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 Expert  724613

Expert in Pediatrics, Adolescent, & Young Adult & Administrative Medicine, Medical-Legal Issues, Public Health


Available for your Consulting and Expert Witness Needs

California (CA)
USA
Education Work History Career AccomplishmentsPublicationsConsulting Services Expert Witness Market Research

Summary of Expertise:

Listed with other top experts in: 

Strong background since establishing the first student internship program in bioehtics at the Kennedy Bioethics Institute in 1972 - mentor Andre Helligers, then director of the CEnter. Published in medical ethics journals. Hospital ethics committee experience. Licensed to practice law as well as medicine in CA. Interest in IRB issues.
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bioethics

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medical ethics

30 years clinical experience in Pediatrics, Adolescent and Young Adult Medicine and preventive medicine (all three with Board Certification), Family Practice, and Adult and Pediatric Emergency Medicine. 14 years experience as a Medical Director reviewing complex care cases of all kinds. Six years in full-time academic health care.
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clinical medicine

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adolescent medicine

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forensic medicine

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neonatal resuscitation

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young adult

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emergency medicine

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family medicine

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pediatric emergency medicine

MD, JD with 14 years experience as a Medical Director for Health Plans and Physician Groups. MPH degree as well. Experienced in working with health Departments and regulations, including Workman's Comp.
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Department of Health and Social Security standard

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workers' compensation

Masters Degree in Public Health from UC Berkeley with a minor concentration in epidemiology and published in field. Academic experience in questionnaire design.
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epidemiology

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medication risk assessment survey

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survey design

14 years as a Medical Director for Health Plans and Physician Groups including NCQA preparation and work in Quality Assurance review, grievances and appeals.
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health care industry quality management

MD, MPH, JD with 30 years clinical experience and 14 years experience as a medical director for Health Plans and Medical Groups and 20 years medical legal consulting experience. Taught health care systems including international comparison to graduate students in nursing at University of Phoenix. Expert on delivery of care issues for children and youth. Expertise in cultural diversity.
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health care system

14 years experience as a Medical Director for Heath Plans, Medical Groups and a Home Health company including all insurance products.
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health care management

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health insurance

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health care plan

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managed care

14 years experience as a medical Director for Health Plans and Medical Groups. Extensive medical record review experience going back to PRO work in 1986 and charting quality improvement as early as 1979. Consultant for California Medical, Dental and Cosmetology Boards. 20 years experience in medical legal consulting and now also licensed to practice law in California.
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medical record

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administrative medicine

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case analysis

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medical analysis

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medical case review

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medical center

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medical credentialing

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medical record review

Board Certified in Pediatrics and Sub-Board certified in Adolescent Medicine with 30 years clinical experience, 6 years full time and many more years part-time academics with numerous publications in the field. Medical Legal expert in Pediatrics and AM for 20 years. Consultant to CA Med Bd. in Pediatrics and AM. Currently senior Pediatric case reviewer for Anthem Blue Cross of CA in Pediatrics. Extensive experience in MediCal(Medicaid). National Reviewer in Pediatrics and Adolescent Medicine for MCMC, PRN, MES, Permedion, AMR and others.
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pediatrics

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medicolegal

Board Certified in General Preventive Medicine with extensive experience as a community organizer, in school-based health care, juvenile justice care and in developing preventive care guidelines. Published in this field.
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preventive medicine

Board Certified in General Preventive Medicine. Extensive experience in vaccine issues, infectious disease, maternal, child and youth health, and environmental health issues. MPH degree from UC Berkeley with major in Maternal and Child Health and minor concentration in epidemiology. Extensive experience working with PH departments including grant writing. JD degree with interest in regulatory compliance issues. Experience with ADHD and IDEA law issues, autism.
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public health

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environmental health

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infectious disease

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vaccine


Show Secondary and Basic Areas of Expertise
Localities:
Expert may consult nationally and internationally, and is also local to the following cities: Los Angeles, California;  San Diego, California;  Long Beach, California;  Santa Ana, California;  Anaheim, California;  Riverside, California;  Glendale, California;  Huntington Beach, California;  San Bernardino, California;  and Chula Vista, California.

