Year in Review n u m b e r
In this issue: 2011 Year in Review - DCMS at a glance
DCMS Member Roundup - Event Photos
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About
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Cover Photo
Solomon Pearce, DO, with his wife, Erika, and their children Fiona and Sebastian enjoy a night out at the DCMS Member Roundup.
Dallas County Medical Society PO Box 4680, Dallas, TX 75208-0680 Phone: 214-948-3622, FAX: 214-946-5805 www.dallas-cms.org Email: lauren@dallas-cms.org
DCMS Communications Committee Roger S. Khetan, MD.............................................. Chair Robert Beard, MD Gene Beisert, MD Suzanne Corrigan, MD Seemal R. Desai, MD Daniel Goodenberger, MD Gordon Green, MD Steven R. Hays, MD Ludwig A. Michael, MD David Scott Miller, MD
DCMS Board of Directors Shelton Hopkins, MD....................................... President Richard W. Snyder II, MD..........................President-Elect Steven R. Hays, MD..........................Secretary/Treasurer Stephen Ozanne, MD.............. Immediate Past President Garret Cynar, MD Sarah L. Helfand, MD Michael R. Hicks, MD Jeffrey Janis, MD Rainer A. Khetan, MD Dan McCoy, MD Todd Pollock, MD Cynthia Sherry, MD Jim Walton, DO
DCMS Staff Michael J. Darrouzet................... Chief Executive Officer Lauren N. Cowling................................ Managing Editor Mary Katherine Allen........................... Advertising Sales Articles represent the opinions of the authors and do not necessarily reflect the official policy of the Dallas County Medical Society or the institution with which the author is affiliated. Advertisements do not imply sponsorship by or endorsement of DCMS. ©2011 DCMS
According to Tex. Gov’t. Code Ann. §305.027, all articles in Dallas Medical Journal that mention DCMS’ stance on state legislation are defined as “legislative advertising.” The law requires disclosure of the name and address of the person who contracts with the printer to publish legislative advertising in the DMJ: Michael J. Darrouzet, Executive Vice President/CEO, DCMS, PO Box 4680, Dallas, TX 75208-0680.
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Pr es i de nt’s Pa ge Private or Public Practice?
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Bus i ne s s of Medi ci ne The Physician Fear Factor: Stay Independent
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or Go Corporate?
Me mber Roundup Photos
23 7 Communi ty Improving
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Community with Project Access Dallas
2011 Ye ar i n R evi e w
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La r ge Gr oups Recognition for 100-percent
Membership
Dallas Medical Journal (ISSN 0011-586X) is published monthly by the Dallas County Medical Society, 140 E. 12th St, Dallas, TX 75203.
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Update : NTAHP
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W. Phi l Eva ns , MD
N o rth T exa s Ac c o unta b le Hea lthc a re Pa rtners hip Subscription rates $12 per year for members; $36, nonmembers; $50, overseas. Periodicals postage paid at Dallas, TX 75260.
Postmaster Send address changes to: Dallas Medical Journal, PO Box 4680 Dallas, TX 75208-0680.
N ew N a tio na l Presid ent o f the Americ a n C ancer Society
submit letters to the editor to lauren@dallas-cms. org visit us online at www.dallas-cms.org • December 2011 •
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Upcoming State and Federal Compliance Dates to Know 2011
2012
December 23
January 01
Medicare: Medicare SGR Formula, Debt Commission Deadline for House and Senate Votes; Procedural Protections End
Federal Agency: Physician Payment Sunshine Act implications for manufacturers and providers.
January 01
December 31
HIPAA 5010 Electronic Transaction Standards. Upgrade or You Won’t Get Paid!
2011 E-Prescribing Incentives. End-of-year reporting deadline to claim a 1% bonus.
January 01
December 31 2011 Physician Quality Reporting System (PQRS) incentive year ends. Report data by March 31, 2012, to claim a 1% Medicare bonus.
December 31
Medicare: SGR Formula 29.5% Medicare physician payment cut takes effect.
January 01 Private Payor: Blue Cross Blue Shield of Texas announces it will accept billing with national drug codes.
January 02
Electronic Health Records (EHR). Reporting year ends for Medicare EHR incentive program. Register by Feb. 29, 2012, to claim your incentive payment.
Medicare: SGR Formula Office of Management and Budget Orders Required Cuts
January 09 Medicare: Medicare won’t pay hospice claims when required timely face-to-face encounters do not occur.
