lifeline DECEMBER 2018

What’s The Magic Formula for BURNOUT PREVENTION AND RECOVERY? Page 4 TABLE OF CONTENTS |

8 10 4 PRESIDENT’S MESSAGE EMPAC SCORES BIG 8 ADVOCACY UPDATE in 2018

ACEP 10 GUEST ARTICLE Council Meeting Recap 2018 16 ANNOUNCEMENTS

17 UPCOMING MEETINGS & DEADLINES

GENERAL 18 CAREER OPPORTUNITIES ELECTION

California ACEP DECEMBER 2018 Board of Directors & Index of Advertisers Lifeline Editors Roster

2018-19 Board of Directors Independent Emergency Physicians Consortium Page 6 Chi Perlroth, MD, FACEP, President Vivian Reyes, MD, FACEP, President-Elect Vikant Gulati, MD, FACEP, Vice President Sujal Mandavia, MD, FACEP, Treasurer Lori Winston, MD, FACEP, Secretary Mission Page 18 Aimee Moulin, MD, FACEP, Immediate Past President Harrison Alter, MD, FACEP (At-Large) Reb Close, MD, FACEP John Coburn, MD, FACEP Carrieann Drenten, MD, FACEP Philip Fagan, MD Page 18 Jorge Fernandez, MD Michael Gertz, MD, FACEP Doug Gibson, MD, FACEP John Ludlow, MD, MBA, FACEP Karen Murrell, MD, MBA, FACEP Ventura Emergency Physicians Page 18 Mitesh Patel, MD, MBA, FACHE, CPE Hunter Pattison, MD (CAL/EMRA President) Patrick Um, MD, FACEP, FAAEM Advocacy Fellowship 41st Annual Emergency Medicine In Yosemite Page 15 Carrieann Drenten, MD, FACEP, Advocacy Fellowship Director Sam Jeppsen, MD, Advocacy Fellow

Lifeline Medical Editor Richard Obler, MD, FACEP, Medical Editor

Lifeline Staff Editors Elena Lopez-Gusman, Executive Director Kelsey McQuaid-Craig, MPA, Director of Policy and Programs Lucia Romo, Membership and Education Coordinator Lauren Brown, Government Affairs Associate Meri Thresher, Administrative Assistant

2 | LIFELINE a forum for emergency physicians in california WELCOME new members! Caitlyn Olivia Anderson Kenneth Taeyoung Kim Jason Rogers, MD Alfonso Avila, DO Ethan Salomon Kimball Andre Sahakian Whi Inh Shirley Bae Chia-Yuan Michael Lee Federica Sarti Joelle Brown Sarah Kim Lee Alec Samuel Small Sheik Cale, MD Chinyu Jean Lo, MD Ruthy Tam Somil Chheda Sally Mahmoud-Werthmann, MD Carol Tang Brian Wai Wen Chin Lesly Victoria Martinez, MD, MBA, MPH Kyaw Min Thein, MD Danielle R. Cohen Ryan McDonald Daryn Towle, MD Kayla Maria Conover James Edward McDonough Ty Tran Taylor Docter Tarakarama Musunuri Prabhdeep Uppal Amy Do-Nguyen Amol Sanmukh Patel Irene Velarde Juliette Gerardo Lisa G. Patrick, MD Gregory Whitcher Alejandra Gonzalez Jesse Perez Samantha Ashley Wong Marissa Hood Enid Picart Jarred Anthony Worthy Vincent Huynh Emily Pott Jeremy Yenpasook Roopam Jariwal Joseph Powers Mitchell Zekhtser Esther Kim Ranjita Raghavan

100% GROUPS Central Coast Emergency Physicians Loma Linda Emergency Physicians Tri-City Emergency Medical Group Emergency Medicine Specialists of Napa Valley Emergency Medical Group University of California, Irvine Medical Orange County Newport Emergency Medical Group, Inc Center Emergency Physicians Emergent Medical Associates at Hoag Hospital Front Line Emergency Care Specialists Pacific Emergency Providers, APC

DECEMBER 2018 | 3 PRESIDENT’S MESSAGE |

What’s The Magic Formula for By Chi Perlroth, MD, FACEP BURNOUT PREVENTION AND RECOVERY

houldn’t someone have created the magic formula for burnout prevention and recovery by now? There are daily articles on how burnout is linked to “lower quality care, lower satisfaction scores, higher medical error rates, higher malpractice Srisk,” not to mention “more frequent disruptive physician behavior, higher rates of physician divorce, increased depression and suicide.” Much of the literature claims that we are all responsible as individual physicians, (ED) leaders, and hospital systems to do something about it. In fact, even our friends at the Joint Commission have required health and wellness programs in our healthcare organizations because even THEY think burnout is an issue (I know, I chuckled at the irony).

Can someone whittle down all the information out there into a menu contributing to your own personal stress levels. You continuously of things we can do to decrease our levels of burnout and improve blame or complain about in the break room or try to our success for well-being and recovery? And yes, there are lists of normalize by calling it “healthy venting.” You blame the system or things our medical directors, hospital administrators, and even CMS others about how much stress you feel can change to make our lives better and I will include some examples of those for people who might serve in those roles, in this and future (3) Lack of efficacy: “My work isn’t really helping anybody or serving articles. But what we do as individuals (and together as colleagues) any purpose” or “I worry about making a clinical mistake.” will most impact the course of our careers as emergency physicians, Maybe I don’t feel that I’m ENTIRELY unable to recover, but I do find and perhaps translate into how we contribute to the health of our myself tired a lot, and sometimes I just can’t believe how fast my few department more broadly. days off have flown by. To deal, I tell myself, “at least I don’t dread going back to work EVERYDAY.” And I don’t really feel cynical about ALL of I know some of us may be tired of hearing about what my friend calls my patients, just those with special chief complaints (you know which “woo-woo” methods—mindfulness, meditation, journaling, exercise, ones). And I think I’m still doing a good job at work, but some days I yoga, work-flow tools, strategic planning, communication, emotional can’t really identify a person whose life I may have made a difference intelligence tools, and life-scheduling techniques. They may sound in. Does this sound familiar? too emotion-based or pseudoscientific. Sure, I signed up for the heavy breathing session with several of my very nice work colleagues at a Is this really something everyone deals with and do we really need lovely restaurant learning about what mindfulness means. I’ve even to keep talking about this? Does burnout really affect me and my taught myself meditation to help me during a stretch of insomnia. And colleagues? Sadly, my answer was yes. I was hired on to one of my first yeah, I try hard to schedule exercise regularly (even yoga on occasion— jobs because a physician committed suicide. I found out on Facebook too boring for me although it seems to keep my neck and back issues that a close medical school friend jumped off a 20 story building. in check). But writing this article, of course I had to ask myself first, “Do Soon thereafter, I received word that a residency colleague, who was I have symptoms of burnout?” also a high school friend of mine, took her own life. I can definitely relate closely to this issue. I am not trying to imply that all paths lead According to Dr. Dike Drummond’s book, Stop Physician Burnout, to the same result but we have to do something to change course for burnout is defined as: ourselves and our medical colleagues.

