Dallas Medical Journal by Dallas CMS

DCMS Demographics n u m b e r

In this issue: DCMS Members Young and Old - Physician Spotlight on DCMS’ Young and Old

Night Out With the Frisco RoughRiders - Photos from the event

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j u n e

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Anesthesiologist in Beaumont, Texas

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About

the

Cover Photo

Donald W. Seldin, MD, is DCMS’ oldest active member.

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 C. Turner Lewis III, MD David Scott Miller, MD

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Pr es i de nt’s Pa ge A R ed ux: B end ing the C o st

C urve — A Fo rk in the Road

DCMS Board of Directors Richard W. Snyder II, MD.................................. President Cynthia Sherry, MD..................................President-Elect Jeffrey E. Janis, MD..........................Secretary/Treasurer Shelton G. Hopkins, MD.......... Immediate Past President Mark A. Casanova, MD Wendy Chung, MD R. Garret Cynar, MD Sarah L. Helfand, MD Michael R. Hicks, MD Rainer A. Khetan, MD Todd A. Pollock, MD Kim Rice, MD Christian Royer, MD

1 04

F r i s co R oughRi der s

1 09 C ommuni ty

The Accountable Physician Community

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. ©2012 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.

Dallas Medical Journal

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DCMS Member s Young and O l d

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Bus i ne s s of Medi ci ne Guiding Principles for Accountable Care Organization Contracts

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Me di cal Mi s s i ons Day 2012 More than120 patients and 20 physicians

(ISSN 0011-586X) is published monthly by the Dallas County Medical Society, 140 E. 12th St, Dallas, TX 75203.

Subscription rates $12 per year for members; $36, nonmembers; $50, overseas. Periodicals postage paid at Dallas, TX 75260.

12 0

DMCS Member s hi p De mographi cs

Postmaster Send address changes to: Dallas Medical Journal, PO Box 4680 Dallas, TX 75208-0680.

submit letters to the editor to lauren@dallas-cms. org visit us online at www.dallas-cms.org • June 2012 •

101

President’s Page

By Owner

“He who would trade liberty for some temporary security, deserves neither liberty nor security.”

By the time this article appears in the June edition of the DMJ, we will be a couple weeks away from the most anticipated Supreme Court decision impacting the healthcare delivery of this nation. No matter your views on this subject and no matter what decision is rendered, to borrow from Winston Churchill, this is just the end of the beginning of this process of health system reform, not the beginning of the end. A multitude of decisions remain to be made at the federal, state and local governmental and regulatory levels that will shape how healthcare delivery ultimately will manifest. Perhaps the most important of these decisions will affect the relationship between hospitals and physicians. “Physician-hospital alignment” is the new catch-phrase dominating our industry, and how this integration will be promoted and permitted will have a dramatic impact on the physician–patient relationship and the timely access to quality, cost-effective health care. Phyicisian-hospital alignment is most frequently represented by the employee-employer relationship. But is also is reflected in the whole hospital physicianownership model, and every variation and permutation in between, including joint-venure partnerships,and service line management The Supreme Court decision could have a dominant transformative impact on this relationship. Embedded in this legislation (and subsequent regulatory rule making) is language that helps define and restrict how physicians and hospitals will be permitted to interact and partner, especially in anticipation of the emerging world of bundled payments and accountable care organizations. The impending Supreme Court decision affords a good opportunity to revisit some of the views that were circulating about models of physician-hospital alignment before the Patient Protection and Affordable Care Act passed in December 2009. Consequently, I have made the presidential decision to plagiarize myself and use an article I wrote for the October 2009 journal Cardiology (Volume 38, Number 10, page 9). I believe that the vision and arguments are as valid now as they were then, and, depending on the SCOTUS decision, may be prosecuted anew. Bending the Cost Curve: A Fork in the Road There’s been a lot of discussion and debate recently over the best way to “bend the cost curve” in a reformed healthcare system. I think most would agree that the best way to do this would be to develop new incentives in payment that reward better outcomes with evidence-based medicine. I think most also would agree that physicians should play a pivotal role in developing these incentives and in the integrated health systems that emerge. How best to develop these new incentives and what system — or systems — can or should be used as models appears to be where we’ve hit a fork in the road. Some would argue that integrated systems such as at Cleveland Clinic or Mayo are the path to the future. These large systems use EHRs to coordinate care across sources and sites of care. Their physicians are salaried and, some would argue, more motivated toward coordination of care and quality. I would argue that physicians are best positioned to serve as advocates for patients in our pursuit of quality when serving as partners and owners of the system, rather than as salaried employees. The Centers for

