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Cedars-Sinai Medical Group Summer/Fall 2009 Volume 1, Issue 2


In this issue

A Message from the CEO 2

Digital X-ray


Medical Officer's Corner 3

In the Spotlight


One Woman's Story


New Care Team Member 5

Urgent Care Center


New Physicians




Did You Know?


Optometrist May Isbell helps Josie find just the right sunglasses.

Your Medical Group Tops the Charts

Cedars-Sinai Medical Group has once again been awarded "Elite" status, the highest possible designation for quality care recognized by the California Association of Physician Groups (CAPG). This is the third consecutive year the Medical Group has achieved this honor, ranking us among the top 20 physician organizations in the state and one of only three in Los Angeles in 2009.

This prestigious rating is based on results from the annual CAPG "Standards of Excellence" program, which measures quality and affordability of health care services of its member physician groups. The survey assesses each groups' organizational infrastructure and reviews their ability to

offer steadily improving clinical quality, affordable and accessible services, the latest technology and individual responsiveness to patients.

"We are extremely proud of this honor," comments Cedars-Sinai Medical Group Chief Executive Officer Thomas D. Gordon. "Our team truly cares about each and every Medical Group patient, and this is validation that our hard work and commitment to providing them with the highest quality care is making a difference."

Fashion-chic, Sun-safe Year-round

When it comes to sun safety for your children, think of sunglasses when you're putting on the sunscreen. There is evidence to suggest that, for even the youngest children, protective eyewear should be an everyday part of their sun-safety regimen as well. It's a chic accessory they'll have fun with, and in California it has practical value year-round.

Why is it important to protect young eyes?

Because kids typically spend more time in direct sunlight than adults do, they are at higher risk for developing diseases of the eye caused by unprotected


exposure to the sun's rays. And, they are more vulnerable.

Children under the age of 10 have high lens transparency levels that range between 75?95 percent, compared to adults whose levels are typically below 20 percent. That puts children at significantly greater risk of retinal damage that likely won't be apparent until they are much older. In fact, the American Optometric Association states that approximately 80 percent of harmful UV exposure occurs by the age of 18.

According to Cedars-Sinai Medical Group Ophthalmologist Michael Yang, MD, UV rays can cause irreversible damage that accumulates with time. "UV exposure is a leading cause of blindness and other eye diseases that occur later in life, such as cataracts and macular degeneration. The time to begin preventative action is when children are young."

When are the sun's rays most harmful?

UV rays are likely most dangerous between the hours of 10 a.m. and 2 p.m. when the sun is highest in the sky and the rays are most intense. Keep your children safe by using protective eyewear outdoors during daylight hours, especially while at bright, sunny beaches and around reflective bodies of water that could increase the sun's dangerous properties. Clouds do not protect against UV rays, so use protection even when skies are overcast.

continued on page 3

A Message from the CEO

Thomas D. Gordon

Chief Executive Officer

A Few Things You Might Want to Know

For the third year in a row, we have earned the top ranking in the California Association of Physician Groups' Standards of Excellence program. (See front page for further information.)

Being one of only 20 physician groups statewide to earn their highest "Elite" status is a source of great pride for us because it is a good indication that you, our patients, are receiving high quality care and service responsive to your needs. That is our mission and the motivation for all our operational decisions.

Responsive to Your Needs: One of the primary reasons we have received this ranking for three consecutive years is that we don't rest on our laurels. To achieve and maintain the Elite standard as our patient population grows, we continually assess, refine and expand our services to provide you with convenient and timely access to our quality care team and the latest advances in technology, programs and services.

Expanded Access: Right now we are in the process of adding a new Medical Group location at 8536 Wilshire Boulevard. The new space will allow us to add more physicians to our group to further improve your access to the specialists you need. By early 2010, we anticipate bringing as many as 13 new doctors on board, including internal medicine physicians and various other specialists.

New Services: We are expanding and enhancing some of our services. We are adding space to our in-house laboratory in our offices at 99 La Cienega so you have timely access to appointment availability. We have almost completed our conversion to digital X-ray, and most of our physicians can now preview enhanced images almost immediately from their desktops and start your treatment sooner.