(1) “Exhaustion—extremely tired and unable to recover Unfortunately, despite all the research, surveys, and experts on this topic, there is no Magical Formula. That’s because, wait for it, we’re (2) Depersonalization—Compassion fatigue—You feel cynical all different. Because our stressors come from different aspects of our and sarcastic about your patients. You blame the patient for

4 | LIFELINE a forum for emergency physicians in california practice and personal life, our path will be different. What I can offer is people that could help you out of this downward spiral. And when a consistent approach suggested by many of the experts: you do those things, you are giving away your power to change things. Playing the victim means you missed an opportunity to take charge.” (1) Get out of denial and recognize your own burnout symptoms 3. TAKE ACTION. WHAT DEPLETES YOU, WHAT (2) First change the behaviors and thoughts that prevent change REPLENISHES YOU? (3) Identify what depletes you and start making changes one by one, “Many of us feel stress and get overwhelmed not because we’re taking and identify what replenishes you and put those activities in your on too much, but because we’re taking on too little of what really calendar one by one strengthens us,” states Marcus Buckingham. Dr. Drummond states (4) Find someone to do this with to keep each other accountable and everyone is different in how they experience and deal with burnout. to help each other “Recovery is a process of switching out old habits with new ones, one at a time.” But we have to TAKE ACTION. “Try things out in your life. Do 1. BURNOUT: RECOGNIZE THE SYMPTOMS something new in order to get new results. If it works, keep doing it. If it doesn’t, move on.” He also notes, “More is not better. Find a few things What does Burnout feel like? You find yourself thinking, “I just want to that you think might get your juices flowing.” “Move from avoiding the get through the day,” or worse you dread going into work. You become things you don’t want. Move to figuring out what you really want, and frustrated, fatigued, or angry during many of your shifts. You find going to get it.” yourself the “Lone Ranger” doing everything yourself, despite having a team around you. You act the perfectionist when you agonize over Understand what depletes you. This could be job specific stresses, details that are not clinically relevant or chastise patients and staff for such as your schedule, patient volume expectations, EMR, ICD-10, minor imperfections. In some cases your colleagues or administrators documentation requirements that keep changing, patient satisfaction may talk to you about your attitude and energy or disruptive behavior. scores, mergers and more mergers, your compensation formula, profit Typically you feel bad about the incidents they call you out on, while sharing, your relationship with staff or leadership, or fear of litigation justifying what you did or said as a reasonable response given the (again). situation. You feel your only solution to your problem is to work harder, and you get angry at people who don’t work as hard as you do. These Even life stresses can affect your career. Your relationship with your are all symptoms of burnout. If you think this is all normal, then you spouse or significant other, your children and raising and caring for a may have capitulated to burnout already. family, birth of a new baby, your own personal health issues, financial hardships (debt, sending kids to private school, saving for kids college), 2. “DEPROGRAM” OR CHANGE THE THOUGHTS THAT failing health of family or parents. High stress levels at home can PREVENT CHANGE actually prevent recharge. “This will show up as burnout on the job, even when the problem is not on the job site at all.” Deprogram your superhero expectations and get rid of your martyr syndrome. It’s okay to take care of your personal needs. In fact, it’s Your three energy accounts are: physical, emotional, spiritual. Rest, essential. It’s okay to feel tired, stressed, even trashed on difficult good food, and exercise are obvious important programs. This is your days. You are not being weak or a wimp. But “if you are burned out personal responsibility no matter what. Are you spending enough or headed in that direction, there is something about the stress at time for the important relationships in your life? Are you spending work and the things you do now to recover that are not working. You enough quality time with the people you love who energize you and are leaking energy and not replenishing it, like a boat with a hole so give you meaning? Great energy can come from outside your medical large that bailing as fast as you can does not keep you from sinking.” practice. Coaching your child’s baseball team, camping with your In his book, Dr. Drummond continues, “That is why a sabbatical will son’s boy scout group, working at the RotaClinic, and gardening and never cure burnout. It only provides temporary relief. Do you ever see feeding your family with the fruits (and vegetables) of your labor. These people happy and refreshed when they come back from vacation or are things some of my colleagues do to reenergize. sabbatical, but then go back to their ways a few months later? That's because when you come back to life/work and you have not changed 4. FIND A BUDDY anything from before the sabbatical, the excess drain begins anew. There is still a hole in your boat.” Without significant changes in your “Share insights with colleagues, friends, and family.” It is well known actions, your energy accounts will be depleted once again. Deal with that “learning, growing, personal development, and self-exploration your Inner Critic— it will say things like, you are being selfish, you can’t are radically accelerated when you are having conversations with afford to do this, this is never going to happen, life is too difficult for people who care about you along the way.” This is like having a this type of change, I am too busy for this. You can play the victim—it’s workout partner. I personally swim faster and farther when I swim with everyone else’s fault, EMR, patient satisfaction surveys, your medical my swim buddy. If I have an ED colleague or even a friend in a different director and administrator demands. According to Dr. Drummond, profession with whom I am working on this, we will keep each other “Blaming, justifying and complaining never work. These behaviors will accountable and each of us will make more of an effort to effect the never get you what you want. You will only alienate the very same changes instead of just thinking about them or writing them down

DECEMBER 2018 | 5 on a pretty list. Yes, misery loves company, but there is teamwork and 7. Identify an IT Champion in your department. Ask your Medical synergy in any number greater than one. Share your goals, and you will Director if this individual can log in hours and get paid for swim faster and farther. developing common templates and documentation requirements for the whole department to use. These requirements constantly So, in this article, I can start by addressing the most common complaint change so it is helpful to have one or two individuals in charge of related to burnout that I hear about: The EMR. Here are some real this. We all have these colleagues in our department who make ACTION ITEMS you can utilize: using EMR look easy. Utilize their talents and everyone saves time.

