President’s Message

President’s Message

Posted on Feb 1, 2021 in President's Message | 0 comments

I hadn’t seen a doctor in years.

Some of it, probably most of it, was my fault of course. I had procrastinated and tried to reassure myself with thoughts that I was exercising pretty regularly, eating pretty well. Heck, probably too well. I thought, “I’m a doctor, I’ll know when there is something wrong.”

Then there was the pandemic and transition to virtual visits. The switching of primary care doctors due to changes in health insurance and contracted providers. My wife kept on pestering me, “When are you going to make a doctor’s appointment?” I relented, got onto MyHealthOnline (MHO), and made an appointment with my assigned PCP.

I was anxious the night before my appointment. What would be uncovered after several years of shameless neglect? I went into the clinic, breezed through the obligatory COVID screening, and was routed into the exam room. The medical assistant greeted me and promptly said, “We need to get your weight and height”. A sense of dread came over me as my pants had gotten quite a bit tighter around the waistline in the past year, and I reluctantly faced the music.

I was the heaviest I had ever been. Call it the COVID 20. My height had shrunk by half an inch. My blood pressure was high. The rest of the exam proceeded uneventfully, but then came the expected recommendations from my doctor regarding lifestyle modification. Easier said than done. Throughout the day, scattered blood test results filtered back through alerts on MHO. My vitamin D was low. My cholesterol was higher than I wanted it to be. My hemoglobin A1C was borderline. My uric acid was high.

Clearly, things had to change. Internally, I signed a commitment to change contract, and set about the next few days to right the ship. I refrained from eating too much food at night (difficult with ER shift schedule). I moderated my carb consumption. I went out for several runs in the next few days, but every time I got on the scale, I was mortified by the task before me.

I had a clinical day off midweek, and though it was raining and gloomy, I overcame inertia and got out on my bike. You have to take the opportunities when they come. I was thoroughly soaked and quite cold, but invigorated by being outdoors. Then the clouds parted, if only just briefly.

Call it coincidence, divine providence, or the physical diffraction of light. It was beautiful.

2021 hopes to be better than 2020, but only if we make it so. Self care is vital.  Make time to take care of yourself, and if you haven’t seen your doctor recently, make an appointment!

Verbal order signage

On the business side of things, our verbal order signage compliance has lagged considerably after gains in 2019.

Please remember to sign your Verbal/Telephone Orders. Our Medical Staff Rules and Regulations state that Verbal and Telephone Orders must be signed within 48 hours.

Right now, we are well below the 90% mark and at risk for citation by regulatory agencies (i.e. JCAHO). Please do your part and sign your orders ASAP.

Please see attached for order signage within Haiku!

Additional tips:

1. Hardwire signing your Verbal/Telephone Orders. Make signing deficiencies the first and last thing you do daily.

2. Sign ALL Verbal/Telephone orders including Discontinued and Canceled orders.

3. Work with your group to sign orders for each other. Inform your team when going off service and ask that your orders be signed.  Patty Fitzgibbons will work with you and your group to make it easy to sign each other’s verbal orders.

4. Inform Health Information Management when going on vacation so deficiencies can be placed on hold while you are out.

In order to place a hold on any potential medical record deficiencies, you have 3 options:

1. Call the local HIM/Medical Records Department, Chart Completion Team at Summit:  510-869-6545, option 2 (Summit Campus only).

2. Call or email the S3 physician line (Summit and/or Alta Bates Campus) 855-398-1641, Option 1, or email S3Chart CompletionTeam@Sutterhealth.org.

3. Call or email the HIM Manager (Summit and/or Alta Bates Campus) Summit:  510-869-8741, or Email Stinnal@sutterhealth.org.

Cosigning Verbal Orders – Setting Email Reminders

Verbal Order Email Reminder

Providers are able to receive email reminders when there are verbal orders in their In Baskets.  This requires a modification to the In Basket Settings.

1.  Click on In Basket from the main menu in EPIC.

2.  Click on Settings

3.  Click on Reminder Email

4.  Click the box to the left of “Subscribe with email address and,

     in the field to the right, type your email address

5.  Enter the Message Type “Verbal Order Cosign”

6.  Enter the Outstanding Days to the right of the Message Type

If there is a workflow issue we can assist with, please contact Patty Fitzgibbons, Physician Liaison, at 510-869-8339 (office) or 510-325-9618 (cell) or by email fitzp@sutterhealth.org.

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

President’s Message

Posted on Jan 4, 2021 in President's Message | 0 comments

Who would have thought that getting a shot would be such an emotionally charged event? As the Pfizer and Moderna vaccine began to be deployed nationwide, social media and news sites erupted with images of the first recipients receiving their inoculations.

