Report on the 2008 Leadership & Legislative Conference
TAFP members learned how to advocate effectively for the specialty
A group of current and future TAFP leaders gathered in Austin Friday, Aug. 15 and Saturday, Aug. 16 to hone their leadership and legislative skills in preparation for the upcoming 2008 election cycle and 81st Texas Legislative Session.
The conference began Friday night with dinner and a discussion on the current state of health care policy by Kim Ross, a political jack-of-all-trades who has acted as a lobbyist, health policy analyst, grassroots specialist and media authority over the course of his career. Ross told the audience that family medicine has the opportunity to step up as the voice of medicine because of increasing emphasis on the value of primary care and the medical home.
“It is my personal opinion that primary care advocates should lead this debate,” Ross said. “Everyone is going to be looking at [family physicians], and when you do step up, you may incur some fire.”
Saturday’s lectures armed physicians with the tools to “fight the fire,” beginning by viewing the TAFP Advocacy in Action video, “Doctor’s Orders: A Survival Guide for Family Physicians.” The conference continued with Ross’ Lobbying 101 seminar. In this discussion, he emphasized that relationships are key, whether they are organic—built before the legislator earned his or her office—or homegrown—built over time through contributions of time or other resources. One of the most important lessons attendees learned was to stay within their expertise as physicians. Lobbying doesn’t mean having a comprehensive knowledge of fiscal impact. Rather, physicians can more effectively state their case by expressing what they know: How would this issue affect your patients and practice? The Academy is also available to provide resources, talking points and additional lobbying tips.
Alfred Gilchrist, CEO of the Colorado Medical Society and former TMA legislative director, continued the morning lectures by speaking on the “art of the possible.” He gave an account of the medical society’s work in Colorado to secure the nation’s first standardized contract legislation and protect Colorado liability reform. He again emphasized the physicians’ role in meeting with local legislators before the legislative session to obtain their commitment to medicine.
Two prominent media experts, Harvey Kronberg of the online political journal Quorum Report and Dave McNeely of the University of Texas at Austin School of Journalism, gave their tips on interacting with the media. Kronberg advised attendees to think in 20-second “sound bites” and avoid medical jargon that could be misinterpreted after the interview. McNeely warned attendees not to “get in a fight with someone who buys ink by the barrel,” stressing that relationships with the press can be powerful and beneficial with proper preparation and respect.
The final exercises of the day allowed physicians to lobby and attend a mock hearing at the Capitol. Split into four groups, attendees discussed graduate medical education, liability, Medicaid reform and managed care issues. Each group chose representatives to “lobby” the speakers, representing legislators and their staffs. From these mock situations, physicians learned to maintain their demeanor, even in challenging circumstances; make succinct points using facts and personal experience; and to not threaten, promise or negotiate on points of high tension.
At the hearing, physicians appeared before a panel of legislators, played by Gilchrist, TAFP lobbyist Marshall Kenderdine, TAFP CEO Tom Banning and former TMA lobbyist Connie Barron. One physician from each group appeared before a House committee to state their case. From this exercise, physicians again learned that effective testimony uses personal experience and facts to craft the family medicine message.
Attendees left the conference armed with tools to make a difference as advocates for the specialty. Two ways all TAFP members can become more active is by signing up for the Key Contacts program, which allows physicians to make use of existing relationships with legislators or volunteer to cultivate new relationships, and the Physician of the Day program, which brings a physician to the Capitol each day during the legislative sessions to staff the Capitol Health Clinic. For more information on Key Contacts, Physician of the Day, to view Doctor’s Orders advocacy video or to read more about TAFP’s advocacy efforts, visit the Advocacy section of the TAFP Web site, www.tafp.org/advocacy.
Mabry elected to be AAFP Speaker
Leah Raye Mabry, M.D., R.Ph.
Leah Raye Mabry, M.D., R.Ph., of San Antonio was elected to serve as AAFP Speaker of the Congress of Delegates at the Academy’s meeting in San Diego. The Speaker presides over the AAFP Congress, the AAFP’s policy-making body. Its membership consists of two delegates from each constituent chapter as well as special constituency representatives. When in session, the Congress hears reports from AAFP officers, resolutions from chapters, and reports from the Board of Directors and commissions.
A longtime leader on the state and national levels, Mabry has served as AAFP Vice Speaker since 2005, is a TAFP Past President, a past recipient of the TAFP Family Physician of the Year award, and served three consecutive two-year terms as one of TAFP’s delegates to AAFP.
Mabry is chief of staff at CHRISTUS Santa Rosa City Center Hospital in San Antonio and the associate director of their family medicine residency program. She is also a clinical associate professor in the Department of Family Medicine at the University of Texas Health Science Center in San Antonio and a fellow at the Faculty Development Center in Waco. She received her medical degree from the University of Texas Health Science Center at San Antonio and completed a residency at Bexar County Medical Center Hospital.
Goertz announces candidacy for AAFP President-elect
Roland Goertz, M.D., M.B.A.
