Archives / 2012
  • TAFP’s top 10 news stories of 2012

    Tags: news, 2012, texas medical board, affordable care act, quality, health care costs, accountable care organization, recovery audit contractor, administrative burden

    As another year draws to an end and we’re once again waiting to see what Congress will do to about the SGR and the fiscal cliff-tastrophy, your TAFP Communications staff put together a list of the top 10 news stories from Texas Family Physician and TAFP News Now based on unique page views recorded through our analytics system.

    Not surprisingly, it shows that family physicians are concerned about the practice environment and the future. These stories outline new regulations, administrative burden, experimental practice and payment models, and the future of the specialty.

    1. TMB rules you may not know but should

  • Social media changing the face of health care as we know it

    Tags: social media, twitter, facebook, linkedin, blog, fmrevolution

    While visiting Dr. Justin Bartos, this year’s TAFP Physician of the Year, we convinced the North Richland Hills doc to join the family medicine revolution (#FMRevolution) and create a Twitter handle (@jbartos3). We are proud to say that our very own TAFP President, Troy Fiesinger, M.D., maintains his own blog ( and is very active on Twitter (@TroyTxFamilyDoc). The Academy, of course, is also lively across multiple social media platforms including Twitter (@TXFamilyDocs), Facebook, and LinkedIn.

    While it may seem as though I’m speaking in code, it’s actually just the language of the technologically advanced 21st century. Get used to these hashtags, handles, links, and profiles, because they are here for the long haul. But what can social media do for health care and doctors like yourself, you ask? Simply put, it makes things that you already do easier, digitally. In fact, Medscape reports that one in four physicians already uses social media on a daily basis.

    Websites like the aforementioned ones allow you to network with other physicians, connect with patients, follow medical organizations, and stay up to date on just about any kind of news. The Medscape study also found that primary care physicians are usually motivated to use social media as a way to connect with peers and be influenced by them. The Academy uses social media to spread news to our members, keep in contact with similar organizations and people relevant to health care and the state of Texas, and network with like-minded people.

  • Meet the new TAFP Communications Specialist, Samantha White

    Tags: communications, social media, staff

    On the eve of a recent photo shoot, I walked through my usual pre-shoot routine. Charge the battery. Empty the memory cards. Clean the lens. Load up the camera bag. A series of steps I’ve done so many times I could now complete successfully in my sleep. This shoot would be different, however. The following morning I would be shooting my first set of images for TAFP’s Texas Family Physician, a magazine I’m sure you are all aware of.

    I took over Kate’s reins as your communications specialist early in October (no worries though, she’s still around!) and have been nothing but excited about working for TAFP. She spent a few weeks teaching me much of what she knows and I feel fortunate to have her as a mentor in the position.

    Born and raised in the panhandle (mostly Lubbock), I ventured south to get my photojournalism degree from UT Austin. I’ve been here in Austin for over six years now, and am a true Texan at heart. I’ve worked as a freelance photographer for about that long as well, shooting everything from babies and families to editorial images.   

  • Standardization can relieve administrative burden, if we can get there

    Tags: administrative burden, standardization, health care reform

    The amount of time and money physicians and their staffs spend on the administrative tasks of medicine is astounding. A recent perspective article in the New England Journal of Medicine quantifies it this way: “The average physician spends 43 minutes a day interacting with health plans about payment, dealing with formularies, and obtaining authorizations for procedures,” and physician practices hire coding and billing staff “who spend their days translating clinical records into billing forms and submitting and monitoring reimbursements.”

    That translates to an annual cost of $361 billion spent on health care administration, and half of these expenditures are unnecessary.

    The authors argue that standardization is key to reducing administrative costs, and much of this can be achieved through health information technology and electronic health records. Though they say the only entity with the “clout” to push through standards in medical transactions is the federal government, measures in the Affordable Care Act and the Health Information Technology for Economic and Clinical Health Act (HITECH)—like instituting regulations on payers and providing incentives to physicians and facilities—may start us on the right path when previous efforts have failed.

  • Travis County's Proposition 1

    Tags: vote, proposition, medical education, election, medical school

    The recent chatter of new medical schools in Austin and South Texas is back in the news, as Proposition 1 is on this year’s ballot in Travis County. If approved, the proposition would increase property taxes in order to fund healthcare services that will later be provided by a new medical school in Austin. Both schools will be a part of the University of Texas system.