Education:
Year   Degree   Subject   Institution   Honors
1977   MD   Medicine   Georgetown University  
1981   MPH   Maternal & Child Health, Epidemiology   University of California Berkeley School of Public Health  
2006   JD   Law   Concord-Kaplan Law School  
1973   BS   Psychology, Political Science, and Premed   Georgetown University   Cum Laude and Mahoney Medal

Work History:
Years   Employer   Department   Title   Responsibilities

2006 to

 

Expert's Firm

 


 

Consulting Medical Director

 

UM consulting

2001 to

 

(Undisclosed Consulting Company)

 


 

Consultant

 

Utilization management for labor trusts, oversees insurance and foreign insurance cos.

2002 to

 

Expert's Firm

 


 

Consultant

 

MediCal & Healthy Families Managed Care (200,000 insured lives) – Pediatrics, Grievances and Appeals and Emergency Care and Ambulance Transport Reviews, substitute for CMO when he is away, appear at arbitrations and mediations

2002 to

 

(Undisclosed Consulting Company)

 


 

Consulting Medical Director

 

Home infusion company – consulting medical director for Managed Care Issues

1994 to 1995

 

Aetna Health Plans of California

 


 

Associate Medical Director

 

Utilization and Quality Management chart reviews for HMO, POS, and PPO health insurance products. Chair: Quality Management and Pharmacy Comms. Member of Credentialing Comm. - 9000 MDs/yr. reviewed. Develop health education & community involvement programs for health plan members and employees. Management liaison with Employee Activities Committee. Assist Medical Director in full range of administrative and clinical duties; substituted for Medical Director when she was not available, including National P&T Committee.

Accomplishments: Developed several epidemiological, evaluative and interventional studies to improve managed care performance. Developed liaison with mental health provider including clinical studies. Assisted national office in review of technology assessments and preventive health guidelines and programs. Substituted for Medical Director on national Pharm & Therapeutics Comm. Developed processes to streamline physician credentialing. Extensive experience preparing for NCQA review. Able to rapidly learn processes and contribute fully to management in large, advanced market, despite no previous full-time management experience.

1997 to 1998

 

Great American Health Plan

 

Health Services

 

Medical Director & Director

 

Director of Health Services for this start-up MediCal (Medicaid) Managed Care Company. Responsible for QA, QM, UM, Credentialing, Pharmacy and Health Education Departments and involved in all other aspects of program development, contracting and community planning.

Accomplishments: In less than three months brought together a cohesive health services team, enabling GAHP to pass its first Calif. Dept. of Health Services Audit and developed processes to improve quality of care.

GAHP was purchased by Universal Health - SD Med. Dir. position eliminated, 8/98

1991 to 1994

 

University of Texas Medical Branch, Galveston

 

Departments of Pediatrics & Emergency Services

 

Associate Professor, Director of Adolescent Medicine, Faculty

 

Assoc. Prof. In Pediatrics, Preventive Med, Medicine and Surgery Depts. University –wide ER Supervisory Comm, Computer/IS Comm., P&T Comm. Re-established Adolescent Medicine teaching and service component including Juvenile Justice and College health programs, enhanced community programs. Responsible for Pediatric ER program and Child Abuse Program oversite

1983 to 1985

 

New York Medical College

 

Adolescent and Preventive Medicine

 

Assistant Professor, Research Director

 

Research Director, Division of Adolescent Medicine. Author of one of the earliest Robert Woods Johnson School-based Health Clinic grants for a high school in the poorest US Congressional District – Bronx, NY


