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Wednesday, December 10, 2014

GME EXPANSION A TOP PRIORITY FOR TEXAS SPECIALTY SOCIETIES


Winning greater investment in graduate medical education (GME) programs is a priority of almost every one of the state specialty societies that presented its plans at the 2014 TMA Advocacy Retreat last weekend. Primary care and specialties — from family practice to ophthalmology — listed GME expansion on their legislative priority lists. Scope of practice, Medicare parity for Medicaid payments, network adequacy, and new hassles with prescribing hydrocodone combination products also were mentioned prominently. In other highlights from the retreat:
  • TMA President Austin King, MD, led a wide-ranging and energetic discussion among leaders from more than a dozen county medical societies. The issues ranged from membership recruitment and retention to better engagement with employed physicians.
  • A panel of the TMA and TMA Alliance members in the Texas Legislature previewed the hot-button issues in the session that will begin on Jan. 13. State Rep. John Zerwas, MD (R-Simonton), offered some real hope for GME expansion when he said lawmakers will find more funds for GME if Texas physicians demand it loudly enough.
  • Physicians, students, and alliance members received some hands-on training in media relations, social media advocacy, and how to lobby lawmakers. Mark your calendar for the 2015 First Tuesdays at the Capitol: Feb. 3, March 3, April 7, and May 5.

ANOTHER TEXPAC-ENDORSED CANDIDATE WINS STATE SENATE SEAT


State Rep. Lois Kolkhorst (R-Brenham) won the special election for the vacant District 28 seat in the Texas Senate. Representative Kolkhorst, who has chaired the House Public health Committee for the past four years, was endorsed by TEXPAC because she believes in protecting the patient-physician relationship and wants to keep the government out of your examining room. Her local physicians support her strongly, and she relies on them for guidance when creating health care policy. In a five-candidate field, Senator-Elect Kolkhorst won Saturday’s election with 55 percent of the vote. The seat became vacant after Sen. Glen Hegar’s election as state comptroller.

BOARD APPROVES DRAFT NEW TMA STRATEGIC PLAN


With the addition of the phrase “TMA stands up for Texas physicians” to our mission statement and some revisions to TMA’s priority goals and strategies, the TMA Board of Trustees voted to approve a draft new strategic plan for the association. These revisions were made with input from staff and all boards, councils, committees, and sections. The general consensus among leadership was that, for the most part, the original plan is still on target. The modifications focused on simplifying and strengthening the language. The plan will next be presented for adoption by the House of Delegates and then sent back to boards, councils, and committees for development of tactics and implementation plans.

SHALL WE TWEET ... AND MAKE A DIFFERENCE?


Silly as its name sounds, Twitter is a communication tool of choice for the Texas Legislature. Groups that most effectively use this social network to influence the legislative process have trained their supporters to faithfully echo the organizations’ Twitter messages. This tactic substantially increases the groups’ Twitter reach … and impact. While TMA has been active on Twitter for years and has a large following, our tweets don’t get enough reinforcement from TMA members. As part of our plan to better engage the 85th Texas Legislature at all levels, we’re asking TMA leaders and member physicians to join the TMASMA (TMA Social Media Advocacy) campaign in the Twittersphere. For those new to it, we’ve posted four step-by-step videos that walk you through everything from creating a Twitter account to mastering the medium on your smartphone. Once you’re onboard, be sure to watch for and retweet TMA tweets marked with the #TMASMA hash tag. Check out our six-step TMASMA Marching Orders and get tweeting!

DR. WELTGE HONORED BY ACEP


Congratulations to Arlo Weltge, MD, the hardworking TMA, TEXPAC, and Harris County Medical Society leader. He received the John A. Rupke Legacy Award for his lifelong commitment to the American College of Emergency Physicians (ACEP). “Dr. Weltge is a well-recognized leader in emergency medicine at the national level,” said James J. McCarthy, MD, chair of the Department of Emergency Medicine at The University of Texas Medical School at Houston, where Dr. Weltge is a clinical professor of emergency medicine. “His dedication to his patients, colleagues, and the specialty of emergency medicine is an inspiration to us all. I'm proud to be able to call him a friend and colleague.

EVPGRAM TAKES A HOLIDAY

We won’t publish the EVPGRAM for the next few weeks because of the December holidays. We’ll be back in your in-box in time for the start of the 84th Texas Legislature in January. On behalf of the TMA staff, I wish you a Happy Hanukkah, Merry Christmas, and a wonderful New Year!

Monday, November 24, 2014

VISIT REVEALS A CHANCE, HOWEVER SLIM, OF SGR REPEAL THIS YEAR


Sustainable Growth Rate (SGR) formula repeal this year is a definite maybe. That’s the feedback 16 members of the Coalition of State Medical Societies received from our visits on Capitol Hill last week. Congressional leaders remain committed to repealing Medicare’s SGR formula, we heard. The big question remains whether the stars will align for that to happen in the few legislative days that remain before Congress adjourns for the year early next month. The SGR will mandate a 21-percent cut in physicians’ Medicare payments on April 1, 2015, if Congress doesn’t intervene. The Texas delegation for the visits included former TMA Board of Trustees Chair Carlos Cardenas, MD; our chief lobbyist, Darren Whitehurst; and me. The other states in the coalition are California, Arizona, Oklahoma, Louisiana, Florida, South and North Carolina, New Jersey, and New York.

TEXAS RETAINS CLOUT ON KEY HOUSE HEALTH PANELS


Committee appointments in the U.S. House of Representatives for next year were announced while we were in Washington, D.C. Three good friends of Texas medicine will be very well placed to influence issues like SGR reform and the repeal of onerous federal regulations. Rep. Kevin Brady (R-The Woodlands) will remain as chair of the Subcommittee on Health of the House Ways and Means Committee. Rep. Gene Green (D-Houston) will become the “ranking member,” or lead Democrat, on the Health Subcommittee of the House Energy and Commerce Committee, and Rep. Michael Burgess, MD (R-Lewisville), will be the third-ranked Republican on the subcommittee. TMA has excellent relationships with all three congressmen and their staffs.

LINEUP SET FOR TMA ADVOCACY RETREAT, DEC. 5-6


We have some special treats in store for the TMA 2014 Advocacy Retreat, Dec. 5-6, at Barton Creek Resort in Austin. The highlight, as always, will be the round-robin sharing of key legislative priorities from TMA and the state specialty societies. (Our priorities are outlined in Healthy Vision 2020, Second Edition.) Friday night’s dinner speaker, giving an update on the political landscape and a preview of the 2015 legislative session, is James R. Henson, PhD, director of the Texas Politics Project at The University of Texas at Austin. For our closing luncheon Saturday afternoon, we’ve secured four physician members of the Texas Legislature: Sen. Donna Campbell, MD (R-New Braunfels; and Reps. Greg Bonnen, MD (R-Friendswood); J.D. Sheffield, DO (R-Gatesville); and John Zerwas, MD (R-Simonton). Saturday morning’s agenda features breakout sessions for media training, lobby training, and social media advocacy training. Hope to see you there.

TMA WINS APPEALS COURT RULING IN SCOPE CASE


The Texas Third Court of Appeals sided with TMA in our challenge of a Marriage and Family Therapists Board rule that would have allowed therapists to diagnose. “We conclude that the diagnosis of mental diseases or disorders is excluded from the statutory scope of practice for licensed marriage and family therapists,” the court ruled. This case is one of an ongoing series of legal challenges we have mounted to stop state regulatory agencies from expanding allied health practitioners’ scope of practice beyond the authority granted by the Texas Legislature. In the legislature, we continue to oppose expansion of practitioners’ scope beyond what is safely permitted by their education, skills, and training.

PHYSICIANS FOUNDATION PANEL AIRS HEALTH CARE CHALLENGES FOR D.C. AUDIENCE


Former TMA President Sue Bailey, MD, took part in a three-physician panel organized in D.C. by The Physicians Foundation. Denton OB-Gyn Joe Valenti, MD, moderated the panel, which explored the changing dynamics of medical practices and how those changes are affecting practicing physicians and patients. The audience included U.S. Rep. Phil Roe, MD (R-Tenn.), a variety of congressional staffers, and several reporters. The discussion keyed off of the findings of the foundation’s biennial physicians survey, which shows more than 80 percent of America’s physicians are overextended or at full capacity. The survey “reflects a mood among doctors that is still uncertain and sometimes dispirited, but which is evolving. Relative to the national surveys The Physicians Foundation conducted in 2012 and 2008, doctors are somewhat more positive in their outlook.”

HAPPY THANKSGIVING

We all have so much to be thankful for — I’m thankful that we’ve reached the 48,000 mark in TMA membership. That means we can do so much more for you. EVPGram will take its annual Turkey Day Holiday next Monday. We’ll be back in your in box on Dec. 8.

Wednesday, November 19, 2014

COALITION HEADS TO CAPITOL HILL TO WORK SGR AND OVERREGULATION


The 10 members of the Coalition of State Medical Societies are off to Washington this week to lobby the lame duck Congress on two of medicine’s key issues. We’ll be asking, once again, for repeal of Medicare’s Sustainable Growth Rate formula, which will mandate a 21-percent cut in physicians’ Medicare payments on April 1, 2015, if Congress doesn’t intervene. We’ll also be pushing for the repeal of onerous federal regulations — like the ICD-10 conversion, big improvements in the Recovery Audit Program (RAC program), and standard electronic prior authorization processes for all insurance companies. The Texas delegation will include former TMA Board of Trustees Chair Carlos Cardenas, MD; our chief lobbyist, Darren Whitehurst; and me. The other states in the coalition are California, Arizona, Oklahoma, Louisiana, Florida, South and North Carolina, New Jersey, and New York. I’ll report on our progress next week.

