Sombrero

Pima County Medical Society

Home Medical Society of the 17th United States Surgeon General

March 2013

AHCCCS expansion is win-win ACA: Unaffordable Care Act

In Memoriam: We say farewell to eight PCMS physicians

D DIIS SA AB BIIL LIIT TY YL LIIM MIIT TS SO ON NT TH HE ER RIIS SE E

YOU YOUEXAMINE EXAMINEYOUR YOURPATIENTS PATIENTSEVERY EVERYDAY, DAY,OFTEN OFTENDISCOVERING DISCOVERINGRISKS RISKSNOT NOTOUTWARDLY OUTWARDLYAPPARENT. APPARENT. BUT BUT HOW HOWOFTEN OFTENDO DOYOU YOUEXAMINE EXAMINEYOUR YOUROWN OWNRISKS? RISKS? IT ITMIGHT MIGHTBE BETIME TIMETO TOTAKE TAKEA ACLOSER CLOSERLOOK. LOOK.
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Associates Associatesof ofWealth WealthManagement ManagementStrategies Strategieso o er ersecuri securi titi es esthrough throughAXA AXAAdvisors, Advisors,LLC LLC(NY, (NY,NY NY212-314-4600), 212-314-4600),member memberFINRA, FINRA,SIPC. SIPC. Investment Investmentadvisory advisoryproducts productsand and services serviceso o ered eredthrough throughAXA AXAAdvisors, Advisors,LLC, LLC,an aninvestment investmentadvisor advisorregistered registeredwith withthe theSEC. SEC. Annuity Annuityand andinsurance insuranceproducts productso o ered eredthough thoughAXA AXANetwork, Network,LLC. LLC. Wealth Wealth Management ManagementStrategies Strategiesisisnot notaaregistered registeredinvestment investmentadvisor advisorand andisisnot notowned ownedor oroperated operatedby byAXA AXAAdvisors Advisorsor orAXA AXANetwork. Network. AXA AXAAdvisors Advisorsand andAXA AXANetwork Networkare arenot not a a liated liated with with Pima Pima County County Medical Medical Society. Society. PPG PPG 69384 69384 (07/12) (07/12)

SOMBRERO March 2013

Sombrero
Pima County Medical Society Ofcers
President Charles Katzenberg, MD President-Elect Timothy Marshall, MD Vice President Melissa Levine, MD Secretary-Treasurer Steve Cohen, MD Past-President Alan K. Rogers, MD

Official Publication of the Pima County Medical Society Members at Large

Richard Dale, MD Anant Pathak, MD

Vol. 46 No. 3

PCMS Board of Directors

Diana V. Benenati, MD R. Mark Blew, MD Neil Clements, MD Executive Director Steve Nash Phone: 795-7985 Fax: 323-9559 E-mail: steve5199@simplybits.net Advertising Bill Fearneyhough Phone: 795-7985 Fax: 323-9559 E-mail: billf 5199@gmail.com

Michael Connolly, DO Bruce Coull, MD (UA College of Medicine) Stewart Dandorf, MS, MPH (student) Howard Eisenberg, MD Afshin Emami, MD Randall Fehr, MD Jamie M. Fleming (student) Alton Hank Hallum, MD Evan Kligman, MD Melissa D. Levine, MD Clifford Martin, MD Kevin Moynahan, MD Soheila Nouri, MD Jane M. Orient, MD Guruprasad Raju, MD Scott Weiss, MD Victor Sanders, MD (resident) Editor Stuart Faxon Phone: 883-0408 E-mail: tjjackal@comcast.net Please do not submit PDFs as editorial copy. Art Director Alene Randklev, Commercial Printers, Inc. Phone: 623-4775 Fax: 622-8321 E-mail: alene@cptucson.com

Thomas Rothe, MD, president-elect Michael F. Hamant, MD, secretary

Board of Mediation
Bennet E. Davis, MD Thomas F. Griffin, MD Charles L. Krone, MD Edward J. Schwager, MD Eric B. Whitacre, MD

At Large ArMA Board

Ana Maria Lopez, MD,

Pima Directors to ArMA Timothy C. Fagan, MD R. Screven Farmer, MD Delegates to AMA

William J. Mangold, MD Thomas H. Hicks, MD Gary Figge, MD (alternate)

Arizona Medical Association Ofcers

Gary Figge, MD, immediate past-president

Printing Commercial Printers, Inc. Phone: 623-4775 E-mail: andy@cptucson.com Publisher Pima County Medical Society 5199 E. Farness Dr., Tucson, AZ 85712 Phone: (520) 795-7985 Fax: (520) 323-9559 Website: pimamedicalsociety.org

SOMBRERO (ISSN 0279-909X) is published monthly except bimonthly June/July and August/September by the Pima County Medical Society, 5199 E. Farness, Tucson, Ariz. 85712. Annual subscription price is $30. Periodicals paid at Tucson, AZ. POSTMASTER: Send address changes to Pima County Medical Society, 5199 E. Farness Drive, Tucson, Arizona 85712-2134. Opinions expressed are those of the individuals and do not necessarily represent the opinions or policies of the publisher or the PCMS Board of Directors, Executive Ofcers or the members at large, nor does any product or service advertised carry the endorsement of the society unless expressly stated. Paid advertisements are accepted subject to the approval of the Board of Directors, which retains the right to reject any advertising submitted. Copyright 2013, Pima County Medical Society. All rights reserved. Reproduction in whole or in part without permission is prohibited.

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SOMBRERO March 2013

Inside
6 Dr. Charles Katzenberg: Why AHCCCS expansion 8 9 11 14 20 23 30 30
is a win-win-win. Steve Nash: Our exec describes our raison detre. Milestones: Advancements for doctors Adler, Lemole, and Moreno. Makols Call: It should be called Unaffordable Care Act. Behind the Lens: Car enthusiast Dr. Hal Travelin Tretbar covers the main attention-grabber at the recent Barrett-Jackson auction in Scottsdale. PCMS News: Contributions from three of our members. In Memoriam: Because of delay caused by our previous issues content, we sadly must report the deaths of eight physicians. CME: Coming events for Continuing Medical Education credits. Members Classifieds

On the Cover
Holy hubcaps, Batman! Did you hear the price our car brought at auction? Find out in this months Behind the Lens (Dr. Hal Tretbar photo).

CORRECTIONS

On page 18 of our special Carondelet St. Marys Hospital February issue, Steven Vaughan, M.D. was mis-identified in the photo as Braughan. On page 10 a drawing of a hallway was mis-identified as the new lobby for Carondelet Heart & Vascular Institute. PCMS staff takes full responsibility and apologizes for the errors.

The artist rendering is the new lobby for Carondelet Heart & Cardiovascular Institute, part of a $17 million construction transformation.

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SOMBRERO March 2013

AHCCCS expansion: Can we afford not to?

By Charles Katzenberg, M.D. PCMS President
hold up its end of the bargain, Gov. Brewer created a circuit breaker that would scale back AHCCCS eligibility if the federal government fails to cover at least 80 percent of the cost. Benefits of participating and receiving federal dollars: 1.No expense to Arizona taxpayers. 2.Help for rural hospitals, safety-net hospitals, and hospitals currently experiencing increasing levels of uncompensated care. 3.Pumps billions into the Arizona economy. 4.Upholds the commitment to Arizona voters who have twice passed referenda to expand AHCCCS. 5.The Urban Institute calculates Arizona would receive more than $7 in federal aid for every $1 it contributes to expanding coverage. The Arizona Chamber of Commerce, the Arizona Hospital Association, the Arizona Board of Regents, the Arizona Medical Association, the Arizona Osteopathic Medical Association, Maricopa County Medical Society, and Pima County Medical Society all support the AHCCCS expansion. Passing it the legislature is considered a tossup and may be influenced by constituents calling or e-mailing their legislators. Below is a list of Pima County legislators. Please contact them! Question: Who will become eligible to gain Medicaid coverage starting in 2014 through the Affordable Care Act? Low-income adults up to 100 percent of the FPL. Low-income adults up to 138 percent of the FPL. Low-income adults up to 150 of the FPL. Answer: Beginning in 2014, ACAs Medicaid expansion will provide a new coverage pathway for millions of currently uninsured low-income adults, including childless adults who have been historically excluded from Medicaid coverage. The Supreme Court ruling on the ACA maintains the Medicaid expansion, but limits the Secretarys authority to enforce it, which may impact state decisions to implement the expansion. States that expand Medicaid coverage will receive substantially enhanced federal support to cover newly eligible low-income adults up to 138 percent of the FPL: $15,415 for an individual and $26,344 for a family of three in 2012. Question: What types of assistance does Medicaid provide for Medicare beneficiaries? Medicaid pays for Medicare premiums and copays for lowincome beneficiaries. Medicaid pays for healthcare services not covered by Medicare, such as home and community based services. Both are true.
SOMBRERO March 2013

he Arizona Legislature is about to make a monumental decision: Will Arizona continue its current policies on Arizona Health Care Cost Containment System Medicaid eligibility, or will it move to expand enrollment as the Affordable Care Act marches toward full operation in 2014? In a move that took many by surprise, Gov. Jan Brewer supports AHCCCS expansion and has outlined a strategy that will use federal dollars to insure more Arizonans. She calls it the conservative choice for Arizona. Why are we talking about expanding AHCCCS? The simple answer is because it is the right thing to do. Lets look into this complex issue:

AHCCCS, established in the 1980s, uses a managed care model and it is estimated that per-member costs are less than 88 percent of the national average for Medicaid patientsGood job Dr. Marc Leib, AHCCCS medical director and PCMS member. AHCCCS is a cost-efficient healthcare delivery system. Current enrollment is 1.35 million, or 21 percent of 6.56 million Arizonans. In 2000, Proposition 204 was passed which expanded AHCCCS coverage to 100 percent of the federal poverty level (FPL) for all adults. This level of coverage exceeded that of most states. The current recession began in 2007. In 2011, due to lack of funding, the Arizona Legislature decided to disallow childless adults from applying for AHCCCS. This dropped about 150,000 people from AHCCCS. Expansion would provide healthcare for an additional 300,000350,000 Arizonans with incomes up to 133 percent of the FPL, including those who were dropped in 2011 and 2012. In 2012 the FPL was $11,170 for an individual and $23,050 for a family. Financing of the AHCCCS expansion may seem a bit convoluted, but at the end of the day more people are covered and the Arizona economy is stimulated. The governor claims that the expansion will not cost the general fund anything because the state will tax hospitals to raise the states portion of the expansion, $154 million in first full year. Arizona hospitals support this because they expect to make back the tax burdens through increases in admission activity. To match Arizonas $154 million, the federal government will contribute $1.6 billion, as the Affordable Care Act will pay the full cost of covering newly eligible individuals from 2014 to 2016a win-win-win! To cover the contingency that the federal government will not
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Answer: Medicaid plays an important role for nearly 9 million low-income Medicare beneficiaries, known as Dual Eligible, by filling in the gaps in Medicares benefit package. Medicaids assistance ranges from paying for Medicare premiums and copays to coverage of benefits not offered under Medicare, such as long-term care services and supports in nursing homes and in the community and, in some states, vision, dental, and case management services. Dual Eligible beneficiaries represent 15 percent of enrollees, but nearly 40 percent of all Medicaid spending. (Questions are from Kaiser Family Foundation Medicaid Quiz www.kff.org/medicaid/medicaid_quiz.cfm) Question: What can I do? Answer: If you live in legislative districts 9, 11, or 14, please contact your Republican legislators to let them know you support the AHCCCS expansion. If you call, just leave your support message. If you are unsure what legislative district you live in, call PCMS at 795.7985. District 9: Rep. Ethan Orr, eorr@azleg.gov, 602.926.3235. District 11: Sen. Al Melvin, amelvin@azleg.gov, 602.926.4326; Rep. Steve Smith, ssmith@azleg.gov, 602.926.5685; Rep. Adam Kwasman, akwasman@azleg.gov, 602.926.5839. District 14: Sen. Gail Griffin, ggriffin@azleg.gov, 602.926.4326; Rep. David Gowan, dgowan@azleg.gov, 602.926.3312; Rep. David Stevens, dstevens@azleg.gov, 602.926.4321. Contact them today and help them make this important decision! n

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SOMBRERO March 2013

Makols Call
By Dr. George J. Makol

The Unaffordable Care Act

I wrote in a previous essay that there was a gem hidden in the Patient Protection and Affordable Care Act (ACA), and that is its Health Care Exchanges. However, due to arcane and nearly incomprehensible rules that states must follow, Ohio alone estimates a cost of $63 million to set up an exchange and $43 million to run it, based on a state sponsored KMPG study. Multiply $100 million by 50 and add that to the $1.7 trillion estimated cost of implementing the ACA, and it becomes unaffordable. But wait! What if we could have done all this at virtually no cost? Crazy, you say, and impossible. Well, maybe not. Please remember that a big part of what makes health insurance so pricey is that state legislators monkey with insurance requirements, mandating that if an insurance company wishes to sell policies in their state, it must cover certain services. These services correlate very closely with political donations made by chiropractors, naturopaths, pharmacy benefit companies and others. So except for Wyoming, where politicians have been hands-off on the insurance offerings, everyone must buy a Cadillac policy, whereas most people would be better of with a more affordable Chevy. Our states have insurance commissions and insurance commissioners in place, already being paid. Instead of a 2,700-page monstrosity, most of ACAs aims could be legislated at the federal level at little or no cost, and written up on three or four pages. The federal government could have stayed out of the private insurance market completely and just legislated that each state must have a simple insurance exchange, with but one type of policy, untouchable by local legislators. This would be a simple Blue Cross/Blue Shield type of policy, with a $250 surgical, hospital, and outpatient procedure deductible, a $25 co-pay to see any medical doctor, a three-tiered pharmacy benefit with corresponding co-pays, and nothing else! A pharmacy benefits company like Medco would provide pharmacy parameters, with no medication cut out from their national formulary. There would be no free birth control pills, no infertility coverage, no coverage for chiropractors, naturopaths, Indian shamans, fortunetellers, etc. Mental health coverage would be limited but available. Pre-existing conditions would mandate a premium of 125 percent of the base level, and only five conditions would be considered pre-existing: cardiovascular disease and stroke, diabetes, internal cancers, COPD, and degenerative neurological diseases like Parkinsons and auto-immune diseases. All these patients would be covered, but in a nod to the insurance companies, they could charge a little morebut not five times the base premium. To prevent an individual from waiting until illness strikes to buy a policy, these five conditions could have a three-month exclusion period unless transferring directly from another policy, like an employer-sponsored health plan. Before everyone starts writing in about how unfair this would be: all current private insurances would remain untouched, and available to anyone who could afford the coverage. Medicaid and Medicare would still be in force. If such an exchange for basic coverage was created, private insurers would rush to provide simple and likely affordable add-on policies like we have now for Medicare Advantage participants, which could add more mental health benefits, more physical therapy, etc. Remember that trying to cover virtually everything is what made health insurance unaffordable in the first place. Still, you say, maybe not everyone will sign up. Well, employers are already cutting their work forces to fewer than 50 workers, hiring part-timers so they will not have to comply with the ACA, or both. People are saying they will just pay the fine and not buy coverage, but recently it has been a announced that by 2016 the penalties that I thought were too small to be effective, will be raised to as high as $12,500! Remember that the Supreme Court has ruled that these penalties are really a federal tax, and remember that 49 percent of the population does not pay any federal income tax. So who will pay this tax for them? You saw that person in the mirror when you shaved or put on makeup this morningthats who.

SOMBRERO March 2013

Lets face it: the main complaint about our current system is that patients can be driven to bankruptcy due to the high cost of care, which is not about to get cheaper. With basic coverage provided by an exchange in each state, no one covered would become destitute due to illness. But, maybe the premiums would still be too high for many individuals and families. Well, we would have $1.7 trillion in federal dollars that we have not spent (we actually do not have a spare $1.7 trillion, but politicians like to pretend that we do). So lets take a tenth of this amount, which we might actually haveabout $170 billionand distribute it proportionally to each of the 50 states. States could use this to lower premiums, or to provide the last three months free for anyone who signs up for the exchange policy for one year, or other inducements. You catch more flies with honey than with vinegar. And the previously passed bill requiring insurance companies to spend 80 percent of their collected premiums on benefits for patients would be in place for just the exchange policy or policies, and this exchange should be open to competition to guarantee a lower premium. I say we cannot afford the whole Affordable Care Act. According to the Medicare Trustees report from April 2011, the net present value of the non-funded liability of Medicare is 42.8 trillion! I found this hard to believe, so I pored through the 256-page Federal Budget Report to confirm this number. You will be relieved, as I was, when I tell you that I found the number to be only $38.6 trillion as stated in the Federal Budget Report of 2011, on page 239. I certainly feel better, and it reminded me that we were lectured last year in this publication that Medicare had a low administrative cost of 2.5 percent. Now if you tally up the savings over the next 75 years from this low overhead figure, the unfunded liability of Medicare is only $38.5 trillion. What a relief! I feel as confident as I would if I found out that Bernie Madoff had been made treasury secretary, or that my daughter was to attend the new Mel Gibson Charm School. Statistics are easy to throw about; it is their true relevance that really matters. I wrote all this in about 1,100 words. Did we need 2,700 pages? Sombrero columnist George J. Makol, M.D. practices with Alvernon Allergy and Asthma, 2902 E. Grant Rd., and has been a PCMS member since 1980. n

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SOMBRERO March 2013

Milestones

Dr. Adler new FPM medical editor

Dr. Adler has been mak ing his mark on FPM for many years, Executive Editor Leigh Ann Backer said, as an author of articles about electronic health records and other health information technology, a peer reviewer, and more recently a member of the FPM Editorial Advisory Board. We are excited about the opportunity to work more closely with Ken and help implement his vision for FPM. Ken is a family physician who sees patients full-time at a fourprovider office in Tucson, Ariz., where he is also president of a physician-owned, primary care medical group, Arizona Community Physicians, and medical director for the group, responsible primarily for information technology and quality. The group, which includes 124 physicians at more than 50 sites, combines elements of solo and small group private practice with elements of a large physician organization. The doctors own their equip ment and own or rent their buildings, yet they are also shareholders in the group and jointly own two imaging centers and a lab. Ken has led his own office to recognition as a level-3 patientcentered medical home twice, first under the National Committee for Quality Assur ances 2008 standards and again under the 2011 standards. Kens breadth of knowledge and experience will be invaluable to us as we work to develop content that helps family physicians build more rewarding practices and improve patient care.

Kenneth G. Adler, M.D., M.M.M., who has practiced in Tucson for 24 years and first joined PCMS in 1989, has joined the peer-reviewed journal Family Practice Management as its new medical editor. FPM is one of three journals published by the American Academy of Family Physicians and is editorially independent of AAFP, which has about 106,000 members. In an editorial, Dr. Adler said:

Im excited and honored to join the Family Practice Management team in the position of medical editor. This is FPMs 20th year of publication, and it owes much of its long history of excellence to Robert Edsall, FPMs recently retired editor-in-chief. I hope to continue and build upon Bobs fine work. In my opinion, FPM is a unique medical journal. Historically it has offered its readers nuts and bolts advice on how to manage a practice, along with innovative ideas about how to provide more effective and efficient care for patients. The articles have been real, practical, and timely. From my perspective, FPM should help its readers in three ways. First is to help you provide better patient care. That means delivering care that is safer as well as more effective, efficient, and service-oriented. The second is to help you achieve better financial performance. That means maximizing revenue while reducing costs with the end result of better com pensation. Third is to help you do the first and second without losing your san ity. That means learning skills like delegation, teamwork, and prioritization. Times have changed. More family physicians are employed by hospitals and health systems than ever before, yet many physicians remain in private practice. How do we meet everyones needs? We recognize that some of our articles may interest all readers, while others may appeal to only a subset. As you well know, the face of healthcare delivery is rapidly changing. Today the buzz is about an ever-expanding array of initials such as PCMH (patient-centered medical home), EHR (electronic health record), PHR (personal health record), ACO (accountable care organization), and ACA (Affordable Care Act). More abbreviations and newer ideas will surely come as our nation grapples with the dual challenge of providing increased access to care while trying to control and even reduce costs. Where does FPM fit in? We want to help you understand the changes and challenges that lie ahead. We want to provide tools to help you lead your patients and your communities to better health. And we would love to see you fulfilled and satisfied while you do it.
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Dr. Lemole chief of staff

Nationally noted neurosurgeon G. Michael Lemole, M.D., has been named to a two-year term as chief of staff at The University of Arizona Medical CenterUniversity Campus, 1501 N. Campbell Ave., the university reported Jan. 30. Elected by the hospitals medical staff, Dr. Lemole will be chief administrative officer for the nearly 800 university and community physicians who practice at the University Campus. He also will serve as chairman of the hospitals Medical Executive Committee.

