About TMA Related Organizations TMA Calendar Site Map Contact Us

Monday, January 31, 2011

WINTER CONFERENCE BRINGS TMA LEADERS TOGETHER IN A TIME OF CHANGE

The head-spinning pace of change in American medicine gave physicians at 2011 TMA Winter Conference plenty to talk about. Our boards, councils, and committees moved forward on action plans to prepare Texas physicians for accountable care organizations and health information exchanges and to help us win scope-of-practice, Medicaid, and tort reform battles. Speakers forecast both stormy weather and rainbows. “TMA is a nimble and a powerful organization,” said TMA President Sue Bailey, MD. “Take this message back home to your colleagues: If you want to keep up, stick with us. There’s no better place to be.” Among the conference highlights:
  • Leading blogger Kevin Pho, MD, explored the promises and mine fields of social media for physicians. Connecting with patients online “is a physician imperative for the 21st century,” Dr. Pho said in his keynote address. Among his other tips: Don’t “friend” your patients on Facebook, and Google your own name weekly to protect your online reputation. We broadcast Dr. Pho’s speech live on the Internet and saved the video for you to watch today.
  • Texas Attorney General Greg Abbott said today will be a big day for the future of health system reform. He tipped us off that U.S. District Judge Roger Vinson in Florida will issue his initial ruling in the 26 states’ — including Texas’ — lawsuit challenging the new law’s constitutionality. General Abbott said the suit is not intended to stop needed reforms of our country’s health care systems, but rather it’s to stop Congress from “trampling the Constitution.” Watch the video.
  • American Medical Association President Cecil Wilson, MD, explained what AMA likes and hates about the health reform law and praised Texas physicians for our leadership in tort reform.
Leaders of state agencies whose budgets and programs would be slashed as lawmakers try to balance the budget described the impact of the budget cuts and how they hope to handle them.

COUNTY LEADERS SHARE HOPES AND CHALLENGES

There’s no better time than right now for county medical societies to share some good ideas. Keeping membership and interest in county programs is a growing struggle. The private practice of medicine is under attack from hospitals and crumbling government health programs. But 31 leaders from 22 Texas county societies found silver linings in each other’s dark clouds. TMA’s annual County Medical Society Leadership Forum gave these local leaders the chance to lean on each other’s — and TMA’s — shoulders and share their secrets for success. Here’s one I can share: Strong county societies and vibrant grassroots activism are the secrets of TMA’s success.

TMA ENDORSES CONGRESSMAN SMITH'S NATIONWIDE TORT BILL WITH KEY CAVEAT

Congress should pass legislation reforming the nation’s medical liability system as long as it “in no way preempts the state reforms that have been won in Texas and other states,” Dr. Bailey wrote in a letter to House Judiciary Committee Chair Lamar Smith (R-Texas). Two Georgia congressmen and Chairman Smith introduced a bill that puts a nationwide $250,000 cap on noneconomic damages and requires most medical liability suits to be filed within three years of the injury. As filed, the bill does protect Texas’ landmark 2003 liability reforms.

STUDENTS CHOOSE NEXT YEAR'S LEADERS

TMA’s Medical Student Section selected two rising stars to join TMA leadership. Baylor College of Medicine student Neil Parikh will sit on the TMA Board of Trustees starting after TexMed 2011, and Maryam Shambayati of the Texas College of Osteopathic Medicine will be the student member of the Texas Delegation to the AMA. Congratulations Neil and Maryam, and welcome to your future. 

TMA PRESIDENTS TEACH AND TALK

Dr. Bailey took TMA’s popular Health Reform School to Abilene to share with members of the Taylor-Jones-Haskell County Medical Society TMA’s tools to help physicians survive and thrive in the new health care landscape. It was her last stop this month before the busy winter conference. And President-Elect Bruce Malone, MD, bookended the weekend in a television talk show appearance discussing health care issues with General Abbott, John Colyandro of the Texas Conservative Coalition, and Tim Graves of the Texas Health Care Coalition.

FIRST TUESDAYS NO. 1 IS TOMORROW

I look forward to seeing a great turnout from TMA leaders at tomorrow’s First Tuesdays at the Capitol. If you haven’t registered for the first battle of our white coat invasion, you still have time. Or you can make plans to come to Austin March 1, April 5, and May 3. “We need every physician, every medical student, and every alliance member to be involved this spring,” Dr. Bailey says in a video invitation to join our lobby team. “We’ll be in Austin visiting legislators. We want you to be here, too. We want a sea of white coats on the capitol lawn.”