1. First check your attitude. “Get rid of EMR” is sarcastic and not There is so much more to discuss about prevention and recovery helpful. The biggest problem with EMR is our attitude toward from burnout. Keep reading those articles that flood your inbox. technology. Being a hater is an emotion that will actually get in Look for specific tactics that speak to you and try out those changes the way of completing your documentation in a timely way. We all one by one. See how it changes your mood, saves you time, or know EMR is not going away. If you don’t embrace it or invest in connect more with patients and family. I will continue to collate tips becoming more of an expert, it will guarantee continued misery to share with you, but in the meantime, please consider exploring and worsening struggles. the 4 items in the Not-So-Magical Formula: 1. Get out of denial 2. Change your thoughts about change 3. Identify your stressors and 2. If you are given the opportunity, become a power user or super your replenishers 4. Find a Buddy. n user. You end up getting lots more training. I did, and it helped me with my fear of technology, even though I am a self-professed Thanks for reading, techno-peasant, having been dragged into the 21st century. Chi Perlroth 3. Take all the training the vendor offers, twice. Use templates. Beg, borrow, and steal others’ shortcuts. Program quick keys. You have to invest some hours to do this so you can save tens and hundreds Drummond MD, Dike. Stop Physician Burnout, What to Do When Working Harder of hours later. You can’t expect to ace a test without studying, so Isn't Working. 2014. why would you think this should be automatic or that someone can do it for you?

4. Who are the people in your group who don’t complain about the EMR? Who are the people who leave on time and love the program (well, they may not admit this as it’s very unpopular to like EMR)? Ask them if you can watch them chart for a few hours. Watch them,

not ask them what they do. They may not be able to explain it to Independent Emergency you or their explanations may not make as much sense to you, but Physicians Consortium when you watch what they do, you will see how you can apply it The Best of Both Worlds: to your practice. Have them slow down and do it again. Take notes. Independent Emergency Group Large Group Business 5. Chart only what is required. You are not writing the great American Join IEPC - Your ED Group will remain independent, but not be alone. novel. Leave your perfectionist English Major at the door (you know who you are). The three purposes of the chart are: continuity • Collaboration • Group Purchasing • Benchmarking Data • Business Strength of care, billing, and covering your legal part. Would that perfectly • Shared Innovations • Networking placed comma or semicolon really be crucial in a court of law? Visit our web site for employment opportunities at locations around the state.

6. Use your team. Use your scribes. Utilize them to prevent you from forgetting key documentation items you keep getting dinged for. Write out your preferences and give a print out to every new scribe you work with (they’re ALWAYS new since they’re constantly moving on to medical, nursing, or PA school!). Go over this list with your scribe for the first 5 minutes of your shift. Track your productivity or the time you save or the number of times you get dinged for missing documentation. That will allow you to fully appreciate your upfront investment and start feeling the benefits of the amount of time you are saving every shift. And as a lovely side effect, it may even improve your billing and productivity (and decrease the emails and nasty-grams you get about TADs - Independent Emergency Physicians Consortium 696 San Ramon Valley Blvd., Ste. #144, Danville, CA 94526 turnaround documents). 925.855.8505 | www.iepc.org

6 | LIFELINE a forum for emergency physicians in california 30TH ANNUAL

LEGISLATIVE LEADERSHIP CONFERENCE

APRIL 23, 2019 SACRAMENTO, CA ADVOCACY UPDATE |

EMPAC By Elena Lopez-Gusman and SCORES BIG Kelsey McQuaid-Craig, MPA in

2018 GENERAL ELECTION

The major focus of the 2018 General Election centered on the House of Representatives and the US Senate, but there were also important statewide elections in California and a slew of initiatives on the ballot. Voter turnout in the general election was 48% in California, which is higher than the last midterm election in 2014 and had a resounding effect on State Assembly and Senate races.

emocrats felt they had a great opportunity to build upon the As a part of the process in determining which candidates EMPAC should super majority they secured in 2016 in the State Assembly support, your advocacy staff interviewed a wide array of candidates D and to regain a super majority in the State Senate after losing for statewide office and toured numerous others in emergency one Senator to a recall earlier in 2018. A supermajority would allow departments around the state. In total, EMPAC contributed to Democrats to pass any measure requiring a two-thirds vote such as tax eighteen candidates during the 2018 election cycle. Of those eighteen measures without having to reach across the aisle for compromise. candidates, fifteen were elected! That’s a success rate of 83.3%. To achieve this, the Democrats would need to pick up one seat in the State Senate to get them to 27. The Democrats targeted multiple Building relationships with elected officials early in and throughout Assembly and State Senate districts that had long been considered their careers is extremely important. While we don’t have a crystal ball, Republican strongholds. They were successful in picking up enough we endeavor to support allies who will be elected to leadership or seats in both houses to obtain the largest supermajority in decades. become a vocal champion of our causes in committee and on the floor A supermajority does not necessarily make achieving a two-thirds of the legislature. For example, EMPAC has been a long-time supporter vote on legislation easier, but the number of seats picked up by of Assembly Member Wood, who serves as the Chair of the Assembly more liberal Democrats will limit the influence of Republicans and Health Committee, and Assembly Member Lorena Gonzalez, who more “moderate” or “business” Democrats. serves as Chair of the Assembly Appropriations Committee.

8 | LIFELINE a forum for emergency physicians in california From San Diego to Los Angeles to the North Coast, EMPAC supported • Assembly Member Eloise Gomez Reyes (AD 47) – Won with candidates for the Assembly and State Senate had strong showings. 100% of the vote Incumbent elected officials Assembly Members Brian Dahle, Jim • Assembly Member Richard Bloom (AD 50) – Won with 100% Wood, Monique Limon, Miguel Santiago, and Brian Maienschein of the vote were all reelected. In the statewide races, Gavin Newsom won his • Assembly Member Wendy Carrillo (AD 51) – Won with 86.6% race for Governor and Xavier Becerra was elected to his first full term of the vote as Attorney General after being appointed by Governor Jerry Brown in 2017. • Assembly Member Miguel Santiago (AD 53) – Won with 70.9% of the vote In addition to our support of candidates, California ACEP took a • Josh Lowenthal (AD 72) – Lost with 46.9% of the vote position on two ballot initiatives – Yes on Proposition 2 and No • Assembly Member Brian Maienschein - AD 77) – Won with on Proposition 8. Prop. 2 amends the Mental Health Services Act 51.4% of the vote to fund the No Place Like Home Program, which finances housing for individuals with mental illness. Prop. 8 caps the allowable • Assembly Member Lorena Gonzalez Fletcher (AD 80) – Won reimbursement amounts by insurance companies for dialysis care; with 72.2% of the vote we argued that arbitrary price caps on providers are not health care OUTCOME OF BALLOT PROPOSITIONS: solutions. Proposition 2 passed and Proposition 8 was defeated, both • Proposition 51 (School Bonds) – Passed with 55.1% of the vote by resounding margins. • Proposition 1 (Bonds to Fund Veteran and Affordable Thanks to generous contributions to EMPAC by California ACEP Housing) – Passed with 55.1% of the vote members like you, emergency physicians have become a force to be reckoned with in California politics. As strong as our results have • Proposition 2* (Amend Existing Housing Program for Mental been in the 2018 election cycle, the strength and influence of our Illness) – Passed with 62.3% of the vote opponents in Sacramento cannot be underestimated. Without member involvement and contributions from all of our donors, • Proposition 3 (Bond for Water and Environmental Projects) – we will not be able to continue to develop and elect emergency Failed 46.3% to 53.7% medicine champions. • Proposition 4 (Bond for Children's Hospital Construction) – For more information on how to make a contribution to EMPAC, Passed with 61.4% of the vote please contact us at [email protected] or by calling the • Proposition 5 (Senior Property Reduction) – Failed 40.9% Chapter office at (916) 325-5455. to 59.1%

