Dr. Markus is a leader in improving trauma care in Washington state and is a clinic instructor of family medicine at the University of Washington   Please join us in congratulating Dr. Markus on her new position.

The following physicians were also elected as officers at the association’s annual meeting:

Dr. Deborah J. Harper, Spokane pediatrician, president-elect; Dr. Dean Martz, Spokane neurosurgeon, 1st Vice President; Dr. Nicholas Rajacich, Tacoma orthopedic surgeon, 2nd Vice President; Dr. Ronald R. Morris, Puyallup family physician, Secretary-Treasurer; Dr. Douglas R. Myers, Vancouver otolaryngologist, Assistant Secretary-Treasurer. The seventh officer of WSMA Executive Committee is past-president, Dr. Brian P. Wicks, Silverdale orthopedic surgeon, who will serve as committee chair.

HEALTH ADVISORY: SALMONELLA INFECTION
October 7, 2008
Action requested:

Public Health is investigating a cluster of Salmonella cases reported in the past week, including 3 with links to a restaurant in Seattle’s Chinatown/International District. The first week of October saw 11 reports of suspected or confirmed salmonellosis, compared to 22 cases for all of September 2008. 

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The WSMA’s 2009 organizational priorities report was approved.  The report includes these priorities:

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On Oct. 1, CMS began publishing on its Web site most system edits in the Medically Unlikely Edit (MUE) program, according to a news release from the agency.

The MUE program was launched in January 2007 to reduce billing errors, but until now most edits were not publicly released because they were considered confidential.

Because the MUE program also detects questionable payments that could be linked to fraud or abuse, CMS said in the release that some of the 9,700 MUE program edits would not be published.

Click here for more information on the MUEs including FAQs: http://www.cms.hhs.gov/NationalCorrectCodInitEd/08_MUE.asp#TopOfPage.

Please contact Shuan Tomlinson at 800-338-2746 ext. 4547 or by email at stomlinson@acponline.org with questions on these or other topics.

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MEDICARE WON'T PAY FOR MEDICAL ERRORS
Beginning October 1, 2008, Medicare will stop paying hospitals for the added cost of treating patients who are injured in their care. Medicare has put 10 "reasonably preventable" conditions on its initial list, saying it will not pay when patients receive incompatible blood transfusions, develop infections after certain surgeries, or must undergo a second operation to retrieve a sponge left behind from the first. Serious bed sores, injuries from falls, and urinary tract infections caused by catheters are also on the list. Officials believe that the regulations could apply to several hundred thousand hospital stays of the 12.5 million Medicare covers annually. The policy will also prevent hospitals from billing patients directly for costs generated by medical errors

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LEGISLATIVE UPDATE
As the 110th Congress comes to a close, the House and Senate cleared several health care bills in the last few weeks and sent them to President Bush for his signature:

• Poison Center Support, Enhancement, Awareness Act of 2008 (S.2932) – Reauthorizes the nationwide toll-free phone number for poison centers, expands the national media campaign and continues grants for the 61 national poison control centers.
• Health Care Safety Net Act of 2008 (H.R. 1343) – Reauthorizes the health centers program through 2012.
• "Michelle's Law" (H.R. 2851) – Ensures that dependent students who take a medically necessary leave of absence from school do not lose health insurance coverage, and for other purposes.
• "QI Program Supplemental Funding Act of 2008"(S. 3560) – Provides $45 million in supplemental funds for the Qualifying Individuals (QI) program that helps Medicare beneficiaries pay premiums for outpatient care.
  

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MENTAL HEALTH PARITY PROVISIONS
Mental health parity legislation was included in the $700 billion bailout of Wall Street firms passed today by the House and on Wednesday by the Senate.  The legislation would require group health plans of 51 or more employees to cover mental illnesses at the same level as physical ailments.  It does not require the plans to offer such coverage but it must be equivalent if they do. Health plans violating the requirement could be subject to federal excise taxes 

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ACEP LEGISLATION
This week, Reps. Yvette Clarke (D-NY), Bill Pascrell, Jr. (D-NJ) and John Larson (D-CT) signed on as co-sponsors of the “Access to Emergency Medical Services Act (H.R. 882/S. 1003).”