As part of our ongoing effort to improve safety, our pharmacy staff has initiated a new Injection Center that allows them to more closely medically monitor the administration of certain common injections for patients at the 200 and 250 North Robertson offices. Those services are expected to expand to other locations next year.

Partnering for Your Good Health: These are just a few examples of the enhancements we believe will allow us to better serve you now and in the future. We appreciate you entrusting your medical care to us, and we look forward to continuing our partnership with you for your good health.


Film Goes the Way of Flashbulbs as X-Ray Goes Digital

The days of using film in your personal camera will soon be a distant memory for most of us. Like flashbulbs. Your family photos are now available instantly with a simple upload to your computer, and you can share them quickly with anyone you choose. And so it goes with medical X-ray as well.

Cedars-Sinai Medical Group began the transition from plain film to digital X-ray in November 2008. All of the Group's internal medicine physicians and most of the specialists now have almost instant access to patient X-rays in their offices. The others will soon follow.

What does that mean to you if you need a chest X-ray, for example? It's unlikely you'll notice a difference initially because the process of taking the X-ray appears the same. However, the new technology has changed everything behind the scenes. The bottom line is that you will know the results of your X-ray and get the treatment you need significantly sooner.

In the old system, the film would be developed and new film taken if the image quality wasn't good. "With the digital system, the technologist can view the quality of the image on the spot," Internist and Medical Director Howard Wynne, MD, explains. "The clarity of these images is far superior and that makes them easier to read."

Delivery of the film and the report used to take days in some cases. Today, images are quickly uploaded into your electronic medical record and your physicians have remote access to them, sometimes within minutes. If a specialist is needed to review them, he or she will also have electronic access, and you will have your report within a few hours, not days.

The images are stored digitally, which certainly saves space. But it also lessens the risk of lost films. And, if you need them at a later date, you and your physician have easy access. There's no longer any need to hand-carry film from office to office.

"It's all very seamless for the patient now," Dr. Wynne comments. "If you receive care in our Urgent Care Center or even the Cedars-Sinai Emergency Department, those X-rays and all other pertinent information from your care will be quickly available to your Cedars-Sinai Medical Group physician through your electronic medical record. And the doctors will have access to any previous X-rays or important background information. Our technology upgrades are really helping us to enhance quality of care and safety for our patients."

Share your thoughts with us

Please call our Patient Services Department at (800) 700-6424 Monday?Friday, 8:00 a.m. to 5:30 p.m., with any issues you may wish to discuss.

Cedars-Sinai Medical Group physicians, including Internist and Medical Director Howard Wynne, MD, (pictured above) now have nearly immediate desktop access to digital X-rays for their patients.

Well-Being Cedars-Sinai Medical Group Summer/Fall 2009


Sun-safe, Year-round

continued from page 1

What is important when buying sunglasses?

According to Optometrist Peter Koh, OD, price of eyewear does not necessarily dictate the quality of protection.

"Keeping your children's eyes safe can be done affordably, which is important because kids can be hard on glasses," Dr. Koh explains. "Regardless of how much you spend, be sure you get 100% UVA and UVB protection. And choose the shatterproof polycarbonate lenses to ensure their safety."

Optometrist May Isbell, OD, agrees and adds her recommendation that the lenses be free of any distortion. "Sometimes lenses, especially in less expensive glasses, can cause objects to look out of proportion or skewed in some way," she explains. "Children are less likely to notice the problem or to mention it to you, so it's a good idea to test the glasses yourself before you make the purchase."

How do I get my child to wear sunglasses?

Wear your own sunglasses. Setting a good example of protecting your own eyes is an important key to helping your children develop healthy habits for life.

Include your children in the buying process. Let them choose the look they like the best. What matters is that they wear the glasses. There is a wide variety of styles available for kids, from fun, playful colors to more sophisticated frames that mimic those worn by celebrities, parents and older siblings.