A professor of surgery and chief of the Division of Neurosurgery in the Department of Surgery, Dr. Lemole is an expert in skull-base surgery. He was thrust into the national spotlight two years ago as neurosurgeon to Rep. Gabrielle Giffords, who was shot in the head at point-blank range at a Congress on the Corner event in Tucson on Jan. 8, 2011. She and 11 other shooting victims survived; six others died. Dr. Lemoles clinical interests include diseases of the base of the cranium, or skull base, where all of the critical blood vessels and nerves enter or exit the skull. Among the most delicate and complex areas of the human body, skull-base diseases include both malignant and benign tumors, as well as congenital and traumatic anatomical defects. Dr. Lemole earned his undergraduate degree from Harvard University and his M.D. from the University of Pennsylvania. He completed his residency in 2002 in neurological surgery at Barrow Neurological Institute in Phoenix. At Barrow he
SOMBRERO March 2013

completed fellowships in complex spinal surgery and cerebrovascular/skull base surgery. Before joining the UofA in 2009, he headed the Skull Base Multidisciplinary Program at the University of Illinois at Chicago. He also served as co-director of the Chicago CyberKnife Radiosurgery Center at Advocate Christ Medical Center. Dr. Lemole succeeds outgoing Chief of Staff Paul Gordon, M.D., who now will serve as chairman of the hospitals Credentials Committee, of which Alexander Chiu, M.D. is secretarytreasurer.

In addition, working with The University of Arizona Health Network and the UofA, he will help develop the colleges diversity and inclusion policies and strategies in support of the College of Medicines mission of improving health and healthcare for all Arizonans. Dr. Moreno is professor of psychiatry at the college of medicine in Tucson. He also has served as executive vice-chairman, interim department head, and as director for inpatient, outpatient, residency, and research programs in the Department of Psychiatry. He has a special interest in working with the under-served and has established clinical, educational and research collaborations to decrease the gap of mental health services for immigrants in Arizona. Dr. Moreno has served since 2009 as institutional representative to the Association of American Medical Colleges (AAMC) Group on Diversity and Inclusion (GDI). In 2010 he was elected Western Region Representative of the AAMC GDI. He also served as a member of the first elected GDI National Steering Committee from 2010 to 2012. In this capacity, he helped identify strategic priorities for diversity, inclusion and equity applicable to all AAMC U.S. and Canadian member colleges. A UofA faculty member since 1997, Dr. Moreno has served in a variety of roles at the college of medicine related to academic administration; undergraduate, graduate and continuing medical education; faculty development; promotion; research compliance; resource use; and community advocacy. He is a former chairman of the Faculty Diversity Advisory Committee at the college. Originally from Mexico, Dr. Moreno earned his M.D. at the University of Baja California, then completed his psychiatry residency and research fellowship training in neuro-psychopharmacology at the UofA. He has conducted extensive research in the biology and treatment of mood and anxiety disorders. An expert psychopharmacologist, he is involved in clinical, educational and consultative activities in this area. College of Medicine Diversity Statement The UA College of Medicine is privileged to be located in Arizona, a land of rich cultural traditions and heritage. Respect for diversity, defined with regard to race, ethnicity, culture, physical abilities, talents, language, spiritual practices, sexual orientation, gender identity and life experiences, is essential to the successful attainment of our mission to promote health and improve the prevention, diagnosis and treatment of disease for all the people of Arizona and beyond, through education, research and patient care. The College of Medicine expresses its commitment to diversity by: Educating, training and employing diverse faculty, staff, and student body. Fostering the development of personal attributes in its employees and students that are necessary to achieve its mission. Encouraging and supporting culturally relevant scholarly activities that acknowledge and respect systems of healing that emerge from different traditions, and providing a culturally competent, inclusive and respectful environment. This commitment to diversity enables us to provide state of the art education, deliver the highe st quality health care, critically address health care inequities, and perform leading edge research to benefit all our communities. n
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Dr. Moreno deputy dean for diversity

Francisco A. Moreno, M.D. has been appointed deputy dean for diversity and inclusion at The University of Arizona College of MedicineTucson, the university reported, saying the new position will build on existing diversity and inclusion efforts.

Diversity is an important priority that must permeate all aspects of the College of Medicine, Dr. Moreno said. My goal is to continue to build a culture in which each College of Medicine program, committee and office that involves leaders, staff, faculty or students embraces and champions diversity. The College of Medicine has a long history of commitment to diversity and values differences that contribute to the achievement of our research, education, clinical and service missions, said Steve Goldschmid, M.D., college of medicine dean in Tucson. This new position elevates diversity and inclusion as important strategic priorities for the college as we seek to effectively address the healthcare needs of the increasingly diverse populations of Arizona and the nation. Dr. Morenos accomplishments as a faculty member and as our representative to the American Association of Medical Colleges Group on Diversity and Inclusion make him a valuable addition to our leadership team. His guidance will help us promote a collaborative climate that recognizes and rewards diversity and encourages the full participation of everyone. Diversity and inclusion are the tools that will shape our achievement of excellence. The university reported that as chief diversity office for the UA College of MedicineTucson, Dr. Moreno will lead the its many existing diversity and inclusion efforts for students, residents, faculty and staff, coordinating and evaluating programs in a larger, integrated initiative. In addition to overseeing the UA College of Medicine Office of Outreach and Multicultural Affairs and Arizona Hispanic Center of Excellence. He will work with the offices of admissions, student affairs, student development, graduate medical education and faculty affairs to attract diverse students, residents and faculty; provide opportunities for success; and foster a culture of inclusion and collaboration.
SOMBRERO March 2013

Raison detre
By Steve Nash PCMS Executive Director

hen the PCMS Long-Range Planning Committee sat down to do its final report, committee members Timothy Fagan, M.D., Alan Rogers, M.D. and Evan Kligman, M.D. added something different: the reasons the medical society exists, not just what it does. Over the next month or so, Ill discuss in this column the areas your medical society will pursue over the next five years, starting with immediate priorities. In the meantime, here is the preamble to the long-range report approved by the PCMS Board of Directors: We believe medicine is a calling and not merely an occupation. The Medical Society welcomes all ethical practitioners of

allopathic and osteopathic medicine who reside in Pima County, or in counties without a medical society, to join as colleagues to promote and defend the art and science of medical practice. Becoming a physician requires sacrifice, determination, commitment, and intelligence. One earns the designation of M.D. or D.O. We oppose any effort to lessen the educational rigor required to become a physician for lucrative or transient reasons. We pledge to welcome, shelter, honor, and promote our members to the best of our ability, so that they may focus on one patient and one decision at a time. We support personal responsibility of physicians and patients alike. Achieving health is a partnership with our patients. We affirm physicians must be part of discussions to preserve public health and further the social fabric of our community, but equally affirm those concerns are secondary, as we seek to do our best for the individual human being in front of us, who is our patient.

Support
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We stand on guard against intrusions into our profession. We will use our powers of persuasion with any elected body dealing with health matters. We will use all legislative and professional avenues to defend our values. We declare that physicians are a precious resource in the state of Arizona. We will fight to preserve that resource as hard as others when they fight for the protection of their home, values, or land. We revel in our ancient traditions as well as our modern accomplishments. Each practitioner adds to our legacy through care, research, or technique. The Medical Society honors each member in return. The Medical Societywe are you. n

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Behind the Lens

Holy hubcaps, Batman! Or, the $4 million memory

By Hal Tretbar, M.D.

As Robin might say, Holy Barrett-Jackson, Batman, they sold our 1966 Batmobile for $4.6 million. Who would pay that much for an old car from a TV series? Phoenix car collector Rick Champagne would. Why would he want it? Ah, the power of nostalgia! On Jan. 12, 1966 a new TV series Batman appeared on ABC in full color. Wikipedia calls Batman the biggest TV phenomenon of the 1960s. It was the only primetime show other than Peyton Place to broadcast twice a week, airing at 7:30 p.m. Wednesdays and Thursdays. The 120 episodes over the next two years starred Adam West and Burt Ward acting as corny as if Famous custom car builder George Barris was happy when his Batmobile was the comic book had come to life. the most popular car at the Barrett-Jackson auction (Barrett-Jackson photo). We had come to Tucson the previous year. My boys, ages 10, 8, and 5, were always parked in front of our RCA black-andwhite TV on those nights. I dont think our 4-year-old daughter was interested, but usually I was right there with the kids. Adam West played Batman/Bruce Wayne, a millionaire who secretly uses his fortune to fight crime. Burt Ward played Batmans partner and Waynes ward, Robin/Dick Grayson. Their faithful butler Alfred (Alan Napier) was the only other person regularly in the snow. From time to time Batgirl/Barbara Gordon (Yvonne Craig) would help out. Other recurring characters were Gotham Citys Police Chief Miles OHara, and Commissioner James Gordon. The villains were memorable: Cesar Romero as the Joker, Frank Gorshin as the Riddler, Burgess Meridith as the Penguin, Vincent Price as the Egghead, and George Sanders as Mister Freeze. Catwoman was played variously by Julie Newmar, Lee Meriwether, and Eartha Kitt. The show was so popular with the Hollywood set that many of them appeared in minor roles or in cameo
14 SOMBRERO March 2013

26 AOA Category 1A Credit, 26 AMA PRA Category 1 Credit 4 Additional Credit Hours Available with Bonus Workshops 2 Additional AOA Category 1A Credits May Be Earned by DOs Completing the Outcomes Assessment After the Conference

