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June 5, 2018



California's End of Life Option Act Overturned by Court in May Ruling

The Riverside County Court formally entered its judgment in the Ahn v. Hestrin case and officially has invalidated the California End of Life Option Act (EOLOA). The May 25 ruling was in response to California Attorney General Xavier Becerra's May 21 appeal and the court’s original May 15 decision. Attorney General Bacerra's appeal argued that the Special Session in which the Act was passed was dedicated to health care and that aid-in-dying is a health care issue, so passage of the Act was appropriate. He also requested the law be allowed to continue during the appeals process; a three-judge panel rejected that request.


Despite the May 25 dismissal, the court has given EOLOA supporters and the Attorney General's office time to make the case as to why the court should allow the law to continue while a final ruling is sought. This action has caused uncertainty among patients seeking life-ending medicines, as well as among physicians who support them. Several experts argue that, despite the appellate court’s decision to allow more evidence to be gathered for an appeal, the original ruling that patients and physicians are prohibited from participating in the law means that it remains illegal to provide EOLOA care as the case proceeds through the courts. Others argue the opposite.


In the absence of legal certainty about the status of EOLOA, CAFP currently is unable to recommend a course of action. As soon as more information is known, we will communicate with members.



Jeffrey Luther, MD Appointed to AAFP Reference Committee on Education

Senior CAFP Delegate to the American Academy of Family Physicians (AAFP) Jeffrey Luther has been appointed to the 2018 Congress of Delegates’ Reference Committee on Education, which will meet in New Orleans, LA on Monday, October 8. Congratulations, Dr. Luther.



Updates on Board Action on Resolutions Posted to Website

The CAFP Board of Directors took steps to improve opportunities for member input on proposed policy resolutions submitted by members between annual All Member Advocacy Meetings (AMAM). Under bylaw changes adopted in 2013, the Board now acts on all proposed policy resolutions, even those submitted to it at the AMAM, at which it hears testimony.


The process now will include:

  • All resolutions/policy proposals submitted to the Board of Directors after the deadline for receipt of resolutions at the AMAM and prior to the next AMAM will be posted on the CAFP website. Members will be notified about the posting via CAFP’s Academy in Action electronic newsletter. The resolutions will remain on the website until the next quarterly Board meeting at which they will be considered, but for no less than one month prior to the next meeting. If a resolution is received within less than one month of a Board meeting, it will be held over until the following Board meeting to allow adequate time for members to comment. Member comments will be provided to the Board.
  • A chart reflecting actions taken by the Board on all resolutions will be posted on the website and updated after each meeting of the Board of Directors. All authors are notified of actions taken on their resolutions.

    As a reminder, CAFP members are invited to submit proposed policy resolutions to the CAFP Board of Directors at any time during the year, not just at the AMAM, which next will convene in Sacramento at The Citizen Hotel, March 9-10, 2019. Family Medicine Lobby Day will be held Monday, March 11.



    CAFP Board Will Meet July 14

    A truncated Board of Directors meeting will be held on July 14, prior to the start of the Academy’s every-three-years strategic planning session on that afternoon and evening and Sunday morning, July 15. The 2017 Financial Review will be considered along with proposed actions on a number of resolutions submitted at the All Member Advocacy Meeting and afterward, as well as updated recommendations on bills pending before the state legislature. CAFP will welcome new Board members at this meeting: Alex McDonald, MD, New Physician Director, Brent Sugimoto, MD, Editor, Robert Assibey, MD and Cynthia Chen-Joea, MD, Resident Co-Directors and Ms. Andrea Banuelos Mota, Student Co-Director. One Student Co-Director has yet to be named.



    SPARK Is a Great Place to Share Information: Today’s Topic is PrEP

    CAFP Editor Brent Sugimoto, MD asked a question on SPARK last month about family physicians’ awareness and use of PrEP for patients with HIV. We had some terrific dialogue among members and the Committee on Continuing Professional Development will be taking on the topic for education. CAFP member Ron Goldschmidt, MD also posted the following information, and we thought we should share it with all CAFP members.


    “Our Clinician Consultation Center at SFGH/UCSF provides free telephone consultation to clinicians on our national PrEPline at 1-855-448-7737 (1-855-HIV-PREP). Consultations take about 10 minutes and can include a review of the appropriateness of PrEP in individual cases, administration tips, drug-drug interactions and management of (rare) side effects, laboratory monitoring and what to do if there are abnormal laboratory results and some information on how to get the costs of PrEP covered. We would be delighted to give you more information for any CAFP outreach activities, as the goal is to make sure clinicians are comfortable providing PrEP when appropriate and are able to handle any problems that might arise. We also run the national PEPline and find that we frequently provide consultations to clinicians who do not realize that their patient might be a candidate for PrEP when their course of PEP is complete. That is another great guidance opportunity for the PEPline-PrEPline. Glad to help in any way CAFP and its membership would like.”


    Do you have a question you’d like answered? A problem you’d like to share? An idea that might make practice easier? SPARK is your online community – all CAFP members are enrolled, you need only to login and create your profile to engage with your colleagues. It’s time to get involved:



    Reproductive Health Initiative Launches … Free CME Options Available to Family Physicians

    Did you know that the average American woman becomes sexually active at age 17 and wants two children? She will spend approximately four years of her sexually active reproductive live either pregnant or trying to get pregnant, and 25+ years trying to avoid pregnancy.


    CAFP has launched a three-year educational initiative that includes a wide range of activities – from live sessions at meetings to an ABFM performance improvement (Part IV) module, all of which are free! We encourage you to begin the program and by completing our Learner Self-Assessment (LSA). This online knowledge and attitude assessment gives you a sense of practice gaps and assists you in planning educational interventions to close the gaps. Colleagues from every state AFP chapter will be participating and you’ll be able to see where you fall in the scoring. The assessment also includes the correct answers and all citations and rationales. The LSA is sponsored for .25 AAFP Prescribed or AMA PRA Category 1 credits™ and is free to all health care clinicians. Visit our website for more information on the activities available to you and your practice team.



    June 2018 Member of the Month Rossan Chen, MD

    Congratulations to our June Member of the Month, Dr. Rossan Chen. Dr. Chen is a graduate of University of California, San Francisco and completed her residency in Family and Community Medicine at San Francisco General Hospital. She currently is co-director of the Community Medicine curriculum at the Kaiser Napa Solano Family Medicine Residency Program in Vallejo. Dr. Chen serves as chapter president for the recently-reactivated Napa-Solano chapter of CAFP and regularly represents the Family Physicians Political Action Committee at local events and meetings with her legislators. When asked about a current project, Dr. Chen says, “I am collaborating to build a health policy and advocacy toolkit. The toolkit is designed to be used by residents on a two- or four-week health policy and advocacy elective anywhere in the country.”