January 15 Federal Agency: IRS – Estimated tax payment due
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• December 2011 • Dallas Medical Journal
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President’s Page
Private or Public Practice? The pressure cooker that is Medicine in the United States continues sitting on the fire, and the gauge is headed for the red line. We are producing inadequate numbers of primary care physicians while the population ages, technology advances, costs increase, and resources (i.e., the economy) stagnate. Something will given, but the idea that starving Medicare’s funding will solve anything is wrongheaded; the care needs to be given regardless of whether the state or the patient pays for it. I have been trying to clarify the factors in our private practice system that are highly expensive for the practitioner, and the primary driver seems to be the paper and verbal interaction with third-party payers. Imagine an office in which you evaluated the patient, created your own records, made your recommendations, and provided your referrals and/or prescriptions. Then, the patient paid you and left. You then started the cycle with your next patient. That actually is the system in some European countries. A third party is involved that pays, but it pays the patient, not you (unless the patient is destitute). Each patient has a medical ID card that allows the insurance company, whether it is the state, a private company or a combination, to watch out for fraud. What changes would be necessary to our system to enable such a streamlined practice? First, let’s address the relative importance of such changes. Physician charges/payments historically constituted about a third of the pie. Now the fraction is smaller, but it’s still a big slice. Our system expenses have grown so large, however, that even if every physician practiced entirely gratis, the US medical system would be more expensive than that of other developed countries. Clearly, other issues must be dealt with. For instance, the piecework system subtly encourages the system to produce more pieces. If those pieces are defined as procedures requiring a day or more in a hospital or ambulatory surgery center, then a decision by a surgeon to perform that procedure generates a much higher cost to the system than the actual charges by the surgeon. Each of us is, of course, sure that he/ she is not influenced by such venal goals, but what about that doc down the street? In systems where the piecework system has been eliminated or greatly curtailed, the number of procedures has dropped. But so has efficiency, so the answer is not clear. I doubt we will ever see a universal salaried physician system.
Second, we have to consider the prescription drug costs that have gone through the roof. R&D costs make up less than 15 percent of pharma expenses, but, if pharma firms are threatened with payment reductions, they claim a need for income to maintain R&D. There is the assertion that the US market is providing pharma firms with R&D funds that are denied them in countries that have more controlled payment systems. More drug patents now are produced in Europe than in the United States. So, at a minimum, we should allow Medicare to negotiate for lower costs — something that currently is illegal. Everyone waxes hot about medical costs — and then we allow direct-to-consumer advertising. That either wastes the time spent explaining why the wonder drug seen five times last week on TV is not a good idea for this patient, or it results in the capitulation of the physician and, therefore, an increase in drug charges. Third, office overhead has to drop. The payment to physicians will decrease, but if one’s overhead is dropping at the same rate, efficiency is increased. The growth of the concierge practice is a great experiment. It can’t work for most patients using the current model, but it could morph into a more universal system. The basics of the current model are that the patient makes an annual payment out of pocket and, therefore, gets more complete access to the physician. Usually the patient pays the physician for the office visits. The patient submits the charges to his insurance company, which then pays the patient. Another way to cut overhead would be to require uniformity in insurance plans. Already, Medicare has different well-defined levels of Medigap coverage, and the levels are the same for each company. There is no legitimate reason that the forms for all medical plans that all insurance companies provide are not identical, that their coverage rules are not the same, or that they don’t have a common phone number to get clearance for tests and procedures. Finally, patients must accept less hand-holding. An office receptionist should not be necessary. Currently, the receptionist has additional duties, so he/she might as well welcome patients and sign them in as they arrive. But if the paper work were cut by one half or two thirds, or even eliminated, then when the patient learned to simply sign in and wait, that FTE would not be needed. Organized medicine needs to stop negotiating for crumbs and start trying to change the system to allow for the noncorporate practice of medicine. The traditional model will not be viable once the available payment covers only your office expenses. Left to the hospitals and insurance companies, the system will become our employer.
Shelton Hopkins, MD
visit us online at www.dallas-cms.org • December 2011 •
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Renew online or contact Cara Jaggers, director of membership, at 214.413.1423 or cara@dallas-cms.org for more information.
visit us online at www.dallas-cms.org • December 2011 •
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R e a l Pat i e n t s . R e a l s t o R i e s .
to “Thanks Baylor, asthma doesn’t scare me anymore.
”
Anabel Acostas’ allergies and asthma took all the fun out of being a kid. “I used to play soccer, but I had to stop. I didn’t feel normal and it really hurt to breathe,” she said. At Martha Foster Lung Care Center at Baylor Dallas, Anabel, age 11, learned how to manage her asthma. Breathing treatments and learning what allergens to avoid helped get it under control. “I have to wrap my stuffed animals in a plastic bag, put them in the freezer for a couple of nights, and, in the morning, they’re ready to play with for six weeks.” Today, Anabel swims and rides her bike without breathing problems. Soon she’ll start gymnastics. “I’m so glad Baylor helped me with my asthma.”
For a physician referral or for more information about asthma care services, call 1.800.9BAYLOR or visit us online at BaylorHealth.com/AsthmaToolbox. 4004 Worth Street, Ste. 300, Dallas, TX 75246 Physicians are members of the medical staff at one of Baylor Health Care System’s subsidiary, community, or affiliated medical centers and are neither employees nor agents of those medical centers, Baylor University Medical Center at Dallas, or Baylor Health Care System. Rules of Two is a federally registered service mark of Baylor Health Care System. ©2011 Baylor Health Care System. BMFLCC_106 DCMS CE 11.11
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DCMS values your opinion. We need your input to make your Dallas County Medical Society even better! We’re interested in your feedback regarding DCMS’ advocacy efforts, communication tools and pieces, and membership events and services. Our survey only has 15 questions and should take no longer than 3 minutes to complete.
