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I’m delighted to have Kelly Wranik joining the WCMS team this fall to help us assess our mini-internship program so that we can make it even better. Kelly is a senior in UNR’s Community Health Sciences program where she’s majoring in public health.

During her internship, she will be interviewing past participants and physicians, local and state leaders and other key community leaders who can influence health care in our community. Our objective is to identify ways we can adapt or revise the program in order for it to obtain participation from those who influence legislation, regulations and policies concerning health care and the practice of medicine.

The outcomes will be an assessment and recommendations that our public relations committee will use to update and revise our mini-internship program for 2018.

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Suicide can be Prevented

Suicide is an unfortunate reality that takes the lives of an estimated 400 physicians in U.S. every year. Fortunately, depression, suicidality, mental health and distress are responsive to proper intervention. Doctors too.

Nevada regulations now require physicians to earn two CME credits every four years in an effort to promote physicians’ abilities to recognize a patient who might be in danger of harming himself or herself. However, the regulation doesn’t address suicide prevention for physicians.

It raises the question: “While we’re looking out for our patients,  who’s looking out for us?”

At the Nevada State Medical Association annual meeting in late August, the first CME program about suicide prevention was presented. A few days later, one of our own members took his life.

Tragically, we lost John Maberry, M.D., a member of WCMS, in late August. He was remembered Sept. 9 at Idlewild Park during the “Walk for Hope,” sponsored by the Nevada Coalition for Suicide Prevention. But, we need to do more.

In the president’s letter to members, Dr. Andrew Pasternak encouraged members to please make sure to check in with colleagues and partners during difficult times. Additionally, we need to take the first step to combating this problem by freely communicating about depression, mental illness and suicide. If you need help, please contact Dr. Pasternak at 775-219-6535 or WCMS at 775-825-0278. Anyone also can call the Nevada Coalition for Suicide Prevention at 775-687-0847 or 775-687-0849. Rest assured, confidentiality will be maintained.

This is our first step—communication about suicide and opening avenues for those who wish to talk. We thank psychiatrists Steven Rubin, M.D., and Charles Price, M.D., both of whom have offered to be available to members who want to talk.

The next step–WCMS is beginning to explore ways in which we can provide a physician wellness program. This will take time but it is an important step. Many of our medical society colleagues have programs in place that we can explore as we determine how to implement our next step—creation of a program. Your input is appreciated.

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By Bruce Knowlton
National Certified Chi Kung/Tai Chi Teacher

A Sigh of Relief is one of the most powerful self-healing tools we have. Unfortunately, most people do not use it until they are frustrated and angry. It is always preferable to release rather than to store anger, frustration, anxiety and worry. Science has proven that those emotions actually sabotage the immune system and other self-healing mechanisms by producing poisonous chemicals within the body.

If one practices the Sigh of Relief 25 to 30 times a day, it creates a tool the body will use whenever any stress arrives. One will find themselves doing the Sigh of Relief without thinking about it.

Here’s how to do it:

Breathe in, using the diaphragm. On the exhalation release an audible sigh. The sigh can be a sweet, relaxed, soft sigh expressing restfulness and trust, visualize peace and safety. Or it can be a loud groan, freeing accumulated frustration, anxiety, and other tensions. Do it several times. Pay close attention to the sensations you experience. The Sigh of Relief gets your internal medicine moving immediately.

Application Suggestions:

Health Maintenance: As soon as you feel tension building up in your system, use the practice as a prevention.

Health Improvement: Use the method more often. Find a way to be more aware of when tension is just beginning to build up.

Disease Intervention: This practice is a powerful healing tool. Use it often. Even if you are limited in your movement or must spend time in bed, it dramatically activated the relaxation response.

Benefits: Deep breaths are the best lymph pump. The relaxation on the sigh shifts the function of the autonomic nervous system and releases healing neurotransmitters into the system. The capillary circulation opens up when tension is releases, which dramatically reduces blood pressure and the risk of heart attack.

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Two of our members have been voted the Best of Reno Doctors. Jennifer Racca, M.D., Digestive Health Associates, was voted a gold winner in Reno Magazine’s Health & Beauty category. Ali Nairizi, M.D., Nevada Pain, was selected the silver recipient.

Dr Jennifer Racca, Digestive Health Associates
Dr Jennifer Racca, Digestive Health Associates
Dr. Ali Nairizi, Nevada Pain
Dr. Ali Nairizi, Nevada Pain

This was the magazine’s first Best of Reno contest. More than 20,000 area residents voted for their favorites in categories including: Food & Drink, Health & Beauty, Resorts & Gaming, Shopping & Services, Places to Go & Things to Do.

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From left: Mary Ann McCauley, WCMS executive director; Denise Savell, DNP, RN and Anita Savell attended Dean Thomas Schwenk’s, state of the medical school address where Anita was recognized by Dr. Schwenk as one of the first-year student’s and for her research work.