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appearances, including Art Carney, Tallulah Bankhead, Liberace, Rudy Vallee, Ethel Merman, Milton Berle, Shelley Winters, Zsa Zsa Gabor, Joan Collins, Dick Clark, Sammy Davis Jr., Andy Devine, Jerry Lewis, Art Linkletter, and Edward G Robinson. The show would open with the Batman logo accompanied by the pounding Batman Theme written by Neal Hefti, whose only lyric, sung by female voices, was Batman. After a guitar figure: De de de de de de about 15 times, then Batman! The typical story began with a villain committing a crime such as stealing a fabulous gem or trying to take over Gotham City. The next scene would be inside Commissioner Gordons office where he and Chief OHara would deduce which villain was responsible. Gordon would then press a button on his red Batphone. The scene would cut to stately Wayne Mansion where Alfred

The Batmobile was based on a Lincoln Futura, a Ford concept design. It was designed and built in three weeks.

would answer the Batphone in Waynes study. Alfred would discreetly interrupt Wayne to answer the phone. When Wayne learned who the criminal was he would turn a concealed switch hidden in a bust of Shakespeare on his desk. This would cause a bookcase to slide back and reveal two firemans poles. To the Batpoles! Wayne would exclaim. As he and Grayson would slide down to the Batcave, a mechanism was activated that dressed them in their crimefighting outfits. Batman and Robin would arrive in the Batcave in full costume and jump into the Batmobile with Batman in the drivers seat. Robin would say, Atomic batteries to power turbines to speed. Batman would respond, Roger, ready to move out. The shiny black red-trimmed Batmobile would roar out of the Batcave with fire shooting out of its turbine exhaust. As the car approached the mouth of the cave a hidden door would swing open and a hinged traffic barrier outside would drop over to allow the Batmobile to get to the road. POW! BAM! ZONK! would appear onscreen in ballons in true comicbook style as Batman and Robin would punch
16 SOMBRERO March 2013

out or otherwise defeat the given nemesis in the second episode. Episodes were filmed as two-part cliffhangers. The first would end with the heroes in some dire situation. The mock-dramatic narrator would end it with, Tune in tomorrow, same Bat-time, same Bat-channel! Gradually the Batmobile became the star of the series as it saved the Dynamic Duo from many dangers. Every control had a Bat-label. You could pull the Bat-turn handle to deploy parachutes for braking, then make a sudden 180-degree turn and eject them by pushing the Parachute Jettison Button. The Batslicer for cables was on the nose. The Batcomputer connected to the super Batcomputer in the Batcave.

All of the crimefighting gadgets in the cockpit are labeled, including the Bat Turn handle that allows 180-degree turns. The roof light reminds us it was still serving as a police car.

Cindy Wool Memorial Seminar on Humanism in Medicine

Sponsored by the Maimonides Society of the Jewish Federation of Southern Arizona In conjunction with the University of Arizona College of Medicine

Keynote Speaker:

DAN SIEGEL, M.D., Author of Mindsight

Professor of Psychiatry at the UCLA School of Medicine

THE 2013 SEMINAR IS PRESENTED IN MEMORY OF ARNOLD HOLLANDER, M.D.
Dan Siegel, M.D.

Wednesday, April 17, 2013 Marriott University Park Hotel at Main Gate 5:00 pm Cocktails; 6:00 pm VIP Dinner & Seminar $100 7:00 pm Dessert Reception & Seminar $36
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If someone tried to steal the car, the wrong key activated the Ejector Seat. There was an antenna that extended and shot the Bat-beam before we knew what lasers were. The front facing Bat-ray could open doors. The super power Bat-magnet saved someone in a straightjacket because of the metal buckle. The rear bumper sprayed nails to deter the Riddler and oil to foil the Joker. In a 2000 TV segment, Hollywoods famous rodncustom car builder George Barris described how he designed and built the original Batmobile. Bill Dozier came to me as a producer of a show for 20th Century Fox. He said, What kind of a car can you give us? We start shooting Batman in three weeks. Dozier had in mind a show with a POW and BANG kind of action. I had a car that would go with a Pow and a Bang. It had to have rocket tubes, gas knobs, an ejector seat, etc. It started out as an experimental Lincoln Futura concept car. It weighed three tons and was powered by a big old Ford V8. So in three weeks we created and built the Batmobile. Everything had to work because we didnt have computers for special effects. When you see smoke, there is smoke. You see the burner come out of the back; we used kerosene and an igniter and a fan to blow out the exhaust flames. The Batmobile was the most popular car at this years BarrettJackson Auction Feb. 13-20 in Scottsdale. Displayed in the topend Salon Section between a Rolls-Royce, a Duesenberg and a Bugati, the Batmobile still got the most attention. Because of its popularity with the crowds, it was the only one with a full- time

security guard. I paid a $40 entrance fee so I could photograph this one-of-a-kind memory from the good old days. Car Week magazine interviewed Craig Jackson of BarrettJackson after the auction. How did the bidding on the Batmobile go? Well George [Barris] thought it was worth $5 million all the way, and we thought it was worth between $3 and $4 million, so George was right The car was like a cult when we pulled it on the block. It was unbelievable! If I had any idea what was going to happen, Id have had twice the security on the block. The whole staging area lanes outside the tent followed the car in. Everybody was on their feet. We pulled the car in. We dimmed the lights, started playing the theme to Batman, the car came in, George was sitting on top of it, Linda Vaughn wearing a Catwoman outfit was walking in with it ... It was unbelievable. Is Rick Champagne a familiar sight at the auctions? Hes been a customer of ours for about 15 years. He wanted the Batmobile, so he came with a $10 million line of credit to buy it. After the Batmobile went across the auction block, winner Rick Champagne was interviewed on TV. He said he bought it for his wife and that she said she was going to put it in her living room. Later Car and Track magazine joked that they could probably afford to put it in their own Batcave. We hope that the cars new owners will cherish the memories of Batman, Robin, and the Batmobile from 1966-67 that still resonate with so many Americans. n

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PCMS News

Boom(ers) time for PCOA

By Charles Katzenberg, M.D.
Every day for the next 18 years, 10,000 Americans will turn 65. Baby Boomers are 26 percent of our population, born between 1946 and 1965. If any of you out there need a little help, take heart. Tucson has an organization dedicated to us Boomers: Pima Council on Aging. PCOA is part ofthe national network of designated Area Agencies on Agingand a local treasure. PCOA is a membership-

supported 501(c)3 nonprofit, dedicated to improving the health of older adults.Steve Nash and I metwith their leadership to learn more about their mission and services. It was no surprise that many of their services are aligned with preventive health care and that I needed to learn a lot more in order to share the PCOA opportunities with my patients and PCMS. PCOAs mission is to promote dignity and respect for aging, and to advocate for independence in the lives of Pima Countys older adults and their families, now and for generations to come. The engine of PCOA is its wide range of volunteer-based programs and community services.Adults of all ages who have interest, energy, and/or special skills will find many ways to help others. One way is through the Retired Senior Volunteer Program. Or, you can serve as a member of the PCOA Advisory Council, help in delivering some of the services, and so much more. Some of the core programs include Medicare/Insurance Counseling including the New to Medicare monthly workshops; Partners in Planning to help you plan for your long-term care needs; and Personal Budgeting Assistance. Caregiver Support Groups are available around the county and now you can participate in a support group from the comfort of your own home by telephone or Skype. And if you need a break from caregiving, Respite Services are available. Arizona Living Well is a series of health promotion classes that are evidence-based. They are about managing ones personal health, staying fit, and maintaining or improving quality of life. They include 1) A Matter of Balance, offering classes on fall prevention, 2) Managing Ongoing Health Conditions offering a series of sessions on dealing medically and emotionally with chronic disease, and 3) Enhance Fitness, which offers low-to-moderate exercise classes. Each program presents sessions throughout Tucson and inGreen Valley. PCOA also presents an active adult lifestyle expo, Ages n Stages, with the theme ofliving a more resilient life. The two-day expo this yearwill be March 1 and 2 at the Tucson Convention Center with Carondelet as this yearslead sponsor. PCOA is the local expert on anything related to aging and a great resource for us Boomers. For more information about PCOA programs and services and volunteer opportunities, call Adina Wingate at 258.5067 or e-mail awingate@pcoa.org. Learn more online at www.pcoa.org, or visit them on Facebook.

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March 12: Dermatological Manifestations of Systemic Disease, with Dr. Norman Levine.
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April 9: Interventional radiology, with Dr. Julie Zaeta, private practice radiologist, and Dr. Steve Smyth, UofA assistant professor of radiology. Also at this event, Foundation awards for lifetime achievement in furthering medical education will be made to doctors Richard Dale, James Dunn, Frank Marcus, and John Wilson. May 14: Healthcare reform symposium on the PPACA: What does it all mean? Speakers TBA. June 11: Breast Cancer Treatment, with Dr. Ana Maria Lopez, medical oncologist; Dr. Eric Whitacre, surgeon; and Marilyn Croghan, radiation oncologist. Sept. 10: Newer Antibiotics: The How, When, Why, and Complications and Indications of Their Use, with Assistant Professor of Medicine Anca Georgescu, M.D., Department of Infectious Disease, UofA College of Medicine. Oct. 8: Ocular Signs of Conditions of Systemic Disease, with Dr. Robert Snyder. Nov. 12: Cardiac and Urological Robotic Surgery, with UofAs Dr. Robert Poston (cardiology) and Dr. Sanjay Ramakumar of Urological Associates of Southern Arizona.
And sometimes it snows Dr. Mark Blew led a Walk With a Doc on a blustery Feb. 9 and it turned into a one-on-one experience for walker Carolyn Matthiason, Ph.D. (Steve Nash photo).

Think early for THMEP trip

Tucson Hospitals Medical Education Programs 4th Bi-Annual Colorado River Medical Conference, scheduled for July 16-21 to go down the river through the Grand Canyon, still has some open slots, Dr. Richard Dale said. Please call or e-mail him if you are interested: 721.8505 or rdale9136@aol.com. Significant others and children age 8 and older are invited, he said. We leave Lees Ferry Tuesday, July 16, 2013 at 8 a.m. and return there Sunday, July 21. This trip is mildly strenuous, potentially dangerous (large rapids) but extremely fun and educational. Conference topics include general and vascular surgery, plastic surgery, orthopedics, and internal medicine. About 12 AMA Category 1 CME credits are pending. Registration is $200 for physicians and affiliated dentists, and $100 for RNs, residents, allied health professionals and medical retirees. Deposit is $500 per person. Cost will be $2,400 for the full trip plus the registration fee, exclusive of one nights lodging at Marble Canyon.