Questions? Contact Lauren Cowling, DCMS director of communications, at 214.413.1447 or lauren@dallas-cms.org.
Early diagnosis and treatment of HIV saves money and improves health outcomes. Routine HIV testing in health care settings is as cost effective as other screening programs, including type 2 diabetes and breast cancer mammography. Learn more at
www.testtexashiv.org
Krentz HB, Auld MC, Gill MJ. The high cost of medical care for patients who present late (CD4 < 200 cells/μL) with HIV infection. HIV Medicine. 2004;5:93-8.
message no 6 dcms.indd 1
6/12/11 7:09:35 PM
visit us online at www.dallas-cms.org • December 2011 •
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PRACTICE MANAGEMENT
Isn't it about time you focused more on medicine, and less on administrative hassles?
D
o you enjoy reading managed care contracts? How about completing multiple applications? Do you know if you are being reimbursed correctly? Could a physician-operated IPA be the answer?
What do you get out of SPA Membership? Contracting: SPA reviews hundreds of pages of legal terms with the cooperation of the health plan and presents you with an objective summary of the terms in a format which is standardized. Then, "SPA Compare" allows you to analyze the fees offered compared to local Medicare and to other commercial plans in a way that is customized to your practice. Operations: The contract summary and SPA Compare may easily be used by your collections operation to be sure that you are being paid properly under the SPA Contract. SPA maintains relationships with its contracted health plans which help you receive what you are entitled to under the SPA Contract.
FACT: Physicians earn more money per hour in the clinic and the O.R. — practicing the skill of medicine — than they can playing accountant, coder or office manager. Delegation is the key of every successful business enterprise.
Credentialing: All SPA Contracts include delegated credentialing and recredentialing. This allows you to contract with many plans by completing only one application and allows you to keep your credentials updated with many payors through only one entity. Ancillary Services: SPA has group purchasing rates for medical supplies, medical waste disposal and other services for SPA members. This helps you to keep your overhead
costs low. Value: All of these benefits come from a physician-run IPA for less than $80 per month. Want to find out more? Call us at 214-346-6623, or visit us at www.spa-dallas.com. We can help you get back to the practice of medicine in 2012.
SouthweSt PhySician aSSociateS - iPa Find out more about how we can help your practice at www.spa-dallas.com or call 214.346.6623 8150 N. Central Expressway • Suite 1250 • Dallas, TX 75206
Business of Medicine
The Physician Fear Factor: Stay I nd e p e n de n t o r G o C o rp orat e? By Diane K. Shaw, JD As provisions of the Patient Protection and Affordable Care Act are enacted, a sea of change is sweeping across America, most notably in the medical field. To say the reform law and its rapidly evolving regulations are creating fear among physicians would be an understatement. In fact, an alarming number of physicians are so frightened that they believe their only option for remaining in practice is to work underneath a corporate entity, hospital or Accountable Care Organization (ACO), rather than maintain their independent practices and face these landmark changes as both medical specialists and business owners. This is understandable, given all the unknowns for physicians in the immediate and longer terms. The challenge looms of managing ever-changing regulatory and compliance measures, including: • RAC audits • Medical fraud units • False claim provisions • Antikickback rules • Stark regulations • HIPAA requirements • OSHA regulations • Pharmaceutical regulations • Licensing requirements • Criminal prosecutions Added to this growing regulatory pressure is another dark specter — declining reimbursements for physician services. The PPACA and Reconciliation Act indicate that direct Medicare spending will decline approximately $390 billion from FY 2010 to FY 2019. Moreover, healthcare economists predict that private insurance plans will be forced to slash reimbursements in order to remain competitive in a marketplace of shrinking coverage options. Combine these trends with the dramatic Medicaid cuts coming down the pike, and the future can seem pretty dark and frightening. With physicians’ apprehensiveness of being responsible for compliance and being financially unable to hire more staff to manage the paperwork, it’s no wonder physicians are surrendering their role as practice managers and business owners, letting someone else deal with the regulatory headaches. Before switching from owner to employee, physicians must consider what these changes in responsibilities might mean and their effect on the physicians professionally, financially and in terms of personal fulfillment. Financial Considerations — How is the organization’s billing set up? Does its billing cost exceed yours, and if so, will it minimize your returns? Will the
A corporate entity’s financially motivated decision to settle a case can have long-term consequences: it can damage a physician’s hardearned reputation and impact his or her licensing, data bank reporting and privileges . compliance expenses, risk management expenses, benefit expenses, or overhead expenses affect your returns? Management Considerations — Will you have control over your contracts? Will you be able to choose and control your professional liability insurance company? Personal Considerations — Will you be allowed to retain your freedoms, flexibility and hours? Ethical Considerations — Will you be allowed to retain your power to decide whether to settle or to try a case? For most hospital- or corporate-owned medical affiliations, the decision on whether to fight or settle a lawsuit is purely financial. Affiliated physicians often are given no choice in their malpractice insurance carrier and are denied the option to settle or to try a case. A corporate entity’s financially motivated decision to settle a case can have long-term consequences: it can damage a physician’s hard-earned reputation and impact his or her licensing, data bank reporting and privileges. A physician who addresses the effects through legal or other means would be paying completely out of pocket. If you boldly choose to stay the course, exercise equal caution. Physicians who affiliate with an ACO or corporate entity must consider reductions in their independence, but to make headway in the face of continued reimbursement reductions, those who remain independent must bolster their internal business structures with qualified and efficient support for billing, regulatory compliance and financial management. When it comes to deciding how to practice medicine, the choice is up to each physician. Those resisting the urge to flock to ACOs will have much to learn. With so much in flux, now is the time to take the first step. Reach out to professional organizations, like-minded physicians and supportive legal advisors to pave the path toward a more stable future. Diane K. Shaw is a practicing attorney and a member of the DCMS Circle of Friends. She can be reached at dshaw@dkshaw.com or 214.217.8288.
