Roger Ohanesian, MD
OCMA member since 1976
Roger Ohanesian, MD, a Laguna Beach ophthalmologist, returned in July from his 30th humanitarian trip to Armenia, where his efforts and those of the Armenian EyeCare Project that he founded in 1994 have helped turn ophthalmic care in the country from "a state of despair into a center of excellence," he says.

Dr. Ohanesian made his first medical mission to Armenia in 1992, responding to a general plea for help from its health minister that year to "fight the growing wave of blindness" caused by war and an earthquake. During the recent trip, "I brought with me about 15 ophthalmologists and [many] other people from Orange County," Dr. Ohanesian says. "Everyone had some connection to medicine." He makes two trips every year with the EyeCare Project, for about two or three weeks apiece.

In addition, the project helps to advance the training of Armenian ophthalmologists. "I find some of the country's very skilled people, bring them over to the United States and get fellowships for them," Dr. Ohanesian explains. Doctors in the program have earned fellowships related to retinal surgery, glaucoma, neuro-ophthalmology and orbital surgery, and they have studied at institutions such as the Procter Foundation, the Massachusetts Eye and Ear Infirmary, USC and UC Irvine, he says. With their new skills, these physicians have established seven or eight clinics in Armenia since 1998, with the EyeCare Project providing equipment, he adds.

Since 2003, the project has also operated a mobile eye-care facility that an 18-wheeler carries along the poor roads of Armenia's countryside. Dr. Ohanesian estimates that the facility has been the site of 170,000 patient screenings and 8,000 surgical procedures.

Richard Declusin, MD
VCMA member since 1986
Dr. Declusin, an Oxnard cardiothoracic surgeon, was one of only four California surgeons found to have significantly better patient mortality than the state average following coronary artery bypass graft surgery, according to a July 12 agency report. The Healthcare Quality & Analysis Division of the California Office of Statewide Health Planning and Development issued the report after examining 121 hospitals and 302 surgeons during 2003 and 2004.

"We do a lot of our surgery, about 98 percent of it, as beating heart surgery, where we don't put the patient on heart-lung bypass," Dr. Declusin says, explaining the success that he and partner Bruce Toporoff, MD, a cardiothoracic surgeon, have had with lower patient mortality. In the nation overall, only about 25 percent to 30 percent of surgeries are done using the beating heart technique, he says. Still, Dr. Declusin is quick to credit the contributions of other staff, including anesthesiologists, cardiologists, critical care specialists and nurses, for the positive outcomes as well.

The OSHPD's California Report on Coronary Artery Bypass Graft Surgery only includes 2003-04 data from Dr. Declusin's work at St. John's Regional Medical Center in Oxnard. However, he's seen the data for last year. "We're rated the best again," he says, proudly. More recently, his team began working this year at Los Robles Hospital and Medical Center in Thousand Oaks.

Michelle Laba, MD
VCMA member since 2007
Dr. Laba is the medical director of the new Mandalay Bay Women and Children's Medical Group in Oxnard, which opened its doors to patients this spring.

"I've been the medical director of Mandalay Bay [Children's Center] since July 2004, but in May of this year, we changed the name and created a joint venture with our obstetrician/gynecologist," Dr. Laba says. The center's reinvention involves "a new facility, all sorts of different services and many more doctors." The center is the first of its kind in Ventura County, and there is only one comparable facility each in Los Angeles County and San Diego County, she adds.

The unusual focus on care for both women and children is intended to make visits to the doctor more convenient for the center's largely underserved patients. "A mother is able to be seen for her routine gynecologic needs, for post-partum care or for any kind of [ob/gyn] problem," says Dr. Laba. "Once a pregnancy is complete, she is referred to the same group of doctors on the pediatric side for childcare."

The women's and children's medical center also makes it possible for pediatricians and obstetricians to work jointly on special programs. In one such program, obstetricians screen all pregnant women to assess their use of drugs or alcohol and offer recovery options, while Dr. Laba and other pediatricians take care of the children after birth. Another project deals with depression. "We just launched a project where we jointly screen women for post-partum depression both at the six-week, post-partum OB check, and at the two-week or 1-month-old well-child visit," she says. "We have a psychologist available onsite to offer counseling services."

Janis Neuman, MD
RCMA member since 2004
Dr. Neuman in August became medical director of Exclusive Care, a health plan for Riverside County employees and their families, as well as in-home support staff through the state's Public Authorities for In-Home Supportive Services.

The former chief of medical services for the Riverside County Department of Public Health, Dr. Neuman now oversees Exclusive Care's utilization management, dealing with denials and appeals. "I also do a lot of coordinating and facilitating care for patients, and working with providers to provide care for members," she says. "So far we have about 10,700 members." Additional members may be added as the program has recently been expanded to offer services to retirees in Orange County.

In her new position, Dr. Neuman considers distinguishing Exclusive Care from its competitors a priority. "We're starting a pharmacy at one of our clinics to help prescription coverage for patients," she says. In addition, Dr. Neuman is identifying "centers of excellence," which she says the health plan would use for patients with certain needs, such as transplant, coronary artery bypass or prostate cancer treatment. "We're looking at sites where you can go and have these procedures done with the best possible outcome."

Arthur Calick, MD
OCMA member since 1974
Dr. Calick is medical director of the Chest Pain Center at Fountain Valley Regional Hospital, which became Orange County's first accredited center of its type in May.

"It seems like the term chest pain center could mean anything--a doctor's office, a lab or a hospital," Dr. Calick says. "It wasn't a term that people would use, [saying] 'I'm going to a chest pain center, and I expect to get the best care by the best physicians.' There was no guarantee that that's what they would get."

However, the Society of Chest Pain Centers, established by nationally recognized cardiologists and emergency medicine specialists, has been working to change that situation for the past seven years, Dr. Calick says. "The society set up a program that it wanted hospitals throughout the country to fall in line with, because the practice of taking care of people with chest pain was so varied," he explains. The lack of standardization stems partly from the development of new techniques over the past 20 years, yet lives can be lost without a scientific approach, he adds.

"It actually takes them months to review your hospital," Dr. Calick says. "They make a detailed site visit, talk to everybody involved and look at your equipment." Ultimately, the investigators send data to the society's board, which makes the final accreditation decision based on three criteria: a scientific approach; unified operations involving paramedics, the hospital and a preventive plan; and a strong quality-improvement program.

Dr. Calick knows of only two other local accredited centers, including Long Beach Memorial Medical Center and Riverside Community Hospital. "If there's some way to encourage major hospitals like St. Joseph and Hoag to join on, it would really be a good thing to standardize care throughout Orange County," he says.