Magazine story

Leveraging LARCs: Long-Acting Reversible Contraceptives Part of Texas’ Solution to Unwanted Pregnancies, Maternal Deaths - 10/17/2019

Today LARCs are one of the safest and most-effective types of reversible birth control, but their reputation took a huge hit in the 1970s thanks to the Dalkon Shield intrauterine device (IUD). Memories persist of news reports about the shield’s many defects. This mistrust of LARCs — along with other obstacles to their wider use — hamper progress toward a wider goal for Texas medicine: improving maternal health and reducing maternal deaths across the state.


Q&A: Mobilizing Members - 10/16/2019

Michael J. Darrouzet takes over as TMA chief executive.


Rule of Fear: Misconceptions About Immigration Rule Deters Migrants From Seeking Care - 10/15/2019

In September 2018, U.S. Citizenship and Immigration Services proposed a change in the rule for “public charges” – people who depend primarily on the government for assistance. The about-face would limit access to green cards and temporary visas for most immigrants who receive Medicaid and other public benefits. Almost immediately, the news instilled fear among immigrant communities along the Texas-Mexico border, and rumors started spreading about what the change meant for their access to health care.


Easing the Pain? Opioid Settlement Brings Valuable Funding to Fight Crisis - 10/15/2019

September 2019 brought what could become a major victory for the state’s handling of opioid addiction. Drug-maker Purdue Pharma – which faced thousands of lawsuits from cities and states, including Texas, for its role in the national opioid crisis – announced it had agreed to a settlement with 24 state attorneys general and other plaintiffs. The maker of OxyContin and other pain drugs says the agreement will provide more than $10 billion to address the epidemic.


Big Noises Big Issues: Health Care Takes Center Stage One Year Out From 2020 Election - 10/15/2019

One year from now, Texas voters will hit the polls. They’ll be voting for president, for Congress, and for seats in the Texas Legislature. At the state and national levels, health coverage, Medicaid access, and prescription drug costs have gotten plenty of attention already, and they’ll get plenty more between now and the closing of the polls on Nov. 3, 2020. Here’s a look at some of the major health care debates taking center stage during the 2020 election cycle, what voters are and will be hearing about, and what Texas Medical Association policy says on those particular issues.


Commentary: A Voice in Medicine is a Voice for Our Patients - 10/15/2019

Just like every physician, I want to be the best doctor for my patients. There is the obvious way – as a capable di-agnostician and clinician. While a necessary and valuable role, as clinicians we only impact one person at a time. To have a bigger impact on the health of our communities we must take medicine outside of the exam room and engage in health care advocacy.


Profile: A Strong Start for Texas Women in Medicine - 10/15/2019

Passionate. Knowledgeable. Dedicated. Strong. Those four words only begin to describe the multitude of women who practice medicine throughout Texas. So it’s only fitting that the physician elected as interim chair of the Texas Medical Association’s new Women in Medicine Section exemplifies these qualities.


Commentary: Texas Has a Secret Weapon Against Cancer - 10/14/2019

Cancer is the No. 2 cause of death in Texas and across the United States. The good news is that things change, and we can be active agents in making sure that they change for the better. Reauthorization of the Cancer Prevention and Research Institute of Texas (CPRIT) would do more than keep the ball rolling; it would save lives.


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.


Texas Medicine Magazine - 10/01/2019

Texas Medicine Magazine


Texas Medicine Back Issues - 10/01/2019

Back Issues


Warning: Watch Your Referrals - 10/01/2019

Federal anti-kickback law has changed, and it’s gotten broader. As a result, you may need to re-examine your practice’s compensation arrangements. That includes payments for laboratory referrals.  


Talk to Patients About: Measles Update - 10/01/2019

Measles outbreaks in the U.S. were once a rare event, but in 2019 they turned into a potential public health crisis. Between Jan. 1 and Aug. 8, more than 1,200 cases of the deadly disease – which the U.S. Centers for Disease Control and Prevention (CDC) declared eradicated in America in 2000 – have been confirmed in 30 states.


More Pain for Small Shops? 2020 Quality Program Rule Could Mean More Penalties - 10/01/2019

Small and solo practices already take the worst of the administrative and financial pounding the Quality Payment Program (QPP) dishes out each year. In the Texas Medical Association’s analysis, the government’s plans for the QPP in 2020 would make the situation even harder on those smaller shops. Since QPP’s birth in 2017, small practices have struggled with the demands and synapse-straining complexities of the program’s Merit-Based Incentive Payment System (MIPS). And TMA analysis shows the payment penalties those “have-not” practices incur fund the bonus payments earned by MIPS “haves” – often, larger practices with the resources to make the program work. Under the 2020 changes that the Centers for Medicare & Medicaid Services (CMS) has proposed, the maximum penalties for practices who don’t hit their MIPS targets will be larger than ever. But TMA’s review shows that MIPS – despite CMS’ claims to the contrary – isn’t getting any simpler.