visit us online at www.dallas-cms.org • December 2011 •
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Member Roundup
The 9th Annual DCMS Member Roundup on Oct. 28 featured magician James Munton, lots of food, fun, and physicians’ families.
Magician James Munton and Leo Crowley, MD
Matthew Nevitt, MD, and Grant
DCMS Board Members Drs. Wendy Chung and Sarah Helfand
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Tammy and Martin Cohen, MD
Kids stand in line for the balloon artist.
Valentino Fernandes, MD, with Christopher, Zachary and Benjamin
James Munton gets help with a trick from DCMS President Shelton Hopkins, MD.
Remigio Capati, MD, with family members Herminia, Leo, Regi, Teo, Marissa, and Patricia
Jim Davie, MD, and Ruthie
Jason Willis, MD, and Dominic
Kristian and Amy Hayes, MD, and Aaron and Kelsea
Michael Johnston, MD, with his children Annie, Lucas and Nicholas
visit us online at www.dallas-cms.org â&#x20AC;˘ December 2011 â&#x20AC;˘
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Community
Improving Community with Project Access Dallas By Jim Walton, DO, MBA, Project Access Dallas Medical Director I have a habit of eating quickly and reading books slowly. After a 4 – 5 month slog, I recently finished David Brooks’ “The Social Animal.” Toward the conclusion of the book, I stumbled on a couple of items worthy of our attention as DCMS continues its community service/ health efforts. In the final chapters, the book’s aging protagonist reflects on his contributions to the world, venturing into the political life of our nation and his aspiration to create more civility. Reflecting on politics, he sketches his tendencies to establish political affiliations based on a set of principles most closely aligned with familiar ideas and themes, set in his mind during early childhood. The author concludes that regardless of whether we align with the right, left or center of the political spectrum, our subconscious is telling our conscious mind which political ideas we like and which we don’t. As I read further, I began to see Brooks’ intent to leave the reader with a sense of the possible. With this in mind, I began to wonder if some new combination of political thought and action could help organized medicine take a giant step toward improving the health of our community through our community service. Likewise, I am certain that when DCMS acts to increase community service and improve community health, it does so believing that its physician members desire to meaningfully engage in promoting a better society. We might focus on a limited number of themes in which to discover associations and correlations that will improve community health. This may be difficult because, as scientists, our subconscious may tend to ignore the “softer” and more difficult to prove correlating features of the complex systems of
culture, morals and behavior. In no uncertain terms, Brooks describes the tendency, when selecting our political opinions of social improvement (either right or left), to negate, minimize or ignore the social and communal bonds undergirding a person. For example, despite the great technical skills that have produced medications and behavioral change theories for people plagued by diabetes, the hardest skill yet to be developed is the one of listening, understanding and building trust with both patients and communities suffering disparities of diabetes. Through the work of Project Access Dallas, we have developed a social technology, Community Care Coordination, that helps uninsured diabetics control their disease. Community Care Coordination combines investments in healthcare delivery teams that are armed with technical advice (access to physicians, medications and self-management education) with community building initiatives (increasing patient’s trust in the healthcare system), all in one strategy. Care coordinators develop a deep understanding of the moral and cultural aspects of the target community, acquiring knowledge of forces that help change points of views and lifestyles of diabetic patients. With this new strategy, we have developed ways to alter behaviors responsible for shaping and controlling diabetes in low-income populations. Lessons learned with Community Care Coordination are strong reminders of what David Brooks seems to be saying: the social constructs that help create our personalities, attitudes and beliefs can be understood and manipulated to improve community health and society. Let’s keep learning.
visit us online at www.dallas-cms.org • December 2011 •
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2011 • Shelton Hopkins, MD, was installed as the 128th president of the Dallas County Medical Society.