Monday, January 24, 2011

STARK BUDGET DRAFT SLASHES STATE HEALTH PROGRAMS

As promised, Texas House of Representatives leaders unveiled a 2012-13 state budget that balances without new taxes or any help from the Rainy Day Fund. Instead, they filled the $30 billion shortfall with steep spending cuts. As health care makes up a big chunk of state spending, it would take its share of cuts under the House draft. Among the ill-advised proposals:


  • This would be in addition to the 1-percent cut that hit in September 2010 and the 1-percent cut slated for Feb. 1.
  • Eliminating the Physician Education Loan Repayment Program, Family Medicine Residency Program, General Internal Medicine Statewide Preceptorship Program, Texas Statewide Family Medicine Preceptorship Program, and General Pediatric Preceptorship Program.
  • Lifting — at least in part — the ban on hospitals directly hiring physicians.
  • Allowing advanced practice nurses to prescribe certain drugs.
The House plan does include some solid cost-cutting proposals that we can support — provided they get the details right. These include:

  • Redirecting Medicaid patients with nonemergency conditions from the emergency room to a clinic, and
  • Expanding a program that uses preventive screenings to avoid pregnancy-related Medicaid costs.
Senate leaders are expected to release their own draft spending plan this week.

U.S. HOUSE MOVES PAST REPEAL AND INTO REPLACE

The new Republican majority in the U.S. House of Representatives took the symbolic act of voting 245-189 to repeal the new health reform law. All of the Texas Republicans in the House voted for repeal and all of the Texas Democrats voted against it. I say “symbolic” because the repeal bill has no chance of moving in the Democrat-controlled Senate. But House leaders are now looking into ways they can improve on or replace some of the serious shortcomings in the new law. I met on Capitol Hill with two senior Texas congressmen to discuss some of their plans:

  • Rep. Lamar Smith (R-San Antonio) and I reviewed his HR 5, which calls for California- and Texas-style medical liability reform with a rock-solid preemption clause that says stronger state tort laws prevail over any federal legislation. As chair of the House Judiciary Committee, Rep. Smith is in a great position to move this bill.
  • Rep. Michael Burgess, MD (R-Lewisville), and I talked with Lee Spangler, TMA vice president, Medical Economics, to review some of the key changes we need in the new law. These include replacing the Medicare Sustainable Growth Rate formula and reining in or eliminating the Independent Payment Advisory Board; ensuring physicians and Medicare patients the right to contract privately for services; and repealing the Stark restrictions on physicians’ rights to own hospitals. The American Medical Association has developed a good list of needed changes.

NEW LEADERS TAKING OVER IN HOUSTON, DALLAS, EL PASO

Between us, TMA President Sue Bailey, MD, and I made the rounds for the installation of three new county medical society presidents. Orthopedic surgeon Shelton G. Hopkins, MD, is the new president of Dallas County Medical Society. At the El Paso County Medical Society, obstetrician-gynecologist José Aun, MD, is the new leader. And gastroenterologist Guru Reddy, MD, is now president of Harris County Medical Society. Congratulations to all of these new leaders.

EDITORIAL BOARDS TAKE SERIOUS INTEREST IN HEALTH CARE LEGISLATION

Dr. Bailey led TMA delegations who laid out our legislative agenda to the Houston Chronicle and El Paso Times editorial boards. The reporters and editorial writers were very receptive to our concerns and our proposals. I look forward to the papers publishing strong editorials soon.

SOME HOSPITAL LEADERS EMBRACE COOPERATION WITH PHYSICIANS

In my travels last week, I had the chance to meet with Joel Allison, president of the Baylor Health Care System; Methodist Hospital CEO Ron Girroto and his senior team; and Maura Walsh, president of the Gulf Coast Division of HCA. I was accompanied by Drs. Sue Bailey, Carolyn Evans, and Tomas Garcia; TMA chief lobbyist Darren Whitehurst; Harris County Medical Society EVP Greg Bernica; and Dallas County EVP Mike Darrouzet. We discussed TMA’s legislative agenda and issues like the corporate practice of medicine, physician employment, scope of practice, and the state budget. I was very pleased that they were supportive of TMA and our positions, unlike the Texas Hospital Association and the Texas Organization of Rural and Community Hospitals, who are pushing hard to allow hospitals to directly employ — and control — physicians. 

