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Contra
TO: BOARD OF SUPERVISORS -FROM: William Walker, M.D., Health Services Director g N,a,tn s Costa
DATE: November 18, 2008
County
"1 COUII
SUBJECT: Medical Staff Appointments and Reappointments — November 2008
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION: Approve the following recommendations made by.the Medical Executive
Committee.on November 17, 2008
FISCAL IMPACT: None
BACKGROUND: The Joint Commission on Accreditation of Healthcare Organizations has requested
that evidence of Board Approval for each Medical Staff member will be placed in his
or her Credentials File. The above recommendations for appointment/reappointment
were reviewed by the Credentials Committee and approved by the Medical Executive
Committee.
New Medical Staff Members
Jonathan Kalkstein, MD Psychiatry/Psychology
Hanna Kang, MD Family Medicine
Michele Montandon, MD Family Medicine
Chiyo Shidara, DDS Dental
Chiu Hung Tung, MD Anesthesia
Lawrence Vierra, MD Surgery—Ortho
CONTINUED ON ATTACHMENT:__YES SIGNATURE:
� "RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
_, lPPROVE OTHER
SIGNA URE(S):
ACTION OF BOARD ON ef' APPROVE AS RECOMMENDED V OT R
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
Y UNANIMOUS (ABSENT G/►'1_r� ) AND CORRECT COPY OF AN ACTION TAKEN
AND ENTERED ON THE MINUTES OF THE BOARD
AYES: NOES: OF SUPERVISORS ON THE DATE SHOWN.
ABSENT: ABSTAIN:
ATTESTED b
DAVID J.TWA,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact Person: Jeff Smith,MD(Hosp.Adm.)
Cc: County Administrator
County Auditor-Controller BY: s� DEPUTY
Health Services Director
Medical Staff Adm.(J.Fon)
H.S.Personnel(M.Brown)
Application for Staff Affiliation
Leslie Splivalo, NP Family Medicine
David Grant Medical Center—Travis AFB — Family Medicine Resident
Benjamin Kohnen, MD
Advance to Non-Provisional
Peter Broderick,MD Family Medicine C
Jessica Cohen, MD Internal Medicine A
Anniken Hansen, MD Family Medicine ' A
Lisa Keller, MD Ob/Gyn A
Olga Kelly, MD Pediatric A
Alice Lin, MD Family Medicine A
Alvin Loosli, MD Family Medicine* C
Nishant Shah, MD Family Medicine A
Request for Implanon Privileges
Tara Lehman, MD Family Medicine A
Biennial Reappointments
Victoria Agnost, MD Pediatrics A
Philipp Bannwart, MD Family Medicine A
Joseph Barger, MD Emergency Medicine C
Judith Bliss, MD Ob/Gyn A
James Carpenter, MD Pediatrics A
Sandeep Dosanjh, MD Family Medicine A
John Echols, MD Psychiatry/Psychology A
Michael Gynn, MD Surgery A
Brian Hertz, MD Family Medicine C
Anthony Jones, MD Internal Medicine A
Liam Keating, MD Surgery A
V. Arek Keledjian, MD Internal Medicine C
Donald Lantz, MD Family Medicine C
Alvin Loosli, MD' Family Medicine C
Jack Rosenfeld, DDS Dental A
Amarjit Sandhu, MD Pediatrics C
David Stone, MD Internal'Medicine A
Mark Van Handel, MD Internal Medicine A
Biennial Renewal of Privileges
Michele Tomasulo, NP Family Medicine
Request to add a new privilege to Surgery forms —See Attachment 1
Request to remove PALS certification requirement to take calls
Medical Staff—Appointments and Reappointments—November 2008 Page 2 of 3
a
Voluntary Resignations
Navdeep Baath, MD Psychiatry/Psychology
Margaret Dally, MD Family Medicine
Tirath Gill, MD Psychiatry/Psychology
Estelle Gregory, MD Psychiatry/Psychology
Colleen Kenney, DPM Surgery - Podiatry
Medical Staff—Appointments and Reappointments—November 2008 Page 3 of 3
Attachment 1
Contra Costa Regional Medical Center
Privileges Request Form
Practitioner:
Privilege Description °; d Z
CIII.9 E D=With Direct Supervision v E U 2 a rr
m
CL z C=With Consultation o o 0 E 0) � �c U�
o U=Unrestricted w w 0
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Surgery
ENT D Sur orN/A N/A
SGN Thyroid & Parathyroid Surgery. Ent
24 g
U Sur or 15 cases
Ent in last
2 yrs.
I certify that I have reviewed the Contra Costa Regional Medical Center Privilege Criteria, and that I meet the specified criteria
for education/training, experience, and current competence for the privilege, which I have indicated above.
Signature of Requesting Practitioner Date
Signature of Department Chairperson Date