• DCMS hosted 20 events during the year that gave members a chance to network with colleagues, give back through community service, and spend time with their families. • Our first DCMS Spring Celebration Picnic at the Dallas Arboretum brought almost 350 physicians and their families. • DCMS Facebook was launched in June. • The entire Dallas Medical Journal is now available online. • The Dallas County Medical Society employs 31 full-time staff members through DCMS, Project Access Dallas and the North Texas Accountable Healthcare Partnership. • The North Texas Accountable Healthcare Partnership received grant funding for the advancement of health information exchange efforts in North Texas. The Partnership will use the HIE to connect data from physicians, hospitals, health plans, and ancillary services in our community, and to track clinical performance. The Partnership is a nonprofit 501(c)3 organization which includes physicians, hospitals, employers, and health plan leaders of North Texas’ county medical societies, Dallas-Fort Worth Hospital Council, DFW Business Group on Health, and the major health plans. The Partnership’s mission is to promote and reward healthcare clinical performance for North Texas residents that is coordinated, transparent and value based. • DCMS welcomed four new members to the DCMS Circle of Friends, including HiTRUST ID Services as an endorsed Diamond Level sponsor.
ACTIVE 4029
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1st YEAR 120
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RETIRED/MILITARY 814
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LEAVE 123
YEAR IN REVIEW During the 2011 legislative session, DCMS joined TMA in the fight to protect the patient-physician relationship in every aspect of the healthcare system. As part of this effort, DCMS sent 42 members to Austin for First Tuesdays at the Capitol during February, March, April, and May. DCMS/TMA accomplishments during the legislative session included: • Fought off severe cuts to physicians’ Medicaid payments. Result: Physicians won’t be forced to stop seeing Medicaid patients. • Protected the patient-physician relationship against corporate interference. Result: Patients’ healthcare needs come before a corporation’s bottom line. • Defended clinical autonomy of physicians employed by rural hospitals, 501(a)s and future healthcare collaboratives. Result: Physicians and their patients have ultimate control of healthcare decision making. • Won reforms to the Texas Medical Board. Result: The improved TMB disciplinary process is much more fair for physicians, without endangering Texas’ medical liability reforms. The anonymous complaint was eliminated. • No scope-of-practice expansions. Result: Midlevel practitioners and allied health professionals must stay within a scope of practice safely permitted by their education, training and skills. The physician remains the leader of the healthcare team. • Safeguarded the public health system. Result: Cuts to tobacco cessation and chronic disease prevention programs were mitigated. • Improved immunization requirements. Result: College students are protected from meningococcal meningitis, and new vaccination policies ensure that health workers won’t spread infectious diseases to their patients.
RESIDENTS 472
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STUDENTS 842
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TOTAL MEMBERS 6,445
In recognition
of their continued support, DCMS spotlights
large group practices of 20 or more physicians that have
100% membership.
DALLAS ANESTHESIOLOGY ASSOCIATES 4144 N Central Expy, Ste 360 Dallas, TX 75204-3140 214-827-7460 www.daadoctors.com
METROPOLITAN ANESTHESIA CONSULTANTS, LLP 3300 Oak Lawn Ave, Ste 200 Dallas, TX 75219-4265 214-252-3500 www.metroanesthesia.com
Dallas Anesthesiology Associates is a professional association of 21 board-certified physician anesthesiologists serving multiple hospitals and surgery centers throughout the greater Dallas area since 1962. Focusing on anesthesia for patients of all ages greater than 12 months, we provide the most up-to-date techniques for inpatient and outpatient general, orthopaedic, ENT, gynecologic, urologic, breast, and plastic surgeries. In addition to all forms of general anesthetic techniques, DAA promotes and practices the latest forms of regional and block techniques both for surgery and post-operative pain management. (DAA Mission Statement)
Metropolitan Anesthesia Consultants is comprised of more than 45 physicians providing excellence in anesthesia care at many hospitals and surgery centers throughout the Dallas/Fort Worth Metroplex. Our commitment to our patients, surgeons and hospitals can be seen through the education, training and experience of each of our doctors. Under our physicians, patients can be assured that they are in the very best of hands for any type of surgery. (Metro Anesthesia Web site)
DALLAS NEPHROLOGY ASSOCIATES 1420 Viceroy Dr Dallas, TX 75235 214-358-2300 www.dneph.com Dallas Nephrology Associates is one of the nation’s largest groups of practicing nephrologists. Since 1971, it has enjoyed the trust of its patients throughout the Dallas metropolitan area. DNA is a professional medical association consisting of physicians and other vital support staff, including nurse practitioners, physician assistants, nurses, laboratory and X-ray technologists, dietitians, social workers, technicians, and research staff. (DNA Web site) DIGESTIVE HEALTH ASSOCIATES OF TEXAS, PA 7929 Brookriver Dr, Ste 300 Dallas, TX 75247 214-689-5960 www.dhat.com Digestive Health Associates of Texas, P.A., is the largest gastroenterology physician group in the country. The provision of high-quality, cost-effective patient care is the primary goal of DHAT physicians. By maintaining a staff of exceptional subspecialists, DHAT is uniquely qualified to deliver services supporting the full spectrum of an individual’s digestive health care. Our physicians share expertise, talent and technology to promote the patient’s positive outcome, comfort and quality of life. Excellent nursing staff and other healthcare professionals support our physicians. (DHAT Web site) EXCEL ANESTHESIA 4100 International Plaza, Ste 600 Fort Worth, TX 76109 800-863-2002 www.excelanesthesia.com Excel Anesthesia is an all-physician anesthesia group dedicated to providing the highest quality perioperative care. Our group originated as a cardiac anesthesia practice in 1979. Excel Anesthesia attends to all facets of complex modern anesthesia practice. Excel Anesthesia is committed to continuing education, continuous quality improvement, and the incorporation of state-of-the-art monitoring and techniques in our practice. Excel Anesthesia strives to apply the principles of excellence to every aspect of every case. (EA Web site)
