March • 2022
March Brings to Us
March brings to us discussions on women's history,
Physician wellness and burnout, to us no mystery,
An open letter to the nation on prioritizing youth,
And advocacy we do beyond the voting booth.
President's Column
Nelson Branco, MD, FAAP
One of my first columns for this newsletter as Chapter Vice President was about physician wellness and burnout. What I wrote then is even more true now, as we enter the third year of the COVID pandemic. Quoting that column from 2019:

“I recently attended a talk by Tait Shanafelt, MD, the Chief Wellness Officer for Stanford Medicine. After presenting the statistics and discussing the scope of the problem, he talked about some interventions that specifically addressed burnout and satisfaction by fostering community and support from colleagues. The results were impressive, if unsurprising, physicians who had a structured, regular way to connect with colleagues had lower levels of burnout and found more meaning in their work. His summary: “The medicine was colleagues connecting with each other. Everything else was the syringe.”  
As I said in that column, my involvement with my AAP colleagues is the “medicine” for me. Staying connected to you all and doing the learning, advocacy and work of caring for each other and our patients is one of the ways I stay energized and enthusiastic. Starting this spring, the chapter is offering another resource for our members who may be feeling emotional fatigue and stress. We are partnering with Dovetail Learning to conduct Resilience Circles to help our members get some respite and recharge. These Resilience Circles are structured around the Dovetail Learning We Are Resilient approach, which provides “practical, research-based skills for coping with stress, strengthening relationships and finding joy.” If you are interested in getting more information or participating in this program, sign up here:
If you’re looking to get more involved with the chapter at the board level, please let us know. Chapter elections will be held this spring and there will be openings for some Member-at-large and Officer positions. We also have many committees that are always looking for more members - take a look at the Committees page on our website for a complete list. 

While you’re on the website, take a look at the Events page for information about upcoming Chapter Chats, and very soon you’ll be able to register for our Spring CME Meeting - it will be another great meeting with interesting speakers and useful topics.

In my last few columns, I recognized all of our Chapter members who are working with AAP National committees, sections and councils. We have some additions to that list already. Dr. Gregg Lund is the Chair-Elect of the Section on Osteopathic Pediatricians (SOOPe) and Dr. Virginia X. Barrow is a newly elected member for the Committee on Continuing Medical Education (COCME). Congratulations to both of them! 

I am also very pleased to share that Dr. Mikah Owen has accepted our invitation to become our AAP CA Chapter 1 EDI Champion. We will be working with Dr. Owen to establish this role within our chapter leadership and I look forward to learning from him and working together to make sure that equity, diversity and inclusion are part of everything we do as a chapter. Please join me in welcoming Dr. Owen to this role.
Vice President's Column
Nicole Webb, MD, FAAP
As many of you know, March is Women’s History Month. What you may not know is that what we now recognize nationally as Women’s History Month started out in 1978 in prime AAP CA-1 territory. Organizers in Santa Rosa, CA planned a local Women’s History Week celebration. Organizers picked the week including March 8 to coincide with International Women’s Day. The movement quickly spread across the country, and in 1980 under the leadership of the National Women’s History Project (now the National Women’s History Alliance), women’s groups across the country successfully lobbied for national recognition. President Jimmy Carter made a proclamation in February 1980 recognizing the week of March 8 as National Women’s History Week. You can read more here.

Over the years, Women’s History Week has grown to Women’s History Month, still spearheaded by the National Women’s History Alliance (NWHA). This year’s theme is “Women Providing Healing, Promoting Hope”, which in their words is “both a tribute to the ceaseless work of caregivers and frontline workers during this ongoing pandemic and also a recognition of the thousands of ways that women of all cultures have provided both healing and hope throughout history.”

I’m sure many of us, reflecting on the past 2 years in particular, can think of no better theme for honoring women this year. Yet, even as we honor women as healers and promoters of hope, I can’t help but reflect on the wide and pervasive gender disparities that exist in medicine, including in pediatrics. Women comprise over a third of the physician workforce as a whole, and nearly two-thirds of pediatricians. In my discipline of pediatric hospital medicine, that number is closer to 70%. Despite this, women in pediatrics make only $.76 for every $1.00 earned by their male counterparts. While the absolute percentages vary slightly, these discrepancies are seen across all medical specialties and subspecialties, pediatric or otherwise. There are also significant disparities by race/ethnicity however the primary driver of differences in wages is gender, as shown by the 2021 AAMC Report: Exploring Faculty Equity at US Medical Schools by Gender and Race/Ethnicity.

These findings echo gender disparities seen in the US workforce as a whole, and have likely only worsened during the pandemic, as women report higher degrees of burnout and depression, greater caregiving responsibilities, and higher likelihood of working reduced hours or leaving the work force altogether. Indeed, it is telling that, while March was initially chosen for Women’s History Month to coincide with International Women’s Day, it also coincides with Equal Pay Day, which is the day that marks how long into the new year women must work to equal the pay received by men in the previous year. This year, that date is March 15, 2022. To put this into perspective for those of us in medicine, according to a recent study, women physicians will earn on average $2 million less than their male counterparts over a 40-year career.

These disparities are sobering, and while they are multifactorial, gaps still persist even after adjusting for such factors as race/ethnicity, specialty and work hours, workload and work setting, and children, periods of work reduction, and work choices made for the family. This highlights the need for comprehensive, structural change. 

The AAP supports such efforts. In fact, one of the AAP Top 10 Resolutions from 2021 addressed this: “AAP Support for Gender Pay Equity for its Members”. Specifically, the resolution states that “the Academy publish and publicize a statement of its unequivocal support for gender pay equity in pediatrics”, and that “the Academy encourage transparent oversight of compensation models, metrics and actual total compensation and annual internal publication within departments, institutions and practices by rank, years of employment, and gender”.

There are many opportunities to engage with this work within the AAP, at the chapter, district, and national level. Do not hesitate to reach out if you have suggestions or insights to offer. Another great way to continue to focus on this and other issues, and shape the AAP Advocacy agenda, is by submitting a resolution for the Annual Leadership Conference (formerly Annual Leadership Forum or ALF). The deadline to submit resolutions for this year is April 1, 2022, and you can find more info, including an info session on resolution writing, here.

The field of medicine has come a long way since 1850 when Elizabeth Blackwell made headlines for being the first woman to enroll at a US medical school. We still have quite a way to go toward achieving equity, however. As with all disparities, to achieve sweeping, structural change, we need allies and dedicated advocacy. As we reflect on Women’s History Month this year, let’s all make a commitment to working toward gender equity, both in medicine and in the broader context of life overall. 
Boosting Teens' COVID Vaccine Confidence
Morgan Leighton, MD, MPH, FAAP, Chapter Immunization Champion & Janice Kim, MD, MPH, FAAP, Chapter Secretary and Communications Director
#Tweetiatricians, did you see the chapter’s social media posts encouraging teens to talk with their parents and pediatricians about COVID vaccines? No? Well… phew! That’s because the Chapter received a grant from National AAP to post social media ads to build confidence in COVID vaccines for adolescents, and we aimed the ads for 13- to 17-year-olds! So if you didn’t see them, that means Instagram and Facebook did its job.  
Spearheaded by Morgan Leighton, MD, MPH, FAAP, our chapter’s Immunization Champion, with the help of Megan Warner, MPH, Isra Uz-Zaman, MS, and Janice Kim, MD, FAAP, this project reached over 570,000 viewers and generated 4,000 clicks to a teen-focused COVID vaccine resource page on our website. National AAP provided social media ad training through a consulting group and funding. Through a partnership with the California Department of Education, Morgan recruited a 17-year-old college student, Joyce, to create a short video describing her personal reasons for getting the COVID vaccine. Meanwhile, an ad directed 187 teens in our catchment area to a short survey about the COVID vaccine; 82% of respondents who did receive their vaccine(s) shared their reason was to protect themselves, family members, and/or their communities. They also shared their concerns about the vaccine. Equipped with these insights, Morgan created two videos speaking to teenagers that addressed side effects and vaccine safety. In a single week, these videos reached 125,561 and 124,652 teenagers respectively, nearly 2,000 of whom clicked on our resource page to learn more. On average, the cost of a given ad to reach a teenager was a penny and it cost between $0.88 - $4.71 to generate a click. 
We were encouraged by how we could engage youth directly, and that 82 (43%) of the teens surveyed volunteered their emails to be contacted to give more input in the future. With the training provided, we have also added a skill set to the chapter in how to use social media ads to reach focused populations that we hope can help with other projects in the chapter. Let us know if you’d like to hear more about this project or use a similar strategy for something you’re working on!
The SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH, CFAAP
SGA Chapter Representatives
We will have SGA updates for you next month, but in the meantime, AAPCA1 has signed on to a national open letter advocating for investments to support families of young children. 
Read Full Letter:
We encourage you to advocate and amplify these further by circulating these sign-ons to your networks and coalitions. 
For the most up-to-date information on AAP California bill positions, letters, and outcomes from the current California Legislative year, go to For the latest organizational advocacy updates follow @AAPCADocs on Twitter. If you have questions and/or are interested in knowing more about certain legislation, reach out to our State Government Affairs Chapter Representatives Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH at
Addressing Social Emotional Health and Early Childhood Wellness (ASHEW)
John I. Takayama, MD, MPH, FAAP
Physician Co-Lead for AAPCA1 ASHEW QI Project
This article was previously published in the AAP SODBP Newsletter
In early 2020, at the start of the Covid-19 pandemic, the American Academy of Pediatrics recruited 7 chapters to embark on a national collaborative to improve screening for social emotional health in young children. Each chapter, in turn, recruited ten practices to participate in ASHEW, a quality improvement (QI) initiative to screen for postpartum depression, social determinants of health and social-emotional development in young children. The purpose of ASHEW was to enable pediatric practices to identify and address unmet social needs and support social and emotional wellbeing of children and families.