CANDIDATES SUPPORTED BY EMPAC IN THE 2018 ELECTION • Proposition 6 (Repeal of Fuel Tax Approved by Voters) – Failed CYCLE INCLUDE: 43.5% to 56.5% • Antonio Villaraigosa – Governor – Lost in Primary • Proposition 7 (Change Daylight Saving Time Period) – Passed • Gavin Newsom – Governor – Won with 60.8% of the vote with 60.2% of the vote • Dave Jones - Attorney General – Lost in Primary • Proposition 8* (Regulates Kidney Dialysis Treatment Charges) • Xavier Becerra - Attorney General – Won with 62.3% of the vote – Failed 39.3% to 60.7% • Senator Richard Pan (SD 6) – Won with 68.9% of the vote • Assembly Member Brian Dahle (AD 1) – Won with 64.1% of the • Proposition 9 – Did not appear on the ballot vote • Proposition 10 (Rental Control on Residential Property) – • Assembly Member Jim Wood (AD 2) – Won with 66.7% of the vote Failed 39.3.8% to 60.7% • Assembly Member Kevin McCarty (AD 7) – Won with 68.9% of the vote • Proposition 11 (Emergency Ambulance Employees On-call) – Passed with 60.2% of the vote • Robert Rivas (AD 30) – Won with 65.9% of the vote • Assembly Member Joaquin Arambula (AD 31) – Won with • Proposition 12 (Farm Animals Confinement Standards) – 62.1% of the vote Passed with 61.8% of the vote • Assembly Member Monique Limon (AD 37) – Won with 79.2% *California ACEP supported Prop. 2 and opposed Prop. 8. n of the vote

DECEMBER 2018 | 9 GUEST ARTICLE |

2018 ACEP Council Meeting Recap

By Susanne J. Spano, MD, FACEP and Vik Gulati, MD, FACEP

10 | LIFELINE a forum for emergency physicians in california CEP held another successful Council Meeting this year, and the California delegation included thirty Councillors, three Alternate Councillors, and five Past A Leaders. ACEP’s 2018 Annual Council Meeting was held on September 29th and September 30th at the Manchester Grand Hyatt, San Diego, CA. Over 420 Councillors were present this year. Forty eight resolutions were sent to Reference Committees and voted on in Council. Two late resolutions (<90 days) were withdrawn by the Utah Chapter. There were no emergent resolutions (<24 hours). Elections for the ACEP President-elect and Board of Directors were also held. Below is a recap of the resolutions and election results.

REFERENCE COMMITTEE A: as good for the environment, our patients, and for air quality - but was not adopted under concerns of complexity of implementation Bylaws and Governance Resolutions included the Commendation and concerns that such a resolution was beyond the scope of ACEP of Dr. John Rogers, supported by 53 chapters and 27 sections bylaws. EMRA passionately argued physician suicide should be standing together in thanks for his service to emergency medicine. treated as a sentinel event. Multiple amendments and substitutions The American College of Osteopathic Emergency Physicians was were presented and refuted by the Council. The Council recognized recognized as an organization meeting criterion for a seat on the this was a major issue and continues to explore the best way to help Council. Divestment from fossil fuel-related companies was argued members and prevent suicide.

DECEMBER 2018 | 11 2018 ACEP Council Meeting Recap

REFERENCE COMMITTEE B: Resolution 12: Nominating Committee Revision to Promote Diversity – Council Standing Rules Amendment - Adopted Advocacy and public policy resolutions were heavily debated. Outside mandates on meeting safe shelter requirements prior to discharge of Resolution 13: Growth of the ACEP Council - Adopted homeless patients were formally opposed. Emergency department Resolution 14: Diversity of ACEP Councilors - Adopted copayments for Medicaid beneficiaries were discouraged, as they do not decrease ED utilization, and attempts to collect from medically Resolution 15: Divestment from Fossil Fuel-Related Companies - indigent persons was argued to be futile, unethical, and costly. Funding Not Adopted for Buprenorphine-Naloxone treatment programs was unanimously Resolution 16: No More Emergency Physician Suicides - Adopted adopted. The Council asked the Board to address drug shortages rather than take a stand now against group purchasing organizations (GPOs) Resolution 17: Physician Suicide is a Sentinel Event - Not Adopted as an identified contributor. A brief battle ensued regarding a patient’s Resolution 18: Reducing Physician Barriers to Mental Health Care - right to privacy regarding inclusion of Methadone in state drug and Adopted prescription databases, but ultimately methadone was conceded to be no different than other prescription opiates listed in such databases. Resolution 19: Reduction of Scholarly Activity Requirements by the Separation of migrant children from their caregivers was hotly ACGME - Adopted debated. Although ACEP has previously released a press statement on this topic, the resolution was adopted. An additional resolution on Resolution 20: Verification of Training - Adopted immigration was referred to the ACEP Board of Directors. REFERENCE COMMITTEE B (ADVOCACY/PUBLIC POLICY) REFERENCE COMMITTEE C: Resolution 21: Adequate Resources for Safe Discharge Emergency medicine practice resolutions, apart from recreational Requirements - Adopted cannabis use which was not adopted after much debate, were either Resolution 22: Addressing Mental Health Treatment Barriers wordsmithed or approved on the consent agenda. A resolution on Created by the IMD Exclusion - Adopted expert witness testimony was referred to the ACEP Board of Directors. Resolution 23: Advocating for CMS Policy Restraint to Avoid ELECTIONS: Restricting Quality Emergency Care - Adopted

ACEP President: Vidor Freidman (FL) Resolution 24: ED Copayments for Medicaid Beneficiaries - Adopted ACEP President-Elect: William Jaquis (FL) Resolution 25: Funding for Buprenorphine-Naloxone Treatment Board of Directors: Programs - Adopted

