December • 2022
In December, we sleigh through

In December, we sleigh through this "Tripledemic" together,
Mental Health for physicians is a priority during this cold weather,
the bells are ringing with new AAP leadership opportunities,
and Puzzles will bring together physicians from different communities.
President's Column
Nelson Branco, MD, FAAP
I’d like to start by apologizing for the absence of a November newsletter. A family emergency took Yolanda away from the office during the week when she would have been preparing and sending the newsletter. Rather than send two newsletters within a couple of weeks of each other, we decided to combine November and December and publish today. We hope you didn’t miss it - I’m guessing that you were all just as busy as I’ve been with all of the “Tripledemic” action. When they’re talking about RSV on CNN, you know it’s bad. It certainly has been a strange start to our viral season so far. It is hard to escape - whether at home or at the office - I’m sure you’ve seen more non-COVID illness in the past month than at any time since 2020. I think I’ve diagnosed as many AOM in the past two weeks as I had in the past two years all together. 
I hope you’re as excited as I am for the 7th annual Pediatric Puzzles CME on December 10 in San Francisco. Puzzles is back. In-person attendance is limited so if you haven’t signed up yet, make sure to do it right away. We’ll be talking about sleep, teeth, brains, bones, babies and bugs - check out the website for details and to register. 
I’d also like to encourage anyone who would like to get more involved with our chapter to check out the committees page to see if there are any committees doing work that you’re passionate about, or addressing issues that you’re interested in. There are open positions on our board that we would like to fill: Early Career Physicians Representative and South Valley Member-at-Large. Please email Yolanda or me if you would like to learn more about either of these positions.

There are also opportunities to join an AAP National committee coming up - applications are due soon, so if you are interested please let us know ASAP. The following committees have vacancies to fill: 

The AAP has recently announced the application deadline for a Healthy People 2030 Grant focused on The Next Generation Medical Home. If you have ideas for what you’d like to see in the medical home of the future, please let us know. We would love to put together an application for this grant, and provide some real support for our members who are creating and maintaining a medical home for their patients. Please get in touch if you would like to help us work on this grant.
At the beginning of October, our chapter board met for our annual Board Retreat at the Partnership Health Plan offices in Fairfield. Most of us were in person, but a few joined virtually, thanks to the support of the PHP IT staff. We’re grateful to Partnership and our board member Dr. Jeff Ribordy for helping make that space available. It was a great time to reconnect and discuss the current status of the chapter as well as our goals for the year and years to come. We reviewed the information presented at our Annual Chapter Meeting (recording available here), talked about our strategic plan and priorities and reviewed the successes and achievements of the past year. We’re focused on finding and applying for grants to replace those that we are completing, providing ongoing education and support through our Chapter Chats, starting a second round of Resiliency Circles and working on two new projects - an AAPCA1 Foundation fundraising effort and a Parent/Caregiver advisory group. Please contact us if you’re interested in either of those - we’d love to have more help and involvement!

I hope that you all had a November filled with gratitude and some time to spend with the people you love and care about. I am grateful to all of you, my AAP colleagues, for the learning, expertise, friendship and support that you provide to me. Thank you for being a member of AAPCA1, and thank you for all the work you do on behalf of kids. I wish you all a healthy and manageable end-of-year and holiday season. Thank you for all that you do to care for the kids in your community. 

Our Patients Need Us Not to Burnout
Omoniyi Omotoso MD, FAAP, MPH
Contra Costa & Solano Counties Member-At-Large
I never thought I’d be in therapy and writing about it in a newsletter. As I reflect on my journey as an individual, a parent and also a pediatrician, integrating work and life has been a lot. As I struggled in my personal life, it affected my work and likewise, my work-related burnout adversely affected my life outside of clinic. Fortunately, I have great social supports who encourage me to take better care of myself. That led me to therapy. Like you, as a pediatrician, I am well-versed in wellness anticipatory guidance. Each day I counsel my patient-families. I have scripts for self-care, stress busting, wellness promotion practicees and the value of psychotherapy. But knowing it and doing it are two different things.