ASK CONGRESS TODAY FOR TWO-YEAR ICD-10 DELAY


Have you faxed or mailed your letter to your U.S. representative yet, asking him or her to support a two-year delay in ICD-10? Texans in House leadership tell us there’s a good chance we can move the mandatory ICD-10 implementation date backward two more years from Oct. 1, 2015. But it will take a grassroots show of support from medicine. Cut and paste our sample letter onto your personal stationery, then send it to your representative by mail or by fax. It’s important the letter is on your personal stationery. And please add your own reasons why ICD-10 is a bad idea.

AMA HOUSE ADDRESSES MOC, MEANINGFUL USE, AND INADEQUATE NETWORKS


Some of medicine’s thorniest issues received serious attention last week when the American Medical Association House of Delegates met in Dallas. The delegates:
  • Adopted new policy that maintenance of certification (MOC) exams should be evidence-based and relevant to clinical practice, and not be a “mandated requirement for licensure, credentialing, payment, network participation or employment.”
  • Called on the Centers for Medicare & Medicaid Services (CMS) to suspend all penalties for failing to meet meaningful use criteria.
  • Said the states need to continue to be the enforcers of inadequate network rules for health insurance plans and called on insurers to publish “accurate, complete directories of participating physicians” on paper and electronically. Plans with inadequate networks, the house said, should “treat patient visits to out-of-network physicians the same as in-network visits.” 
  • Said minors should not be allowed to buy e-cigarettes.
  • Backed interstate compacts to make it easier for physicians to obtain licenses in multiple states.

OUR DEEPEST SYMPATHIES TO DR. FITE AND HER FAMILY


I am very sad to have to share the news that Anna Floyd, the daughter of TMA Board of Trustees member Diana Fite, MD, died suddenly last week. Mrs. Floyd, age 33, had three young children, including a 1-year-old baby. The family will receive visitors tomorrow from 5 to 7 pm at One Life Church, 16920 N. Texas Ave. in Webster, Texas. A service will follow at 7 pm.

TMA TO FEDS: SUSPEND BAD MEANINGFUL USE MEASURES


This is one of the many reasons physicians are starting to call it “meaningless use.” Many patients, especially elderly ones, have no desire to access their health records online, and physicians should not be forced to coerce them to do it, TMA President Austin King, MD, said in a letter to CMS Administrator Marilyn Tavenner. But that’s what meaningful use core measures 7 and 17 try to do, and physicians’ inability to meet them is responsible for the very low levels of doctors attesting to stage 2 of meaningful use. Dr. King asked CMS to suspend those measurers immediately and to “work with Congress to suspend all meaningful use physician penalties set to begin Jan. 1, 2015.”

VALLEY WINS APPROVAL OF NEW SURGERY RESIDENCY

A new general surgery residency program will open next summer in the Rio Grande Valley. Congratulations to The University of Texas Health Science Center San Antonio and Doctors Hospital at Renaissance. The Accreditation Council for Graduate Medical Education has approved the program, which will have four surgical residency slots.


Tuesday, November 11, 2014

AMA SETS POST-ELECTION ACA STRATEGY


Two key Texas congressmen in the battle to replace Medicare’s Sustainable Growth Rate (SGR) formula told the American Medical Association House of Delegates they will push to finish the job when Congress reconvenes next week. Reps. Michael Burgess, MD (R-Lewisville), and Kevin Brady (R-The Woodlands) asked for AMA’s help to win final passage of the SGR repeal bill, which stalled earlier this year, in the lame duck session of Congress. (Dr. Burgess said he prefers the term “extra innings.”) Replacing the SGR is one of AMA’s legislative priorities, Sue Bailey, MD, of Fort Worth, vice speaker of the AMA House, told the Texas Delegation to the AMA. The others are:
  • Achieve permanent Medicare-parity in Medicaid payments; first for primary care physicians providing primary care services, then for all of medicine;
  • Repeal the Independent Payment Advisory Board, a change Sen. John Cornyn of Texas has been promoting; and
  • Streamline the regulatory mess surrounding value-based purchasing, the Physician Quality Reporting System, and other Medicare quality programs.

REPUBLICANS SWEEP THE BALLOT


TEXPAC did very well with our endorsed candidates last week. As our polling data predicted, this was a very Republican election cycle. The governor’s race decidedly set the tone for the rest of the ballot with Attorney General Greg Abbott beating State Sen. Wendy Davis by 20 points. In fact, the biggest surprise was the handful of Democratic incumbents who lost their seats in this Republican wave. I know some say that the state is turning purple, but the results in key races strongly contradict that statement. The battle to replace Senator Davis in Fort Worth was probably the most-watched race not only by our physicians but also by the state in general. While this was a hard loss for TEXPAC, the superb efforts led by Robert Rogers, MD, and Tarrant County Medical Society Executive Director Brian Swift made a significant impact. A Republican in that district should have run at 56 percent but instead only earned 53 percent of the vote.

A "BRIGHT NEW DAY" FOR VA HEALTH CARE?


The issue of veterans’ access to timely health care returned to the American Medical Association House of Delegates this weekend in a far more positive light than it enjoyed five months ago. In June, in the wake of scandals over excessive wait times in the Department of Veterans Affairs (VA) health care system, the AMA House pushed for President Barack Obama and Congress to make it easier for private practice physicians to care for VA patients. TMA was at the forefront of that fight, led by TMA Delegation Vice Chair Asa Lockhart, MD, of Tyler. New VA Secretary Robert McDonald appeared before the AMA House on Saturday. He spent an hour telling delegates about changes in his agency and answering physicians’ questions. Watch Secretary McDonald’s speech and see Dr. Lockhart’s assessment of the progress VA has made since June.

MED STUDENTS WIN AMA LEADERSHIP POSTS


Congratulations to three Texas medical students elected to leadership positions at the AMA Medical Student Section (MSS) this weekend:
  • Jennifer Nordhauser, a first-year student at The University of Texas (UT) Health Science Center at San Antonio, is the new MSS Region 3 legislative chair.
  • Romero Santiago, a second-year student at UT-Southwestern, is a new MSS Region 3 delegate; and Jared Bell, a second-year student at the Texas Tech University Health Science Center Paul L. Foster School of Medicine in El Paso, was elected a Region 3 alternate delegate.

TEXAS ADOPTS EBOLA MONITORING PLAN

Gov. Rick Perry has directed Texas Health Commissioner David Lakey, MD, to implement a four-stage monitoring plan for Texans suspected to have been exposed to Ebola in West Africa. The plan, devised by the governor’s Texas Task Force on Infectious Disease Preparedness and Response, does not require mandatory, government-imposed strict quarantine for cooperative asymptomatic health care workers unless they meet the "high-risk" category. “The guidance is based on science and on doing what’s right for the people of Texas and for the health care workers who travel abroad to fight this disease,” Dr. Lakey said. The Dallas County Medical Society Infection Prevention and Control & Antimicrobial Stewardship Committee also issued a letter applauding the Texas Task Force recommendation and urging elected officials not to quarantine health care workers who care for Ebola patients.

Monday, November 3, 2014

VOTE TUESDAY FOR THE PARTY OF MEDICINE


If you didn’t vote early, remember … you can’t “vote late.” Tuesday is Election Day. With Gov. Rick Perry’s decision not to seek another term, just about every statewide executive office is an open race. TEXPAC, your political action committee, recommends outstanding candidates for all of those seats as well as in legislative and judicial races. “Many Texas physicians see their practices as under attack from multiple outside forces, few of which really understand what it means to take care of a patient,” said TEXPAC Board Chair Jerry Hunsaker, MD, of Corpus Christi. “Here at TEXPAC, we like to think of ourselves as a shield that protects our practice by trying to elect candidates who will take away from — or at least not add to — that multitude of outside forces. It’s up to you, tomorrow, on Election Day, to put some real muscle behind that shield.” Polls are open 7 am-7 pm. You must vote in your home precinct, and a picture ID is required.

AMA HOUSE OF DELEGATES COMES TO DALLAS


The 2014 Interim Meeting of the American Medical Association House of Delegates convenes Saturday afternoon at the Hilton Anatole in Dallas and runs through Tuesday, Nov. 11. The agenda for the interim meeting is limited to public and private sector advocacy issues. Reports and resolutions will focus on issues like Medicare reform, regulatory relief, and public health. The TMA House of Delegates is sending no new resolutions to Dallas, but your Texas delegation will be busy testifying on the items that affect Texas physicians and patients. We’ll also be gearing up for former TMA President Sue Bailey, MD’s, race for speaker of the AMA House next June.

COUNTY EXECS TACKLE THORNY ISSUES


The executive officers of Texas’ 10 largest county medical societies came to Austin for a two-day meeting with me and senior TMA staff. We addressed and developed action plans for some of the biggest challenges facing organized medicine in Texas: How can we continue to grow membership? How can we remain strong in the political and legislative arenas? What key services do Texas physicians expect of us? As a grassroots-driven organization, TMA’s strength has and always will come from the counties. I am committed to preserving a state-county relationship that is the envy of the nation.

TMA EXPLORING ACCOUNTABLE CARE LEADERSHIP PROGRAM WITH UT-DALLAS


"Physician-led” is a hot buzzword in health care reform circles, as it should be. Only physician-led programs can ensure that patient care is everyone’s top priority in the new accountable care environment. But do you have what it takes to take charge? We want to make sure, so TMA is developing a physician leadership program to teach skills needed for success in the new marketplace. TMA staff met with Michael J. Deegan, MD, clinical professor of healthcare leadership and innovation in the Naveen Jindal School of Management, The University of Texas at Dallas, to explore affiliating with the school’s Healthcare Leadership and Management for Physicians Certificate Program. A TMA Council on Practice Management Services task force will meet with Dr. Deegan later this month to discuss program design and curriculum, and to develop mutual goals for the 10-month program. It is anticipated that the first TMA class cohort would be accepted in March.

