FROM YOUR PRESIDENT

Why bother?

If not you, who? If not now, when?

By Erica Swegler, M.D., TAFP President

It was 4:30 p.m. on Thursday, Dec. 23. I had just finished seeing a 36-year-old man with significant left lower quadrant abdomen pain, although not an acute surgical abdomen. However, I wanted an urgent CT to confirm suspected acute diverticulitis, especially prior to a three-day holiday weekend, with the patient wanting to travel out of town. Had the patient presented to the ER instead of the office, he certainly would have had a CT performed. Even though I found a facility willing to do the CT for me (no small feat), I needed to have my staff obtain the dreaded “prior authorization.”

No problem. I could have an answer to my urgent request — in 4 hours! The patient and I certainly hoped to be home by then.

I had seen a patient in follow-up from an emergency room visit earlier that same afternoon. Calling for the ER records from the medical records department of the hospital where she had been seen and where I was not on staff, elicited a series of faxing release forms back and forth and waiting, with several follow-up calls by my staff to be able to get the desired information. No, the records department felt they could not just verbally give us the information we needed to proceed with care. Ah, the joys of HIPAA — a laudable privacy concept bogged down with thousands of pages of regulation. In this illustration, it left the patient frustrated and waiting. It also cost my office time and money.

What causes frustration for many physicians as they navigate their day? Seldom is it medical issues. Mostly concerns are voiced over regulatory issues from insurers, state and federal governments. Prior authorization, “physician education” programs to help you choose the most appropriate radiological test, CLIA, HIPAA, Medicaid and Medicare regulation, and possible fines for non-compliance are just a few of the things that top the “hassle factor” list.

How does one effect change in these regulatory arenas? One must get involved. The first step each of you reading this have already taken: you are the dues-paying members of your association, TAFP, which represents the voice of family medicine in an organized fashion, guided always by what will help us care for the patients we serve. I cannot stress how important your membership is. It allows us to have a very effective legislative department and a capable lobbyist in Tom Banning. Without Tom, Proposition 12 may not have seen the light of day, nor passed. Many of you were involved in voting for Proposition 12 and encouraging your patients to do the same via a grassroots campaign.

I ask you to continue your involvement. Many important issues will be on the docket during this legislative session: school finance, Medicaid, Sunset of the Medical Practice Act and workers’ compensation to name a few. Contact the TAFP. Let the staff know your areas of special interest and expertise. Volunteer to join TMA on “First Tuesdays” at the Capitol. Volunteer to be the Physician of the Day for the Legislature, where you’ll see the legislative staff and visitors who need care during the legislative session and you’ll be recognized on the floor of the House and the Senate. Write, e-mail or fax your state representative and senator when called upon through urgent faxes and e-mails from the TAFP. Your voice is tremendously important, because of the patients you care for, the patients you represent also when you speak.

If you are not one who wishes to do any of the above, consider additional support for TAFP’s work by contributing in the other way you can — financially. A donation to the TAFP Political Action Committee will allow us to continue to educate legislators in both non-legislative and legislative years. The PAC allows us additional access to the people involved in the political process. TAFPPAC is happy with your one-time contribution, but most helped by a monthly contribution on an ongoing basis charged to your credit card. Can we not all give up one fast-food meal? It would be beneficial to do so for all concerned. (I definitely have your good health at heart also!) Please consider carefully what is it worth to you to be out of the bleacher seats and onto the playing field — as a starter and a star.

To quote the Knights of Columbus: “If not you, who? If not now, when?” Or, to paraphrase others, “They (who must do something) are us.”

To get involved:

TAFP’s Key Contacts

The Academy’s Key Contact program seeks to identify family physicians who are willing to serve as a resource to their legislators, advocating the values of family medicine and the needs of the patients you serve. To participate, contact:

Paige Newman, (512) 329-8666 or pnewman@tafp.org.

Physician of the Day

As a service to the Texas Legislature, TAFP provides a

physician in the Capitol during the legislative session. To be the Physician of the Day, contact:

Paige Newman, (512) 329-8666 or pnewman@tafp.org.

TAFPPAC

The TAFP Political Action Committee speaks on behalf of family physicians and their patients through grassroots involvement and political campaign participation and contributions. Make the voice of family medicine heard in the halls of the Texas Capitol with your one-time or periodic donation today! To contribute to TAFPPAC, contact:

Tom Banning, (512) 329-8666 or tbanning@tafp.org.

TAFP Foundation

Help advance the specialty of family medicine through the support of medical students and residents and the funding of research related to the specialty by contributing to the TAFP Foundation. For information and to donate, contact: