About TMA Related Organizations TMA Calendar Site Map Contact Us

Tuesday, May 27, 2014

VOTE TODAY IN PARTY PRIMARY RUNOFF ELECTIONS


You could have voted early, but you can’t vote late. Today is election day for the party primary runoff races. TEXPAC has endorsed 12 statewide and legislative candidates who we believe will be strong supporters of medicine’s agenda. Lt. Gov. David Dewhurst and attorney general candidate Dan Branch are at the top of the Republican ballot. Most of these races are shaping up to be very close, so please find the time to vote. Encourage your family, friends, colleagues, staff, and patients to cast their ballots as well. Not sure where to vote? Find your polling place.

DR. KING GETS PRESIDENTIAL WITH TMA STAFF


Summer is always time at TMA for planning and setting strategy. We beat the heat with an early start this year. TMA President Austin King, MD, spent much of the week working with staff here in Austin. Be sure to follow him on Twitter at @TMA_Pres. Legendary lobbyist Jack Gullahorn sat in with Dr. King, chief TMA lobbyist Darren Whitehurst, and me as we discussed our legislative agenda for 2015. We also worked on Dr. King’s speaking schedule, which is beginning to firm up; if your county society, specialty society, or other group wants to hear from him, please email us.

COALITION OF STATE MEDICAL SOCIETIES SETS LONG-RANGE PLAN


The CEOs from the Coalition of State Medical Societies met in Austin to lay down a two-year strategic plan for our federal lobbying activity. The coalition comprises Texas and the state societies from Arizona, California, Florida, Louisiana, New York, North Carolina, Oklahoma, and South Carolina; our joint membership is nearly 160,000 physicians and medical students. Along with issues such as  private contracting for Medicare patients and physician ownership of hospitals, we decided to focus on two critical areas:
  1. Replacing Medicare’s Sustainable Growth Rate formula will be a key element of our work to repair the flaws in the Affordable Care Act.
  2. We will promote physician leadership through physician-led accountable care organizations. The major issue is access to capital for doctors.

TMA WORKING WITH HOSPITALS ON MEDICAL STAFF LEADER EDUCATION


Ted Shaw, the new president and CEO of the Texas Hospital Association (THA), invited senior TMA staff and me to meet with him and his education team. They asked TMA to collaborate with them on developing their orientation for presidents of hospital medical staffs. This two-day program offers newly elected medical staff leaders tools and resources they need for success in their new leadership roles. The TMA Council on Health Service Organizations will review the proposed agenda and make recommendations. The session will take place Oct. 24-25 at THA headquarters.

MED STUDENT'S WORK EARNS ANSON JONES AWARD


While in Austin, Dr. King gave medical student Rachel Pearson her Anson Jones, MD, Award. Rachel won first place in the Physician Excellence in Reporting category for “Texas’ Other Death Penalty,” which appeared in The Texas Observer. Said one of the judges about her article: “Your first-hand report about providing health care at a free clinic in Galveston was a dramatic inside account of the shortcomings of emergency care for the poor that the public rarely gets to see.” Another judge added, “The article showed a side of lack of health care access that most people don’t see — and challenged medical students to see they can make a difference.” Rachel is an MD/PhD candidate at The University of Texas Medical Branch at Galveston. Congratulations!

TMA STANDS UP FOR SENIORS, DUAL ELIGIBLES

Peggy Russell, DO, an Austin geriatric specialist, testified for TMA at the Joint Legislative Committee on Aging. Dr. Russell explained how Texas needs to improve access to care for our many elderly and vulnerable citizens. She pointed out the need for graduate medical education and geriatric fellowships, noting that many young doctors don’t go into geriatric care because of low Medicaid and Medicare payments. “It’s hard for physicians to pay off their school debt because of the gross disparities in payment for this population,” said Dr. Russell. She told committee members that one of our top priorities is to reverse the payment cut for care you provide to dual-eligible patients.

Monday, May 19, 2014

TEXPAC BACKS “DOCTORS’ DOZEN” IN PRIMARY RUNOFFS

Early voting begins today and runs through Friday for the May 27 party primary runoff elections. TEXPAC has endorsed 12 statewide and legislative candidates who we believe will be strong supporters of medicine’s agenda. Lt. Gov. David Dewhurst, attorney general candidate Dan Branch, and State Sen. Bob Deuell, MD (R-Greenville), are just three examples of men and women who will fight government intrusion into the patient-physician relationship, support our liability reforms, work to improve the Texas Medicaid system, and help us stand guard against public health threats. Please make a plan to vote early for these outstanding candidates.