    As university systems expand and new medical schools open up, we must ask what they intend to do about the lack of primary care physicians not only in the state, but all across the country. Programs are being put into place to encourage students to pursue primary care, but are not widespread among schools.

    AAFP Executive Vice President, Dr. Douglas Henley, M.D., addressed the shortage when speaking to the AAFP Congress of Delegates in Philadelphia last week. Henley describes a new type of medical education – “one which is more clinically oriented; one where all students are first educated and trained as ‘comprehensivists’ before seeking specialty training as residents; and one where students are taught to be leaders of efficient teams of health care professionals focused on delivering patient centered care to meet the triple aim of better care, better health, and lower cost.”

  • Reminders for Primary Care Summit

    Tags: primary care summit, houston, dallas, membership, hotel, parking, event

    The 2012 Primary Care Summit in Dallas is upon us and we are looking forward to seeing you there! Below you will find important information to make sure everything this weekend goes smoothly for you.

    Registration Schedule

    Important – This year’s Primary Care Summit will be held in the Dallas Ballroom on the 3rd floor. To make registration easier, TAFP staff will open registration Thursday evening, Nov. 1. Registered attendees may pick up their materials on Thursday from 5:30 - 6:30 p.m. at the TAFP Registration Desk on the 3rd floor of the Westin Galleria. Please note that you will still need to stop by the registration desk on Friday to sign in.

  • TAFP members can make a difference this legislative session

    Tags: advocacy, key contacts, physician of the day, tafppac

    Use TAFP resources to educate lawmakers on issues important to family medicine

    TAFP serves as your voice in the Texas Legislature and we have a team of advocates with strong relationships throughout the Capitol community and in state agencies working on your behalf. We continue to make strides for the specialty, but we can’t do it without your help. TAFP members can make a difference and we invite you to get involved in the fight for family medicine.

    The 83rd Texas Legislature convenes on Tuesday, Jan. 8, and getting involved is possible no matter how much time you’re able to commit. Whether taking five minutes to read one of TAFP’s Advocacy Action Item e-mails and send a message to your representative, or a few minutes to donate to TAFPPAC online, or dedicating a day to see patients at the Capitol, your involvement matters. Here are a few opportunities to consider.

  • Time to swing for the fences

    Tags: president, fiesinger, advocacy, family medicine

    An excerpt from the 2012 incoming presidential address

    By Troy Fiesinger, M.D.
    TAFP President, 2012-2013

    Whether we practice in Houston or Henderson, Wichita Falls or Weimar, El Paso or Del Rio, Alpine or Austin; we are all Texas family physicians. We bring different perspectives to the Academy based on where we live and where we’re from. I know what it’s like to work in a large integrated health care system, run a community health center, and teach our future family physicians, but I don’t know how to run your practice. I want to hear from each of you about how we can strengthen family medicine and take care of our patients.

    Our health care system is in the midst of a painful rebirth. The insurers, the government, and the hospitals are pulling us in different directions. We stand with our patients at the middle of this storm of abbreviations and acronyms: ACA, ACO, PCMH, EHR, and the Medicaid 1115 waiver.

  • Nurse practitioners are no substitute for physician-led team

    Tags: aafp, scope of practice, report

    By Roland Goertz, M.D., M.B.A.; Chair, AAFP Board of Directors

    By the year 2020, our nation is expected to face a shortage of 45,000 primary care physicians. To address this shortfall, as well as rising health care costs, the nation is seeing a movement to grant independent practice to nurse practitioners.

    But, this flawed, stop-gap approach overlooks some obvious obstacles to replacing physicians with non-physicians. For example:

  • Van Winkle: It is our time to lead

    Tags: van winkle, congress of delegates

    In less than two weeks, the AAFP Congress of Delegates will elect a new slate of officers and three members to serve on the AAFP Board of Directors. TAFP has a candidate in this year’s Board of Directors race—Castroville family physician Lloyd Van Winkle, M.D.—and we’re gearing up to support him in Philadelphia.

    A quick brief on our national academy, the membership of the Congress of Delegates, AAFP’s policy-making body, consists of two delegates from each state chapter plus spots for special constituencies, family medicine residents, and medical students. During the two-and-a-half days of meetings, each of the six reference committees (Advocacy, Bylaws, Education, Health of the Public and Science, Organization and Finance, and Practice Enhancement) will hold hearings open to all AAFP members, current officers will give speeches, board members and commissions will present reports, and delegates will consider resolutions.