I have learnt to honor the burden I gladly carry as a caregiver. And I quickly discovered why it took me so long to get to therapy. It is hard work. I constantly found myself working so hard at everything else - work and taking care of patient issues, I ended up late to many therapy sessions for a while. My therapist stuck with me through it until one day the realization finally sunk in. How can I keep doing this work I love so much and be fulfilled and happy despite the hard stories and tough situations my patients bring? I began to see how being able to voice my work experiences, in that container of therapy, gave me perspective and a chance to practice sitting with difficult things so I didn’t have to carry it so much when I was at home. 

As another winter (hopefully a rainy one) approaches, hard to believe it has been almost 3 years since the Covid pandemic declaration. Yet you and I continue to show up for our patient-families. We acknowledge the toll it has taken on us and our own families as well. From a 2020-2021 U.S. physician survey results published in Sept 2022 Mayo Clinic Proceedings, many of us have seen a two-fold increase in burnout symptoms and decreased professional fulfillment. 

We’ve all been told to be resilient and applauded for it. The burden to address the work-related stress and trauma does not fall on us alone. Our healthcare system must adapt to support us even more. Earlier this summer, the U.S. Surgeon General highlighted how systemic changes for more trauma-informed government policies and health systems infrastructure to better support us and our work. Meanwhile as advocacy for such transformation evolves, we still need to take care of ourselves so we can continue to do the vital hard work we do each and every day for our patient-families. How do we do that in a healthy way? 

“The best way out is always through,” from Robert Frost’s poem “A Servant to Servants.” So true as I learnt from my therapist. We keep life and work integrated in a sustainable manner by figuring out how to get through the difficult work experiences and practicing self-care. It can feel like we are not doing anything yet we know we are making a difference. It is a hard sell to tell colleagues to stay in the difficult spaces and continue working. Yet I’ve learnt how valuable it is to have a reflective space to share my experiences, feel heard, have my experiences normalized, and realize I am not alone. Working with Alameda County Primary Care Psychiatry Consultation Program (PCPCP)’s Child Psychiatrist – Madeleine Lansky MD, I learnt how little Child Psychiatrists know about what is going on. But they stay present, are reflective and over time, try to figure out what is going on. 

And how do we create this for our personal benefit? And for our patients’ benefit? The good news is there are many professionals including physician groups already doing this. Since the 1950’s, our Family Medicine colleagues have been utilizing Balint groups with this idea in mind. Balint group is one method for discussing approaches to patient cases, actively listening to each other, and the opportunity, as Dr. Lansky coined, to “compost” our work experiences. The Integrated Behavioral Health model such as the work we’re doing is another example. The AAPCA1 Pediatric Resilience Circles are doing similar work – do sign up for this month’s new series. We are so good at many things but we cannot do everything individually. We need each other. What is the positive, healing practice you are using to process your work experience as you and your colleagues leverage your resiliency? Our patient-families need us not to burn out.
Suggested video:
(40) Compost Happens (2022 Short Film) - YouTube [video credits: Profound Sustainability; and Zena and Amo Films]


Suggested reading:
Beverly D. Kyer, MSW,CSW,ACSW "Surviving Compassion Fatigue: Help For Those Who Help Others"

Suggested reflective practice program:
AAP California Advocacy Grant to Enhance Healthy Mental Development Pediatric Mental Health Advocacy Panel
Diane Dooley, MD, MHS, FAAP 
Mental Health Committee Chair
As part of AAP California’s effort to help our members address increased mental health concerns among children and youth, we are announcing a new initiative to support and influence California’s statewide reforms in mental health services.

Thanks to recent grant funding, we are recruiting 6 Pediatric Mental Health Advocacy Panel Members from January – September 2023 to influence proposed statewide reforms, such as Cal-Aim and the Children and Youth Behavioral Health Initiative. We are also looking for Circle of Support Members who will meet intermittently and provide feedback and support for the grant activities.

View the complete grant and positions' description HERE.

To apply, please complete the following brief application questions found HERE and submit them to Dr. Diane Dooly at by December 12

Applicants will be notified regarding their participation by December 19. The first virtual meeting will be held on January 17. Please contact Diane Dooley, MD if you have any questions or concerns.
There’s Still Time to Register! 7th Annual Puzzles CME Conference on December 10 in San Francisco
Join AAPCA1 for our 7th Annual Puzzles CME Conference with interactive lectures by experts in pediatric neurology, dentistry, infectious disease, and much more. We heard you! 