By reducing food servings 40-50 percent with no seconds. By eating very slowly. By avoiding sauces such as ketchup, mustard, gravy and salad dressing! By avoiding the use of sugar and all forms of candy. By using no cream in my coffee/tea. By drinking only diet drinks. I offer the following caveats, helpful hints and comments: 1.The first 7-10 days are the hardest and require the most discipline. 2.Use the following techniques to get your mind off food: watch TV, go for a walk, use the computer, check your email, play video games, clean out drawers or take out the garbage. 3.Become appalled at the sight of obesity. I keep in mind the appearance of those obese men with their bellies hanging over their belts! I have cut out a profile of such a man and pinned it to my desk lamp as a reminder. I think this is more effective than an academic exercise of making a list of the medical benefits of weight loss. 4.Are you in a blue funk? Are you feeling down, frustrated or unloved? Dont look for comfort in food. 5.If you have fallen off your diet and wake up the next day feeling guilty, think what was the reason and how it can be avoided n the future. This can be a learning experience. 6.Develop a willingness to look upon food and eating only as a necessity. Consider it no more than the taking of medication. Watch out for traditions. Lets do lunch is social as much as functional and in such a setting there is a tendency to overeat. Be on your guardand no after-dinner mint! 7.Stay in control of meals that are prepared for you. A good cook will add salt and condiments to make food tasty. This can be a temptation to overeat. Assuage the cooks feelings when you politely decline a second helping and say you dont want the cook to be party to breaking your diet. 8.Do you feel fatigued? This may cause those hunger pangs. I suggest taking a warm shower, lying down and trying to nap. You might feel better afterward. 9.Remember, restaurant portions are huge. I eat just a third and have the fried potatoes exchanged for baked with no butter or sour cream. You can take the balance of the meal home even if you have no doggie.
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How I lost 20lbs in 8 weeks

By John Clymer, M.D.
[Recent reports say the obesity epidemic is slowing, but dont visit the tailor just yet. Most experts predict that 42 percent of Americans will be obese by 2030. Here is a success story from a psychiatrist and former president of both the ArMA and PCMS, 87 and retired.] During my nearly 58 years of active practice, I have tried to lose weight on several occasions but failed. It was only after I retired, where I was under less pressure and had more time to devote to a weight loss program, have I succeeded. I am now at 153 pounds and my body mass index is under 23. I feel just great. The basic elements of my weight loss program were: The discipline to lose weight. The good fortune to be physically able to do daily hour-long exercise such as walking. By eating a 1,800-2,000-calorie low-salt, low-fat, high-protein (meat) diet with emphasis on fruits and vegetables. By avoiding salty foods (see No. 10) and snacks including those at bedtime.
SOMBRERO March 2013

10.There are 10 types of food responsible for 40 percent of our sodium intake. Among them are soups, lunchmeats, pizza, cheese, potato chips, pretzels, bread and rolls. I try to avoid them. 11.I try to eat meals at the same time of day. For my lifestyle its breakfast around 7:30, lunch around 1:30 and supper around 6:30. 12.Avoid sweet desserts; eat fresh fruit instead. 13.Weigh daily. Use the same scales at the same time of day and clothed the same way. This keeps you on track. 14.When the weight plateaus, stay on the diet. It will eventually drop! 15.Be prepared to have your clothes altered. Let yourself be proud of what you accomplish. For me, the next chapter is maintaining!

In memory of Pappys memory

By Wayne Vose, M.D.
This is a true story. When I was a medical student doing a rotation at Good Samaritan Hospital in Phoenix in 1979, my supervising intern said to me: You have to see this old guy They say hes 135. He was ambulatory until 115. His daughter initially took care of him. She got too old, so his granddaughter took care of him. She was in her 80s and too old, so they found someone younger, in her 30s, to take care of him. I tracked his room down, went in, introduced myself, and began trying out my newly acquired interviewing skill of testing a patients memory. I had low expectations. Pappy, I said loudly over the television. My intern had told me that Pappy was hard of hearing. Long pause. Yeah ... Do you know where you are? Long pause. Yeah. Where? Long pause. A hospital. Wow, I thought. Hes oriented to place. Pappy. Long pause. Yeah ... Do you know what the date is today? Long pause. He told me the date and it was correct to within a couple of days. Remarkable, I thought. Now to test his remote memory with a name. I now had rising expectations, but this next one would probably be the
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The audience listens to Warren Breidenbach, M.D. describe hand transplants and reconstructive surgery Feb. 12 at Pima County Medical Foundations Evening Speaker Series.Next up is on March 13: Dermatological Manifestations of Systemic Disease with guest speaker Norman Levine, M.D. (Steve Nash photo).

showstopper. Lyndon Johnson was president 1963 to 1969, ten years earlier. Do you remember President Johnson? Long pause. Yeah ... What was his first name? Long pause. Andrew. My jaw dropped! Pappy actually remembered Andrew Johnson, the vice-president who took over as president when President Lincoln was assassinated in 1865! Pappys remote memory was indeed intact! WOW!! The story went that Pappy was 12 years old when President Lincoln signed the Emancipation Proclamation in 1863. As a young black man, he was set free from slavery. So shortly after that Pappy went to Missouri to work as a cowboy. There he punched cattle with the cousins of the outlaw Jesse James. I did some calculating. If what I was told was true (and there is a well-known phenomenon of age-inflation among the elderly), Pappy was born in about 1851, about 128 years old when I interviewed him, more than 100 years older than I was. Wow! Just think of all the events that took place during Pappys life inventions and discoveries such as surgical antisepsis, modern anesthesia, antibiotics, X-rays, the electrification of the world, the automobile, the airplane, the radio, the telephone, the television, and the computer. And think of the politicians who came and went. I bet with a memory that good, if Pappy had run for elected office he would have been different from a lot of politicians: he would have remembered his campaign promises! Dr. Vose is a radiologist who joined PCMS in 1987. n

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In Memoriam
By Stuart Faxon

[that] the College of Medicine was at the end of a long, unpleasant phase of its development. According to newspaper reports, the unpleasantness began in 1973 when Dr. Peacock began battling the university after his removal from departmental leadership. By 1977 he and surgery professor Dr. Neal A. Vanselow had sued and counter-sued each other accusing slander and malice and requesting compensation for alleged damages. In all, seven suits were filed by Dr. Peacock or his supporters and Dr. Vanselow. Many of Dr. Peacocks fellow surgeons stood by him in the long battle. In 1974, the Citizen reported in June 1977, when Schaefer appointed Dr. Douglas Lindsey head of the department, the faculty revolted, continuing to attend department meetings chaired by Peacock. Infuriated, Lindsey banished Peacock from the campus about one month later. Shortly after, Peacock filed a lawsuit demanding [his] reinstatement both as department head and surgery professor. In 1977 Citizen staff writer Karen C. Casto interpreted it thus: Behind him Peacock will leave few supporters and many poignant memories of a surgery department he hoped to lead to national prominence in plastic surgery, a specialty that first gained him recognition in the Korean War for his work in reconstructing hands and treating burn patients. Behind him he will also leave many embittered colleagues, fellow surgeons and professors who first became divided during the battle that began when Peacock was first ousted as surgery chief in May 1973. In 1977 Casto wrote that to some, Dr. Peacock was an obviously brilliant manperhaps too bright for the everyday world of human relationships. He is a man who is both hypnotizing and terrifying, charismatic and abrasive. To others he is a devout Christian, a man who is devoted to his profession, patients and students. He also is devoted to his brand of teaching, a brand that appeared to fall by the wayside toward the end of his struggle with the UA administration, a struggle that took place behind the scenes, in the courts and in public view on campus. That brand of teaching is one reason the nationally acclaimed surgeon came to the UA. It was a new medical school then, not as firmly constructed as its counterparts. It made an ideal place to bring about a renaissance in surgical teaching, he once said. At the heart of Peacocks teaching method was the weekly mortality and morbidity conference where students were pitted against physicians in fierce Socratic battles to determine what went wrong in surgery. Not only were students never expected to yield to authority, but should teacher and pupil agree, Peacock would then become devils advocate. That criticism, at times in front of the entire faculty pushed doctors and students toward a previously unmatched standard of excellence, he once said. Nor was criticism limited to medical conferences. Casto wrote that Dr. Peacock shouted and screamed, medical staff said, and many of his rude comments to them and accusations of incompetence became charges against him in the UAs case to
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Dr. Erle E. Peacock, Jr., 1926-2012