    The election will be held on Wednesday, Oct. 17, with voting early in the morning and results revealed before noon.

  • Money & Medicine: Reflections on the message

    Tags: pbs, health care reform, advance directive, end-of-life, care, money, medicine

    We have known for years that the payment system for health care services provides incentives for hospitals and physicians to run more tests and perform more procedures. Debuting this week, a PBS special “Money & Medicine” examines not only runaway health care spending, but also the danger patients face from over-diagnosis and over-treatment.

    “If you add up medical errors, drug interactions, and hospital-acquired infections, medicine itself is the third leading cause of death in this country,” one expert says in the film. And another, “I’m paid more when I harm my patients; I’m paid more when I do more, even when it’s not beneficial.”

    Contributing to the estimated 30 percent of U.S. health care spending—$800 billion a year—that pays for unnecessary services, the filmmakers identify several forces at play. First, briefly, the providers:  “One person’s waste is nearly always another person’s income, and income turns into strong political defenses of areas that are classic waste.” Next, the patients: Patients’ demands are changing the behavior of providers. And particularly in end-of-life care, the family can demand “full court” care regardless of the odds.

  • The sour side of sugary drinks and what family physicians can do about obesity

    Tags: obesity, sugar-sweetened beverages, family physician, weight of the nation, weight loss

    Regularly drinking sugar-sweetened beverages like soda and sports drinks will make you fat.

    By now this is an old message, but it gains more ground with each new article, study, or documentary released about the American obesity epidemic. The latest research comes from three studies published in the New England Journal of Medicine. Two of the studies found that drinking noncaloric drinks could lower children’s weight gain, and the third study found that people with a genetic predisposition for weight gain were twice as likely to gain weight if they drank sugary beverages compared to people who did not drink these beverages.

    One of the studies’ authors, Dr. David Ludwig from Boston Children’s Hospital, told Reuters Health, “I know of no other category of food whose elimination can produce weight loss in such a short period of time. The most effective single target for an intervention aimed at reducing obesity is sugary beverages.”

  • It’s time to fight for the Statewide Primary Care Preceptorship Program

    Tags: preceptorship, family medicine, bias, corkran

    You never know how the choices you make today might dramatically affect your future, how a few seemingly insignificant weeks can alter the trajectory of your life. That’s the hope and the promise of the Texas Statewide Primary Care Preceptorship Program.

    As Travis Bias, D.O., told TAFP’s Kate Alfano for an article in the fall 2010 edition of Texas Family Physician, he entered medical school expecting to become an orthopedic surgeon. He worried about the debt he would accrue during his medical education and believed he’d have to pursue a more lucrative specialty to pay it off more quickly.

    Then he completed his family medicine preceptorship as a requirement of his medical school curriculum, and now, Bias is a family doctor.

  • Family physician’s relationship with his patients returns inspiration, support

    Tags: physician of the year, bartos, physician, patients, relationship

    An excerpt from Dr. Justin Bartos’ Physician of the Year acceptance speech

    By Justin V. Bartos III, M.D.

    Thank you for the great honor of being named the 2012 Texas Family Physician of the Year. It is a dream come true. As you work on behalf of your patients, your practice, and the specialty of family medicine, you often wonder if this effort is recognized by your colleagues. It is extremely gratifying to receive such an award.

    I practice under the Medical Clinic of North Texas, which comprises more than 150 primary care physicians. I also spend a portion of my time as the medical director of the Dr. David Pillow Senior Health Clinic at HCA North Hills Hospital. This has been a very fulfilling part of my practice. David Pillow was my mentor when I started my practice 27 years ago. Using the fundamentals of the patient-centered medical home we have a very effective proactive team approach to senior care.

  • By choosing wisely, physicians can help address the unsustainable trajectory of health care costs

    Tags: perspective, young, choosing wisely, health care costs, aafp

    By Richard Young, M.D.

    “Every admitted patient should have a chest X-ray and a VDRL,” said one of my Type A personality internal medicine attending physicians during residency. The year was 1990 and this attitude was shared by a few other knowledgeable physicians at the time, though others questioned the practice and were more flexible in their medical decision-making. I would venture to guess that few family physicians or internists practice this way in 2012, but the practice is not completely dead.

    A lot has changed since 1990. The total cost of U.S. health care was $724 billion and consumed 12.5 percent of the gross domestic product.1 In 2012, the total cost of U.S. health care is estimated to be $2.8 trillion and will consume 17.6 percent of GDP.2 This health care inflationary trend has continued unabated for the last 50 years.

