40 minute read
By Mario Gutierrez, Senior Management Analyst, City of San Antonio Metropolitan Health District, Diabetes Prevention and Control
Promoting Lifestyle Change to Prevent Type 2 Diabetes
By Mario Gutierrez, Senior Management Analyst, City of San Antonio Metropolitan Health District, Diabetes Prevention & Control
The City of San Antonio offers a diverse and vibrant social fabric that has allowed the residents who live here options to participate and engage in a culture that has developed over decades and arguably over centuries. Although Texas is known for a climate dominated by high summer temperatures and frequent oppressive humidity levels, mass-scale outdoor events such as “Fiesta” draw the types of crowds not seen in similar size cities. Dancing in the streets and walking a mile or two are standard demands met by eager party goers. Concerted efforts to develop an accessible interconnected walking, hiking and biking trail system to most of the 300+ neighborhoods in the City of San Antonio, which provides an amenity and destination to exercise and reconnect with nature that is unique in its type and scale.
City parks are in the top five priorities for residents when polled. Neighborhoods that lack a park within 20-minute walking distance are known to fiercely advocate for the necessary funding to create, expand or add amenities to spaces that allow people to walk, play sports, or entertain their children at the playground. A “Fitness in the Park” program compliments the trails, pools, gardens, centers and specialty areas that make up the park system of over 300 facilities. For all these positive social aspects there is an equally disturbing dark side to living in San Antonio.
Type 2 diabetes is more common in African Americans, Hispanic, Latinos, American Indians, Asian Americans and Pacific Islanders. If you live in a lower income neighborhood then chances are high that you have been diagnosed with prediabetes or with Type 2 diabetes. There are many reasons certain populations are confronted with this statistic. Lacking education about the disease and its causes is one reason. Facing barriers to accessible healthcare and a physician with who to discuss how healthy lifestyle choices can impact overall health is another reason. The San Antonio Metro Health Department houses the Diabetes Prevention & Control Program with the mission of engaging with residents on three primary fronts: coaching to make lifestyle changes to help prevent or delay the disease, promote risk reduction strategies so that the whole family may benefit and ways to manage the disease if they’ve received a diagnosis.
The Diabetes Prevention & Control team of trained lifestyle coaches employ the CDC Prevent T2 Lifestyle Change curriculum to work with program participants in both English and Spanish. The CDC describes the Prevent T2 Lifestyle Change Program as a yearlong program designed for people with prediabetes. It is also for people who are at
high risk for type 2 diabetes and want to lower their risk. The program goals aim to help participants achieve a moderate weight loss by eating well and being physically active. Through this curriculum, by the end of the first six months participants are encouraged to lose at least 5% to 7% of their starting weight and get at least 150 minutes of physical activity each week at a moderate pace or more. By the end of the second six months the goal is for participants to keep off the weight they have lost, keep working toward their goal weight, if they haven't reached it, lose more weight if they wish and keep getting at least 150 minutes of activity each week.
The Diabetes Prevention and Control Program has achieved CDC recognition for our work. The Prevent T2 program participants meet once a week for four months, every other week for two months and once a month for six months for a total of 26 sessions. Lifestyle coaches help participants set goals, track their eating and activity, assess their progress and solve problems. Along the way they collect data in the lifestyle coach log (lifestyle coaches log to record participants’ data for each session). Coaches also set the tone for the sessions and they foster a supportive and respectful group culture. They encourage participants to share their thoughts and feelings but do not pressure them to do so and they make sure all participants get a chance to speak. Lifestyle coaches also engage participants by using teaching strategies and hands-on activities. Participants differ in their tastes, beliefs and interests so lifestyle coaches tailor the program to the participants. Some participants may face personal barriers to lifestyle change. For instance, they may have limited access to healthy food, transportation, childcare, a safe place to walk, technology, time and healthcare. Lifestyle coaches help participants work through these barriers. Lifestyle coaches engage the community throughout the year at a variety of community events, health fairs, fitness events, food drives and other avenues. Coaches speak to prospective participants and can provide a brief written diabetes risk test developed by the American Diabetes Association to determine if a prospective participant might be at risk of developing type 2 diabetes or prediabetes. The risk test consists of seven questions; How old are you? Are you a man or a woman? Have you ever been diagnosed with gestational diabetes? Do you have a mother, father, sister or brother with diabetes? Have you ever been diagnosed with high blood pressure? Are you physically active? What is your weight status? If participants score a 5 or higher, they are at increased risk of having type 2 diabetes. However only their doctor can tell for sure if they have type 2 diabetes or prediabetes. Coaches encourage participants to talk to a doctor to see if additional testing is needed. Higher body weight increase diabetes risk for everyone.
