, and all
enjoyed the experience. In addition, we have had a number of
medical student mixers hosted by both Fellows and Junior
Fellows. One of our main goals for 2006 is to have at least one
mixer at every medical school in the district.
The Shingo Exchange Program
The Shingo Exchange Program, in which Japanese residents
attended the 2005 ACM in San Francisco while a Junior Fellow
from each district attended the Japanese equivalent of the ACM,
was a huge success. This spring Jennifer Ragazzo, MD, the
District IX Junior Fellow secretary-treasurer, will represent us in
Japan. We will look forward to her report about her experience.
District IX website
Dr. Ragazzo; Section 5 Junior Fellow Vice Chair Jane van Dis,
MD; and Section 7 Junior Fellow Chair Alberto A. Mendivil,
MD, are working on revamping the district’s website to include
more accessible information and important links for both
Fellows and Junior Fellows. There will be a special section for
photos from the meetings and medical student mixers.
Junior Fellow College Advisory Council
The Junior Fellow College Advisory Council continues to focus
on the Accreditation Council for Graduate Medical Education
work-hour limits, especially in regard to how they might be
affecting training and how programs are handling and implementing them. The College has been collecting information
from each residency to determine what difficulties have arisen
from the restrictions and how programs, especially smaller ones,
have overcome these difficulties. This information will be available to programs so that all may benefit from seeing how certain
programs have dealt with issues such as residents on maternity
leave or those taking leaves of absence. If you have information
that you feel would benefit others in this area, please submit it
to me through our district office, district9@acog.org.
Michael L. Haydon, MD, has been elected the new District IX
Junior Fellow vice chair. We both look forward to a productive
year and continuing the great work that Immediate Past Junior
Fellow Chair Sharon E. Moayeri, MD, accomplished during her
term. District physicians report measures to reduce language barriers
nitial analysis of data from a survey of District IX members
showed that physicians understand the importance of language access for their limited-English-proficient patients and
employ a variety of strategies to reduce language barriers to
care. Almost two-thirds of respondents reported knowledge of
specific instances of compromised care resulting from language
barriers. Patient misunderstanding of diagnosis or treatment,
medication noncompliance, and delayed access to care were
cited by more than 50% of respondents. Survey respondents
rated quality of care, patient safety, and patient understanding of
care as the three most important reasons for ensuring accurate
communication.
Physicians also reported employing a range of strategies to
promote access to services for limited-English-proficient and
non-English-proficient patients. Responding physicians relied
most frequently on bilingual staff and their own language skills.
Two-thirds of respondents rated themselves as proficient in a
language other than English. The survey also revealed, however,
that physicians use family members, friends, and minor children
of patients as interpreters more frequently than trained professionals. They reported that cost and availability issues limit
both their use of in-person and telephone-based professional
interpreters.
Supported by a grant from the California Endowment, District
IX undertook a project to examine the attitudes and practices of
its members related to addressing language barriers faced by
women with limited or no English-language proficiency. The
project conducted physician focus groups in Orange County and
Fresno and consumer focus groups in San Diego and Fresno
I
Gibbons award facilitates
medical student recruitment
he objective of the John Gibbons Medical Student
Award is to support ACOG efforts at the district level to
encourage medical students to select ob-gyn as their chosen
specialty.
The amount of the award is $5,000 for each ACOG district per year. The award is provided for 2005, 2006, 2007,
and 2008. The award may be used at the district’s discretion, provided the use is consistent with bringing medical
students into ob-gyn. Each district will determine the
amount of the award for each student and the number of
medical students receiving the award.
Please note that these funds may only be used for medical
student travel expenses to ACOG national, district, or section activities. At the end of each year, unused funds from
the award must be returned to ACOG headquarters. Funds
do not carry over into the subsequent year. If you have any
questions, please contact Steve Cathcart, 800-281-1551;
scathcart@acog.org. T
during the spring and summer of 2005. The focus groups helped
to identify and frame priority issues for inclusion in the member
survey. An expert advisory group of physicians further guided
the development of the focus group formats and survey questions. The survey was fielded this past September, and 290
physicians completed it. Forty-seven percent of respondents
work solo or in small group practices, and 22% work in hospitals or within the Kaiser system. Eighty-three percent serve
urban or suburban areas.