  • Defining the meaning of “meaningful use”

    Tags: texas family physician, meaningful use, technology, tradition, balkcom, president's letter

    By I.L. Balkcom IV, M.D.
    TAFP President

    Shhhh! Don’t tell anyone, but I am attempting to practice on my laptop so I might understand how to have a “meaningful” encounter with my patient. I have made progress in technology in that I even sent our chief operating officer, Kathy McCarthy, an e-mail this year—a proud moment in my technological infancy. Now I find myself immersed in a small screen with small print and myriad options for the EHR. As Peanuts would say, “ARRRGHH!” as I erase an entire page by accident.

    Now for those of you who are fortunate enough to know all things computer or young enough to have grown up with iPhones, laptops, and MP3 players, I heartily congratulate you. Some of us less technologically gifted are still learning how to turn on these infernal machines and not to treat them like coke machines—beat and kick the “heck” out of them. I wish so often they would say something so I could keep up my tirade. Oh, I forgot. They do talk to you now.

  • View pictures from the 63rd Annual Session and Scientific Assembly

    Tags: annual session and scientific assembly, business meetings, leadership, committee, commission, report

    About 400 family physicians and other health care providers gathered in Austin this July to learn, network, see old friends and make new ones, all while celebrating the specialty of family medicine at the 63rd Annual Session and Scientific Assembly. For your TAFP staff, this was a special Annual Session because it was held in our hometown, so we enjoyed recommending our favorite restaurants, coffee houses, and activities to any attendees who were interested.

  • Call for nominations: Select our next Member of the Month

    Tags: membership, member of the month, nomination

    Here’s a quick quiz on a Monday morning. What do the following have in common: A private-practice physician inspiring fitness in her community by leading by example, an Army doc who joined the service after 9/11, a third-year resident in Odessa originally from Nigeria, and a San Antonio educator who completes triathlons in her spare time? They’re all TAFP members and they’ve all been profiled as a TAFP Member of the Month!

    Launched in February 2011, Member of the Month has introduced us to 17 TAFP members who practice their own unique “brand” of family medicine. It’s published in TAFP News Now and on, and features a brief biography and Q&A giving voice to their passions and viewpoints.

    The idea was brought to Academy staff by Melissa Gerdes, M.D., 2010-2011 TAFP president, and has taken root as one of my favorite projects. And with 7,000 family physicians, family medicine residents, and medical students, we have lots more work to do.

  • Things to know for TAFP’s Annual Session & Scientific Assembly

    Tags: annual session and scientific assembly, membership, hotel, parking, conference, reminder, network, event

    We’re gearing up for the 63rd Annual Session and Scientific Assembly and can’t wait to welcome all TAFP officers, leaders, members, CME attendees, and special guests to Austin. We have an eventful conference planned for you and we look forward to seeing you in our hometown.

    Please visit the TAFP registration desk (locations and hours listed below) to pick up your materials including your CME syllabus, registration packet, and Official Program. Your Official Program includes schedules, maps, and other important information about the conference.

    > This essential resource is available online for viewing on your laptop or mobile device at

  • The epidemic of our times: Diabetes

    Tags: diabetes, resources, kadir, annual session and scientific assembly, preventive care

    By Lamia Kadir, M.D.

    Diabetes is a personal issue for me, as with many; my mother was diagnosed decades ago. I firmly believe a solid knowledge of diabetes is crucial for all primary care physicians. To know diabetes is to know medicine.

    According to the American Diabetes Association, 25.8 million children and adults in the United States—8.3 percent of the population—have diabetes. There were 1.9 million new cases of diabetes diagnosed in people over age 20 in 2010.

  • Annual Session Restaurant Guide: TAFP staff picks

    Tags: restaurant, entertainment, members, annual session and scientific assembly, staff, recommendation

    To welcome you to our hometown for the 63rd Annual Session and Scientific Assembly at the Hilton Austin Hotel July 11-15, the TAFP staff compiled a list of our favorite downtown restaurants. From elegant to home cookin’, there’s something for everyone! See the list below for each staff member’s recommendation, organized by distance from the Hilton Austin Hotel.

