President’s Message

Posted on Sep 2, 2021 in President's Message | 0 comments

I felt a pit in my stomach that weighed a ton. I had just gotten out of a code, a cardiac arrest that had sadly not survived. He was a relatively young man, and had a sudden and dramatic collapse, with not too many comorbidities. In short, his demise was quite unexpected. We had done everything possible, but that day was just not meant to be.

A short while later, my charge nurse notified me that his family had arrived and were waiting to hear news. Of course, I was encumbered, mired in the details of my other patients, but I knew that talking to the family was going to be the most important thing I did that day.

I had Stevie, the chaplain, as backup for some emotional support – not just for the family, but for me as well. When delivering bad news, you can never know how a family will react. Most of the time, it’s just sadness, but sometimes, it’s anger that can be misdirected at physicians and nurses.

As I walked toward a private room where the family was waiting, my brain had to switch gears. While working, I tend to be pretty analytic, almost a bit too calculating and cold in allowing logic to dominate my decision making. Though cognitive neuroscientists have dispelled the myth of a strict right/left brain divide, there are some useful distinctions between the two halves that interact. Take for example Broca’s area, the portion on the parietal lobe that encodes speech/language: the left side typically analyzes the content of the language, while the right side interprets the prosody and emotional content of speech.

I sat down with the deceased patient’s wife and his brother. Behind masks, our eyes met, and I could see that she was still hopeful. As I delivered the bad news, I could tell that she needed to hold my hand. She grasped very tightly on my every word. And as I tried to be analytical, I knew that that was not what she needed. She needed more, that human connection of grief. I hugged her as she sobbed. She thanked me for all I had done.

When I left that room, the pit I had in my stomach was gone. Perhaps it was a sense of relief on my part that the ominous task was complete, but I think that it was actually that I was able to help a family get some closure.

These are the challenges we face everyday, as we get lost in the minutiae of medical data. Our patients expect a translation of data into something more relatable, more personal. This is not only in times of bad news, but with equivocal and good news as well.  

On the business side of things, I hope you all have read the emails from the system, the medical staff, and our chief medical executive, Dr. Boynton.

Below is additional information to help us be compliant with the public health order recently instituted.

Vaccinated (at a Sutter hospital Dec 2020 – Mar 2021)

We should have your vaccination records. No further action is required.

Vaccinated (not at a Sutter hospital via myEHS)

If you are already fully vaccinated but did so in an outpatient setting or a non-Sutter hospital you should have received an email requesting you to submit your information. If you have not already done so, please use the following link to provide your vaccination information:  http://covid19.sutterhealth.org/VaccinationProof/external

Not vaccinated

If you are not yet vaccinated, then by Sept 30, 2021 you will need to submit either/or:

  1. Valid proof of vaccination: http://covid19.sutterhealth.org/VaccinationProof/external
  2. Valid religious or medical exemption via the following links:

http://covid19.sutterhealth.org/ReligiousExemption/external

http://covid19.sutterhealth.org/MedicalExemption/external

In addition, you will need to provide negative test results semi-weekly starting August 23, 2021 in order to continue treating patients in the hospital setting. Please use this link to submit your test results: http://covid19testresult.sutterhealth.org/external

  • Recommendations on testing frequency and timing can be found in CDPH guidance for acute care hospitals and all other clinical environments.
  • Clinicians do not need to submit proof of their test results. The state only requires they report the result of the test. However, it is recommended they retain proof of each test.

If you plan to be fully vaccinated, you will be exempt from the bi-weekly testing requirement two weeks after receiving either a single-dose COVID vaccine or the second dose of a two-dose vaccine and no further action will be required.

Please contact Leanna Hudson (Manager, ABSMC Medical Staff Services) if you have any questions or need assistance with your submission.

Jeff Chen MD, MPH, FACEP
Chief of Staff, ABSMC Summit Campus

It’s time again for the NRC Physician Engagement Survey!

Posted on Sep 2, 2021 in Uncategorized | 0 comments

It’s time again for the NRC Physician Engagement Survey! 