The practices of the responding physicians reflect California’s
linguistic diversity. Almost half reported typically encountering
three or more languages in their practice during any given
month. About one-third reported that more than 10% of their
patients are limited-English-proficient.
The survey identified Spanish as spoken by patients in almost
all of the practices of the reporting physicians. Chinese, which
includes the Mandarin, Cantonese, and Taiwanese dialects, was
second with more than one-third of the respondents reporting
that they have Chinese-speaking patients. Asian Indian dialects
and Hmong, Vietnamese, Farsi, and Arabic languages were also
reported.
While the number of completed surveys is too small to apply
survey findings to District IX’s full membership, the respondents
revealed a wide range of approaches to reduce the language barriers of their patients. District IX anticipates that the full analysis
of the survey responses will help guide education and technical
assistance efforts that promote the dissemination of best practices. Survey results are currently being compiled and analyzed
for the final report, due to be published in early March. District IX welcomes new staff
fter working in the California political arena for the past 17
years, Margaret Merritt joined the District IX office October
26. While working for the Legislature, Margaret focused primarily on K–12 education, mental health, and women’s health
issues. As our new executive director, Margaret is sure to provide us with the kind of leadership that will serve to expand our
focus and increase our level of participation and influence in
California. You may contact her at mmerritt@acog.org.
District IX is also happy to welcome Diana Cowan to the
District IX office as our new executive assistant. Prior to joining
the District IX staff, Diana worked as the district representative
for California Assemblyman Darrell Steinberg (D-Sacramento).
She has extensive experience in planning, facilitating, organizing, and managing events. Diana has a strong commitment to
women’s health and will work with Margaret to ensure that the
District IX office runs smoothly and efficiently. You may contact Diana Cowan at district9@acog.org. A
IX News 3
Update on the California Legislature
Ruth E. Haskins, MD, chair, Committee on State Legislation
Shannon Smith-Crowley, JD, legislative advocate
Ruth E. Haskins,
MD
Shannon SmithCrowley, JD
Medi-Cal rate cuts implemented
January 1 started the year off on a down
note. The governor’s office implemented
a 5% Medi-Cal rate cut after all legal
appeals to prevent the cuts were exhausted. District IX is part of a large budget
coalition of Medi-Cal physicians, other
providers, and consumers that sued to
stop the cuts, and now we will work legislatively to restore the money.
In a year in which millions of dollars
are proposed for outreach to enroll children in Medi-Cal and Healthy Families, it
doesn’t make sense to decimate the very
network of physicians that will be needed
to take care of increased numbers of
patients. Gov. Arnold Schwarzenegger’s
administration and legislative leaders
appear open to legislation to fix the problem. Now, it is a matter of increasing the
priority of the issue.
While the urgency at the moment is to
deal with the 5% cut, we recognize that
every year that physicians fail to obtain a
Medi-Cal rate increase it is a net decrease
for Fellows. As you know, your practice
costs increase even when Medi-Cal rates
do not.
Medi-Cal and Medicare formerly were
structured to have cost-based reimbursement systems, but those were abandoned
because of rising costs. However, there
can be no denying that even in practices
that scrimp and cut wherever possible,
there will be increases to the cost of
delivering care.
Conveying your situation to lawmakers
is where we need your help. There simply
is not good enough data yet to make the
case for how Medi-Cal rates hurt access
for patients.
The California Medical Association and
the American Medical Association are
working on models to better assess
access, but that will be some time in coming. Meanwhile, even anecdotal evidence
from practicing physicians will be helpful
to us in making our case. Please flood
District IX with your experiences and
projections for what Medi-Cal rates (cuts
and freezes) have done or will do to your
practice and contact me, ssmithcrowley@sbcglobal.net; 916-457-5217.
Covering maternity services
The governor’s office is looking for
other areas in which cost savings could
be achieved to offset savings obtained by
cutting Medi-Cal rates. The California
Medical Association is working with the
administration on areas such as electronic
medical records and disease management.
However, there is an area that would
achieve substantial and swift savings, but
the administration hasn’t warmed to it:
District IX cosponsored SB 1555 in 2004,
proposed by Sen. Jackie Speier (DHillsborough), which would have
required individual insurance policies to
cover maternity services as part of basic
services. The bill was vetoed by Gov.