Doctors and clinics can play an important role in the success of the participant goals of the Diabetes Prevention & Control Program within the San Antonio Metro Health Department. Whether a patient is at risk for type 2 diabetes or has already received a diagnosis, we can help. The diabetes prevention and control program is currently working to develop a bi-directional referral system to connect patients to the interventions they need, while providing necessary feedback on their progress and participation in the program. Doctors and clinics can download and fill out a patient referral form so that lifestyle coaches can follow up with the patient and provide them with the next scheduled date for the Prevent T2 session.
The referral form is available on our website at www.diabeteshelp.com/physician-patient-referral/ and sent via FAX to 210-207-8700.
Questions about our program and session schedule can be answered by calling 210-207-8802.
Mario Gutierrez is a Senior Management Analyst at The City of San Antonio Metropolitan Health District, Diabetes Prevention and Control.
2022 Women Leaders in Medicine Awards Event
By Bexar County Medical Society (BCMS)
100% Large Practice Group of the Year MacGregor Medical Group Dianna Burns-Banks Community Service Award
C. Junda Woo, MD
Iyunoluwa Agboola, MD University Medicine Associates (UMA)
Vivan Bucay, MD 2022 One At Heart Award Isabel Basaldu-Prado, MD Pediatrix Medical Group, San Antonio
N. Alexandra Castro-Peña, MD 2022 Rising Star Gonzaba Medical Group Veronica Betancur, MD CentroMED
Eesha Farooqi, MD 2022 Rising Star – Mentor Leader Award ABCD Pediatrics
Every year, the Bexar County Medical Society recognizes the great effort of local female leaders who excel in the delivery of patient care through their hard work and dedication of the honored practice of medicine. The 2022 Annual Women Leaders in Medicine Event was held on September 14, 2022 at the UIW Skyroom. The event was attended by more than 420 medical community members in Bexar County.
Elizabeth Glazier, MD Palliative Care Champion WellMed Medical Management, Inc.
Andrine Grant, MD Health Texas Medical Group
Tricia Hilliard, MD Little Spurs Pediatrics Urgent Care Cynthia Gneco, MD Health Texas Medical Group
Constanza “Julie” Gutierrez, MD South Texas Radiology Group
Vidhya Illuri, MD University Medicine Associates (UMA) Anupama Gotimukula, MD Texas Indo-American Physicians Society, Southwest Chapter
Allyson Harroff, MD Texas Oncology
Chris Kean, COO 2022 Practice Manager of the Year The SA Orthopedic Group (TSAOG)
2022 Women Leaders in Medicine Awards Event
Rebecca Kelso, MD Alamo Heights Dermatology
Kimberly Moran, MD Baptist Medical Center San Antonio Infectious Diseases Consultants
Abby Richmond, MD Pathology Reference Laboratory Melinda B. MacFarland, MD Baptist Medical Center Perinatal Associates of San Antonio
Lubna Naeem, MD Internal Medicine of Stone Oak Pakistani American Physician Organization
Carolyn A. Robinson, DO, FAAD Texas Dermatology Whitney McCarthy, MD Clinical Pathology Associates
Lauren Pankratz, MD Diabetes & Glandular Associates
Sandra Rojas, MD South Texas Spinal Clinic
Illeana Silva, MD University Medicine Associates (UMA)
Rosa I. Vizcarra, MD MacGregor Medical Center Nancy Vacca, MD Community First Health Plans
Lou Ann Wellford, MD Greater SA Emergency Physicians Nichole J. Van De Putte, MD Communicare Health Centers
Janet F. Williams, MD, FAAP UT Health SA
2022 UT Health SA Colette M. Kohler Award Recipients
BCMS also recognized the following UT Health SA Physicians
By Bexar County Medical Society (BCMS) and UT Health San Antonio