This year it will run for the entire month of September. We will be raffling AfterShoks headphones on a weekly basis for the duration of the survey window. Winning names will be randomly selected by NRC, so you must participate to be eligible to win. The sooner you complete the survey, the more chances you have to win!


Look for an email invitation from NRC Health <WorkforceSurveyInfo@nrchealth.com> with the subject line “Please Respond! 2021 Physician Engagement Survey for Alta Bates Summit Medical Center”. It only takes 10 minutes to complete! All responses will remain confidential, so you can feel comfortable sharing your thoughts and input anonymously. As a reminder, if a question asks your opinion of a service or specialty that is not a part of your usual practice, please skip the question rather than answering neutrally. If you receive more than one survey request, please complete one for each facility.

Thank you in advance for participating!

Ursula Boynton, MD
Chief Medical Executive
Alta Bates Summit Medical Center
Office: 510-869-6785│Cell: 510-703-7334
Administrative Assistant: Maria Freeman
Office: 510-869-8766│E-mail: freemamd@sutterhealth.org

Patient Experience

Posted on Sep 2, 2021 in Announcements | 0 comments

Below are our patient experience scores from the HCAHPS patient satisfaction surveys. MD Communication is the black line and represents the monthly overall score for this domain. The blue line is answering the question “How often did your doctor explain in a way you could understand?” The green line is the CMS 50th percentile. I sure feel that we provide better than average care, but these numbers suggest we are just below it.

So what can we do to improve?

Hospitalist Paul Cheung interviewed a group of high performing doctors to learn best practices on improving patient satisfaction.  Here are a few tips he recommends:

  • Anticipate our patients’ fears and address them proactively. For example, “You must be scared by the words ‘heart failure’, well, your heart might be pumping weakly, but it is not about to stop on you.  We will get it pumping normal!”
  • The next step discussion: helping the family and patients understand what will be happening going forward. I like to talk about ‘the plan for the day’ and ‘the plan for the stay’ so the patient and family know what to expect going forward.

 Thanks for all your work on this!

 Leif Hass, MD and the MD Communication Task Force

Tragic Optimism vs Toxic Positivity

Posted on Sep 2, 2021 in Wellness Committee | 0 comments

Tragic Optimism vs Toxic Positivity – it is important to find meaning in hardship rather than try to gloss over life’s realities, especially when times are tough!

Ms. S is a 75 yo who recently lost a child to a violent crime and another to Covid and kidney complications. Now she lives alone and has just found out about a lung mass.  During one of our conversations she said, “God helps us find a way when there is no way.”  I got goosebumps, my body’s signal to me that I was in the presence of something awesome.

My younger defiantly atheistic self would have questioned the merits of that answer, but now I see the wisdom of it – even for those of us who don’t believe in a guiding deity.  We can find transcendence in suffering.

 I am a big fan of gratitude and looking for the positive in life, but to be human is to suffer loss.  A meaningful life is derived in large part by how well we grow during these inevitable times of hardship. Covid, climate change, political and economic uncertainty, we are all suffering now or have our heads in the sand.

How does gratitude fit into this idea of “post-traumatic growth”?  Gratitude should not be “I’m lucky for all I have”, but “I am grateful for what others have given me and for the opportunities life has presented for making a meaningful life.” With that comes a desire to give back, strengthen relationships, build culture and grow spiritually.  Gratitude researchers call this existential gratitude: being grateful for all that life brings, both the good and the bad.

Gratitude can help us appreciate the little good things at the fringes of our suffering and also help us face the suffering with a growth mindset.

Loss is a defining part of the human experience.  Fully feeling our losses can tie us to others who have suffered and those who have worked to lighten our burden.  As health care providers, we should all feel grateful for the opportunity we have to lessen the burden of those we care for.  We might not do it through a cure, it might just happen with an open-ended question and a quiet presence that invites sharing of hard-won wisdom.  We can learn from our patients about grace and gratitude – a gratitude with depth.

The day Ms. S went home I took her hand and thanked her. “Your grace amidst suffering is a thing of beauty.” I said.

“Your loving presence might be the best medicine I have on God’s journey.” She said

No Pollyannaish “lucky me’s” or blithely blind positivity.  Just some old fashion thanks for sharing ourselves with each other.