    >> View more top downtown Austin restaurants as profiled previously on our blog by our multimedia intern and downtown authority, Haley, at

    504 East 5th Street (between Neches and Red River)
    (512) 477-7497
    Cuisine: Italian
    Distance from the Hilton: 1 block or 285 feet

  • Annual Session Preview: Restaurant Guide

    Tags: restaurant, entertainment, members, annual session and scientific assembly

    By Haley Dawson

    Austin has become known for its unique and exquisite dining experience. Adhering to the “Keep Austin Weird” philosophy, Austinites are serious about supporting local business. As such, you’ll find restaurants in Austin unlike any others you’ve visited before. Because this year’s Annual Session takes place in the heart of downtown within walking distance of many top-rated eateries, why not spend an evening or two taking advantage of all the capitol city has to offer? Whether you dine on interior Mexican, authentic Italian pizza, or fancy barbeque, you’re sure to leave with a fully sated palate. Listed below are just a few restaurants of the dozens to choose from.

    1. Chez Nous

  • What you need to know for the 2012 Family Medicine Chief Resident Conference

    This Friday we kick off the two-day Family Medicine Chief Resident Conference, held in conjunction with the new UNTHSC Faculty Development Center. We’re excited to facilitate lectures, panel discussions, and hands-on skills workshops to give these family medicine leaders the skills they need for a challenging year ahead.

    As always, TAFP staff is happen to answer any onsite questions or concerns. You’ll always find someone at our registration desk, located on the 37th floor in front on the Majestic 1 room of the Sheraton Dallas Hotel.

    Read on for more information on what you need to know to have a great conference. We look forward to seeing you in Dallas!

  • Explore TAFP’s hometown at the 63rd Annual Session & Scientific Assembly

    Tags: austin, preview, cme, annual session and scientific assembly, event

    Join TAFP July 11-15 when we host the 63rd Annual Session and Scientific Assembly in our hometown, vibrant and quirky Austin, Texas. All of the elements for the premier conference for primary care physicians converge at the Hilton Austin Hotel and Austin Convention Center, located in electric downtown.

    There’s a little something for everyone here: from fine dining, live music, and shopping, to museums, the great outdoors, and family activities. Stroll down historic Congress Avenue, see imaginations soar at the Austin Children’s Museum, watch our resident bats take flight at dusk, or jog the Town Lake Trail around Lady Bird Lake. Even if you’ve visited Austin before, TAFP welcomes you to explore our ever-changing city.

    CME and bonus workshops

  • We’re back and we’re energized, now to get to work!

    Tags: aafp, ncsc, alf, leadership, gabler, echols

    “Family medicine is an unstoppable force but we have work to do. Engage your colleagues!” That was the message from AAFP President Glen Stream, M.D., M.B.I., at the opening event of AAFP’s Annual Leadership Forum, and the unofficial theme of both ALF and its sister conference, the National Conference of Special Constituencies, held in Kansas City this past weekend.

    More than 20 TAFP delegates, leaders, and staff attended to represent our state. NCSC attendees—representing GLBT physicians, minority physicians, women, international medical graduates, and new physicians—developed recommendations for the AAFP Congress of Delegates and held elections for various national leadership positions. ALF attendees learned the latest on leadership, association management, media interaction, website optimization, and how to stay relevant in a competitive market.

  • State leaders must be willing to invest in the training of more primary care physicians

    Tags: workforce, shortage, primary care, cogme, centers for medicare and medicaid services, payment

    By Tom Banning

    There is not a self-respecting health policy analyst here or anywhere in the country who will say otherwise – we need to invest in and produce more primary care physicians.

    The conventional economic wisdom, backed by common sense and an abundance of evidence drawn from the real world, is that patients with ready access to primary care receive more timely and optimal health care services with better outcomes. Primary care physicians provide preventive, coordinated, and continuous care which results in less invasive and costly medical intervention and reduces the probability of redundant or unnecessary services.

  • Texas residency slots not keeping up with medical school graduates

    Tags: report, legislature, medical school, residency, texas higher education coordinating board, graduate medical education

    A new report reveals a severe problem in addressing the Texas physician workforce shortage: Though more medical students are graduating from Texas medical schools, our state won’t have enough first-year residency slots to keep them in the state to complete their training.

    The Texas Higher Education Coordinating Board finds that while Texas medical schools have increased their enrollment by 31 percent from fall 2002 to fall 2011, at least 63 graduates will not be able to enter a Texas residency program in 2014. Without action, this shortfall will reach 180 by 2016.

