Stories written by Kara Nuzback

Road to Resolution - 01/31/2018

No one knows the challenges of a rural practice better than family physician Jeff Alling, MD, who delivered babies for 18 years at a hospital that later stripped him of his obstetric privileges. With help from the Texas Medical Association and the Texas Academy of Family Physicians, Dr. Alling and other family doctors ultimately regained their obstetrical privileges. But the road to resolution was rocky, and the parties narrowly avoided an expensive legal battle.


Tax Fraud - 07/06/2017

A nationwide identity theft scheme is targeting physicians and leaving the Internal Revenue Service liable for hundreds of thousands of dollars in fraudulent tax refunds. As of June, more than 100 Texas Medical Association members notified the association someone had stolen their Social Security numbers and attempted to claim their tax refunds. The association has learned the crime's victims also include physician assistants, advanced practice registered nurses, dentists, podiatrists, and pharmacists. Texas is one of 49 states and the District of Columbia affected by this con.


Battling a Destructive Virus - 04/28/2017

Infectious disease experts and epidemiologists urge physicians to educate their patients about Ebola and to know the signs that may indicate a patient has the virus.


On a Charitable Mission - 10/13/2016

Volunteer physicians answered the call over the summer to care for Central American immigrants crossing the border from Mexico into Texas. Nearly 100,000 unaccompanied minors and families flooded into the United States from October 2013 to August 2014.


Hiring Scribes - 10/03/2016

Many physicians say electronic health records (EHRs) have not made their lives any easier. Though the systems have the potential to improve accuracy and efficiency in a medical practice, EHRs often mean extra administrative work for physicians and less face time with patients. To address these issues, some physicians have hired medical scribes, who sit in during patient visits and document the exam in the EHR. Doctors says scribes make it possible for them to focus on the patient again.


Survey Results Are In - 06/02/2016

Access to care is likely to become a challenge as the physician workforce dwindles, doctors face myriad new regulations, and technology struggles to keep up. A survey of 20,000 physicians commissioned by The Physicians Foundation finds 81 percent of physicians are either overextended or at full capacity in their patient load.


Schoolhouse Stock - 06/02/2016

Texas does not require schools to stock epinephrine unless it's prescribed for a specific student. Texas allergists are now fighting to pass legislation that would force schools to stock unassigned epinephrine injectors so that coaches, school nurses, and other trained staff could immediately treat students who suffer a severe and unexpected allergic reaction.


We Have Your Daughter - 06/02/2016

Virtual kidnappers attempt to extort money from their victims by saying they've kidnapped a member of the victim's family. While no actual kidnapping occurred, the callers use coconspirators, who sometimes scream for help in the background, to convince their victims of the legitimacy of the threat. During June and July of this year, the FBI received multiple reports indicating physicians in McAllen, Laredo, Brownsville, and Del Rio were contacted in attempts to collect extortion payments in "virtual kidnapping" schemes.


Tobacco Dangers - 06/02/2016

This year marks the 50th anniversary of the first surgeon general's report to link smoking to cancer. Public health progress in curtailing smoking is under attack as the tobacco industry, which rakes in more than $135 billion in annual sales, markets a new host of products to a new generation of consumers.


Crossing the Border - 06/02/2016

Hot, humid locations like Southeast Texas provide the perfect environment for the spread of viruses travelers typically bring back to the United States after a trip to the tropics. For instance, dengue and other diseases that travel via mosquito can make their way to the U.S. Gulf Coast. According to the Texas Department of State Health Services (DSHS), 23 Texas patients acquired dengue locally in 2013 — a fourfold increase from the prior 10 years combined. And, dengue is not the only tropical disease to emerge in the United States. DSHS officials identified the first case of chikungunya, a virus also transmitted by mosquitoes, in Texas in July.


Patient Safety First - 06/02/2016

Thanks to opposition from the Texas Medical Association and other organizations, the Texas Board of Nursing (TBON) has withdrawn proposed rules that would have allowed advanced practice registered nurses to make medical diagnoses. TBON announced its proposal on the heels of another scope-of-practice debate involving dentists. In June, a new State Board of Dental Examiners rule took effect, allowing dentists to screen for and treat sleep disorders. The board adopted the rule even though TMA and the Texas Neurological Society testified against the change, pointing out its potential to harm patients with severe obstructive sleep apnea.


The More Your Patients Know - 06/02/2016

In February, the Texas Institute of Health Care Quality and Efficiency released its strategic plan to guide the institute's activities for the next five years, including an initiative to improve health literacy in the state. Many physicians already are taking steps to improve health literacy among their patients. TMA is helping doctors promote health literacy by participating in the national Walk With a Doc program, which promotes patient-physician communication and healthy lifestyles, and the Choosing Wisely campaign, which allows physicians to play a key role in health care literacy by not ordering and recommending tests or treatments that cost a lot of money that have not proven to be effective.


