Lt. Gov. Cruz Bustamante writes about his personal battle with obesity. He notes that the direct and indirect medical costs of obesity in California are $21.7 billion annually. What's one way to reduce those costs? Personal accountability--his own.

Mitchell Streger, MD * Mathias Fobi, MD * Thomas LaGrelius, MD * Paul Silka, MD * John V. Hill, MD

Learn and communicated the common-sense guidelines to prevent illness and injury.

For medical ethics reasons, the assocation has proposed legislation to eliminate physician participation in executions.

Gov. Arnold Schwarzenegger signed legislation in late February that reverses a 5 percent Medi-Cal provider rate cut that went into effect Jan. 1. The bill passed unanimously in both houses of the Legislature. The California Medical Association and a broad coalition of healthcare organizations applaud the action, which protects 3 million poor, elderly and disabled Californians who rely on Medi-Cal for their healthcare.

The economic divide between specialists and general practitioners is real, but physicians don't take out their financial angst on each other. Insurance plans and government payers get the blame for ratcheting down reimbursement. Still, salary considerations are changing who practices what, as medical students move away from primary care. Take a closer look at the salary rankings for 30 practitioner types. On the cover is Kristin Santangelo, MD, a Ventura urologist. She says, "I hear a generalized gripe about more work for less pay."

Physician-authors share why the want to write and what subjects are most important to them. Meet Patricia Salber, MD; Robert Kotler, MD; Howard Murad, MD; Anton Hasso, MD; and Peggy Fritzsche, MD.

I don't know about you, but my practice runs on pens, and I can't seem to keep a pen for more than a few minutes. I am not sure what happens to my pens. They must jump from my pocket or I must just set them down without noticing. To keep my practice going, I count on a fresh supply of pens from my local drug reps. But now some folks are calling on a ban to cut off my supply of pens.

Effective this month, Medicare carriers will no longer accept "surrogate" physician identification numbers, according to Catalina Jovane, director of economic advocacy services for the Los Angeles County Medical Association.

Physicians get an update on CMA-sponsored bills in 2006 and discuss politics in an election year. Physician-assisted suicide, HMO reform and scope-of-practice bills are the key battleground issues.

Even though he wanted to, Allan Perry Sr., MD, never pressured his kids into pursuing the medical profession. After watching his colleagues make that mistake, he vowed not to take that path. "When a couple of my friends pressured their kids into entering medicine, their kids became doctors and hated it. Some of them quit," says Dr. Perry, a Glendale plastic surgeon and longstanding member of the Los Angeles County Medical Association. Instead, his children say Dr. Perry Sr. led them to the profession by example. Two out of three kids ended up following in his footsteps.

Challenges to medical staffs are likely to continue. Under the auspices of a strong medical staff organization, we should have the numbers and resources to lead our colleagues away from conflicts and toward collaboration to ensure a fertile hospital environment.

The Orange County Medical Association hosted a Physicians Advocacy Forum on Saturday, Feb. 25, in Irvine that attracted more than 90 physicians from Orange County and surrounding areas. The forum highlighted issues facing medical staffs.

My experience of evolving from a small family practice into a medium-sized multispecialty medical group triggered thoughts on the dilemma that forced this transition. Having lived through the revolution from patient responsibility to employer responsibility for payment of medical care, I offer these thoughts. I present this through the limited view of outpatient practicing physicians.

Three years ago I wrote an article for this magazine about whether healthcare was a right or just another necessary commodity, like food and shelter, to be purchased out of the family budget. It was my opinion that healthcare was perceived by 21st century Americans as a right and that no amount of economic or philosophical reasoning was going to change this feeling. Perception, in this case, was reality. Nothing in the past three years has caused me to change my opinion. If anything, it has been reinforced. Public attitudes have become even more fixed.

Riverside County's shortage of judges can negatively impact medical malpractice cases. The county has called two civil case moratoriums to cope with the problem. Given the environment, physicians would benefit from understanding how such moratoriums impact medical malpractice lawsuits.

A new UC Riverside medical school may be a step forward in alleviating a projected shortage of physicians uncovered in a number of studies during the past five years. San Bernardino County Medical Society members should participate however we can to make the medical school a reality.

The San Bernardino County Medical Society discussed physician reimbursement issues, reviewed financial reports, approved the Nominating Committee's slate and pondered the Inland Empire Regional Health Information Organization.

When the Medicare Part D drug benefit was enacted on Jan. 1, the Medicare system became responsible for the prescriptions of its 41 million recipients. In essence, the federal government became the largest buyer of pharmaceuticals in the U.S. However, the legislation that authorized Medicare's drug benefit forbids the federal government from negotiating directly with the drug manufacturers to obtain lower drug prices for seniors and the Medicare program.

The Ventura County Medical Association is proud to present a variety of education events for physician members. Take a look at the local offereings and take part in the meetings.

Here are four ways to meet your pain management requirement before December's done.

By offering special incentives, radiologist Danny Chang, MD, is increasing mammography screening rates at Kaiser in Riverside and beyond.