"HEY, DOC" RETURNS


More than 730,000 Texans have purchased health insurance coverage through the Affordable Care Act health insurance marketplace. Since April, many people have used their coverage for the first time but don’t understand what they purchased, what it covers, or how to use it. They are confused. Last fall, TMA launched our “Hey, Doc” educational campaign to provide answers to patients’ most frequently asked questions about the ACA marketplace. We answered 32 questions in the six-month series. As the confusion continues about these new plans, and a new round of open enrollment begins Nov. 15, many of the “Hey, Doc” Q&As are more relevant today than when we first published them. So “Hey, Doc” is back. We are updating and re-issuing our videos, blog posts, and news releases weekly. Feel free, once again, to use the material to educate your staff and answer your patients’ questions.

TMA'S BUSINESS BOOT CAMP LIVE WEBCAST, TOMORROW AT 9 A.M.:

If you haven’t been able to make it to any of our Business Boot Camp seminars across the state, sit down with your staff in front of the computer tomorrow at 9 am (CT) for some CME without the travel hassles. Live from Austin, this three-and-a-half hour webinar shows you how to monitor revenues and expenses, bill smart and collect what’s due, fine-tune your payer mix, and avoid incentive program penalties. Register now.

Tuesday, October 28, 2014

TMA TO TASK FORCE: EBOLA OUTBREAK HIGHLIGHTS NEEDS IN COMMUNICATION AND TRAINING


With the good news of no new Ebola virus cases in Dallas and the apparent recovery of the two nurses who were infected, the nation turned its concern to the New York City physician who contracted the disease while working with Doctors Without Borders in Guinea. Here at home:
  •  More than 1,000 physicians and nurses tuned in to ask questions of Ebola experts in a Tele-Town Hall meeting convened by TMA and the Texas Nurses Association (listen to the recording). 
  •  TMA released a video, Why You're Not At All Very Likely to “Catch” Ebola, featuring Robert Haley, MD, director of the Division of Epidemiology in the Internal Medicine Department at The University of Texas Southwestern Medical Center in Dallas.
  • Chip Riggins, MD, the local health authority and executive director for the Williamson County and Cities Health District, testified on behalf of TMA before Gov. Rick Perry’s Texas Task Force on Infectious Disease, Preparedness, and Response. Dr. Riggins called for improvements in communications between practicing physicians and public health agencies; more graduate medical education slots in public health, prevention medicine, and epidemiology; and more attention paid to the needs of private practice physicians during an infectious disease outbreak.  

EARLY VOTING ENDS FRIDAY


This is the final week of early voting for the Nov. 4 elections. During early voting, which ends at 7 pm Friday, you may cast a ballot at any election site in your county. Data from last week showed early voting surges in some areas of the state, including Tarrant County, where TEXPAC is backing Libby Willis in a State Senate race against a blatantly antiphysician, antipatient candidate. TEXPAC recommends these outstanding candidates on your ballot. One way to remember to vote is to envision now a detailed plan of exactly where and when you will go to the ballot box. Make sure that plan includes encouraging your family, friends, staff, and patients to vote as well.

DR. KING CRISSCROSSING THE STATE FOR TMA


TMA President Austin King, MD, is keeping up his exhaustive travel schedule on behalf of Texas medicine. Between last week and this, Dr. King will have made public appearances in Houston, Lubbock, and Fort Worth, as well as numerous private meetings in between. Some highlights:
  • Tonight in Fort Worth, Dr. King is on the bill along with Congressman Michael Burgess, MD (R-Lewisville) and Texas Health and Human Services Executive Commissioner Kyle Janek, MD, at a health care town hall meeting hosted by State Rep. Matt Krause (R-Fort Worth).
  •  In Houston last week, he shared TMA’s Healthy Vision 2020 plans with the Executives Association of Houston and the Houston Chronicle editorial board.
  • Coming up in Lubbock, Dr. King has sessions planned with leaders, faculty, and students of the Texas Tech University Health Sciences Center; an editorial board meeting at the Lubbock Avalanche-Journal; and a lead role at the 2014 Health Care Symposium put on by the Texas Dispute Resolution System. 

MY LATEST IN FORBES.COM EXAMINES LOOMING PHYSICIAN SHORTAGE


The nation faces “drastic shortages” of physicians in many specialties — especially internal medicine and psychiatry — but our government doesn’t seem to be doing much about it. “Affordable Care Act Fails to Address Physician Shortages — Here’s How We Can Better Deal with This Challenge,” looks at a new tool, The FutureDocs Forecasting Tool, underwritten by The Physicians Foundation, that can help us figure out where to focus. “Unlike previous estimates of supply and demand, FutureDocs projects shortage and surplus by how well physician supply matches use of physician services; which in turn can be used to understand what type of care patients will need in the future and which geographies are experiencing greater imbalances in supply and distribution of physicians,” Physicians Foundation CEO Tim Norbeck and I wrote. “For example, while Rochester, Minnesota, the home of the Mayo Clinic, may be projected to have a surplus of specialists, Slidell, Louisiana is projected to have a significant shortage. What’s needed now is a scientific assessment of the supply and demand for health care services upon which to build the necessary health care infrastructure to ensure the health of the U.S. population.”

DON'T LET YOUR MEMBERSHIP LAPSE. RENEW TODAY!


Intrusion after intrusion is threatening your practice and the care of your patients as you know it. Fortunately, you can trust TMA and your county medical society to stand by you to address them. Your association advocates relentlessly in Austin and Washington to eliminate red tape and bureaucracy. But even as we work to deliver these legislative fixes, TMA provides first-class solutions to your practice headaches. The 2015 congressional and state legislative sessions are right around the corner. Renew today. The TMA Knowledge Center can answer your renewal questions at (800) 880-7955 or by email at knowledge@texmed.org.

REGISTER TODAY FOR TMA'S 2014 ADVOCACY RETREAT

Join TMA and state specialty societies in Austin Dec. 5-6 as we plan for the 2015 sessions of Congress and the Texas Legislature. Registration for the 2014 TMA Advocacy Retreat is open now.

Monday, October 20, 2014

HAVE EBOLA QUESTIONS? ANSWER YOUR PHONE TONIGHT


We received the good news this morning that the Texas Department of State Health Services (DSHS) has cleared Thomas Duncan’s first 43 Ebola contacts in Dallas after 21 days passed with no signs or symptoms. Local, state, and federal public health officials continue to monitor 120 people for the disease. Texans, however, remain concerned and worried about the outbreak. You can learn the latest about Texas’ Ebola response and how to protect you and your staff by participating in TMA’s Tele-Town Hall meeting tonight. TMA physician experts and Department of State Health Services’ leaders will be on hand to answer your questions from 7 to 8 pm. TMA and the Texas Nursing Association are cohosting the meeting. We will call you directly at your home phone number. All you need to do is pick up the phone and stay on the line. If you don’t want to participate, just hang up. If you can’t make the call and want to hear what was discussed, please go to TMA’s Ebola Virus Resource Center. A recording of the meeting will be posted Tuesday. This event is the latest in the series of TMA activities to keep Texas physicians and the public informed about the science of the Dallas Ebola crisis. They include: 
  • Protect Yourself From the Ebola Virus — an easy-to-understand patient flyer, in English and in Spanish, that we developed in conjunction with the Dallas County Medical Society (DCMS).
  • What if Someone Walks Into My Office With Ebola? — science-based guidelines to prepare your practice and protect your staff and patients if someone presents with Ebola symptoms.
  • “Facts, Not Fear” — an outstanding town hall meeting that DCMS hosted with WFAA-TV. Watch the replay.
  •  TMA’s Ebola Virus Resource Center — The U.S. Centers for Disease Control and Prevention (CDC), DSHS, U.S. Department of Health and Human Services (HHS), and Dallas County Health and Human Services have issued numerous bulletins, guidelines, and other materials to help you respond to the Ebola outbreak. We organize them for your ease of use.

VOTE EARLY, STARTING TODAY


Early voting in the Nov. 4 general election starts today and runs through Friday, Oct. 31. Here’s a few reasons for you to head to the polls in this nonpresidential-election year:
  • One candidate for the Texas Senate says physicians want to “administer life-ending procedures” to our patients! Really.
  • Other, more medicine-friendly, candidates have pledged to help us cut government regulations on our practices, boost public health, increase funding for graduate medical education, and protect our tort reforms.
TEXPAC recommends these outstanding candidates on your ballot. In most counties, you may cast an early ballot at any election site. On Nov. 4, you may vote only at your home precinct.

DR. KING PLANS MESSAGING STRATEGY FOR MEDICINE


Texas physicians and TMA are under an unprecedented attack. Candidates and special interest groups on both the left and the right, leveraging social media, are striving to undermine your authority and the patient-physician relationship. TMA President Austin King, MD, met with senior TMA staff to work on our ongoing strategy to counter the assault. It’s terribly important that we succeed, not only to protect your professional dignity as physicians but also to ensure that TMA can continue to win big victories for medicine at the Capitol. As we move forward, we will be asking for you — medicine’s leaders — to help us get the word out about our science-based dedication to patients and health. Today, though, I’m asking you to help us develop a slogan or tagline for this campaign. What does medicine really stand for? Send me your ideas. 

