March 2016 | Physician Magazine

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<ul><li><p>MARCH 2016</p><p>A PUBLICATION OF PNNwww.PhysiciansNewsNetwork.com</p><p>R E P O R T I N G O N T H E E C O N O M I C S O F H E A L T H C A R E D E L I V E R Y</p><p>P L U S : K E Y S T O B E I N G F I N A N C I A L L Y P R E P A R E D F O R R E T I R E M E N T </p><p>OF</p><p>F</p><p>IC</p><p>I AL M A G</p><p>A</p><p>ZI</p><p>NE</p><p>OF</p><p>F</p><p>IC</p><p>IAL MAG</p><p>A</p><p>ZI</p><p>NE</p><p>The Ins &amp; Outs ofHEALTHCARE REAL ESTATE</p></li><li><p>Join us on Saturday, March 19, 2016</p><p> Talk to a banker about retirement savings options Try the My Retirement Plan (MRP) online tool Speak to a financial advisor at Wells Fargo Advisors* about the Envision planning process Learn about the unique retirement planning needs for business owners Meet with a banker at your local Wells Fargo store on March 19 during normal banking hours</p><p>Investment and insurance products: NOT FDIC-Insured NO Bank Guarantee | MAY Lose Value</p><p>* Investment products and services are offered through Wells Fargo Advisors, LLC, Member SIPC, a registered broker-dealer and separate non-bank affiliate of Wells Fargo &amp; Company.Envision is a registered service mark of Wells Fargo &amp; Company and used under license.Deposit products are offered by Wells Fargo Bank, N.A. Member FDIC. 2016 Wells Fargo Bank, N.A. All rights reserved.</p><p>Its never too early or too late to put your retirement savings plan in place and start taking steps toward making your dreams come true.</p></li><li><p>MARCH 2016 | W W W. P H YS I C I A N S N E W S N E T WO R K .COM 1</p><p>Volume 147 Issue 3</p><p>MARC</p><p>H 2016 | TABLE O</p><p>F CO</p><p>NTEN</p><p>TS</p><p>COVER STORY</p><p>8 The Ins &amp; Outs of Healthcare Real Estate This months feature examines trends in healthcare construction nationwide and in California along with expert tips on finding the right space for your practice, negotiating a lease and meeting regulatory and safety requirements. We also look at the effects that virtual office space might have on the medical real estate industry in the future.</p><p>FEATURE </p><p>14 Benefits and Risks of Using Mobile Apps for Healthcare15 Keys to Being Financially Prepared for Retirement </p><p>FROM YOUR ASSOCIATION</p><p>4 Presidents Letter | Peter Richman, MD</p><p>16 United We Stand | At Work for You</p><p>15</p><p>Physician Magazine (ISSN 1533-9254) is published monthly by LACMA Services Inc. (a subsidiary of the Los Angeles County Medical Association) at 801 S. Grand Avenue, Suite 425, Los Angeles, CA 90017. Periodicals Postage Paid at Los Angeles, California, and at additional mailing offices. Volume 143, No. 04 Copyright 2012 by LACMA Services Inc. All rights reserved. Reproduction in whole or in part without written permission is prohibited. POSTMASTER: Send address changes to Physician Magazine,801 S. Grand Avenue, Suite 425, Los Angeles, CA 90017. Advertising rates and information sent upon request. </p><p>Join us on Saturday, March 19, 2016</p><p> Talk to a banker about retirement savings options Try the My Retirement Plan (MRP) online tool Speak to a financial advisor at Wells Fargo Advisors* about the Envision planning process Learn about the unique retirement planning needs for business owners Meet with a banker at your local Wells Fargo store on March 19 during normal banking hours</p><p>Investment and insurance products: NOT FDIC-Insured NO Bank Guarantee | MAY Lose Value</p><p>* Investment products and services are offered through Wells Fargo Advisors, LLC, Member SIPC, a registered broker-dealer and separate non-bank affiliate of Wells Fargo &amp; Company.Envision is a registered service mark of Wells Fargo &amp; Company and used under license.Deposit products are offered by Wells Fargo Bank, N.A. Member FDIC. 2016 Wells Fargo Bank, N.A. All rights reserved.