    According to THECB and reported by the Texas Tribune, Texas had more than 550 residency programs in 2011 that offered a total of 6,788 residency slots. By 2014, Texas will need 220 more residency positions to achieve the 1.1 to 1 ratio of first-year residency positions to Texas medical school graduates. 

  • An introduction to RRNeT, the Research Residency Network of Texas

    Tags: family medicine residency program, research, faculty, medical student

    By Jason Hill
    RRNeT network coordinator

    The Research Residency Network of Texas, or RRNeT, is a collaboration of 10 Texas family medicine residency programs across the state, representing 100 family physician faculty and 300 family medicine residents who see approximately 300,000 outpatient visits per year. The program is comprised of physicians and researchers who meet bi-monthly to discuss research projects. RRNET is united by a single goal: to generate medical research that meets the needs of our diverse patient population. RRNeT’s patients are comprised of Latinos (55 percent), African Americans (12 percent), Caucasians (27 percent), and Asians (4 percent).

    To begin a study, physicians discuss reoccurring medical issues and concerns arising in their day-to-day clinical work. “What patient issues are most puzzling or worrisome?” A consensus answer to this question often determines the research agenda for the upcoming year. Each year, one or two large research studies are implemented. Research topics to date have included alternative medicine use, medication compliance, teen preventive care, cost-efficient care, low back pain, and obesity. After selecting a research topic, RRNeT members derive specific research aims to shed light on underlying causes, further describe the topic, and  test linkages between the causes and associated health outcomes.  Then study design, sampling, procedures, and data collection processes are determined. At this point, RRNeT members acquire permission to conduct the study with their respective institutional review boards.

  • Reflecting on 15 years at TAFP

    Tags: anniversary, mccarthy, tafp foundation

    By Kathy McCarthy, TAFP COO

    In recognition of the 15th anniversary of my time at TAFP, I’d like to take a moment to reflect. In these tough economic times, most feel lucky just to have a job. I am especially blessed to have one that I enjoy, that challenges me, and that rewards me in so many ways. I began working for TAFP in 1996 as a secretary and left after about nine months to get certified to teach grade school. After a few months of substitute teaching, I knew that I was not well suited to teaching. I returned to Austin and found myself back with TAFP on April 7, 1997, as “special projects coordinator.”

    I’ve seen lots of changes in those years, many driven by revolutionary technology. When I started working in membership, we still had a microfiche machine to view member records and speakers would show up for our CME event with slide carousels!

  • McAllen family physician brings monument to Capitol grounds

    Tags: barrera, monument, legislature, community, capitol

    After 12 years of planning, Texas leaders unveiled a Capitol grounds monument on March 29 honoring Tejanos, the first Spanish and Mexican descendants who introduced many of our state’s proud traditions and culture.

    This is el sueño (the dream) of McAllen family physician and TAFP member Cayetano E. Barrera III, M.D., as event emcee State Rep. Richard Peña Raymond said at the unveiling ceremony. Back in 2000, Barrera and his wife were walking the grounds of the Texas Capitol when they noticed that none of the statues or monuments recognized Hispanic contributions to the state. With his love of history and respect for genealogy, Barrera knew that the Tejano contribution was too important in the formation of Texas culture to ignore. And over the next decade, he worked as president of the Tejano Monument Committee to meet with sponsors, architects, engineers, historians, board members, legislators, and all other necessary contacts to raise support and funding for the monument.

    The final product is a grand tribute to the Tejano contribution. It features 11 life-size bronzed statues mounted on slabs of pink granite: a vaquero on horseback corralling two longhorns, a Tejano couple with a baby, a young girl, a boy leading a goat, and an explorer gazing over the whole scene.

  • Patient-centered medical home: Are we or aren’t we?

    Tags: texas family physician, perspective, patient-centered medical home, family medicine residency program

    By David W. Bauer, M.D.

    When is a patient-centered medical home not a patient-centered medical home? In my practice, the answer is “every day.” In 2009 we received NCQA’s designation as a Level 3 PCMH. To achieve this, our physicians had to document ways in which our patients had enhanced access to our practice, provide examples of how we use evidence-based guidelines to provide quality care, demonstrate the means by which we coordinated care across time and space, and a number of other measures. We do, in fact, do those things every day. What we don’t do, is do all of them for every single patient, every single day.