NYC DOCTORS, PATIENTS DISSATISFIED WITH CHANGING HEALTH CARE SYSTEM

As part of my work for The Physicians Foundation, I attended two focus groups in New York City. Interestingly, the reactions of New York doctors and patients to our changing health care system are quite similar to what TMA surveys are finding here in Texas. Physicians are going into hospital and corporate settings expecting less red tape and the ability to spend more time with their patients. However, they are finding the red tape is heavier and they have less time to spend per patient. Patients said they are experiencing longer waiting times and now have to go to multiple offices for tests, when in the past, tests were typically available in one office or office building.

DR. KING: RELEASE OF CANDIDATE'S MEDICAL RECORDS IS "OUT OF BOUNDS"

The Texas Tribune reached out to TMA for our take on the public release of the medical records of a candidate in the race for the Republican nomination for lieutenant governor. In his essay for the Tribune, TMA President Austin King, MD, writes: “A patient's medical record is a window into the sacred patient-physician relationship. It documents what the patient said, in trust that it would be kept confidential. Only doctors, other health care professionals, patents and their families ― and, unfortunately, those who pay for care ― have the legal and ethical right to look through that window. As much as any of us might be interested in the health care travails of an entertainer, politician, or business mogul, their right to privacy trumps our voyeuristic desires. … Texas politics is a contact sport, but releasing a candidate's personal medical records is out of bounds.”

TEXAS TAKES TWO CANDIDATES, SIX RESOLUTIONS TO AMA HOUSE OF DELEGATES

The Texas Delegation will have plenty of work to do when the American Medical Association House of Delegates convenes in Chicago next month. Actually, it looks like we can put a checkmark in the “done” box for one of our chores. Tyler anesthesiologist Asa Lockhart, MD, is running for the Council on Medical Service, and there are only four announced candidates for the four seats up for grabs. However, Russ Kridel, MD, of Houston is one of eight men and women seeking five seats on the AMA Board of Trustees. We’re also carrying six resolutions from the Texas house to the AMA: 

  • Work to prevent recoupments if an Affordable Care Act (ACA) marketplace insurer has not notified the physician that a patient is in the last 60 days of the grace period for not paying his or her premiums;
  •  Push for a federal law requiring insurers to provide real-time claims adjudication;
  •  Have the AMA Council on Ethical and Judicial Affairs issue rulings on whether AMA’s continued support for parts of the ACA violates the AMA Code of Medical Ethics;
  • Commission a study to compare the federal estimates of direct and indirect costs attributable to the Physician Quality Reporting System, meaningful use, and ICD-10 with the actual time and costs required by physicians to comply with these mandates;
  •  Organize an official protest of the “immediate-use” exception to the United States Pharmacopeia Chapter 797 guidelines on sterile compounding; and
  • Eliminate the law requiring private sector laboratories to report to Medicare their payment rates for lab tests.

SO LONG, MARCUS WELBY, MD, EXPLORES CHANGING HEALTH CARE LANDSCAPE

A new book, supported in part by The Physicians Foundation, profiles physicians who are seeking new ways to deliver medicine, as fee-for-service fades as the predominant payment model. Veteran Texas health care journalist Steve Jacobs wrote So Long, Marcus Welby, MD: How Today's Health Care Is Suffocating Independent Physicians. It explores the five top issues The Physicians Foundation considers most pressing for doctors.

OHIO-BASED FIRM TO TAKE OVER MEDICARE CASE REVIEW IN TEXAS

Medicare has separated the program’s case review and monitoring activities from the traditional quality improvement undertakings of its Quality Improvement Organizations (QIO) and has contracted with two firms to perform the reviews nationally. Although KePRO will take over that activity in Texas from TMF Health Quality Institute, the Ohio firm promises it will continue to use Texas physicians to conduct the reviews. (Note that TMF did not bid on that contract.) The feds expect to announce in July the awarding of additional contracts for firms to work with physicians and hospitals on improving the quality of care they provide. Both changes will be effective Aug. 1.