</p><p>Its never too early or too late to put your retirement savings plan in place and start taking steps toward making your dreams come true.</p><p>14</p></li><li><p>SUBSCRIPTIONSMembers of the Los Angeles County Medical Association: Physician Magazine is a benefit of your membership. Additional copies and back issues: $3 each. Nonmember subscriptions: $39 per year. Single copies: $5. To order or renew a subscription, make your check payable to Physician Magazine, 801 S. Grand Avenue, Suite 425, Los Angeles, CA 90017. To inform us of a delivery problem, call 213-683-9900. Acceptance of advertising in Physician Magazine in no way constitutes approval or endorsement by LACMA Services Inc. The Los Angeles County Medical Association reserves the right to reject any advertising. Opinions expressed by authors are their own and not necessarily those of Physician Magazine, LACMA Services Inc. or the Los Angeles County Medical Association. Physician Magazine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. PM is not responsible for unsolicited manuscripts.</p><p>The Los Angeles County Medi-</p><p>cal Association is a profes-</p><p>sional association representing </p><p>physicians from every medical </p><p>specialty and practice setting </p><p>as well as medical students, </p><p>interns and residents. For more </p><p>than 100 years, LACMA has </p><p>been at the forefront of cur-</p><p>rent medicine, ensuring that its </p><p>members are represented in the </p><p>areas of public policy, govern-</p><p>ment relations and community </p><p>relations. Through its advocacy </p><p>efforts in both Los Angeles </p><p>County and with the statewide </p><p>California Medical Association, </p><p>your physician leaders and staff </p><p>strive toward a common goal</p><p>that you might spend more time </p><p>treating your patients and less </p><p>time worrying about the chal-</p><p>lenges of managing a practice.</p><p>LACMAs Board of Directors consists of a group of 30 dedicated physicians who are working hard to uphold your rights and the rights of your patients. They always welcome hearing your comments and concerns. You can contact them by emailing or calling Lisa Le, Director of Governance, at lisa@lacmanet.org or 213-226-0304.</p><p> EDITOR </p><p>DISPLAY AD SALES / DIRECTOR OF SALESCLASSIFIED AD SALES</p><p>EDITORIAL ADVISORY BOARD</p><p>PRESIDENT PRESIDENT-ELECT </p><p>TREASURER SECRETARY </p><p>IMMEDIATE PAST PRESIDENT</p><p>CMA TRUSTEEALTERNATE RESIDENT/FELLOW COUNCILOR </p><p>COUNCILOR SSGPF COUNCILOR DISTRICT 9</p><p>CMA TRUSTEE COUNCILOR</p><p>COUNCILOR DISTRICT 2COUNCILOR-AT-LARGE</p><p>ETHNIC PHYSICIANS COMMITTEE REPCOUNCILOR DISTRICT 1</p><p>COUNCILOR DISTRICT 17COUNCILOR DISTRICT 14</p><p>COUNCILOR USCCOUNCILOR DISTRICT 7 COUNCILOR DISTRICT 6 </p><p>COUNCILOR-AT-LARGE COUNCILOR ALLIED PHYSICIANS </p><p>COUNCILOR-AT-LARGECOUNCILOR DISTRICT 3</p><p>COUNCILOR DISTRICT 10MEDICAL STUDENT COUNCILOR/USC</p><p>COUNCILOR SCPMG RESIDENT/FELLOW COUNCILORYOUNG PHYSICIAN COUNCILOR</p><p>COUNCILOR-AT-LARGECOUNCILOR SSGPF </p><p>ALT. MEDICAL STUDENT COUNCILOR/UCLACOUNCILOR-AT-LARGE </p><p>CHAIR OF LACMA DELEGATION</p><p> Sheri Carr 858.226.7647 | sheri@physiciansnewsnetwork.com</p><p>ADVERTISING SALES</p><p>Christina Correia 213.226.0325 | christinac@lacmanet.orgDari Pebdani 858.231.1231 | dpebdani@gmail.comDavid H. Aizuss, MD Troy Elander, MD Thomas Horowitz, DO Robert J. Rogers, MD </p><p>HEADQUARTERS</p><p>Physicians News NetworkLos Angeles County Medical Association801 S. Grand Avenue, Suite 425Los Angeles, CA 90017Tel 213.683.9900 | Fax 213.226.0350www.physiciansnewsnetwork.com</p><p>LACMA OFFICERS Peter Richman, MDVito Imbasciani, MDWilliam Averill, MDRichard Baker, MDPedram Salimpour, MD</p><p>LACMA BOARD OF DIRECTORS</p><p>David Aizuss, MDErik Berg, MDRobert Bitonte, MDStephanie Booth, MDJack Chou, MDTroy Elander, MDHilary Fausett, MDSamuel Fink, MDHector Flores, MDC. Freeman, MDSidney Gold, MDJinha Park, MDStephanie Hall, MDDavid