Douglas Curran, M.D. of Athens addresses the press at the Capitol

Primary care group tells legislators: Access to care fading fast

Two TAFP members joined other representatives of the Primary Care Coalition at the state Capitol in early February as they released a report outlining dangerous trends in Texas’ medical practice environment. The report, entitled “Fading Away, Access to Primary Care: Flirting with Disaster,” describes converging factors that they say threaten the state’s physician workforce, including declining reimbursements, dramatic hikes in liability insurance premiums and increasing dependence on Medicare and Medicaid due to a sagging economy.

TAFP members Roland Goertz, M.D., of Waco and Douglas Curran, M.D. of Athens were among the presenters at the press conference.

“Texas’ health care delivery system has reached a critical juncture,” said Goertz, a past president of TAFP and the current chair of the Texas Higher Education Coordinating Board’s Family Practice Advisory Committee. “When you combine the soaring administrative costs of running a practice, including unsustainable increases in professional liability insurance, with the slow-pay, no-pay tactics employed by health plans, you’ve got a small business nightmare.”

“I really like what I do,” said Curran, a recent TAFP Physician of the Year, “but we’ve got to get to a point where we can survive.” Curran told reporters from several of the state’s newspapers that the future of rural health care in Texas could soon resemble the television show “Gunsmoke.” “If there is a physician in the area, you can get care. And if there’s not, people will have to go without.”

March meeting

Report from TAFP Interim Session

On March 7, 8 and 9, family physicians, residents, medical students, nurse practitioners, physician assistants and others gathered for an exciting weekend of CME, TAFP business and more. Each year TAFP produces a one-day CME program, called the C. Frank Webber Lectureship, in conjunction with the interim meeting of TAFP’s committees and the Board of Directors. For the last 13 years, TAFP has added on a conference designed for family practice residents and students. The conference was held just north of Austin at the Austin Marriott North in Round Rock.

The C. Frank Webber Lectureship kicked off at 7 a.m. this year with a breakfast CME lecture. The education continued all day, culminating with a dinner lecture, which ended at 7:30 that evening. In all, there were 11.5 hours of accredited CME with all meals included in the low TAFP member registration fee of $25. A total of 287 people registered for the conference, far surpassing all previous years. Speakers from across the country lectured on topics including asthma, sleep disorders, depression and bacterial resistance.

TAFP President, Robert Hogue, M.D., and the TAFP Executive Committee got the business meeting started Thursday night and there were a few meetings on Friday, but most of the business was conducted on Saturday. It was a long and productive day, beginning with several meetings, including the Section on Rural Physicians, at 7 a.m. and ending with the adjournment of the Board of Directors at 10:30 p.m. Throughout the day, the looming state budget crisis was a main topic of discussion. Just before the meeting, it was announced that the projected state budget shortfall would be larger than anticipated. Discussion of the latest proposed budget for the Texas Higher Education Coordinating Board, which included reduced funding for residency programs and no funding for the Texas Statewide Family Practice Preceptorship Program, led the Commission on Academic Affairs to collect names on a petition to save the preceptorship program. The rest of the weekend, in committee and commission meetings, in the Board of Directors meeting, and in the student and resident conference, members rose to speak of the importance of the program. TAFP collected the lists of names and brought copies to members of the House Appropriations Committee and the Senate Finance Committee on Monday.

TAFP members in attendance at Interim Session left the meeting charged to do their part and contact their legislators to save graduate medical education and Medicaid and CHIP, which were also targeted for serious cuts in an attempt to balance the budget. In the days following Interim Session, e-mails were sent to members about these issues. You can read more about the budget crisis and other legislative issues in the Legislative Update.

The Texas Conference of Family Practice Residents and Students was held March 8-9. It was a record-breaking year with 90 registrants for the conference. The students and residents were honored to have the president of the American Academy of Family Physicians, James C. Martin, M.D., and the student member of the AAFP Board of Directors, Marc Carey, Ph.D., on hand for the conference. Lecture topics included parliamentary procedure, how to get out of debt and an introduction to TAFP. Saturday evening the group broke into two tracks and the residents learned about negotiating employment contracts while the students learned about choosing between residency programs. Sunday morning an active open forum was led by Carey along with some of Texas’ student and resident leaders — Cliff White, Janet Hurley, M.D., Andrew Mills, M.D. and Jake Margo, M.D. The conference ended with Dr. Martin talking about the Future of Family Medicine project.

Texas mourns deaths of two San Antonio FPs

Dr. John M. Smith, Jr. passed away on March 16, 2003 in San Antonio, Texas. Dr. Smith was a graduate of North Texas State University and Tulane University School of Medicine. He joined the U.S. Army Medical Corps in 1942 and worked at a tent hospital on the beaches of Normandy. He also treated casualties from the Battle of the Bulge. After the war, Major Smith married Jane Jordan of Victoria, Texas and established a private practice in San Antonio. Dr. Smith became a very active member of the medical community. As well as his service to the TAFP, he held leadership positions in the Bexar County Medical Society, Texas Medical Association, San Antonio Medical Foundation, Texas Medical Foundation, American Medical Association PAC, Texas State Board of Health, and Texas Medical Association Board of Trustees. His honors include: Most Outstanding Citizen of San Antonio, Distinguished Service Award of the American Medical Association, Distinguished Service Award of Texas Medical Association, The Golden Aesculepesis Award of the Bexar County Medical Society, and the C.D. Taylor Award of the Tulane University Medical School. Dr. Smith was well loved in his 55 years of practice and is survived by his four children and nine grandchildren.

Dr. James A. Baros died on Feb. 27, 2003 in San Antonio, Texas at the age of 79. Dr. Baros enlisted in the U.S. Air Force and worked as a navigator on a B-52 bomber during World War II. He was awarded the Arial Combat Certificate of Valor for his military service. In 1948, he graduated from Texas A&M University and entered the University of Texas Medical School at Galveston. He married Estelle Rother and ran a family practice in San Antonio for 49 years. He was a member of the Bexar County Medical Society, Texas Medical Association, American Medical Association, and American Academy of Family Physicians as well as TAFP. He was also the Chief of Staff of the Baptist Memorial Hospital System in 1973. Baros, or Dr. Jimmy as he was known, was also a full-time rancher who developed championship show cattle in Moulton, Texas. He is survived by his wife of 53 years, six children, and 11 grandchildren.