Tiffany J. Tanner, MMS, PA-C

***** ***** ****** *****· Lancaster · CA · 93536

818-***-**** · adc6p6@r.postjobfree.com

EDUCATION

Midwestern University, College of Health Sciences Glendale, Arizona 2007-2009

Master of Medical Science degree in Physician Assistant Studies

Emphasis in Addiction Medicine, Dual Diagnosis, Pain Management, and Sleep Disorders

HITECH Act Educational Course; CME Course attended at Midwestern University, AZ; February 18, 2011

California State University Northridge Northridge, California 2001-2005

Bachelors of Arts degree in Biology, Pre-Medical focus of Study

PROFESSIONAL LICENSE, REGISTRATION, and CERTIFICATION

NCCPA registered Physician Assistant (Exp 12/31/2021) PANCE successfully completed September 8, 2009, PANRE successfully completed 2015

California State License: PA 20567 (Exp 10/31/2020)

DEA Registration Number: MT2048317 (Exp 11/30/2021) Controlled Substances Education Course (CME Course by CAPA and the DEA) successfully completed September 21, 2009

NADEAN Registration Number: XT2048317

NPI: 190*******

Advanced Cardiac Life Support/ Pediatric Advanced Life Support

ACADEMIC EXPERIENCE / CLINICAL TRAINING

Mental Health: Chemical Dependency, Dual Diagnosis, Pain Management, Sleep Disorders Including a 3 month Master’s Practicum; Dr. Jerry Rand, M.D.

Bay Recovery Center, San Diego California.

Pediatric Medicine; Dr. Todd Harker, M.D.

Kaiser Medical Group, Escondido California.

OB/Gyn; Paula Lopiccolo, N.P. & Dr. Leonard Kurian, M.D.

Dr. Kurian Obstetrics and Gynecology, Lancaster California.

Primary Care Medicine; Dr. David Zimmerman, M.D.

Office of Dr. David Zimmerman, MD, PLLC, Mission Viejo California.

Neurosurgery; Shari Sharp, PA-C & Dr. Christopher Duma, M.D.

Brain and Spine Surgeons of Orange County, Newport Beach California.

Internal Medicine; Dr. James Stewart, M.D.

Stewart Medical Group, Alhambra California.

Emergency Medicine; Dr. Christopher Saucedo, M.D.

Scripps, Green Hospital, La Jolla California.

RELATED PROFESSIONAL EXPERIENCE

June 2014—May 2017

Garrison Family Medical Group: Physician Assistant, under the supervision of Dr. Ric S. Garrison

See an average of 25-45 patients daily in Urgent Care and Primary Care

Instituted a telemedicine platform during the COVID19 pandemic to help keep our patients and our community healthy through this trying time

Created public service announcement type videos during the COVID19 pandemic in order to help our patients and community have better understanding of the situation as it evolved

Perform thorough history and physical exams on Urgent Care and Primary Care patients.

Order appropriate diagnostic exams.

Interpret diagnostic exam results appropriately and in a timely manner.

Formulate appropriate therapeutic treatment plans.

Collaborate with supervising physician when appropriate.

Consult with specialists and/or hospitalists when indicated: Consult cases with specialists such as surgeons, obstetrics, pediatrics, or other as indicated by findings. Consult with other facilities when higher level of care or other specialties needed in order to arrange transport.

Develop appropriate treatment plans (including prescription medications, OTC medication recommendations and follow up care).

Work hand in hand with other healthcare workers including Nurse Practitioners, Medical Assistants, Radiology Techs and Radiologists.

Manage chronic an ongoing medical problems including but not limited to hypertension, diabetes, COPD, asthma, allergic rhinitis, chronic pain syndromes.

Evaluate and create treatment plan for management of opiate use disorder, including but not limited to safe prescribing of buprenorphine as well as other medications for safety and comfort associated with withdrawal.

Maintain up to date urine drug screens for pain management and addiction patients.

Check with CURES prior to prescribing controlled substances.

Perform procedures as needed (including but not limited to: sutures, fracture and joint dislocation reductions, incision and drainage of abscesses, trigger point injections for pain relief, nerve blocks and digital blocks, and lumbar puncture).

Maintenance of national certification, California state license, DEA, NADEAN prescribing certificate.

Maintenance of ACLS and PALS certification.

June 2014—May 2017

Antelope Valley Emergency Medical Associates: Physician Assistant, Emergency Department at Antelope Valley Hospital, under the supervision of Dr. Atilla Uner, MD and Dr. Thomas Lee, MD (as well as other supervising physicians within the group)

Perform thorough history and physical exams on Emergency Department patients.

