Group urges lawmakers to fix Texas’ fractured health care system

The Texas health care delivery system has reached a breaking point and if lawmakers don’t take steps to reinforce its primary care networks, the health care system will crumble and drown the state’s economic health in a flood of debt and disease, according to a report recently released by the Primary Care Coalition.

Members of the PCC include the Texas Academy of Family Physicians, the Texas Academy of Internal Medicine Services and the Texas Pediatric Society. Together they have developed a report entitled, “Fractured: The State of Health Care in Texas,” which outlines dangerous demographic and socioeconomic trends facing our health care system.

In a press release about Fractured, TAFP President Doug Curran, M.D., commented on one problem Texas’ health care system faces: the uninsured.

“One in every four Texans has no health insurance. When they get sick and go to the emergency room for care, businesses, homeowners, individuals and local communities will pay those bills through higher taxes,” said Curran in the TAFP release. “It is a vicious cycle that shifts the cost of providing uncompensated care to private health insurance, which in turn drives soaring health insurance premiums and leads to a lack of available, affordable health insurance options for employers and individuals alike.”

Other issues the PCC would like lawmakers to address during the upcoming 80th Legislative Session center on statistics in the study:

• The cost of uncompensated care for the uninsured adds $1,551 to the average annual premium for private insurance in Texas, according to Families, USA,
• Medicaid now insures 2.7 million Texans — 12 percent of the state’s population, yet only 38 percent of Texas physicians accept new Medicaid patients,
• Texas has a rapidly growing population, ballooning at both ends of the age spectrum, that is increasingly likely to suffer from costly chronic diseases, and
• Since 1997, the number of U.S. medical school graduates choosing to enter family medicine and general internal medicine residencies has fallen by almost 50 percent.

The full report can be downloaded from TAFP’s Web site.

Physician shortage looming

The nation will experience a shortage of primary care physicians, specifically family physicians, by the year 2020 unless the U.S. health care system changes soon, according to a study released by AAFP last month. The report, titled “Family Physician Workforce Reform: Recommendations of the American Academy of Family Physicians,” states that the United States must have at least 139,531 family physicians, or a ratio of 41.6 family physicians per 100,000 people, to meet the nation’s need for primary care. In 2004, there were 31.2 family physicians per 100,000 people.

The study took into account factors such as population growth, increasing health risks due to more chronic disease, increased use of health information technology and others to determine the impending shortage.

AAFP has identified a number of goals it plans to pursue to fight the shortage, such as encouraging the use of the TransforMED Model of Care, increasing its advocacy effort, increasing support of medical education funding and improving residency training to include issues of the evolving population.

After the release of the study, both the Academy and family medicine garnered positive media attention around the country. Within Texas, the study appeared on the Cox News wire, the Associated Press wire, in the Houston Chronicle and on the television news station, KVUE, among others.

These public statements serve to alert lawmakers of growing concern for primary care shortages and barriers to care.

Read the full report at on AAFP’s Web site.

HPV vaccine resources available

On June 10, the Advisory Committee on Immunization recommended that girls age 11 to 12 be routinely given the Human Papillomavirus Vaccine to protect against HPV. To educate providers and the public on the vaccine and inform them about different recommendations for disbursement, the inaugural Vaccine Advisory, a public information e-letter released by the Immunization Branch of the Texas Department of State Health Services, provides informational links from the ACIP, the Centers for Disease Control and Prevention, the Texas Vaccines for Children Program, ImmTrac Texas immunization registry and others. The links for providers and the public include:

• CDC HPV and HPV vaccine webpage for health care providers
  http://www.cdc.gov/nip/vaccine/hpv/default.htm
  http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine-hcp.htm
• Gardasil® package insert (pdf file)
  www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf
• HPV Vaccine Information Statement
  http://www.cdc.gov/nip/publications/VIS/default.htm#hpv
• CDC HPV fact sheet
  http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htm
• CDC Cervical Cancer Awareness webpage
  http://www.cdc.gov/nip/vaccine/hpv/hpv-faqs.htm

The HPV vaccine is currently the only FDA-approved immunization to prevent cervical cancer, precancerous genital lesions and genital warts due to HPV. To be added to the distribution list for the Vaccine Advisory, e-mail Maria Maldonado at the DSHS Immunization Branch and write “Subscribe to Vaccine Advisory” in the subject line.

ACT now for asthma

TAFP invites all members to attend the Asthma Coalition of Texas’ Annual Meeting on Oct. 12 – 13, 2006 at the Austin Marriott at the Capitol in Austin, Texas. At the meeting, which is free to participants, attendees will explore the initiatives and interventions of the National Asthma Program and find out what is being done in different Texas communities to control asthma. The focus of the 2006 Annual Meeting, “Bridging the Communication Gap,” will be illustrated through presentations, poster sessions and breakout sessions. At the end of the meeting, the 2007-2010 Texas Asthma Plan will be revealed.

Keynote speaker Michael McGeehin, Ph.D., MSPH, will address the state of asthma at the national level and within Texas. McGeehin is the director of the Division of Environmental Hazards and Health Effects, NCEH, CDC and the director of the U.S. National Asthma Program for CDC.

Register online by visiting the Asthma Coalition of Texas Web site.

Two Texans take national offices

Congratulations to Leah Raye Mabry, M.D., and Roland Goertz, M.D., both recently elected to AAFP offices during AAFP’s 2006 Scientific Assembly. Goertz will begin his three-year term on the AAFP Board of Directors and Mabry will serve her third term as AAFP Vice Speaker for the Congress of Delegates. Go to the news section of the TAFP Web site to read more about Dr. Goertz and Dr. Mabry.

Call for Proposed Bylaws Amendments

Any TAFP member wishing to submit a proposed amendment to the TAFP bylaws must submit it to Kathy McCarthy at TAFP headquarters by Dec. 15, 2006. The TAFP bylaws can be viewed by going to www.tafp.org/membership/organization/bylaws.pdf.

Amendments can be e-mailed to Kathy McCarthy or faxed to (512) 329-8237. Members submitting a proposed amendment must include a statement giving the rationale for the amendment.

The TAFP Bylaws Committee will review the amendments at the 2007 TAFP Interim Session meeting on March 2, 2007. The Chair of the Bylaws Committee will present the proposed amendments, with the recommendations of the Bylaws Committee, to the Board of Directors at this conference. If the Board of Directors approves the amendment, it will go before the TAFP members in attendance at the TAFP Annual Business Meeting in July 2007, to be voted on.

Call for nominations: AAFP alternate delegate

TAFP is currently soliciting nominations for the position of AAFP Alternate Delegate. The position opened when former AAFP Delegate Roland Goertz, M.D., was elected to the AAFP Board of Directors.

The AAFP alternate delegate is responsible for representing Texas at three meetings throughout the year: the multi-state meeting in February, the Annual Leadership Forum in May and the AAFP Scientific Assembly in September.

Those interested should send a letter of interest and a CV of no more than three pages to the Texas Academy of Family Physicians, c/o Jim White, 12012 Technology Blvd, Austin, Texas 78727. Nominations must be received in the TAFP office by Nov. 6, 2006. After the TAFP Nominating Committee reviews the nominations, the Executive Committee will take the final vote in December and the chosen delegate would assume the office immediately.

Copyright 2006, Texas Academy of Family Physicians