Career Accomplishments:
Associations/Societies

American College of Legal Medicine, Fellow since 2/07; Society for Adolescent Medicine, Fellow since 9/85; American Academy of Pediatrics, Fellow since 11/82; American College of Legal Medicine – 2003 – ; Fellow: 3/07 - Marketing Comm. - 2004

American College of Physician Executives; International Assn. for Adolescent Medicine; American Public Health Association; Society for Adolescent Medicine Member, 1981-1984, Fellow, 1985 - National Advocacy Committee 1994-98 & 2006 – Website Committee 2006; Physicians for Social Responsibility; American Academy of Pediatrics

Licenses/Certifications

California Med. License, 1978 -; Texas Medical License, , 1992 - 1995 & 1998 - ; N. Y. State Med. License, 1985-1988 (inactive); Drug Enforcement Agency; Passed CA Bar, 7/06 – Licensed to practice law in California; American Ht. Assn. CPR, Neonatal Resuscitation Certification and Pediatric Advanced Life Support- 1993 – 1994 (PALS Instructor), recertified: NN Resuscitation, 5/2002; Recertified – Pediatrics & Adolescent Medicine – 4/00; Board Certified - Preventive Medicine - 11/98; Board Certified - Adolescent Medicine - 11/94; American Board of Pediatrics Certification; National Medical Boards Certification

Professional Appointments

Children's Advocacy Institute, Univ. of San Diego Law School, Board of Advisors 2006 -

Physicians for Social Responsibility: Chief Pacific Regional Director, Chief SW Regional Director, Board of Directors Executive Committee, President Westchester, NY Chapter


Publications:
Publications and Patents Summary

Hundreds of peer-reviewed journals, chapters, books, articles, etc.

Selected Publications and Publishers  
 - Washington Post  
 - Pediatrics  
 - New Physician  

Consulting Services:
Selected Consulting Examples:
  • Verimed Inc., Pediatrics Editor – NLM “ADAM” and other on-line health Encyclopedias, pharmaceutical consulting, and articles for WebMD.
  • Consultant in Pediatrics, Adolescent & Preventive Medicine, CA Medical; Board, Dental Bd. And Cosmetics Bd.
  • Consultant, UCLA Cent. for Health Policy Research, STDs & Managed Care
  • Utilization Case Review Nationwide: Medical Review Institute of America, Physicians Review Network, MCMC, Covance, MES and others
  • Design -nursing drug dispensing protocols, San Bernardino County Juvenile Hall.
Click the green button above to contact Expert for a free initial screening call regarding your expert consulting needs.  Expert is available for consulting to corporate, legal and government clients.  Remember, your initial screening call to speak with Expert is free.

Expert Witness:
Expert Witness Experience Summary:
20 years medical legal consulting - and now also licensed to practice law - very experienced in testimony, deposition and declaration work from all points of view - plaintiff and defense background
Recent Litigation Client Requests:
  • Expert for consulting on Pediatric emergecy/internal.
Click the green button above to contact Expert for a free initial screening call regarding expert testimony, litigation consulting and support, forensic services, or any related expert witness services.  A few litigation needs include product liability, personal injury, economic loss, intellectual property (patent, trademark, trade secret, copyright), and insurance matters.  Remember, your initial screening call to speak with Expert is free.

Language Skills:
Foreign Language   Description
French   Very Good
Spanish   Good
Portuguese   Fair

Market Research:
Pharmaceutical consultant to numerous companies for over 12 years primarily on relation to managed care markets

Click the green button above to contact Expert for a free initial screening call regarding your marketing research, industry research, and company research needs.  For research needs involving multiple experts or secondary research, a Research Director can be assigned to coordinate the work into a custom report for you as a potentially quicker and more cost effective alternative to doing this work yourself or hiring a boutique consultancy.  Remember, your initial screening call to speak with Expert is free.

Additional Skills and Services:
Training/Seminars

Numerous national and international presentations

Other Skills and Services

Experienced writer and editor including editing ADAM Internet encyclopedia, being an Internet site medical director.


 

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