Health care reform in the United States
By Kim D. Slocum
President, KDS Consulting, LLC
Three years ago, I was interviewed for an article in Texas Family Physician entitled “Payment reform—The next step toward an efficient high-quality health care system.” At that time, I said that the United States would see one of three futures for health care: one based on rapidly escalating consumer cost shifting, one making significant use of price controls, or one focused on measuring and rewarding “value.” So, where do we stand in early 2015 and what can we expect next?
At the moment, the concept of shifting costs to consumers is in high gear. The passage of the Medicare Modernization Act of 2003 created an opportunity for employers to move to high deductible health plans, which it was presumed would turn consumers into “happy economists” who would diligently study cost and quality ratings for various medical services, come to medical encounters fully prepared to argue the merits of each recommendation with their physicians, and only receive care that would optimize their clinical outcome.more
April 30 – May 2, 2015 | Kansas City, Missouri
By Christina Kelly, MD
The American Academy of Family Physicians National Conference of Constituency Leaders will be held April 30 - May 2, 2015 (with a preconference on April 29) in Kansas City, Missouri. This is the AAFP’s premier leadership and policy development event for underrepresented constituencies, which includes new physicians (physicians in their first seven years of practice), women, international medical graduates, GLBT, and minority constituencies.
At this leadership meeting, we gather every year for a purpose. We gather to: learn about how we can make a difference for our patients and our specialty, inspire each other to advocate, lead the way to action, and challenge our colleagues to join us in our efforts. A variety of issues are discussed at this meeting, such as patient barriers to quality health care that you want the AAFP to address, challenges within a variety of practice settings that you want fixed, or changes that need to occur to continually improve family medicine.more
Travis Bias, DO, DTM&H
In middle school, I aspired to become a DJ. Because this required me to take the least amount of math. Despite this original goal, I started my time at Southwestern University as a pre-med student and headed to UNTHSC Texas College of Osteopathic Medicine to begin my medical education. A career as a physician stood perfectly at the intersection between intellectual challenge and service to others.
I was drawn into medicine to make a difference. The calling of a medical career can be heard as young as 18. It requires determination, a selfless heart, and compassion no matter the situation. Between the ages of 22 and 26, however, a young physician-in-training must decide which specialty he or she would like to be practicing from age 30 until retirement. This decision shapes career options and powerfully influences the future lifestyle, and thus capacity for relationships, growing a family, and personal balance and well-being. This choice in path, like in other careers, also affects potential lifetime income. Thus, specialty choice is not to be taken lightly, especially given the growing burden of educational debt that young medical graduates face.more
By Dale Ragle, MD
TAFP President, 2014-2015
Welcome colleagues to a new year, a new Congress, and a new Texas Legislature. On all fronts, health care is evolving. These changes present family physicians tremendous opportunities to shape our future health care system. It’s up to all of us as family physicians to advocate for our specialty in the halls where decisions are made that affect our patients and our practices.
In Washington, D.C., the 114th Congress is well under way and is busy on a number of health care issues. AAFP’s advocacy work is focused on fixing Medicare’s broken payment model, changing Meaningful Use requirements, delaying ICD-10, and reforming graduate medical education funding. Another area in which AAFP is concentrating efforts is in making payment for direct primary care services a qualified health benefit under IRS rules. This would enable patients to pay for direct primary care with pre-tax HSA and FLEX account dollars, a move that would aid the expansion of this emerging and promising model of practice.more
Thank you for registering for TAFP’s 2015 C. Frank Webber Lectureship. We look forward to seeing you later this week at the Omni Austin Hotel at Southpark. Below is some information about the conference. If you have any questions or concerns, please call (512) 329-8666 or e-mail firstname.lastname@example.org.
Thursday, March 5 | 12:30 - 7 p.m.
Friday, March 6 | 6 a.m. - 7 p.m.
Saturday, March 7 | 6:30 a.m. - 4:30 p.m.
By Blair Cushing
Fourth-year TCOM student
As a fourth-year medical student, I have spent the past four years highly concerned about what fate would await my classmates and me on Match Day, which is now only a few weeks away. With each passing year, the number of graduating medical students has climbed while the number of available first-year residency positions has remained stagnant. It is anticipated that in 2016, Texas medical schools will graduate 100 more doctors than available residency positions in the state. With three new medical schools expected to matriculate their first classes that fall, this number could easily rise to over 350 by the year 2020 in the absence of any new investment in graduate medical education.
Despite Texas being one of the few states that currently uses state tax dollars to support GME, the dollars have not kept up with the need and more importantly, a flawed funding formula has prevented this money from being used in ways that align with the health care needs of our population. Fortunately, the 84th Texas Legislature affords us a unique opportunity to reform the way GME dollars are allocated in Texas.more
Hey Texas medical school students, have you been eagerly awaiting the open enrollment period of the Texas Statewide Family Medicine Preceptorship Program? Well wait no more. We are currently accepting applications, so tell your friends and sign up today.
Our preceptorship program offers medical students the chance to break out of the academic setting and see what medicine is really like when it’s practiced in the community. By spending two to four weeks with a practicing family doctor, they can experience the joy and fulfillment of a career caring for patients who are friends and neighbors. They find out that family medicine isn’t just about running on the hamster wheel and treating runny noses and sore throats all day.
Sure we have survey results that show when medical students complete rotations in the Family Medicine Preceptorship Program, they are more likely to choose a career in family medicine, but the family doctors who cherish the memory of their rotations tell the story better.more
Working to improve Texans’ access to health care in the 84th Texas Legislature
By Anna Chatillon
Policy coordinator for the Texas Women’s Healthcare Coalition
The Texas women’s Healthcare Coalition, of which TAFP is an active steering committee member, is a coalition of 47 health care, faith, and community-based member organizations. We are dedicated to improving the health and well-being of Texas women, babies, and families by assuring access to preventive health care for all Texas women. Access to preventive and preconception care—including health screenings and contraception—means healthy, planned pregnancies, and early detection of cancers and other treatable conditions. The TWHC was formed in response to the devastating legislative budget cuts to women’s health care in 2011.
Now that the prior level of funding has been restored, it is clear the restoration was only the first step toward ensuring that all women in Texas have access to the preventive care they need. Even now, only three in 10 women who need publicly funded health care have access to it. Texas desperately needs to appropriate more funding for women’s health care in the next legislative session. The consequences of failing to provide women access are too high, both in human costs and in financial implications, for Texans to accept.more
By Brad Wiewel
The Wiewel Law Firm
Asset protection is something that many physicians, including family physicians, don’t focus on until they have been threatened with a malpractice lawsuit. I know, because I have had more than my share of telephone calls from frightened physician clients wanting to know if it is too late to do the planning I recommended when we met at my office to discuss their estate plans.
Unfortunately, the answer is, “It’s almost always too late.” You must plan to protect your assets from being taken before a claim against you is pending, expected, or threatened.more
By Lloyd Van Winkle, MD
For years, we’ve been hearing about the decline — even death — of the small primary care practice, but I’m here to say that obituary is premature, if not flat-out wrong. When a recent study published in Health Affairs touted the value of small practices, I didn’t need convincing. I’m a small practice owner and have been for nearly 30 years.
The study found that primary care practices with one or two physicians had one-third as many preventable hospital admissions compared to practices with 10 to 19 physicians. The study also reported that smaller practices achieved their impressive results despite caring for a higher percentage of patients with chronic conditions than larger practices.more