Order appropriate diagnostic exams.

Interpret diagnostic exam results appropriately and in a timely manner.

Formulate appropriate emergency therapeutic treatment plans.

Collaborate with supervising physician when appropriate.

Consult with specialists and/or hospitalists when indicated: Consult cases with specialists such as surgeons, obstetrics, pediatrics, or other as indicated by findings. Collaborate with hospitalists as needed when clinical impression indicates the need for admission. Consult with other facilities when higher level of care or other specialties needed in order to arrange transport.

Develop appropriate treatment plans (including prescription medications, OTC medication recommendations and follow up care).

Work hand in hand with other healthcare workers including RNs, LVNs, Emergency Department Techs, Respiratory Therapists and Radiology Techs and Radiologists.

Check with CURES prior to prescribing controlled substances.

Perform emergency procedures as needed (including but not limited to: sutures, fracture and joint dislocation reductions, incision and drainage of abscesses, trigger point injections for pain relief, nerve blocks and digital blocks, and lumbar puncture).

Maintenance of national certification, California state license, DEA.

Maintenance of ACLS and PALS certification.

February 2012—January 2016

Promises Treatment Centers via David A. Sack, APMC: Physician Assistant, under the supervision of Dr. Robert Saltzman, MD and Dr. Greg Skipper, MD

Perform thorough history & physical exams upon intake to the residential treatment program: Perform comprehensive history and physical exam including but not limited to: obtaining preliminary history and assessing for addiction/dependency, dual diagnosis/psychological issues, general medical wellbeing/disease, suicide risk, and the need for an emergency 1-to-1 in the event of moderate to severe physical or emotional distress.

Formulate initial diagnoses and treatment plan: Identify all pertinent diagnoses for new patients. Formulate initial treatment plan including but now limited to: determining detox status, initiating detox protocol, ordering pertinent laboratory and other diagnostic evaluations, ordering necessary medications.

Adjust treatment plan as necessary: Adjust detox medications appropriately to encourage safe and timely detox, while keeping the patient as comfortable as possible throughout the process. Manage other medical issues that may arise over the course of treatment, adjusting initial treatment plan as needed.

Welcome patients; promote the Promises brand through excellence and compassion: Welcome new patients upon their arrival to the facility. As first point of contact, and the first impression of the medical/clinical treatment team, ensure that the highest quality of care and compassion is exemplified in every patient/provider interaction.

Inform all clinical team members of each new patient’s diagnoses and treatment plan via email or summary during weekly clinical treatment team meeting: Consult with supervising physician and other medical team members to determine the best course of action for difficult/challenging cases. Collaborate with other, medical (psychiatrists and nurses) and non-medical (psychologists, MFTs, LCSWs, acupuncturists/massage therapists, neurofeedback specialists, spiritual counselors, and other support staff), members of the clinical team to provide an integrated and holistic approach to patient care.

Available by telephone during ‘On Call’ hours for any questions or concerns by treatment staff or patients with respect to medical issues: Must also be available to report to the treatment center while on call in the event that a patient needs evaluation for new or ongoing medical concern. Provide medical assessment of new/ongoing medical complaints and provide new or adjusted treatment plan to the nursing staff; will consult with supervising physician and other medical/psychiatric staff if needed and notify all clinical team members of any treatment changes in a timely manner.

Round at the treatment facility: Perform on-site re-assessment of all detox clients, and evaluate need for adjustments to treatment. Evaluate and manage medical concerns of any patient (not only detox patients).

Facilitate Health Topics Group seminar: Lead a discussion based health education group for the residential treatment patients. Topics covered in this group include but are not limited to: neuroscience and physiology of addiction, neuroscience and physiology of recovery, and health maintenance.

Educate patients about medical/health aspects of addiction/dual diagnosis: Educate patients about their conditions, provide resources for more in depth research. Provide patients with reassurance regarding health issues and concerns while attempting to provide clarity and understanding as well.

Cooperate and collaborate with supervising physician(s) and other PA(s): Maintain timely communication through phone, email or other documentation to ensure the highest possible level of care as well as a fluid continuity of care for all patients.

Responsible for staying informed via email: Check email multiple times daily when on call to stay informed of any/all medically relevant issues that may arise within the milieu.

Maintenance of national certification, California state Licensure and DEA Registration

April 2011—March 2013(Locum Tenens to permanent position through Harris Medical Group)

West Anaheim Family Physicians: Physician Assistant, under the supervision of Dr. S. Clarke Smith, MD (April 2011—March 2013)

Patient and practice coverage/oversight while supervising physician was out of town: All aspects of patient care and practice coverage, including but not limited to, treating scheduled and walk-in patients, handling patient urgencies by telephone, consulting with hospitalists, and working with office staff to best treat the patients while Dr. Smith was out of town.