A Lost Art - 06/02/2016

Cesarean births can be lifesaving for a mother and her baby during a difficult delivery. But new data indicate overuse of the procedure, often putting mothers at risk of excessive blood loss and long recovery times. Medical groups are now urging physicians to allow longer labor times to cut down on the country's high cesarean section rate and to improve patient safety.


Standing Up for Patients - 05/25/2016

The Affordable Care Act promotes collaboration and team treatment of patients. The Texas Medical Association agrees collaborative care is crucial, but the association wants to ensure physicians remain the head of the team. With the Texas Legislature in full swing, physicians face several bills that would challenge that leadership and expand the scope of practice for nurses, chiropractors, and other health professionals without a license to practice medicine.


Caring Across State Lines - 05/25/2016

The proposed Interstate Medical Licensure Compact would expedite the process to obtain a license to practice medicine in any state that participates in the compact, making it easier for physicians to move from state to state or to practice telemedicine.


The Next Generation of Cancer Research and Prevention - 05/25/2016

With restored funding from the 2013 Texas Legislature, the Cancer Prevention and Research Institute of Texas (CPRIT) is up and running again, with an emphasis on funding cancer prevention projects and recruiting top cancer researchers to Texas.


Too Much Trust - 05/13/2016

Many physicians hire an office manager to take over the administrative side of the practice so the physician can do what he or she does best — care for patients. But paying bills, depositing money, handling payroll, and accepting payments from patients are everyday tasks that give office managers a lot of power over a medical practice. It's crucial that physicians keep an eye on financial operations to help keep their employees honest.


The Next Phase of Cancer Care - 05/13/2016

The success of cancer treatments brings new issues to light, including how physicians — both specialists and primary care physicians — can support patients once active treatment is over. Survivor care plans, though not as common as they should be, are an important part of any survivor's aftercare. The plans include a summary of the patient's diagnosis and treatments, as well as a course of action for screenings, office visits, and lifestyle recommendations.


The New Company Doctor - 05/13/2016

Health care costs rise every year for employers and employees. Worksite wellness clinics are gaining popularity among many large corporations for their potential to lower health care costs and reduce employee absences. Rather than pay for each employee to visit a separate primary care physician, employers are contracting with medical groups that set up primary care clinics at the workplace.


Sun to Set on Overzealous Fraud Investigations - 05/13/2016

After a scathing Sunset Advisory Commission report on the Office of Inspector General (OIG), the Texas Medical Association supports improving the agency's investigations of physicians accused of fraud, waste, and abuse. The report says the OIG — tasked with preventing, detecting, and investigating fraud, waste, and abuse in the Medicaid system — fails at fraud prevention, takes more than three years to resolves cases, and wins back only a fraction of the amount of allegedly abusive or wasteful spending it identifies.


Ruling Could Yield Chaos - 05/13/2016

Two conflicting court rulings on the use of health insurance premium subsidies could affect patients' health — and doctors' wallets. On July 22, the U.S. Court of Appeals for the District of Columbia Circuit ruled that the government should not be providing premium subsidies to consumers buying health insurance in states like Texas that use HealthCare.gov, the federally run Affordable Care Act insurance exchange. But, later the same day, the U.S. Court of Appeals for the Fourth Circuit in Richmond, Va., upheld the current practice of allowing premium subsidies for anyone buying health insurance in either the federal marketplace or a state exchange.


Protecting the Family - 05/13/2016

Physicians in Texas can prescribe treatment to nonestablished patients only in cases of sexually transmitted diseases or when the governor declares a pandemic. In other cases, Texas Medical Board (TMB) rules prevent physicians from administering postexposure prophylaxis (PEP) unless a "proper professional relationship" has been established. The Centers for Disease Control and Prevention (CDC), the American Public Health Association, and the American Academy of Pediatrics recommend PEP as a preventive measure for various infectious diseases, including pertussis and meningococcal meningitis, for family members or others in close proximity to patients with the illnesses. The Texas Medical Association is working with TMB to change the rules associated with PEP to better enable physicians to implement CDC recommendations.


Medical Board Wages War Over Telephone Treatment - 05/13/2016

In a case working its way through Texas courts, Teladoc argues that a face-to-face meeting is unnecessary for new patients. Teladoc provides telephone patient consultations, claiming that a phone call with a licensed physician can serve as a convenient supplement when patients don't have the time or money to see their primary care doctors. Some physicians say a phone conversation is not enough to properly diagnose and treat a patient with whom the physician is unfamiliar.


HIEs and the Gateway to Better Care - 05/13/2016

Health information exchanges (HIEs) are becoming a more widely used method for physicians to share valuable patient information. A proposed health service enterprise gateway would connect to local health information exchanges and give physicians a single place to exchange data with all state health agencies.


Grappling With Small-Business Insurance - 05/13/2016

Some physicians offering health insurance to their employees are feeling the impact of the Affordable Care Act. The TMA Insurance Trust can help physicians navigate their insurance purchases.