Board Certified Pediatrician Adolescent Medicine Expert Witness

Expert Witness No.899

STATE

Education

1973 Georgetown University College of Arts & Sciences,
Washington, DC
B.S.

1977 Georgetown University School of Medicine
Washington, D.C.
M.D.

1978University of California Irvine
Orange and Long Beach, California
Pediatrics PL-1

1980 Children's Hospital of Northern California
Oakland, California
Pediatrics PL-2,3

1981University of California, Berkeley
Berkeley, California
M.P.H.

1983 Los Angeles Children's Hospital
Los Angeles, California
Adolescent Medicine Fellowship

2006 Concord Law School
Los Angeles, CA
JD

Specialty

Pediatrics and Adolescent Medicine
Preventive Medicine

Certification

National Medical Boards Certification
American Board of Pediatrics
Adolescent Medicine Subspecialty Board
American Board of Preventive Medicine

Licensure

California, Texas - Active
New York - Inactive

Experience

August, 2006Consulting Medical Director:  Care1St Health Plan, Alhambra, CA,
International Care Network, Irvine, CA  Medical-legal, UM  and other consulting & Clinical practice, Sharp Rees-Stealy Medical Grp., SD, CA and other locums
(also  Nov. 2001 – Sept.,. 2002& May, 2001 – Sept. 2001)

Oct 2002 – July, 2006 Medical Director:  Riverside Physician Network, Riverside, CA

Responsible for all aspects of medical management – 54k lives  - Commercial & Senor Plans
MLR reduced  from 89% - 76 %, profitability achieved

August – Oct.,2001Vice-President & Chief Medical Officer Tower Health, Long Beach, CA
Responsible for all health services including Health Education and Cultural & Linguistics programs.
Chair of UM, P&T, QM committees.
Contracts with over  100 IPAs – Commercial and Medicaid Plan  - 100K lives
Worked with Conservators to close Plan per State order

Nov, 2000 – August, 2001Consulting Medical Director

Oct, 2001 – Dec.,  2001 Tower Health,  Long Beach, CA
Responsible for UM, Claims Review, IPA denial oversight, Pharmacy
Developed disease management protocols and instituted an active case management program.
Chair, Utilization Management Committee
Returned to consulting position when company closed by State of CA

Dec, 2000 – April, 2001, Medical Sciences Director, Real-age.com
Sorrento Valley, San Diego, CA
Medical Director for science team for innovative Internet Health Information, Education and Disease Management website.

Sept, 1998 - Dec, 2000 Pediatric and Adult Urgent Care  &
May, 2000-Dec, 2001Medical Management  & Medical-Legal Expert Consulting
Children’s Hospital San Diego, Sharp Rees-Stealy Pediatrics, Valley Immediate Care, Clinica Consuela,, CCN, Inc, TASA and others

Jan, 1998 – Aug, 1998Medical Director & Director of Health Services
Great American Health Plan, San Diego, CA
Responsible for QA, QM, UM, Credentialing, Pharmacy and Health Education
Demonstrated quality in presentations to physicians, non clinical staff, managed care organizations, local/state political advocacy programs and consumers
Directed a cohesive health services team for start-up MediCal ( Medicaid) Managed Care Company
Led the organization's  first successful audit by the California Department of Health Services
Worked with start-up IPA and several others

July, 1995 Regional Medical Director

Oct, 1997 FHP Health Care, San Diego, California
Responsible for all of Northern CA, plus half of Southern, CA 500k lives and over 150 IPAs
Responsible for Physician and IPA liaison with assigned regions, as well as QM, Risk and Case Management reviews for Commercial and Senior Medicare risk HMO products
Improved Credentialing processes
Revised and reinstated technology assessment program
Assisted in passing California tech assessment legislation
Transitioned various elements of the delivery system through financial and personnel changes and reorgs

Member : California and National Pharmacy & Therapeutics Comm,, HEDIS Improvement Committee
Inter-regional  Benefit Interpretation Committee
Southern California QM Committee
Statewide Credentialing Committee
Southern California Claims Appeals Board
California Government Affairs Committee
Chair:
Sub-regional Health Care Advisory Committees
Technology Assessment Committee for California
Medical Director for California Organ Transplant Program
California Medical Director for Government Affairs

