California Medical Association

Thursday, May 5, 2016

San Francisco Medical Society Blog

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Providing news to the San Francisco Medical Community.


Kristin Hudacek, MD: SFMS March 2016 Member of the Month

Dr. Kristin Hudacek has roots in the East Coast, but is now a full-fledged San Francisco Giants fan. She majored in Chemical Engineering at Princeton University, and then received her medical degree from the University of Pennsylvania. She completed her dermatology residency at Drexel University College of Medicine/Hahnemann University Hospital in Philadelphia, where she served as chief resident in her final year. 

Dr. Hudacek has worked as a board-certified dermatologist at the office of Richard G. Glogau, MD since 2014. She practices medical dermatology, with an interest in women's dermatologic needs and pediatric dermatology. She is also passionate about cosmetic dermatology, and enjoys individualizing her approach to improve the appearance of each patient with the use of botox, fillers, peels, lasers and sclerotherapy. She is accepting new patients. 

 In the Bay Area, Dr. Hudacek enjoys yoga, Spinning, and finding the perfect falafel. She recently got engaged, and she and her fiancé are having fun planning their wedding.

Click here to view Dr. Kristin Hudacek's practice information.


Why are you a SFMS member?

Since I am relatively new to San Francisco, I enjoy meeting people in the Bay Area. The SFMS allows me to connect with the local medical community and also keeps me updated on important health issues, such as the regulation of tobacco products and end-of-life care.

Which SFMS member resource is most helpful to you?

The events are my favorite part. I enjoy learning about advocacy issues and meeting other physicians at the SFMS mixers.

What do you like to do when you're not at work?

I like trying new restaurants and San Francisco is a foodie's paradise. Some of my most memorable dining experiences in the past year include visiting Lazy Bear and Al's Place. In the Bay Area, I also enjoy attending San Francisco Giants games and hiking scenic trails.

What is the most important thing you learned in medical school or residency?

To keep learning. My medical training taught me how to be comfortable reading medical literature, in particular the dermatological medical literature. Given that new treatments and guidelines are coming out constantly, it is important to stay current by reading medical journals. In the field of dermatology, it has been especially exciting to see new oncology treatments show promising results, even in advanced cases of melanoma.

What are some of the biggest opportunities or challenges you see in health care within the next five years?

Maintaining the affordability of pharmaceutical prices is a constant struggle. I dislike changing my prescribing habits in order to write for drugs that are more affordable, but I also know that prescribing medications with exorbitant prices is impractical. I provide patients with medication coupons whenever I can.

What do you love most about practicing dermatology?

Variety! I love that dermatology combines medical treatments, surgical procedures and cosmetic interventions. I'm also fortunate to treat everything from skin cancer to photoaging, and to see patients of all ages.

What is the best piece of advice you have been given throughout your career so far?

Care for the individual, not the disease. While I can read extensively about the treatment of any skin disease, my therapeutic plan will differ based on the age and habits of each particular patient. That is the art of medicine, and that is what keeps each patient visit unique and interesting.

Who’s your favorite music artist/band?

Led Zeppelin, Lady Gaga and Frank Sinatra.

What is your favorite restaurant in San Francisco?

Universal Cafe and La Ciccia

If you weren't a physician, which profession would you like to try?

Teacher. I enjoy educating others about dermatology, and have spoken to nursing students, urgent care health professionals, and mothers' groups about important dermatological conditions and skin care.


SFDPH Health Advisory: Request to Report Overdoses and Deaths due to Illicitly Obtained Fentanyl

At least 48 overdoses presenting in Sacramento County during March-April 2016, and several in other Northern California counties, including two in San Francisco, are believed to involve illicitly obtained fentanyl, an extremely potent opioid analgesic. The overdoses were caused by pills that the purchasers believed to be the opioid Norco® but actually contained fentanyl; several overdoses in 2015 involved both white powder and counterfeit Xanax® pills containing fentanyl in San Francisco. In response, the California Department of Public Health (CDPH) has instituted a surveillance effort based on hospital reporting to local public health departments. 

Actions Requested of San Francisco Hospitals and Medical Providers:

1. Report overdoses and deaths suspected or confirmed to be due to illicitly-obtained fentanyl to SFDPH. Obtain a Confidential Morbidity Report (www.sfcdcp.org/diseasereporting.html), complete the top half and fax it to SFDPH Communicable Disease Control at (415) 554-2848. 