Christopher Kang (WA) incumbent Resolution 26: Funding of Substance Use Intervention and Mark Rosenberg (NJ) incumbent Treatment Programs - Adopted John (JT) Finnell (IN) Resolution 27: Generic Injectable Drug Shortages - Referred to ACEP Board of Directors Anthony Cirillo (RI) Resolution 28: Inclusion of Methadone in State Drug and COMMITTEE A Prescription Databases - Adopted Resolution 29: Insurance Collection of Patient Financial Resolution 6: Commendation of Dr. John Rogers - Adopted Responsibility - Adopted Resolution 9: American College of Osteopathic Emergency Resolution 30: Naloxone Layperson Training - Adopted Physicians Councilor Allocation –Bylaws Amendment - Adopted Resolution 31: Payment of Opioid Sparing Pain Treatment Resolution 10: Achieving Unity by Expanding Criteria for Eligibility & Alternatives - Adopted Approval of Organizations Seeking Representation in the Council – College Manual Amendment - Not Adopted Resolution 32: POLST forms - Adopted

Resolution 11: Codifying the Leadership Development Advisory Resolution 33: Separation of Migrating Children from Their Group (LDAG) - Council Standing Rules - Adopted Caregivers - Adopted

12 | LIFELINE a forum for emergency physicians in california Resolution 34: Violence is a Health Issue - Adopted Resolution 43: Fair Remuneration in Health Care - Not Adopted

Resolution 35: ACEP Policy Related to Immigration - Referred to Resolution 44: Firearm Safety and injury Prevention Policy ACEP Board of Directors Statement - Adopted

Resolution 45: Support for Extreme Risk Protection orders to REFERENCE COMMITTEE C Minimize Harm - Adopted (EMERGENCY MEDICINE PRACTICE) Resolution 46: Law Enforcement information gathering in the ED Resolution 36: ACEP policy related to medical cannabis - Adopted policy statement - Adopted

Resolution 37: ACEP Policy Related to “Recreational” cannabis - Resolution 47: Supporting Medication for opioid use disorder - Not Adopted Adopted

Resolution 38: Antimicrobial Stewardship - Adopted Resolution 48: Surreptitious recording in the ED - Adopted

Resolution 39: Care of the Boarded Behavioral Health Patient - LATE RESOLUTIONS Adopted

Resolution 40: Care of individuals with Autism Spectrum Disorder Resolution 49 in memory of C. Christopher King, MD, FACEP – in the ED - Adopted Adopted

Resolution 41: ED and EP Role in the Completion of Death Resolution 50 in memory of John Emory Campbell, MD, FACEP - Certificates - Adopted Adopted n

Resolution 42: Expert Witness Testimony - Referred to ACEP Board of Directors

California Graduates California has 19 residency programs with approximately 200 emergency medicine graduates each year. Nine programs participated in our "Where are they going" request and we are happy to share where you can find California graduates in 2019.

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1 2 2 1 2 1 3 74 1 1 - Peru 1 - New Zealand 1 2

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DECEMBER 2018 | 13 2018 Graduates 2018 Graduates WHERE ARE THEY WGOHINEGR? E ARE THEY GOING?

9 1 1 1 3 8 UT 9 OH IL CO CA CA CA ARROWHEAD Alex Jabourian, DO ARMC - EMS FellowshAip, RColtoRn, COA WHEAD STANFORD/KAISER Braeden Carrico, DO - Queen of the ValleAyl, eGxle nJadobroa,u CrAian, DO ARMC - EMS Fellowship, ColtoBnr,i aCnA Ichwan, MD - St. Francis Medical Center, Lynwood, CA Eric Sechrist, DO - Pomona Valley Hospital, Pomona, CA June Gordon, MD - Stanford University, Palo Alto, CA Kathryn Seiler, DO - Twin Cities CommuBnirtya eHdosepnita Cl, aTremripcloet,o Dn, OCA - Queen of the Valley, GlendoKriras,t eCnA Hornbeak, MD - Redlands , San Bernardino, CA Lauren Bennallack, DO - Mercy MedicalE Creincte Sr,e Rcehddriinsgt,, CDAO - Pomona Valley Hospital, PomonMae,g aCnA Storm, MD - Clovis Community Medical Center, Clovis, CA Philip Buss, MD - Kaiser Permanente, Sacramento/Roseville, CA Liezl Avila, DO - Mountain View PhysiciKana Gthroruypn- S aSne Ailnetro,n iDo ORe g- iTonwali,n U pClaintide, sC ACommunity Hospital, Templeton, CA Nina Jabourian, DO - Kaiser- Fontana/Ontario, Fontana, CA Siobhan Smith, MD - Stanford University, Palo Alto, CA Sara Wattenbarger, DO - Kaweah Delta/SLealmuar eAndv Benetinstn, Vailslaalicak, C,A DO - Mercy Medical Center, ReThdodmiansg G,i lCdeAa, MD - O'Conner Hospital, San Jose, CA Tifany Hoyne, DO - Regional San Jose, SaLni eJozsle ,A CAvila, DO - Mountain View Physician Group-W Siallinam A Dnixton, iMoD R - eStgainofonrda lU,n Uivperlsaitny,d P,a lCoA Alto, CA Casey Dart, MD - US Acute Care Solutions, Denver, CO Nina Jabourian, DO - Kaiser- Fontana/Ontario, FonJetsasinca R, aCinAey, MD - US Acute Care Solutions, Denver, CO Sara Wattenbarger, DO - Kaweah Delta/Selma AdvKerinsttiinsat E, vVainssa, MliDa ,- UCSA Acute Care Solutions, Denver, CO 1 1 1 7 Carter Neugarten, MD - Northwestern University, Chicago, IL PERU PA AZ CA Tifany Hoyne, DO - Regional San Jose, San Jose, CAAlexander Zozula, MD - University of Cincinnati, Cincinnati, OH HIGHLAND Colin Little, MD - University of Utah, Salt Lake City, UT Eben Clattenburg, MD - Tuba City Regional Health Care Corporation. Tuba City, AZ Amarinder Singh, MD - Oakcare/Highland, Alameda, San Leandro 1 1 1 7 1 1 1 9 PERU PA AZ CA 1 Ben Thomas, MD - Associate Physician, Kaiser Permanente San Leandro NEW NV MD HI CA Claire Lyons, MD - Berkeley Emergency Medicine Group/Summit Alta Bates ZEALAND Dara Mendelsohn, MD - Associate Physician, Kaiser Permanente Central Valley David Martin, MD - Highland Emergency Medicine Fellowship Monique Smith, MD - Emory University EHmerIgeGncyH MedLicinAe ReNsideDncy Faculty UC DAVIS Peter Wroe, MD - Associate Physician, KEaibseern P eCrmlaatntennteb Euarstg B, aMy D - Tuba City Regional HealthA dCaamr eH aCwokrinps,o DrOa -t iEoasnte.r Tn uSiberara C EiPt-y N, oArtZhern NYO Hospital, Bishop, CA Austin Kilaru, MD - National Clinical SchAomlaras rPirnogdraemr ,S Uinnivg hof, PMA HDe a- lOtha Pkolcicayr Fee/lHlowigshilpand, AlameBdjaor,k S Oalanfs Ldoettairn, MdrDo - UHCo Dsapviist Ualltsrasound Fellowship, Sacramento, CA Andrea Dreyfuss, MD - Highland Ultrasound Fellowship, ACEP Ambassador to Peru Brian Harms, MD - Memorial Med Ctr, Modesto & Rideout Memorial Hospital, Marysville, CA Ben Thomas, MD - Associate Physician, Kaiser PerGmararentte Tnhtiel, SMaDn - CLoettagned Hroospital, Santa Barbara, CA Claire Lyons, MD - Berkeley Emergency MedicineJo Gn rHoauynpe/sS, MuDm - mRidieto Autl tHae aBltah,t Yeusba City, CA Dara Mendelsohn, MD - Associate Physician, KaisSearm P Jeeprpmsena, nMeDn - tReid Ceoeunt tRreagilo nVaal Mlledyical Center, Marysville, CA 1 5 Suzie Ondak, MD - Sutter Hospital, Rosevilla, CA OR CA David Martin, MD - Highland Emergency MedicinTea yFloerl lSotawytsonh, iMpD - Kaiser Permanente, Oakland/Richmond, CA Monique Smith, MD - Emory University EmergencWyh Mitneyd Dicuifrneesn Re, eMsDid - Keanisceyr- FKaicseur lPteyrmanente North Valley, Sacramento CA Peter Wroe, MD - Associate Physician, Kaiser PermKaatyn Sewnimte, DEOa -s Tth Be aEmyrgency Group, Queens Med Ctr, Oahu, HI KAISER SAN DIEGO Kelly Gray, MD - Calvert Memorial Hospital, Prince Frederick MD Andrew Stolle, MD - Scripps Mercy, San ADiuegsoti, nCA Kilaru, MD - National Clinical Scholars ProOglrivaemr D,u Utcnzaikv, DoOf -P MAid Hdleemaolrteh H Posopliitcaly, A Fueckllaonwd, sNhewip Zealand Andrew Williamson, MD - Sharp MemorAianl, dSarne aDi eDgroe, CyAfuss, MD - Highland Ultrasound FelloBwriasnh Bipia,g iA, MCDE P- R Aenmo EbPa - sSst.a Mdaoryr' st Mo ePdiecralu Center, Reno, NV Charles (Chuck) Yu, MD - Kaiser Permanente, West Los Angeles Travis Anderson, MD, MBA - Northern NV EP -Renown Hospital, Reno, NV Emily Utschig, DO - Kaiser Permanente, San Diego Kyle Brodmann, MD - Kaiser Permanente, San Diego Seth Meyer, MD - Kaiser Permanente Pacific Northwest, Portland, OR 1 8 1 5 NJ CA OR CA