ON MY VISIT TO THE GREEK CAPITOL OF TEXAS


At the invitation of TMA Board of Trustees member Doug Curran, MD, chief lobbyist Darren Whitehurst and I travelled to Athens to meet with the Henderson County Medical Society. We reviewed Healthy Vision 2020 and our 2015 legislative priorities. If you want Dr. King or a member of the TMA staff to speak to your county medical society, contact our Ambassador Program.

SURVEY FINDS CLINICAL AUTONOMY THREATENED


Only 31 percent of U.S. physicians — and slightly fewer in Texas — say they are free to make what they consider to be the best decisions for their patients, according to The Physicians Foundation’s 2014 Survey of America’s Physicians. About 53 percent in both Texas and nationwide said they have some limitations in their clinical autonomy. But nearly 18 percent of Texas physicians and 15 percent of those across the country said, “My decisions often are compromised.” TMA and The Physicians Foundation are working to educate the public and policymakers on both the causes and the implications of this troubling trend so that we can begin to reverse it.

HARD HATS HITS HELMET RECORD IN OCTOBER

Thanks to your collective efforts, TMA’s Hard Hats for Little Heads is putting more than 6,000 helmets on Texas children in October. That’s the most helmets we’ve ever given in one month. TMA declared October as Hard Hats for Little Heads Month to mark the program’s 20th birthday and to celebrate 20 years of keeping kids safe.

Tuesday, October 14, 2014

SECOND EBOLA CASE SHOCKS DALLAS


Four days after the death of the first patient diagnosed with Ebola in the United States, someone who helped to care for him in a Dallas hospital has apparently become the first person to acquire the disease in this country. The New York Times is reporting that the person is a female nurse at the hospital. U.S. Centers for Disease Control and Prevention Director Tom Frieden, MD, said the nurse wore the appropriate protective clothing and equipment while caring for the first patient, but she became infected due to a “breach of protocol.” None of the 48 original known contacts of the first patient has shown any symptoms, Texas Health Commissioner David Lakey, MD, said on Sunday. Dallas County Medical Society (DCMS) President Todd Pollock, MD, and John Carlo, MD, chair of the DCMS Community Emergency Response Committee, urged calm. “DCMS physicians have long been trusted community leaders and have a long history of responding to many public health issues, from organizing Dallas’ participation as a field test site for the Salk polio vaccine in 1945, to leading the county’s response to the West Nile Virus epidemic in 2012,” they said in a Sunday night email to Dallas doctors. “Physicians are one of society’s most trusted voices, so it is imperative that we speak up and contribute to the conversation using factual information based on medical science.” In that vein, we offer the following resources: 

THE WORST ATTACK YET ON MEDICINE


Politics can be an ugly, dirty business. A campaign mailer from a Texas Senate candidate in Fort Worth fits that bill, assassinating the character of physicians all across the country. In not one, but two, mail pieces Senate District 10 candidate Konni Burton says she “will fight to protect the elderly and disabled patients from doctors who want to administer life-ending procedures.” TEXPAC has endorsed Libby Willis — Burton’s opponent — and is working with the Tarrant County Medical Society (TCMS) to turn out the vote for Ms. Willis. TEXPAC District Chair Robert Rogers, MD, who is hosting a fundraiser for Ms. Willis at his home tonight, sent a letter to all TCMS member physicians. “One candidate who wants to be our next state senator from Tarrant County says physicians want to murder our patients,” Dr. Rogers wrote. “This is an outrage! It’s character assassination of an entire profession. She must be stopped, and we have the power to stop her.”

DR. VARMA APPOINTED TO TEXAS MEDICAL BOARD


Gov. Rick Perry appointed Lubbock pediatrician Surendra Varma, MD — a great leader of organized medicine in our state — to the Texas Medical Board. Dr. Varma is associate dean of Graduate Medical Education and Resident Affairs at Texas Tech University Health Sciences Center-Lubbock. A past president of the Lubbock-Crosby-Garza County Medical Society, Dr. Varma is the 2014 recipient of TMA’s Platinum Award for Excellence in Academic Medicine.

NEW TMA NEWS SERVICE BEGINS WEDNESDAY


Watch your inbox at around 7:30 am each weekday beginning Wednesday for an email from “TMA Daily Headlines.” Inside will be our newest free member service. From health care news in Congress and Texas Legislature to news regarding practice management, public health, and medical education, you can count on TMA Daily Headlines for the comprehensive coverage you need to prepare for the day ahead.

MAKE PLANS FOR TMA 2014 ADVOCACY RETREAT

Come to Austin Dec. 5-6 to help prepare TMA and state specialty societies for the thorny issues that await in the 2015 Texas Legislature and U.S. Congress. Registration is now open!

Wednesday, October 8, 2014

EBOLA CONTACT TRACING IS CORE PUBLIC HEALTH WORK


Although our fragmented public health system still needs some significant repairs, the response has been on target since the diagnosis of Thomas Duncan of Dallas as the nation’s first Ebola patient. As of 11 am today, public health physicians had confirmed 10 persons definitely had been exposed to Ebola through Mr. Duncan, and 38 possibly had been exposed. All 48 of those people are being monitored daily throughout the 21-day incubation period of Ebola. “Our function here is to monitor every contact and every possible contact,” Texas Health Commissioner David Lakey, MD, said in a briefing yesterday afternoon. “The good news is that we have had no more cases, and no one has reported any symptoms.” I am particularly proud of Dallas County Medical Society physicians in working with state and national public health officials to contain this outbreak. Public health specialists John Carlo, MD, and Robert Haley, MD, have done an outstanding job explaining this frightful disease to the public through the news media. On Friday, TMA, Dr. Lakey’s office, and the Texas Hospital Association (THA) conducted an Ebola briefing for legislative staffers at the state Capitol. TMA will send a special issue of our Action newsletter later today with a comprehensive list of resources physicians need to talk to their patients about Ebola and assess possible cases.

SUNSET REPORT CALLS OUT MEDICAID FRAUD CONTROL TACTIC


The state’s use of freezing payments to providers suspected of possible Medicaid fraud “has gone beyond the law’s intent,” according to a 225-page report on the Texas Health and Human Services Commission (HHSC) issued late Friday by the Texas Sunset Advisory Commission. The report includes sweeping recommendations for the vast agency, including further consolidation of the state’s health activities. The Sunset Commission described the HHSC Office of Inspector General (OIG) as an agency with poorly trained staff and little accountability or transparency. Sunset devoted an entire chapter of its report to OIG’s improper use of payment holds. “Despite the intended serious nature of payment holds, OIG uses payment holds as a negotiation tactic or bargaining tool, even for cases that do not pose significant financial risks to the state,” Sunset reported. “[Payment hold] hearings provide for excessive process and create undue burdens on providers as compared to cases presenting more serious risks to the state and public.” Sunset Commission recommendations serve as a starting point for deliberations by the 2015 legislature.

COALITION OF STATE MEDICAL SOCIETIES: PASS SGR FIX, AND FUNDING, BY JAN. 1


The Coalition of State Medical Societies wrote congressional leaders, exhorting them to pass Medicare Sustainable Growth Rate (SGR) payment reform by Jan. 1, 2015, and to find the funding needed to ensure its passage. “We cannot urge you strongly enough to engage now in the pursuit of a long-term funding solution,” the nine medical societies wrote. “We ask for you to remain open to an array of potential funding sources, some that you may have opposed in the past. But please remember, these vital funds will accomplish a historic change in America’s health care system.”

TMA, HOSPITALS TEAM UP FOR MEDICAL STAFF LEADER TRAINING


The fall session of the Orientation for Presidents of Hospital Medical Staffs, cosponsored by TMA and THA, is Oct. 24-25 in Austin. Hospital medical staff leadership are invited to learn about quality reporting requirements, error and risk management, a 2015 legislative update, and more.

FEDS HOLD $75 MILLION FROM TEXAS HOSPITALS ON MEDICAID WAIVER QUESTION


Questions about the source of the dollars some Texas hospital districts are using to obtain matching funds from the Centers for Medicare & Medicaid Services (CMS) under the Section 1115 Medicaid waiver program have led CMS to withhold $75 million in payments for uncompensated care to hospitals in the Dallas, Austin, and Corpus Christi areas. “It appears that the [Texas money] may be derived from funds that the government entity previously would have spent on providing the services that are now being provided/funded by the private entity and/or direct payments made to the governmental entity from private entities,” CMS officials wrote to state Medicaid Director Kay Ghahremani. CMS will defer further payments pending its investigation.

MY LATEST ON FORBES.COM: PHYSICIAN MORALE STILL LOW, BUT IMPROVING

The newly released Physicians Foundation survey of American physicians shows some bad news — but not as bad as our 2012 survey revealed, I explain in my latest post on Forbes.com. The survey of 20,000 U.S. physicians reports that 56 percent describe their morale as negative. But optimism has increased by more than 12 percentage points — especially among younger, employed physicians — since 2012. “Health care has become over-regulated, overly bureaucratic and overly administered by non-physicians,” Physicians Foundation CEO Tim Norbeck and I wrote. “This has created an increasingly dispirited cadre of physicians being forced to implement ill-conceived rules and regulations that do not benefit the patient and unnecessarily increase the cost of care.”