Richel Avery, MD Interim Medical Director, UT Health Verde Hills Assistant Professor/Clinical UT Health SA Primary Care Center Shweta Bansal, MD Professor, UT Health SA Medicine Department Division of Nephrology Jessica Blower, MD Medical Director, UT Health Westover Hills Assistant Professor/Clinical UT Health SA Primary Care Center Cynthia Cantu, MD Medical Director, UT Health De Zavala Assistant Professor/Clinical UT Health SA Primary Care Center Division of General Internal Medicine
Sara E. Espinoza, MD Professor, UT Health SA Medicine Department Division of Geriatrics, Gerontology and Palliative Medicine Elena Jimenez-Gutierrez, MD Medical Director, San Antonio Refugee Health Clinic; Co-Director, New Health Equity Track for Internal Medicine Residents; Assistant Professor/ Clinical for UT Health SA Medicine Department, Division of Hospital Medicine
Jeannie Harden, MD Medical Director of Reeves Inpatient Rehab Unit and Pediatric Rehabilitation Vice Chair of Clinical Operations for the Department of Rehabilitation Medicine Assistant Professor/ Clinical for UT Health SA Rehabilitation Medicine Sarah K. Horn, MD Assistant Professor/Clinical UT Health SA Neurology Department
Marsha C. Kinney, MD Professor and Chair UT Health SA Pathology and Laboratory Medicine Department Cordelia Moscrip, MD Medical Director, UT Health Medical Drive Assistant Professor/Clinical UT Health SA Primary Care Center Mayra Perez, DO Assistant Professor/Clinical UT Health SA Primary Care Center
Arlene Reyes, MD Assistant Professor/Clinical UT Health SA Primary Care Center
Monica Verduzco-Gutierrez, MD Professor and Chair UT Health SA Rehabilitation Medicine Department Sudha Seshadri, MD Founding Director of the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases and of the NIA Designated Alzheimer Disease Research Center Professor, UT Health SA Neurology Department
Sandhya Vinu-Nair, MD Director of Emergency Radiology at University Hospital Program Director of ER Radiology Fellowship Associate Professor UT Health SA Radiology Department Joyce Yuen, MD Medical Director, UT Health Shavano Assistant Professor/Clinical UT Health SA Primary Care Center
Chandana Tripathy, MD Medical Director, UT Health MARC Primary Care Associate Professor/Clinical UT Health SA Primary Care Center Division of General Internal Medicine Tanya T. Van, MD Section Chief, Breast Imaging, and Intervention Associate Professor/Clinical UT Health SA Radiology Department
Ambili Ramachandran, MD Chief (Interim) Division of General Medicine Assistant Professor/Clinical UT Health SA Medicine Department Division of General Internal Medicine
Emily S. Wang, MD Associate Professor/Clinical UT Health SA Medicine Department Division of Hospital Medicine
By Monica Jones, BCMS Chief Operating Officer
On October 1, 2022, the Bexar County Medical Society (BCMS) participated in the 29th Annual San Fernando Health and Safety Fair. The Health and Safety Fair offered free medical screenings, consultations, immunizations and health information to hundreds of our San Antonio community members. This community effort is supported by local businesses and non-profit organizations like BCMS. There were over 300 community and medical volunteers with varying backgrounds working the fair. Among those were BCMS physicians, medical students, physician families and BCMS staff.
BCMS has participated in the San Fernando Health and Safety Fair before, but this year was different. We had more volunteers and stood out with our brand-new items purchased with the Texas Medical Association Foundation “Vaccines Defend What Matters” grant. BCMS has a commitment to community service through our “Ask a Doctor” program and has participated in many fairs and events throughout our years of service. The difference has been the emphasis on COVID-19 vaccination hesitancy and the number of community members visiting our booth.