2. Test for fentanyl when conducting drug screening, by adding it to the panel of substances tested. Positive fentanyl tests in the absence of overdose are not reportable, but can provide an opportunity for providers to educate patients regarding the potential for overdose due to fentanyl. 

3. Improve patient safety

a) Discourage patients from purchasing pills on the street. 

b) Refer patients with opioid use disorder to treatment. San Francisco has treatment-on-demand at BAART Turk Street and BAART Market Street methadone clinics close to Civic Center area. 

c) Ensure patients who may access opioids from the street have naloxone. Either direct patients to the DOPE Project or prescribe naloxone directly. 

Persons who may be exposed to opioids are encouraged to have access to naloxone, a short-acting opioid antagonist that is sprayed intranasally or injected to reverse an overdose. Naloxone is not a controlled substance, can be prescribed by any licensed provider, and can be administered by witnesses as a first aid measure. Naloxone is covered by Medi-Cal, Healthy SF, and most health plans, can be furnished by pharmacists without a prescription, and is available free from the DOPE Project, targeting drug users and their friends and family via syringe exchange sites.

Treatment Referrals

Click here for the SFDPH Health Advisory issued on May 3, 2016.


Physicians Champions Bills to Increase Access to Care at Legislative Leadership Day

More than 300 physicians, including SFMS members, participated in CMA’s Legislative Leadership Day on April 13 at the State Capitol. The SFMS group, represented by leadership as well as at-large members, met with Senator Mark Leno, Assemblymember David Chiu, and Assemblymember Phil Ting. 

The SFMS delegation focused on advocating for a package of public health bills that puts the focus on issues like vaccination, tobacco tax, increasing provider rates for Medi-Cal, and establishing a Graduate Medical Education Trust Fund in light of inadequate funding levels from the federal government. 

SFMS would like to thank the participants for championing the cause of San Francisco physicians and their patients. We hope to bring an even larger group to Sacramento for Lobby Day 2017.

Click here to view more photos from the event


CMS Releases Notice of Proposed Rulemaking for MACRA

CMS released a notice of proposed rulemaking (NPRM) for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Supported by a bipartisan majority and stakeholders, such as patient and medical associations, the MACRA legislation ended more than a decade of last-minute fixes and potential payment cliffs for Medicare doctors and clinicians. It also made numerous improvements to America’s health care system. 

Currently, Medicare measures the value and quality that physicians and other clinicians provide through a patchwork of programs. In the MACRA legislation, Congress streamlined these programs into a single framework to help clinicians transition to payments based on value from payments based on volume. The proposed rule would implement changes through this unified framework known as the Quality Payment Program, which includes two paths: 

  1. Merit-based Incentive Payment System (MIPS): Most Medicare clinicians will initially participate in the Quality Payment Program through MIPS. MIPS allows Medicare clinicians to be paid for providing high value care through success in four performance categories:
  • Quality (50% of total score in year 1)
  • Advancing Care Information (25$ of total score in year 1)
  • Clinical Practice Improvement Activities (15% of total score in year 1)
  • Resource Use (10% of total score in year 1)
  1. Advanced Alternative Payment Models (APMs): Clinicians who take a further step toward care transformation would be exempt from MIPS reporting requirements and qualify for financial bonuses. These models include:
  • Comprehensive ESRD Care Model (Large Dialysis Organization arrangement)
  • Comprehensive Primary Care Plus (CPC+)
  • Medicare Shared Savings Program – Track 2
  • Medicare Shared Savings Program – Track 3
  • Next Generation ACO Model
  • Oncology Care Model Two-Sided Risk Arrangement (available in 2018) 

Click here to review the press release on the MACRA proposed rule

Additional resources


SFMS Advocates for Public Health Protections to Help Prevent Diabetes, Heart Disease, and Stroke

Today, the SFMS joined the American Heart Association and other public health experts in a press briefing in support of World Health Day and San Francisco’s sugar-sweetened beverage warning label for advertisements legislation.

The City’s warning label ordinance, endorsed by SFMS, is widely recognized as a consumer-friendly tool to increase health awareness and information. Supervisor Scott Wiener and Dean Schillinger, MD, from the UCSF Diabetes Center highlighted the importance of educating communities and consumers most negatively impacted by sugary drinks. SFMS was represented by board member John Maa, MD, and UCSF medical students.


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