By Laurel L. Williams, DO
Medical Director, Centralized Operational Support Hub
Texas Child Mental Health Care Consortium
Clinical vignette: It’s 3 p.m. on a busy Thursday. Kevin and his mother zoom into your office for the third time in six weeks. Today’s chief complaint is stomach pain and mild diarrhea. Kevin is 9 years old and has had some stomach issues in the past. Mom has been reading up on COVID-19 and heard that children more often present with stomach versus respiratory symptoms. The history does not really fit COVID-19 and you are starting to wonder about anxiety. But how to talk with mom without looking like you are brushing off the COVID concern? You wish you had a child psychiatrist on speed dial.
What’s faster than a pizza delivery and better for your physical and emotional well-being? The new state-funded Child Psychiatry Access Network at (888) 901-2726.more
The 2020 CFW Resident and Student Track was canceled due to the COVID-19 pandemic, but the Section on Resident Physicians and Section on Medical Students still held virtual elections for various officer positions. The following are the 2020-2021 resident and student officers.
Section on Resident Physicians
By Scott Finley
Manager of Media Engagement, Texas Alzheimer's Association
The Alzheimer’s Association in partnership with the TAFP and the University of North Texas Health Science Center is presenting a live CME event on Wednesday, June 17 from 6 to 7 p.m. The event is titled “Family Physicians and Early Detection of Cognitive Impairment and Alzheimer’s Disease.”
Dr. Mary Quiceno will be our speaker in the webinar. Dr. Quiceno is a board-certified neurologist affiliated with William P. Clements University Hospital and University of Texas Southwest Medical Center, where she is the Director of the Memory Disorders Clinic. She has held steering committee positions on national consortia, and she has served as investigator for the Alzheimer’s Neuroimaging Research Initiative/ADNI and the Texas Alzheimer’s Research and Care Consortia/TARCC. She is appointed to the Texas Council on Alzheimer's Disease and Related Disorders. At the Alzheimer’s Association, she is vice chair of the Medical and Scientific Research Committee for the Dallas and Northeast Texas Chapter.more
By Jean Klewitz
TAFP sent letters to Texas congressional lawmakers in support of legislation introduced to the House and Senate that has the potential to add 15,000 physicians to the pandemic-strained physician workforce. The letters were signed by TAFP President Javier Margo Jr., MD.
Earlier this month, AAFP put out the call for state chapters to join in the academy’s efforts to advocate for this legislation. The letters from TAFP went to Texas congressional lawmakers in the House and Senate regarding the Healthcare Workforce Resilience Act, H.R. 6788 and S. 3599. “This legislation is a good, incremental, step to address an immediate need presented by the COVID-19 pandemic," the letter said.more
By Scott Finley
Manager of Media Engagement, Texas Alzheimer's Association
Right now, 5.8 million Americans are living with Alzheimer’s disease and related dementias. By 2050, this number is projected to rise to nearly 14 million. In Texas, this amounts to over 400,000 Texans currently living with Alzheimer’s disease and related dementias with an expected growth of more than 20% by 2050.
The Alzheimer’s Association is partnering with TAFP to provide a variety of resources to support family physicians throughout the disease continuum, including early detection and diagnosis of Alzheimer’s and related dementias, management of these conditions, and care planning and support services following a diagnosis.more
By Antonio Barksdale, MD
As providers, particularly primary care providers, it is becoming more and more vital to establish a positive and strong rapport with every patient. This rapport fosters trust, openness, and ultimately yields better compliance along with improved outcomes. How is this rapport established? How do we get patients to trust us? How do we get patients to listen? How do we improve compliance? And how do we improve patient satisfaction scores?
There is a slew of research on these topics and we have an entire team in our organization to address the last question. The one thing I’d like to highlight in this article is being mindful of how we are communicating and what messages we are sending beyond the surface of our words. We’re communicating all day. We greet, we ask, we explain, we plan, we disclose, we lecture, we theorize, we talk about numerous things with our patients. Patients however only hear a portion of what is being said. To some providers, this can be disconcerting and frustrating. After all, we’ve invested our time, expertise, energy in order to tell the patient something beneficial, so they should readily scoop it all up ... right? Research shows that patients only grasp 20-60% of the information spouted at them, depending on the type and complexity of the information.more
The best laid plans of mice and men
By Javier “Jake” Margo Jr., MD
I don’t know about y’all, but man, I have really been looking forward to this summer because there’s been something special on my calendar — something I have always wanted to do since I attended summer Scout camp back when I was a kid. For the first time since I became a Scout, I have plans to attend Boy Scout summer camp for an entire week, this time as a counselor! It happens to be at the longest continuously operating Boy Scout camp in Texas, the same camp my grandfather and my father went to, and the same one my son attended as a Cub Scout.
