October • 2021
October has Opted for a Beautiful Fall

October has opted for a beautiful fall 
Where we address burnout, wellness and upon resilience, call.
We highlight members on AAP councils, committees & sections,
And continue to bring to you our reflections.

President's Column
Nelson Branco, MD, FAAP
A few weeks ago, I fulfilled one of my last duties as the chair of the AAP Indian Health Special Interest Group by moderating two sessions of the International Meeting on Indigenous Child Health (IMICH). This biannual meeting is put on jointly by the AAP and the Canadian Paediatric Society (CPS), and brings together clinicians, researchers, public health professionals and others interested in the health and well-being of Indigenous communities across the globe. There are participants and presenters from the United States, Central and South America, Canada, Greenland, Australia and New Zealand. It is always fascinating to see the work being done by and with Indigenous communities. Though I no longer work primarily with Native American kids in my ‘day job,’ I always learn and am inspired by the passion and advocacy of my colleagues who are. My role with the IH-SIG followed six years as a member of the Committee on Native American Child Health. That was my first experience on an AAP National committee and as I’ve written before, it was one of my most valued professional experiences.

Many of our chapter members are involved in AAP National councils, sections and committees. I suspect that few of us can quote the difference between the three - check the AAP Community website if you’re curious. While our chapter is focused on the needs of our local communities, children and members, we partner and connect with our colleagues across the state and nationally through our participation in District IX, AAP California and AAP National

Over the next several months, I’d like to highlight our chapter members who are involved in leadership at the National AAP level. I’ll start with councils - to quote the AAP website: “Councils develop policy, educational opportunities and advocacy initiatives, and translate policy and education into practice.” Being on the executive committee of an AAP council is a privilege and a lot of work. Please join me in acknowledging these colleagues who have the knowledge and expertise necessary to do this work and are willing to share it. We’re all grateful to them for sharing their time and expertise. 
Rhea Boyd, MD, COCM Executive Committee (Council on Communications and Media)
Francisco Alvarez, MD, COQIPS Executive Committee (Council on Quality Improvement and Patient Safety)
Scott Needle, MD, COCD Executive Committee (Council on Children and Disasters)
Ryan Padrez, MD, COSH Executive Committee (Council on School Health)
Shashank Joshi, MD, COSH Executive Committee (Council on School Health)
Raul Gutierrez, MD, COICFH Executive Committee (Council on Immigrant, Child and Family Health)
Andrew Wiesenthal, MD, SM, COCIT Executive Committee (Council on Clinical Information and Technology)

As I run through Councils, Sections and Committees over the next few months, I will no doubt unintentionally overlook some of our colleagues. Please feel free to point out any omissions, and I would encourage any of you who are participating in AAP National activities to let the rest of us know about it by writing a newsletter article, doing a Chapter Chat or including information in one of our chapter email updates. We are always looking to provide resources, share news and make more connections between our chapter members.
Vice President's Column
Nicole Webb, MD, FAAP
Fall is in the air! As a native New Englander, there is no time of year I love more than fall. The changing colors of the leaves, the sound they make crunching under your feet as you take a walk on a brisk morning or chilly evening, the smells in the air. Pumpkins, harvest, scarves, hayrides, Halloween, all of it I have loved for as long as I can remember. Such was the intensity of my longing as a recent transplant to Southern California over 20 years ago, that my best friend actually collected some leaves and sent them to me. While the leaves eventually crumbled despite my best efforts to preserve them, I’ve never forgotten the kindness and empathy behind them.  

As a parent of young children, my love of fall has only grown, and I’ve been excited to share those traditions with my kids. This year, however, more than pumpkins and hayrides I find myself reflecting a lot on resilience and burnout. As we head into our busy season as pediatricians, seeing a resurgence of the typical pediatric illnesses that were absent last fall with sheltering in place and distance learning, we are still grappling with a pandemic that continues to drain us of resources, financial, physical, and emotional. For many of us, the air is filled with smoke rather than the scents of harvest and celebration.

The concern for widespread burnout in medicine is not new: Medscape’s National Physician Burnout, Depression and Suicide Report 2019 found 44% of physician respondents overall and 41% of practicing pediatricians were experiencing burnout. However, this crisis has only worsened during the COVID-19 pandemic, with at least half of physicians now reporting symptoms of burnout. There are also significant gender disparities in burnout, with women reporting symptoms of burnout at higher rates than men.

With our increasing recognition of burnout has come increasing recognition of the importance of resilience, and many of us are likely very used to these concepts by now. There is indeed much that we can do as individuals to promote resilience and mitigate burnout. For myself, I have finally, truly learned that self-care is a necessity and not an indulgence. I have been more consistent in making time to exercise since the onset of the COVID-19 pandemic than at any time in my adult life. I also find myself being more intentional in protecting my personal time; whereas before the pandemic I would often respond to emails immediately and come in for every non-urgent meeting. I now proactively choose what is most important to me, which has meant learning to be comfortable with saying no. 
San Mateo Member-At-Large Update: Explaining the Impact of COVID-19 on Young Children in Media
Neel Patel, MD, FAAP