    Consider the analogy of a patient with diabetes whose hemoglobin A1c is 6.9. We would say that the patient’s diabetes is well controlled and congratulate the patient. But there are many ways that a patient could achieve this value. One would be to have very little fluctuation of her glucose from hour to hour. Another would be for the patient to drop into the 40s overnight, and climb to 200 immediately after meals. The hemoglobin A1c is an average, and doesn’t factor in variation. For years, decreasing variation has been the mantra of those working to improve quality, increase efficiency, and decrease medical errors in the hospital setting. As we migrate toward a new model of health care in this country—the PCMH—it would be valuable to embrace this concept in our offices as well.

  • Protecting our most vulnerable

    Tags: responsibility, balkcom, abuse, children, president's letter

    By I. L. Balkcom IV, M.D.
    TAFP President 2012-2013

    Her name was not important. This little 6-year-old girl I had been called to examine in the emergency room now sat silently, flanked by her mother and mother’s boyfriend.

    I was in my third year of residency and was summoned to evaluate this patient who I’d been told had fallen in the bathtub at home. She had a large bruise around her left eye.

  • Best practice: What one Austin practice is doing about obesity

    Tags: best practice, obesity, weight loss

    By John K. Frederick, M.D.

    If your clinic is anything like ours, we are being deluged with obesity and its downstream effects of diabetes, hypertension, obstructive sleep apnea, and heart disease.  New evidence surfaces almost daily in the medical literature describing some new correlation between obesity and negative health consequences. This situation is also discouraging because there aren’t many good community resources that are both easy to access and effective. The inertia of poor diet and lack of exercise is overwhelming. Repeated advice and encouragement often seem useless, and eventually it feels as if there is no point. Even the employees in our own clinic seem to be disproportionately affected with this condition.

    Several factors contributed to our recent action. Perhaps it was seeing how fast the box of doughnuts emptied in our break room. Or, maybe it was the Medscape article pointing out that overweight doctors tend to spend less effort on recognizing and treating obesity. That hit close to home!

  • ICD-10 delay in the works

    Tags: icd-10, coding, centers for medicare and medicaid services, deadline, aafp

    By Kent Moore

    With 5010 implementation effective Jan. 1, 2012, the next major hurdle facing physicians and the rest of the health care system is implementation of International Classification of Diseases, 10th Edition  (ICD-10). Currently, that is slated to happen on Oct. 1, 2013.

    Or is it? In mid-February, officials at the Centers for Medicare and Medicaid Services (CMS) and Health and Human Services (HHS) announced that a delay in implementation may be forthcoming. First, acting CMS Administrator Marilyn Tavenner told reporters that the CMS will “re-examine the timeframe” for ICD-10 implementation through a rulemaking process. She did not say when that rulemaking process will begin, and she did not actually say that implementation will be delayed.

  • What you need to know for C. Frank Webber and Interim Session

    Tags: cme, interim session, tafp, leadership, c. frank webber lectureship

    It’s conference week! Whether you’re joining us for high-quality CME or to help develop policies to direct the Academy, we have all the information for you to have a great experience learning and interacting with TAFP and your colleagues. All events will take place at the Omni Austin Hotel Southpark; view more information on driving directions and parking below.

    If you have any questions or concerns this week, please call (512) 329-8666. For on-site assistance, find a TAFP staff person at the TAFP registration desk, or go to the Omni front desk for help locating a TAFP staff person.

    Here’s a quick rundown of events, with links to their detailed schedules:

  • Welcome to the all-new

    Tags: website, media, redesign, logo, aafp, tafp

    posted 02.21.12

    Here at TAFP headquarters, we are proud to introduce the completely retooled The new site features a host of interactive opportunities with the goal of engaging our members in all facets of what the Academy has to offer.

    At first you’ll notice that the site is much more graphically inviting, with lots of pictures to highlight various services, opportunities, resources, and news items of interest to family doctors. The home page is designed to introduce you to the site and welcome you to explore the various departments without overwhelming visitors with massive amounts of text and options.

  • Addressing primary care access begins with the workforce

    Tags: workforce, legislature, budget, medical school

    By now, it’s common knowledge that Texas faces a growing shortage of primary care physicians. We currently have approximately 18,000 primary care physicians to care for more than 25 million Texans, an unfavorable ratio that will worsen as fewer medical students choose to enter primary care fields and as the population continues to balloon at both ends of the age spectrum.

    In an op-ed published Feb. 10 in the Houston Chronicle, Sen. Jane Nelson, R-Flower Mound, wrote about this dire need to address primary care access in Texas, acknowledging that the non-emergency medical services and coordinated care primary care physicians provide for their patients has been shown to increase quality and efficiency, and lower costs.