Surgeon and administrator Dr. Erle Ewart Peacock, Jr., 86, the most controversial physician in 1970s Tucson, died Oct. 25, 2012, according to an Oct. 28 report in the Charlotte (N.C.) News & Observer: The Chapel Hill resident was the son of long-time UNC Professor of Accounting Erle E. Peacock and Vera Ward Peacock, He was raised in Chapel Hill where he attended Chapel Hill schools and Dr. Erle E. Peacock, Jr. in 1969. graduated from UNC-CH, Harvard Medical School, and UNC School of Law. Dr. Peacock served in the U.S. Navy during World War II and in the Army Medical Corps where he specialized in hand surgery at Valley Forge U.S. Army Hospital during the Korean War. He returned to UNC shortly after the hospital opened and was founder of the Plastic Surgery Division and the UNC Hand Rehabilitation Center. In 1968 Dr. Peacock was recruited by the University of Arizona to be the founding Chairman of the Department of Surgery and Chief of Surgery at the new University Hospital. He also taught and practiced surgery between 1977 and 1982 in New Orleans at Tulane University before returning to Chapel Hill and the private practice of plastic surgery from 1982 to 1993. After retiring from surgical practice in 1993, Dr. Peacock practiced healthcare law in Raleigh, N.C. with Hollowell, Peacock & Meyer and subsequently in solo practice in Chapel Hill. PCMSs file on Dr. Peacock is full of newspaper clippings and a transcription of a 2002 interview of him for our History Committee, 25 years after the great unpleasantness. In a June 6, 1977 editorial, the Tucson Citizen called Dr. Peacocks UofA departure a time for healing: Dr. Erle E. Peacocks resignation from the University of Arizona College of Medicine, they wrote, is almost anticlimactic as a closing chapter to a controversy that engaged so much public attention for so long. Nonetheless, his departure can only be regarded as a prelude to better days for both Peacock and the college. Late last week, when Peacock announced his decision to accept a position with Tulane University in New Orleans, the sense of relief felt by the UA administration was apparent, as university President John P. Schaefer wished the former Department of Surgery chairman well and expressed hope
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dismiss him from the faculty on grounds of unprofessional conduct. And it was not only about Dr. Peacocks personality, but also about differences over how the new organization was to be run financially. In 2002 Dr. Peacock returned to Tucson to speak to the annual national meeting of the Association of American Physicians and Surgeons, and the PCMS History Committee interviewed him at that time, with doctors Jim Klein and Dick Dale; the late doctors Elliott Stearns and Rocky Jackson; Jerry Freund, and others. Asked about the beginning of the great unpleasantness, Dr. Peacock said the request for his resignation took him by such surprise that he did not take it seriously at first and continued about his business. Later it became his challenge. He stated in the press at the time that he felt the guilty should resign and that the guilty did not include him. At PCMS, he noted that he wanted to change graduate surgical education based on the great German system of educating surgeons in the great German universities of Lisigviene and Gertigan, in which at the same time graduate students were learning surgery, which would be taught as a performing art, they would continue their education in the humanities, sciences, journalism and all of the things that it takes to make a truly educated person. I thought the residency program had become too much a vocational training program. His department was founded on four magnificent ideas, Dr. Peacock said: 1.Human scar tissue can be controlled. 2.There was enough work being done in arterial and vascular surgery to make the lymph system the next big field for surgeons. 3.Adaptive immunity was the answer to transplant (Boy, we were dead wrong but thats what we thought.) 4.Drug addiction could be controlled by central nervous system surgery. He said that because of his strong belief in these ideas and the nearly 200 people he had brought to Arizona to pursue them, he could not resign quietly as requested, and the big clash got fully underway. His firing as department head was not enough for many. By 1976, the Arizona Daily Star reported, 80 percent of the medical faculty had signed a petition asking Dr. Peacock to resign as a tenured professor as well. By 1986 Dr. Peacock had a victory of sorts. As reported in the Tucson Citizen that year, Dr. Peacocks appeal ended and he was awarded $774,453 for wrongful dismissal, split nearly 50-50 between the physician and his attorney. The universitys insurance coverage paid the award. I have won a free-speech case and have faith in the judicial system of this country, Dr. Peacock said from North Carolina. We kept appealing to a higher court until we got justice. For any members interested in this tortuous and torturous history upon the occasion of Dr. Peacock himself becoming history, albeit four months ago, PCMS has the 37-page transcription safely filed!
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Dr. James J. Corrigan, Jr., 1935-2012

Dr. James J. Corrigan, Jr., pediatrician, specialist in pediatric cancers and blood disorders, academic medicine careerist, former UMC chief of staff and section head of Pediatric Hematology/ Oncology, and 1988 PCMS president, who joined PCMS in 1973, died Dec. 19, 2012, of adenocarcinoma of the pancreas, which he battled for 14 months. He was 77. James John Corrigan, Jr. was Dr. James J. Corrigan, Jr. at born Aug. 28, 1935 in Tulane in 1994. Pittsburgh, Pa., son of Rita Mary and James Corrigan, D.D.S. He earned his undergraduate degree at Juniata College in Huntingdon, Pa., and went on to University of Pittsburgh School of Medicine, earning his M.D. in 1961. He interned at University of Colorado Medical Center, where he also did his pediatrics residency 1962-64. He had a fellowship in pediatric hematology at University of Illinois Medical Center, Chicago, 1964-66. If one can meet a soul mate on a blind date, Jim Corrigan did in 1954, the family told the Arizona Daily Star. He and Carolyn married six years later. She related how he came to focus on pediatrics: Very early in 1962, Jim was a medicine resident, she said. At that time Dr. Richard Martin, who came to Tucson and was a pediatrician here, asked Jim to help him out one night in the 24-hour ER assignment, as the pediatrics resident had to leave because his wife was having a baby. The next day when Jim came home, he had a smile from ear to ear. When I asked him why, he said, I just had the best time Ive ever had last night. I was treating babies and small children. The next day he went to Dr. Gordon Mieklejohn, IM chief, and told him he wanted to change to pediatrics, so he took Jim up to see Dr. Henry Silver as Dr. C. Henry Kempe, pediatrics chairman, was not available that day. And the rest is history! Dr. Corrigan was in Denver and Atlanta, Ga. before coming here. We arrived in Tucson in December 1970, Carolyn recalled, and Jim officially began work on Jan. 2, 1971. In 1988 Dr. Corrigan was the first full-time UofA College of Medicine faculty member to be elected PCMS president. He taught at The University of Arizona until 1990, beginning as an associate professor of pediatrics. During his time there, the university reported, he served as chief of the Section of Hematology/Oncology, chief of staff at UMC (now The University of Arizona Medical CenterUniversity Campus) and director of the Mountain States Regional Hemophilia Center at Tucson (now Arizona Hemophilia and Thrombosis Center). In 1990, Jim joined Tulane University School of Medicine as
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vice-dean for Academic Affairs, Carolyn said. While a professor of pediatrics and internal medicine, he served as vice-dean, then dean, and finally vice-president of Tulane University Health Sciences Center, 2000-2002. He retired from Tulane in 2002. Back in Tucson Dr. Corrigan returned to the UA Department of Pediatrics as a clinical professor, teaching and mentoring residents in clinical problem solving until just last year. During Jims many years as a faculty member [what residents called] Corrigan Rounds was a mainstay of pediatric education at the UA, said Dr. Alan Bedrick, professor and chief of the Section of Neonatology and Developmental Biology. His wit, candor, honesty, and dedication to patient care and education have left an indelible impression on the practice of pediatrics. Jim Corrigan was a phenomenal teacher and mentor to me and countless other pediatricians in Arizona. Thousands of students and pediatric residents benefited from his exhaustive medical knowledge and caring approach to patient care. The UofA reported that Dr. Corrigan published more than 200 scientific articles, abstracts and book chapters during his long and distinguished career. He received many awards and honors, including the Ross Award in Pediatric Research (1975), the Philip S. Hench AwardDistinguished Alumnus Award from the University of Pittsburgh (1997) and the Distinguished Alumnus Award from Juniata College (1999). In May 2012 Pima County Medical Foundation honored Dr. Corrigan, Dr. Vincent Fulginiti and Dr. Brendan Phibb with the Foundation Award, recognizing a recipients lifetime exemplary achievement in furtherance of medical education. In November 2012 the UofA Department of Pediatrics honored Dr. Corrigan with a Special Merit Award for Outstanding Education, recognizing his dedication and commitment to teaching pediatric residents. Dr. Corrigan was a member of the American Academy of Pediatrics, the American Society of Pediatric Hematology/ Oncology, the American Society of Pediatrics, the Society for Pediatric Research, the American Society of Hematology, and the International Society of Thrombosis and Haemostasis. In 1990 he was elected a Fellow of the Royal Academy of Medicine in Ireland, and he served as president of the Irish-American Paediatric Society 2003-05. He served a three-year term on the executive committee of the Section of Hematology/Oncology of the American Academy of Pediatrics. He chaired Foothills Forum 2010-1012 Dr. Corrigan was an avid fisherman, enjoyed golf, and was a very enthusiastic piano-playing jazz fan. He unofficially led the Pediatric Jazz Band, a septet that donated its services to various fund-raisers. The PJB included pediatricians David Geller on trumpet, George Comerci on alto sax, Bill Banner on electric guitar and vocals, John Hutter on acoustic guitar, Charles Tom Tompkins on bass violin, and Hugh Allen on Drums. The band did everything but hard rock or progressive jazz, Dr. Corrigan said. Mainly we do swing from the 1930s and 40s, Dixieland, and 1950s rocknroll. In 1985 Dr. Geller, then 30 and the bands youngest member, joked to the Arizona Daily Star, Most of the stuff we do was written well before I was born.
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Dr. Corrigans wife, Carolyn, served as president of PCMS Auxiliary (now Alliance) 1980-81, and as president of the Arizona Medical Association Auxiliary 1988-89. Carolyn; sisters Patricia Boudreau of California, Mary Jane Amodeo of Florida and Michelle Hittie of Indiana; son Jeff; daughter Nancy; five grandchildren; one great-grandchild; and 18 nieces and nephews survive him. A memorial service was given Jan. 19 at St. Thomas the Apostle Church in Tucson with Dr. Vincent Fulginiti giving the eulogy. The family thanks the staffs at University of Arizona Cancer Center and TMC Hospice for their caring and concern. The family requests that memorial donations be made in Dr. Corrigans name to University of Arizona Arthritis Center/UAF, Box 245093, Tucson 85724-5826. The funds support a pediatric rheumatology faculty position.