Roland Goertz, M.D., M.B.A., of Waco officially announced his candidacy for AAFP President-elect at the AAFP Scientific Assembly in San Diego. The election will take place at the 2009 meeting in Boston. Goertz currently serves on the AAFP Board of Directors and has served in various leadership roles within TAFP and AAFP, including as TAFP president in 1995.
Currently, Goertz is the CEO of the three foundations that oversee all operations of the Waco Family Health Center and also serves as chair of the Family Medicine Residency Advisory Committee of the Texas Higher Education Coordinating Board. During his medical career, he has held several leadership roles within family medicine residency programs and medical schools.
Goertz was awarded his medical degree by the University of Texas Health Science Center at San Antonio Medical School and completed a family medicine residency at John Peter Smith Hospital in Fort Worth where he served as chief resident during his last year of training. Goertz also completed a clinical teaching fellowship in family medicine and received a master’s in business administration from Baylor University.
TMA appoints family physicians to leadership posts
Two faculty members with the Austin Medical Education Program were appointed to positions within the Texas Medical Association. Dana Sprute, M.D., was re-elected to the council on public health for a three-year term and David Wright, M.D., was appointed to the council on medical education for a one-year term.
Jonathan MacClements, M.D., of Tyler is the newest member of TMA’s Committee on Physician Distribution and Health Care Access, established to help identify needed improvements to the state physician education loan repayment. He joins Chair Troy Fiesinger, M.D., of Conroe; Donald D. Cole, III, M.D., of Austin; D. Michael Ready, M.D., of Temple; Peter Valenzuela, M.D., M.B.A., of Odessa; Robert Young, M.D., of Amarillo; and resident Eddie J. Turner, Jr., M.D., of Houston.
Lloyd Van Winkle, M.D., of Castroville has been appointed to serve a one-year term on the TMA Committee on Rural Health. This committee works toward the improvement of rural health, reviews and comments on governmental laws and regulations that have an impact on rural practices, and educates physicians and the public about the concerns of rural medicine.
TAFP local chapter news
September meetings address hot topics in family medicine
Two TAFP local chapter meetings in Harris County and Travis County drew attention to current issues facing the specialty and brought in experts to address the audience.
The Travis County AFP held a meeting on Sept. 8. The group of 50 heard a report on the upcoming legislative session from TAFP CEO Tom Banning as well as how members in Austin can get involved in TAFP’s advocacy efforts. Roland Goertz, M.D., M.B.A., of Waco, laid out the background and information on the patient-centered medical home model supported by AAFP. The audience asked questions about the medical home, including how physician payment could function under the model.
On Sept. 10, the Harris County AFP held a panel discussion on the uninsured anchored by Edward Langston, M.D., chair of the American Medical Association’s Board of Trustees. The audience of 120 had the opportunity to ask Langston and other panel members—HCAFP President Ashok Tripathy, M.D., Texas Delegate to the AMA Art Klawitter, M.D., Chair of AAFP’s Delegation to AMA Dale Moquist, M.D., and Banning—questions about this and a variety of topics. Other questions ranged from payment reform for primary care to retail health clinics.
Annual Session displays the art of family medicine
Story by Samantha Peek | Photos by Jonathan Nelson
More than 350 physicians joined TAFP staff and leaders to explore the art of family medicine at the 59th Annual Session and Scientific Assembly in Houston. Amid fun and fellowship, a magician and a treasure hunt, family physicians from around the state earned up to 24 AMA PRA Category 1 Credits™, shaped Academy policy at the TAFP committee and commission meetings, learned about all facets of the medical industry in the Exhibit Hall, and explored the Bayou City.
At the Annual Business and Awards Lunch on Saturday, the 2008 awardees for TAFP’s top honors were unveiled and the 2008-2009 officers assumed their new posts. Among the recipients were Fredericksburg family doctor John P. Ramsay, M.D., Texas Family Physician of the Year; longtime physicians Robert Echols, M.D., of Kilgore, and John Green, Jr., M.D., of Ballinger, Physicians Emeriti; State Rep. Ellen Cohen, Patient Advocacy Award; former TAFP president F. David Schneider, M.D., Sam A. Nixon, M.D., Leadership Award; Lewis Foxhall, M.D., TAFPPAC Award; Clare Hawkins, M.D., TAFP Foundation Philanthropist of the Year; and Tricia C. Elliott, M.D., Exemplary Teaching Award.
In his acceptance speech at the Awards Lunch, Physician Emeritus Echols told the audience that he had attended Annual Session meetings for close to a half-century. “When I left these meetings, I always went home feeling that I had gained a lot. I learned new things about new things and I learned new things about old things. When I got home I was dealt the challenge of continuing to study hard and to push for good patient care, which I did, and I owe this attitude to the Academy. All the time I was aware that back in the offices, those elected physicians in the Academy were always fighting the political and economical battles as needed and we were grateful for that always.”