Wednesday, January 19, 2011

LAWMAKERS FACE SHORTFALL OF UP TO $30 BILLION

The 2011 Texas Legislature convened in a big hole. A huge, $30 billion, hole, in fact. And leading budget writers in both the House and Senate — backed by state leaders — say they will focus on spending cuts — not new taxes or the state’s Rainy Day Fund — to fill it. As expected, that means the first-draft budgets will take some big slices out of spending on Medicaid, the second largest state expenditure after public education:

  • “We will prioritize what’s important in this state,” said Gov. Rick Perry. “We will fund those. And we will craft a budget that meets those revenue projections.”
  • “It is impossible to balance the budget without making cuts in” health care and education, said Senate Finance Committee Chair Steve Ogden (R-Bryan). Together those two items make up more than 81 percent of general revenue appropriated in the biennial budget. Medicaid will cost the state an additional $4.5 billion this budget cycle due to the end of the federal stimulus money lawmakers used last session to help fund the state’s health care programs.
  • Lt. Gov. David Dewhurst said a Senate version of a base budget for the next two years would eliminate 8,000 state employee slots.
  • House Appropriations Committee Chair Jim Pitts (R-Waxahachie) said the initial House plan would mean fewer state workers and fewer state programs. He also predicted it would spark outrage from legislators’ local school districts and hospital and nursing home administrators.

PERRY CALLS FOR MORE LIABILITY REFORMS

Already Texas’ longest-serving top executive, Governor Perry takes the oath of office again today along with Lieutenant Governor Dewhurst. As part of his plan to keep Texas’ economy strong, the governor is proposing new tort reforms. They include an early dismissal option for frivolous lawsuits, creation of a “loser pays” system, and ensuring new laws cannot create causes of action unless the legislature expressly says so. In 2003, Governor Perry was instrumental in the passage of our hugely successful health care liability reforms.

TMA MEMBERSHIP PASSES 45,000

TMA closed 2010 with a record 45,046 physician and medical student members. That means TMA remains the largest and (the best) state medical association in the country. I really appreciate the hard work of TMA’s membership staff and our partners in the county medical societies. The more members we represent, the stronger our collective voice, and the more we can accomplish for you and the patients you serve. If you haven’t yet, please renew your membership for 2011 today. Installment options are available; call the TMA Knowledge Center at (800) 880-7955 or e-mail knowledge@texmed.org.

HAVE YOU REGISTERED FOR FIRST TUESDAYS YET

The budget woes top a long list of problems Texas physicians face in the 2011 legislative session. Hospitals, trial lawyers, and nonphysician practitioners all will be gunning for medicine. Frequent and regular visits between physicians and lawmakers are the most effective way for us to make sure state leaders understand the potential consequences of bad decisions. The easiest way for you to make those contacts is at our vaunted First Tuesdays at the Capitol program. Please be a white-coated lobbyist for a day on Feb. 1, March 1, April 5, or May 3 — or all four. We need you.

PHYSICIAN LEADERS: MEDICAID AND CHIP CUTS WILL BACKFIRE

Leaders of organized medicine in Texas warned state officials that further cuts in payments to physicians for treating patients in Medicaid and in the Children's Health Insurance Program (CHIP) will only make it harder for patients to find the medical care they need. And that, they say, will increase, not decrease, costs. TMA President Sue Bailey, MD, and the presidents of the specialty societies representing anesthesiologists, cardiologists, emergency physicians, family physicians, gastroenterologists, internists, neurologists, obstetricians and gynecologists, ophthalmologists, orthopedists, otolaryngologists, pathologists, pediatricians, psychiatrists, radiologists, and urologists, as well as the president of the Texas Medical Group Management Association, signed the letter to the Texas Health and Human Service Commission (PDF). The 1-percent cut for Medicaid and CHIP physician services planned for Feb. 1, they said, “will result in more physicians restricting their Medicaid participation, thus exacerbating the challenges patients face in finding a participating physician.” The cut could cost the state money, they said, “because more patients will have no choice but to rely on costly hospital emergency rooms for care.”

