California Society of Anesthesiologists Bulletin Spring 2013 - (Page 26)
District rePOrts
Autumn 2012
stanley Brauer, mD
District 2
Mono, Inyo, Riverside and San
Bernardino counties
Various challenges continue to face CSA members in
District 2, just as in all of California, but with some
unique local variations. Efforts to get a medical school
started at the University of California, Riverside, continue to fail due to lack of funding. A bill to allocate $15
million for this project was effectively killed in the state
Legislature in August. Could it have anything to do
with the fact that the bill, A.B. 1309, was sponsored by a
Republican legislator in a Democrat-controlled legislature? Could it be that the Democrats had a legitimate
point in refusing to fund the bill because there was no
way to pay for the school without raising taxes, which
the Republicans wouldn’t support? Whichever party
one supports, it seems like another example of partisan
politics where both sides refused to work out a solution.
With financially challenging conditions in the “Inland
Empire,” a recent proposal from the Centers for Medicare and Medicaid Services (CMS) is frustrating and
illogical. The problem arises from CMS designating
areas, over-broadly, as rural versus urban, and failing
to take actual geographical disparities into account.
The millions of residents in our district live mainly in
urbanized areas, but CMS lumps them together with
very rural areas such as Barstow and Blythe. At the same
time that our district is disadvantaged, the proposal
would reduce the rural penalty for San Diego and Santa
Cruz counties, this latter penalty’s correction having
been championed by the CMA. Physicians in Santa
Cruz would receive a 9 percent increase while District 2
would increase by 0.5 percent. Hospitals in the district
face the same problems in reimbursement.
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I have not heard from members of any major new practice challenges. The practice environment continues
to evolve, with the major unknowns for all of us being
what will happen with national health care policies and
how they will affect local reimbursement.
Wayne Kaufman, mD
District 3
Northeastern Los Angeles County
The one thing in life that is constant
is change. And it appears that the winds of change are
beginning to affect the practice of anesthesiology in
District 3 (and I am sure throughout California as well).
For the first time, approximately half the graduating residents of the University of Southern California (USC)’s
Keck School of Medicine have chosen to continue their
training by seeking subspecialty fellowships rather than
entering the private practice workforce. Our residents
pursued the full gamut of subspecialty training, including cardiac, pediatric, pain management, critical care,
and regional anesthesia. Many of our residents left the
state to continue their training. It is unclear if their decisions were based on a tightening job market in our state,
a need to ready themselves for health care in the PPACA
future, or a real interest in their chosen field and perhaps
a desire to return to academics and teach. But what I can
say is that it was not a one-time blip because our 2013
class is already traveling both the state and the nation
for fellowship interviews.
Evidence of the vast changes that PPACA is having on
health care can be seen within District 3. Whether the
law will make things better or worse for the average
patient is unclear and subject to debate. However, it
is certain that the law gives major advantages to large
Table of Contents for the Digital Edition of California Society of Anesthesiologists Bulletin Spring 2013
Editor's Notes
ASA Director's Report
Peering Over the Ether Screen
On Your Behalf: Legislative and Practice Affairs
Education, Hawaii... What Could Be Better?
California and National News
From the Executive Director
2013 CSA Spring Anesthesia Seminar
District Director Reports
Book Review
Educational Article
California Society of Anesthesiologists Bulletin Spring 2013
https://www.nxtbook.com/allen/csab/63-1
https://www.nxtbook.com/allen/csab/62-4
https://www.nxtbook.com/allen/csab/62-3
https://www.nxtbook.com/allen/csab/62-2
https://www.nxtbook.com/allen/csab/62-1
https://www.nxtbook.com/allen/csab/61-4
https://www.nxtbookmedia.com