Justin V. Bartos, MD, TAFP President

Report on the campaign to Take Back Medicine...

Be a role model • Be politically active • Expand your capabilities

We will need more recruits and a restocked war chest for TAFPPAC, our political action committee. Now is the time for you to step up. The future success of your practice will depend on it. There is a survey included on page 51 of this magazine that can also be found on the Web site, www.tafp.org. I strongly encourage you to complete it and send it to TAFP headquarters in Austin. The information we receive from you will be invaluable next legislative session.

The latest battle was waged in May before the House Committee on Insurance when many of the major players met to debate the medical liability crisis at the Capitol. One of my local representatives, Vicki Truitt, described it this way. First, the doctors got up and beat up on the attorneys; then the attorneys got up and beat up on the doctors. Then they both got up and beat up on the insurance companies. A local business leader who participated in the conversation asked the rhetorical question, “When will they all get on the same page?”

From other reports I received on the meeting this was probably a more optimistic description of how medicine faired than actually occurred.

The attorneys utilized the Institute of Medicine Report on medical errors in defending the current situation. They used the report to describe how the civil justice system is the only avenue to protect the public from the flawed and error-prone health care system.

The attorneys exposed the weaknesses of the Texas Board of Medical Examiners ability to investigate and follow through on complaints against physicians. They claimed the investigation and sanctioning process at the State Board of Medical Examiners was ineffective, using information that was highlighted in a recent exposé in the Dallas Morning News. They claimed that many cases that have merit are never resolved and the physicians involved continue to practice with their licenses intact. The rest of the story that they did not relate can be heard from the members of the State Board of Medical Examiners, who will tell you that the attorneys involved turn every investigation into a trial-like atmosphere. The burden of proof is so high that many complaints that may have merit cannot be resolved due to legal maneuvering.

The attorneys completed their attack by exposing supposed flawed decisions by the malpractice carriers, stating there were cases that should have obviously been settled out of court. They pointed to poor business and investment practices that resulted in losses for the companies forcing them to raise premiums. The carriers denied this was the problem and pointed to high loss ratios and high settlement costs for frivolous lawsuits.

After the hearing, many questions were left unresolved, but the legislators clearly understood that if left unaddressed, the mounting liability crisis will have devastating consequences to patients’ access to care. The unresolved question that legislators are now grappling with is what solutions will work to address the immediate crisis of affordable, accessible liability coverage as well as long-term solutions to the overall problem of lawsuit abuse.

BE A ROLE MODEL

Steve Garza, M.D., a family physician from Uvalde, attended the hearing and presented testimony on behalf of the TAFP. Steve lives in an area where all the family physicians have stopped or will soon stop performing obstetrics due to the untenable increases in malpractice premiums. Now patients face driving long distances for care. Steve told the story of how his malpractice premiums nearly tripled from the prior year when they were in the low $20,000 range. This increase eliminated any possible return for providing obstetrical care, because more than eight of every 10 deliveries in Uvalde is paid for by Medicaid. This situation ultimately led Steve and those covering physicians to discontinue their obstetrical practices. The closest physician performing routine deliveries is now over an hour away.

This is the story that I related to Rep. Truitt. When access to care is compromised, all other arguments become secondary. This is the issue that will push the Legislature to act. Don’t give up. Call TAFP legislative staff and relay your stories.

Physicians faired better at the prompt payment hearing in Fort Worth. Tim Coleridge, D.O., our parliamentarian, testified before the Senate Select Committee on Prompt Payment on the impact payment delays were creating for his department at the University of North Texas as well as a large independent practice association he manages. Tim, along with the members of the Tarrant County Medical Society, demonstrated why we must have statutory changes on the components of a clean claim and how expediently a claim should be handled, that cannot be overridden by contract. A representative from Aetna was present who by all accounts displayed the arrogance of the health plan for all to see. Senators Nelson and Moncrief had a great time pushing him to acknowledge the problems created by Aetna’s payment process.

BE POLITICALLY ACTIVE

Our political activity is increasing as we approach the upcoming elections. We had some startling results in the primaries across the state and one in particular in North Texas.

Organized Medicine supported the election of Judge Dale Wainwright to the Supreme Court over a better-known, better-funded trial lawyer candidate and Wainwright won. The more astonishing story was of Dr. Michael Burgess, an OB/GYN physician from Carrolton, Texas who won the Republican primary for the U.S. House of Representatives over U.S. House Majority Leader Dick Armey’s son. I know Michael and he will be a remarkable asset to Congress.

I also had the opportunity to participate in the TEXPAC Board of Directors meeting as an alternate director from my district. It was an incredible moment etched in time as a roll call vote was taken to determine the endorsement for governor in the upcoming election. Preceding the vote, more than 20 people expressed their views. Then the room was deathly silent as each director’s name was called and their voice vote was cast. “Yes,” “Yes,”  “No,” until the roll was complete.

Tony Sanchez won the endorsement by a substantial margin. Now it is time for our own TAFPPAC to meet. Mark your schedule to attend our TAFPPAC meeting Wednesday, July 10 at Annual Session. Contact Greg Herzog at (512) 329-8666 and give a monthly contribution to the PAC.

There is an old axiom in politics. It is the first thing any political science major ever learns. “Politics Drive Process Which Creates Policy.” We need PAC funds to offer campaign support and develop relationships with candidates across the state. With the post-redistricting turnover in the Legislature this year, we have more opportunities to develop important relationships with new members. The stakes for medicine are higher than they have ever been in my career, with the triple threat of malpractice reform, professional taxes, and managed care reform, not to mention a probable $5 billion deficit. Invest in your future and the future of medicine.

EXPAND YOUR CAPABILITIES

When you are practicing each day and you look into the eyes of your patients, they also look into your eyes and see the concern and passion you have for their well-being. You feel the contribution you make each day is valuable to society and to the overall health and security of our communities and our nation.

I need you to step out of your offices and meet the policy makers from your community, your state representatives and senators, and your U.S. congressmen and women. Tell them about your concerns for the future of medicine, particularly primary care. Tell them how malpractice premiums and excessive taxes will reduce the services you are able to provide or the number of Medicaid and Medicare patients you serve. Tell them your concern about where the elderly or indigent patients will receive care. Explain how you fear the continued deterioration of the public health system and the emergency rooms as they’re overrun with these patients. Explain that the outcome of their illnesses will be worse due to delays in treatment and cost more in the end. Tell them not to allow the fragile reimbursement system that provides care for these individuals to be undermined.

Those of you that have not been active, expand your influence within your community. As physicians we are looked upon as leaders in our communities. Use your talent. Develop new skills and participate. That is how those that wish to devalue us or manipulate us have succeeded. It is time for a counter attack.