The Doctor - and Lawyer - Will See You Now: Medical-Legal Partnerships - 09/27/2019

Elderly woman. Low-income. Chronic pain. Needs to see a rheumatologist. Needs physical therapy. Struggling to pay rent. Has no insurance. Has no disability coverage. As a family physician at a federally qualified health center (FQHC) in Austin, Sharad Kohli, MD, sees a lot of cases like this. In similar health care settings, the patient might face two bad choices: wage bureaucratic war to obtain better health care benefits or simply give up. At People’s Community Clinic, Dr. Kohli referred her to an in-house lawyer who successfully appealed her denial of disability insurance. “[The lawyer] got her a significant income, which allowed her to pay her rent and also helped her get insurance through Medicaid and Medicare,” Dr. Kohli said. “And then she was able to see the rheumatologist and the physical therapist.” This kind of success helps explain why medical-legal partnerships (MLPs) like the one at People’s Community Clinic came about in 1993 and began expanding nationally after 2001. Te...


The Promise of Artificial Intelligence - 09/27/2019

“Prepare Yourselves, Robots Will Soon Replace Doctors in Healthcare,” screamed the headline in a 2017 Forbes magazine article. Media coverage like that makes it easy to see why artificial intelligence (AI) sounds like scary science fiction to some physicians.


Q&A: El Paso Surgeon On-Call During Mass Shooting Response - 09/27/2019

Just as Alan Tyroch, MD, sat down to breakfast in Las Vegas on the morning of Aug. 3, celebrating his mother in-law’s 90th birthday, a gunman walked into a Walmart hundreds of miles away in his hometown of El Paso and opened fire, ultimately killing 22 people and injuring 24 more. Over the following minutes, as shooting victims were rushed to hospitals throughout El Paso, Dr. Tyroch – chief of surgery and trauma medical director at University Medical Center of El Paso – was coordinating and delegating duties via text to the hospital’s numerous surgeons, physicians, residents, and other health care professionals.


Vote for CPRIT - 09/26/2019

On Nov. 5, Texans will vote on Proposition 6, a constitutional amendment designed to extend CPRIT’s funding by $3 billion and keep the agency’s grants flowing for an estimated 10 additional years. (See “Vote for Proposition 6 on Nov. 5,” page 21.) TMA supports this effort to keep CPRIT’s current funding from running out in 2022.


Moving On: John Zerwas, MD, Trades Politics for Academics - 09/26/2019

John Zerwas, MD, trades politics for academics, but likely will remain a voice of influence


No Docs of All Trades: Ruling Reinforces Expert Witness Reforms - 09/26/2019

Before Texas’ landmark liability reforms passed in 2003, gray areas in the law often led to serious green for people who sued physicians.


System Failure: Houston Practices Fight WellCare for Payment - 09/26/2019

Several Houston-area practices say a botched technology conversion by insurer WellCare after it acquired a Medicare Advantage plan led to prior authorization and network confusion, undue denials, and unpaid claims by the barrelful.


The ACA Marketplace - 09/19/2019

Physicians find themselves in a land of confusion months after the debut of the Affordable Care Act health insurance marketplace. Pervasive problems with the exchange rollout, including enrollment delays and questionable health plan networks, disrupt physicians' office operations and affect patients' access to care.


Doctors Drive New Opioid Laws - 09/18/2019

Several new laws will affect how physicians practice and how they prescribe controlled substances, including a delay on required checks of the state’s prescription monitoring program (PMP); a limit on opioid prescriptions for acute pain; and a new electronic prescribing requirement coming in 2021.


A New Understanding: Improving Care for LGBTQ Patients - 09/18/2019

Like everyone else, LGBTQ patients can face some unusual medical problems. But many of these patients’ biggest challenge is that their health problems can be amplified by hostility from others. Meanwhile, structural problems within the health care system frequently discourage LGBTQ patients from visiting physicians. LGBTQ patients frequently avoid physicians because of previous bad experiences. Many physicians who would like to treat LGBTQ patients often hesitate because they fear they lack the training.


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).