TMA WINTER CONFERENCE IS LESS THAN TWO WEEKS AWAY

Sometimes January events sneak up on us really quickly. Are you registered yet for 2011 TMA Winter Conference, Jan. 28-29, here in Austin? Please join us for a power-packed day and a half.

Monday, January 10, 2011

INTENSE LEGISLATIVE SESSION CONVENES TOMORROW

The 2011 Texas Legislature gavels to the start of its 140-day session tomorrow. It will be 140 very difficult days for medicine — plus some likely difficult special sessions. The $20-billion-plus budget shortfall will put huge pressures on lawmakers to cut Medicaid, medical education, and public health programs. Hospitals, trial lawyers, and nonphysician practitioners all will be gunning for medicine. “We have a plan,” says TMA President Sue Bailey, MD. “But we need your help.” For an in-depth look at our plan, download Caring for Patients in a Time of Change and read our 16 legislative issue briefs. To find out how you can help, watch Dr. Bailey’s video. While legislative sessions usually get off to a slow start, the next two days will prove crucial. Here’s why:


  • This morning, Comptroller Susan Combs presented her official biennial revenue estimate. That number tells legislators they need about $4.3 billion to balance the rest of the 2010-11 budget. While the state economy, and tax collections, have begun to pick back up, observers say Comptroller Combs’ revenue estimate leaves lawmakers in a $26.8 billion hole to maintain current state services for the 2012-13, two-year, budget.
  • The most important piece of business after tomorrow’s swearing-in ceremonies will be the selection of the next speaker of the House of Representatives. Current Speaker Joe Straus (R-San Antonio) faces challenges from two members of his own party — Reps. Warren Chisum of Pampa and Ken Paxton of McKinney — who say he isn’t conservative enough. The GOP holds a 101-49 edge in the House.

NATION'S TOP PHYSICIAN BLOGGER HEADLINES 2011 TMA WINTER CONFERENCE

Kevin Pho, MD, a Nashua, N.H., primary care physician, and the “KevinMD” behind the popular and influential KevinMD.com blog, will speak at the 2011 TMA Winter Conference Jan. 28-29 at the AT&T Conference Center in Austin. Dr. Pho’s presentation, Medicine in the Age of Social Media, will address why physicians should engage in blogs, Twitter, or Facebook. The conference also will include discussions on the impact of the state budget deficit on health care in Texas, the uncertainty regarding health system reform, attempts by hospitals and large groups to employ physicians, and the continuing Medicare meltdown. Register today; it’s free for TMA members.

REGISTER NOW FOR FEBRUARY'S FIRST TUESDAY AT THE CAPITOL

Our first First Tuesday of the year is just three weeks from tomorrow. This year the immensely popular and effective TMA lobby days, sponsored by the TMA Alliance and TEXPAC, take place Feb. 1, March 1, April 5, and May 3. Be a medical lobbyist for a day. You will make a difference.

HEALTH REFORM REPEAL VOTE POSTPONED AFTER ARIZONA SHOOTING

Saturday’s attack on U.S. Rep. Gabrielle Giffords (R-Ariz.) led House Speaker John Boehner (R-Ohio) to put off all House action this week, including the planned vote to repeal the 2010 federal health reform law. While the repeal is sure to pass with the big Republican majority in the House, it likely won’t get past the Democrats in the Senate or President Obama’s promised veto. Still, it will focus attention on the fears many physicians and patients have with the law 

SENIOR STATE HEALTH CARE OFFICIALS COMING AND GOING

A highly effective Texas commissioner of insurance is on his way out as a new medical director of the Texas Medical Board (TMB) is on her way in.
  • Insurance Commissioner Mike Geeslin announced he will not seek another term when his current stint in office expires Feb. 1.
  • Louisiana otolaryngologist Linda Gage-White, MD, will become TMB medical director in mid-January. She is a former president of the Louisiana State Board of Medical Examiners and replaces Alan Moore, MD. Texas law requires TMB to hire a medical director if the agency's executive director is not a physician.

NEW LEADERSHIP VIDEO OUTLINES COUNTY SOCIETY ROLES AND RESPONSIBILITIES

What’s a county medical society to do? The second webinar in the TMA Leadership Series, sponsored by Pfizer, will help answer that question. This free 12-minute video is presented by Holly Alt, JD, from TMA’s Office of the General Counsel. We hope it will help you better understand Rules, Rights, and Powers: A Look at County Medical Society Bylaws.