While I’m at home trying desperately to figure out how to set adequate parental protections on out Internet browsers and restrict my kids’ access to any and all Showtime original series on streaming Netflix, researchers at Baylor College of Medicine are posing some challenging ethical questions physicians are ever more likely to face. What if you tested a patient’s genes and found that he or she was likely the child of an incestuous relationship? What would your ethical responsibility be?
The BCM researchers write in the Feb. 12 issue of The Lancet that they have witnessed several of these cases while performing genomic tests on children. The topic is broad, with various implications regarding the age of the parents at the time of conception, their relational status, the possibility of criminal behavior or abuse, not to mention the emotional stigma and distress involved for the patient.
With all the promise genetic testing holds for understanding, identifying, and treating various conditions and disease states, the ethical ramifications are staggering, and this is just one particularly interesting and puzzling question to explore. Check out the article: http://tinyurl.com/47k7unt. We’d be interested to know your thoughts, so use the comment feature. What are your thoughts on the ethics of finding evidence of incestuous parentage through genetic testing, or just the ethics of genetic testing in general?more
The Senate Finance Committee has held hearings for the past two weeks on every section of the budget, and because so many primary care programs suffered cuts (as did most other programs), many interesting exchanges have come to light. In all the discussions, though, both lawmakers and those testifying agree that primary care is of the utmost importance to ensuring Texans’ access to care.
Because residency programs play such a large role in producing the primary care physician workforce, here enters Paul Klotman, M.D., president and CEO of Baylor College of Medicine. He testified during the Feb. 8 hearing of the Senate Finance Committee, and Sen. Bob Deuell of Greenville questioned him on the closing of the Baylor College of Medicine Kelsey-Seybold Family Medicine Residency Program. Here’s their exchange.
Sen. Deuell: A family medicine program closed. What’s your take on that?more
By Melissa Gerdes, M.D.
TAFP President, 2010-2011
Our Academy’s vision statement begins: “The Texas Academy of Family Physicians is dedicated to the promotion of a health care environment that values the vital role of family physicians.” I spoke of the importance of recognizing and promoting the value of Texas family physicians in my installation speech. It will take all of us doing what family physicians do every day: taking care of ALL Texans, knowing them, and tailoring care to individuals and communities.
How do we create value? How do family physicians feel valued? If we equate value to payment, I am afraid we will always be disappointed. Perhaps if our current triangular third-party payer system evolves, payment may provide a sense of being valued. For now, I would suggest we focus on the true ways in which family physicians are already valued. In my short four months as president, I have seen ample evidence that family physicians do play a vital role in our health care system and that people value us.more
By John K. Frederick, M.D.
I’ve been at this right at 20 years now. Some things are the still the same and will never change: the importance of a smile, a touch, a listening ear to a worried or discouraged patient, or wise counsel to a parent facing the health crisis of a child. That’s the clinical stuff, and it’s still “all good.” On the business side of my medical practice, things aren’t still the same. For all sorts of reasons the business has steadily gotten worse—lower payments, longer hours, and ever more forms to complete. Yet the same national politics which have caused an erosion of private practice over the years seems now to have turned, and may now offer us a golden opportunity. The crafters of the new federal health care law put us right back in the middle of things, requiring new vertically integrated health care ACOs to be built on a foundation of primary care! As a result this is the best, most timely opportunity for family medicine doctors since the advent of our specialty! What we do in the next 24 months may well either cement our validity with the public and general medical community, or relegate us to lapdog status.
Until now we have been putting out fires, providing episodic care driven by patient demand. There are a number of lesser-trained medical folks quite capable of working at this level. Our response has been to increase visit volume, and perhaps become more accurate in our coding. But in the near future our broader skill set, our breadth of training, and our ability to see the big picture will set us apart. Chronic medical care drives most of the health care costs in our country, and we are in a perfect position to put a significant dent in those costs with the help from one of the good EHRs now on the market. The really good news is that voluminous data now exists that health systems designed and led by primary care provides for lower costs and improved patient outcomes. And the politicians now know it.more
By Melissa Ayala
Launching into a new decade, TAFP experienced a year full of advancements in every category, from technology to politics. 2010 was marked with hard-hitting and award-winning advocacy and communications work, high-quality CME programs, and an ever-expanding network of member resources.
When Tom Suehs, executive commissioner of Texas Health and Human Services, addressed the Senate Finance Committee in a hearing on Feb. 1, he told the 15 senators in no uncertain language that going through with cuts to primary care proposed in the Senate’s draft budget will damage access to care.
Suehs (pronounced “seas”) is pushing for exceptional items that would reduce the cut in payment for primary care physicians treating kids enrolled in Medicaid and CHIP from 10 percent to 2 percent. This would cost the state around $125 million in general revenue next biennium, according to a Feb. 1 article in Quorum Report.
“I’m really concerned about having to cut primary care rates for physicians treating children,” Suehs told the committee. “We’ve already cut 2 percent this biennium from when y’all wrote the [2010-2011] budget. I believe that’s about as far as I can tolerate to maintain the access to primary care so I’m asking to put back not all 10 percent, but 8 percent. Exceptional item 1A is for Medicaid children, exceptional item 1B is for CHIP.”more