Dr. Preston J. Taylor, 1925-2012

Dr. Preston J. Taylor, IM physician who practiced with The Tucson Clinic for 30 years, and who joined PCMS in 1956, died at home Dec. 28, 2012. He was 87. Preston Johnson Taylor was born Sept. 16, 1925 in Brigham City, Utah, one of six children. I pretty much knew I wanted to be a doctor from age 14 on, he later recalled. He earned his undergraduate Dr. Preston J. Taylor in 1984. degree at University of Utah and his M.D. at U.U. School of Medicine in 1946. He interned at Boston City Hospital and did his residency at Presbyterian Hospital, New York City. Subsequently he returned to Boston City and served as chief resident in medicine. Board-certified in IM, Dr. Taylor served as an internist for the VA in Salt Lake City. He was a teaching Fellow at Harvard Medical School; clinical instructor in medicine at U.U. School of Medicine and consultant with the universitys student health service; was on the associate staff of LDS Hospital in Salt Lake City; and was an assistant visiting physician for Salt Lake General Hospital. He married the love of his life, Phyllis, 63 years ago, the family told the Arizona Daily Star. Preston served honorably in the Army Medical Corps during the Korean War. After the war, Dr. Taylor entered private practice and worked at The Tucson Clinic for 30 years. He was dedicated to his patients and routinely made housecalls to those in need. He retired from private practice in 1986 and volunteered at The University of Arizona College of Medicine where he helped develop a widely used clinical examination program for medical students (OSCE). He was a
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recipient of the UofAs Distinguished Citizen Award, and the Vernon and Virginia Furrow Award for innovation in medical education. The paper reported two years ago that Dr. Taylor suffered an M.I. in 1986 and underwent triple-bypass surgery, and that after his recovery he joined the staff at UMC, teaching clinical medicine to second-year students. He retired in 1995. In the 1990s Dr. Taylor participated with PCMS and PCMS Auxiliary to help judge students in the Southern Arizona Science and Engineering Fair. Columnist Bonnie Henry, writing in the Jan. 4, 2010 Arizona Daily Star, noted that Dr. Taylor, then 84, wrote a humorous book for family and friends called Doctor Taylor Speaking, about his 1950s and 60s housecalls, including those to a brothel and a Mafia den. It was, he says, the only time he practiced medicine in a house of ill repute, Henry wrote. It was also when a housecall was seven bucks. Preston was an avid short-wave radio operator with contacts around the world, the family reported. He was an accomplished painter who loved art, opera, classical music, and golf. Preston and Phyllis were blessed with four loving daughters, 11 grandchildren and six great-grandchildren who survive him. Preston was a caring and generous person, and all his family and friends will miss him greatly. A memorial service was given on Jan. 5 at the Church of Jesus Christ of Latter-day Saints on East Fort Lowell Road. Memorial contributions may be made in his name to the University of Utah School of Medicine; University of Utah Physics Department; University of Arizona College of Medicine Library; Arizona Opera; or Tucson Symphony Orchestra.

extraordinary teacher and physician. He was a great role model for residents and medical students in his approach to adolescent patients. He showed how you can be an activist in promoting childrens health on a national level as well as being a great clinician. George is remembered for his compassionate patient care, his enthusiastic teaching style, his infectious smile, and his incredible altosaxophonesolos, said Rich Wahl, M.D., professor and section chief of adolescent medicine at the UA, the university reported. George Donald Comerci was born Dec. 3, 1931 in Newark, N.J. After earning his undergraduate degree at Rutgers University College of Pharmacy, he went to medical school at Temple University in Philadelphia, graduating in 1959. A U.S. Navy reservist 1950-54, Dr. Comerci interned 1959-60 at the U.S. Public Health Services U.S. Marine Hospital, Staten Island, N.Y. He did his pediatric residency at Temple University Medical Centers Saint Christophers Hospital for Children. After four years of private practice in New Jersey, he was appointed assistant professor of pediatrics and outpatient director at Glennon Childrens Hospital, Saint Louis University Medical School. Dr. Comerci was one of the founding members of the UA Department of Pediatrics, the university reported, a pastpresident of the American Academy of Pediatrics, and a major figure in the development of adolescent medicine as a pediatric subspecialty in the United States. In 1969 he became director of ambulatory pediatrics and deputy head of the Department of Pediatrics at the UA College of Medicine, where the departments ambulatory-focused teaching program was twice winner of the Ambulatory Pediatric Associations (APA) Teaching Award. Dr. Comerci served for two years as the colleges first associate dean for continuing medical education, and in 1979 became professor of pediatrics and of family and community medicine. In 1976 St. Elizabeth of Hungary Clinic, now St. Elizabeths Health Center, awarded Dr. Comerci a special certificate for invaluable service and cooperation in establishing a cooperative program between St. Es and Arizona Medical Center. In 1977 Dr. Comerci established the adolescent medicine program at the UA. The UA College of Medicine George Comerci Visiting Professorship in Adolescent Medicine was established in 2007 to honor Dr. Comerci for these groundbreaking accomplishments. He was director of adolescent and young adult medicine until 1991, when he was named director of pediatric and adolescent medicine at Desert Hills Center for Youth and Families in Tucson. He was a fellow of the Society for Adolescent Medicine. He received the societys annual visiting professorship and award in 1991 and its prestigious Outstanding Lifetime Achievement in Adolescent Medicine Award in 1996. In 2004, he received the
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Dr. George D. Comerci, 1931-2013

Dr. George D. Comerci, founding member of the University of Arizona Department of Pediatrics, former associate dean of the College of Medicine, nationally recognized specialist in adolescent medicine, and PCMS member since 1970, died Feb. 10 of natural causes, the university reported. He was 81. Pediatrician and PCMS pastpresident Dr. Eve Shapiro described Dr. Comerci as an incredibly warm and caring individual.

Dr. George D. Comerci in 1991 when he was named director of pediatrics and adolescent medicine at the former mental When I first came to Tucson in health hospital Desert Hills 1986, she said, I worked with Center for Youth and Families George at the adolescent clinic (Ray Manley Portraits photo).

at the university. He was an

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Clifford G. Grulee Award from the American Academy of Pediatrics for his outstanding service to the organization. Dr. Comerci was president of the Pima County Pediatric Society and the Arizona Chapter of the American Academy of Pediatrics. In 1996, he was the recipient of the Arizona Chapters Special Achievement Award. He was national president of the Ambulatory Pediatric Association in 1978, and in 1990 was named its Annual Visiting Scholar. He was chairman of the American Academy of Pediatrics (AAP) Section on Adolescent Health and, in 1987, received its annual Adolescent Medicine Distinguished Service Award. Dr. Comerci served on numerous AAP committees including the Committee on Scientific Meetings, and chaired the AAP Task Force on Substance Abuse. Dr. Comerci served as national president of the AAP in 1994-1995. Moreover, he had a positive impact on his family: His son graduated from the UA College of Medicine, and his grandson is currently enrolled in medical school at the UA. His daughter-in-law and two of his grandchildren graduated from the UA College of Nursing. He is survived by his high school sweetheart and wife of 59 years, Jane, who was a nurse, supported George throughout his career, and was a devoted mother/homemaker; their three children, George, Janice, and Andy; and seven grandchildren. Memorial services were Feb. 16 at Immanuel Presbyterian Church, 9252 E. 22nd St., Tucson.

Stafford was a certified flight instructor. The plane was registered to a Tucson company. FAA and NTSB are investigating the crash. Urologist and PCMS past-president Dr. Sheldon H.F. Marks, Dr. Steinbronns junior partner 1989-91, said Dr. Steinbronn was the consummate professional, meticulous, and all about doing the best, whatever was needed. Nobody was better in urologic oncology. He would tackle huge cancers with great results. He was an amazing resource for the Tucson community. Del Vern Steinbronn was born Jan. 27, 1948. He earned his M.D. at the University of Arizona College of Medicine in 1974, did his surgery internship there, and his urology residency, completing in 1979. He was double-boarded in urology and radiation oncology. His last practice was at 2310 N. Wyatt Drive in Tucson Medical Park, and before that, Southern Arizona Urologic Oncology on North Craycroft Road. In 2003 he relocated to 5240 E. Knight Drive. He retired in September 2006. Suvivors include his wife, VA pathologist Dr. Karen Steinbronn, who joined PCMS in 1979.

Dr. William A. Grana, 1942-2013

William A. Grana, M.D., M.P.H., retired University of Arizona College of Medicine orthopedic surgeon and PCMS member 2000-2004, died Feb. 1 of cancer, the university reported. In a remembrance, orthopedic surgeon and PCMS member Dr. John T. Ruth wrote: It is with great sadness that the College of Medicine and the Department of Orthopedic Surgery announce the death of Dr. William Grana. Dr. William A. Grana. Dr. Grana lost a very short battle with cancer today [Feb. 1] with his wife, Susan, at his side. He was born [in 1942] and grew up in St. Louis, Mo. He went to college and medical school at Harvard University. He met Susan in high school in St. Louis and they married in 1965 while he was still in med school. After graduating he returned to St. Louis for the first two years of residency at Washington University. At the end of the two years he joined the U.S. Air Force, in which his first duty station was Davis-Monthan AFB. During his second year in the Air Force he served as an advisor in Vietnam during the war as part of the State Department program to help the Vietnamese run their provincial hospital system.
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Dr. Del V. Steinbronn, 1948-2013

Dr. Del V. Steinbronn, retired urologist and radiation oncologist who joined PCMS as a resident in 1979, died in a Casa Grande plane crash Feb. 2. He was 65. KVOA News 4 Tucson reported on Feb. 7, and The Associated Press and San Francisco Chronicle reported Feb. 8, that authorities had released the names of two men killed in the crash of a private twinDr. Del V. Steinbronn in 1984. turboprop Beechcraft King Air E-90 at Casa Grande Municipal Airport Feb. 2 as it was landing and burst into flames north of a runway. Officially identified by the Pinal County Medical Examiners Office, were Dr. Steinbronn and Stephen J. Stafford of Green Valley, 51. Both longtime friends had many years of flight experience and died from injuries sustained in the crash impact, reports said.
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He returned to finish his orthopedic residency at Washington University and then completed a sports medicine fellowship in Oklahoma City at the University of Oklahoma Health Sciences Center in 1975. He was board-certified in orthopedic surgery. He practiced in Oklahoma for 25 years and started the first multidisciplinary sports medicine facility there. In May 2000 he and Susan moved back to Tucson where he became the first head of the [UofA College of Medicine] Department of Orthopedic Surgery. In July 2011 he retired from the university and a became a professor emeritus. He remained on faculty with a primary focus on teaching residents and students. Dr. Grana was a giant in the field of sports medicine and a pastpresident of the American Orthopedic Society for Sports Medicine. His accolades and contributions to the field of orthopedics are extensive and include another passion: being editor-in-chief of Orthopedic Knowledge Online, with active involvement right up to his passing. He was a mentor to me and many. He is survived by Susan, two children, and three grandchildren and remembered by hundreds of residents, fellows, and students whose lives he touched in so many says. He will be greatly missed, but his contributions will live on. Dr. Granas wife, Susan; son William of Nashville, Tenn.; Daughter Beth Wing of Dallas, Texas; and three grandchildren survive him.

Dr. Mabelle A. Cremer, 1927-2012

Dr. Mabelle A. Cremer, retired since 1994, former TMC chief of obstetrics and PCMS member 1974-1995, died Dec. 8, 2012 at age 84. Mabelle Alfriede Cremer was born Dec. 26, 1927 in Brooklyn, New York City. She was a 1948 graduate of Smith College and 1953 graduate of New York Medical College Flower and Fifth Avenue Hospitals. She interned and did her OB GYN residency at Flushing (N.Y.) Hospital and Dispensary.