— Benjamin Franklin

Medicare and Medicaid Services for the first time ever in July 2009 released results of a risk-adjusted comparative survey of approximately 4,700 US hospitals looking at the Medicare population from July 1, 2005, through June 30, 2008 (www.hospitalcompare.hhs.gov). Some of the more popular brand-name physician-salaried hospital systems that routinely are promoted as the ideal model for hospital-physician integration by The New York Times (Mayo and Geisinger) had CHF readmission rates that were “No Different” than the US national rate, with a notable one in particular (Cleveland Clinic) finishing in the “Worse” category (bottom 5 percent of the nation). This is significant because, up until that point, the administration had been promoting 30-day heart failure readmission as the prime example of waste in healthcare delivery. Out of the four risk-adjusted cardiac clinical outcomes studied in this survey, physician-owned models were ranked No. 1 in the nation for lowest MI mortality (Austin Heart) and for lowest CHF readmissions (Baylor Heart and Vascular Hospital). In Texas, the top two hospitals for lowest CHF readmissions and MI mortality are physician-owned integrated models. Furthermore, the Median Medicare Payment by MedicareSeverity DRG for these physician-salaried facilities were more than 15 percent to 25 percent higher than the physician-owned facilities that finished number No. 1 in the nation in terms of quality. Physician-hospital ownership represents an alignment of interests between the hospital and physician in the pursuit of timely access to quality, cost-effective care. In the future world of Accountable Care Organizations, where reimbursement will be bundled by DRG to an integrated system, a physician-owned hospital is, in my opinion, exactly the form of physician-hospital integration that will be most effective regarding quality, cost and timely access. I am not advocating that the physician-owned model be the only model that is proposed for healthcare reform, but it should not be left out of the discussion. You cannot have a discussion about healthcare reform and the most effective physician-hospital integration model and not mention a model that ranks first in the nation in two out of the four cardiac outcomes categories studied, and with lower costs. In a July (2009) USA Today article about Baylor and its No. 1 ranking, ACC CEO Jack Lewin, MD, said, “The best-quality health care in America is certainly not the most costly care …. I would be very frustrated if our health reform agenda doesn’t emphasize these kinds of opportunities.” Quality health care is inherently cost-effective. Judging by the recent CMS survey, I don’t agree with the blanket statement that in general, salaried physicians at integrated institutions using EMRs provide superior quality and are more affordable. If timely access to quality, cost-effective health care is as simple as having salaried physicians in an integrated hospital model using EMRs, then why are Congress and other groups bothering with proposing pilots? The US government already operates the largest, nationwide hospital organization of salaried physicians under one roof in an exquisitely integrated system of healthcare delivery using EMRs, and has done so for decades. Why are Congress and others not promoting this example as THE model of physician-hospital integration in this grand debate of healthcare reform? I think some already suspect an answer.

visit us online at www.dallas-cms.org • June 2012 •

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Lisa Perkins with Southwest Diagnostic Imaging, Deuce, and Drs. Paul Solomon and Stan Pomarantz

night out with the Frisco RoughRiders

More than 60 DCMS members and guests watched the Frisco RoughRiders play the San Antonio Missions on April 25 at Dr Pepper Ballpark. This was the 5th year DCMS has offered the event free to members.

Israel Denis and Nastran Safdarian, MD

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Elysia Moschos, MD, and Andrew, Jerry and Alexandra Dever

â&#x20AC;˘ June 2012 â&#x20AC;˘ Dallas Medical Journal

Roberta and Don Read, MD

John Zavaleta, MD, and Annie Saldana

Top: David Kabel, DO, and Julie Bottom: James Blakely, MD, and Mary; Diane and Cliff Moy, MD

Sita Boppana, MD, with her parents

Luis Robles, MD, and Wanda

Daniel Kaplan, Deuce and Seth Kaplan, MD

Drs. Preston and Mary Blomquist and Kara

Michael Johnston, MD, with Lucas, Deuce, Annie; and Nicholas

visit us online at www.dallas-cms.org • June 2012 •

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Every 9-1/2 minutes someone in the US is

infected with HIV. The CDC recommends routine HIV testing in medical care settings for patients 13 to 64 years old. Routine HIV testing is the first line of defense against HIV and AIDS. Learn more at

www.testtexashiv.org

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Federal Agency: Deadline to opt out of Medicare.

