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Tuesday, May 27, 2008

HONORING OUR VETERANS

I hope you enjoyed a restful Memorial Day weekend. I’m sure many of you spent time in your offices, emergency rooms, and hospitals. Thanks for your dedication.

WILLIAMS HOSTS “ME & MY DOCTOR” LISTENING SESSION

Nearly 100 physicians and patients came together at a town hall meeting in Wichita Falls as part of our Me and My Doctor: We Know Best campaign. TMA President Josie Williams, MD, and Wichita County Medical Society President Gary Ozier, MD, served as hosts to a crowd concerned about preserving their access to the physicians of their choice. 'You need to help us help you,' Dr. Williams said. 'I honestly believe we can work together.' State Rep. David Farabee (D-Wichita Falls) and staffers for several other legislators also joined the event. The purpose of the multimedia campaign is to rally physicians and patients to wrest control of medical decision making away from outside interests.

TMA WINS THE BATTLE OF THE ANKLE, AGAIN

The Third Court of Appeals left the podiatrists with no leg to stand on in their ongoing battle to expand their scope of practice. Two months ago, the court ruled that the Texas State Board of Podiatric Medical Examiners was wrong when it adopted a rule that expanded the definition of the foot to include the bones in the ankle. At that time, it directed a lower court to rehear the case. The podiatry board and the Texas Podiatric Medical Association asked the appeals court to take a second look, and the court came back with an even stronger ruling. TMA and the Texas Orthopaedic Association will continue to fight for patient safety in this case, which likely will go next to the Supreme Court of Texas.

TMB OPENS WINDOW ON LICENSING

At TMA’s strong urging, the Texas Medical Board (TMB) activated an online system that allows physicians to monitor the progress of their medical license application. The License Inquiry System of Texas (LIST) not only gives physicians a quick look at their status but also should free TMB staff from answering those questions over the phone and let them focus on processing applications. TMB President Roberta Kalafut, MD, also announced a series of town hall meetings across the state this summer. “We want to encourage a more active dialogue with doctors and with the public,” she said. Look for more details in the June 1 issue of TMA’s Action newsletter.

TMA HELPS YOU COMPARE THE CANDIDATES

Where do Sens. Hillary Clinton, John McCain, and Barrack Obama stand on health care reform, Medicare and Medicaid, pay for performance, and other critical issues? Check out TMA’s side-by-side comparison of the candidates’ positions.

ARE YOU GETTING RIPPED OFF FROM THE INSIDE?

The newest Podcast TMA sheds some light on embezzlement: how to prevent it and how to treat it if it shows up in your practice. This and other practice operations problems are covered in our free e-book, TMA Practice E-Tips Greatest Hits, Vol. 1.

ARE YOU GETTING RIPPED OFF FROM THE INSIDE?

The newest Podcast TMA sheds some light on embezzlement: how to prevent it and how to treat it if it shows up in your practice. This and other practice operations problems are covered in our free e-book, TMA Practice E-Tips Greatest Hits, Vol. 1.

Monday, May 19, 2008

TORT REFORMS UNDER ATTACK; TIME TO RIDE TO THE RESCUE

Texas trial lawyers, their cronies at The University of Texas law school, and front groups like Texas Watch are firing broadsides at our 2003 medical liability reforms. They say the reforms weren’t needed, aren’t working, and are bad for Texans. TMA and our liability reform allies are gathering the data and building the political muscle to protect Proposition 12. (Don’t miss the excellent article in Saturday’s Wall Street Journal.) But we need your help. We need your success stories. Tell us about new physicians who’ve come to Texas because of the reforms and made a difference in your community. Tell us how your patients have benefited.

ANOTHER ATTACK ON PHYSICIAN OWNERSHIP SURFACES

This time Congress is thinking of attaching limits on physician ownership to a bill to fund the Iraq War. The Senate Finance Committee approved a supplemental appropriations bill that would starkly limit physicians’ ability to buy into hospitals and other facilities in the future. It would grandfather existing owners, but the details are not clear. The House passed a very different version of the bill, which likely will draw a presidential veto.

TMA PANEL FINDS BLUE CROSS COST RATINGS “DECEPTIVE AND INVALID”

TMA President Josie Williams, MD, called on Blue Cross and Blue Shield of Texas to stop using its risk-adjusted cost index (RACI) to evaluate physicians in its BlueChoice Solutions program. Dr. Williams’ letter is based on a strongly worded report from a TMA ad hoc committee that found RACI is so problem-ridden as to be “deceptive and invalid” for measuring how cost-efficient a network physician is. RACI is based on extremely flawed claims data, such as holding physicians responsible for patients they’ve never seen.