Hopp, MDKambiz Kosari, MDSion Roy, MDPaul Liu, MDMaria Lymberis, MDPhilip Hill, MDNassim Moradi, MDVamsi AribindiAshish Parekh, MDJerry Abraham, MDPo-Yin Samuel Huang, MDMichael Sanchez, MDHeather Silverman, MDAnnie WangNhat Tran, MDFred Ziel, MD </p></li><li><p>StabilityPreferred Insurance prides itself on its stability, which includes maintaining some of the best andmost consistent pricing available for CMA members. And because of its Medical Provider Networkof credentialed medical professionals, claim costs can be closely monitored and managed whileproviding quality care to injured employees.</p><p>SafetyIn addition to mandatory CalOSHA information and videos on workplace safety, Preferreds teamof Risk Advisors are available for consultations when you need them. They also have a strong fraudprevention policy and as a California-based carrier, they know exactly what it takes to do businesssuccessfully in this State. </p><p>SavingsCMA members qualify for an additional 5% discount*on top of Preferred Insurancesalready competitive rates. Preferreds rates are set for long term consistency, and are managedby focusing on safety and injury prevention, fraud prevention and the control of medical costsfor your practice by getting employees back to work as soon as practical.</p><p>ServiceMercers team of insurance advisors is knowledgeable about the needs of physicians and is availableto walk you through the application process. Preferreds claims examiners are experts in helpingmembers with an employee injury or illness claim. Plus Preferreds payroll management and flexiblepayment plans help you manage your premiums in the way that works best for you and yourpractices cash-flow needs.</p><p>Call Mercer today at 800-842-3761 for a premium indication.CMACounty.Insurance.service@mercer.com or www.CountyCMAMemberInsurance.com.</p><p>See how CMA/LACMAs Workers Compensation team can help you save!</p><p>The CMA/LACMAs exclusive new Workers Compensation program can help </p><p>your practice save money!</p><p>Mercer Health &amp; Benefits Insurance Services LLC CA Ins. Lic. #0G39709 Copyright 2016 Mercer LLC. All rights reserved. 75258 (3/16)777 South Figueroa Street, Los Angeles, CA 90017 800-842-3761 www.CountyCMAMemberInsurance.com CMACounty.Insurance.service@mercer.com</p><p>*Most practices will qualify for group pricing and receive the 5% discount; however some practices will need to be underwritten separately when they do not qualify for the special program terms and conditions. A minimum premium applies to very small payrolls.</p><p>Underwritten by: Scan for info:Sponsored by:</p><p>MERCER Project 75258, LACMA, (3/16)</p><p>Full Size: 8.375 x 10.875 Bleed: 8.625 x 11.125Folds to: N/A Perf: N/AColors: 4cStock: N/APostage: N/AMisc: N/A</p><p>75258 LACMA Mar16 WC Ad:ADS 2/18/16 4:47 PM Page 1</p></li><li><p>4 P H YS I C I A N M AG A Z I N E | MARCH 2016</p><p>THE RECENT CONVIC TION of Hsiu-Ying Lisa Tseng, DO, who originally was arrested on March 1, 2012, accused of three counts of murder and held on $3 million bail, has raised physician aware-ness of several issues of importance.</p><p>Twelve patient deaths had occurred over a three-year period, but other doctors had pre-scribed narcotics to nine of the patients as well. She was convicted on Oct. 30, 2015 of three counts of second-degree murder in the deaths of three pa-</p><p>tients who died of narcotic overdose, 19 counts of un-lawful controlled substance prescriptions and one count of obtaining a controlled substance by fraud. </p><p>She was sentenced on Feb. 5, 2016, to 30 years to life and will be eligible for parole in 30 years. The case was prosecuted by Los An-geles County Deputy Dis-trict Attorney John Nieder-mann.