Practices prepared to carry out this initiative by participating in workshops to learn strategies, tools and resources; and adapting them to increase screening, counseling, connecting and following. With support from national leadership, each chapter tailored a standard curriculum to one that fit regional needs. Critical aspects were the training of chapter leaders, practice leaders and practice team members in understanding and implementing key primary drivers (Table 1) and monthly collaborative meetings for practices to share successes and challenges.

Table 1. ASHEW Primary Drivers1
1. Prepare practice environment for trauma and resilience-informed care
2. Foster and continually expand referral networks
3. Utilize family-centered, strength-based approach
4. Establish and maintain effective systems to support assessment, primary care intervention, referral and follow up
5. Ensure care is delivered to advance race and ethnic equity

In California Chapter 1, composed of pediatricians that serve 48 counties in Northern California, we relied on expertise and experiences from adopting California’s mandate to screen all patients annually for Adverse Childhood Experiences ( In one of the learning sessions for pediatricians, Dayna Long, MD, FAAP, provided an overview of the prevalence of ACEs and the rationale for screening, as well as resources for both clinicians and patients on trauma-informed care (Table 2). One message that resonated was a reminder to ask about family strengths and protective factors. Many of our practices used the PEARLS screening tool ( to assess both ACEs and social determinants of health.
Chapter Leadership: Gena Lewis, MD, FAAP; John I. Takayama, MD, MPH, FAAP
Subject Matter Expert: Dayna Long, MD, FAAP
Family Advisor: Jacques Ibula Katakanga, MBA
Project Manager and Chapter Executive Director: Isra Uz-Zaman, MS
Project Coordinator: Aliza Newman, BA
Introducing our Annual Spring CME Conference: 
Itches, Wheezes, and Sneezes
Mika Hiramatsu, MD, FAAP
CME Committee Chair
Have you wondered whether to send that kid with terrible asthma to the allergist? Do you think you’ll ever prescribe dupilumab? Do you sometimes wish your patients’ subspecialists would just talk to each other? Your wish is answered . . . at the upcoming May 7 CME meeting in Fairfield. We will have an allergist, dermatologist and pulmonologist respond to your case questions. Located conveniently at the intersection of highways 680 and 80, 15 minutes from the Vacaville outlets and a half-hour from Napa Valley, you can enjoy the afternoon relaxing after a fulfilling morning of education. Come join us! Registration opens very soon.
Chapter Member Spotlight - What We Are Reading
Do Healthy Young People Need the COVID-19 Vaccine? - By Pamela Simms-Mackey, MD, FAAP 
What's Up Docs? Blog
We'd Like to Feature You!
Opportunities for Your Benefit
21st Annual Developmental Disabilities: Update for Health Professionals
This 21st annual interdisciplinary conference offers a unique update for primary care and subspecialty health care professionals and others who care for children, youth, and adults with developmental disabilities and complex health care needs. Our successful inaugural live stream conference in 2021 was well-received, reaching an audience of more than 300 registrants representing 16 states. Due to continuing concerns with the COVID 19 pandemic, we will continue the live stream format, employing a live stream webinar and user-friendly interactive virtual platforms. The live presentations will be recorded and made available for 30 days so you can review any content you might have missed.