SWfoahlleofnwMeptaturhykre-ecssdhema1ss0iiman0%gprlpteUrVgoPutpeiurdcotertielviccnetheievsyaefeoswriehnaargpfpoyGr,yhuoeuiardltchehyilldeiyrneenes:,s FPLibLolTetaulienygrtrsgchsgaectrbro,,aboywlyooetrhlrntaeiacpUnsotpsVuemeiAnn(ssfigmoahhnrelapetdltapnotbeUsrwltreVeapsiBntrathotnoroaipdncfyr)ofsotilmeteprncepmlsroleescsstoeoelfltoyoprcrtroohetvceeoecergtyitnoehintei,oenyes

If a very young child just won't wear sunglasses, try a hat with a brim. In fact, a hat combined with sunglasses will provide the greatest protection.

For Answers to Your Vision Questions, Please Call Us

Beverly Hills Vision Center An Affiliate of the Cedars-Sinai Medical Care Foundation 250 N. Robertson Blvd. Beverly Hills, CA 90211 Phone: (310) 385-3450

Debunking the Myths of Managed Care Referrals

In the early days of managed care, the insurance referral process to get health care services outside of your primary care physician's office had a reputation for paperwork that took time and patience. Times have changed, and, with the support of your doctor and the help of the Medical Group team, today the process is efficient and timely.

Where do I start?

It's important that you understand your benefits package. Every plan is unique, and as with your car or home insurance policy, it's in your best interest to have a clear understanding of what is covered and what isn't, and what your financial responsibilities are.

How can the Medical Group help?

We are here to help you interpret your coverage with your health plan and administer their rules. We will help you manage your benefits to get you the services you need as quickly as possible.

With HMO (health maintenance organization) plans, we are classified as a delegated medical group. As a result, there are certain referrals we may approve automatically. For PPOs (preferred provider organizations), we can often help, but in some cases the patient is required to handle coverage verification and/or provider status in their preferred network.

What if I need a referral?

At CSMG, all of our primary care physicians are board-certified or in the process of becoming so. Therefore, they are all well-trained to address most of your health care needs, and you may not need to see other physicians. If you and your physician agree that specialty care is medically necessary, your physician may be authorized to refer you directly (pre-approved referral), or can request a referral approval from the Group or your insurance plan on your behalf (pending referral).

Pre-approved referrals account for over 70% of the referrals we make and oftentimes can be obtained directly from your physician's office. Pending referrals take a little more paperwork and processing time to ensure your coverage. For example, plan coverage varies widely for physical therapy and home health, so we may need to do a

all clinical information is available at the time the request is received.

? Urgent referrals: Processed within 72 hours. ? Stat referrals: Processed within four hours

by physician request only.

Who should I call for help?

If you need a referral or help with a referral, start by calling your primary care physician's office or call our Patient Services Department at (800) 700-6424. We are your partner in good health, and our goal is to help you get the care you need.

benefit check and co-pay validation to save you from unexpected expense.

Medical Officer 's Corner

What are the time frames for referral approval?

Stephen Deutsch, MD

By law, we follow the National

Quality Assurance guidelines for

processing times for both HMO

and PPO requests. These are

maximum times allowable, but

most are processed more quickly.

? Routine referrals: Processed

within five days, provided

Chief Medical Officer Cedars-Sinai Medical Care

Foundation Internal Medicine

Well-Being Cedars-Sinai Medical Group Summer/Fall 2009


In the Spotlight

Making a Difference is Their Greatest Reward

Toni Marcelino

Medical Assistant

Location: Office of Harvey Crystal, MD 250 N. Robertson, Suite 500 Beverly Hills, CA 90211 (310) 385-3500

"It's not just about me helping our patients. I get a lot from

them as well," Toni Marcelino explains of her work as a

medical assistant. "I've been here so long that

I've seen some of our patients' grandchildren

grow to young adults. They are like family

You don't feel like it's really work.

to me." It's been two years since Marcelino was

named employee of the year, but the positive spirit and can-do attitude that won her that

It's just giving.

recognition has not changed. She loves her job, caring for patients in Dr. Crystal's office, drawing blood, taking their vitals, filling out

Toni Marcelino

their paperwork, listening carefully and even

giving comfort before the

doctor arrives. She's been

going the distance to help

her patients every day

since 1993.

"You don't feel like

it's really work. It's just

giving," according to

Marcelino. And, on at least

one occasion, going the

extra mile for her patient--

literally--when she stopped

by the pharmacy on her way

home from work to pick up

a prescription and deliver

it to a sick, elderly patient

who had no other way of

getting her medication.