FOLLOW THE MONEY

Health insurance companies are not only putting it to your practices, but they’re also hitting the small employers that pay the way. Since many physicians’ practices are small businesses, they’ve got you coming and going. As employers pay more and more for health insurance, the health plans pay less and less for health care services. To improve relationships with small business, TMA has developed and promoted a tool to help them determine how much of their premium dollars actually go toward health care. It can help your practice, too.

RAND STUDY FINDS MORE RATINGS PROBLEMS

The Physicians Advocacy Institute sponsored a workshop that featured some soon-to-be published research into the failings of the health plans’ physician rating systems. Consistent with our research, the findings from the RAND Corp. study show significant problems with the ratings scales and the data they depend on. The lead researcher said the demand for accountability and consumer-directed care will only grow stronger. She challenged medicine to offer alternatives for measuring how physicians deliver high-quality, affordable health care.

Wednesday, May 14, 2008

Monday, May 12, 2008

DEWHURST STANDS STRONG FOR LIABILITY REFORMS

The annual Texas Alliance for Patient Access (TAPA) membership meeting focused on the challenges to our 2003 liability reforms that we expect to come in the 2009 Texas Legislature. Lt. Gov. David Dewhurst told TAPA members he remains a firm supporter. “We're in good shape in Texas because of your efforts,” he said. “When our only goal is putting Texas first and we work together, we can solve anything.”

OPPONENTS REVEAL PLANS TO WEAKEN CAPS

Texas trial lawyers laid out their antitort reform agenda to the Texas Senate State Affairs Committee. In addition to taking another shot at relaxing liability protections for emergency medical care, the plaintiffs bar told the committee that they want to:

  • Increase the $250,000 cap on noneconomic damages for physicians in a liability case,

  • Tie the level of the cap to inflation,

  • Have the cap apply to each defendant in a case, and

  • Require physicians to carry minimum levels of liability insurance coverage.


TMA, TAPA, and our allies are committed to holding the line on our 2003 reforms, which have boosted patients’ access to high-quality health care and drastically reduced physicians’ liability premiums.

TMA TO CONGRESS: STOP PRETENDING OWNERSHIP LIMITS SAVE MONEY

TMA President Josie Williams, MD, sent a sharply worded letter to key Texans in Washington. Dr. Williams asked them to, once again, prevent the hospital lobby from putting into law Stark limits on physician ownership of health care facilities under the guise of saving Medicare costs for the government. “We urge you not to allow this provision to become part of the Supplemental Appropriations Bill or any other legislation,” she wrote. “This is neither a Republican nor a Democratic issue; rather it is an issue of immense importance to Texas physicians and our patients. It is key to the future viability of our health care systems.”

QUALITY TEXAS CITES TMA FOR EXCELLENCE

TMA is making great progress in improving our operations. The Quality Texas Foundation says we have “well-deployed, effective, systematic approaches to organizational management, with good performance levels and trends evaluated against industry standards.” We are waiting for the foundation’s comprehensive report on how we can improve.

E-TIPS GREATEST HITS FOCUSES ON IMPROVING PRACTICE OPERATIONS

For more than eight years, TMA has offered practice management advice to physicians and office managers through our semimonthly TMA Practice E-Tips. Now we’re culling some of our best tips into a series of free “greatest hits” e-books. Our first, on practice operations issues such as personnel problems and how to deal with angry patients, is out on the Internet now (PDF). Watch for an accompanying Podcast TMA segment soon.

Monday, May 5, 2008

WILLIAMS INSTALLED AS 143RD TMA PRESIDENT

A nationally known expert on measuring and improving the quality of medical care is the new president of TMA. Josie Williams, MD, took the oath of office at TexMed 2008 in a room packed with family and friends. She pledged to lead TMA and Texas physicians in a movement to transform medicine. “There is no way to do it the way we’ve always done it,” Dr. Williams said. “We cannot attempt to deliver 2009 medicine in a 1950 chassis. It’s like trying to launch the space shuttle into orbit on the backs of the Kitty Hawk.” Dr. Williams is the fourth female president of TMA, and the first since Betty Stephenson, MD, of Houston, in 1994.

HOUSE PICKS FLEMING

The TMA House of Delegates rewarded its speaker with a promotion, unanimously selecting Houston neurologist Bill Fleming, MD, as president-elect of TMA. Dr. Fleming will take office at TexMed 2009 in Austin. In other elections:

  • The house promoted Vice Speaker Steve Brotherton, MD, to speaker of the house. The new vice speaker is Austin psychiatrist Clifford Moy, MD.