Schwarzenegger, who wanted to keep
choice in insurance policies even though
HMOs and insurance through most
employers require coverage. There is
some noise that the bill could be reintroduced regardless of District IX sponsorship.
There is concern that enrollment in
maternity-free insurance products is substantially increasing. If that’s true, the
cost for the rest of the market that needs
maternity coverage will increase, perhaps
pricing women out of the market.
While the proposed $125.6 billion
budget is the largest state budget ever,
and the deficit is being somewhat mitigated by increased state revenues, there still
is not a lot of money for the Legislature
to spend to implement new programs. We
expect to see in 2006 what occurred in
2005: legislators pushing public health
responsibilities onto physicians to avoid
state costs.
Depression brochures
So far this year we have been able to persuade Assemblyman Paul Koretz (D-West
Hollywood) to drop a bill that would have
required physicians to give pregnant
patients a brochure on postpartum depression and mood disorders. Instead, a group
representing those affected (District IX,
California Medical Association, psychiatrists, and others) was able to propose a
public awareness campaign with ideas for
funding. We will work with Assemblyman Koretz and staff, as well as the
Department of Health Services to develop
the campaign. Early intervention is needed on these types of bills and bills that
otherwise try to legislate the practice of
medicine.
Egg donation for research
Sen. Deborah Ortiz (D-Sacramento) is
reprising her vetoed bill on egg donation
for research. Senate Bill 18 was vetoed
last year because of other unrelated
provisions, but Gov. Schwarzenegger
indicated he would like to see a bill on
only egg donation. Nonphysician groups
would like to have details in the law
regarding the practice of egg extraction
and donation.
While the bill may be intended to apply
to eggs used only for research, this is sure
to spill over into IVF and even clomid
use in offices. We will work to show why
this level of detail in a law is bad practice.
The bill introduction deadline was
February 24. If this year is like every
other, 90% of the introduced bills will be
introduced on that date, so we will keep
you posted.
Breast cancer brochure
The Medical Board expects to sponsor a
bill to limit the law regarding when a
patient undergoing a breast biopsy must
receive a breast cancer brochure mandated by the state. At its July meeting, the
Medical Board heard testimony that many
women undergoing biopsies were unnecessarily alarmed when reading the
brochure. The brochure’s first five pages
discuss biopsies. It states that the patient
should stop at page five unless she’s had
a diagnosis of cancer. However, given
Continued on page 5
4
March 2006
Continued from page 4
human nature, most women keep reading,
leading to unnecessary concern and a
mistrust of their physician when the
physician has said that the lump is likely
not cancer but then hands her a brochure
discussing her options for dealing with
cancer.
Additionally, this 32-page brochure is
expensive to publish, and the Medical
Board believes limiting the brochure to
those who truly need it would allow for
better use of these resources. Your comments on you and your patients’ experiences with this booklet would be helpful
in negotiating this bill. If interested,
please contact me, ssmith-crowley@
sbcglobal.net; 916-457-5217.
We were able to stop a bill, AB 1427,
sponsored by Assemblyman Dennis Lee
Mountjoy (R-Monrovia), that would have
required physicians to retain fetal tissue
obtained during a minor’s abortion for
four years. The intent was to have the
tissue available for DNA analysis in the
prosecution of statutory rape. In testimony in the Assembly’s Public Safety
Committee, it was made clear that this bill
was unnecessary and no law enforcement
entity supported it.
The Office of Statewide Health
Planning is moving forward with a proposed pilot project to study whether
advanced practice clinicians (nurse practitioners, certified nurse midwives, and
physician assistants) can safely perform
early aspiration abortions in certain settings. Fellow Laurie C. Gregg, MD, a
California Medical Board member, will
be monitoring the project.
2005 legislative year final results
We played a good game of defense in
2005. There was not a bill that went
through that we believe will hurt practicing physicians. However, only some of
the offensive game was successful. The
California Medical Association was
extremely active this year in managedcare bills. The CMA was able to stop
unfavorable bills that would have prohibited physicians from billing patients when
the patient had insurance and an authorization of discount card plans.