MY LATEST AT FORBES.COM: RACS ARE RECKLESS BOUNTY HUNTERS

My most recent post at Forbes.com starts with the story of the Medicare recovery audit contractors (RACs) going zero for three in their investigation of one Texas physician. Finding no error doesn’t seem to dissuade the auditors. “These RAC processes are arbitrary, and the auditors get paid by the federal government up to 12.5 percent of anything they find that is out of compliance with the vast array of arcane and indecipherable regulations our physicians are subjected to under the [Affordable Care Act] and other laws,” Physicians Foundation CEO Tim Norbeck and I write in “RACs Are Reckless Bounty Hunters In Our Healthcare System.” The article goes on to document the systemic ills that infect the RACs. Have you had your own illogical run-in with the auditors? Send me an e-mail with your story.

TMA FOUNDATION HONORS FORT WORTH HEALTH CARE LEADERS

Fort Worth Mayor Betsy Price and Project Access Tarrant County received the TMA Foundation’s (TMAF’s) Health Leader Awards during TMAF’s 21st annual gala at TexMed 2014. Mayor Price was cited for the many health promotion programs she helped to start in the city, including FitWorth, Walk! Fort Worth, and the Blue Zone urban project. Project Access, a program of the Tarrant County Medical Society, was honored for providing free health care to low-income individuals in the county who lack insurance and don’t qualify for public assistance.

ARTICLE OUTS ANTI-MEDICINE POLITICAL ACTIVIST

An interesting article this weekend in the The New York Times and The Texas Tribune exposes some of the hard-nosed political antics of West Texas oilman Tim Dunn. Empower Texas, the political action committee that tried to take out State Reps. J.D. Sheffield, DO (R-Gatesville) and Susan King (R-Abilene) in the March 6 Republican primary and is targeting Sen. Bob Deuell, MD (R-Greenville) in the May 27 runoffs, is financed almost entirely by Dunn’s oilfield millions. “It’s not a movement,” TMA political consultant Bryan Eppstein told the Times and Tribune. “It’s a special interest agenda of one person.” TEXPAC, which is pushing back against Empower Texas in several runoff races, is unveiling a series of newspaper ads supporting Dr. Deuell and House candidates DeWayne Burns of Cleburne, John Wray of Waxahachie, and Rob Henneke of Kerrville.

TMA TO FEDS: WATCH OUT FOR UNINTENDED CONSEQUENCES OF EHR REGULATIONS

In a strongly worded letter to Karen DeSalvo, MD, the national coordinator for health information technology (HIT), TMA urged the federal agency to be wary of the unintended consequences of its proposed new rules for certifying electronic health records (EHRs). “Many EHR vendors use the release of these new criteria as an opportunity to charge practices higher fees for new, upgraded software,” wrote Matt Murray, MD, chair of TMA’s ad hoc Committee on HIT. “Physicians are continuously asked to pay more for EHR upgrades and modules to the point that it costs them significantly more than the incentive gleaned from the Meaningful Use program. The unintended consequence is that physicians will discontinue participation in Meaningful Use.”

PERRY APPOINTS TWO TMA MEMBERS AS STUDENT REGENTS

A pair of TMA-member medical students are sitting on state governing boards thanks to appointments from Gov. Rick Perry. Gerald “Jerry” Korty from the University of North Texas Health Science Center Texas College of Osteopathic Medicine (TCOM) is the new student representative on the Texas Higher Education Coordinating Board. Christopher “Chris” Vera, another TCOM student, is the new student regent for the University of North Texas System.

APPLY BY JUNE 13 FOR TEXAS PHYSICIAN PRACTICE QUALITY IMPROVEMENT AWARD

TMF Health Quality Institute released the online application for the 2013-14 Texas Physician Practice Quality Improvement Award. TMA and the Texas Osteopathic Medical Association cosponsor the award, which recognizes practices that provide reliable preventive services using health information technology and effective care management methods. TMF has scheduled online question and answer sessions for May 13 and May 20. The application deadline is June 13.

Monday, May 5, 2014

DR. KING TAKES REINS OF TMA

Saying he will work to stop physicians from “being marginalized out of the health care debate,” Abilene otolaryngologist Austin King, MD, became the 149th president of TMA at TexMed 2014. “We think that because we had to suffer through organic [chemistry] and all those courses, because every year we had to go back to the bank and borrow more and more money, we think that we’re entitled,” he said. “We’re not entitled, we are privileged. Society has granted physicians privileges that it has granted to no other. We hold the scales of life and death for our patients.” The new president of the TMA Alliance is Angela Donahue, RN, of Fort Worth. She spoke of the pivotal role the alliance plays in TEXPAC, First Tuesdays at the Capitol, and the TMA Foundation.

