Archives / 2009
  • Bending the cost curve

    Tags: academy update, health care costs, reform, health care, policy

    Now comes the hard part

    By Tom Banning
    TAFP Chief Executive Officer/Executive Vice President

    If one accepts the premise that politics drives health care policy, then it would follow that flawed politics produces flawed policy. Those hoping for a vigorous and thoughtful debate on health care reform—what works and how to pay for it—are instead forced to settle for media theatrics and hyperbole that come dangerously close to the level of UFO conspiracies.

    The town hall debacles and orchestrated lunacy during the August recess have dispelled any lingering hope that Congress can move away from the partisan bickering and sniping that has increasingly characterized what passes for debate in one of the world’s greatest deliberative bodies. Congressional leaders on both sides of the aisle, with the blessing and encouragement of their caucus’ political consultants, talk not in terms of medical economics and policy options for improving our health care system, but rather in calculated polling and focus-group-generated strategies designed to fire up their respective political base and confuse and scare the public to meet their own political objectives.

  • I didn’t know family docs could do that!

    Tags: scope of practice, family medicine, value, family medicine residency program

    By Troy Fiesinger, M.D.
    TAFP Vice President

    I was playing golf recently in a charity tournament with a couple of orthopedic surgeons whose office is down the road from mine. As we made the usual small talk about where we went to medical school and residency, I mentioned that I delivered babies. The response I received was tinged with incredulousness: “You deliver babies? I didn’t know family doctors still did that.”

    For me, obstetrics is part of what defines me as a family physician. Few things can compare to meeting a patient as a teenager, caring for her through high school and early adulthood, delivering her first child, and then helping her cope with the stresses of motherhood while her husband is deployed in Iraq. Her parents and little brother were also my patients. That is the essence of family medicine. Why wouldn’t I want to care for the entire family throughout the life cycle? When I am asked what I specialize in, I answer “everything.” I enjoy being a jack of all trades.

  • Invest in students, residents to keep specialty strong

    Tags: president's letter, kumar

    From the inaugural address of TAFP’s new president

    By Kaparaboyna Ashok Kumar, M.D., F.R.C.S.
    TAFP President, 2009-2010

    It is a great honor and privilege to serve as your president. I thank every one of you for placing your confidence in me and I will work sincerely and tirelessly to protect the interests of our members and patients.

    As I begin my term as president, I would like to thank some very special people. I thank my family, especially my wife Elaine, for their love, understanding, patience and support, without which I would not be able to take up these responsibilities.

  • Health care politics 101

    Tags: academy update, reform, health care, policy

    By Tom Banning
    TAFP Chief Executive Officer/Executive Vice President

    At the risk of sounding overly cynical, epiphanies in politics are rare, if they exist at all. Ground-breaking legislative reforms are more likely to evolve from several years of toiling in the political trenches. Even then, legislative breakthroughs may be a result of sheer unanticipated luck, stumbling by an opponent, an inadvertent absence of a determined adversary, or the weird and largely unplanned alignment of mutual interests, as politics makes strange bedfellows.

    Legislative reform is by definition a reactionary sport. Reforms typically occur after, not before, the proverbial train wreck, plane crash, biblical storm or financial meltdown. Health care reform is no different and in many respects will be much more difficult to achieve, as reformers are attempting to transform the system before it collapses.

  • Reflections of three years on the AAFP Board

    Tags: perspective, aafp, board of directors, goertz

    By Roland A. Goertz, M.D., M.B.A.

    Three words describe the three years I have served on the American Academy of Family Physicians Board of Directors: challenges, changes and opportunities. In a brief three-year period, the board has dealt with everything from declining non-dues revenues to deciding how to optimally impact the best opportunity in over a decade to reform an ailing health care system. We live in an interesting time as family physicians in today’s health care system, and as such, my tenure on the board has been quite a journey.

    After only a brief period spent enjoying the euphoria of a successful election, new board members are handed a packet outlining their first responsibilities. Meeting dates are placed on calendars and primers on the inner workings of the Academy are reviewed. You are thrust into a constant and voluminous flow of information distributed in multiple formats. If one has not already developed a method of efficient data management, interpretation and use, necessity quickly breeds invention as a board member.

  • Seeking a system that respects the patient-physician relationship

    Tags: president's letter, legislature, physician, patients, relationship, youens

    By Robert Youens, M.D., M.M.M.
    TAFP President, 2008-2009

    Recently in a neighboring community to mine with practicing family physicians, a hospital, surgeons, obstetrical care, ER coverage and multiple visiting specialists, two interesting developments have occurred. First, a new clinic has opened with a $1 million grant and the backing of the local community and a citizen champion. The plan is to have it qualify as a Federally Qualified Health Center “look-alike” that will allow it to receive Medicare and Medicaid reimbursement at significantly higher levels than the locally practicing physicians. This clinic is able to see any patient: Medicare, Medicaid, private insurance or private pay. Incidentally, the guiding force behind the clinic says they currently have a nurse practitioner and a “family practice” doctor, but he wants to get a pediatrician because his primary reason for starting the clinic is to help children.