District IX prevented bills from passing
that would have required physicians to
offer women HIV testing at every annual
exam and family planning visit, regardless of the physician’s assessment of risk
factors. District IX helped change a bill
requiring six hours of continuing medical
education on women’s heart health to a
public awareness bill using existing
resources, in part due to Vivian M.
Dickerson, MD, who placed emphasis
on the issue during her term as ACOG
president last year.
District IX actively advocated a
balanced process for oocyte donors for
stem cell research, rather than letting the
moratorium on egg donation that Sens.
Deborah Ortiz (D-Sacramento) and
George C. Runner Jr (R-Lancaster)
originally were considering.
District IX worked to ensure that
patients can obtain emergency contraception and birth control pills in a timely
manner, while allowing an out for
pharmacists with moral or religious
objections to the medications.
District IX advocated for more humane
treatment of pregnant and laboring
women in custody. We supported the
removal of the sunset date of the successful safe abandonment of newborns
program. For the disposition on specific
bills, please refer to the District IX report
at www.capitoltrack.com. Click on
“subscribers” on the top left side of the
website, which will direct you to the
login page. The username is “acog,”
and the password is “acogix.”
Increased dental coverage for
pregnant Medi-Cal patients
Given the tie between dental health and
pregnancy, it is good news to have Senate
Bill 377, which was sponsored by Sen.
Ortiz.
The bill was signed into law last year,
expanding which categories of Medi-Cal
patients are entitled to dental services and
what type of services. If your pregnant
Medi-Cal patient needs dental care and is
unclear about her coverage, refer her to
Denti-Cal, 800-423-0507. The Mercury Free Act of 2004
n January 11, Howard Backer, MD, MPH, chief of
the Department of Health Services Immunization
Branch, sent a letter to all California physicians about
the implications of a new California law on influenza vaccine
orders for the 2006–07 influenza season.
The letter begins with The Mercury Free Act of 2004 chapter 837, statutes of 2004, which will limit the administration
of mercury-containing vaccines to pregnant women and children younger than three. As a consequence of this legislation,
effective July 1, it will be against California law to administer
doses of inactivated flu vaccine from a multi-dose vial to
pregnant women or children younger than three because of
the level of the mercury-containing preservative, thimerosal,
contained in multi-dose vials.
Only doses from single-dose syringes or vials with trace
O
levels or no mercury may be given to these groups after July
1. This law does not apply to persons who are three years of
age and older and those who are not pregnant.
To order the appropriate formulation of influenza vaccine
for the 2006–07 influenza season, health care providers need
to consider this new law and to estimate the number of their
vaccinated patients who will be pregnant or younger than
three. Pre-booking for certain influenza vaccine
manufacturers and distributors has already begun.
As in previous years, orders for federally purchased
influenza vaccine through the Vaccine for Children Program
will occur separately from orders for privately purchased
vaccines.
For more information visit www.dhs.ca.gov/
ps/dcdc/izgroup/pdf/OrderingFluVaccine_MercuryLaw.pdf. IX News 5
District IX ADM in Los Cabos, Mexico
ACOG President Elect Douglas W.
Laube, MD, and Dr. Cindy Macer,
with her husband, District IX
Immediate Past Chair James A.
Macer, MD
ACOG Vice President of
Practice Activities Stanley
Zinberg, MD, MS
District IX Vice Chair Jeanne A. Conry, MD, (middle)
with two exhibitors at the ADM
Jeff Skilling, MD, with his wife, Kelly A.
McCue, MD, and District IX Secretary
Laurie C. Gregg, MD, and her
husband, Jeff Gregg, MD
Committee on State Legislation Chair
Ruth E. Haskins, MD, and Immediate
Past Chair Josephine L. Von Herzen,
MD
Section 1 Vice Chair Kelly A. McCue,
MD, and Malcolm L. Margolin, MD
Sharon A. Winer, MD; Diana E.
Hoppe, MD; Philip J. Diamond,
MD; and Colleen P. McNally, MD
District IV Fellow Robert L. Vermillion, MD,
and District IX Legislative Advocate
Shannon Smith-Crowley, JD, and her
husband, Blane Smith-Crowley
The District IX
Executive Committee
attends a dinner at
the ADM
Section 7
Vice Chair
Dennis J.
