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NewsWatch

December 2008


From Your WA/ACEP President, Eric Shipley MD

Emergency Medicine Without Borders
Mark your calendars for WA-ACEP’s 3rd Annual Emergency Medicine Without Borders conference, May 27-29, 2009 at Bell Harbor International Conference Center, Seattle, Washington.  This year we have two pre-courses’ offered as well as 2 full days of premier scientific programming.  Spread the word!  This is a great educational opportunity for the entire emergency medicine community, including nurses, physician assistants and paramedics.

Call for Posters: Don’t miss out on submitting a poster for Emergency Medicine Without Borders.  A prize will be awarded to the winner!

Click here
for the conference schedule

Click here for poster instructions


2009 ACEP Report Card Released
On Tuesday, December 9, ACEP released the second “National Report Card on the State of Emergency Medicine.”  Please go to http://www.emreportcard.org/ for complete information on the Report Card and its recommendations.
The Report Card will be a significant tool for ACEP's legislative advocacy efforts at both the state and national levels.  It will help position ACEP as the leading resource and voice on issues critical to the delivery of emergency care.  The Washington Chapter American College of Emergency Physicians Board of Directors released the following statement about the report card:

“The problem with Emergency Medicine in Washington State is not in the trenches where outstanding medicine is practiced.  The problem reflected in the C grade, is one of systems that require political and economic solutions that involves everyone in the state.”

Click here to download the report card for Washington State

In This Issue

Physician CMS Enrollment Update
ACEP and EDPMA sent a joint letter to CMS asking to delay and reassess the need for new policy in the Medicare physician payment final rule that reduces allowable retroactive billing from 27 months to 30 days.   We are guardedly optimistic that CMS will respond favorably and will keep you posted. (The letter will be on the ACEP website).  However, you should submit any outstanding Form 855-I, 855-B and/or 855-R to your carrier/MAC by signed receipt courier or Express Mail with a cover letter showing the applications were mailed and received by the carrier/MAC by December 31, 2008. 

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Medicaid Publishes Final Rule on ED Co-Payments for Non Emergency Visits
The DRA 2005, Sec. 6043 created an option for states to allow hospitals to impose co-payments on Medicaid patients whose visits to the ED have been determined (after the medical screening exam) to be non-emergent.  The co-pay has been quantified in this final rule, but can only be applied if there are viable/available community-based alternatives for care that do not charge co-pays.  We suggest that you check with your hospital(s) to see if they are participating.

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CMS Releases 2009 PQRI Measure Specifications; Nine EM Measures Included
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, Jan. 1, 2009 – Dec. 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule covered professional services furnished during that same period (the 2009 calendar year).

The 2009 PQRI consists of 153 quality measures and 7 measures groups. Nine may be reported as “emergency medicine” measures:
#28:  Aspirin at Arrival for Acute Myocardial Infarction (AMI)
#31:  Stroke and Stroke Rehabilitation: Deep Vein Thrombosis Prophylaxis (DVT) for Ischemic Stroke or Intracranial Hemorrhage
#34:  Stroke and Stroke Rehabilitation: Tissue Plasminogen Activator (t-PA) Considered
#54:  12-Lead Electrocardiogram (ECG) Performed for Non-Traumatic Chest Pain
#55:  12-Lead Electrocardiogram (ECG) Performed for Syncope
#56:  Community-Acquired Pneumonia (CAP): Vital Signs*
#57:  Community-Acquired Pneumonia (CAP): Assessment of Oxygen Saturation*
#58:  Community-Acquired Pneumonia (CAP): Assessment of Mental Status*
#59:  Community-Acquired Pneumonia (CAP): Empiric Antibiotic*
* Clinicians utilizing the critical care code (99291) must indicate the emergency department place of service (23) on the Part B claim form in order to report this measure.

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ED Call Coverage Task Force Representatives
WSMA President and WA-ACEP Board Member, Cindy Markus, MD will chair the task force on the ED call coverage crisis.  Other WSMA representatives are Drs: Dean Martz, Stuart Freed, Kit Baldwin, Steve Murray, and Nick Rajacich. 

