Monday, March 10, 2014
Hundreds of physicians from Texas and around the country met with their U.S. senators and representatives last week as part of the Coalition of State Medical Societies and the American Medical Association’s National Advocacy Conference. David Henkes, MD, chair of the Texas Delegation to the AMA, led our group, which focused on repealing Medicare’s Sustainable Growth Rate (SGR) formula and on the avalanche of problems coming with the transition to the ICD-10 coding system in October. SGR repeal, of course, is the most pressing problem, as we face a 24-percent cut in Medicare payments April 1 if Congress takes no action. We’re excited about the prospects of SGR repeal through H.R. 4015/S. 2000, sponsored by Rep. Michael Burgess, MD (R-Lewisville). But while organized medicine and much of Congress support the policy positions in the bill, its passage is by no means certain. First, it lacks bipartisan support on how to finance its 10-year, $138 billion price tag. Secondly, congressional leadership seems loath to schedule any tough votes this election year. All of this points to the need for even more grassroots lobbying from TMA members. So far, you’ve sent more than 1,400 emails through TMA’s Grassroots Action Center and made hundreds of calls through the AMA’s (800) 833-6354 hotline. But we can’t let up now. Please call and write today, and solicit your partners, colleagues, patients, and friends as well. In 12 years of this fight, we’ve never seen such a good chance for success.
The Party of Medicine performed exceedingly well in the March 4 party primaries. Several candidates from the TMA family — like State Reps. J.D. Sheffield, DO (R-Gatesville), and Susan King (R-Abilene), a TMA Alliance member — blew away their Empower Texas-backed opponents. All of the judicial candidates we backed — including the three sitting Supreme Court justices who faced trial lawyer-financed challengers — easily won their party nominations. Overall, 91 percent of the slate of TEXPAC-endorsed legislative candidates won. Some, however, are headed for May 28 runoff elections. That includes State Sen. Bob Deuell, MD (R-Greenville), and former State Rep. Mark Shelton of Fort Worth, who is seeking the Senate District 10 nomination. Even worse, we lost 11 races outright, and some very good friends of medicine will not be coming back to Austin next year. As TEXPAC Director Clayton Stewart told me, “We were simply unable to fund many of these candidates at the level needed for them to prevail. This is a problem, but it’s a problem we can solve from within, not something we can blame on ‘forces beyond our control.’ ” The solution, of course, is for more physicians and alliance members to join TEXPAC and recruit your colleagues.
We continue to hear horror stories of how much trouble physicians are encountering as they try to provide care to patients covered by the federal Affordable Care Act (ACA) marketplace exchange plans. We’re seeing difficulties in confirming patients’ coverage and trouble referring patients to specialists. TMA’s Payment Advocacy staff has begun weekly calls with Blue Cross and Blue Shield of Texas — which has marketplace plans in all 254 Texas counties — to address these issues, improve service, and help make the exchange better for patients and doctors. Blue Cross continues its efforts to reduce long hold times for practices attempting to verify eligibility for patients who have new coverage through the exchange. Through the TMA Hassle Factor Program, we are putting offices that are experiencing these difficulties directly in contact with senior Blue Cross personnel to resolve the problems. Have questions? See our updated, members-only question-and-answer white paper on the marketplace exchange plans.
If “meaningful use” were really meaningful, maybe the push for all physicians to adopt electronic health records would be tolerable. In “Technology Is Interfering With Your Doctor's Visit — And It’s Driving Physicians Crazy,” the latest Forbes.com blog post from Physicians Foundation CEO Tim Norbeck and me, we examine how the bull rush to technology by government and private payers and hospital systems is building a new wall between patients and their physicians. “The Department of Health and Human Services values EHR technology and its role in the doctor’s office — referred to as meaningful use — as the standard of care; thereby undervaluing our most important asset — the physicians’ knowledge, education, training, and intelligence,” we write. “The physician is demoted to a keyboard operator so that the government’s Holy Grail — personal information — can be entered into its massive database.”
The profession of medicine is much more than the practice of medicine, former TMA President Rob Tenery, MD, reminds us in his new book Bedside Manners. Through a series of easy-to-read but thought-provoking essays, accompanied by 99 guiding axioms, Dr. Tenery walks us through physicians’ interactions with patients, colleagues, payers, bureaucrats, politicians, even the news media. He constantly refers back to the art of medicine — perceived by patients and others as a physician’s bedside manner. “The pioneers of medicine were introduced to this profession in an era when taking care of patients was considered an act of beneficence and not just a transaction,” he writes in a blog post the launches his new book. “When undesirable outcomes were accepted as ‘acts of God’ and not misdiagnoses. When medicine was a calling to most and not just a vocation. Advances in the science, third-party payment systems, marketing and fear of reprisals have changed all that. Unfortunately, there is no going back! What have not changed are the patients. Although they are no longer all accepting, they are still afraid. They still are in pain. They still want their physicians and the other medical professionals who care for them to care about them too.”
Monday, March 3, 2014
If you didn’t vote early in Tuesday’s party primary elections, be sure to vote tomorrow. Texas medicine’s strength flows from the grassroots involvement of our 47,000-plus physician and medical student members: policy development, legislative testimony, media interviews, calling Congress, and — most grassroots of all — voting. TEXPAC, your political action committee, has endorsed an exceptional slate of candidates who have strong physician support, who understand our issues, and who have a good chance of winning. By helping to elect these candidates, you’re helping TEXPAC protect your patients and your profession from the intruders who want to tell you how to practice medicine. Whether you’ve already voted or you’re headed to the polls on Tuesday, share the experience. Remind your spouse, your colleagues, your staff, your patients, your friends, and your family to vote, too. The Party of Medicine needs your support.
TMA Board of Trustees Chair Carlos Cardenas, MD, leads a high-powered Texas physician delegation to Washington this week. In conjunction with the Coalition of State Medical Societies and the American Medical Association National Advocacy Conference, we’ll be lobbying Congress to pass the bill to repeal the Medicare Sustainable Growth Rate (SGR) formula. To support our team on the ground, we’re calling on all Texas physicians to flood Capitol Hill on Wednesday with SGR-repeal phone calls. Call AMA’s toll-free hotline, (800) 833-6354, Wednesday to tell Sens. Ted Cruz and John Cornyn and your representative that you want an SGR repeal, not another a short-term patch for the 17th time. Or, you can send an email through the TMA Grassroots Action Center. Joining Dr. Cardenas and TMA staff on the trip will be AMA House of Delegates Vice Speaker Sue Bailey, MD; AMA Trustee Joe Annis, MD; Texas Delegation to the AMA Chair David Henkes, MD; AMA Council on Science and Public Health Chair Russ Kridel, MD; and Texas Delegation members Drs. Asa Lockhart, Les Secrest, Michelle Berger, and Dawn Buckingham.