  • Delegates re-elected TMA Secretary-Treasurer Art Klawitter, MD, and Board of Trustees members Carolyn Evans, MD; Carlos Cardenas, MD; and Austin King, MD.

  • The Board of Trustees chose Nacogdoches ophthalmologist Lyle Thorstenson, MD, as its new chair. Michael Speer, MD, is the new vice chair; Dr. King remains as secretary; and Drs. Evans and Cardenas round out the members of the board’s executive committee.

HOUSE TACKLES MEDICINE’S PRIORITIES

The TMA House of Delegates efficiently dispatched an immense agenda at TexMed 2008 in San Antonio. Among its actions, the house:

  • Adopted private- and public-sector strategies for TMA to pursue to reduce the number of uninsured Texans;

  • Recommended that TMA work closely with the Texas Attorney General on issues such as health payment plan programs that rate physicians and the underpayment of noncontracted physicians;

  • Approved several recommendations to address emergency department overcrowding;

  • Adopted policy on evidence-based medicine;

  • Voted to support the addition of cystic fibrosis to the panel of tests for newborn screening;

  • Supported efforts to expand and promote state student loan repayment programs; and

  • Replaced TMA’s policy on gun control with one that focuses on responsible gun use.

HUTCHISON AND LEGISLATOR-DOCTORS IN THE HOUSE

U.S. Sen. Kay Bailey Hutchison, cosponsor of the Save Medicare Act of 2008, led an all-star cast of elected officials who addressed the TMA house. Senator Hutchison’s bill would stop the 10.6-percent cut in physicians’ Medicare payments scheduled for July 1 and provide a 1.8-percent hike for next year, buying time for Congress to enact a permanent fix to the flawed Medicare payment formula. “I really hope that we can do something that eases your pain and makes sure that none of you has to turn away any Medicare patients,” she said. U.S. Rep. Michael Burgess, MD (R-Lewisville), who is carrying a bill to peg Medicare payments to the cost of running a medical practice, also spoke to the House of Delegates, as did State Sens. Bob Deuell, MD (R-Greenville), and Kyle Janek, MD (R-Houston).

HEARN IS FIRST MALE PRESIDENT OF TMA ALLIANCE

Wichita Falls businessman Patrick Hearn is the 91st president of the TMA Alliance, succeeding the irrepressible Mia Price of Denton. “I’m honored to follow in the footsteps of some extraordinary women, who have set the bar high,” Mr. Hearn said. The alliance chose D’Anna Wick of Tyler as president-elect.

PAST, PRESENT, FUTURE LEADERS NAB AWARDS

As we reported in last week’s EVPGram, Houston family physician Max Butler, MD, the former TMA president, received the TMA Distinguished Service Award. His old friend Cliff Burross, MD, made the presentation. In other awards:

  • Bohn Allen, MD, won the Young Physician Section’s Young at Heart award. Brandy Landon, a prospective physician from Honey Grove, Texas, received the Michael O’Malley, MD, Memorial Scholarship. The award helps rural high school seniors pursue a degree in medicine.

  • The Resident and Fellow Section named El Paso obstetrician William Sullivan, MD, the winner of the J.T. Lamar” McNew, MD, Award for mentoring.

  • Dennis Dove, MD, of Amarillo, chair of the TMA Council on Medical Education, received the C. Frank Webber, MD, award from the Medical Student Section. The students also named the University of North Texas Health Science Center (UNTHSC) the Chapter of the Year and UNTHSC student Travis Bias the Student of the Year.

THREE TEACHERS WIN BUTLER PRIZE

Three outstanding Texas science teachers won the 2008 TMA Ernest and Sarah Butler Awards for Excellence in Science Teaching. The awards honor teachers who share their energy and enthusiasm for science through creative and innovative methods. This year’s winners are Bradley Neu of Lubbock High School in Lubbock, Jill Bailer of Jane Long Middle School in Houston, and Michelle Yates, formerly of Bess Race Elementary School in Crowley.

TMA, FOUNDATION AWARD MINORITY SCHOLARSHIPS

Eight minority Texas college students entering medical school each received a $5,000 scholarship at TexMed 2008. Since 1999, TMA has awarded scholarships to encourage outstanding minority students to enter medicine and help meet the medical needs of Texas’ diverse population. To date, TMA has awarded 38 scholarships, totaling $190,000. Generous physicians, county medical societies, and corporate donors finance the scholarships through the TMA Foundation.