</p><p>Dr. Tseng joined her hus-band at a clinic in Rowland Heights in general practice in 2007. A Los Angeles phar-macy alerted authorities to possible illegal prescribing by the physician. The Drug Enforcement Administra-tion conducted an investi-</p><p>gation that included undercover agents posing as patients attempting to obtain narcotics. Dr. Tseng wrote over 27,000 controlled substance prescrip-tions over a three-year period from 2007 to 2010. She was contacted over 12 times by the coroners office or law enforcement officers informing her of the deaths of her patients by drug overdose. She surrendered her DEA license in 2010 and her li-cense to practice in the state of California in 2012.</p><p>She was convicted under implied malice. Ac-cording to Wikipedia, malice refers to a partys intention to do injury to another party. Expressed malice is when there is manifested a deliberate intention to take away the life of a human being. Malice is implied when no considerable provoca-tion occurs or when the circumstances attending the killing show an abandoned and malignant heart. Knowingly prescribing narcotics and seda-tives to addicts who have a high chance of over-</p><p>dose met these criteria, according to the deputy district attorney, especially when the physician had been notified many times of patient deaths that the coroners office attributed to prescription drug overdose. </p><p>Physicians in the community are concerned that they may be held criminally liable for prescription drug overdose and will therefore decrease their prescribing patterns. In the past, physicians were told that they were undertreating pain and could be liable under malpractice law for patient abuse. That is the proverbial position of being between a rock and a hard place. </p><p>Physicians must treat pain appropriately for the benefit and safety of the patient. Performing a thorough history and physical examination, devel-oping an assessment and describing a treatment plan are necessary components. Some patients may manipulate the physician. Documentation of a good faith effort on the part of the physician pro-tects against legal action. </p><p>The CURES datbase now provides an addition-al tool. While cumbersome, it may alert the physi-cian to a potential drug-seeking patient. </p><p>The physician may refer the patient to a pain specialist or an addiction specialist or develop a medication contract with the patient. </p><p>Physicians should not ignore warning signs. If a physician is contacted by a state or federal agency, it is best to seek assistance. </p><p>Taking CME courses in narcotic topics and adopting guidelines are other methods to show good faith. </p><p>There are consultants who will review (or de-velop) office policies and procedures and make recommendations to reduce risk. All of these ef-forts are to protect both the physician and their patients. </p><p>Lastly, Dr. Tseng did not go to medical school and spend years in training to become a drug pusher. Something happened along the long route to lead her astray.</p><p>She discussed untreated depression in her final defense. That may or may not be true. However, we as physicians should seek out help when we feel overwhelmed. Talking with colleagues may alert someone to unrecognized drug, alcohol or mental health issues. </p><p>We need to develop wellness and diversion programs to maintain the health of the profession. We may then all practice medicine as we originally intended. </p><p>PR</p><p>ES</p><p>IDE</p><p>NT</p><p>S L</p><p>ET</p><p>TE</p><p>R |</p><p> PE</p><p>TE</p><p>R R</p><p>ICH</p><p>MA</p><p>N, </p><p>MD</p><p>We need to develop well-</p><p>ness and diver-sion programs </p><p>to maintain the health of the </p><p>profession. We may then all </p><p>practice medi-cine as we origi-nally intended. </p></li><li><p>Learn the latest treatments and play an important role in the care of Soldiers and their families. As a physician on the U.S. Army Reserve health care team, youll continue to practice in your community and serve when needed. Youll work with the most advanced technology and distinguish yourself while working with dedicated professiona...</p></li></ul>