Monday, September 29, 2014

TMA TO LEGISLATIVE LEADERS: RAISE MEDICAID AND CHIP RATES


TMA and 17 state specialty societies called on the Legislative Budget Board (LBB) to “take bold action” to increase “utterly inadequate physician payment rates” in Texas Medicaid and the Children’s Health Insurance Program (CHIP). In written testimony we asked LBB to:
  • Maintain Medicare parity in the 2016-17 state budget for primary care physicians currently receiving those higher rates. Congress enacted and funded the higher rates, but without legislative or congressional action, that increase will expire Dec. 31, 2014.
  • Extend the parity payments for primary care to services provided via CHIP.
  • Establish competitive Medicaid and CHIP payment rates for physician specialties that are not included in the Medicare parity increase.
  • Reverse the 8-percent payment reduction for physician assistants and advanced practice registered nurses practicing under physician supervision. The cut, which will take effect in early 2015, will undermine Texas’ efforts to promote team-based models of care, an essential element of reforming the Medicaid delivery system.
The testimony cites preliminary data from TMA’s 2014 physician survey, which indicates only 34 percent of physicians accept all new Medicaid patients, a 33-point decrease since 2000. TMA says “grossly inadequate payment is the single overriding reason physicians cite for why they or their colleagues limit or no longer participate in Medicaid.” LBB, chaired by House Speaker Joe Straus and Lt. Gov. David Dewhurst, sets the base state budget bill from which lawmakers will start working when they convene in Austin in January.

TEXPAC ANNOUNCES PATRICK, WILLIS ENDORSEMENTS, AND MORE


What’s a bipartisan PAC doing in an election cycle like this? Why, just what we’ve always done — supporting candidates who stand up for patients and medicine. With strong personal backing from physicians around the state and locally, State Sen. Dan Patrick (R-Houston) earned TEXPAC’s endorsement in the race for lieutenant governor, and Libby Willis (D-Fort Worth) picked up our approval for the open Senate District 10 seat. Those were the two most high-profile races in which TEXPAC issued formal endorsements this month. See the full list on the TEXPAC website. If you’re not registered to vote, be sure to sign up by Oct. 6 to be eligible to vote in the Nov. 4 elections.
  • “We know Dan will fight to increase graduate medical education funding so more medical students can finish their residency training in Texas,” TEXPAC Board Chair Jerry Hunsaker, MD, said about Senator Patrick. “We also can count on him to support the development of physician-led teams to provide high-quality health care to Texans. In addition we know he will work hard to ensure physicians get paid in a fair and timely manner.”
  • Of Ms. Willis, TEXPAC District Chair Rob Rogers, MD, a Fort Worth allergist, said, “We are confident Libby will work to protect the vitally important patient-physician relationship in Texas, keeping the government, big insurance, and other parties out of physicians’ exam rooms.”

ENROLL TODAY IN TMA'S BUSINESS BASICS SEMINAR


Passive financial management can rob you of the resources you need to care for your patients. Manage finances proactively to secure your future. Take charge of your practice finances at TMA’s newest live seminar. Our Business Basics seminar series begins Oct. 7 and runs through Nov. 12 in cities across the state. The seminar is partially underwritten by a grant from The Physicians Foundation to keep the cost low.

MAGAZINE RANKS TEXAS AMONG BEST STATES TO PRACTICE


According to Physicians Practice magazine’s annual survey (free account required to access), Texas is one of the four best states in the country to practice medicine. The top ranked state? Mississippi. The magazine says, “Texas did very well in our analysis, with a low physician density, low cost of living, and a low tax burden. Oh, and did we mention the ‘astonishing’ malpractice rates?”

DR. KING TALKS UP MEDICINE IN WICHITA FALLS

In a 90-minute meeting with the Wichita Falls Times Record News, TMA President Austin King, MD, laid out the problems that beset medical practices today and the solutions we propose in TMA’s Healthy Vision 2020, Second Edition. “Physicians in these areas, like every place else, are inundated by red tape and by hassles with all these different medical programs,” Dr. King said. “And in rural areas, most of the programs are government programs.” He was joined by two Wichita Falls-area physician leaders: Susan Strate, MD, vice speaker of the TMA House of Delegates; and Jonathan Williams, MD, chair of the TMA Committee on Rural Health. The visit was the first of many Dr. King will make across the state in coming months. Today he is meeting with the editors at his hometown Abilene Reporter-News.

Monday, September 22, 2014

SURVEY: U.S. PHYSICIANS OVERWHELMINGLY DISHEARTENED; TEXANS EVEN MORE SO


Overworked physicians, harried by mountains of federal regulations and the looming switch to ICD-10, seeing little help from electronic health records (EHRs), their clinical autonomy threatened, are pessimistic about the state of the medical profession, according to one of the largest and most comprehensive physician surveys conducted in the United States. Texas physicians were even more negative. The 2014 Survey of America’s Physicians: Practice Patterns and Perspectives, conducted by The Physicians Foundation, queried more than 20,000 physicians nationwide. More than 1,800 Texas physicians responded to the survey. Among the key findings:
  • Nationally, 55 percent are “very” or “somewhat” negative about the current state of the medical profession. Among Texas physicians, that figure is almost 64 percent.
  • Half of all physicians and 61 percent of Texas physicians are “very” or “somewhat” negative or pessimistic about the future of their profession.
  • About 80 percent of all physicians, and a like share of Texans, say they are “overextended and overworked” or “at full capacity.”
  • Physicians spend a staggering 20 percent of their time on nonclinical paperwork.
  • Half of all U.S. physicians, and 58 percent of the Texans, say the switch to ICD-10 next year will “create a severe administration problem.” Only 11 percent of U.S. doctors and 8 percent of Texas physicians say the shift will “improve diagnosis or quality of care.”
  • About 80 percent of Texas physicians — and 85 percent of the entire sample — say their practice has put an EHR system in place. Almost one-third of those nationally, and a quarter of the Texans, say the EHR has improved the quality of care. But across the board about one-fourth say it has detracted from the quality of care, nearly half say it has detracted from practice efficiency, and almost as many say it has detracted from the quality of patient interaction.
  • When it comes to clinical autonomy, almost 18 percent of Texas doctors and 15 percent of physicians nationwide say “my decisions often are compromised.”
I will drill down into some more specific data sets from the survey in coming weeks.

WHAT ABOUT REFILLS OF HYDROCODONE COMBINATION PRESCRIPTIONS?


Our phones continue to be swamped by calls from physicians and office managers concerned about the Oct. 6 switch from Schedule III to Schedule II for hydrocodone combination drugs. One of the most common questions: “If I write a prescription for a hydrocodone combination product on Oct. 5 (while it is still a Schedule III drug) and specify refills, will pharmacies honor those written under the Oct. 5 prescription, or must I rewrite the prescription as a Schedule II drug?” Here’s our answer: Prescriptions for hydrocodone combination products that are issued before Oct. 6 and that have authorized refills may be dispensed in accordance with U.S. Drug Enforcement Administration rules until April 8, 2015. Both the Texas Department of Public Safety and the Texas State Board of Pharmacy have indicated to us that refills authorized on prescriptions dispensed prior to Oct. 6 will be honored. For more answers, see the hydrocodone Q&A page on our website.

TEXANS IN D.C. CAUTIOUSLY OPTIMISTIC ABOUT SGR REPREAL THIS YEAR


We made a trip to Capitol Hill to talk about repealing Medicare’s Sustainable Growth Rate (SGR) formula and some of the other federal priorities in our revised Healthy Vision 2020 document. TEXPAC Board Chair Jerry Hunsaker, MD, and Lyle Thorstenson, MD — the Texan on the AMPAC Board — were joined by TMA Legislative Affairs Director Dan Finch and TEXPAC Director Clayton Stewart in a visit just before Congress adjourned until after the Nov. 4 elections. The most important SGR discussions, of course, were with U.S. Reps. Michael Burgess, MD (R- Lewisville), and Kevin Brady (R-The Woodlands). Both see a potential for revising and passing an SGR replacement bill during the lame duck session after the election. The devil, of course, is in the details, and the details always boil down to money.

TMA: CHIP MANAGED CARE PLANS RESPONSIBLE FOR OUT-OF-NETWORK PAYMENTS


Since federal law prohibits patients covered by the Children’s Health Insurance Program (CHIP) from paying anything other than a co-pay, the state of Texas should require managed care organizations in CHIP to cover the costs for out-of-network physicians. That’s the position TMA takes in a formal letter to the Texas Health and Human Services Commission. “The [health plans] are responsible, and should be held accountable, for setting rates at an appropriate level to attract an adequate number of physicians and other providers to join their networks and paying out-of-network providers at a rate sufficient to ensure balance billing does not occur,” TMA General Counsel Rocky Wilcox wrote in our comment letter. “Precluding medical providers from billing shifts the responsibility for the outstanding medical expense from the [plans] that voluntarily accepted network adequacy responsibilities and payment obligations under CHIP to physicians and other providers who never agreed to participate in CHIP or enter into a contract with the CHIP [plans].”

TMA OPPOSES BILL TO EXPAND AUDIOLOGISTS' SCOPE

TMA and more than 110 national organizations, state and local medical associations, and state and local specialty societies delivered a clear message to members of the U.S. Congress: Oppose any efforts to give audiologists direct, unlimited access to Medicare patients without a physician referral and to include audiologists in the definition of physician. The groups outlined their opposition to House Resolution 5304 in a letter to Congress. “Audiologists are not physicians and should not be considered as such under the Medicare program,” the letter states.