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NORTH TEXAS EAR, NOSE AND THROAT ASSOCIATES 900 E Northwest Hwy, Ste 250 Grapevine, TX 76051 972-264-5600 www.mynorthtexasent.com The members of NTENT are selected based upon their credentials, reputation, areas of clinical expertise, ability to work within a group structure, and geographic location. We have more than 70 board certified/board eligible otolaryngologists and cover every hospital facility in the Dallas/Fort Worth area. NTENT is the largest ENT group in the Southwest and one of the largest ENT groups in the country. NTENT holds contracts that represent more than 90% of the covered commercial lives throughout DFW. NTENT’s unique structure has been discussed as a model for success in the national publication for the AAO-H&N. (NTENT Web site) PINNACLE ANESTHESIA CONSULTANTS, PA 13601 Preston Rd Ste 1000W Dallas, TX 75240-4911 972-715-5000 www.pinnacleanesthesiamed.com Pinnacle Anesthesia is dedicated to improving care of our patients through the prevention, evaluation, diagnosis, treatment, and rehabilitation of painful disorders. Pinnacle Anesthesia offers a variety of services and provides high-quality service to an extensive range of practice settings in over 100 locations throughout the Metroplex. (Pinnacle Web site) Radiology Associates of North Texas 816 W Cannon St Fort Worth, TX 76104-3146 817-321-0300 www.radntx.com Radiology Associates of North Texas provides high-quality, valueoriented, diagnostic imaging and therapeutic services to our patients, referring physicians and payors in the North Texas medical community. Our focus through continuous improvement is to enhance the quality of life to all those we serve, both in the hospital and outpatient imaging environments. Our contributions enhance our reputation and ensure growth within the community. (RANT Web site)
RADIOLOGICAL CONSULTANTS ASSOCIATION 221 W Colorado Blvd, Ste 440 Dallas, TX 75208-2376 214-946-4397 www.rcaonline.net
UROLOGY ASSOCIATES OF NORTH TEXAS 612 E Lamar Blvd Arlington, TX 76011 817-784-0818 www.uant.com
Radiological Consultants Association is a multispecialty radiology group based in DeSoto. We provide on-site hospital and outpatient imaging center coverage and teleradiology services. For more than 30 years, our team of board-certified, fellowship-trained radiologists has been committed to offering excellence in radiologic health care by providing the highest quality screening, diagnostic, and interventional radiology services to both patients and providers in our community. (RCA Web site)
With 50 physicians and 20 locations throughout the Metroplex, we are one of the nation’s largest fully integrated urology practices. UANT is a unique combination of experienced and fellowship-trained physicians, utilizing state-of-the-art diagnostic and therapeutic facilities, with a commitment to excellence and a relentless pursuit of quality. This linking of medical professionals and the latest technology with a mission of delivering “world class” patient care has led to the development of our nationally recognized Centers of Excellence with fellowship-trained and experienced specialists in urology. (UANT Web site)
TEXAS RADIOLOGY ASSOCIATES 1820 Preston Park Blvd, Ste 1200 Plano, TX 75093 972-867-7862 www.texasradiology.com Texas Radiology Associates has been providing radiology services to the North Dallas community since 1972. We practice high-quality 24-hour hospital-based radiology. We are a large, dynamic group of more than 60 radiologists and represent every subspecialty of the exciting and fast-growing field of radiology. Most of our radiologists are fellowship-trained at leading institutions in subspecialties including interventional radiology, women’s imaging, neuroradiology, pediatric radiology, abdominal imaging, musculoskeletal imaging, cardiovascular imaging, MRI, nuclear medicine, and emergency radiology. As a result, we offer the full spectrum of diagnostic and interventional radiology services, including all modalities and both vascular and nonvascular procedures. (TRA Web site)
UROLOGY CLINICS OF NORTH TEXAS 8230 Walnut Hill Ln, Ste 700 Dallas, TX 75231 214-691-1902 www.urologyclinics.com Urology Clinics of North Texas gives its patients excellent care and treatment of urological disorders, and delivers that care courteously, caringly and efficiently. We strive to provide highly positive medical outcomes, apply proven advanced technology and pharmaceuticals, and deliver care in locations convenient to patients throughout Dallas, Collin and Rockwall counties. We affiliate with hospitals and other physicians who share a reputation for excellence, and continuously expand and update our medical knowledge, skills and techniques. (UCNT Web site)
TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN 2222 Welborn St Dallas, TX 75219 214-559-5000 www.tsrhc.org Texas Scottish Rite Hospital for Children is one of the nation’s leading pediatric centers for the treatment of orthopaedic conditions, certain related neurological disorders, and learning disorders, such as dyslexia. Admission is open to Texas children from birth to 18 years of age. Patients receive treatment regardless of the family’s ability to pay. (TSRHC Web site)