Learn More & Register HERE.
Opinions and practices of pediatricians and pediatric providers regarding discussing climate change within pediatric clinical settings. 
On behalf of fellow pediatricians and the University of Pittsburgh, we are inviting you to participate in a research survey to learn more about the opinions and practices of pediatricians and pediatric providers regarding discussing climate change within pediatric clinical settings. This study includes a 5-minute online survey reporting your opinions on discussing the health effects of climate change with patients and families. Following the survey, you will have a chance at one of twenty $50 Amazon gift cards. Chances of being chosen are expected to be approximately 1 in 20. In a second survey, you will be asked to enter personal contact information. This is only to contact you if you are chosen to receive a gift card and will not be linked to your first survey answers. 
Participation is voluntary. If you are interested, please follow this link to THIS SURVEY.

For questions, you can contact the study coordinator, Erin Mickievicz (, or the principal investigator from the University of Pittsburgh, Dr. Maya Ragavan ( Thank you so much for considering and we are so deeply grateful to learn from your expertise! 
So Much Happening! Here's a Snapshot.
You Can Register Now!
March 9 at 1PM - Improving ADHD Care in Pediatric Settings: Overcoming Barriers to Implementing the AAP ADHD Guidelines in Practice - REGISTER HERE
March 9 at 7PM - Addressing Mental Health in Primary Care: Applying Integrated Care Practices to Optimize and Elevate the Mental Health Care Pediatricians Deliver Every Day - REGISTER HERE
March 23 at 7PM - Clinical Recommendations & Models of Care for Newcomer Children - REGISTER HERE
April 13 at 4PM - Enhancing Adolescent Health & Immunization Services AAP Webinar 2 - REGISTER HERE

Save the Date!
April 20 - Mental Health Chat w/ CAPP
May 7 - Annual Spring CME Conference in Fairfield
May 11 - Mental Health with CAPP
June 8 - HP 2020 Medical Legal Partnerships
June 22 - Enhancing Adolescent Health & Immunization Services AAP Webinar 3
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Your membership makes a difference for children in California, thank you!

The AAPCA1's ability to advocate on behalf of children is only as strong as the support we receive from our members. Encourage your colleagues to join today by visiting the AAPCA1 website.

Our mission is to promote the optimal health and development of children and
adolescents of Northern California in partnership with their families and communities, and to support the pediatricians who care for them.

Executive Committee:
President: Nelson Branco • Vice President: Nicole Webb
Secretary: Janice Kim • Treasurer: Nivedita More • Past President: Raelene Walker
Executive Director: Isra Uz-Zaman

Board Members:
North Valley MAL: Thiyagu Ganesan • Sacramento Valley MAL: Lena van der List • Central Valley MAL: Deborah Shassetz • South Valley MAL: Tashya Jayasuriya Whitehead • San Francisco MAL: Vacant • Santa Clara MAL: Meera Sankar • San Mateo MAL: Neel Patel • North Coastal MAL: Jeffrey Ribordy • Monterey Bay MAL: Graciela Wilcox • Alameda MAL: Vacant
• Contra Costa/Solano MAL: Omoniyi Omotoso

Pediatric Insider News Editors:
• Mika Hiramatsu • Deborah Shassetz • Alyssa Velasco

Project Assistant: Yolanda Ruiz