Monday, September 15, 2014

REVISED HEALTHY VISION SETS TMA ADVOCACY COURSE


The fields of engagement — the Texas Legislature, U.S. Congress, courts, state and federal bureaucracies — are many. The issues are all-encompassing. But TMA’s approach, as outlined in the new second edition of our Healthy Vision 2020 document, is clear. As TMA President Austin King, MD, writes in his welcome message, “Our government must make it easier — not more difficult — for us to care for our patients.” I encourage you to study the document, and share our healthy vision with lawmakers, business leaders, and your colleagues. You can order print copies from the TMA Knowledge Center at (800) 880-7955. Here’s our Top Ten List:
  1. Reverse recent cuts in physicians’ Medicare, Medicaid, and Children’s Health Insurance Program payments, particularly those that hurt access to care.
  2. Devise and enact a system for providing health care to low-income Texans with realistic payment to physicians, less stifling state bureaucracy, and no fraud-and-abuse witch hunts.
  3. Repeal the broken Sustainable Growth Rate formula. Enact a rational Medicare physician payment system that works and is backed by a fair, stable funding formula.
  4.  Increase funding for graduate medical education.
  5. Protect Texas’ landmark medical liability reforms.
  6. Stop any efforts to expand scope of practice beyond that safely permitted by nonphysician practitioners’ education, training, and skills.
  7. Standardize Medicaid managed care administrative processes.
  8. Ensure criteria used to measure physicians’ performance are evidence-based, fair and accurate, and truly evaluate quality and efficient care, not just cost.
  9. Stop Recovery Audit Program (RAC) bounty hunters. Eliminate adoption of the ICD-10-coding system.

SPEAKERS IGNITE TMA FALL CONFERENCE AUDIENCE


TMA and physicians have become political targets in Texas, and it’s time to fight back. That’s one of many key messages delivered at 2014 TMA Fall Conference. Dr. King used a multimedia display to illustrate the degree and intensity of the attacks. We need to grow TEXPAC’s treasury and membership so we can have the resources we need to counter what he called Orwellian doublespeak being used against us. Among the other conference speakers:
  • State Sen. Jane Nelson (R-Flower Mound), the newly appointed (and first women to hold that post) chair of the Senate Finance Committee, said the huge turnover in the Texas Legislature over the past three years creates a challenge for medicine to educate the newcomers on the nuances of our complex issues. But looking back to her first election to the Senate in 1992, she told the crowd, “I wouldn’t be here today without TEXPAC.”
  • TMA Council on Legislation Chair Dawn Buckingham, MD, of Austin walked through TMA’s Healthy Vision priorities for the 2015 Texas Legislature and urged the audience members to build relationships now with their state representatives and senators.
  • Dallas nephrologist Donald Wesson, MD, past chair of the ABIM Foundation, explained how physicians can gain the upper hand in the quality-of-care debate by embracing the Choosing Wisely® program. “Texas can be, and should be, a vanguard state,” he said.
  • Despite some strong candidates running good campaigns, 2014 won’t be the year a Democrat wins a statewide elected office in Texas, predicted Evan Smith, CEO and president of The Texas Tribune. “An asteroid could fall on all the Republican candidates this cycle, and they would all win,” he said, pointing to the GOP’s strong advantage among Texans who actually vote.
  • Pat Evans, retiring after 48 great years as executive director of the Big Country County Medical Society in Abilene, told the physicians, “God put you here to heal people. Remember, no government or hospital administrator or big insurance company can take that away from you.” 

IS THIS ANY WAY TO TREAT A DOCTOR?


Our Facebook page is exploding with likes, shares, and comments on our new Doctors Are Under Siege by the Federal Regulatory Barrage flyer. It has garnered rave reviews from physicians around Texas and around the country for accurately portraying the weight of federal demands on a practice today. Please download it, print it out, and share it with your patients and friends in high places. TMA’s lobby team will distribute it on Capitol Hill next week.

POST TORT REFORM, TEXAS STILL ATTRACTING RECORD NUMBERS OF NEW PHYSICIANS


The Texas Medical Board (TMB) licensed a record 3,994 new physicians for the fiscal year that ended last month. The number of new physicians applying for a Texas license also reached an all-time high of 5,149. Texas has averaged licensing 3,254 new physicians each year since the passage of our medical liability reforms 11 years ago. “The state medical board is now licensing twice as many doctors per year than in the medical crisis years before lawsuit reforms were enacted,” said Howard Marcus, MD, chair of Texas Alliance For Patient Access.

TMA DECIPHERING HYDROCODONE CHANGE CHALLENGES


The U.S. Drug Enforcement Administration’s decision to reclassify drugs that contain hydrocodone combinations from Schedule III to Schedule II continues to elicit questions and a good bit of anger from Texas physicians. TMA is working to get some solid answers from the maze of state and federal agencies with jurisdiction, and we’ll update our online Q&A document as we get them. I’ve also asked our lobby team to see what legislative remedies are available.

GOVERNOR NAMES NEW MEDICAL BOARD CHAIR

Gov. Rick Perry appointed Michael Arambula, MD, the new chair of TMB. Dr. Arambula, a TMA member, is a psychiatrist in private practice and an adjunct associate professor in the Department of Psychiatry at The University of Texas Health Science Center at San Antonio. The governor also appointed John Guerra, DO, an OB-Gyn from Mission, to TMB.

Monday, September 8, 2014

OUR HEALTHY VISION GROWS EVEN SHARPER


We wrote and published TMA’s Healthy Vision 2020 in 2012 as a roadmap for our advocacy efforts for the remainder of the decade. Two years and several awards later, our legislative and congressional destinations have shifted; we accomplished some of our original objectives, and new problems have emerged for us to solve on behalf of Texas physicians. That’s why our lobby, policy, legal, and communication teams rewrote the document over the summer. Every member who attends TMA’s 2014 Fall Conference this weekend will receive a copy of Healthy Vision 2020, second edition, at registration. And Dawn Buckingham, MD, chair of the TMA Council on Legislation, will discuss it during the conference General Session. It also will be available to read and download from www.texmed.org/healthyvision by then, or you can order print copies from the TMA Knowledge Center at (800) 880-7955. New this year are not only a comprehensive list of advocacy accomplishments from the first edition, but also separate sections on health information technology hassles to be solved and Medicaid red tape to be cut.

JOIN US THIS WEEKEND IN THE LOST PINES ALONG THE COLORADO FOR TMA FALL CONFERENCE


In addition to the great speakers I told you about last week, 2014 TMA Fall Conference on Friday and Saturday at the Hyatt Lost Pines near Bastrop will offer camaraderie, fun, and a few surprises in a delightful location. Physicians and alliance members who attend can get their 2014-15 flu shots on site Saturday or watch a live stream of the third and final day of TEDMED 2014 on Friday. The TEXPAC Board of Directors will consider some endorsements for the Nov. 4 general elections. (Have you seen the cover story in September’s Texas Medicine on “the new TEXPAC?”) You can earn nearly 4 hours of continuing medical education (CME) credit on Saturday. Online registration is closed, but you can still register onsite. The conference is free for TMA members. See you there.

NEW TMA MENTAL HEALTH TASK FORCE TO CONVENE


TMA’s Task Force on Behavioral Health, established by our Council on Science and Public Health, will meet for the first time Saturday at TMA Fall Conference. Chaired by Dallas psychiatrist Les Secrest, MD, the task force will prepare for mental health issues expected to arise in the 2015 Texas Legislature, including the Sunset Advisory Commission’s review of the Texas Department of State Health Services (DSHS). James G. Baker, MD, DSHS medical director for behavioral health, will present an overview of the Texas Public Behavioral Health System.

A HELMET GIVEAWAY OF STATEWIDE PROPORTIONS


Next month, TMA’s Hard Hats for Little Heads bike helmet giveaway program celebrates 20 years of keeping kids safe. You still have time to plan an event in your community to help us meet our goal of 50 helmet giveaways across the state during October. We provide everything you need for a successful event: free helmets, banners, event signage, promotional flyers, educational handouts, and media relations support. When you buy up to 50 helmets ($7.35 each, including shipping), TMA matches your purchase with free helmets. Check out these ideas for events or come up with another idea for your giveaway. To have your event included in TMA’s big media announcement, let us know about it by Friday, Sept. 19. To get started, contact Tammy Wishard, TMA’s outreach coordinator, or call (512) 370-1470.

TMA's HIPAA SECURITY SEMINAR SERIES BEGINS THIS WEEK


Register today for HIPAA Security: The Keys to Compliance, TMA’s new statewide seminar series. We will give you an overview of the HIPAA Security compliance rules, and explore techniques you can use to identify and address any HIPAA deficiencies in your practice. This is a perfect opportunity for you and your staff to jump ahead of the curve on HIPAA Security readiness. Those who attend this live program will receive a coupon code for $10 off the electronic version of our new publication, HIPAA Security: Compliance and Case Studies. Can’t make it in person? Register for the live webcast of the Sept. 25 seminar, complete with all the CME, bells, and whistles.

TMA PREPARES HOSPITAL MEDICAL STAFFS FOR NEW "MEGA-STAFF" RULES

Legal disputes between big hospitals and Texas physicians are heating up, and TMA is actively engaged. In addition to joining lawsuits against hospital systems by our member physicians, TMA’s Office of General Counsel is now educating physicians on Medicare’s new conditions of participation (CoPs) for hospital medical staffs. The biggest change, effective July 11, allows hospitals in multihospital systems “to have a unified and integrated medical staff for its member hospitals.” The previous rule required each hospital to have its own independent medical staff. In their presentation, our lawyers point out that it requires a majority vote of the medical staff of each separate hospital to opt in or opt out of this “mega-staff” structure. In a formal comment letter to the Centers for Medicare & Medicaid Services (CMS), TMA, the American Medical Association, and more than 80 other medical societies urged the agency to give hospital medical staffs more time to study and prepare to implement a new rule that makes “unprecedented changes to the Medicare hospital CoPs that will dramatically alter the make-up and efficacy of hospital medical staffs nationwide.” CMS turned us down. Look for more information on hospital medical staff issues in upcoming EVPGrams.