1 1 4 UC SAN DIEGO FL CA NJ Nicholas Aldridge, MD - Kaiser Permanente, San Diego, CA Joseph Brown, MD - University of California, San Francisco KAISER SAN DIEGO James Corbett-Detig, MD - Pioneers Memorial Hospital, Brawley, CA KAWEAH DELTA Andrew Stolle, MD - Scripps Mercy, San Diego, CABrenna Derksen, MD - University of California, San Diego Thomas Ence, MD - Pioneers Memorial Hospital & SHARP Chula Vista, CA Renee DeNolf, DO - Kaweah Delta Health Care District Andrew Williamson, MD - Sharp Memorial, San DNiaengcoy ,G CloAber, MD - Stanford Medicine Stephen Wolfe, DO - Mercy Medical Center, Redding CA, Dignity Health Thien Nguyen, MD - Kaiser Permanente, Los Angeles, CA Xi Damrell, MD - Methodist Hospital of SCahcraamrleenst o(,C Shacuracmke)n Ytou C, AMD - Kaiser Permanente, West Los Angeles Cameron Smyres, MD - University of California, San Diego Yong Hwan Kwon, MD - Redlands Community Hospital, Redlands CA Emily Utschig, DO - Kaiser Permanente, San DiegoMark Darocki, DO - Ocean Medical Center, Brick, NJ Juan Arhancet, DO - Jackson Memorial HKoyspleita Bl arto thdem Uaninvenr,s iMty Dof M- Kiaamiis, eFLr Permanente, San Diego Briah Koch, MD - Mountainside Hospital, Montclair, NJ Seth Meyer, MD - Kaiser Permanente Pacific Northwest, Portland, OR 1 11 OR CA 1 1 1 13 6 MIN TX IL HI CA UCSF 1 1 4 Brian Chang, MD - Adventist HealNthJ Clear LakeF,L C lear Lake,C CAA Charles Murphy IV, MD - UCSF Emergency Medicine - Clinical Research Fellowship LAC-HARBOR UCLA Chloe Thomas, MD - UCSF/ZSFG and Kaiser Permanente East Bay Anthony Lucero, MD - Kaweah Delta Med Center, Visalia, CA Delphine Huang, MD - Stanford - Biodesign Fellowship Christopher Redgate, MD - Harbor-UCLA Med Center, PEM Fellowship Divya Thapar Ray, MD - Kaiser Permanente Walnut Creek and Kaiser Permanente Antioch Craig Allred, MD - Kaiser, Fontana, CA KAWEAH DELTA Gabriel Sudario, MD - UC Irvine Emergency Medicine, Multimedia Design Education Daena Watcha, MD - Good Samaritan HoRsepnitael,e S aDne JNosoe,l Cf,A DO - Kaweah Delta Health Care DisTtercihcntology Fellowship Hemang Archaya, MD - UCLA, IDHEAL Fellowship Gretchen Fuller, MD - UCSF/ZSFG and Kaiser Permanente San Francisco Jung-Eun Lim, MD - Kaiser, LA area Stephen Wolfe, DO - Mercy Medical Center, ReddiKnagrl aC CAa,n Dseicgo,n MiDty - UHCeSFa/lZtShFG and Kaiser Permanente Oakland Kaoru Itakuara, MD - Kaiser, South San XFria Dncaismcorell, MD - Methodist Hospital of SacramentNoid, aS Daecgreasyms, MenD t-o S tCanAford Emergency Medicine - Administrative Fellowship Kristina Shigyo, MD - Intl. Med Corps & YSto. Mnagr yH Mweda nCe Kntwer,o Lnon, gM BDea c-h R, CeAdlands Community HoRsopsintya Dl,a Rnield, MlaDn - dUsC SCFA Emergency Medicine - Medical Education Fellowship Mark Paulsen, MD - Mission Hospital, Laguna Beach, CA Steven Straube, MD - UCSF/ZSFG and St. Mary's Medical Center Mary Ann Gallup, MD - PIH Health HospJiutaal,n W Ahirtthiear,n CcAet, DO - Jackson Memorial Hospital atJu tlhiae C hUangi vBuelrliscikt, yM Do f- KMaiisaerm Peir, mFaLnente Sunnyside Medical Center, Portland, OR Michael Hwang, MD - Kaiser, RedwoodsB arnida Sha nK Loecanhd,r Mo, CDA - Mountainside Hospital, Montclair, NJ Trevor Wilson, MD - Ventura County Hospital, Ventura, CA Ziyad Khesbak, MD - California Hospital, Los Angeles & Harbor-UCLA Bennett Lee, MD - Wahiawa General, Hawaii Dwayne Corcoran, MD - Mt. Sinai, Holy Cross Hospital, Chicago, IL Tom Fadial, MD - UT Houston, TX 1 1 1 13 TX IL HI CA

