Stories from Texas Medicine, February 2020

Appropriate Use of Time? Medicare Rules for Advanced Imaging Orders Pose Prior-Auth Burdens - 04/09/2020

An effective way to cut down on overuse of potentially harmful imaging, or a prior authorization-esque burden on physicians who order needed tests? Texas physicians see Medicare’s “appropriate use” system for advanced imaging both ways. As of Jan. 1, physicians ordering advanced imaging tests for Medicare patients must consult an electronic portal, which evaluates whether the test meets Medicare’s own “appropriate use criteria” for whether a test should be ordered. Then when the claim is filed, physicians must document that they checked the system and its determination.  


Talk to Patients About: Why Do Some Vaccinated People Still Get Sick? - 02/24/2020

Every so often, physicians encounter a patient who still gets sick despite getting vaccinated against that disease. Patients naturally ask, how could this happen? There are various reasons.


Q&A: Stethoscopes and Telescopes - 02/21/2020

Ever since he was a boy, Temple family physician John Manning, MD, has been fascinated by space. Now, Dr. Manning is also an amateur photographer. About 10 years ago, he merged his interests in photography and space into his latest obsession: astrophotography.


Reaching for the Cure: Texas Medicaid Doesn't Cover Hepatitis C Drugs Until Patients Are Seriously Ill - 02/18/2020

Infectious disease specialist Ogechika Alozie, MD, has a ready-made solution for patients diagnosed with hepatitis C now that five medications can rid patients of this deadly disease. But for Texas Medicaid patients, there’s a catch. The program does not pay for the cure based just on a diagnosis. Instead, Medicaid pays only after a blood test, biopsy, or sonogram shows the liver is so badly damaged that it’s on the verge of cirrhosis. At that point, patients who get the medication will be cured of their hepatitis C but more vulnerable to other deadly illnesses, like liver cancer.


Preserving Do No Harm: Supreme Court Tosses Challenge to Medical Ethics Committee Law. - 02/18/2020

Twenty years after it took effect, Texas’ medical ethics committee review law has withstood challenge after challenge. The Texas Supreme Court is on the verge of ending the latest high-profile attack on the law that ensures physicians can uphold their professional obligation to “do no harm.” In October 2019, the state’s high court declined to take up Kelly v. Houston Methodist Hospital, in which the mother of a deceased patient attempted to overturn a provision of the Texas Advance Directives Act. Justices’ action leaves intact an appeals court decision that preserves physicians’ ability to use their medical judgment in end-of-life cases.


Doctor on the Set: Surgical Resident Thrives in Hollywood - 02/18/2020

About two years ago, Michael Metzner, MD, took a break from his San Antonio surgical residency program for what was supposed to be a year-long gig in the bright lights of Hollywood. He hasn’t come back. He says he will … just not quite yet.


Clearing the Haze: Texas Physicians Demystify Vaping - 02/18/2020

The rise in EVALI deaths and hospitalizations has changed the conversation about vaping and gives physicians an opportunity to champion tighter rules and higher taxes on an untested, unhealthy product that remains lightly regulated in both the U.S. and Texas.