My name is Anita Savell. I am a first-year medical student at UNR Med. Through this column I will share my medical school experience I progress through my education.

With just one month of medical school behind me, I have a lot to learn, but in this short time I have already learned several important lessons. First, everything people say about the demands of medical school is true. In order to stay on top of the flow of information, I am either in class or studying from 8am until 10pm. After learning lesson one, I quickly learned lesson two: the importance of balance. I have begun building things I can look forward to into my schedule.

Medical school is a constant challenge and the admissions process reflects this rigor.

The medical school application cycle made for a grueling year. With June came over twenty drafts of a personal statement. July saw an onslaught of secondary applications and late nights writing after long days working in a laboratory. August through February brought a half dozen interviews spanning the country as I balanced traveling with finishing my senior year
in electrical engineering.

The interview circuit was filled with surprises. The day before an interview in Georgia, I was driving around towns outside Atlanta when the air got very still, the sky got dark, and sirens began to ring. I ducked inside a big box store, and we were all told to take shelter in the photo department—a tornado had touched down in town. Let’s just say I was glad I got rental insurance.

When planning for one February interview, the cheapest hotel I could find was a $200 per night Motel 6. I jokingly asked my dad, an avid football fan, “Is Houston hosting the Super Bowl or something?”. His eyes widened and he tried to keep from smiling. Sure enough I would be traveling to Houston, Texas, the fourth largest city in the country, when the largest sporting event of the year was happening within walking distance of my interview.

Thankfully I survived both the Super Bowl crowds and the tornado unscathed. The application cycle ended in May, when I decided to attend the University of Nevada Reno School of Medicine.

Editor’s Note: Anita joins us as a regular columnist in The Communicator to share her observations and experiences so we can follow her through her medical school journey.

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The Washoe County Medical Society (WCMS) and the Nevada State Medical Association (NSMA) advocate for physicians in the legislature and in front of regulatory boards such as the Nevada State Board of Medical Examiners, Nevada Dental Board, Board of Osteopathic Medicine, State Board of Pharmacy and the State Board of Health, among others.

2016-2017 Regulatory Successes

  • Successfully defeated a Dental Board regulation which authorized Dentists and Dental hygienists to administer botulinum toxin (“botox”) and dermal filers.
  • Successfully defeated a Board of Health regulation which would require all providers of care to report actual or suspected cancer to the Cancer Registry or face a $25,000 fine.
  • Successfully lobbied to pass a new regulation that allows physician prescribers to delegate the transmission of an electronic prescription to a designated agent such as an RN, MA or scribe.
  • Successfully negotiated a Board of Medical Examiner’s regulation to provide common sense guidelines for physician oversight of a Medical Assistant.

2017 Legislative Successes

  • Secured Governor’s veto of an insurance company bill that would ban balance billing and cap fees for out of network health care services to the insurer’s economic advantage.
  • Negotiated with the Governor’s office to ensure new opioid legislation preserves clinical judgment and avoids draconian prescribing caps found in other states.
  • Improved a collaborative pharmacy bill to ensure that physician’s oversight and clinical judgment directs the patient care and to clarify in Nevada law that pharmacists do not diagnose.
  • Negotiated a common-sense revision to a proposed partnership bill which allows physicians and psychologists to form partnerships and still protects the tenants of Nevada’s implied prohibition of the corporate practice of medicine.
  • Defeated a measure which would criminalize and prohibit a physician from performing any procedure deemed to reassign the anatomical sex of a patient including relocating the urethral meatus, unless the child assented to the procedure.
  • Successfully removed physicians from a bill that would assess a “provider tax” on all physicians to leverage monies for Medicaid funding.
  • Protected patients from unskilled application of botulinum toxin
    (“botox”) by limiting those licensed professionals who may administer and requiring that botox injections be administered only by licensed professionals in a medical facility.
  • Protected Ambulatory Surgical Centers from attempts by hospitals to force certain procedures into hospitals.
  • Secured Governor’s veto of a bill that would allow any Nevadan to purchase Medicaid without limitation.
  • Negotiated the reduction of proposed mandatory CME for suicide prevention from 3 CME units every two years to 2 CME units every four years.
  • Worked with Board of Medical Examiners to authorize their ability to take possession of records due to physician death or another incapacitation.
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Dr. Thomas Schwenk Dean of the School of Medicine and VP of Health Science
Dr. Thomas Schwenk Dean of the School of Medicine and VP of Health Science

August is always an exciting month at UNR Med, as new students arrive to begin their medical studies and careers. This August was more exciting than usual. UNR Med welcomed the Class of 2021 to our fully northern Nevada-based medical school with a new and exciting orientation experience – MedFIT.