WSHA representatives are: Mike Wilson, CEO of Sacred Heart in Spokane; Johnese Spisso, VP of Medical Affairs, UW Medical Center and Harborview; Dr. Mike Newcomb, CMO at Franciscan Health System; Cindy Mayo, CEO, Providence Centralia Hospital; and Mark Benedum - CEO, Highline Medical Center.

The objective of this task force is to review the issues of how limited on-call coverage is placing disproportionate burdens on some communities, and problems of local call coverage, and to seek consensus recommendations on how best to respond – with policy recommendations back to both associations. 

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Health Advisory for King County: Influenza Activity and Antiviral Drug Resistance

Action requested:


- Review information below about influenza activity, vaccination and antiviral resistance.

- Be alert for potential future changes in recommendations for antiviral treatment of influenza based on the results of additional testing as the season progresses. 

- Continuing to vaccinate patients throughout the flu season remains the most effective way to protect as many individuals from influenza infection and its complications as possible.

Influenza activity locally and nationally is at a low level, which is typical for this time of year. Flu season typically peaks in January or later and has been in February or March in 11 of the past 20 seasons.

Most influenza viruses identified and characterized this season are well-matched to the current vaccine. However, it is too early to determine which influenza virus type or subtype will predominate this season. Vaccination efforts should continue during December and throughout the influenza season, which can persist into spring.
Additional information regarding influenza including local influenza surveillance and influenza vaccine, is available from Public Health at: http://www.kingcounty.gov/healthservices/health/communicable/diseases.aspx
Influenza information from CDC is available at http://www.cdc.gov/flu.

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Governor Gregoire to Address WSMA at Legislative Summit – January 26
Governor Gregoire is confirmed to speak at the WSMA Legislative Summit on Monday, January 26 at the Red Lion Hotel in Olympia.  To register to attend, go to www.wsma.org.  The cost is free for all WSMA members.

The Summit will begin with comments from the governor, including what’s in store for health care this legislative session as she outlines the state’s severe budget situation and budget cuts that could impact health care.

After the governor, national communications consultant, Pat Clark, will work with the highly regarded former house speaker, Denny Heck, to demonstrate the best way to communicate our messages with legislators.  It will be an informative, engaging session.

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Basic Health Plan (BHP) Enrollment Trim Begins
The state has begun to cut BHP enrollment.  The Health Care Authority (HCA) plans to reduce enrollment by 7,700 from the current 105,000 over the next seven months, part of the governor’s effort to cut the shortfall in the final six months of the current state budget.  "After December 5, for every two people that drop off, we will only fill one," said Steve Hill, HCA director, in recent press coverage.  The reduction is said to save $6.7 million between now and June 30, 2009.

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New CMS Rule Affects Contracted Interpretations For Diagnostic Tests
Beginning on Jan. 1, the Centers for Medicare & Medicaid Services (CMS) will apply a new rule to certain diagnostic tests (excluding clinical diagnostic lab tests) ordered and billed by physicians or their group practices.

In an attempt to curb what it sees as overuse of diagnostic tests and abusive arrangements between providers, CMS has expanded a Medicare billing rule that prevented physicians from marking up the cost of the technical component (TC) of diagnostic tests purchased from an outside supplier (the "purchased diagnostic test rule"). Now referred to as the "anti-markup rule," the new rule will prohibit a billing entity, such as  a physician or group practice, from marking up either the professional component (PC) or the TC of a test that was performed by a physician who does not share a practice with the billing entity. The rule will apply when the ordering physician and the billing entity are the same or are related through common ownership or control.

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U.S. Emergency Rooms Find Ways To Fix What Ails Them
Hospital emergency rooms are characterized by long waits, patients spending hours or days on beds in ER hallways and shortages of specialists willing to see emergency patients. The cause of the nation's ER overcrowding is obvious: Too many patients and not enough ER capacity.