Stepping up to lead the Academy during 2008-2009, the new TAFP officers were installed. The new TAFP officers are President Robert Youens, M.D., of Weimar; President-elect K. Ashok Kumar, M.D., of San Antonio; Vice President I. L. Balkcom, IV, M.D., of Sulphur Springs; Treasurer Melissa Gerdes, M.D., of Whitehouse; and Parliamentarian Troy Fiesinger, M.D., of Conroe.
In Youens’ first presidential address, he told the audience that he loves his profession and embraces the uniqueness of family medicine. “The longer I am at this business, the more I realize that our particular brand of medicine is what’s best for all patients. Our holistic approach to the treatment of our patients continues to make us the best specialty on which to found a health care system.”
This year, the Town Hall meeting was combined with the meeting of the Commission on Legislative and Public Affairs. Rep. Garnet Coleman, D-Houston, and Rep. John Zerwas, M.D., R-Houston, discussed health care issues likely to be addressed during the next legislative session. These included scope of practice, retail health clinic expansion, the Texas Department of Insurance sunset, graduate medical education and health care workforce, Medicaid and CHIP funding, and efforts to reduce Texas’ high rate of uninsured.
Coleman complimented the Academy on its work during last year’s legislative session, including the passage of needed reforms in the Children’s Health Insurance Program. “We did some good things with your help,” he said. “That’s why we have a CHIP program.”
Zerwas, an anesthesiologist in Katy, told the group that scope of practice is likely to be a hot topic in the next Legislature, as nurse practitioners push for autonomous practice. Allowing nurse practitioners to practice without physician supervision is “the wrong thing to do for our patients,” he said. “We had a lot of nurse anesthetists who have gone on to become anesthesiologists and they’ll tell me, ‘John, I didn’t know what I didn’t know.’”
Saturday night brought the main event as a circus-themed President’s Party gave TAFP members and their families a chance to welcome the new TAFP president to office. In addition to great food, attendees played carnival games, enjoyed performances from a magician and clown, and tried their luck to win prizes under the big top.
It’s never too early to mark your calendars for other TAFP symposia where you can expect more educational programs, informative topics and great events. The 2008 Primary Care Summit is approaching quickly and will be held in Houston Oct. 17-19. The 60th Annual Session and Scientific Assembly will be held in Arlington July 15-19, 2009.
Student recognized for family medicine recruitment efforts
Christina Sheu, student membership coordinator for the Family Medicine Interest Group at the University of Texas Medical School at Houston, was recognized by AAFP for outstanding student recruitment efforts for the 2007-2008 academic year.
The main responsibility of the AAFP student membership coordinator is to inform other medical students on his or her campus about the specialty of family medicine and the benefits and services of being a student member in the AAFP, according to AAFP. They do this by coordinating student orientations, handing out issues of the American Family Physician Journal, and providing AAFP student membership applications and materials to their peers.
Under Sheu’s leadership, the UT Houston FMIG doubled their total student membership and submitted more than 10 AAFP membership applications. Two other coordinators in the country were recognized during the FMIG Breakfast during National Conference in May.
San Antonio public health advocate receives national public health award
Janet P. Realini, M.D., M.P.H., a family physician from San Antonio, was awarded the 2008 Public Health Award by the American Academy of Family Physicians at its annual meeting in San Diego. AAFP’s Public Health Award recognizes individuals who are making extraordinary contributions to the health of the American public. Realini was awarded the TAFP Public Health Award in 2007.
Current president of the non-profit Healthy Futures, Realini has dedicated herself to empowering the young people of San Antonio to make informed, healthy decisions. She developed the Healthy Futures Alliance, a community coalition devoted to reducing teen and unplanned pregnancy in San Antonio and Texas. Realini says she is grateful for her background in family medicine, “with its exposure to all ages, to behavioral as well as physical health, and to understanding systems.”
Realini says she can still remember the first pregnant teen she saw when she was a resident at the University of Texas Health Science Center Family Medicine Residency Program in San Antonio. She recalls being “taken aback” by the difficult situation the teen and her family faced.
“Since then, I have come to understand that teen pregnancy is complex, and the answers involve more than medications and counseling,” Realini continues. “It is not just about girls, and it is not just about sex. Young people, both males and females, need good information about abstinence and birth control. But they also need reasons to postpone pregnancy—goals and dreams, and a sense of a bright future for themselves, and they need lots of caring adults in their lives.”
Her efforts focusing on teen pregnancy prevention and sexual education have had a significant impact in her community. Bexar County has one of the highest teen pregnancy rates in the nation, but during her years with the San Antonio Metropolitan Health District, these rates dropped more than 20 percent. Here she founded Project WORTH, or Working on Real Teen Health, which is an outreach program emphasizing abstinence, parent communication and healthy youth development.
Realini is the author of BIG DECISIONSTM, an educational curriculum for junior high and high school students that promotes abstinence as a teen’s healthiest choice while also providing important information for teens who become sexually active. Each year, these programs educate thousands of youths and their parents. In 2007, Project WORTH reached more than 6,400 teens.
Realini received her medical degree from the University of California in San Francisco and her master’s in public health from the University of Texas School of Public Health.