Dr. Mabelle Cremer in 1984.

Certified by the American Board of Obstetrics and Gynecology, she was a clinical instructor at George Washington University School of Medicine in the early 1970s after serving on staff at Grand Canyon Hospital in Grand Canyon, Wickenburg Hospital in Wickenburg, and Boswell Memorial Hospital in Sun City. Before going to TMC in 1990 she was an OB GYN since 1975 with Tucsons GHMA Medical Centers, then an independent multidisciplinary 50-physician group. In 1990 GHMA said it operated Tucsons only 24-hour urgent care facility at 3102 E. Bellevue. On Dec. 24, 2012, the Arizona Daily Star ran an obituary for Mabelle C. Silverstein, M.D., as she was the widow of Martin E. Silverstein. M.D., saying she passed on to join her beloved husband on the anniversary of their wedding. She was laid to rest in the Beth Israel Cemetery in Woodbridge, N.J. alongside Martin on Sunday, Dec. 16, 2012. Mabelle was an accomplished physician, and served in the medical community in Arizona from 1969 well into the 1990s. Mabelle gave generously of her time, serving on many boards and was an active member of several medical societies. She shared a love of travel, horses, and community service with her husband, Martin. She enjoyed the arts and adored gardening, often volunteering in community planting and beautification projects. She is survived by seven nieces and nephews and 13 grandnieces and grandnephews. She will be greatly missed by her family and her community, alike. Rest in peace, Mabelle. You will be missed. n

Dr. David A. Mullon, 1924-2011

IM physician David A. Mullon, M.D., PCMS member 1963-76, and again in 1984-92, died on Oct. 10, 2011, according to www.tributes.com, which had no further information. He was 86. PCMS was not informed until recently. David Alan Mullon was born April 2, 1924 in Port Washington, N.Y. He served in the U.S. Navy 1943-45, and in the U.S. Army 1951-53. He earned his M.D. in 1949 at the Dr. David A. Mullon in 1986. University of Virginia, Charlottesville, and interned and did his residency at Bellevue Hospital, New York City. He was an Assistant in Medicine 1953-56 at New York University College of Medicine. He practiced 1956-58 in Farmington, N.M.; 1959-61 at University of Virginia Hospital; and 1961-63 at the VA Hospital in Tucson.

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Direct: 480.219.5436 ecomitz@cobelaw.com

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480.998.7800 | www.disabilitycounsel.net
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6720 North Scottsdale Road, Suite 150, Scottsdale, Arizona 85253

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CME

April
April 18: Trauma Update 2013 is at Pima County Health Department Abrams Public Health Building. Registration is through Carmen Martinez at 520.694.4806 or Carmen. martinez@uahealth.com. (TNCC registration is through Arizona ENA website.) For more information on any trauma education opportunities, contact Dan Judkins at UAMC Trauma: daniel.judkins@uahealth.com or call 520.490.7770. April 18-20: A Multidiscplinary Update in Pulmonary & Critical Care Medicine is at Westin Kierland Resort, 6902 E. Greenway Pkwy., Scottsdale 85254; phone 480.624.1000; fax 480.624.1001 info@kierlandresort.com http://www.kierlandresort.com/ CME: AMA Category I toward Physicians Recognition Award; AOA accreditation 2A. Course targets pulmonary physicians, internists, hospitalists, and specialists in critical care medicine and brings together a multidisciplinary faculty to provide a state-of-the-art update in pulmonary and critical care medicine. Lectures given by leaders in pulmonary and critical care medicine, pulmonary pathology, and radiology provide a comprehensive approach to the current evaluation and management of various respiratory diseases. Course features new and pertinent information plus reviews on developments in respiratory and critical care medicine, and includes lectures and Q&A sessions and an interactive format that allows for immediate audience participation. Website: http://www.mayo.edu/cme/pulmonary-medicine-2013s963 Mayo School of Continuous Professional Development, Mayo Clinic, 13400 E. Shea Blvd., Scottsdale 85259; phone 480.301.4580; fax 480.301.8323mca.cme@mayo.edu http://www.mayo.edu/cme

Gratitude, and the Immune System: Neuroscience of the Immune System; The Contemplative Brain and Mindfulness; Healing Traumas: Doors to Awakening; Cognitive Neuroscience and Mindfulness; Feeding Intuition; Being in the World; the Nine Domains of Gross national Happiness (GNH) in Bhutan: What We Can Learn; Complexity, Spirituality, and Compassion. Not included are airfare from the U.S. to Bhutan; travel insurance; alcoholic beverages; tips; traditional hot-stone bath; airfare from Bangkok-Paro, Bhutan-Bangkok. Group discounted fares are being negotiated with Druk Air, exclusive Bhutanese airline that flies into Bhutan. We plan to have all group participants fly Bangkok-ParoBangkok, together. Round-trip fare is: $859. 15-day tour and symposium: $3,695.00 Double ccupancy, per person. Single occupancy: $495 add-on. Included are a tour Ayutthaya, ancient capital of Siam (Thailand), from the 12th Century; Bhutan visa and daily triff of $200 per day including 20 percent taxes; All ground transport in Bhutan and all transfers; all meals and lodging in Bhutan; English-speaking Bhutanese guides; all Buddha Dharma Symposium workshops, panels (CEUs certificate add $50); donations to monasteries and Traditional Medicine Institute; entry into all monasteries, temples, sacred sites, ritual dances and archery events; opportunities to interact with Buddhist monks and lamas; events at the Institute for Traditional Medicine and visits to indigenous villages. Contact: Charles Simmons and Marla Perry-Simmons, Tucson, 331.8338. May 23: Trauma Update 2013 is at Sierra Vista Fire Dept. Registration is through Carmen Martinez at 520.694.4806 or Carmen.martinez@uahealth.com. (TNCC registration is through Arizona ENA website.) For more information on any trauma education opportunities, contact Dan Judkins at UAMC Trauma: daniel.judkins@uahealth. com or call 520.490.7770.

May
May 3-5: The Mayo Clinic Headache Symposium is at Hotel Nikko San Francisco, 222 Mason St., San Francisco, Calif. 94102; phone 415.394.1111http://www.hotelnikkosf.com/ CME: AMA, AAFP, AOA. Course provides attendees with expert panel discussions, skill stations in occipital nerve blocks and neurotoxin injection, post-traumatic headache from sport concussion, self-assessment activity, and discussion on audience-provided cases. Updates in the diagnosis and management of both primary and secondary headache disorders. Some of the special topics are pediatric headache, migraine headaches and hormones, adjunctive treatment in migraine, new and emerging treatments in migraine, low- and high-pressure headaches, thunderclap headaches, and headaches in the elderly and in special populations. Website: http://www.mayo.edu/cme/neurology-and-neurologicsurgery-2013s156 Mayo School of Continuous Professional Development, Mayo Clinic, 13400 E. Shea Blvd., Scottsdale 85259; phone 480.301.4580; fax 480.301.8323. mca.cme@mayo.edu http://www.mayo.edu/cme May 31-June 14: Falling Awake With the Buddha, a 15-day Buddhist Symposium and Cultural Immersion Tour, is a pilgrimage into the heart of the Himalayan Kingdom of Bhutan including continuing education units and a two-day Bangkok interlude. Several potential workshop areas of exploration with the Bhutanese Buddhist presenters, monks, and lamas, and the American presenters, and the workshop participants, will be: Buddhist contemplative wisdom; Looking deeply into Resilience; Bringing compassion and resolution into your professional and personal practice; Optimism,

Members Classieds
To advertise in Sombrero classifieds, call Bill Fearneyhough, 795-7985.
PART TIME OBGYN NEEDED: The University of Arizona, Campus Health Service (CHS) is seeking a Part-Time, .50 FTE, Board Certied OB-GYN Physician for the Womens Health Clinic. This is a year round position in an interesting and rewarding medical practice that provides health care to a population that includes a wide range of ages, cultures, clinical presentations and needs. Duties will include compassionate and excellent OB-GYN patient care; early diagnosis and referral for pregnancy; pre-conception counseling; family planning; screening and treatment of STIs; pap screening and follow up; and providing technical direction for the RN and MA support staff. Procedures include LEEP, colposcopy, IUDs, I and D of abscesses. The ability to practice in a harmonious and collegial fashion with the four experienced NPs in the department is essential. (3-13) Outstanding UA benets include health, dental, vision, and life insurance; sick leave and holidays; UA/ASU/NAU tuition reduction for employee and qualied family members; access to campus cultural and recreational activities; retirement; malpractice insurance coverage and more! For more information, please go to www.uacareertrack.com/applicants/ Central?quickFind=207193 OFFICE FOR LEASE: Medical or Professional Ofce Space for Lease or Sale. 1,806 sq.ft. near St. Josephs Hospital on Carondelet Drive. Five exam rooms and two physician ofces. Favorable lease rate and terms. Call 749- 1454 or 885- 6701 (Dr. Wood). (1-13) OFFICE SPACE AVAILABLE: New Ofce Space available for rent in Northwest Tucson off of Oracle Rd adjacent to a busy rheumatology practice. Up to 2,000 sq ft available. Can be built to suit for ofces, physical therapy or other medical needs. For information, contact Sue Haeger 382-4795. OFFICE SPACE NEEDED: Seeking a medical ofce approx. 2000 sq ft. with 3-4 exam rooms for sale or lease. Location between TMC and St. Josephs area. Please contact Roxann at 520-320-1369. OFFICE SPACE: Professional/Medical Ofce Space for Lease. Central location, tenant friendly rates, move-in ready. See details & photos at: www.space-4-lease.com

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Y EA R S
O F CA R E

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as owners, our policyholders benefit directly when claims experience is favorable. this is clearly demonstrated with the board of trustees declaration of our eighth consecutive dividend:

$42 million for members of record on december 31, 2012. the $42 million dividend reflects an average reduction of approximately 35% of 2012 premiums written.

MEDICAL PROFESSIONAL LIABILITY INSURANCE

(602) 956-5276 (800) 352-0402 www.mica-insurance.com

Dividends declared in any given policy year reflect MICAs financial performance during that year. Past performance does not guarantee future dividends.

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