Archives / 2011 / October
  • From the editor: Introducing a new look for Texas Family Physician

    Tags: texas family physician, redesign, family physician

    Eleven years ago, when I came on board as managing editor of Texas Family Physician, I was fresh out of journalism school with a love for design and an eye for art, photography, and typography, but no real-world experience in producing magazines. I learned much in those first few issues about the nuts and bolts of magazine production, all the while trying to appear as though I knew something about an expanding range of increasingly complex editorial topics my new magazine was required to cover.

    My first cover story tackled the problems with the financing of graduate medical education – talk about jumping in at the deep end.

    During those first issues, I knew the magazine needed a new look, a form and function that could achieve the news and information focus we wanted to deliver, while keeping the warmth and conversational nature we wished to convey. In 2002, we launched the first redesign of TFP under my direction, and while we’ve worked in each issue since to refine that design, I believe the artistic concept has served the Academy well.

  • Hart of Dixie: Feel-good family medicine hits the small screen

    Tags: media, rural medicine, family physician, new physician

    By Juleah Williams

    Among this season’s new fall line-up comes a new drama from the CW – Hart of Dixie – featuring surgeon-turned-country doctor Zoe Hart. Full disclosure: As can be expected from most CW programming, this show is geared toward a teenage audience and includes enough love triangles and “frenemies” to keep their attention. However, exposing this young population to the benefits of primary care and emphasizing the importance of having a relationship with a personal family physician is crucial to increasing interest in the specialty down the road.

    As the story goes, Zoe graduated at the top of her class from medical school and seeks to follow in the footsteps of her father, a cardiothoracic surgeon. After residency she fails to be accepted into a fellowship because her superiors deem her “too cold.” Desperate, she decides to accept the offer of a kind stranger—who turns out to be her real father—to join his family medicine practice as a general practitioner in Bluebell, Ala.

  • The unintended, but not surprising, negative consequences of hospitalism

    Tags: health care costs, family physician, hospital

    By Richard Young, M.D.

    A recent study in Annals of Internal Medicine looked at what happened when patients were cared for in the hospital by private physicians (presumably often their personal physicians) compared to hospitalists.

    For a little background, hospitalists are doctors whose job is limited to taking care of patients in the hospital. They pick up new patients in shifts or cycles and almost always have no previous relationship with the patients. They rarely see patients in clinics and have no long-term outpatient relationships with patients.

  • Payment Reform recap: Demonstrating value

    Tags: health care reform, medical home, practice transformation, family physician, health care, debate, payment

    Following the most basic model for success in business means minimizing overhead and maximizing revenues, Dr. Mark Laitos pointed out at TAFP’s Payment Reform Summit last Saturday. For doctors in private practice and other health care providers, this means billing for as many relative value units, or RVUs, as possible at the best conversion rate, and maximizing ancillary revenue, when possible.

    And while this strategy is simple enough, Laitos said it has reduced the “proud field” of medicine to “conveyor belt medicine.” Worse, as payers – including health insurers, employers, and patients to some extent – strive to minimize RVUs, the solution to the cost crisis in a fee-for-service system is to slash payment to physicians and deny care to patients.

    Of course neither patients nor doctors (nor the organizations that advocate for them) would allow this to happen considering the scale needed to rein in escalating health care costs. The solution, then, as speaker after speaker suggested, is to trade the volume-based model for a value-based model. This is also the cover story of the latest Texas Family Physician magazine.

  • With Texas health care in the spotlight, opportunities abound

    Tags: budget, media, legislature, health care, debate

    As could be expected, Gov. Rick Perry’s decision to seek the Republican nomination for president has intensified state and national media scrutiny of Texas’ health care record, particularly regarding the uninsured, Medicaid, health care costs, and our medical liability climate.

    TAFP has long been on record in our public positions—from “Fading Away” to “Fractured” to “The Primary Solution”—that starving down our primary care infrastructure and the continued fragmentation of care across the spectrum of settings  transcends moral concerns and translates into very real economic consequences that threaten everyone from local taxpayers to employers and families. We have been equally ardent in our position that a vibrant primary care delivery system operating in a healthy liability climate is the solution to the crisis facing our health care delivery system.

    Armed with these resources, TAFP’s physician leaders, lobby team, and advocacy staff have routinely briefed top Texas political and health care writers, as well as legislators and their staffs, particularly leading up to and during legislative sessions. Now TAFP has been called upon for similar briefings and interviews by a rapidly growing body of national writers from media outlets as diverse as CBS News, NBC News, NPR, the Wall Street Journal, the Los Angeles Times, the Washington Post, the New York Times, the Boston Globe, Kaiser Family Foundation and Politico, the Hill, and others.

  • The chance of a lifetime

    Tags: texas family physician, president's letter, balkcom

    An excerpt from the inaugural speech of TAFP’s new president

    By I. L. Balkcom IV, M.D.
    TAFP President, 2011-2012

    In 1987, as I was graduating from the Columbus medical center’s residency program, I thought I was hot potatoes. We were good. The 12 of us just thought that we were it. I felt like I could do a Caesarean section with a teaspoon. There was no body cavity I couldn’t align. We felt like we could just do it all.

    So, armed with that knowledge, I set off in the world. I happened to be going to a meeting at the Capitol one day, and as I checked in at my hotel, I was puffed up pretty good. I signed in: “Dr. I. L. Balkcom, IV, M.D.”

  • Texas can improve care and cut costs with medical home, shared savings initiatives

    Tags: texas family physician, perspective, medical home

    By Greg Sheff, M.D.

    I am fortunate to be a part of a multi-year patient-centered medical home and shared savings pilot at Austin Regional Clinic. ARC is an approximately 300 physician multi-specialty group delivering care at 18 clinics and seven hospitals throughout the Austin area. Earlier this year, ARC joined a multi-year medical home pilot administered by Blue Cross and Blue Shield of Texas. The pilot was initiated in large part in response to Texas legislation requiring the Employees Retirement System, the self-funded insurer for state employees, to experiment with alternate payment and delivery models in an attempt to reduce the state’s ever-increasing health care costs. We are one of five physician groups in the state participating. Our program serves roughly 45,000 patients, including both the ERS (whose health care benefits are administered by BCBSTX) and BCBSTX fully-insured populations.

    In addition to the traditional PCMH goal of comprehensive, coordinated, accessible, patient-centered care for all, ARC is also implementing processes to proactively identify high-risk patients and then deploy intensive, focused, physician-led care management interventions to these high-risk patients.