Today, the emergency department has essentially become the front door to most hospitals. About 50% of hospital admissions, excluding obstetrical services, now come from the ER, up from 36% in 1996, according to a Centers for Disease Control and Prevention report. According to the CDC, the average patient will wait about an hour to see an ER doctor, up from 38 minu!tes a decade ago.Some hospitals are finding ways to make their emergency rooms more efficient while maintaining safety:

• Hospitals such as Cooper Hospital-University Medical Center in Camden, N.J., are forming "fast-track" areas in their emergency departments to more quickly treat patients with minor illnesses and injuries, such as small cuts or ankle sprains. Often, these areas are staffed by physician assistants or nurse practitioners, leaving the doctors to treat more serious problems.
• Hospitals such as Dublin (Ohio) Methodist Hospital are using computerized physician ordering systems to speed patients' ability to get blood tests and other diagnostic tests. All patient records are computerized, making it easier for nurses and doctors to check on a patient's status; all tests can be ordered electronically, which can reduce delays, says Dave Boehmer, the ER medical director.
• Scripps Mercy Hospital in San Diego and Chula Vista has installed a computerized tracking system to help better monitor patients and available bed space to reduce the time patients wait for an in-patient bed. The hospital has also added a second triage area and put a full-time phlebotomist in the emergency department to speed blood testing.
• Hudson Valley Hospital Center in Westchester, N.Y., has implemented what it calls a "no-wait" ER by letting its triage nurse start caring for the patient by ordering tests and moving the patient registration to the bedside via portable computers.

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New Pharmaceutical Guidelines
Physicians' relationships with industry, pharmaceutical companies in particular, have gotten a lot of attention and scrutiny this year. State and federal government officials, as well as industry representatives, are increasingly clamping down on improper financial exchanges.

The Pharmaceutical Research and Manufacturers Association, which represents the country's top pharmaceutical research and biotech companies, adopted a voluntary code that goes into effect next week which lays out what reps should not do—give non-educational items as gifts, take doctors out for meals, and so on. On the flip side, the AMA has ethical guidelines for physicians (also voluntary) outlining what types of gifts physicians should refuse.

There are relationships far more nefarious than gift exchanges that still need to be addressed, including payments for articles in medical journals that endorse a particular therapy or drug. Just last week Sen. Charles Grassley, R-IA, sent letters to pharmaceutical company Wyeth as part of an investigation into the company's involvement in medical ghost writing.

These issues are a ticking public relations time-bomb for physicians. In an era of growing transparency and consumerism, each revelation about a handful of physicians profiting from industry ties erodes the public's trust in all physicians.

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WELCOME NEW WA/ACEP MEMBERS
New Members
Anthony A. Ferroggiaro, MD, FACEP – Spokane
James C. Kussy, MD – Granite Falls
Daniel P. McImail, MD – Tacoma
Matthew D. Otto, MD – Tacoma
Allan H. Rappaport, MD, JD - Seattle
John P. Short, MD – Olympia


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CALENDAR OF EVENTS
May 27-29, 2009
Emergency Medicine Without Borders
Bell Harbor International Conference Center
Seattle, Washington
 
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JOB POSTINGS

Mason General Hospital Emergency Physicians is seeking a partner to join 7 full-time board certified emergency physicians. We are a completely democratic group that staffs a single critical access hospital in Shelton. Excellent contract with paid medical liability insurance. ED Volume approximately 22K/yr. Physician staffing of 34 hours daily. You will be a partner from day one and paid the same as the rest of the group on an hourly rate. We are at the base of the Olympic Peninsula about 20 minutes north of Olympia. Send your CV to Dean Gushee, MD (dgushee@masongeneral.com) or call 360-427-6791.

Needed-a physician to work at Pasco Worker Care, an Occ Med Clinic providing care to injured workers.This is a full time job with competitive salary and benefits. No weekends, nights or major holidays. Experience in EM preferred. Send a resume to drted@yakimaworkercare.com.

Sterling Healthcare is seeking EM physicians to join a growing group and practice in a beautiful setting in Spokane, WA. This Level III trauma center operates 24/7 and is staffed with more than 40 registered nurses experienced in emergency, trauma, and critical care.  The Emergency Services Department also includes cardiac treatment rooms and a separate Express Care Unit.  Physicians work 8 hour shifts with double coverage by physicians and mid- levels in the main ED.  The Express Care unit is open 16 hours a day and staffed by mid-level providers.  Annual ED volume is 43,000 with 21 beds. Candidates must be BC Emergency Medicine or Primary Care with recent ED experience. ACLS, ATLS, and PALS certification required. Sterling Healthcare offers flexible scheduling, independent contractor status, professional liability insurance, CME, and competitive compensation. Please contact Molly Smith at 1-800-877-5520 ext 1020 or email molly.smith@sterlinghealthcare.com or fax CV to 904-805-1418