Patient assessment and management: E&M, diagnostic blood work and imaging, proper referrals to specialists

Primary care provider: Maintain continuity of care for patients ensuring that all patients return to the office following visits by specialists or other providers to maintain a stable medical home for every patient; follow up with other providers to coordinate care; follow up with hospitalists and hospitalized patients to assure the highest level of care is provided at all times.

Medical management chronic conditions: Diagnose, treat and manage chronic medical conditions (including but not limited to: diabetes, hypertension, dyslipidemia, vitamin deficiencies, hormone deficiencies, and more).

Preventative care medicine: Provide annual physical exams for men women and children; provide immunizations; order, interpret, and follow up with regular screening tests for cancer, diabetes, blood dyscrasias, and a multitude of other conditions.

Family planning: Provide well-woman exams; prescribe birth control; perform/assist in vasectomies

In Office Procedures: Perform and assist in performing procedures including but not limited to: skin biopsies, skin tag removals, shave biopsies, punch biopsies, incision & drainage procedures, colposcopies, vasectomies, digital blocks, trigger point injections, large joint injections, ingrown toenail removals.

Medical supervision of office staff: Cooperatively with Dr. Smith, as well as independently in the case of his absence, manage and supervise other members of the medical office staff. This included one medical assistant, one front office worker (occasionally, one pre-medical student).

Manage medical emergencies: Assess and manage any medical emergencies that arose while I was the most highly licensed medical personnel on site.

Maintenance of national certification, California state Licensure and DEA Registration

October 1, 2009 – February 21, 2010 & August 6, 2010 – September 17, 2010 & April 2011; Intermittent Short Term Contract Work

Jerry N. Rand, APMC; Specializing in Pain Management, Chemical Dependency, and Dual Diagnosis: Physician Assistant, under the supervision of Dr. Jerry Rand, MD

Patient assessment and management: Patient E&M; diagnostic test order & interpretation (blood work, split night polysomnography, urine drug screens, EKG, pulmonary function test, among others); referral of patients to appropriate specialists to facilitate patient care.

Medical management of residential patients: Management and treatment of residents in the closely associated residential treatment program; focusing on management and treatment of chemical dependency, pain management and dual diagnosis. (The program treated patients through group therapies, psychotherapy, massage, acupuncture, and medical care).

Detoxification: Assisted with and, under the direct supervision of a medical doctor, performed medically supervised detoxification. Created taper regimens to detoxify patients at high risk for serious sequelae due to the detox process, and followed patients through all stages of detoxification to ensure the patients’ success, safety, and comfort throughout the process.

Maintenance and oversight of medical practice when physician was away: Manage the practice and the patient population—approximately 4000 to 5000 patients, and up to 25 inpatients at any given time—in the event that supervising physician was away on business. (All national and state regulations were followed during these times).

Holistic Evaluation & Management of Chemical Dependency, Chronic Pain, and Dual Diagnosis patients: Performed intake evaluations of new patients which included thorough physical, social, psychological and spiritual evaluations. From complete evaluations, determined diagnoses and structured/implemented patient-specific treatment plans. Following initial evaluation and implementation of treatment plans, followed up on patient status as they progressed from intake through discharge and often to outpatient treatment.

Counseling: Familiar and comfortable with counseling techniques from both medical, and to a much lesser degree, a counseling standpoint. Aptitude in assisting distraught patients and family members alike cope in the moments immediately following intervention and/or admission into the program. Proficient in supporting patients as they develop communications skills, set boundaries, work their recovery program, and develop relationships as they work through their positive life change.

Call duty/After hours urgent follow-up: Responsible for taking calls after hours from patents with urgent concerns at home, as well as house-techs and patients from the residential treatment facilities. Responsible to see patients with urgent needs (including urgent/emergent intake evaluations) after hours and on weekends when necessary. Adjusted medications, changed/corrected dosages via telephone consultations when needed, in situations in which the patient could not be seen in the medical office (an essential function for assisting with patient adjustment to sleeping and being alert, functional and comfortable, during and following detoxification; also essential any time medications were adjusted, especially in very sensitive patients).