ABSMC rolled out its first wave of vaccinations for health care workers two weeks ago, and it has been extremely successful (aside from the initial hiccups with myEHS). All active medical staff members are eligible to receive the vaccine in this first round, and affiliate and courtesy staff will be offered the vaccine later.

I never thought that I would have wanted to have my picture taken for a shot, but others clearly felt the same. Elation, relief, anxiety – all of those emotions bundled into one brief moment.

I applaud all of you for stepping up to get vaccinated. This is the first step of real recovery from the pandemic. You are protecting yourself, your patients, and your families in this process. As I looked at the initial data from the Pfizer vaccine, I was struck by one particular graph.
Red is placebo, and blue is the vaccine, and that’s only after the first dose.

We have to be mindful however, that our eagerness to be vaccinated does not translate wholly to other health care workers and patients. Vaccine hesitancy is a real issue, particularly among communities of color, who have justifiable reasons to distrust medicine in the U.S. We must play our part to convince those around us that the vaccine is first safe, and that it is also efficacious.  Tell your stories, in person, online, and whatever avenues you have to promote mass vaccination.  This is how we get back to normal.

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

President’s Message

Posted on Dec 2, 2020 in President's Message | 0 comments

Thanksgiving just passed, and even though I was working, somehow the holiday was actually quite pleasant.  Several patients said to me, “thank you for being here” – something that I don’t commonly hear, and that small gratitude made me feel much better about the day. I was even able to share some laughs with a particularly upbeat patient who was on her way to the OR.

We’ve all sacrificed a lot this year. These holidays have traditionally been times when we have gotten together with friends and family, shared a meal and stories, and generally reveled in good times. But this year pleads with us not to do that, or certainly not in as carefree a fashion as previous years.

There is a path forward. The promise of an efficacious vaccine is not on the horizon, it’s just around the corner. We have 3 potentially viable vaccines from Pfizer, Moderna, and Oxford/AstraZeneca currently undergoing review process from FDA for emergency use authorization. Sutter has invested in ultra cold storage in anticipation of the distribution of the vaccines. And yet, the nation is experiencing its largest surge yet, with nearly 200,000 new cases reported daily. Most counties in California have gone back to more restrictive measures and even stay at home orders. This past holiday has seen a tremendous amount of travel that threatens to bring that surge back to our doorsteps. We are certainly seeing signs of a steady rise in cases across the Sutter system in the last few weeks.

So I ask of you to be patient, minimize non-essential travel, refrain from getting together with extended family, and continue to adhere to sound public health advice. We are so close, and while the recovery won’t be immediate once the vaccine is deployed, this is our only way to get back to a semblance of more normal living.

Thank you for all the work you have done throughout the year, and thank you for the sacrifices you’ve made. I am proud to be part of the Summit family. Please, let’s us all be safe through this holiday season, and I look forward to us all getting together in person soon.

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

President’s Message

Posted on Nov 3, 2020 in President's Message | 0 comments

This month I would like to try something different.

We are a big medical center with a lot of doctors, and some members of the medical staff I just don’t regularly encounter through my clinical practice as an emergency physician. I’m sure that some of you feel similarly in your daily practice, and as such, I am starting an interview series: “An evening with one of your Summit Medical Staff.”

I would like to start this series with a colleague that to this date I have only met through meetings, but who continually impresses me with the deftness of his comments and his appreciation of the intricacies of other specialties. Not to mention that he is the hippest dressed doctor at Summit!

Sebastian Sasu, MD, chair of Pathology.

Me: “Thanks for giving me some time this evening Sebastian. I know you have a busy schedule, so I appreciate you allowing me to intrude.

SS: Any time for you, Jeff.

Me: So I wanted to do this so that we can learn a little more about you. What made you choose to be a pathologist? We used to have a running joke in my med school that pathologists like dead people…

SS: So, this is going to sound really weird, but the reason I chose pathology is because I like to have the last say. (laughter ensues) We used to go to these multispecialty conferences, the internal medicine doctor would stand up and present the case, and they would tell us all about the patient and how he came in, and then they would say that they got all these radiology studies done, and then he would turn to the radiologist, who would stand up and say “oh, we did these studies and we found this really weird mass, and then we did a biopsy of it.” And then everybody would turn to the pathologist and ask, “what did this patient have?” There is definitely a satisfaction to figuring out what is going on.

Me: If you were not a doctor, what would you be?

SS: A journalist. I’ve always wanted to be a journalist. I’ve always wanted to travel to these fantastic places and cover amazing stories. That sense of get up and go and adventure has always been very enticing.

Me: I know you spent some time practicing in LA. Let’s get down to brass tax, are you an LA or NY guy, or has the Bay area stolen your heart?