Magnificent North Olympic Peninsula of WA State: Emergency Physician Openings.  Waterfront or mountain side living, driving distance to Seattle, ferry boat ride to Victoria, BC! Excellent full and part time opportunities now available in our stable, cohesive and collegial group of practitioners. Offering:  private, stable, single hospital democratic group, equally shared night/weekends, excellent pay/benefits, flexible scheduling, no buy-in, equal partnership, 12 hours shifts with mid-level support, 27k annual volume in expanding dept, Level 3 Trauma Center.  We are located at the foot of the Olympic National Park on the bluffs overlooking the Strait of Juan de Fuca, providing magnificent views everywhere you look!  Port Angeles is in the rain shadow of the Olympic Mountains with wonderful out door activities and a wide range of community attractions.  It is the site of Olympic National Park (a World Heritage Site) and a beautiful salt water location with easy access to Seattle and Victoria, B.C.  Email or send CV to: James Wallace, MD c/o Nancy Buckner, Physician Recruiter, Olympic Medical Center, 939 Caroline Street, Port Angeles, WA  908362, 360 417 7231, nbuckner@olympicmedical.org or James Wallace, 360-417-3281, Jwallace@olympicmedical.org.

Wenatchee Emergency Physicians is seeking BC/BE emergency physicians for full time employment and partnership. We see 30k patients per year at Central Washington Hospital, a level III trauma and regional referral center. In addition we are expanding to staff a new ED under construction at the Wenatchee Valley Hospital (attached to the Wenatchee Valley Medical Center). We offer superb recreational opportunities, excellent physician and nursing staff, a growing community, and affordable housing. Contact Tom Ettinger MD FACEP morsno@charter.net 509-679-9708, Scott Stroming MD FACEP stroming@nwi.net 509-679-3635, or one of our partners at Central Washington Hospital 509-665-6163.

Tacoma Emergency Care Physicians (TECP) is a 19 member democratic group of Board Certified/Board Prepared Emergency Physicians staffing two hospitals in Tacoma, WA. We seek a full time emergency physician. Our primary hospital (Tacoma General) is an
urban level II trauma facility with high acuity and superb medical staff in all specialties. Shifts are eight hours with excellent compensation. TECP provides malpractice insurance.  Physicians are eligible for partnership after one year. Located on Puget Sound 35 minutes from downtown Seattle and one hour from the Cascade Mountains, recreational and cultural opportunities abound. Visit our website at www.tecp.net.  Contact Heather Marshall, heathermarshallmd@comcast.net, 253-820-6412.

Eastern Washington - Full Time Opportunity. Samaritan Hospital, Moses Lake, has an annual patient volume of 13,000. The shifts are 12 hrs. with 10 hrs. of PA/NP coverage.  The physician will see an average of 1.25 patients per hour with 12% admission rate. Trauma Capabilities and Resources:  Samaritan Healthcare serves a 75,000 population area with 32,000 in the local area.  Patients transferred are sent by ground ambulance to Central Washington Hospital in Wenatchee or by helicopter to Deaconess Medical Center, Sacred Heart Medical Center in Spokane, or Harborview, Seattle. Physical Description of the Emergency Department:  9 rooms and 10 beds.  This ED includes a trauma/cardiac room, 2 cardiac bays, a pediatric room, casting room, OB room, 2 minor medical rooms, a mental health room and a room with an undesignated function. Availability of Ancillary ServicesRadiology 24/7, Nighthawk:  nights, CT 24/7, Ultra Sound 24/7, MRI off-site, Pharmacy, Pyxis system, Lab, Respiratory Therapy. Brief Description of Community: Moses Lake is the commercial hub of the Columbia Basin in Grant County located at the intersection of Interstate 90 and State Highway 17.  The lake, Moses Lake, is the largest, natural body of fresh water in the county, with over 120 miles of shoreline.  Due to the large number of lakes, streams and the Columbia River this is a fisherman’s paradise, with trout, salmon, bass, spiny ray and walleye pike plentiful. The area is in the path of the Pacific flyway, goose and duck hunting is a sportsmen attraction.  Deer hunting is excellent in nearby Clockum and Blue Mountains which have large elk herds.  Winter sports include an outdoor ice skating rink, downhill skiing at several locations within a few hours drive, as well as cross country skiing and snowmobiling.  The area provides several golf courses, tennis courts, a family aquatic center with water slides and an Olympic size competitive pool.  A large area in nearby sand dunes has been designated for ORV and recreational use. Average annual rainfall is about 8 inches and average snowfall is 15 inches.  For more information about this opportunity, please call: Emily Enck (800) 336-8614 x 2115 or email: emily_enck@teamhealth.com Quality of Care.  Fairness.  Integrity. Professionalism