October 1

HIT: Medicare EHR incentive program. Last chance to achieve 90 days of meaningful use for first-year particpants.

November 15

State Agency: Texas franchise tax, reports & payments — Extension Due Date.

December 31

E-Prescribing Incentives. End-of-year reporting deadline to claim a 1-percent bonus.

December 31

Federal Agency: HIPAA. Privacy and security audits.

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visit us online at www.dallas-cms.org • June 2012 •

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PRACTICE MANAGEMENT

Isn't it about time you focused more on medicine, and less on administrative hassles?

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

Community

The Accountable Physician Community by Jim Walton, DO, MBA, PAD Medical Director Accountability in health care is a popular topic. I regularly meet with physicians to discuss the changing healthcare landscape, and how accountability for improving quality and reducing costs is a growing concern among those who purchase health care. During the conversations the idea of “shared accountability” typically comes up. That is to say, if physicians are to be held accountable, what about the patient’s accountability? Further, what about the payer’s side of the equation? Many physicians express a sincere desire for payers to construct health insurance benefit plans that encourage/incentivize patients to change health-destroying behaviors. After some discussion, we agree that mutual accountability is needed in the art and business of health care. Sometimes I question what mutual accountability would look like if each stakeholder’s interest could be identified and addressed. We rapidly are arriving at the time for earnest dialogue about becoming more accountable to one another’s needs. In fact, as physicians we were trained to respond to our patients’ expressed needs. Many of us do this to the point of exhaustion most weeks of the year. Additionally, we respond to the needs of our colleagues, providing valuable consultative support for complex patients. Viewed this way, accountability to one another is part of being a physician. Project Access Dallas is another expression of Dallas physicians acting in an accountable manner to both patients and to one another. Hundreds of primary care physicians in private practice and in community, charity and public health clinics provide health care to people who are unable to pay for the service. Additionally, hundreds of specialists support these physicians and patients. The hospitals that support the physicians’ participation help us create a complex web of mutual accountability. Project Access Dallas illustrates an intrinsic willingness and capability to sustain accountable actions for health care in our community. Building on this premise, could we leverage our success to move toward greater mutual accountability for health care in Dallas? To borrow a term, the “medical neighborhood” might be a fitting label for the next phase of our “Accountable Physician Community.” visit us online at www.dallas-cms.org • June 2012 •

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Jennifer Brackeen, DO, and husband, Chad, at her medical school graduation in 2006

Donald W. Seldin, MD, in his UTSW office

DCMS Members Both Young and Old by Lauren Cowling, director of communications

With some 6,400 members, DCMS comprises physicians of various backgrounds, ages and interests. This article looks at the extremes of one aspect of DCMS membership — the youngest and oldest members. The youngest practicing DCMS physician, Jennifer K. Brackeen, DO, is a 31-year-old anesthesiologist. At the other end of the spectrum is 92-year-old Donald W. Seldin, MD, a professor of internal medicine at the University of Texas Southwestern Medical School. Dr. Seldin joined DCMS in 1952; Dr. Brackeen is at the beginning of her career and joined DCMS in 2011. The differences between Dr. Brackeen’s career and Dr. Seldin’s are vast. When Dr. Seldin began his career, roughly 5 percent of physicians were women. Today, that number has increased to 32 percent and continues to grow. They entered the medical field for different reasons. For Dr. Seldin, a medical career was a way to provide for his family. He grew up in New York City during the Great Depression with dreams of working in the arts. He was particularly interested in philosophy and poetry, but late into his studies at Washington Square College (now NYU), he decided that those passions wouldn’t allow him to support his family. He then applied to several medical schools, eventually choosing Yale. Dr. Brackeen grew up in Troy, Texas (population about 1,300), playing basketball and, because of injuries, underwent several surgeries. These surgeries and

