Stories from Texas Medicine, August 2019

Charting Medicine’s Statehouse Progress: A Successful Legislative Session for Physicians - 10/08/2019

Legislation is just one piece of a healthy Texas. But it’s a big piece, and when the Texas Medical Association told the lawmakers of 2019 how it should fit, those legislators largely shaped it to what physicians and patients need. The house of medicine convinced lawmakers that raising the age to purchase tobacco to 21 was the right thing for the state’s present and future. Medicine also successfully persuaded the legislature and Gov. Greg Abbott to improve insurance network adequacy and directories, which will help with surprise medical bills.


Opioids and Pharmacy: PMP Extension Granted - 09/16/2019

When it came to opioids and pharmacy matters, some of the major pieces of medicine’s 2019 agenda came down to something everyone wishes they had more of: time. Physicians need it to get comfortable with a mandate to check the state’s prescription monitoring program (PMP). Patients need it to make sure the pain medications they’re prescribed do what the drugs are supposed to do. The legislature listened, and TMA achieved wins on both counts, as well as on increased transparency from pharmacy benefit managers (PBMs).


Firearms Safety: A Growing Public Health Threat - 09/04/2019

Michael Bagg was bothered by how his fellow students at McGovern Medical School at UTHealth in Houston reacted to the 2017 Las Vegas shooting, which killed 58 people. He started talking with a classmate about ways to address firearms that would improve safety while also respecting the rights of gun owners. Together, they came up with a preclinical curriculum for an elective class on firearms safety that has been taught at the school for the past two years. The course, which more than 100 students have attended, addresses topics such as the treatment of injuries and threat identification.


Anybody There? Physicians Unfairly Penalized for AWOL Medicare Advantage Patients - 09/04/2019

You’ve tried and tried and tried. Phone calls, emails – nothing. A Medicare Advantage plan assigned you a patient who didn’t choose you, and the patient is driving that point home – by ignoring you. Or maybe the contact information the plan gave you is out of date, and the patient’s latest phone number or email is unknown. Either way, your as-yet-unseen patient is AWOL – and you can be penalized for it on health plans’ quality ratings, which ultimately can affect payments. New Texas Medical Association policy takes aim at the unfairness this lack of patient response can present for physicians, while opening up an opportunity for medicine to work with health plans to solve the problem.


A Qualitative Approach to Understanding HIV-Related Stress in Texas - 09/03/2019

Much of the southern United States is characterized by unique social, structural, and political systems that may relate to increased stress and poor health outcomes for those living with HIV. Notably, research indicates that Texas has higher survival rates for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) than general southern trends, which might suggest that Texans living with HIV experience HIV-related stressors and coping strategies influential to health differently than those living elsewhere in the South. This study used grounded theory and semi-structured interviews to increase understanding of HIV-related stress in Texas. Participants (N=20) were 12 people living with HIV in Texas and 8 HIV-care providers in Texas. Results indicated 5 emergent stress-related themes: housing strain, substance use, limited financial abilities, relationship dynamics, and internal pressures and psychosocial resiliency. Results also highlighted some of the potential...


Talk to Patients About: Hib - 08/02/2019

Despite its name, Haemophilus influenzae type b – or Hib – doesn’t cause influenza. In the 1890s, doctors thought this bacteria might cause flu and – despite later research showing flu is caused by a virus – the name stuck. But Hib does cause several severe illnesses, mostly among children under 5 years old. Meningitis is the most common.


Setting the Record Straight: Supreme Court Curtails TMB for Over-Sanctioning Physician - 08/02/2019

Eight years ago, when he experienced a rare patient death, McAllen family physician Ruben Aleman, MD, signed the death certificate the way Texas physicians had been doing it for years, and the only way he knew how: using pen and paper. That resulted in the Texas Medical Board (TMB) not only coming after him, but accusing him of “unprofessional or dishonorable conduct that is likely to deceive or defraud the public” – words found in the state Medical Practice Act. The Texas Supreme Court recently decided that was an overreach for a physician who simply hadn’t signed up on the state’s electronic death registration system, which at the time was relatively new.


One Giant Step for Physicians: A Texas Physician’s Role in Space-Race Medicine - 08/02/2019

This summer marks the 50th anniversary of America’s Apollo 11 Lunar Mission – the first time humans set foot on the moon. Across the world, the event was heralded as a milestone of scientific achievement, and its three-man crew – Neil Armstrong, Col. Buzz Aldrin, and Lt. Col. Michael Collins – became American heroes. Laboring behind the scenes were swarms of unsung individuals whose expertise made the enterprise possible, including Texas cardiologist Lawrence E. Lamb, MD. His 2006 memoir Inside the Space Race: A Space Surgeon’s Diary remains a vivid account of the essential role physicians played in the race to reach the moon.  


Texan Continues String of Woman AMA Presidents - 08/02/2019

After 151 years of all-male leadership at the American Medical Association, a family physician from Texas broke through the glass ceiling on June 17, 1998. Twenty-one years later, another Texas physician is set to become the AMA’s sixth woman president – and its third in a row.


Making Telemedicine Work - 08/02/2019

Recent trends and new TMA-backed laws are about to reshape physicians’ practices when it comes to implementing telemedicine.


TMB: Back on Track - 08/02/2019

Two years ago during the 2017 regular session, the Texas Legislature put the practice of medicine in the state in serious danger, failing to renew the Texas Medical Board (TMB) and the state’s Medical Practice Act. In 2019 House Bill 1504 by Rep. Chris Paddie (R-Marshall) put TMB back on the standard 12-year sunset cycle, renewing the board through 2031.


Scope of Practice: Shot Down - 08/02/2019

When it comes to shooting down dangerous attempts to expand non-medical practitioners’ scope of practice, TMA’s advocacy army once again proved to be expert marksmen in 2019. Medicine trained its scope on bills that would have allowed nurse practitioners, chiropractors, and optometrists, among others, to wade into the practice of medicine.


Medicaid: Reforms, But No Raise - 08/02/2019

Medicine didn’t get everything it needed from lawmakers for Medicaid, including TMA’s biggest and boldest ask of the 2019 session. Still, progress TMA achieved on managed care reform and other facets of Medicaid will advance physicians’ efforts to care for the most vulnerable Texans.


Education: Planning for Growth - 08/02/2019

Medical education made some gains in the 2019 legislative session, including the statutory approval of two new medical schools.


Public Health: Tobacco Triumph - 08/02/2019

Texas physicians got the kind of huge win on tobacco issues they haven’t seen in decades – a law to keep tobacco products away from young people.


Insurance: Network Solutions - 08/02/2019

Charting Medicine’s Statehouse Progress TMA went into this session looking to attack insurer network inadequacy and health plans’ use of care impeding prior authorization demands. On both fronts, medicine scored solid legislative wins that will make it