TOM GARCIA, MD, IS TMA PRESIDENT-ELECT

The TMA House of Delegates unanimously selected Houston cardiologist Tom Garcia, MD, as president-elect. The TMA Alliance chose Patty Loose of Austin as its next president. Both will take office at TexMed 2015 in Austin. In other election news:

  • Austin ophthalmologist Michelle Berger, MD, was elected TMA secretary/treasurer. 
  • The house reelected Speaker Cliff Moy, MD, and Vice Speaker Susan Strate, MD. 
  • Drs. Dan McCoy and Linda Villarreal were reelected to the TMA Board of Trustees. Houston emergency medicine specialist Diana Fite, MD, and Fort Worth pediatrician Gary Floyd, MD, were elected new board members. Brad Butler, MD, an anesthesiologist from Longview, is the first to win the young physician seat on the board. The new resident trustee is Maryam Shambayati, DO, of Plano, and the new medical student member is David Savage of The University of Texas Medical School at Houston. 
  • The trustees chose Don Read, MD, as their chair; Doug Curran, MD, as vice chair; Drs. McCoy and David Henkes as members of the executive committee; and Dr. Fite as secretary. 
  • New members of the Texas Delegation to the American Medical Association are Drs. Sue Bornstein of Dallas, Cynthia Jumper of Lubbock, Roxanne Tyroch of El Paso, and Alex Valadka of Austin. 

HOUSE: TMA OPPOSES ICD-10 FOREVER

Ratifying a position TMA has pushed in Congress and at AMA, the House of Delegates adopted a resolution directing that TMA “work to permanently delay the implementation of ICD-10.” One delegate tweeted, “If they want our data, then they should pay us for it.” Delegates also:

  • Called for changes in the Affordable Care Act (ACA) to prevent recoupment of payments to physicians made during the ACA grace period when physicians have not received adequate notice that the patient has not paid his or her premiums; 
  • Adopted resolutions to fight air pollution and improve immunization rates; 
  • Said Congress should permanently adopt Medicare payment parity for Medicaid services provided by primary care physicians and extend that parity to all other specialties; 
  • Directed TMA to work with other organizations to “aggressively pursue the reduction or elimination of as much of the documentation burden as possible”; 
  • Established new TMA policy on the number of attempts and amount of time allotted for passage of medical licensing exams; 
  • Called for insurance companies to provide real-time adjudication of claims; 
  • Approved a phased-in dues increase of up to $12 per year for five years; and 
  • Rejected a proposal to eliminate TMA’s International Medical Graduate Section.   

ALAN BAUM, MD, WINS DISTINGUISHED SERVICE AWARD

The witty and irascible Houston ophthalmologist Alan Baum, MD, was presented the TMA Distinguished Service Award, the association’s highest honor, at TexMed 2014. A former TMA president and longtime board chair, Dr. Baum made his mark as a leader in TEXPAC and TMA’s legislative activities. “Calling on legislators can make such a difference, when they see you’re willing to share what’s important to your patients and your practice,” he said. “Doing so, you represent so much more than yourself.” Other awards presented at TexMed 2014 included:
  • Surendra Varma, MD, a pediatrician from Lubbock and long-serving leader at the Texas Tech Health Sciences Center School of Medicine, received the Platinum Award, the top honor in TMA’s Award for Excellence in Academic Medicine.
  • The Resident and Fellow Section’s J.T. “Lamar” McNew, MD, Award went to Arlo Weltge, MD, of Houston.
  • From the Medical Student Section, the C. Frank Webber, MD, Award went to K. Ashok Kumar, MD, of San Antonio. The Student of Year is Justin Bishop of Texas Tech. The students’ Chapter of the Year is The University of Texas Medical Branch at Galveston chapter.

ZDOGG: BRING BACK "ANALOG MEDICINE"

Between his raps and one-liners, TexMed 2014 keynote speaker Zubin Damania, MD, and his alter ego ZDoggMD delivered a template for any physician — or group of physicians — to redefine the culture of medicine and return joy to their practice. He described his journey from idealism to burnout and back again with the creation of Turntable Health, a unique primary care practice in Las Vegas. “We are the smartest, most creative, educated, brilliant people on the planet, and we’re treated like crap, and it’s time that it stopped,” he said. “And this is a way to do it that we stand up, individually and together, to make it happen.” (Watch video.) Comparing modern day medicine to “crappy MP3s made up of zeroes and ones that you stole off the Internet,” Dr. Damania said he chose “Turntable Health” to reflect the fact that “medicine is a warm, analog relationship.”