And I also have on my calendar a plan to take my family for a half week of amazing fun at the Boy Scouts of America Family Adventure Camp at the world famous Philmont Scout Ranch in New Mexico. That’s right. I have a plan to introduce my family to one of the BSA’s four high adventure bases. Attending this camp is widely regarded as a pinnacle experience in scouting, particularly by those of us who were fortunate enough to have attended as Scouts.more
Funding opportunity applications due June 26
Once a year, family medicine residents and medical students come together to engage in real talk about family medicine with family medicine leaders, educators, and recruiters at the National Conference of Family Medicine Residents and Medical Students. This year, National Conference is going virtual. From July 30 to August 1, you can attend 11 hours of education with workshops and main stage speakers. All sessions will be recorded, and registrants will have online access to the recordings for 30 days. The popular Expo Hall will be broken into “floors” so you can find the residency programs and exhibitors you are most interested in. You can schedule one-on-one appointments with residency programs, recruiters, and other exhibitors. You can also network with fellow attendees.
With the move to virtual for this year, the price tag to attend is much lower and there are more opportunities for financial assistance if you act fast.more
Practical solutions for today’s and tomorrow’s family physicians
Fourteen chapters of the AAFP have joined forces to develop a three-part webinar series to recognize that in the midst of chaos, family physicians have a unique opportunity to harness and forge their own financially successful practice management path.
The primary goal of the series is to provide family physicians and their practice teams high-value education on critical practice management issues during this time of unparalleled crisis in American health care. By learning to be nimble and adapting to change, practices are capitalizing on innovation like never before — hear how a few family medicine practices are thriving.more
By Tom Banning
There is no question that the COVID-19 pandemic has created unprecedented financial pain throughout our health care system. Primary care physicians have seen a drop in patient visits of more than 50%, specialty physicians have seen patient volume evaporate, and hospitals are burning through cash as patients avoid going to the emergency room and non-urgent surgeries and other elective procedures that make up the bulk of hospital revenue have been canceled.
In a Stateline article this week, The Pew Charitable Trusts warns of the “possibility that the non-hospital health system will be decimated, and many of the surviving providers will be ill-prepared to deal with the pent-up demand that emerges from this crisis.” They predict a near future rife with acquisitions and mergers for independent physicians unable to survive months with no revenue.more
By Brian Justice
UPDATE: As of April 16, 2020, the Small Business Administration reports the funds for the PPP loans and EIDL advances have run out. Congress is considering appropriating another $2.5 billion so for now, the program is suspended. We will let you know as soon as we know more. https://www.sba.gov/disaster-assistance/coronavirus-covid-19
The devastating economic impact of the coronavirus pandemic is being felt by medical practices across the country, but help is supposed to be available through the Coronavirus Aid, Relief and Economic Security Act (CARES) for small businesses. The Small Business Administration will oversee the distribution of millions of dollars in grants and loans through the Paycheck Protection Program (PPP) and Economic Injury Disaster Loan (EIDL) Grants to help small businesses, like your practice.more
By Christopher Crow, MD, MBA, President of Catalyst Health network and Tom Banning, CEO of Texas Academy of Family Physicians
Following the devastation of World War II, the United States enacted the Marshall Plan to rebuild a heavily damaged Europe. Our war against this novel coronavirus is far from over, but it is already wreaking havoc on the nation’s primary care workforce. Our frontline health care providers are putting themselves at risk every day without proper personal protective equipment while community-based primary care clinics are facing economic disaster.
We need a Marshall Plan for our primary care and public health infrastructure.more
By Tom Banning, TAFP CEO
Hello to all, from TAFP headquarters in Austin. I want to share with you a resource that I hope you find helpful.
TAFP hosted an interactive webinar on business continuity during COVID-19 on March 31, 2020. We leaned on accounting and practice management experts at Catalyst Health Network who have designed a customizable, multivariable dynamic financial model that allows physicians to run scenario analysis on their practice’s financial health.more
By Kathy McCarthy, TAFP COO
When TAFP was formed, the membership was largely homogenous. Not just in demographics, but in practice setting. Over the years, that has changed and while many members still own small practices, they are no longer the majority. The day-to-day practice of a family physician member of TAFP is varied, with some in larger groups with no ownership stake, some working in ERs and urgent care, some at FQHCs and public health clinics, some working as hospitalists, some focusing on providing palliative care, and, of course, some educating the next generation of family physicians. With that variety amongst our members, we know that the effect of COVID-19 pandemic on our membership is also varied.