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her fascination with the human body led her to medicine as a career. Their paths to choosing their specialties also differed. Dr. Seldin studied under academic research physician John P. Peters, MD, and was greatly influenced by him and eventually chose to follow in his footsteps. “He was such an inspiring role model,” Dr. Seldin recalls. “He was world-renown and a man of great integrity. His guidance and my interest in theories and mechanisms led me into research and academia.” Dr. Seldin started his career at Yale after serving in Germany as a captain in the US Army. When he had almost completed his service in Germany, he received a letter from Dr. Peters that was no more than two lines long. It basically said, “I’d like to offer you a position….” Today, the process a physician goes through to get a job is much more complicated. In 1951 Dr. Seldin was brought to Dallas and UTSW as an associate professor in the Department of Medicine, and within a year he was promoted to professor and department chairman. At this time he was the department’s only full-time faculty member. During his 37 years as chairman, he helped build one of the strongest departments of medicine in the world and turned down other prestigious

job opportunities to do so — including one at Harvard Medical School. In doing so his influence spread across the entire medical center, and today he often is referred to as the “Intellectual Father of UTSW.” Dr. Brackeen chose anesthesia because of its many facets. “There is critical care, pharmacology, nerve blocks, physiology, procedures,” she says. “It’s an exciting and evolving field of medicine. The OR is a great place to work. It’s one of the few areas where doctors and nurses work closely together to take care of patients, and I really enjoy the OR team.” Surprisingly, Dr. Seldin says the influence of technology is not the biggest change he has seen in medicine. “The rise in knowledge has been the biggest change, and that includes technology,” he says. “Whole areas of medicine and specialties have opened up since I started. The knowledge base has expanded immensely. “When I started the medical program, the general physician had to have a broad base of knowledge about all aspects of medicine,” he recalls. “The rise of specialties and subspecialties has changed the face of medicine, especially for patient care.” The physicians agree that the new technologies have their benefits. “I see benefits in being able to see old anesthesia records, evaluations and previous studies,” Dr. Brackeen says. “Physicians also have information at their fingertips and rely less on patients remembering important facts about hospitalizations and studies.” They agree that as technology becomes increasingly prevalent in exam rooms, patient-physician interaction decreases. Dr. Brackeen believes the result of technology will be improved patient care. Although Dr. Seldin says the decrease in patient-physician interaction could be damaging, the use of technology leads to better diagnosis of problems and treatment. His main concern regarding the use of technology in the exam room is the cost it adds to patient care. “Tools have created a distance between the patient and the physician, and these tools also lead to an increase in the cost of care,” he says. “As we know, financial issues involving health care can be complicated for the patient.” Drs. Seldin and Brackeen agree that they cannot predict what the next decade holds for the practice of medicine. Dr. Seldin has seen many changes in the field of medicine since he earned his medical degree in 1943. And with a long medical career ahead of Dr. Brackeen, she’ll undoubtedly witness the same.

Donald W. Seldin, MD, as a student at Yale University .

Jennifer Brackeen, DO

time line Dr. Seldin is born.

Stock market crash precipitates the Great Depression. Penicillin is introduced.

Dr. Seldin graduates from Yale University School of Medicine.

1920 1929 1941 1943

Dr. Seldin begins his career at UTSW.

1951

Dr. Seldin becomes a DCMS member

1952

Medicare and Medicaid create comprehensive health coverage for many Americans.

1965

The US celebrates its bicentennial.

1976

Dr. Brackeen is born.

1980

Dr. Seldin steps down as chairman of the department of medicine. Persian Gulf War begins.

World Trade Center is attacked by terrorists. Dr. Brackeen graduates from University of North Texas Health Science Center. Dr. Brackeen becomes a DCMS member.