Full Time Opportunity at Kadlec Medical Center in Richland, Washington a 181 bed acute care facility with a 20 bed CCU, a 19 bed intermediate care unit and a 12 bed short stay unit.  Hospital has a new open-heart surgery suite, an additional cardiac catheterization lab, and new outpatient imaging center.   Summer of 2008, Kadlec will open a new 71.8 million, six story building which will include new operating rooms, a clinical decision unit and a floor of private patient rooms.  Emergency Department consists of 26 beds with state of the art equipment including a robust intranet linked to PC’s throughout the ED and hospital and a separate Fast Track.  Applications include:  MUSE, Micromedex – (Poisondex, drugdex, Emergidex), Web PACS, and internet access, ED includes electronic medical records and Electronic "T" system.  Providers care for 48,000 patients annually with 56 hours of physician and mid level coverage.  Community offers, excellent school systems, golf courses, wineries, and much more.  For more information, please contact: Emily Enck at (800) 336-8614 x 2115 or email: emily_enck@teamhealth.com

Seattle: Academic Pediatric Emergency Medicine (Children's Hospital & Regional Medical Center) The Department of Pediatrics at Children's Hospital and Regional Medical Center/University of Washington School of Medicine is recruiting one or more board certified/eligible Pediatric Emergency Medicine Physician(s) (MD or DO required) at the Assistant/Associate Professor/Professor level. Position(s) may be full-time or part-time. Contact Tony Woodward, MD, MBA, Chief, Division of Emergency Medicine, Children's Hospital and Regional Medical Center, Emergency Medicine B-5519, 4800 Sand Point Way, NE , Seattle, WA 98105, 206-987-1371, Fax 206-729-3072, E-mail: Tony.Woodward@seattlechildrens.org

Seattle: Pediatric Urgent Care and Emergency Medicine (Children's Hospital & Regional Medical Center) The Department of Pediatrics at Children's Hospital and Regional Medical Center/University of Washington School of Medicine is recruiting two board certified/eligible Pediatric Emergency Medicine Physicians ((MD/DO required) at the Assistant/Associate Professor/Professor level.
Contact Tony Woodward, MD, MBA, Chief, Division of Emergency Medicine, Children's Hospital and Regional Medical Center, Emergency Medicine B-5519, 4800 Sand Point Way, NE , Seattle, WA 98105, 206-987-1371, Fax 206-729-3072, E-mail: Tony.Woodward@seattlechildrens.org

Washington, Walla Walla:  Independent, democratic group seeking BC/BE emergency physician to join our growing group.  We staff St. Mary Medical Center ED which has a 20k patient volume.  Good specialty backup and hospital administration support.  Both St. Mary Medical Center and our ED physicians are ranked in the top 1% nationally.  Level III trauma center for adults and pediatrics.  State of the art 3 yr old ED. You are equal in terms of shifts, salary and benefits from day one.  Come live and work in the heart of WA wine country at the foot of the Blue Mountains.  Contact Byron Miller, MD at Walla Walla Emergency Physicians 401 W. Poplar Walla Walla, WA 99362 (509) 522-5802 or email your CV to byron.miller@providence.org    