"I've known her such a long

time, and she needed help.

Obviously it was an unusual

situation, but if I was able

to touch her that one time,

make her feel cared for, it

was worth it."

Beyond her efforts at her day job, Marcelino is juggling a

lot in her life right now. She is working at earning her LVN

(licensed vocational nurse) credentials, to bring even more to

her patients and give back to the Medical Group.

"It was difficult coming from another country (the

Philippines) to work here," Marcelino recalls. "But I found

a home at Cedars-Sinai. They value me as I am. They

encourage me, help me set goals and provide the resources

to improve myself. I am very lucky." And so are the people

whose lives Marcelino touches each day.

Bella Reznik

Patient Service Representative

Location: Office of Howard Wynne, MD 250 N. Robertson, Suite 505 Beverly Hills, CA 90211 (310) 385-3518

She gets to work early and leaves late, not because she has to

but because she loves her job. "I have dedicated my life to my

profession," says Bella Reznik, a Cedars-Sinai Medical Group

patient services representative for the past 15 years. "I'm not

a doctor, but I help take care of our patients. I try to make

them feel important and cared about--because they are."

Reznik is on the front line,

the first impression a patient

may have of the Medical

Group and of Dr. Wynne. She

answers patient calls, schedules

appointments, handles

referral processing, facilitates

prescription refills and much

more, but her main role, as she

sees it, is to make life easier for

the patients.

"I am open to the needs

of our patients, and I want to

make them feel secure and

comfortable with us. If I can

help, that's my goal. And if I

get a thank you, it makes it all

worthwhile," she explains.

That attitude and her

caring manner are what

led to Reznik receiving the

Cedars-Sinai Health System's

most prestigious employee recognition, the President's Award,

in 2006. "It was such an honor, and I felt I had come so far to

achieve that," she recalls.

It certainly was a very long journey for Reznik, who just

17 years ago was working as a chief librarian in Russia. Her

secret to a successful transition to a new country and to being

an award-winning patient services representative is simple,

she says. "I care. That's the most important thing. I work

for the greatest doctor in the world.

I am respected, and I know I'm an important part of the Medical Group team. Making a difference in people's

Making a difference in

lives makes all the difference in mine." people's lives

makes all the

difference in


Bella Reznik

Well-Being Cedars-Sinai Medical Group Summer/Fall 2009


Choosing Your Partner in Good Health

One Woman's Story

How do you find a good doctor?

For Cedars-Sinai Medical Group patient Hadassa Gilbert, fate intervened. It happened on a day like any other during an ordinary walk up the hill. Ordinary, except for the asthma attack. That's when Gilbert's "guardian angel" appeared out of the blue.

"I was gasping for breath and suddenly this woman walked up with a stethoscope on her neck, a baby on her hip, an inhaler in her hand and a calming presence that reassured me," Gilbert recalls. "It was fate that I had that attack across the street from Cheryl's house."

The woman that Gilbert refers to is Dr. Cheryl Charles, an Internal Medicine physician. The asthma incident was the impetus for Gilbert to see Dr. Charles in her Medical Group office, but open, honest communication and mutual respect have cemented the doctor/patient relationship for 15 years.

The baby on Dr. Charles' hip is now 16, and today, when Gilbert walks by her house on the hill, Dr. Charles has a welcoming smile and a treat in her hand for Gilbert's dog. There's no need for a stethoscope or an inhaler because Gilbert and her doctor have her asthma under control.

The Role of a Primary Care Physician

It's not always as easy to choose a primary care physician that suits your needs and personality as it was for Gilbert. But the selection is very important to your good health now and in the future and deserves your careful attention.

Your primary care physician's role is to treat the whole person. This physician should know you intimately--your family and medical history, lifestyle and habits. He or she is your partner, not only in treating illness, but in helping you prevent illness and coordinating your care, to expertly guide you through the medical system.

"The more you know about a patient and their family, their stresses and their joys, the more you can help them," Dr. Charles explains. "Everything is connected, and there may be that one clue that will help you put all the pieces of the puzzle together."