1987 1991 2001 2006 2011

visit us online at www.dallas-cms.org • June 2012 •

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Business of Medicine Guiding Principles for Accountable Care Organization Contracts The following principles of physician employment and

accountable

care

organization

(ACO)

contracts were developed by TMA’s Ad Hoc Committee on Accountable Care Organizations. Within these agreements is the need to protect quality patient care to patients, both in the context of ACOs and hospital employment efforts. The overarching goal of TMA legislative efforts will be to protect the physician’s ability to make independent medical decisions in the best interest of his or her patients in all practice settings where nonphysician interference is possible. Physician Clinical Autonomy is a Key Protection. As the medical practice environment changes, the need to protect quality patient care and the physician’s exercise of independent medical judgment in providing that care to patients (both in the context of ACOs and hospital physician employment efforts) is paramount. Thus, the principles that physicians may want to consider when independently evaluating contract offers should focus on protecting professional judgment. An employment contract should contain provisions, subject to individual negotiations, that address the following principles: 1. Whistleblower Protection from Retaliation. An employment arrangement with a physician should ensure that the patient’s well-being is placed first. Therefore, provisions to see that physicians are free to make complaints regarding interference in medical decisions by nonphysicians to an appropriate authority without fear of reprisal should be considered for inclusion in employment contracts. 2. Due Process Protections. Physicians must be provided due process in credentialing and privileging, quality assurance activities, utilization review, and peer review. Due process in terms of TMA activities means, at a minimum, the right to notice, a hearing and an appeal to a physician board to challenge adverse decisions. Inclusion of due process protections in contracts provides a fair forum for physicians when they advocate for patients (among other things). It also includes the physician’s (or his group’s) involuntary termination from participation in an ACO. 3. Medical Staff Bylaws as Contracts. Medical staff bylaws of any entity that may employ physicians (not owned by licensed Texas physicians) should have the legal effect of a contract enforceable by the physicians subject to its terms.

4. Referral Limitations. Physicians employed by nonphysician entities must have the freedom to refer patients based on the physician’s clinical judgment and not be directed to refer patients to a favored facility or provider. The contract should reflect that freedom of choice. 5. Prohibitions on “Clean Sweep” Clauses. A physician’s privileges to practice within a hospital facility or other affiliated institution must not be contingent upon employment by any particular nonphysician entity. Thus, the termination provisions of the contract of employment must not affect an individual physician’s privileges to practice in a facility. Furthermore, hospital bylaws should not make privileges contingent on employment. 6. Fair Dispute Mechanism for Performance Measurements. When a nonphysician entity evaluates a physician’s performance through measures or standards, a fair dispute mechanism must exist in the contract to challenge: a. the physician’s involuntary termination; b. the physician’s failure to meet performance standards; c. the physician’s eligibility to receive savings or distributions from the nonphysician entity; d. the amount of the distribution received by the physician from nonphysician entity; e. the patients assigned to the physician’s care under the nonphysician entity; f. the measurements used to determine the quality of care/efficiency of care provided to patients under the nonphysician entity, and any assessment of the quality of care provided to patients by the physician. 7. Freedom of Choice of Liability Coverage. Physicians must have the freedom to choose medical liability coverage from any carrier and not be required to purchase such coverage from the hospital’s preferred carrier. 8. Penalties for Interference with Independent Medical Judgment. Penalties against a nonphysician who interferes with physician medical judgment must include a range of options including fines and revocation of any legal authority issued by the state. 9. Nondiscrimination Protections. A nonphysician entity that employs physicians may not discriminate against or favor a physician based on the employment status of the physician with the entity. Examples of such favoritism arise in call obligations or schedules and charity care obligations.

visit us online at www.dallas-cms.org • June 2012 •

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Business of Medicine 10. Texas Medical Board Enforcement Authority. The Texas Medical Board must be granted authority through a mechanism, such as certification, to ensure enforcement and oversight of the provisions intended to protect patients and physicians. 11. Transparency. ACOs should be required to annually disclose administrative expenditures and the organization’s aggregate payments to physicians and providers (to permit comparison of payments to physicians to facilities). Public and private payers who partner with ACOs must invest sufficient resources to monitor and evaluate the ACO’s compliance with financial and quality benchmarks, including mechanisms to ensure the entity is not withholding medically necessary care to achieve financial gain. ACOs should have the flexibility to use a variety of payment methods alone or simultaneously, including fee-for-service, care management fees, shared savings, partial capitation, or global capitation. ACOs must have the flexibility to develop a mix of financial and other incentives designed to foster safe, high-quality and cost-effective patient care. Financial incentives must be designed to recognize that successful ACOs eventually will achieve efficiencies that will not offer ever-increasing savings. To impose penalties where there is little or