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• Physicians participating in Bridges to Excellence's Physician Office Link, using CCHIT-certified EHRs, can earn up to $50 bonus per year for each patient who meet expectations of at least one clinical improvement program for conditions such as diabetes, and $125 per year for each patient treated under the medical home care model.
• The $150 million Medicare demonstration project provides incentives to 1,200 physician practices for using certified EHRs to improve care.
• New York City's Primary Care Information project has committed $60 million to physicians who work in high-poverty areas.

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MASSACHUSETTS ORDERS HOSPITAL ERS TO HALT DIVERSIONS
Officials at the state Department of Public Health have ordered Massachusetts hospitals to stop turning away ambulances when their emergency rooms are overcrowded. While the practice may give hospitals temporary breathing room, Paul Dreyer, director of healthcare safety and quality, said it has done nothing to solve the problem of patients backing up in ER hallways because hospitals have no open beds. Instead, diverting ambulances has caused problems, he said, interfering with patient choice, increasing the time patients spend in ambulances, tying up the vehicles, and shifting crowding to other hospitals

Several national patient safety groups and the American College of Emergency Physicians discourage the routine use of diversion to solve ER overcrowding. Under the new policy, hospitals will be allowed to close their ERs to ambulances only if they have a serious internal emergency such as a major fire, called a "code black."

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ER PATIENTS OFTEN LEFT CONFUSED AFTER VISITS
A vast majority of emergency room patients are discharged without understanding the treatment they received or how to care for themselves once they get home, researchers say. And that can lead to medication errors and serious complications that can send them right back to the hospital.

In a new study, researchers followed 140 English-speaking patients discharged from emergency departments in two Michigan hospitals and measured their understanding in four areas — their diagnosis, their E.R. treatment, instructions for their at-home care and warning signs of when to return to the hospital.

The study, published online in July by the Annals of Emergency Medicine, found that 78 percent of patients did not understand at least one area and about half did not understand two or more areas. The greatest confusion surrounded home care — instructions about things like medications, rest, wound care and when to have a follow-up visit with a doctor.

The problem is particularly acute when it comes to drugs. A patient-education program used in 130 health delivery systems across the country found that about 40 percent of patients 65 or older have a medication error after they leave the hospital. A 2006 report by the Institute of Medicine found that doctors and nurses were contributing to these errors by not providing information in an effective way.

Experts in doctor-patient communication recommend a “teach back” approach, in which the patient, preferably accompanied by a relative, friend or caregiver, has to repeat the instructions back to the doctor.

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JOB POSTINGS

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 Services:  Radiology – 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

0.6-0.8 FTE position available at Group Health emergency services facility in Bellevue.  Group Health has moved its emergency practitioners and staff to this new, state-of-the art facility physically attached to Overlake Hospital.  Although our official name is urgent care we continue to see 95% of the same emergency and urgent patient volume we managed at Eastside Hospital Emergency Department in Redmond.  We are open 24/7 for Group Health patients and admit directly to Overlake.  24/7 Telemetry/observation service as well. Compensation at ED level.  ABEM/OBEM or board elligibility required.  Position can be locum if working less than 0.5 fte or can be either locum or regular staff at 0.5 and above.  Start time November 2008. Contact John Mercier, MD by email - mercier.j@ghc.org

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.

Full-time position, possibly also part-time position, for BC/BE EM, FP, or IM physician. Join our private, single hospital group at the foot of the Olympics, overlooking the Strait of Juan de Fuca. ED volume 27K. Excellent pay and benefit package. Schedule is flexible, allowing a great lifestyle in the most beautiful part of Washington. Please send CV and questions to James Wallace, M.D., at jamescwallace@msn.com, and/or call 206-349-7627 for more information.

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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