There are some common threads that likely resonate with you. As scientists you are working to understand the virus and reading all you can. As physicians you are concerned about your patients and working on strategies to continue caring for them, often with limited PPE. As mothers and fathers, daughters and sons, sisters and brothers, you worry about your family – especially those who are more vulnerable. As leaders in whatever setting you practice, you worry about your health care team. You watch with alarm the percentage of the coronavirus positive cases who are health care providers, here and in other countries. If you are a parent of school-age children, you are scrambling to figure out how to keep them engaged and learning at a time when schools are closed with many are not reopening this term. You feel the loss of not being able to gather at churches and other community events.more
By Jonathan Nelson
The second episode of our brand-new podcast, Texas Family Doc Talk, is out and it’s all about telemedicine. As family physicians across the country see their number of patient visits plummet, many are turning to telemedicine in hopes of providing consistent, comprehensive care to their patients while maintaining enough cash flow to keep the doors open.
In the podcast, TAFP CEO Tom Banning and I speak with three experts from Catalyst Health Network in Dallas. Jeff Bullard, MD, chief medical officer for Catalyst, describes the experience of transitioning to virtual care. Trevor Clifton, senior financial analyst for StratiFi Health, discusses financial models for moving most of your visits to telemedicine. And Stephenie Tollett, director of revenue cycle for StratiFi Health, talks with us about third-party contract and claims payment issues for telemedicine.more
By Jonathan Nelson
Being locked up in my isolation chamber has its upside. Boredom, it turns out, is the mother of invention. (Thanks, Plato.)
So guess what? Today we watched about 40 YouTube videos and now we know how to make a podcast!more
By Lesca Hadley, MD
On the second day of a spring break medical trip in the mountains of Guatemala, an 87-year-old patient led carefully by her great grandson’s wife entered the schoolroom where I was seeing patients with a UNTHSC medical student, a nursing student, and our Spanish translator. She couldn’t have had another wrinkle on her wizened face. She lived alone on the edge of her village near fields of corn. Everyday she walked her route, selling milk she got from her neighbor to the families in town.
She had delivered milk the previous day, but on this day, she was too weak to stand without help. She had a temperature of 99.5, and she felt hot. Her productive cough was audible. She trembled as our small interprofessional team began to examine her, gently raising her clothing. This was her first time to see a doctor.more
After careful consideration, TAFP leadership has decided to cancel the C. Frank Webber Lectureship and Interim Session along with all associated meetings. The health of our members, your patients, and your communities are our top priorities, and keeping you healthy and available to care for others is paramount.
TAFP will issue full refunds to all registrants over the next one to two weeks. If you made a hotel reservation to attend the conference, please contact the hotel at (512) 343-2626 to cancel.
At this time, we expect to host the Texas Family Medicine Symposium in San Antonio as planned, June 5-7, 2020. We will continue to monitor this evolving situation and we will quickly inform you of any changes.more
A celebration of family medicine: How Disney literally saved my life
By Javier “Jake” Margo Jr., MD
A couple of summers ago, on a rare day off, I was working on a detailed email advocating to keep the electricity on for our not-for-profit community center, when my son James, who was 7 at the time, walked into my office — or as my Harry-Potter-centric friends have dubbed it, the “Room of Requirement,” because anything you need can be found there.
He and I were the only two people in the house since my daughter, Ella, was at Girl Scout Camp and my wife, Lisa, was at work. He had given up trying to teach the cats play catch when he walked in, stopped just short of my elbow, stared silently with his big brown eyes, and asked, “Daddy, will you play with me?”more
Lessons learned: A conversation with Clive Fields, MD, of VillageMD
By Jonathan Nelson
In late February, a patient came in to Village Medical in Houston for her annual exam. She had just returned from Egypt. She presented with mild respiratory symptoms and received appropriate treatment. Three days later, she was notified that some of her travel companions had tested positive for COVID-19. Village Medical referred her to the health department, which in turn referred her to the emergency room where she was hospitalized. Four days later, the CDC confirmed the patient had the new coronavirus. The family physician and nurse who cared for her are now quarantined at home for 14 days and others who came in brief contact with her are being monitored for symptoms, including persistent fever.
The experience has caused Clive Fields, MD, chief medical officer and co-founder of VillageMD, to think a lot about how the country’s frontline physicians should be prepared to handle this potential pandemic.more
As more cases of COVID-19 are confirmed, family physicians should focus on preparation and prevention. Patients will likely have questions and concerns, and you may experience an increase in patients with respiratory symptoms. Now is the time to prepare yourself and your practice for the possibility that the virus will spread. TAFP will share resources as this situation evolves.
The Texas Department of State Health Services COVID-19 resource page for health professionals includes criteria to guide testing for persons under investigation, a health care professional preparedness checklist, and information about personal protective equipment.
The Centers for Disease Control and Prevention has established a site to house information about the virus as it is discovered.more
Want to go to the AAFP Leadership Conference this year? We are seeking applicants for our scholarships to attend AAFP’s National Conference of Constituency Leaders and Annual Chapter Leader Forum, April 23-25, in Kansas City, Missouri.
TAFP offers scholarships for one third-year resident and one minority physician to attend NCCL, as well as two future leader scholarships for members to attend ACLF. Applications are due February 7, so act soon!more