TEXAS REGIONAL MEDICAL CENTER AT SUNNYVALE

no opportunity to increase savings may create an improper incentive that may adversely affect patient care. To that end, and to ensure an ACO maintains a patient-centered focus, ACOs that perform at or below a national or state spending benchmark should continue to be rewarded for maintaining cost-effective, high-quality care. 12. Marketplace Limiting Agreements. Because the purpose of an ACO is to promote community-based care, an ACO must not impose marketplace limiting agreements (e.g., covenants not to compete and exclusivity provisions) upon physicians or physician practices. Further, the ACO must not interfere with the internal management of physician practices regarding noncompete covenants. These basic principles, in whatever practice environment a physician may practice, will protect the patientphysician relationship and clinical autonomy. Physicians should treat ACO agreements that require signatures as if they are binding. Before signing any legal document, physicians should seek advice from retained legal counsel to ensure that rights are protected. For the full TMA Ad Hoc Committee Report, see www.dallas-cms.org/bestpractices.cfm.

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• June 2012 • Dallas Medical Journal

Medical Missions Day 2012 Twenty physicians volunteered in Medical Missions Day at seven charitable clinics across Dallas County, seeing more than 120 patients.

“I had a very nice time, and was amazed at how much they accomplish with so little support! The staff was SO warm and welcoming, and the patient experience was extremely moving. I’m so glad I finally committed to doing this, and look forward to more experiences in years to come.” — Philip D. Korenman, MD

“The 6th Annual Mission Day at Christian Community Action was a huge success. The patients were so thankful for an opportunity to see a specialist(s) for follow-up care of their chronic medical conditions. The patients voiced their feelings of gratitude that the physicians would come out on a Saturday to provide medical care.” — Doris Scales, Christian Community Action

visit us online at www.dallas-cms.org • June 2012 •

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R E A L PAT I E N T S . R E A L S TO R I E S .

‘‘

Baylor taught me how to manage my asthma.

’’

Rachel Cooper was diagnosed with severe asthma as an infant. While other kids played sports, she had to sit on the sidelines. As an adult, she often struggled to get through the day at work. At the Baylor Martha Foster Lung Care Center, Rachel learned how to use a preventative inhaler and peak flow meter to manage her asthma on a daily basis. “They taught me the Rules of Two®, which is if you’re using your rescue inhaler two times a week, or if you’re waking up with asthma two times a month, or if you’re refilling a rescue inhaler two times a year, then you need to see a doctor. It’s really a guide to live by.” Today, Rachel enjoys working out, hiking and skiing without fear of an asthma attack.

For more information about asthma care services, call 1.800.9BAYLOR or visit us online at BaylorHealth.com/AsthmaToolbox. 3500 Gaston Avenue, 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. ©2012 Baylor Health Care System BUMCDIAB-20 DCMS CE 02.12

The Retired Physicians Club

More than 25 retired DCMS physician members enjoyed lunch, a presentation and a tour at the site of the new Parkland Hospital on May 16.

Caption

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Family Doctors. Convenient Care.

For more information or to refer a patient, call 214-345-8300

Enjoy a quality career and a higher quality of life. Call 972-906-8124 or email doctorpositions@carenow.com

8440 Walnut Hill Lane, Suite 100 Dallas, Texas 75231-4472 Southwest Diagnostic Imaging Center is the general partner of Southwest Diagnostic Center for Molecular Imaging.

visit us online at www.dallas-cms.org • June 2012 •

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CONTINUE

THE CARE

DISCHARGED ISN’T THE LAST WORD. RECOVERY IS. Kindred understands that when a patient is discharged from a traditional hospital they often need post-acute care to recover completely. Every day we help guide patients to the proper care setting in order to improve the quality and cost of patient care, and reduce re-hospitalization.

In the Dallas/Ft.Worth area Kindred offers services including aggressive, medically complex care, intensive care and short-term rehabilitation in: 7 Long-Term Acute Care Hospitals • 1 Subacute Unit 1 Inpatient Rehabilitation Hospital • 3 Transitional Care and Rehabilitation Centers • Outpatient Services • Homecare and Hospice Dedicated to Hope, Healing and Recovery www.continuethecare.com

Save the Date!

S C D O L E E R

Disney’s Brave

Sunday, June 24 Studio Movie Grill

(Royal Lane and Central Expressway)

1 p.m. $10 per person

Lunch, popcorn and drinks will be served during the movie. For more information contact Cara Jaggers at cara@dallas-cms.org or 214.413.1423.