May,1994-Associate Medical Director, Southern California Market

July,1995Aetna Health Plans of California, San Bernardino, California

Developed health education and community involvement programs for health plan members and employees
Chair:
Quality Management Committee
Pharmacy Committee
Developed epidemiological, evaluative and interventional clinical studies
Assisted national office in review of technology assessments and preventive health guidelines and programs
Prepared for NCQA review
Substitute Member, National Pharmacy & Therapeutics committee
Streamlined Credentialing process for over 9,000 physicians per year
Over 600K lives and over 100 IPAs

October, 1991Associate Professor of Pediatrics, Internal Medicine, Surgery &
May, 1994 Preventive Medicine
Director of Adolescent Medicine
Pediatric and Adult Emergency Room Faculty
University of Texas Medical Branch, Galveston, Texas
New Drug Approval Committee
Emergency Room Oversight Committee
Computer & Information Services Committee

1987-1991 Pediatrician, Private Practice
Thousand Oaks and Redlands, California
Attending Physician Pediatric Ward & Juvenile Clinics, Ventura Cnty. Med Center 1988, San Bernardino County. Juvenile Hall, 1989 - 91,
Medical Dir., University of Redlands College Health Center, 1990-1991

1985-1987Assistant Professor of Pediatrics, Adolescent and Preventive Medicine
New York Medical College, Valhalla, New York
Successful Author of $600,000 Robert Wood Johnson Grant
Director of Research, Adolescent Medicine Division

1983-1985 College Health Physician
Student Health Center, Loyola Marymount University, LA, CA

Organizations

American College of Physician Executives
American Academy of Pediatrics, Fellow
Society for Adolescent Medicine, Fellow
American Public Health Association
International Association for Adolescent Health

Academic Teaching Experience

Available upon request.

Paid Consulting

Available upon request.

Research Grants Awarded

Available upon request.

Service Grants Written and Awarded

Available upon request.

Professional Society Memberships

Available upon request.

Board Certification & Professional Society Fellowships

National Medical Boards Certification, 1978

American Board of Pediatrics Certification, 1981

Board Certified – Adolescent Medicine 11/94

Board Certified – Preventive Medicine 11/98

Recertified – Pediatrics & Adolescent Medicine 4/00

American Ht. Assn. CPR, Neonatal Resuscitation Certification and Pediatric Advanced Life Support, 1993-1994 (PALS Instructor), recertified, NN Resuscitation, 5/2002

International Health Experience

Available upon request.

International Medical Conferences

Available upon request.

Languages

English (Native)
French (Very Good)
Spanish (Good)
Portuguese (Fair)
American Sign Lang., Russian, German, Italian (All Beginning Level)
Latin (2 years)

Peer Review Medical Journal Articles

Available upon request.

Non-Peer Review Medical Journal Articles

Available upon request.

Papers and Posters Presented At Conferences

Available upon request.

Workshops Presented At Conferences

Available upon request.

Abstracts Published at Meetings But Not Presented

Available upon request.

Letters To Editor In Medical Journals

Available upon request.

Other Publications

Available upon request.

Ground Rounds and Other CME Presentations

The Refugee Camps of Thailand
Health Care for Southeast Asian Immigrants
Adolescent Medicine
Sexually Transmitted Diseases
Suicide and Depresssion in Adolescents
Refugee Camps in Honduras
Intestinal Parasites
Drug Abuse in Adolescents
The Medical Consequences of Nuclear War & The Arms Race
Eating Disorders in Adolescence
Adolescent Concerns about the Threat of Nuclear War
Pediatric & Adolescent Gynecology
Toxic Environmental Hazards:  A Primer For Pediatricians
The Nuclear Winter
What’s New in Congenital Infections
Pediatric and Adolescent Sports Medicine
Adolescent Homosexuality
Getting Into Adolescents’ Heads: The Psychosocial Review of Systems
New Ways of Thinking?  Psychology & The Nuclear Arms Race
Evaluation of Child Sexual Abuse
Public Health Issues in Adolescent Medicine
Sexually Transmitted Diseases in Children
Other Presentations and Details of Each Available upon Request.

Also available upon request are numerous talks given to medical, nursing and public health students, residents and to the general public, or numerous radio and television appearances on a broad range of topics.