Tuesday, September 2, 2014

LEGISLATIVE INSIGHT, CHOOSING WISELY TOP FALL CONFERENCE AGENDA


We’ll unveil the second edition of TMA’s Healthy Vision 2020 document at 2014 TMA Fall Conference as we jumpstart our preparations for the 2015 sessions of the Texas Legislature and U.S. Congress. The conference, Sept. 12-13 at Hyatt Lost Pines between Austin and Bastrop, will feature updates from State Senate Finance Committee Chair Jane Nelson (R-Flower Mound), Evan Smith of The Texas Tribune, and TMA Council on Legislation Chair Dawn Buckingham, MD, on health care and legislation affecting Texas physicians. Donald E. Wesson, MD, immediate past chair of the ABIM Foundation Board of Trustees, will tell you about the Choosing Wisely campaign and how it promotes conversations between physicians and patients to ensure the right care is delivered at the right time. We also have Mike Deegan, MD, clinical professor for health care leadership and innovation at The University of Texas at Dallas, speaking on how Texas physicians can increase their community leadership. Plus … some special surprises. It will be a great way to get your TMA juices flowing again. Can’t wait to see you there.

TMA HELPS YOU PREPARE FOR HYDROCODONE RECLASSIFICATION


Over TMA’s objections, the U.S. Drug Enforcement Administration announced it will reclassify drugs that contain hydrocodone combinations from Schedule III to Schedule II. The change takes effect Oct. 6. We’ve already received numerous calls in the TMA Knowledge Center from physicians concerned about how this will affect their patients and their practices. TMA has prepared a short question-and-answer document that explains exactly what the change entails, how to get official Texas Prescription Program pads, and the status of e-prescribing for Schedule II drugs.

SUPREME COURT UPHOLDS TORT REFORM LIMITS


An attempt to overturn the limit for minors to file medical liability claims that was part of our 2003 tort reform law hit a brick wall at the Texas Supreme Court. The case, Tenet Hospitals v. Rivera involved an allegation of negligence on the part of the hospital during the birth of a child in 1996. Our tort reform law said claims of negligence that occurred before the law passed must have been filed by 2006. In 2004, an attorney for the mother notified the hospital of the minor’s claim, but no suit was filed until 2011. The court was asked to decide whether that part of the law was constitutional as applied to minors injured at birth who would never have the opportunity to sue on their own behalf (since they do not reach the age of majority until eight years after the 2006 deadline). The high court agreed with a brief filed by TMA, the Texas Alliance for Patient Access, and other health care groups that the legislature struck the appropriate balance between a person’s right to sue and the stability needed for medicine and the liability insurance industry. The court left open the possibility that it would revisit the issue in a case with different circumstances.

UNLOCK YOUR IMAGINATION VIA TEDMED


Once again this year, TMA is offering all members free access to the thought-provoking, way-outside-the-box talks from TEDMED Live. TEDMED is the annual, health care-focused conference sponsored by the internationally renowned TED Talks. Unlocking Imagination is the theme of TEDMED 2014, which will take place in Washington, D.C., and San Francisco, Sept. 10-12. We have three ways for you to get involved
  1. Download the TEDMEDConnect mobile app and watch the talks live or from the archives.
  2. Join us here for TEDMED week in Austin. We’re working with TEDxAustin, The University of Texas at Austin, and Seton Healthcare Family to present an HD live simulcast of TEDMED throughout the city and live speakers at each location to promote discussion and idea exchange around the topic Imagine the Future of Medicine: A Better, Smarter, Healthier Austin.
  3. If you’re coming to 2014 TMA Fall Conference, you can watch the live stream from TEDMED on Friday, Sept. 12, 7 am-7:30 pm in the Scribes Club at the Hyatt Lost Pines in Bastrop.

SUNSET COMMISSION ENHANCES REQUIREMENTS FOR SCHOOL SPORTS PHYSICALS

With all of the state’s health care agencies up for review this cycle, the deliberations of the Texas Sunset Advisory Commission are an important preview to the 2015 Texas Legislature. The commission voted to improve standards for preparticipation physicals of students wishing to play University Interscholastic League (UIL) athletics or cheerleading. In the face of mounting concerns about threats to student athletes such as cardiovascular and neurologic conditions, the sunset commission’s recommendation specifies that a physician, physician assistant, or nurse practitioner must sign off on the examination. UIL rules currently allow chiropractors, as well as physicians or their delegates, to perform these physicals. There is nothing in state law related to the physicals. The Sunset Advisory Commission recommendation is the first step toward putting this important patient protection into law.

DR. SCHWERTNER NAMED SENATE HEALTH COMMITTEE CHAIR

With Senator Nelson’s reassignment to chair the Senate Finance Committee, Lt. Gov. David Dewhurst appointed Sen. Charles Schwertner, MD (R-Georgetown), to head the Health and Human Services Committee. We’re still checking the legislative archives, but our best information says Senator Schwertner is the first physician to chair that critical committee.

Monday, June 30, 2014

VA REGISTRY: "I WOULD PASSIONATELY APPEAL TO MY PHYSICIAN FRIENDS. WE NEED TO JOIN."

More than 250 TMA-member physicians have signed up for our registry of private-sector doctors willing to see patients from the Veterans Affairs Department (VA) in the ongoing crisis. Baytown surgeon Monira Hamid-Kundi, MD, is one of them. In this TMA video, Dr. Hamid-Kundi shares her frustration with caring for veterans in the emergency department. She and TMA President Austin King, MD, appeal to Texas physicians to enlist in the registry, despite VA’s long history of slow payment and low payment. “You have to pay back some people who have dedicated themselves to, at times, risking their very life for the lifestyles we have today,” Dr. King said. Neither TMA nor the American Medical Association has heard back yet from President Obama on our request that he “take immediate action” to provide timely access to care for veterans through the health care sector outside the VA system.

 

HELP TEXPAC GROW FOR 2014 ELECTION IMPACT

Guided by Board Chair Jerry Hunsaker, MD, and Executive Director Clayton Stewart, TEXPAC is determined to continue to make a big difference in this year’s elections. We do that with grassroots support for medicine-friendly candidates and, of course, political donations. Those contributions come only from TEXPAC members’ dues, so membership is critical. You can join at the Basic, 300 Club, or Capitol Club levels — or be a charter member of our new Patron Club. As TMA Alliance President Angie Donahue writes to her colleagues, “You have the power to advocate for change. You have the ability to be a hero for medicine and a hero for the patients who are unable to garner the strength to speak with one united voice. You have this ability because you have access to the political voice of the Texas Medical Association: TEXPAC.” Please join today.

TMA MEMBERS TESTIFY ON HEALTH AGENCY SUNSET REVIEW

TMA Board of Trustees member Gary Floyd, MD; former Council on Public Health Chair Chip Riggins, MD; and Houston neurologist Kim Monday, MD, took the witness stand as the Texas Sunset Advisory Commission ramped up its review of state health agencies. Under Texas law, every state agency must be reestablished by the legislature every 12 years, or it goes out of existence. As part of this sunset review, each agency undergoes extensive evaluation by the sunset commission to make sure it is effectively and efficiently meeting Texans’ needs. The commission is composed of five senators, five state representatives, and two public members — one of whom is TMA Council on Legislation Chair Dawn Buckingham, MD. Sen. Charles Schwertner, MD (R-Georgetown), is one of the senators on the panel. This cycle, the commission is examining the Texas Health and Human Services Commission, the Department of State Health Services, and all of the associated state health agencies. TMA is heavily involved, offering recommendations and testimony on how to improve these programs. We’re also on the lookout for recommendations that could weaken them. For details on last week’s testimony, see tomorrow’s issue of Action.

CONNECT WITH TMA SOCIAL MEDIA

Ever since those 35 Texas physicians gathered at Austin’s First Methodist Church in 1853 to organize TMA, the association has served to bring Texas doctors closer together. In the 21st century, that means not just TMA and county society in-person meetings. Stay in touch with your colleagues on TMA’s Facebook, Twitter, LinkedIn, and YouTube accounts. Dr. King recently launched the TMA president’s Twitter feed. Our Young Physician Section, Resident and Fellow Section, and Medical Student Section are all active on Facebook. The TMA Foundation has robust Facebook and Twitter accounts, and the TMA Alliance and TMA Payment Advocacy Department are both on Facebook. New to any or all of these tools? Check out TMA's Social Media Resource Center.

TMAIT SEEKS ADVICE FOR NEW RESIDENTS

And speaking of Twitter, the TMA Insurance Trust is using its Twitter account to solicit some sage advice for the class of incoming residents who start their new posts this week. The first two:
  • From Waco otolaryngologist Brad Holland, MD: “Your profession is what you make of it. Learn, absorb, give care, practice developing a true trusting relationship w/patients.”
  •  From Austin interventional cardiologist Osvaldo Gigliotti, MD: “Never forget what a privilege it is to be a physician. Work hard, learn, and always try to do what is best for your patient.”

EVPGRAM TAKES SUMMER BREAK

It’s that time of year again, time for EVPGram to take some time off for the summer. We’ll be back in your in-box right after Labor Day. But don’t worry, yours truly, the editor, and all the TMA staff will be here working for you and your practice. Stay in touch via Texas Medicine, Action, and the TMA website. And we’ll bring you special editions of the ‘Gram when the need arises.