At Legacy Salmon Creek ED in Vancouver we have two physician openings: 1) BC/BE residency-trained Emergency Physician AND  2) BC/BE Pediatric Emergency Physician.  Legacy Salmon Creek is a 164 bed hospital which is being built out to 220 beds.  The ED saw 48,300 patients in 2007 and about 13,500 are children.  We continue to grow.  We have a separate Pediatric Emergency Department staffed by 3 BC Peds EM physicians, a Peds Critical Care (PICU) physician and Peds-trained and dedicated RNs for 9 to 14 hours/day.  We seek to replace one PEM physician who is returning to Chicago for family reasons and expand our Peds ED hours.  The hospital has an inpatient pediatric service staffed by pediatric hospitalists 24/7, a level 3B NICU and very busy Family Birth Center.  We work closely with Legacy Emanuel Hospital which is a tertiary pediatric Children’s Hospital with PICU.  In 3 years Legacy Children’s Hospital will build a $260 million dollar 7-story Children’s Hospital with 32-bed Pediatric ED.  It is also a Level 1 Trauma Center.  The Legacy Salmon Creek Hospital ED has no trauma designation, but sees trauma, nonetheless. We staff 5 x 8 hour shifts/day (40 hours) in the ED and 2 shifts/day (12 hours) in the ambulatory section of the ED.  The ED and hospital opened just 3 years ago.  The ED is a beautiful, 32-bed state-of-the-art facility.  Due to rising census, a 16 bed extension to the ED is being considered. Our 140 member Emergency, Pediatric Emergency, and Ambulatory physician group ( Northwest Acute Care Specialists (NACS)) staffs the five Legacy Health System Hospital EDs and an Ambulatory Clinic in St. Helens.  NACS is a democratic, independent physician group which contracts exclusively with the Legacy Health System to care for 230,000 patients/year.  We are the largest democratic, independent Emergency Physician Group in the Northwest. Legacy Salmon Creek Hospital is located in a new and growing section of Vancouver, WA with 15 minute access to Portland via I-5.  For more information, contact:
J. Michael Albrich MD FACEP FACP
President, Northwest Acute Care Specialists
Medical Director, Emergency Services
Legacy Salmon Creek Hospital
Vancouver, WA 98686
Office: 360.487.1475
Fax: 360.487.1499

Yakima Regional Medical Center-FT and PT Physician Openings
Yakima, WA – Yakima County - 214 Bed Hospital / 21-bed ED including 10-bed Fast Track and designated trauma bays- Estimated Annual Volume of 29K, 2.38 PPH - BC/BE Emergency Medicine, PALS required - 12 hr shifts with 24 hrs of physician coverage + 8 hrs Family Nurse Practitioner coverage in ED - Additional 8 hrs physician assistant coverage in Fast Track - Competitive Fee For Service Incentive Plan - “A” Rated Malpractice Insurance Program with No Tail Obligation upon departure! Yakima is located in the heart of Washington State, only 2 hours from Seattle. The beautiful agricultural settings include national forests, wildlife viewing, lakes, streams, rivers, skiing and hiking. The Yakima Valley is also the state’s most densely populated wine region. For more information, please contact John Torres, Physician Recruiter at 800-230-5160 ext 3025, email: john_torres@emcare.com, fax: (805) 564-5087. Please visit our website at www.EmCare.com.

Abrupt retirement of a full partner for health reasons has caused us to have immediate opening for a board el/cert emergency physician at Stevens Hospital, Edmonds, Wa. at 42K ED staffed by Edmonds Emergency Physicians, a democratic, single hospital group. Please contact Richard McClelland MD FACEP at richard.mcclelland@comcast.net or at 425-742-3708.

Immediate FT Locum position and PT position available with Associated Emergency Physicians, Inc. at Valley Medical Center. Potential for FT continued employment.
Stable independant democratic group, staffing a single hospital with over 72,000 visits. Level III trauma center. New 56-bed ED under construction. Competitive compensation and benefits. Must be residency trained and board eligible or board certified. Send CV or contact Pattie Giuliani:425/228-3440x2975. Fax: 425/656-5016 email: pattie_giuliani@valleymed.org.

Seattle - Highline Emergency Physicians is democratic independent group of physicians currently seeking full-time ABEM prepared/certified physician. We are a one hospital, two facility group with 8 hour shifts triple coverage in our high volume facility (45 K visits annually) and single coverage in our low volume facility (15 K visits annually). Friendly work environment with rapid patient turnaround and a planned construction of a new department on the horizon. Flexible scheduling allows for ample free time to enjoy the Northwest's abundant opportunities for outdoor recreation. Great nurses! We provide competitive compensation and paid malpractice, health and dental. We are a well established group (contract held for 25 years), respected by the medical staff and community. Send CV to Carter Hill MD; e-mail: carterhill@comcast.net or Fax 206-236-8063, Mobile # 206-409-7598. Position is available summer of 2008 for qualified and credentialed candidate!

