It's Academic: October 2012

New Licensures Hit All-Time High  

Texas continues to draw new physicians, this year more than ever. The Texas Medical Board reported 3,630 newly licensed physicians — an all-time high — in fiscal year 2012, which ended Aug. 31. That’s a 5.6-percent increase over the 3,436 new physician licenses recorded in 2011. The board also received a record 4,253 medical license applications.

This year also brought Texas the second highest number of newly licensed physicians from beyond its borders, topping 2008 by 1 percent. Most of those physicians — 73.5 percent — graduated from medical schools outside Texas. Overall, 42.1 percent (1,528) came from other states or Canada, a slight uptick from 2011. That's compared with 26.5 percent of new doctors, or 963, who hailed from Texas schools in 2012, on par with the 966 in-state licensures in 2011.

Meanwhile, international medical graduate (IMG) licenses peaked at 1,139, up from 1,017 in 2011 and the old record of 1,032 set in 2008. The Texas Medical Association education staff attributes the spike, at least in part, to passage last year of Senate Bill 189. That new law, as of Sept. 1, requires certain noncitizen physicians to practice three years in an underserved community as a condition of full licensure in Texas. Some observers say the new service obligation could chill IMGs’ interest in practicing in Texas in the future, and the additional requirement may have motivated more IMGs to apply for licensure in advance of its implementation.

Overall, physician licensures have steadily climbed since TMA secured 2003 medical liability reforms with the passage of Proposition 12. This voter-approved constitutional amendment authorized the Texas Legislature to cap noneconomic damages in medical liability cases. Since then, Texas has licensed more than 28,000 new physicians, adding an average of 3,135 newly licensed doctors each year — a 33-percent jump over the annual average of 2,363 licensees in the nine years preceding Proposition 12.

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GME Bill Would Create More Medical Residency Slots  

Legislation introduced in Congress in August would create 15,000 new Medicare-funded graduate medical education (GME) slots for physician residency training — 3,000 per year over five years — to ease the nation’s physician shortage.

The Association of American Medical Colleges, which supports the bill, estimates that by 2015, the country will have 62,000 fewer doctors than needed. Texas ranks 42nd out of 50 states and the District of Columbia in physician-to-population ratio for patient care, even though it continues to license record numbers of new physicians.

TMA supports such efforts to increase GME slots, which it says are critical to training a sufficient number of physicians to care for Texas’ rapidly growing population. TMA research shows physicians who complete both medical school and GME in Texas are three times more likely to stay in the state to practice.

The bill is the federal Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act (HR 6352), sponsored by U.S. Reps. Aaron Schock (R-Ill.) and Allyson Schwartz (D-Pa.). If passed and signed by President Obama, qualifying teaching hospitals could receive up to 75 slots each between 2013 and 2017.

Representative Schock said the limit would help ensure that small and rural hospitals can compete for the slots along with large hospitals and hospital systems. New residency slots also would be dedicated to training in specialties in which there is a physician shortage, as designated by the federal government.

Hospitals may receive new residency slots based on certain criteria, including whether they:

  • Are located in states with new medical schools or new branch campuses;
  • Emphasize training in community health center or community-based settings, or in hospital outpatient departments;
  • Qualify for electronic health record incentive payments, and
  • Exceed the current federal cap on the number of residents trained.

The bill also requires teaching hospitals to report on their program costs, as well as certain quality measures established by the U.S. Department of Health and Human Services in conjunction with accrediting bodies. Failing to report on the quality measures could result in a cut to hospitals’ Medicare indirect medical education funding.

Among other things, teaching hospitals would have to demonstrate the extent of training they provide in:

  • Evaluation and management,
  • Coordination of patient care,
  • Relevant cost and value of various diagnostic and treatment options,
  • Methods for identifying system errors, and
  • Use of health information technology.

The American Association of Colleges of Osteopathic Medicine also backs the legislation.

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Academic Physicians: Get the Credit You're Due  

Have you been working hard teaching for the past three to five years? TMA thinks it’s time to reward yourself.

If you are a physician who has taught medical students, residents, or fellows for at least the past three years, and you were a TMA member during that time, TMA encourages you to apply for new awards created for doctors like you.

The TMA Award for Excellence in Academic Medicine recognizes teaching physicians who are clinicians and have a record of TMA leadership, scholarly activity, mentoring, professional development, advocacy, and community service.

“TMA is eager to recognize our physician leaders who are dedicated to caring for patients as well as preparing tomorrow’s physician workforce,” said David P. Wright, MD, chair of the TMA Council on Medical Education. “These awards express the value TMA places on the academic segment of the physician community and the role they play in transforming health care through teaching.”

Qualification for bronze- and silver-level awards is through self-nomination. Physicians may download and submit the application by Dec. 31. TMA is developing criteria for gold and platinum levels and will announce them in coming months.

Once TMA verifies your eligibility for a bronze or silver award, you will receive a framed certificate in the mail. In addition, you will receive recognition in Texas Medicine and a mention in the Handbook Report for the next TMA House of Delegates annual meeting. If you have questions, email Jennifer McHaney or call her at (800) 880-1300, ext. 1451, or (512) 370-1451.

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PPACA Tops Fall Conference Agenda  

Health care economist Thomas Miller will discuss the impact of the U.S. Supreme Court's ruling on the Patient Protection Affordable Care Act (PPACA) on physicians and patients at TMA's 2012 Fall Conference Oct. 19-20 at the AT&T Conference Center in Austin.

Mr. Miller is a former senior health economist for the Joint Economic Committee of Congress and has been at the forefront of health care policy on the national level.

Also on tap is a panel discussion featuring physician and TMA alliance legislators and candidates for election in November. Invited to participate are:

Greg Bonnen, MD     Republican nominee, Texas House District 24
       
Rep. Michael Burgess, MD     U.S. House District 26
       
Donna Campbell, MD     Republican nominee, Texas Senate District 25
       
Sen. Bob Deuell, MD     Texas Senate District 2
       
Rep. Susan King     Texas House District 71
       
Rep. Charles Schwertner, MD     Republican nominee, Texas Senate District 5
       
J.D. Sheffield, DO     Republican nominee, Texas House District 59
       
Rep. Mark Shelton, MD     Republican nominee, Texas Senate District 10
       
Rep. John Zerwas, MD     Texas House District 28

And, the conference’s Legislative Training Session can teach you how to be a persuasive and effective communicator in the debate over new state and federal laws that affect you and patients. There will be two training sessions on Friday, 1:30-3 pm and 3-4:30 pm. Space is limited, so register today!

Finally, the conference will feature a flu shot clinic in the Grand Ballroom Foyer of the AT&T Center from 7:30 to 8:45 am on Oct. 20. The shots are $25. The nasal-spray vaccine is $40. Register for a flu vaccine when you register for the conference. Flu shots can help halt the spread of the flu.

TMA supports 100-percent influenza vaccination among health care workers; those who decline should be required to sign a declination waiver. TMA worked closely with the Texas Pediatric Society, the Texas Nurses Association, and the Texas Hospital Association to support legislation that took effect Sept. 1. The new state law requires each health care facility licensed by the Texas Department of State Health Services to have a policy that identifies the requirements for vaccinating each employee or anyone who comes into contact with patients in the facility. This includes physicians, volunteers, or others not directly employed by a facility.

For more information, contact the TMA Knowledge Center at (800) 880-7955 or email knowledge@texmed.org.

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Get More From Your TMA Membership  

Now you can personalize the TMA website so the news and information you care about most appear on your homepage every time you visit www.texmed.org. Personalize your TMA homepage by Dec. 31, and you will be entered to win one of three copies of TMA's Policies & Procedures – A Guide for Medical Practices, a $295 value!

Check the "Keep Me Logged In" box next time you log in with your TMA username and password. Click on Update Your Profile to tell us your specific interests.

After that, anytime you visit us, you'll be logged in automatically to your personalized TMA homepage. Why not make it your browser homepage, too, so you can follow the topics important to you whenever you go online?

TMA offers fierce advocacy, help for your practice problems, lots of continuing medical education, community outreach programs, innovative ways to interact with your colleagues, and the Calendar of Doom to keep you compliant with all the rules and regulations.

Soon, the customized content will move beyond the website and into the TMA emails and newsletters you receive.

Forgotten your TMA username or password? Call the TMA Knowledge Center at (800) 880-7955 or email knowledge@texmed.org.

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Join or Renew TMA Today: We Could Use Your Help!  

You serve as a necessary and important piece of the medical profession. That’s why your membership in TMA is imperative. Only with grassroots support can we make sure Texas remains a premier state in the education of future physicians, research, and quality patient care.

TMA has been a longtime advocate for academic faculty and medical schools, monitoring legislation, determining the potential impact to patients, and actively lobbying for your interests.

Join or renew today at www.texmed.org/join and see what a difference TMA membership can make. Within your department and/or academic institution, funds may be available to cover the cost of your membership. Please check with your department administrator or chair to see if applicable.

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New-to-Texas Physicians Can Start Here  

Are you a physician who is new to Texas? Have you recruited a physician for your school, your practice, or your community from out of state?

TMA's New to Texas Resource Page can help new or returning Texans get their practices up and running. The page provides links doctors need to be licensed in Texas, plus contact information for relevant state and federal agencies and links to resources such as practice consulting for set-ups, health insurance plan contacts, and employee salary data.

Last is a link to the Ask TMA page on the TMA website. TMA members can email the TMA Knowledge Center or call (800) 880-7955 for fast answers to questions about membership, TMA member benefits and services, practice management or legal information, and more.

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Dr. Dickey Resigns  

Nancy W. Dickey, MD, resigned as president of the Texas A&M Health Science Center (TAMHSC) and vice chancellor for health affairs for the Texas A&M University System on Oct. 9 after 11 years in that post. Her resignation was effective immediately.

During her tenure, Dr. Dickey's leadership as president transformed TAMHSC "into a major academic health center, catapulting it from $10 million per year in research to $80 million per year, growing from four to six colleges, adding three new campuses, and more than doubling the school's enrollment from 880 to 2,100 students," A&M said in a statement.

"For the last 11 years, the administration of the health-related programs of the Texas A&M System has essentially been my life," said Dr. Dickey, a former president of the American Medical Association. She said the "impending merger of the TAMHSC into the university seems an appropriate time for new leadership to take the helm. This is an opportunity for me to return to my passion regarding health policy, health care delivery solutions, medical ethics, and professionalism – and the importance of these topics in the education of health professionals. These are exciting times for the A&M System and Texas A&M University; the move of the health-related programs into the core of the university can only enhance the climb to greater accomplishment and recognition."

E.J. "Jere" Pederson, former executive vice president and chief operating officer of The University of Texas Medical Branch at Galveston, will be acting head of TAMHSC and will become interim head at the November Board of Regents meeting. He is a graduate of Trinity University in San Antonio, and has been actively involved in health care administration for more than 30 years.

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This Month in Texas Medicine  

The October issue of Texas Medicine outlines TMA’s efforts to protect patients by stopping nonphysicians’ attempts to practice medicine without going to medical school. It also tells you about the impending switch from TrailBlazer to Novitas as the Medicare claims administrator for Texas, what Texas physicians are doing to prevent childhood injuries, and how health information exchanges help improve care.

It's Academic is for physicians in academic settings. For more information about TMA’s efforts on behalf of medical education and academic physicians, visit the TMA Council on Medical Education’s Subcommittee for Academic Physicians page on the TMA website.

Please share with your colleagues who are not TMA members and ask them to join.

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