The 2022 goal for our “Ask a Doctor” program is to use the experience, capacity and goodwill of the physician members of BCMS to disseminate information on the importance of being vaccinated to fight the COVID-19 variants through public events and outreach. We have found that partnering with San Antonio Metropolitan Health District (Metro Health) during fairs and events our physicians are able to address vaccination hesitancy and get some people vaccinated on the spot.
During the San Fernando Health and Safety Fair, BCMS was strategically placed next to the Metro Health vaccination clinic. The BCMS “Ask a Doctor” volunteers surveyed over 150 attendees and passed out goodie bags to include hand sanitizer, masks, band aids and literature on vaccination safety and guidelines on what booster(s) they should
- Elizabeth Andrew
get and when. Our physicians fielded many medical questions and were able to point attendees to the correct place for care. If someone was not vaccinated, we answered questions regarding their hesitancy, gave them documentation on how safe the vaccines are, and at times escorted them to the Metro Health vaccination clinic for their COVID19 vaccine/booster. We also fielded questions and concerns regarding the influenza (flu) shot. Again, BCMS was strategically placed across from the Walgreens booth where they were administering flu shots to all ages. Metro Health successfully gave out approximately 237 COVID vaccines. Walgreens successfully gave out 135 flu shots.
BCMS physicians and medical students not only manned the “Ask a Doctor”, “Doc in Booth” and blood pressure room, but contributed through the many health services provided. Our BCMS physicians generously offered their time, medial skills and experience at the prostate, colorectal, dermatology, pulmonary, vascular, and eye exam areas of the health and safety fair. BCMS was also able to donate eight cases of surgical masks which were given to all volunteers, booths and attendees.
BCMS would like to thank all the physicians, medical students, physician families and BCMS staff. All of our volunteers were truly happy to allocate time for this much needed community health and safety fair. It is a privilege to be of service to others. BCMS is committed to community outreach events and looks forward to working with the Texas Medical Association Division of Communications and Marketing to disseminate the most up to date information and documentation to our physicians and community. Quotes from our BCMS physicians
“It was great to get out once again and provide the much-needed service to the community.” -Dr. Adrine K. Grant
“It was an honor to participate! BCMS made a difference by offering the community a means to access critical health resources, COVID vaccines, and health screening including blood pressure and diabetes screening. BCMS physicians offered medical advice and wayfinding recommendations in the healthcare system for individuals with insurance and without. We were available for general medical questions and recommendations on how to access primary and secondary care, regardless of insurance access. It was enjoyable to be able to be a part of such a worthwhile endeavor, serving the San Antonio community, and our family looks forward to participating again!” -Dr. Justin Williams, Greater San Antonio Emergency Physicians
“What a wonderful event! I worked with respiratory therapists and Dr. Carlos Orozco at the respiratory health tent. There we performed spirometry and oximetry on anyone who was interested in knowing their lung function and better understanding resources available in San Antonio to care for people with lung conditions such as asthma, chronic bronchitis, emphysema, cystic fibrosis, and other lung conditions. It was a beautiful day made even more so by the crowd of people seeking health information in our main downtown square around San Fernando Cathedral.” -Dr. John Seidenfeld, Co-Lead, Community Engagement Partnerships (CEP) CIT, Associate Professor, Clinical and Applied Science Education (CASE, University of the Incarnate Word School of Osteopathic Medicine
“Thank you for the opportunity for us to participate in the St. Fernando Health and Safety Fair. We thoroughly enjoyed the experience! BCMS has done a great job in ensuring our participants got their questions answered and concerns addressed at booths staffed by medical professionals. As a physician, I feel empowered to be able to make a difference to our community outside our immediate practice environment. Thank you!” -Dr. Qingxuan “Wendy” Wu, Alamo Neurology Consultants
“The 29th Annual San Fernando Health and Safety Fair was an extremely successful event, returning to the Cathedral and Main Plaza after a two-year hiatus due to the pandemic. This event is so vital to the underserved community, as in the worse cases represents the only access to free or less costly health screenings for many at risk persons. San Antonio health care workers ranging from high school students to retired clinicians volunteered a Saturday morning to offer health screenings along with interpretations and referrals to appropriate care. Multiple customized, spontaneous in person health coaching sessions were conducted at the BCMS “Ask the Doctor” table, the “Doctor In Booth” sponsored by the San Fernando Heath Fair Steering Committee, and other health screenings offered.” -Dr. John Nava, BCMS President-elect
For more information about upcoming health and safety fairs in Bexar County and surrounding areas, visit our website at http://www.bcms.org/CommEvents.php or call Monica Jones, COO at (210) 301-4373.