This year's Puzzles will include a lunchtime meet & greet/networking session, and the day will end by 3:45 p.m. so you can plan a Saturday evening out! 
In Case You Missed It! New Strategies and Resources for Adolescent Mental Health
You can watch the recording of our Mental Health Chat, "New Strategies and Resources for Adolescent Mental Health” by clicking the video below or visiting our Past Events page.

This chat, facilitated by Dr. Diane Dooley, focuses primarily on adolescent depression. It brings information about the newly reorganized mental health system in California, accessing resources for therapy and community support, and the benefits of adopting integrated behavioral health care into your practice.
The SGA Side
Your Key to State Government Affairs
Nora Pfaff, MD, FAAP and Anna Kaplan, MD, FAAP
SGA Chapter Representatives
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 Representative Nora Pfaff, MD, FAAP and Anna Kaplan MD, FAAP at
See All Available Pediatric Jobs on our Job Board!
Opportunities for Your Benefit
Calling Physicians that Help Care for Pediatric Patients with Undescended Testes!
Description of our study:
The Pediatric Urology Team at Lucile Packard Children's Hospital at Stanford, led by Dr. Kunj Sheth, is interested in learning more about how pediatricians decide to order scrotal ultrasounds, including the parameters that guide their decisions, diagnostic outcomes, and the associated additional costs. By completing our brief online survey, we hope to learn more about what leads pediatricians to make decisions related to the use of scrotal ultrasounds in cases of undescended testicles.

To participate, you must be a currently practicing physician above the age of 18. 

Take our survey here (~5-10 minutes):  
Earn 25 MOC 4 Credits with the National Drowning Prevention Quality Improvement Project! - Due January 6
Applications for the National Drowning Prevention Quality Improvement Project are due by January 6. 

Drowning is a leading cause of death for children under age 14 nationally. Through this 7-month project, you will gain practical tools to counsel families on water safety and drowning education with the goal of preventing drowning, increasing awareness of evidence- based drowning prevention strategies, and improving caregiver knowledge of water safety. Participating physicians also receive materials to encourage water safety and drowning prevention in your practice, including water watcher tags and posters. 

This project is open to pediatricians practicing in primary care, urgent care, or emergency medicine settings. Learn more about the project requirements and our successes from the 2022 cohort, which represented 17 states and territories across the country. This project is managed by the Texas Pediatric Society, the Texas Chapter of the American Academy of Pediatrics, in collaboration with Texas Children’s Hospital/Baylor College of Medicine and Rainbow Babies and Children’s Hospital. 

If you have questions or would like more information, please contact the project manager, Alix Bronner, at Apply to be part of our 2023 cohort today!

Learn more about the project here
Download the flyer here
Apply here.
Interim Guidance on Use of Palivizumab Prophylaxis to Prevent Hospitalization From Severe RSV
The AAP recently released interim guidance on use of palivizumab prophylaxis to prevent hospitalization from severe RSV infection during the 2022-2023 season. In this guidance, the AAP recommends programmatic consideration of providing more than 5 doses of palivizumab to eligible children, depending on the duration of the RSV surge in a given region.
To support physicians in providing palivizumab doses to eligible children, the AAP has created a letter to payers, urging them to do the following:
  • Update payer policies to allow for more than 5 doses of palivizumab during the 2022-2023 season
  • Pay adequately for all doses
The AAP has sent this letter to national private payers. We hope this letter is helpful in supporting recommended prophylactic care for children during the 2022-2023 RSV season.
Please let us know your experience with payers updating their systems and policies to support recommended care. Report any issues with this through the Coding Hotline/Hassle Factor Form at
December 10 - 7th Annual Puzzles CME Conference - REGISTER HERE
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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: Resham Kaur • Treasurer: Amita Saxena • Past President: Raelene Walker
Executive Director: Yolanda Ruiz

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: Maya Raman • Santa Clara MAL: Vacant • San Mateo MAL: Neel Patel • North Coastal MAL: Jeffrey Ribordy • Monterey Bay MAL: Graciela Wilcox • Alameda MAL: Renee Wachtel • Contra Costa/Solano MAL: Omoniyi Omotoso

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

Project Assistant: Position Available