Buchanan,
MD, with his
wife, Suzi
Buchanan
ACOG strategic planning: 2006 and beyond
Vivian M. Dickerson, MD, immediate past president of ACOG
s part of my presidential initiative,
it was my pleasure to preside over a
carefully selected committee that
reviewed not only the current ACOG
mission and vision statements, but also the
strategic planning process. It was a surprise
to me that there is such a vast body of
literature on strategic planning and why
it so often fails to create organizational
change.
The committee worked assiduously to incorporate this
pre-existing knowledge into a concise plan that reflected ACOG
values and emerging trends. We were also careful to make the
all-important distinction between a strategic plan and an operational plan. Strategy is a framework for change; operation is
the day-to-day template for implementing the strategy. It was
felt that while ACOG’s commitment to women and to women’s
health had always been appropriately articulated, the importance
of service to membership has not been stated as well.
Two of the four major themes within the new plan address
membership and community. The mission statement was also
significantly modified and serves as a summary of the committee’s thoughts. The mission statement has been now formally
adopted by the Executive Board and reads as follows: “The
American College of Obstetricians and Gynecologists, the
preeminent authority on women’s health, is a professional
membership organization dedicated to advancing women’s
health by building and sustaining the obstetric and gynecologic
community and actively supporting its members. The College
pursues this mission through education, practice, research, and
advocacy. ACOG will emphasize life-long learning, incorporate
new knowledge and information technology, and evolve its governance structure. To achieve its strategic goals, ACOG will
develop an operational plan that includes appropriate metrics.”
A
The outstanding vice presidents and directors at ACOG are
now in the process of implementing the strategic plan through
the creation of an operational template, which will include ways
to evaluate success (metrics). This, combined with the ongoing
strategic planning sessions of the Executive Board, has made the
strategic plan a working document. At the behest of ACOG
President Michael T. Mennuti, MD, the College is also evaluating its committee structure and process, and recommendations
will be considered by the Executive Board.
It is important that Fellows of the College are familiar with
this plan and are able to weigh in when they feel that the operations are not addressing the issues or when they feel that there
has been a “sea change” that would dictate a reevaluation of the
goals and the mission. The plan itself has four major goals and
each delineates ways in which the goals might be achieved within the College framework:
ACOG will nurture and improve the ob-gyn community
ACOG will expand and strengthen membership support
ACOG will advocate for women’s health
ACOG will assess and evaluate the breadth, depth, and
practice of the discipline
Great attention will be paid to incorporating new technologies
as well as new mandates by the American Board of Medical
Specialties and the evolving needs of the practicing physician. It
is hoped that the districts might choose to not only incorporate
the national strategic plan into their long-range framework, but
look at the importance of the strategic planning process and how
it might assist each district in being of better service to their
members. Strategic planning is not just an exercise; it is a template for doing business and a way to make our organization
stronger.
I am pleased to be working with people who are so dedicated
to getting the most out of membership and to giving the most to
our members and the women we serve. District IX to play key role in effort to improve OB care
Elliott K. Main, MD
he State Maternal and Child Health Branch is initiating a
significant multi-year statewide program to measure and
improve the quality of OB care in California. The
initiative will be called the California Maternal Quality of
Care Collaborative (CMQCC). The program is based on a
similar, highly successful program in neonatal care.
The first step, as always, will be to determine what the best
measures of outcomes are. The word “best” is, of course, a
relative term, but needs to include characteristics such as health
impact, ability to be measured accurately, and ability for the
outcome to be changed by medical care.
Once the candidate measures are fully evaluated, hospitalspecific data will be generated, providing a basis for quality
improvement efforts.
Drs. Katherine Liniecki-Gregory and Randy D. Winter from
the District IX Advisory Council will hold leadership positions
T
for this project, and I will be the chair for this initiative. Also
playing key roles will be Drs. Michael Liu and Kimberly D.
Gregory and their team of outcome researchers at UCLA/Cedars
Sinai who are doing fundamental research of obstetric quality
measures.
Other ACOG members will be added to the working committees as the project gets under way. An expected result will be to
redirect thinking about OB quality away from simple measures
of cesarean birth and more toward direct indicators of maternal
and neonatal morbidity.