SS: That’s a hard answer. I spent some time on the east coast, in Boston, and when I was there, I was a Boston guy, then when I moved to LA, I was still a Boston guy living in LA. But then I spent so much time in LA that I ended up being an LA guy. And then my wife pried me away from that, kicking and screaming, and moved us to the Bay Area. And you know, it was a process, people talk about the difference between Southern California and Northern California, and it’s there. The thing I liked about LA, and what I miss about it, is that there’s a lot more ritz, than there is in the Bay Area.

Me: What’s the rest of the pathology department like? Are they as cool as you? I envision you all sitting around drinking absinthe… or maybe that’s toxicology folks.

SS: Probably not, but about half of the department is as cool if not cooler than I am. You know I’ve been encouraging everybody to be more interactive and show their face more, but believe it or not, we have a lot of clinicians, different specialties come by the pathology department and interact with us. Medicine has changed a lot, in the last 5-10 years. It used to be that certain clinicians that we interact with quite a lot would be in our office everyday looking with us at slides, getting to understand the subtleties of when we make a diagnosis. Like what the gray zones are, what the comfort level was at making a diagnosis.

Me: Can anything gross you out, or are you immune to that sort of thing?

SS: Oh man, nothing can gross me out.

Me: What was your most recent ASMR (Autonomous Sensory Meridian Response – a sort of pleasant paresthesia that goes down the spine) moment?

SS: My what? I don’t know what that is. (explanation above ensues). Nope. (refuses to answer)

Me: Describe to me your perfect evening.

SS: Weekday or weekend? It’s different. Ok – weekday, come home, have a nice dinner with my family, have a nice glass of wine, read my book. Weekend – go out for a drink or dinner, catch a band, and have some good cocktails.

Me: What’s the last book you’ve read? Or what are you reading now?

SS: I am reading a fantasy book, believe it or not. It’s called the Black Song by Anthony Ryan, one of my favorite fantasy writers.

Me: You seem to enjoy the finer pleasures. Cosmopolitan, Martini, Manhattan, or none of the above?

SS: None of the above. I’m actually a custom cocktail kinda guy. I don’t do a lot of the traditional ones. The only traditional ones I do are margaritas and mai-tai’s. But I do a bunch of custom cocktails. My wife does gin and tonics, so I modify her gin and tonics quite a bit, an example would be a dark and stormy with muddled mint. It’s halfway between a dark and stormy and a mojito.

Me: How has the pandemic affected you? Not just at work, but personally?

SS: Both positive and negative. So positive, it’s brought me closer to my family. So we’re spending a lot more time together, and it’s been a lot of fun. Negatively, it’s been the lack of a routine exercise regimen.

Me: Second to you, who’s the coolest person in the medical center to sit down and have a drink with?

SS: There’s actually quite a few people that I would love to do that with. You’re trying to pin me down to one person. That’s a tough thing. Shlomo Leibowich.

Me: PC, Apple, or Linux?

SS: Apple anyday. Anyday and twice on Sunday.

Me: Thanks for giving me almost, gosh, 30 minutes of your time tonight. I hope this was fun for you. It was for me.

SS: And pretty honest answers that are not censored. For whatever that’s worth. I hope I’m not going to be in big trouble.

The above was edited for content and time.

A few reminders for this month.

The physician engagement survey is live and running for the next 3 weeks. A raffle for Apple Airpods goes to one winner from each campus each week. Please fill out the survey (was sent to your email last week) and give honest feedback to the medical center!

Open notes is now live, which means that notes and results for your patients are viewable by the patient in My Health Online in real time. Please be aware of how you are documenting!

The rest of the country is experiencing a significant surge in coronavirus cases but we are currently holding steady in ABSMC and the bay area. We are expecting a fall surge to be imminent. Please continue to practice appropriate social distancing, wear masks, and avoid large social gatherings, especially as the holidays approach.

Stay safe and be well!

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

President’s Message

Posted on Oct 1, 2020 in President's Message | 0 comments

The recent death of Supreme Court Justice Ruth Bader Ginsburg, “the notorious RBG” made me reflect and explore further the efforts that she made on behalf of gender equality.  She graduated at the top of her class at Columbia, but found it difficult to obtain clerkships and positions in law firms after graduation, largely due to pervasive gender discrimination in the 1950’s. When she finally secured a professorship at Rutgers, she realized that she was not working in a level playing field, and was, along with the rest of the female faculty, grossly underpaid compared to her male peers; through collective action she was able to subsequently achieve pay parity. She co-founded the Women’s Rights Project at the ACLU and argued many landmark cases before the Supreme Court, with the position of defending the gender rights of both men and women. As a Supreme Court Justice, she wrote the majority opinion in United States vs Virginia Military Institute in 1996, in which it was the decision of the court that a state supported university could not exclude women on the basis of sex.

So how is this relevant to us today and as a medical staff?

Medicine historically has been a male dominated profession, but the last twenty years have seen a rise in the number of female medical school graduates in the US, with 2017-2018 finally seeing more women than men become physicians.  At the Summit Campus, our current breakdown shows that 80% of our allied health professionals are women, but for physicians, only 32.4% of the medical staff are women.