Understand What Matters Most to You

"What Dr. Charles does that I really appreciate is--she listens. She never tries to rush me," Gilbert explains of the relationship with her physician. "She doesn't discount what I'm saying. She's open to her patients, and you really know she cares about you."

For Gilbert, Dr. Charles has the right approach to her medical care, but everyone is different. Most patients want to be heard, but not everyone likes to control the conversation, for example. You may prefer to have your physician do all the detective work and ask all the questions, or you may come with your own list for discussion. Your choice of a personal physician should reflect those preferences.

Getting the Relationship Rolling

Although Gilbert found her physician in a time of crisis, the best opportunity to establish that relationship is when you are healthy and the two of you have time to get to know one another. Don't wait until you're sick or have a health issue to make the first call.

Set up a new patient appointment with the doctor you choose. It will allow the two of you to get acquainted, for you to discuss your health needs with him or her, ask questions and assess whether this is the right fit for you.

Dr. Charles laughingly admits her hillside rescue was an unusual way to meet a new patient, but beginning with Gilbert's first office visit, things normalized. "When I meet a patient for the first time, I go through an organized set of questions

Cheryl Charles, MD, (left) and her patient Hadassa Gilbert have a 15-year relationship based on honest communication and respect.

based on their needs. It helps me get to know them as a person, not just as a patient with a problem," she explains. "But it's also important that the patient write down a list of things to tell me about themselves--not a laundry list, but pertinent things that matter to them."

Your doctor needs to know your medical history, of course, but also your current health concerns and even your fears. "Patients see things on the Internet or hear about them on TV and become concerned that they have symptoms of something serious," Dr. Charles says. "Talking about that with your doctor will either put your mind at ease or lead to further investigation. One way or the other, you will begin to feel better."

Choosing Your Primary Care Physician

If you need help identifying a primary care physician who meets your unique needs, call Cedars-Sinai Medical Group's Patient Services Department at (800) 700-6424 for guidance.

Meet Our New Care Team Member

Physician Assistant

Sara Caan, PA-C Urgent Care Physician Assistant

Medical research is where Sara Caan began her career. Patient interaction was an important missing element for her in that work, however, so she became an emergency medical technologist and soon after, earned her degree as a physician assistant. Today she combines it all, treating Medical Group Urgent Care patients. "I was drawn to the organization because of the interest the doctors take in their patients and the quality of care they provide," she explains. "I'm really pleased to be a part of that."

Location: 8501 Wilshire Blvd., Suite 150 Beverly Hills, CA 90211 (310) 248-7090

Credentials: Physician Assistant-- Certified National Commission on Certification of Physician Assistants

Licensed Paramedic trained in Emergency Medical Services

Medical Education: Master of Physician Assistant Practice Keck School of Medicine University of Southern California Los Angeles, California

?Did you know.... When you have an asthma attack, it feels like

you can't inhale enough air, but in fact your lungs are having trouble exhaling. Asthma can be life threatening unless properly managed, so if you have recurring periods of wheezing,

chest tightness, shortness of breath and coughing, see your doctor immediately.

Well-Being Cedars-Sinai Medical Group Summer/Fall 2009

Cedars-Sinai Medical Group Urgent Care

8501 Wilshire Blvd. Ste 150 Beverly Hills, CA 90211 (310) 248-7000

Open Monday through Friday, 9 a.m.?9 p.m. Saturday and Sunday, 9 a.m.?1 p.m.

Please contact your primary care physician before calling or arriving at Urgent Care if it's during regular office hours.

Cedars-Sinai Medical Group

Urgent Care 8501 Wilshire Blvd. Ste 150


If it's Urgent, CSMG Can Provide the Care

It's Friday and you just got home from work where you battled all day with a cough and congestion that have gotten progressively worse. And, by the sound of it, your eightyear-old is headed down the same path.

Most would prefer to see their family doctor and pediatrician right away in this situation, but it's Murphy's Law that minor illness and injury don't always happen during normal business hours.

"For Medical Group patients, urgent care is a viable and comfortable option," Dr. Antoinette Hubenette, CSMG Urgent Care physician, comments. "Because of our electronic medical records, we have access to their doctor, medical history, medications and allergies when we input their name into the system. We're part of the Cedars-Sinai family, and we treat our patients with the same care and compassion they would get from their own physician's office."