The COVID pandemic means millions of children are staying home instead of going to daycare or preschool. KTVU's Gasia Mikaelian talks with Dr. Neel Patel, a pediatrician, about what impact this could have on their development.
Section on Developmental and Behavioral Pediatrics: Peer-to-Peer Learning Sessions
Renee C. Wachtel, MD, FAAP
Please join us on October 26 for our second Peer-to-Peer presentation on the Autism Spectrum: Challenges Faced by Individuals and Families with Linda Copeland, MD, FAAP
Dr. Copeland is Board certified in Developmental-Behavioral Pediatrics. After residency, she completed a two year fellowship in child psychiatry and a one year fellowship in developmental disabilities at the University of Iowa. As a fellow, she published a national survey on pediatrician practices in the diagnosis and treatment of ADHD with Dr. Mark Wolraich, a prominent researcher in ADHD. 
Pediatric Puzzles Fans, Don’t Despair 
Mika Hiramatsu, MD, CME Committee Chair, FAAP
Although O’Connor Hospital just last month rescinded their invitation to host Puzzles in San Jose, your CME committee and the indefatigable Isra Uz-Zaman are finalizing a new in-person location. Stay tuned! In the meantime, please SAVE THE DATE (Saturday, Dec. 4) for an amazing line-up, including psychopharmacology, dermatology, inclusion/equity/diversity, dyslipidemia and healthy eating, physiatry, advocacy, and counseling around gender. As always the program will include lots of audience-response questions. We can’t wait to see you back in person! Registration coming soon!
CalMed Force Representative Sought on Behalf of AAP-CA
Suzanne Stewart, MD, FAAP

CalMedForce dedicates voter-approved, state tobacco tax revenues from Proposition 56 (2016) to train physicians and help California address its growing physician shortage; which, in a 2017 study by the California Future Health Workforce Commission, is estimated to reach a 10,500-clinician shortfall by 2030.

AAP-CA’s current representative to CalMed is Suzanne Stewart MD FAAP. Thank you for representing us! We are seeking another pediatrician to step in this role to represent AAP-CA at the CalMedForce Advisory Council. This is the proposition 56 funding mechanism to support residency programs with the goal of increasing physicians in underserved areas. More Information can be found HERE 
Email CalMedForce@phcdocs.org or call (916) 551-2899. You may also reach out to Dr. Stewart for more information on the role at sstewart1@marshallmedical.org
The SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH, CFAAP
SGA Chapter Representatives

Your SGA continues to be hard at work representing pediatricians! September 10 represented the end of the 2020-2021 legislative session, and was the deadline for the Assembly and Senate to pass bills for the year. The governor has until October 10 to sign or veto those bills. With the recall election behind us, we also expect the executive branch to be more active in establishing and enacting its priorities, including measures related to school health and COVID. 

For the most up-to-date information on AAP California bill positions, letters and outcomes from the current California Legislative year, go to aap-ca.org/bill. For latest organizational advocacy updates follow @AAPCADocs on twitter. If you have questions and/or are interested in knowing more about a certain legislation, reach out to our State Government Affairs Chapter Representatives Nora Pfaff, MD, FAAP and Zarah Iqbal, MD, MPH at info@aapca1.org.
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Opportunities for Your Benefit
Webinar: Childhood Lead Poisoning Prevention for Healthcare Professionals
The California Department of Public Health, Childhood Lead Poisoning Prevention Branch (CLPPB) is hosting a webinar series during Lead Week 2021 (October 24 – 30), which highlights important lead poisoning prevention work taking place throughout the state of California. On Tuesday, October 26th, from 10-11am, healthcare providers from the Western States Pediatric Environmental Health Specialty Unit (PEHSU) and the California Poison Control System will share innovative strategies for serving vulnerable populations who are at highest risk of lead exposure. The presenters will additionally present case examples and provide information on increasing screening rates, improving chelation efforts, and will offer clinical tools and resources for providers to use when working with families in California exposed to lead. 

Session Presenters: 
Dr. Timur S. Durrani, MD, MPH, MBA
Co-Director of the Western States Pediatric Environmental Health Specialty Unit
Clinical Instructor of Medicine at the University of California San Francisco

Dr. Cyrus Rangan, MD, FAAP, FACMT
Assistant Medical Director for the California Poison Control System (CPCS)
Director of the Bureau of Toxicology and Environmental Assessment at the Los Angeles County 
Department of Public Health 

Dr. Rais Vohra MD, FACEP, FACMT
Rais Vohra is an emergency physician, medical toxicologist, and public health officer for Fresno County

**Register for this session and other Lead Week webinar sessions at tinyurl.com/2yzby8z4
October 20, November 4, December 2 and January 20: SOECP:Leadership, Equity, and Advancements in Pediatrics - LEARN MORE!
October 26: SODBP: Peer-to-Peer Session 2 - Autism Spectrum: Challenges Faced by individuals and families - REGISTER HERE!
November 3: ACT 2021 - Legislative Lobbying - SAVE THE DATE!
November 18-21: The 42nd Annual Las Vegas Seminars at Caesars Palace - SAVE THE DATE!
November 30: SODBP: Peer-to-Peer Session 3 - ACEs and Young Children - SAVE THE DATE!
December 4: 6th Annual Pediatric Puzzles CME Conference - SAVE THE DATE!
December 8: ACT 2021 - Resolution Writing for the Annual Leadership Forum - SAVE THE DATE!
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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: Vacant • 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: Reshem Agarwal
• Contra Costa/Solano MAL: Omoniyi Omotoso

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

Executive Assistant: Sabah Elias