Monica Jones, BCMS Chief Operating Officer
The Circle of Friend Program and what it means to you and BCMS
By August Charles Trevino II, Director of Development
The Bexar County Medical Society (BCMS) Circle of Friends (COF) program was started more than 25 years ago to help support our physician membership. The COF program is a part of our nonprofit 501(c)3 and it consists of businesses that donate monies to participate in the program at different levels. The essential benefits derived are additional non dues revenue to assist BCMS in providing member benefits to you and help keep the cost of dues down. Likewise, our COF program is dependent on business generated by physician members using our sponsors’ products and services. It is important to BCMS that our members support the businesses participating in the COF program and its initiatives. As mentioned, physician members are encouraged to use the COF businesses at every opportunity and take advantage of the many products and services they offer for your practice and personal use. Some points of interest listed here: Internally, Bexar County Medical Society makes every effort to use the Circle of Friends business sponsors in preference to other outside companies. By using Circle of Friends products and services we are able to save money and encourage the business community to participate with and support BCMS. The Circle of Friends sponsors are conveniently listed on the BCMS website under BCMS Vendor Directory and as a monthly listing in San Antonio Medicine magazine. As a BCMS member you can find exclusive discounts on premium products and services that you and your practice use every day. All Circle of Friends sponsors have been reviewed through the Better Business Bureau, broker check (if applicable) and an online business review and search. Why put your trust in outside or off-the-web companies that you know nothing about? COF sponsors are supporters of BCMS through the COF program. It makes sense to use a trusted company that gives back. The COF Program is a wonderful benefit and source of support to the BCMS. Let’s keep this program alive by giving them your patronage.
August Charles Trevino, Director of Development at Bexar County Medical Society.
For questions regarding the Circle of Friends program he can be reached at 210-302-4366 and email august.trevino@bcms.org
- Jurassic Park meets Billions
By David Schulz
Walter Isaacson, biographer of Benjamin Franklin, Albert Einstein, Steve Jobs and Leonardo da Vinci, undertakes his greatest challenge yet in The Code Breaker: Jennifer Doudna, Gene Editing, and the Future of the Human Race – but it is not strictly a biography.
Jennifer Doudna’s life story does provide the through line of this epic tale: it begins with her leading colleagues in vaccine research on an empty Berkeley campus in March, 2020, recognizing that “the government was fumbling its response to COVID, so it was time for professors and graduate students to rush into the breach.”
Concluding the book, Nobel Laureate Doudna is again leading her academic peers in offering their COVID vaccine discoveries to anyone fighting the virus, without arcane licensing agreements. But the 470 pages in between take the reader down a rabbit hole of modern science meeting modern business and patent law. And the true protagonist of “The Code Breaker” is revealed to be a mysterious character called CRISPR.
CRISPR, for the uninitiated (like me), is the biomolecular phenomenon that provides bacteria an adaptive immune systems, protecting them from viruses, even as the viruses evolve. These repeated sequences of code in bacterial RNA turn out to hold the magic key to re-engineering DNA, with all the promise and horror that portends.
The story of their discovery and use, has as many twists and turns as the double helix itself, for Isaacson’s net is thrown wide to encompass all aspects of the “third great revolution of modern times.” He defines these three explosions of knowledge as deriving from the discoveries the “the atom, the bit and the gene.”
The first, nuclear physics, was driven by Einstein’s revelations of relativity and quantum theory, shaping the first half of the 20th Century. The second revolution, information technology, began with the transistor in 1950 and continues unfolding today.
We have now entered the third, the life-sciences revolution, where “children who study digital coding will be joined by those who study genetic code.”