14 | LIFELINE a forum for emergencyLAC- physiciansHARB inO californiaR UCLA Anthony Lucero, MD - Kaweah Delta Med Center, Visalia, CA Christopher Redgate, MD - Harbor-UCLA Med Center, PEM Fellowship Craig Allred, MD - Kaiser, Fontana, CA Daena Watcha, MD - Good Samaritan Hospital, San Jose, CA Hemang Archaya, MD - UCLA, IDHEAL Fellowship Jung-Eun Lim, MD - Kaiser, LA area Kaoru Itakuara, MD - Kaiser, South San Francisco Kristina Shigyo, MD - Intl. Med Corps & St. Mary Med Center, Long Beach, CA Mark Paulsen, MD - Mission Hospital, Laguna Beach, CA Mary Ann Gallup, MD - PIH Health Hospital, Whittier, CA Michael Hwang, MD - Kaiser, Redwoods and San Leandro, CA Trevor Wilson, MD - Ventura County Hospital, Ventura, CA Ziyad Khesbak, MD - California Hospital, Los Angeles & Harbor-UCLA Bennett Lee, MD - Wahiawa General, Hawaii Dwayne Corcoran, MD - Mt. Sinai, Holy Cross Hospital, Chicago, IL Tom Fadial, MD - UT Houston, TX

CEMAF ANNOUNCEMENTS |

The California Emergency Medicine Advocacy Fund (CEMAF) has transformed California ACEP’s advocacy efforts from primarily legislative to robust efforts in the legislative, regulatory, legal, and through the Emergency Medical Political Action Committee, political arenas. Few, if any, organization of our size can boast of an advocacy program like California ACEP’s; a program that has helped block Medi-Cal provider rate cuts, lock in $500 million for the Maddy EMS Fund over the next 10 years, and fight for ED overcrowding solutions! SAVE THE DATE The efforts could not be sustained without the generous Legislative Leadership Conference (LLC) support from the groups listed below, some of whom have April 23, 2019 | Sacramento, California donated as much as $0.25 per chart to ensure that California CALIFORNIA ACEP SPONSORED & CO-SPONSORED COURSES ACEP can fight on your behalf. Thank you to our 2017-18 41st Annual Emergency Medicine In Yosemite contributors (in alphabetical order): January 16-19, 2019 | Yosemite, CA • Alvarado Emergency Medical Associates SUBMIT A LIFELINE ARTICLE • Antelope Valley Emergency Medical Associates Looking for a way to share your emergency medicine experience? Want • Beach Emergency Medical Associates to share a story from your last shift? Or maybe career or life advice? We're • Chino Emergency Medical Associates looking for member and guest articles, including letters-to-the-editor. Please note that all articles and letters are reviewed and may be edited • Coastline Emergency Physicians Medical Group for grammar and content. • Culver Emergency Medical Group If you would like more information or would like to submit a guest article, • Hollywood Presbyterian Emergency Medical Associates email [email protected]. • Las Cruces Emergency Medical Associates • Los Alamos Emergency Medical Associates • Mills Peninsula Emergency Medical Group • Orange County Emergency Medical Associates • Pacific Coast Emergency Medical Associates • Riverside Emergency Physicians • San Dimas Emergency Medical Associates • Sherman Oaks Emergency Medical Associates • South Coast Emergency Medical Group, Inc. • Tarzana Emergency Medical Associates • TeamHealth • Temecula Valley Emergency Physicians, Inc. • US Acute Care Solutions • Valley Emergency Medical Associates • Valley Presbyterian Emergency Medical Associates • Vikant Gulati, MD • Vituity • West Hills Emergency Medical Associates

16 | LIFELINE a forum for emergency physicians in california | CALIFORNIA ACEP UPCOMING MEETINGS & DEADLINES

For more information on upcoming meetings, please e-mail us at [email protected]; unless otherwise noted, all meetings are held via conference call.

DECEMBER 2018 DECEMBER 2018 SUN MON TUES WED THURS FRI SAT

Winter Holiday 24th – 31st 1 Chapter Office Closed 2 3 4 5 6 7 8

9 10 11 12 13 14 15

16 17 18 19 20 21 22 JANUARY 2019 23 24 25 26 27 28 29

New Year's Day 30 31 1st Office Closed

Reimbursement Committee 8th at 9 AM Conference Call JANUARY 2019

SUN MON TUES WED THURS FRI SAT

Martin Luther King, Jr Day 1 2 3 4 5 21st Chapter Office Closed 6 7 8 9 10 11 12

13 14 15 16 17 18 19 Government Affairs Committee (GAC) 17th at 10 AM Conference Call 20 21 22 23 24 25 26

27 28 29 30 31

FEBRUARY 2019 FEBRUARY 2019

Board of Directors Nominations Open 1st SUN MON TUES WED THURS FRI SAT Online 1 2

3 4 5 6 7 8 9 Board of Directors Meeting 7th at 10 AM Sacramento, CA 10 11 12 13 14 15 16