Medical Group Urgent Care began as an extension of physician practices. From those early beginnings, it is now open seven days a week, offers care for children and adults, and is located conveniently to other CSMG offices. Patients should contact their primary care physician's office prior to calling or arriving at Urgent Care if it is during your physician's regular office hours.

The care team includes highly-qualified physicians and physician assistants who specialize in internal medicine and pediatrics and have urgent care experience as well. The rest of the team includes experienced nurses,

medical assistants and patient services representatives.

"We know our patients' physicians and the Group specialists personally," Dr. Hubenette explains. "As a result, we feel comfortable just picking up the phone to discuss a patient's condition directly."

Once the Urgent Care diagnosis and treatment are complete, the information is transmitted quickly back to the patient's doctor, or a specialist when appropriate. As a result, the patient can pick up with his or her doctor when the office opens, and the doctor will have access to the visit details.

"We're all a part of the Cedars-Sinai care team," Dr. Hubenette concludes. "Whether personal physician or specialist or Urgent Care physician, we're all working together in the best interests of our patients, for their good health."

Dr. Albert Shim and the rest of the care team are available seven days a week to help with urgent illness and injury.

Meet Our New Physicians

As Cedars-Sinai Medical Group expands to provide services responsive to the needs of our patients, some exceptional individuals have joined our care team. We'd like to introduce them to you.

Paria Hassouri, MD Pediatrician

Examining a teddy bear or a doll is part of the job for Dr. Hassouri, who does whatever it takes to help her youngest patients feel comfortable in her office. "Going to the doctor can be a daunting experience for a child of any age, especially if they don't know me. So I try to put my patients at ease by relating to them on their level," she says. "At the same time, I work to assure the parents, listen to their concerns and answer their questions. In pediatrics, communication is a key element of a good doctor/patient relationship."

Location: 8501 Wilshire Blvd., Suite 205 Beverly Hills, CA 90211 (310) 385-3345

Board Certification: Board Certified, Pediatrics

Medical Education: Residency, Pediatrics Cleveland Clinic Foundation Pediatric Residency Program Cleveland, Ohio

Medical Degree: University of Pittsburg School of Medicine Pittsburg, Pennsylvania

Jana Posalski, MD Rheumatologist

In her rheumatology practice, Dr. Posalski is able to develop a close, long-term relationship with her patients who suffer from chronic medical problems. Rheumatology is a rapidly evolving field, and she utilizes medical advances to not only treat her patients' symptoms but also address the underlying conditions and greatly improve their quality of life. "This field involves detective work, fitting the medical symptoms together to identify the problem," she explains. "It's gratifying to see the difference treatment can make for my patients."

Location: 250 N. Robertson Blvd., Suite 603 Beverly Hills, CA 90211 (310) 385-3298

Board Certification: Board Certified, Rheumatology

Medical Education: Residency, Rheumatology Cedars-Sinai Medical Center Los Angeles, California

Medical Degree: The Chicago Medical School Finch University of Health Sciences Chicago, Illinois

Well-Being Cedars-Sinai Medical Group Summer/Fall 2009

Nicholas R. Szumski, MD Neurologist

Dr. Szumski was intrigued with the function of the brain at a young age and started down the path toward his chosen field of neurology in the eighth grade. While maintaining an interest in general clinical neurology, he has a passion for movement disorders like Parkinson's Disease. "Although this is a life changing and potentially debilitating disease," he explains, "if it's caught early and treated appropriately, patients can get their lives back on track and maintain a high quality of life. That's what it's all about."

Location: 250 N. Robertson Blvd., Suite 518 Beverly Hills, CA 90211 (310) 385-6016

Board Certification: Board Certified, Neurology

Medical Education: Fellowship, Movement Disorders University of California, Los Angeles Medical Center and West Los Angeles VA Medical Center Los Angeles, California

Fellowship, Medical Education UCLA Center for Educational Development & Research

Residency, Neurology University of California, Los Angeles Medical Center Los Angeles, California

Medical Degree: University of Iowa College of Medicine Iowa City, Iowa

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