Friday, June 27, 2014

TMA TO VA: TEXAS PHYSICIANS ARE HERE TO HELP

TMA President Austin King, MD, announced the registry of private physicians willing to see patients in the Veterans Affairs (VA) health care system in a letter to the director of every VA hospital, clinic, and veterans center in the state. “As the Department of Veterans Affairs health care system works to overcome the recently documented access-to-care problems, I am writing to tell you that the physicians of Texas are here to help you and the veterans you serve,” Dr. King wrote. Already, more than 200 TMA-member physicians have signed up for our registry. The action came after the American Medical Association House of Delegates, at the urging of Texas physicians, voted overwhelmingly to ask President Barack Obama to provide timely access to entitled care for eligible veterans through the health care sector outside the VA system until VA can provide care in a timely fashion. AMA immediately fired off a letter calling on the president to “take immediate action” to clear the way for private-sector physicians to help reduce the VA backlog. If you haven’t signed up for the registry yet, please go to the TMA website and check the I am willing to serve veterans box.

LEADERSHIP ACADEMY EXPLORES HEALTH CARE INNOVATION

TMA President-Elect Tom Garcia, MD, and I attended the Physicians Foundation Leadership Academy at Duke University. Using a combination of lectures and small-group exercises, the program examined the impact of health care innovation versus improvements in medical technology, behavioral economics, and other leadership topics. Every year since the academy began, TMA’s president-elect has attended along with one of our senior staff members. It’s excellent preparation for the challenges that lie ahead. (And speaking of The Physicians Foundation, there’s still time for you to take the foundation’s biennial survey of American physicians. Everyone who completes the survey will be entered into a drawing to win a $10,000 Travel Voucher, a $2,000 Apple voucher, or one of multiple iPad Airs.)

TMA CALLS FOR MEDICAL ASSISTANCE FOR CENTRAL AMERICAN REFUGEES

The Central American women and children streaming into South Texas need medical assistance, and they need it now, says Dr. King, who travelled to McAllen to personally survey the growing refugee crisis. TMA is calling on President Obama and Gov. Rick Perry to provide medical aid to the thousands of women and children who have traveled from Central America to Texas. “Communicable diseases know no borders, and it’s critical we make certain no one is traveling with tuberculosis, pertussis, measles, or any other contagious disease,” Dr. King said. “Medical aid not only protects the Central American refugees. It also protects U.S. residents from potential serious and deadly diseases.”

TMA CALLS FOR MEANINGFUL USE MORATORIUM

Because physicians “are feeling overloaded by the myriad new Stage 2 meaningful use measures imposed on them,” Congress should stop Medicare from requiring any new meaningful use criteria, a TMA leader wrote in a letter to the chair of the U.S. House Energy and Commerce Committee. Otherwise, Matt Murray, MD, the chair of TMA’s ad hoc Committee on Health Information Technology, wrote to U.S. Rep. Fred Upton (R-Michigan), “Texas physicians — out of frustration — will withdraw from the Meaningful Use program at alarming rates.” The letter also praised Chairman Upton for demanding answers from the National Coordinator for Health Information Technology about the future regulatory burden on physicians’ use of electronic health records (EHRs) “TMA strongly recommends that the Centers for Medicaid & Medicare Services (CMS) or Congress suspend the EHR penalties on Medicare charges that are scheduled to take effect Jan. 1, 2015,” Dr. Murray added. “We believe CMS will put patient safety at risk by requiring EHR vendors to meet overly burdensome certification requirements and physicians to implement complex EHR upgrades in a compressed period of time.”

Monday, June 16, 2014

ENLIST NOW TO SERVE OUR VETERANS

At the urging of Texas physicians, the American Medical Association House of Delegates voted overwhelmingly to ask President Obama to provide timely access to care for eligible veterans using the health care sector outside of the U.S. Department of Veterans Affairs (VA) health care system until the VA can provide care in a timely fashion. AMA also will urge Congress to enact long-term solutions rapidly so veterans can always have timely access to entitled care. “It is tragic that our veterans have been forced to wait for the health care they need and deserve, so Texas physicians and our colleagues across the nation want to help care for them until the VA can right the ship,” said TMA President Austin King, MD. As part of this plan, TMA is creating a registry of private physicians across the state who are willing to see veterans in their offices. We don't know payment specifics yet. However, when physicians agree to treat veterans currently, payments typically are made according to the Medicare fee schedule. TMA will share the registry (name, specialty, office address, and phone number) with community groups that work with Texas veterans and with medical directors of VA facilities in Texas. Sign up today for the registry. Check the “I am willing to serve veterans” box and click “SAVE.” Or call the TMA Knowledge Center at (800) 880-7955.

RUSS WINS!

With the election of Houston’s Russ Kridel, MD, to the AMA Board of Trustees, Texas candidates went three-for-three in races at the AMA house last week. (We previously reported Sue Bailey, MD’s, reelection as vice speaker of the house, and Asa Lockhart, MD’s, success in claiming a seat on the AMA Council on Medical Service.) From working with him as a leader of the Harris County Medical Society and the TMA Foundation, I know that Dr. Kridel is extremely dedicated to our physicians and your patients. He ran a great campaign and will be an outstanding board member. I want to send a special thanks to Dr. Kridel’s campaign team and to our campaign partners at the American Academy of Facial Plastic and Reconstructive Surgery and the Neurosurgery Delegation.

RIP, ROBERT G. MICKEY, 1930-2014

I am terribly sorry to report to you the passing of Bob Mickey, my immediate predecessor as TMA executive vice president. Bob served TMA for 29 years, including 11 years at the helm. The funeral was Thursday. Please join me in sending our most sincere sympathies to Anita Mickey and her children and grandchildren. The family suggests memorial contributions be sent to the Settlement Home for Children of Austin (1600 Payton Gin Rd., Austin, TX 78758 or www.settlementhome.org/donate).

VICTORIA PHYSICIANS EXPLORING ACO

Bridget McPhillips, TMA VP of membership and business development, and I met with physician leaders in Victoria to discuss their options for developing an accountable care organization (ACO). They are interested in exploring a Medicare Shared Savings ACO. The group included George Osuchukwu, MD, president of the Victoria-Goliad-Jackson County Medical Society; Rakesh Kathpalia, MD; and Armando Diaz, MD.

DELL MED SCHOOL INAUGURAL DEAN EXCITED ABOUT OPPORTUNITY

Karen Batory, TMA VP of public health and medical education, and I enjoyed an excellent visit with Clay Johnston, MD, the inaugural dean of the Dell Medical School at The University of Texas (UT) at Austin, and Ray Greenberg, MD, executive vice chancellor for health affairs at the UT System. Dr. Johnston discussed the rare opportunity that he and Austin physicians have to create a new medical school from scratch and his desire to build a unique institution. I believe that he and Dr. Greenberg were impressed with the breadth of services TMA offers. We encouraged them to take full advantage of TMA’s ongoing efforts to support physician workforce expansion, including the dire need to build more graduate medical education slots.

TAKE HALF OFF CME PODCASTS IN TMA EDUCATION CENTER

For a limited time, TMA members can take 50 percent off the cost of all continuing medical education (CME) podcasts in the TMA Education Center. Topics include fraud and abuse, HIPAA, RAC audits, meaningful use, cancer survivorship, tobacco counseling, and more. Download these portable CME courses and listen anywhere you find the time.

Monday, June 9, 2014

TEXAS, FLORIDA DELEGATIONS: WE NEED IMMEDIATE HELP FOR VETERANS

In the wake of the revelations of long delays in health care at Veterans Affairs (VA), the Texas and Florida delegations to the American Medical Association House of Delegates asked AMA to push President Obama for immediate action. In an emergency resolution that was cleared Sunday for debate at the AMA meeting, Texas and Florida asked that AMA “publicly insist (by June 12, 2014) that the President of the United States take immediate action to provide full health coverage financial benefits to ensure that United States veterans can rapidly access the medical care they need outside the VA until the VA can provide promised care.” Texas delegation Vice Chair Asa Lockhart, MD, of Tyler and Irag War veteran Ray Callas, MD, of Beaumont testified for the resolution Sunday at reference committee.

DRS. BAILEY, LOCKHART WIN AMA ELECTIONS

Two Texas physicians secured leadership positions at AMA without opposition; a third must wait until Tuesday’s elections. The House of Delegates unanimously reelected Sue Bailey, MD, of Fort Worth to a fourth term as vice speaker. As one of four candidates running for four available seats on the AMA Council on Medical Service, Dr. Lockhart won his post by acclamation. Meanwhile, Russ Kridel, MD, of Houston is among eight candidates seeking the four available spots on the AMA Board of Trustees. We’ll know the outcome Tuesday morning. Some younger Texans also won elections at the AMA meeting:
  • Nnenna Ejesieme, MD, of The University of Texas (UT) Southwestern Medical Center, is the newly elected chair of Region 3 of the AMA Resident and Fellow Section.
  •  Elected to the Medical Student Section Region 3 Executive Council were: Angie Hamouie, UT Medical Branch at Galveston, secretary; and Tennessee Bailey, UT Health Science Center at San Antonio, membership chair.

DR. MCCOY SHARES FATHER'S TALE TO IMPROVE CARE

Dan McCoy, MD, chief medical officer of Blue Cross and Blue Shield of Texas and a member of the TMA Board of Trustees, got a stark view of the other side of the patient-physician relationship when his 93-year-old father fell and broke his hip on a July 4 weekend on his Central Texas ranch. As Dr. McCoy explains in a gripping story on KERA Radio, the fall was the beginning of the end of “Daddy Bill” McCoy’s life. Visits to two different hospitals and emergency departments, a two-day delay in surgery, and an overall lack of coordination of care were the biggest contributing factors. “I know from being an observer in that system that we could have done better,” Dr. McCoy said. “I may be a part of that problem. I’m part of the system. … There was no captain of the ship. We had a model where no one had a relationship. No one knew my dad’s medical history.” In his father’s memory, Dr. McCoy is now crusading to change the health insurance system so physicians have incentives to work in teams, to coordinate care, and to honor patients’ final days.