Leif Hass, MD
Summit Wellness, Chair

Spotlight on Affordability: Alta Bates Summit Outpatient Pharmacy Achieves Zero Out-of-Pocket Costs for Patient Receiving Brand New Medication

Posted on Sep 2, 2021 in Uncategorized | 0 comments

Co-Signing Verbal Orders

Posted on Sep 2, 2021 in Health Information Management | 0 comments

Sutter Community Connect

Posted on Sep 2, 2021 in Clinical Documentation | 0 comments

New Physicians Memo

Posted on Sep 2, 2021 in New Physicians | 0 comments

President’s Message

Posted on Aug 5, 2021 in President's Message | 0 comments

I was enjoying a blissfully peaceful day at the San Diego Zoo with the family. The sun was out, there was a nice breeze, and I had no mask on. Sure, we were outdoors, and the CDC had relaxed mask recommendations for the vaccinated indoors. But this was still a new thing to me, to be in public without a mask on. In fact, this was the first time that I had strayed from the Bay Area since the start of the pandemic, and it was liberating.  Vaccination rates in the state, while not approaching the magic 70-75% hurdle, were quite good in most counties. Overall disease incidence was still quite low.

Abroad however, reports came from Indonesia of a massive surge. Israel was reporting breakthrough infections among the vaccinated. The UK was in the midst of another wave.  News of the highly infectious delta variant became widespread, and I was cautiously hopeful that we would be able to resist this locally.  But as a global pandemic is indeed global, so were we to soon feel its effects.

Upon my return to work, I came to know that we were not going to be spared the latest COVID surge. CDC reports indicated that the delta variant, a more highly infectious strain, and one that seemingly caused more severe disease, was responsible for 80% of new infections in the US. We were once again wearing full PPE, N95’s and eye protection all day, PAPR’s were whirring constantly, and the arsenal of weapons we had to combat the virus were once again deployed. Moreover, as more data came out, we learned that even the fully vaccinated were not exempt from falling ill, though the severity of disease was lessened, the risk of hospitalization and death was substantially mitigated.

In some ways, we are better prepared for this. We know much more about COVID than at the outset, and we have better data on the efficacy of treatment regimens. Dexamethasone, remdesivir, casirivimab/imdevimab, tocilizumab, baricitinib: These tongue twisting names had become part of our daily lexicon and were dutifully employed on the sickest of patients.  But to hear a patient asking for the vaccine when they have already contracted the disease and to have to respond with “we can’t give it to you now, but when (or if) you get better, you should get it in a few months,” – is heart-rending.

In some ways, we are in a worse state. Our hospital is struggling financially, morale is low, there are constant staffing shortages (the causes of which are multifactorial) and patient volume is high. Most recently we are hearing about nationwide shortages of tocilizumab and baricitinib.

I am so thankful of the time that I had to see my dad in San Diego and have some (mostly) carefree moments, but I realize that now is not the time to let our guard down, for the enemy at the gates has returned with increased vigor and strength.

We will get through this, and the vigilance at work has to be met with equal seriousness outside of work. We know that even while fully immunized, we can be infected and transmit disease to others.  There are still vulnerable populations that either have not been vaccinated or cannot receive the vaccine. My kids, about to start school in person in two weeks, are not eligible for the vaccine yet.  So we are not out of the woods yet. Please, mask up when indoors and around large groups of others outdoors.

I can understand the frustration of taking care of patients who have not been vaccinated, but we have the golden opportunity to make a difference. Your patients trust your medical advice, and they are far more likely to be influenced by your counsel than a celebrity or a PSA. Take the time to understand the barriers and the causes of reluctance and address those with an open mind. Vaccination is not the only path forward, but the alternative is going to result in far more deaths, and far more difficult end of life decisions.

Jeff Chen MD, MPH, FACEP
Chief of Staff, ABSMC Summit Campus

Alta Bates Summit TAVR Program Earns Highest Possible Rating from Society of Thoracic Surgeons and American College of Cardiology

Posted on Aug 5, 2021 in Announcements | 0 comments