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Update: North Texas Accountable Healthcare Partnership By Bryan White, NTAHP, HIE executive director
The Partnership Health Information Exchange has taken another large step toward serving North Texas. With the submission to the state and its approval of our business and operational plans (B&O), the Partnership HIE is ready to embrace the implementation phase and begin providing services to our community in 2012. On Oct. 31, the North Texas Accountable Healthcare Partnership (Partnership) celebrated its official first anniversary. The effort originated in 2009 as the North Texas Summit, a meeting to evaluate innovative approaches to improve the quality and value of health care in North Texas. Local representatives included Dallas Mayor Tom Leppert, who met with leaders from health plans, pharmacies, employers, and the hospital and physician communities. The founding members of the Partnership are the Dallas County Medical Society, the Dallas-Fort Worth Business Group on Health, the DallasFort Worth Hospital Council, and CIGNA. Integral to the success of the Partnership’s plan to drive value is the ability to openly share and exchange healthcare information among physicians, hospitals, pharmacies, labs, clinicians, and other healthcare providers. The North Texas community supported the development of this information technology infrastructure through the Partnership, which serves as a neutral governing body with a United Nations approach, representing each stakeholder group. In late 2010, the Partnership applied for grant funding from the Texas Health and Human Services Commission to help develop health information exchange technology. The Partnership was awarded more than $700,000 to execute a six-month plan. The deliverable from this was a robust business and operational plan submitted to the state on Oct. 17, 2011. The B&O Plan was developed with the help of Computer Sciences Corp., Inc., and led by the Partnership HIE Committee. The Partnership Committee consists of representatives from each stakeholder group who provide varying definitions of “value.” For example, solo physicians bring a different voice to the planning effort than do large, multispecialty groups. This also is true with hospitals; the needs and value propositions for independent hospitals are different from those of large systems with integrated physician practices and significant investment in IT infrastructure. The Partnership HIE aims to complement those practices, while providing enough services to entities with little to no current investment to improve the quality and value of health care for their patients. The B&O Plan emphasized the sustainability model and technical services of the Partnership HIE. The Partnership must serve the community as a neutral, nonprofit foundation, but we must do so by developing a sustainable resource. Grant funding from the state, which will cover a significant portion of our development, has catalyzed the Partnership HIE, but we must show value and share value with our stakeholders.
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Because Value = Quality/Cost, the Partnership will focus on reducing the cost of health information exchange to generate realized value by our stakeholders. With such a large service area, we will be able to spread the costs among a great pool of participants. The Partnership HIE’s 13-county region covers 11,700 physicians and 140 hospitals, and includes more than 6.5 million patients. The technology deployment will occur in phases and begin the first quarter of 2012 with direct messaging services. This will allow physicians, hospitals and other clinicians to securely and safely share information electronically, including providing referrals, sending/ receiving information from hospital visits, and sharing test results. This also will serve care coordination efforts and data reporting. This messaging service will allow physicians to securely exchange information outside current systems (including to physicians involved with a different regional HIE), complementing the resources that some stakeholders already have developed. Throughout 2012, the Partnership will work to develop and implement more robust services centered on a master patient index and record locator service. This will allow a physician to look up a patient at the point of care and receive relevant information from past treatment. This will provide physicians with a more longitudinal patient record to supplement existing information. The Partnership HIE will deploy this technology in a number of ways to include as many physicians as possible. Capabilities to integrate into a physician’s EMR or EHR will exist for many EHR products, and we will continuously work to develop these capabilities with new systems. For physicians without a current system or with a system that cannot connect to an HIE, we will provide means to share information, including a Web-based tool with all the HIE features, clinical in-boxes and single sign-on capabilities. The Partnership HIE Committee is still developing many of the specifics regarding sustainability, technology, policies, and procedures. This is a utility developed by the stakeholders who ultimately will use it. We welcome involvement and input from our physician community. If you have any questions, ideas, comments, or concerns, please contact us. Also, we offer a number of opportunities to get involved, including the Technology, Privacy and Security, Sustainability, and Clinical Advisory workgroups. More than 40 percent of the physicians in the North Texas market have signed letters of support for our effort, and we hope you will do the same. Our funding allocation is based on demonstrated support from our community, and we would benefit greatly from your help. A template letter of support can be found on the DCMS Web site or by contacting Bryan White at bwhite@ntahp.org.