Consider it a HolistiC approaCH to Managing Your praCtiCe’s FinanCes. When it comes to your patients, you don’t just treat symptoms. You look at their overall health and lifestyle. And make a diagnosis based on the big picture. That’s how we approach your finances. Both your personal and your practice’s. Making for a healthy, wealthy and wise financial outlook. personal solutions Residential mortgage, including 100% financing Life and disability insurance services Investment management Estate and retirement planning Specialized healthcare deposit products

practice solutions Term financing for partnership buy-ins Equipment financing and lines of credit Real estate financing Healthcare remittance automation Deposit solutions

©2012 Bank of Texas, a division of BOKF, NA. Member FDIC. Broker/Dealer Services and Securities offered by BOSC, Inc., an SEC registered investment adviser, a registered broker/dealer, member FINRA/SIPC. SEC registration does not imply a certain level of skill or training. Insurance offered by BOSC Agency, Inc., an affiliated agency. Investments and insurance are not insured by FDIC, are not deposits or other obligations of, and are not guaranteed by, any bank or bank affiliate. Investments are subject to risks, including possible loss of principal amount invested.

BOKF-WM-3695-06_Healthcare_DMJ_V3.indd 1

3/16/12 2:32 PM

visit us online at www.dallas-cms.org • June 2012 •

119

DMCS Membership Demographics DCMS Membership

Total Members by Age

Top 10 Medical Schools Attended by Members

Active

4,063

20–29

952

UT Southwestern Med Ctr, Dallas

Residents

484

30–39

1,052

U of TX Med Branch, Galveston

6.97%

Students

839

40–49

1,180

UTHSC, San Antonio

5.27%

Retired

819

50–59

1,196

UTHSC-Houston, Houston

4.64%

6,205

60–69

904

Baylor Col of Med, Houston

3.66%

DCMS Active Members

70–79

530

Texas Tech Univ, Lubbock

3.06%

Female

1,067

80–89

315

U of N TX Hlth Sci Ctr, Fort Worth

2.31%

Male

2,922

90–99

U of OK, Oklahoma City

1.71%

Tulane Univ, New Orleans

1.58%

Texas A&M, College Station

1.15%

Total

199 members have a spouse who also is a member.

20.05%

2095 members (and families) have attended a DCMS event in the last year. Top 10 Specialties Among Members Top 5 DCMS Members’ Birth States

Top 5 DCMS Members’ Dallas ZIP Codes

Anesthesiology

502

Internal Medicine

385

27.5%

75231

496

3.86%

75390

329

Obstetrics & Gynecology

283

2.40%

75246

202

Family Medicine

239

2.19%

75093

194

Pediatrics

219

1.88%

75240

183

Orthopaedic Surgery

146

General Surgery

133

Emergency Medicine

129

Ophthalmology

128

Cardiovascular Disease

119

Total Members in DCMS/TMA Leadership: Total DMCS Members in PAD:

167 1,336

LAW OFFICES OF MICHAEL J. KHOURI

Medicare / Medicaid Audit Defense Medicare / Medicaid Fraud Defense Criminal Defense for Health Care providers Telephone: (866) 231-3670 Cell: (949) 680-6332

1701 N. Market Street Suite 318 LB45 Dallas, Texas 75202

www.texas-medicare-lawyer.com

120

• June 2012 • Dallas Medical Journal

NO.

th i ng s p hys ician s n e e d

to k n o w a b o u t i n s u r a n c e

At least 32 million U.S. households own insurance policies that aren’t right for them. 1

Make sure you have the right insurance to help you protect the life you’ve worked so hard to build. 1. Insurance Information Institute. “Changes in Your Life Can Mean Changes in Your Insurance, Says the I.I.I.,” Press Release, January 22, 2007.

Talk to a TMAIT Advisor about insurance for you, your family, and your medical practice. TMAIT is exclusively endorsed by the Texas Medical Association, and we are committed to helping you find the right coverage from an array of plans, including medical, dental, vision, life, short-term disability, long-term disability, long-term care, and office-overhead expense. Call 1.800.880.8181

contact@tmait.org

Request a quote at www.tmait.org

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