This will be an important project that should touch all of us in
California and will have an impact nationwide. After all, 13% of
US births occur in California. The starting date is July 1, but
several of the supporting projects are already under way. You
will hear much more about CMQCC in the coming years so stay
tuned. For more information contact me at 415-750-6003. IX News 7
District and section officers
Chair
Frank R. Gamberdella, MD
805-687-1374
fgamberdella@cox.net
Vice Chair
Jeanne A. Conry, MD
916-784-5010
jeanne.conry@kp.org
Secretary
Laurie C. Gregg, MD
916-486-9814
drlauriegregg@hotmail.com
Treasurer
Jeffrey R. Richardson Jr, MD
805-648-4425
jrr6004@cs.com
Junior Fellow Advisor
Jeanne A. Conry, MD
916-784-5010
jeanne.conry@kp.org
Junior Fellow Chair
Rene B. Allen, MD
323-226-3026
rallensurfer@yahoo.com
Junior Fellow Vice Chair
Michael L. Haydon, MD
mhaydon@uci.edu
Junior Fellow Sec-Treas
Jennifer Ragazzo, MD
jragazzo@uci.edu
Junior Fellow Past Chair
Sharon E. Moayeri, MD
714-345-7936
smoayeri@yahoo.com
Section 1 Chair
Laurie C. Gregg, MD
916-486-9814
drlauriegregg@hotmail.com
Section 1 Vice Chair
Kelly A. McCue, MD
916-480-6978
skillij@aol.com
Section 2 Chair
Katherine Liniecki-Gregory, MD
415-831-2168
kathylgregory@aol.com
Section 2 Vice Chair
Sara E. Gottfried, MD
925-779-5251
sara.e.szal@kp.org
Section 3 Chair
Gail J. Newel, MD
559-322-2900
gnewel@fwmg.org
Section 3 Vice Chair
Randy D. Winter, MD
209-522-1027
winterhaus@aol.com
Section 4 Chair
Danny L. Lickness, MD
805-544-8811
bearvalley@aol.com
Section 4 Vice Chair
Susanne L. Ramos, MD
805-681-8925
sramos@sansumclinic.org
Section 5 Chair
Sharon A. Winer, MD, MPH
310-274-9100
winer@usc.edu
Section 5 Vice Chair
Laura L. Sirott, MD
626-449-5133 ext. 20
llsirott@hotmail.com
Section 6 Chair
Bruce L. Flamm, MD
909-353-4399
bruceflamm@aol.com
Section 6 Vice Chair
Rick D. Murray, MD
909-427-4381
richard.d.murray@kp.org
Calendar of Events
March
12–14
Congressional Leadership Conference
Washington, DC
16–19
Interim District Advisory Council Meeting
Santa Barbara, CA
April
6–9
May
6
JFCAC Annual Meeting
Washington, DC
6–10
Annual Clinical Meeting
Washington, DC
Section 7 Chair
Anita C. York, MD
949-559-1911
anitacyork@aol.com
Section 7 Vice Chair
Dennis J. Buchanan, MD
714-992-5350
canon53@adelphia.net
June
10–14
Section 8 Chair
Diana E. Hoppe, MD
760-944-1000
hoppdi@aol.com
Section 8 Vice Chair
Chrysten E. Cunningham, DO
619-298-6701
drcunninghamdo@msn.com
Leadership Institute at UNC
Chapel Hill, NC
American Medical Association
Annual Meeting
Chicago
August
11–12
Future Leaders in Ob-Gyn Seminar
The Ritz Carlton, Georgetown
Washington, DC
District IX office
Executive Director
Margaret Merritt
November
Executive Assistant
Diana Cowan
8–11
1425 River Park Drive, Suite 235
Sacramento, CA 95815
Phone: 916-920-8100
Fax: 916-920-8118
Email: district9@acog.org
Annual District Meeting
(District III, VI, VIII, and IX)
Kohala Coast, HI
Legislative Advocate
Shannon Smith-Crowley, JD
Phone: 916-457-5217
Fax: 916-457-5215
Email: ssmith-crowley@sbcglobal.net
The American College of Obstetricians and Gynecologists
409 12th Street SW
Washington, DC 20024
non-profit
org
US Postage
PAID
Merrifield, VA
Permit #6418