We have been fortunate to have strong female leadership for the hospital and in our medical staff. Our two prior medical staff presidents and our current vice president are women. Our current Chief Medical Executive is a woman and our regional and organization CEOs are both women. Despite this, I have heard from physician colleagues and witnessed on my own, the bias that exists in treatment of female physicians. This has been supported by several studies[1][2][3] within training programs, and implicit gender bias has wide ranging effects in diminishing the morale of providers and impeding effective patient care.

What is implicit bias? It is subconscious and a product of our cultural norms that cause us to assign certain values and behaviors to certain people; a cognitive shortcut if you will. It is not sexism or racism, but it can lead to pervasive mistreatment of a group of people. Being aware of implicit biases and calling them out when you see them, or recognizing them internally, is a good start to treating others fairly and with compassion and empathy.

Our recent COVID 19 pulse survey showed that as a medical staff, more than 40% of female respondents reported feeling burned out, as opposed to roughly 20% of males. While we are still in the process of trying to discern the reasons for this, the clear difference in perceptions of burnout between the two is quite alarming and will need to be addressed.

 As medical staff president, I want you to know that I strongly support education on implicit bias and will work with administration to help change the climate that continues to favor men over women.

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



[1] Brucker K, Whitaker N, Morgan ZS, Pettit K, Thinnes E, Banta AM, Palmer MM. Exploring Gender Bias in Nursing Evaluations of Emergency Medicine Residents. Acad Emerg Med. 2019 Nov;26(11):1266-1272. doi: 10.1111/acem.13843. Epub 2019 Sep 23. PMID: 31373086.

[2] Galvin SL, Parlier AB, Martino E, Scott KR, Buys E. Gender Bias in Nurse Evaluations of Residents in Obstetrics and Gynecology. Obstet Gynecol. 2015 Oct;126 Suppl 4:7S-12S. doi: 10.1097/AOG.0000000000001044. PMID: 26375558.

[3] Klein R, Julian KA, Snyder ED, Koch J, Ufere NN, Volerman A, Vandenberg AE, Schaeffer S, Palamara K; From the Gender Equity in Medicine (GEM) workgroup. Gender Bias in Resident Assessment in Graduate Medical Education: Review of the Literature. J Gen Intern Med. 2019 May;34(5):712-719. doi: 10.1007/s11606-019-04884-0. PMID: 30993611; PMCID: PMC6502889.

President’s Message

Posted on Aug 5, 2020 in President's Message | 0 comments

It’s been roughly six months since we started planning for COVID-19. We had early hints that the storm was going to come, with an early surge of cases in March. Administration and medical staff leaders came together to devise a plan on how we would handle this new threat; establishing a command center, creating surge plans and capacity to care for those affected, securing PPE, bolstering our testing capabilities, and obtaining therapeutics that may have some benefit. We weathered that initial precipitation quite well, perhaps also lucky that a massive surge did not overwhelm us in the way that it did in other states and localities.

Nationwide, we have approximately 4.5 million cases. Over 150,000 Americans have died. California now leads the country with over 493,000 cases. We have suffered over 9000 deaths. ABSMC has identified and cared for over 468 cases since the start of the pandemic, of which 20 have died. Our current census of COVID patients as of July 30 is 44 cases shared amongst the two campuses. There has been a concerning rise in the overall burden of cases in the community, and as a result, hospitalizations, in the last 2 weeks.

Those numbers above become more personal when among them are our own staff. We recently lost two employees to COVID-19. Janine Paiste-Ponder was an RN on PCU 6 and Juan Salgado was a chef in our Summit café. Both were valued members of our Summit family, and they exemplified the qualities of selflessness and caring that make our medical center so great. They will be greatly missed. I am frightened by the prospect that we will undoubtedly lose more staff members to this deadly disease.

Please know that we are doing everything we can to make this medical center safe for patients and employees. It is absolutely critical that we are consistent with messaging to our fellow doctors and nurses in regards to appropriate PPE, both within and outside the hospital. Miscommunication will only further sow mistrust and fear. Studies have shown that wearing a simple surgical mask while the patient is masked can drastically cut down on transmission. We have an opportunity to model to the community in our personal lives as well, wearing a facemask and eye coverings at all times, even while exercising or being outdoors.  We should not attend large in person gatherings, and limit nonessential travel. Only through concerted efforts inside and outside the hospital can we limit the spread of disease.

A note of positivity:

ABSMC Summit was nationally ranked as a high performing program in bypass surgery, heart failure, and COPD by US News and world report!

https://health.usnews.com/best-hospitals/area/ca/alta-bates-summit-medical-center-6930031#common-care-ratings

Please take care of yourselves and be safe.

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