Experience with buprenorphine treatment: Close work with Dr. Rand as he treated patients with buprenorphine therapy for opiate dependency & pain management. I have attended several talks given by Dr. Rand to colleagues about the uses of Suboxone and Subutex as well as the differences between them; also, while working with him, I was fortunate to have the opportunity for several impromptu lectures on the benefits and risks, drug interactions, and utilization of buprenorphine based medications. When implementing a buprenorphine treatment plan, I have observed nearly 100% positive results in treating intractable, long-term, chronic pain; with associated increase in quality of life, and discontinuation of all other analgesic medication.

Experience treating chronic intractable pain and sleep disorders: Identified patients at risk for sleep disorders (mainly obstructive or central sleep apnea). When appropriate, referred them to specialists for testing; prescribed the appropriate pharmaceutical and behavioral therapies for treatment of these disorders (as well as interpreting test results in order to explain to patients the necessity for CPAP/Bi-PAP therapy, surgical airway correction, etc.).

Internal medicine practitioner: As the primary care provider for patients in the residential treatment facility, provided all services of an internal medicine provider (including but not limited to): evaluation, management, diagnostic testing/interpretation, referrals, continuity of care, and management of chronic comorbid diseases (diabetes, HTN, cardiovascular disease)

Creation/maintenance of complete medical records: Maintained accurate and thorough medical records; ensured clarity of all entries in medical records; ensured that all records were signed by PA-C, and reviewed weekly by supervising physician.

Maintain open communication with supervising physician: Communicated with supervising physician on a regular basis; ensured that any situations outside the PA’s scope or comfort zone were communicated to supervising physician immediately; ensured that supervising physician is up to date regarding all changes in patient status in a timely manner.

Follow-up care: As a “high-risk” patient population, there was a need for frequent and thorough follow up care to ensure appropriate treatment participation and response (taking medications appropriately, not taking other drugs, attending counseling, following other behavioral ‘prescriptions,’ not experiencing adverse reactions, etc.). Provided weekly, monthly, or intermittent follow up visits to outpatients as well as those who had completed an inpatient program.

Supervision of other medical and non-medical staff: Managed and supervised other members of the medical office staff. This included (at minimum): 2 medical assistants, 2 front office workers, 1 medical assistant student (occasionally), 1 PA student (see below). Provided oversight of the medical documentation and actions of other staff, volunteers and assigned “house facilitators,” as necessary.

Preceptor of physician assistant students: Trained 2 physician assistant students from Midwestern University, Glendale, AZ. Cooperated with supervising physician to ensure that the students were given the opportunity to learn the general and specific information they needed in order to prepare for their mid-year-exams, PANCE and ultimately to practice as physician assistants.

Manage medical emergencies: Assessed and managed any medical emergencies that arose while I was the most highly licensed medical personnel on site.

Maintenance of national certification, California state Licensure and DEA Registration

Short-Term Contract Physician Assistant, Aug 6 – Sept 17, 2010

Maintenance and oversight of medical practice: Dr. Rand was called out of town on business, and I was contracted under a short-term agreement. I was charged with the responsibility of managing the practice, including performing any/all of the duties aforementioned. (All national and state regulations were followed during this time).

PROFICIENCY IN OFFICE BASED PROCEDURES (Including but not limited to the following)

Trigger Point Injections: 95-98% immediate & lasting pain reduction reported, allowing decreased pain medication, and increased quality of life.

Occipital nerve blocks (greater & lesser): 89-94% relief reported with increase in function/quality of life; “1-puncture” method for accurate/efficient nerve blocking while minimizing risks of adverse event.

Peroneal nerve blocks (deep & superficial), Ilioinguinal nerve blocks, Lateral Femoral Cutaneous nerve blocks, and Other Peripheral nerve blocks: 90-98% decrease in pain levels, and analgesic use, with increase in function/quality of life reported.

Large joint injections: 100% of patients reported increase in overall quality of life following administration of large joint injections, including verified increase in mobility, and decrease in analgesic use.

OTHER SKILLS

EMR: proficiency in the use of electronic medical record keeping

Communication: Good, clear communication with patients, coworkers and the public.

Creating documents and other information for the website to keep it updated

Create Patient and Community education videos: During the COVID19 crisis, I took it upon myself to begin producing several informational videos to help keep our patients and the public informed

Telemedicine: During the COVID19 pandemic, I researched several telemed platforms and after choosing the best platform for our practice, I set it up for 5 users, including branding and personalization. I remain the administrator of the telemedicine platform.

VOLUNTEER

California Medical Reserve Corps: Volunteered in March 2019 during the COVID19 pandemic

Medical Advisor to the Mayor of Lancaster: During the COVID19 pandemic, I volunteered my time and expertise to help our local mayor make the best possible decisions for our community

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