    She has worked with TAFP and other stakeholders over the last decade to build the primary care workforce to improve the health of Texans and make health care costs sustainable for our state, and last session authored a comprehensive package of reforms to the state’s health care delivery system that aims to improve quality and efficiency in the health delivery system by testing and implementing various performance-based payment methods that provide incentives for improved patient outcomes.

  • A win for the patient-centered medical home

    Tags: quality, family physician, patient-centered medical home, payment

    WellPoint, the country’s second-largest health insurance company, is the latest industry leader investing significant funds into the patient-centered medical home. And while none of their 34 million enrollees are Texans, this still adds weight to the argument that spending more for primary care—upwards of $1 billion—will save money down the road.

    Starting this summer, WellPoint will pay primary care physicians more through an increase to their fee-for-service schedule of around 10 percent, by paying them for “non-visit” services currently not reimbursed (like preparing care plans for patients with multiple chronic conditions), and through shared savings payments for achieving quality outcomes and reducing medical costs. Meeting the shared savings goals alone could make a practice eligible to earn 30 to 50 percent more than they earn now for the same service.

    In addition to paying primary care physicians more, the company will enhance “information sharing,” provide care management support from WellPoint’s clinical staff, and incorporate best practices from their medical home pilots, the company said in a press release. In return, the physicians would have to meet additional requirements including expanded access for patients and maintaining a chronic disease registry.

  • Celebrating a year in the blogosphere

    Tags: membership, social media, communications, family physician

    Celebrating the one-year anniversary of the Texas Family Docs blog (give or take a few days), gives us the opportunity to reflect on how we’re doing and give you, our members, a preview of what’s to come.

    We launched on Jan. 10, 2011, with a goal to increase our connection with you and to encourage more interaction in the “post-health-reform era of rapid changes to the practice of medicine.” And we promised to share insights beyond our traditional news coverage on the issues you care about the most.

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  • Clinical integration: The case for getting involved now

    Tags: clinical integration, health care costs, autonomy, hospital, physician

    By Daniel J. Marino

    What is your reaction to the concept of clinical integration? If you are like most physicians I talk to, you are interested in the idea but wary of the many uncertainties that surround it. You may also have some reservations about getting involved with the local hospital. If you become clinically integrated, will you be able to maintain control of your own practice?

    One thing is clear: Doing nothing is not an option. Unsustainable health care cost trends are creating pressure that is simply not going away. All payers are pushing to reduce costs, and there is broad and deep agreement that greater coordination of care is the solution. Physicians who stick to the clinical models developed under fee-for-service reimbursement are going to suffer from steady fee schedule reductions.

  • Patient relationships are the treasures of family medicine

    Tags: texas family physician, president, balkcom, physician, patients, relationship

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

    It’s just a small, non-descript pin. Its cash value is minimal and if found in someone’s drawer, it would be summarily thrown in the trash while other more prized items would be saved. However, this pin is a treasure to me. I will guard this pin until my time on earth has passed. While cleaning out my drawer I’m sure someone will ask why I kept this.

    The middle of November found me attending a very special event for a young man of 17 years. Luke was receiving his induction as an Eagle Scout in the Boy Scouts of America. I had been honored to be chosen to attend the service, as I had attended to Luke since he was a very young child. His mother and father are patients of mine also and I silently cheered for them, beaming with pride at their son’s accomplishment.

  • 2011 Year in Review

    Tags: texas family physician, 2011, year in review, advocacy, communications, education, tafp foundation, members, leadership

    2011 was a year of new ideas, initiatives, and projects, and your Academy approached all with the same goal: to unite the family physicians of Texas, equip them with the tools to navigate a changing practice environment, and proactively advance the specialty of family medicine.

    By Kate Alfano

    From the start of the legislative session in January to the 10th ABFM SAM Group Study Workshop in December (and all events in between), TAFP members and staff stayed engaged in their mission. Read on for a review of happenings over the past year.

    Advocacy: Just two weeks after the start of the new year, the 82nd Texas Legislature convened, sending TAFP’s leaders, lobby team, and staff into high gear to advocate on behalf of family medicine’s top concerns: graduate medical education, scope of practice, and physician workforce. Compounding the session was a $4 billion deficit in the 2010-2011 biennium and a $23 billion shortfall for 2012-2013, which threatened all state-funded programs and any proposal containing a fiscal note.