Are you considering a change of employment? If so, don't make a move until you give us a call. At any one time we have physician openings across, Washington, Oregon, Idaho, Montana and Wyoming. Northwest Emergency Physicians-TEAMHealth is the largest employer of emergency medicine physicians in the Northwest. Contact: Emily Simpson (800) 336-8614 x 2115 or email: emily_simpson@teamhealth.com or Lynn Benson at (800)336-8614 ex 2123/fax (253)838-6418 or lynn_benson@teamhealth.com

CRAssociates, Inc. (CRA) is a national healthcare management company that is committed to the delivery of high-quality health care services. We have a need for full-time Emergency Medicine Physician to support the Naval Hospital Bremerton. Requirements include:
· Board Certified as an Emergency Medicine Physician
· Min one year exp in last 3 years
CRA is proud to offer you a team environment, excellent compensation and benefits, as well as company-paid professional liability insurance. Please send your resume to Human Resources at one of the following: Fax: 866-550-1476 (Toll Free) Email: ckm@crassoc.com CRA is proud to be an equal opportunity employer.

Washington, Kitsap Peninsula: We staff two brand-new ED's seeing a total of 60,000 pts/annually and seek a full-time BC EM Physician to expand coverage. Established, progressive, democratic group with excellent compensation and benefit package. Mountain and Ocean recreation opportunities abound. One-hour ferry ride to Seattle. See Website: www.harrisonmedical.org E-mail CV to: Gail Donavan at gdonavan@harrisonmedical.org

Longview- Cascade Emergency Associates is looking for BC/BP emergency physicians. Stable and growing practice in a Level III trauma center. Usually one of the busiest practices in the state, with a census in 2005 of 49,500. Brand new ED under construction. Wonderful family-oriented community located on the Columbia River close to a myriad of recreational opportunities. Democratic scheduling and compensation. Contact Holly Liberatore MD, PO Box 2404, Longview, WA 98632, or email liberatoreh@comcast.net

Immediate Full-Time Position for BC/BE EM Physician with Kennewick Emergency Physicians, a Democratic Group staffing a single hospital, 30,000 annual visits with moderate acquity on the banks of the Columbia River. Generous Competitive Package, Guarantee plus Incentive Compensation, Liability Insurance included, Relocation Expenses included, Full Partnership Tract in 18 months, 8-11hour shifts, Double coverage during peak hours, average 12-14 shifts/month with 3 weeks off/quarter built into schedule. Enjoy a peaceful lifestyle in this friendly community of approximately 200,000. Take advantage of hundreds of miles of waterways- fishing, water sports and beautiful sunsets- all near the mountains, over 300 days of sunshine annually, over 40 local wineries. Contact Louis K. Koussa DO, FACEP; 509-521-3396 or 509-627-1798 and email your CV to loukoussa@yahoo.com

WANTED: Emergency physicians for bipolar company. Quark (www.quarkexpeditions.com) leases Russian Icebreakers for 10 to 25 day voyages to the polar regions. We are in need of ED physicians willing to serve as ship’s doctor. On any ship, there at most 110 passengers and 50 crew members. No dressing up and no night life except the scenery and animals. Contact Dr. Dan Zak at zak38@aol.com. Please let your colleagues know about this as well.

Looking for FT & PT physicians in Central WA. (180 miles from Seattle). Enjoy this desert garden with the finest fruits and vegetables as well as the home to award-winning wineries! Washington State designated Level-4 Trauma Center with a 17K estimated annual patient volume. Efficient support staff with a great pace & good mix of patients. Medium to low acuity. Qualifications: BC/BE EM or IM and FP accepted with significant ED experience. We offer an A-rated malpractice insurance program with no-tail obligation upon departure. This is an Independent Contractor facility with a competitive hourly rate and generous sign-on bonus! For more information, please contact John Torres, (800) 230-5160 ext. 3025, john_torres@emcare.com Visit our website at www.emcare.com

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