W. Phil Evans, MD N e w N at i o n a l P res i d ent of t he Ameri can C ancer Society W. Phil Evans, MD, professor of radiology and director of the UT Southwestern Center for Breast Care, in November was inducted as national president of the American Cancer Society, the nation’s largest voluntary health organization. He has served on the ACS national board of directors since 2004. Dr. Evans is a 25-year ACS volunteer and will serve for the next year as a leader and primary volunteer spokesman on medical issues. “We want this to be a world without cancer,” Dr. Evans says. “Since 1990, the lives of 350 more people each day have been saved, thanks to the American Cancer Society and others. If we apply the things we know to do — such as appropriate screening, tobacco control, healthy diet, and increased physical activity — we can get to where we save 1,000 lives a day.” A Texas native, Dr. Evans graduated from UT Southwestern in 1972 and completed his internship and residency at Baylor University Medical Center. He returned to UT Southwestern as a faculty member in 2002. A year later, he became director of the Center for Breast Care. His leadership in multi-institutional studies paved the way for the nation’s switch from film to digital mammography and improved breast cancer screening for high-risk patients by combining mammography with ultrasound. Dr. Evans is a cancer survivor, having undergone kidney surgery for renal cell carcinoma about 15 years ago. He says that his experience continues to impact his interactions with patients and strengthens his desire to advocate on their behalf. “As a doctor, I’m frequently talking to patients about their cancer diagnosis,” he says. “I know what it’s like to be told you have cancer. I strongly support the mission of eliminating cancer from everyone’s lives. I know that each day can make a difference, and I look forward to working with my fellow volunteers and Society staff to move us closer toward a world with less cancer and more birthdays.” Dr. Evans’ interest in breast imaging began in 1980 and led to the development of the Susan G. Komen Breast Center at Baylor University Medical Center in Dallas. Dr. Evans’ clinical research interests are in the fields of percutaneous biopsies of breast lesions,
digital imaging, computer-assisted detection of mammographic lesions, and breast MRI. Dr. Evans is a board certified diagnostic radiologist and has specialized in breast imaging for more than 30 years. He holds fellowships in the American College of Radiology and the Society of Breast Imaging. He is a major advocate for breast cancer screening with mammography. His research has led to the widespread use of imaging-guided breast biopsy instead of surgery as the initial method to diagnose breast cancer and to the acceptance of digital mammography. Compiled from information from the American Cancer Society and UT Southwestern Medical Center at Dallas
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Vanita and Robert Heath with Wayne Gossard, MD
Drs. Masashi Kawasaki and Nancy Hitzfelder, with author and speaker Mike Looney
Drs. Ted Bywaters and Robert Allday
The Retired Physicians Club
in November enjoyed a presentation from Mike Looney about the Battle of the Bulge during Wo r l d Wa r I I . L o o n e y a u t h o r e d t h e b o o k “ T h e B a t t l e o f t h e B u l g e : T h e U n t o l d S t o r y o f H o f e n . ”
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Allscripts Healthcare Solutions, Inc. CareCloud Goldin Peiser & Peiser, LLP Lincoln Harris, CSG Paranet Solutions Rebecca Harrell, Medical Office Specialist Shaw & Associates, PC The Health Group
For questions about the DCMS Circle of Friends, contact Mary Katherine Allen, business development manager, at mkallen@dallas-cms.org or 214.413.1456.
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Celebrating four decades of caring… and counting “For the past 40 years, DNA has grown into one of the nation’s most renowned nephrology practices. We would not be celebrating this milestone without our group of outstanding physicians and the support from the Dallas community. Thank you for your continued support and we look forward to another 40 years of progress.” Dr. Ruben Velez, President and CEO of Dallas Nephrology Associates
Dallas Nephrology Associates is a national leader in providing complete care for patients with kidney disease, hypertension, transplant medicine and complicated metabolic disorders. 1150 North Bishop Avenue, # 100 Dallas, TX 75208-4113
530 Clara Barton Blvd., #150 Garland, TX 75042-5752
5308 North Galloway Ave., #200 Mesquite, TX 75150-1125
1420 Viceroy Dr. Dallas, TX 75235-2208
2651 Bolton Boone Dr. DeSoto, TX 75115-2011
Baylor Medical Plaza II 2020 State Hwy. 114, #190 Grapevine, TX 76051-8649
13154 Coit Rd., #100 Dallas, TX 75240-5787
3604 Live Oak St., #300 Dallas, TX 75204-6169
4708 Alliance Blvd., #835 Plano, TX 75093-5344
4401 Tradition Trail Plano, TX 75093-5633
3601 Swiss Ave. Dallas, TX 75204-6225
4805 Wesley St. Greenville, TX 75401-5649
3604 Live Oak St., #100 Dallas, TX 75204-6169 1250 Eighth Ave., #500 Fort Worth, TX 76104-4144
1625 North Story Rd., #140 Irving, TX 75061-1954 4510 Medical Center Dr., # 309 McKinney, TX 75069-1650
214-358-2300 • 877-6KIDNEY (877-654-3639) • www.dneph.com DNA_DMJadfinal_111511.indd 1
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