MedFIT is modeled after NevadaFIT, the academic boot camp for incoming University of Nevada, Reno undergraduates. Rather than a quick one- or two-day orientation, where students are told about our School of Medicine, they get to experience UNR Med firsthand.

Our 70 new students were involved in activities designed to build relationships with UNR Med and main campus faculty and staff, and perhaps more importantly, with each other. An extremely interesting group, our incoming class speaks 20 languages, has lived in or traveled to 28 countries and has interests ranging from skydiving to playing the French horn to fighting wildfires.

The two-week orientation included labs, lectures, team building exercises, one-on-ones with faculty and leadership, and Art Rounds – an innovative visual teaching session. MedFIT concluded with Family Day and the time-honored White Coat Ceremony, where each student committed to a lifetime of learning, teaching and compassionate care by reciting the Honor Pledge.

Once the festivities came to an end, our students went to work. Classes began August 14, and I had the pleasure of working with first-year students in the Student Outreach Clinic (SOC) the very next day. UNR Med first-year students receive immediate hands-on experience with patients at the SOC, where they are supervised by licensed faculty and community physicians to provide medical care to those in the community who would otherwise go without.

During our UNR Med 2017 State of the School Address on Sept. 12, I highlighted the components of a successful and sustainable School of Medicine and how they work together to usher in a new era of Nevada medical education. MedFIT, a 98.2 percent match rate and a spot (no. 13) in the nation’s top 20 most affordable medical schools are just a few examples of UNR Med’s contributions to student success. We are constantly engaged in conversations with students to look for ways to evolve, improve, and meet their needs and actively incorporate our mission and values in the foundation of a richly-rewarding medical education.

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Pasternak_Andy-200x300I hope all of you had a fun summer full of great memories. Summer always seems to be over in the blink of an eye. As a kid, I always thought that was just because school was out. Turns out, summers seem to be over even faster as an adult!,

Similarly, business is whisking along for the Washoe County Medical Society. Over the past few months, Mary Ann McCauley has created an incredible strategic plan with great input from our WCMS members, which sets our goals for the next few years. She also has been exploring ways WCMS can collaborate with other local organizations to improve the health of our community.

As a great example, WCMS will partner with Immunize Nevada, Renown, and the University of Nevada Reno School of Medicine to promote a fascinating vaccine documentary which will be shown for medical students, residents and undergraduate health sciences students at UNR (WCMS members are also invited!). Every time I mention I am the current WCMS President to someone in the community, I inevitably hear praise for Mary Ann and the energy she brings to WCMS.

Another example of “good energy” was the recent turn out of WCMS delegates for the Nevada State Medical Association annual meeting.
I want to thank all the delegates for taking time away from their families and work on a precious weekend to share their expertise. Every year, I walk away from the NSMA meeting having learned something from my colleagues and this year was no different. We had several thoughtful resolutions that addressed issues such as obesity, domestic abuse, “stop the bleed” education, patient care surveys, and maintenance of certification. If you haven’t had a chance to see the final versions of the resolutions, check them out on the NSMA website.

This year’s NSMA meeting was also notable for our own Dr. Steven Parker being sworn in as NSMA president. All of us at WCMS are looking forward to working with Dr. Parker during his tenure and are excited about fixing some of the database and website problems we have in common over the next few months.

Finally, one other bit of good news. After numerous meetings and some incredible work from Catherine O’Mara, the Nevada Board of Pharmacy recently agreed to a new regulation allowing medical assistants and other delegated agents to initiate electronic prescriptions for medications under the supervision of a physician. While there is still one small hurdle to go before it’s official, we were excited to see this change. WCMS and NSMA will work with practices to make sure that medical assistants are properly trained on e-prescribing and will collaborate with the Board of Pharmacy on the content of this training.
Now that fall is here, I hope you enjoy the cooler temps, changing colors, and getting outside in the mountains for this incredible time of year.

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Requests for a Repeat Next Year

On Sept. 14 members, their families and potential members gathered at Bartley Ranch Regional Park for a picnic and networking. More than 100 attended with many suggesting we make this an annual event. It was made possible through a generous grant from Spine Nevada without whom we couldn’t have offered it at no cost to members. Help us extend a hardy “Thank You” to our sponsor. Watch you emails and upcoming issues of the Communicator for future events.

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Cultural-Competencies-Transgender-Health-WCMS

Join Project ECHO Nevada and Transgender Allies Group for a very special ECHO clinic presentation on:

Cultural Competencies in Transgender Health Care

September 27, 2017 from 12pm to 1pm
Guest Speaker: Dana Pardee
Director of Epidemiology Projects at the Fenway Institute
The cost to attend is free and you can join via computer or smart phone click to download video program:
https://echo.zoom.us/j/684551843

Project ECHO clinics are held via videoconference and are an opportunity for primary care providers at all levels to connect with medical specialists on a variety of topics.

To learn more please visit: med.unr.edu/ECHO

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