    Second, with the help of local and federal politicians, a Veterans Administration clinic is to open this summer to care for veterans in the area who need their services, thus decreasing travel distances to a more remote VA clinic. This clinic was awarded on a bid contract to a company who apparently does this in other places and is to be staffed by various ancillary personnel hired for the business as well as a general practitioner from the area.

  • Who’ll be there to care for me?

    Tags: perspective, medicare, payment

    By John Kurt Frederick, M.D.

    He slowly totters into the exam room with his daughter-in-law in tow. The plastic grocery bag holds all his pill bottles and his metal walker looks like it has been well used. A faint smell of urine wafts from him and his shirt is stained with breakfast. He manages to make it into the room. With difficulty he turns stiffly and lands his bottom in the exam room chair.

    He is my newest Medicare patient, an elderly parent of a friend. He recently moved to the area to be nearer to his only son, his existence now too difficult to manage alone. His medical problems are myriad and complex and he takes a recipe of pills several times a day. I smile and welcome him to Austin as I gently grip his gnarled hand. We converse briefly before I dive into the box of medical records and the sack of pill bottles, many expired, many duplicated, and all powerful and dangerous in their own right.

  • It's the system, stupid

    Tags: health care reform, transformed, health care, policy

    By Tom Banning
    TAFP Chief Executive Officer/Executive Vice President

    Health system reform—with the emphasis on the system, not the players in the system—is on the political precipice. In my previous column, I discussed how policymakers, patients, physicians and those paying for health care are so fed up with our floundering health care system that fundamental, systemic change is inevitable.

    The good news is that among the policy experts who count and vote, there is a broad, evidence-based consensus that economic recovery and health care economics are inextricably linked. Every report accumulating on politicians’ desks, in their minds and perhaps in their hearts declares the restoration of primary care as fundamental to health system reform.

  • Managing our practices as well as our patients

    Tags: business, education, president's letter, youens

    By Robert Youens, M.D., M.M.M.
    TAFP President, 2008-2009

    Hello again. This quarter’s missive is intended to provoke thought about family physicians’ position in the health care landscape of the future. My original intent was going to be to discuss little vs. big in the ideal provision of health care, making an argument that personal attention from a personal physician in a small practice environment is superior to attention from a team in a large bureaucratic institution. I’ll probably always feel this way but instead have some ideas to share about what the future may hold for our specialty and profession.

    Throughout my career I have embraced the business of medicine and my fundamental belief that if we go out of business, we can’t provide care. It is also true that to manage a medical practice and achieve this outcome, someone must be in charge. It is my contention that the physician should be this someone.

  • 2008 Year in Review

    Tags: 2008, year in review, advocacy, communications, education, tafp foundation, members, leadership

    TAFP has an Olympic year in ‘08

    By Kate McCann

    At record pace, 2008 went by in a blur for TAFP. Using the goals set at the September 2007 strategic planning meeting, staff began working on a three-year plan, roaring into the new year with fresh ideas for advocacy and communications, new and improved member services to help practices remain financially viable, and valuable CME programs to allow members to stay ahead of the curve.


  • When it’s bad enough to be good

    Tags: academy update, advocacy, health care reform, primary care

    Health care reform and rescuing primary care

    By Tom Banning
    TAFP Chief Executive Officer/Executive Vice President

    There is an old adage that political leadership is the art of finding a parade and getting in front of it. And the corollary to that axiom is that whether it’s a parade or an angry mob, it’s best to stay in front of it.

    The drumbeat for health care reform might be the sound of a marching band or it could be the din of a brute-force mob for whom might makes right and passion wins over reason. Either way, the need to transform our health care system—and in so doing reinvigorate primary care—is being heard, and more importantly, understood by policy makers, opinion leaders, the business community and the public at large.

  • Reflections on being the “Doctor of the Day”

    Tags: advocacy, physician of the day, legislature

    By Warren Longmire, M.D.

    Most people who come into medicine want to help others. They have a strong desire to give prompt, friendly, medically accurate, and full service to those in need. With this concept in mind, I offer these reflections on 30-some years of participation in the Physician of the Day program, in which family physicians volunteer to treat people at the state Capitol when the Legislature is in session.

    When we began, many legislators were very suspicious of us. They frequently asked, “What do you want for all this care you are giving?” The best answer we had was, “when we figure out just what is needed, we will share it with you.”

  • The secret to better health care

    Tags: health care reform, primary care, value, youens

    By Robert Youens, M.D.
    TAFP President, 2008-2009

    Hello, my colleagues. I have this bully pulpit for the next three quarters and intend to use it tastefully to express my opinion about the state of our affairs. So, here we go.

    We are fortunate to be practicing the most fundamentally pure and satisfying medical specialty there is. Ours is a specialty of science and understanding, of the head and the heart, and of the definable episode and caring continuity.