17 18 19 20 21 22 23 President’s Day 18th Chapter Office Closed 24 25 26 27 28

DECEMBER 2018 | 17 CAREER OPPORTUNITIES |

SOUTHERN CALIFORNIA OPPORTUNITIES: VENTURA CALIFORNIA: New hospital under construction and scheduled to • Tustin, CA - Orange County - 73-bed community hospital, 8-bed ER, open in the Spring of 2018. Central coast of California and 70 miles from LAX. paramedic receiving, low volume. 10 x 24hr = $240,000/yr + incentive Positions available in two facilities for BC/BE emergency physician. STEMI • East Los Angeles - 120-bed community hospital urgent care (non Center, Stroke Center with on-call coverage of all specialties. Teaching facility paramedic receiving) volume 700/mo. Guarantee $100/hr. with residents in Family Practice, Surgery, Orthopedics and Internal Medicine. • Norwalk, CA - 60-bed hospital. 500-600 patient/mo. Paramedic Admitting hospital teams for Medicine and Pediatrics. Twenty-four hour OB receiving. $110/hr. coverage in house and a well established NICU. Physician’s shifts are 9 hrs and • San Fernando Valley - 18000 visits $350000 per year with incentives 12 hours of PA/NP coverage. All shifts and providers have scribe services 24/7. Med surg with psyche beds. Overlap or NP or PA for busy times. Affiliated hospital is a smaller rural facility 20 minutes from Ventura in Ojai. • HOSPITALIST OPENINGS ALSO AVAILABLE Malpractice and tail coverage is provided. New hires will work days, nights, FAX CV to 213 482 0577 or call 213 482 0588 or email [email protected] weekends and weekdays. Send resume to Alex Kowblansky MD FACEP at [email protected] SOUTH ORANGE COUNTY: Mission Hospital and Children’s Hospital at Mission, a CMS 5-Star rated full service hospital. We are an established, independent, democratic group staffing this ED for 22 years. Excellent compensation; malpractice paid; scribes; midlevel providers. We seek an EM residency trained physician for a partnership track. Excellent coverage and midlevel provider support allow for high job satisfaction. UC To advertise with Lifeline and to take advantage of our circulation of over Irvine EM residents on rotation allow for teaching opportunities. Two full-time, 3,000 readers, including Emergency Physicians, Groups, and Administrators dedicated work 6 nights a week. All other physicians average 6 overnight shifts per year! throughout California who are eager to learn about what your business has to offer them, please contact us at [email protected] or give us a call The department serves both a pediatric and adult base station hospital serving all of south OC. High acuity, 70,000 patients a year, comprehensive at (916) 325-5455. referral center, outstanding adult and pediatric sub specialty coverage, adult and pediatric , STEMI Center, and Stroke Center. Send CV to: [email protected]

18 | LIFELINE a forum for emergency physicians in california Looking forwing California an providersITLS list: course? EMREF offers the follo PHI Air Medical, California Eric Lewis, Course Coordinator 801 D Airport Way, Modesto, CA 95354 Phone: (209) 550-0884 ETS – Emergency Training Services Fax: (209) 550-0885 Mike Thomas, Course Coordinator Email: [email protected] 3050 Paul Sweet Road, Santa Cruz, CA 95065 Web: http://www.phiairmedical.com Phone: (831) 476-8813 American Health Education, Inc Toll-Free: (800) 700-8444 Riggs Ambulance Service Perry Hookey, EMT-P Fax: (831) 477-4914 Greg Petersen, EMT-P, Clinical Care Coordinator 7300B Amador Plaza Road, Dublin, CA 94568 Email: [email protected] 100 Riggs Ave, Merced, CA 95340 Phone: (800) 483-3615 Web: www.emergencytraining.com Phone: (209) 725-7010 Email: [email protected] Fax: (209) 725-7044 Web: www.americanhealtheducation.com Loma Linda University Medical Center Email: [email protected] Lyne Jones, Administrative Assistant Web: www.riggsambulance.com American Medical Response (AMR) Department of Emergency Medicine Ken Bradford, Operations 11234 Anderson St., A108, Loma Linda, CA 92354 Rocklin Fire Department 841 Latour Court, Ste D, Napa, CA 94558-6259 Phone: (909) 558-4344 x 0 Chris Wade, Firefighter/Paramedic Phone: (707) 953-5795 Fax: (909) 558-0102 3401 Crest Drive, Rocklin, CA 95765 Email: [email protected] Email: [email protected] Phone: (916) 625-5311 Web: www.llu.edu Fax: (209) 725-7044 Compliance Training Email: [email protected] Jason Manning, EMS Course Coordinator Medic Ambulance Web: www.rocklin.ca.us 3188 Verde Robles Drive, Camino, CA 95709 James Pierson, EMT-P Phone: (916) 429-5895 506 Couch Street, Vallejo, CA 94590-2408 Rural Metro Ambulance Fax: (916) 256-4301 Phone: (707) 644-1761 Brian Green, EMT-P Email: [email protected] Fax: (707) 644-1784 1345 Vander Way, San Jose, CA 95112 Email: [email protected] Phone: (408) 645-7345 CSUS Prehospital Education Program Web: www.medicambulance.net Fax: (408) 275-6744 Thomas Oakes, Program Director Email: [email protected] 3000 State University Drive East, Napa Hall, Sacramento, CA Napa Valley College Web: www.rmetro.com 95819-6103 Gregory Rose, EMS Co-Director Office: (916) 278-4846 2277 Napa Highway, Napa CA 94558 Defib This (ERT) Mobile: (916) 316-7388 Phone: (707) 256-4596 Brian Green, EMT-P Email: [email protected] Email: [email protected] 1543 Pacific Avenue, Suite 104, Capitol CA 95060 Web: www.cce.csus.edu Web: www.winecountrycpr.com Phone: (831) 426-9111 Web: www.defibthis.com EMS Academy NCTI – National College of Technical Instruction Nancy Black, RN, Course Coordinator Lena Rohrabaugh, Course Manager Verihealth/Falck Northern California 1170 Foster City Blvd #107, Foster City, CA 94404 333 Sunrise Ave Suite 500, Roseville, CA 95661 Ken Bradford, Training Coordinator Phone: (866) 577-9197 Phone: (916) 960-6284 x 105 2190 South McDowell Blvd, Petaluma, CA 94954 Fax: (650) 701-1968 Fax: (916) 960-6296 Phone: (707) 766-2400 Email: [email protected] Email: [email protected] Email: [email protected] Web: www.caems-academy.com Web: www.ncti-online.com Web: www.verihealth.com

If you are an EMS Director and would like to provide chest, head shock-injury training to your team, contact California ACEP to get started! ITLS is the only pre-hospital trauma program endorsed by ACEP, since 1986, and is accepted internationally as the standard training course for pre-hospital trauma care.

Search for upcoming courses: http://cms.itrauma.org/CourseSearch.aspx

Please call 916.325.5455 or EMREF is a proud sponsor of California ITLS courses. E-mail Lucia Romo: [email protected] for more information. lifeline PRSRT STD California Chapter, American US POSTAGE College of Emergency Physicians PAID 1121 L Street, Suite 407 CPS Sacramento, CA 95814

Apply for Fellow Status! This year's deadline to submit your application to ACEP is December 15th. Don't miss out on FACEP designation!