The manner in which these three intertwine and their effect on scientific methodology itself turns Isaacson’s work from a straightforward, biographical narrative into an intricate weave of research, discovery, industry, economics, ethics and law. Beginning with Charles Darwin, Gregor Mendel, Thomas Malthus, James Watson and Francis Crick, the author gives a whirlwind tour leading to state of the art knowledge of DNA and RNA and how their structures permit nucleotide bonds to define its role and effect. As IT advances joined DNA understandings, the race to sequence culminated in 1990s Human Genome Project. “The flow of history is accelerated when two rivers converge,” says Isaacson.
However, “Having a map of DNA did not, it turned out, lead to most of the grand medical breakthroughs that had been predicted. More than four thousand disease-causing DNA mutations were found. But no cure sprang forth for even the most simple of single-gene disorders,” the author concludes.
Instead of focusing on DNA, the key was found in its less vaunted cousin, RNA (ribonucleic acid), “DNA doesn’t do much work,” Isaacson explains, “it mainly stays at home in the nucleus protecting its information and occasionally replicating itself.”
RNA doesn’t just curate information; it carries out a broad range of functions, from translating genetic information into the molecular machines and structures of the cell to regulating the activity of genes during development.
“Doudna’s study of RNA structure led her to a field that would become unexpectedly relevant later in her career: viruses. Specifically, she was interested in how the RNA in some viruses, such as coronaviruses, allows them to hijack the protein-making machinery of cells.”
The story refocuses on bacteria, specifically the study of bacteria and archaea (single-cell organisms without nucleus) existing in harsh environments, like supersaturated salt ponds. Graduate student Francisco Mojica was sequencing the DNA of such a bacterium when he discovered 14 identical sequences repeated at regular intervals …
four years after a student at Osaka University discovered the same phenomenon, sequencing E. coli bacteria. These repeated sequences, which read identically backward and forward, were interspaced in specific patterns. Thus, “CRISPR,” for “clustered regularly interspaced short palindromic repeats.”
By 2003, when Mojica focused on figuring out the role CRISPRs played, the genomes of close to two hundred bacteria had been sequenced (as well as those of humans and mice). The “spacers”… the regions of normal looking DNA segments nestled in between repeated CRISPR segments … drove his curiosity when he realized the spacer segments matched sequences in viruses that attacked E. coli.
It was a true “Eureka!” moment: “I just discovered something really amazing,” he said to his wife. “Bacteria have an immune system. They’re able to remember what viruses have attacked them in the past.”
How CRISPR’s virus immunity was validated by records of yogurt production offers a rare lighter moment in the narrative, but as soon as the new technology demonstrated significant industrial value, the story takes a turn from a science techno-thriller to a business betrayal worthy of TVs “Dallas.” The cutthroat world of venture capitalists, patent pirates and legal sharks combine to make researching DNA’s structure simple in comparison.
In the end, Isaacson’s most recent work is as enlightening and educating as any of his biographies, but diffuses focus on the principal characters, their passions and their heroic efforts in detailing how a Zoom-connected, 24hour world-wide laboratory changes expectations of scientific research. Inevitable, perhaps, in an era when laboratory accomplishments are pre-committed to industry for monetization - a world that neither DaVinci nor Franklin would have to have faced.
All quotes from The Code Breakers (Simon & Schuster, 2021). Its review was suggested by a reader and the book is available from San Antonio Public Library in both Kindle and Audiobook editions, as are all the materials reviewed in this column. Suggestions welcome!
David Alex Schulz, CHP is a community member of the BCMS Publications Committee.
We encourage you to use our supporting vendors when ever supplies or services are needed by you or your practice.
ACCOUNTING FIRMS
Sol Schwartz & Associates P.C. (HHH Gold Sponsor) Sol Schwartz & Associates is the premier accounting firm for San Antonio-area medical practices and specializes in helping physicians and their management teams maximize their financial effectiveness. Jim Rice, CPA 210-384-8000, ext. 112 jprice@ssacpa.com www.ssacpa.com “Dedicated to working with physicians and physician groups.”
ACCOUNTING SOFTWARE
Express Information Systems (HHH Gold Sponsor) With over 29 years’ experience, we understand that real-time visibility into your financial data is critical. Our browser-based healthcare accounting solutions provide accurate, multi-dimensional reporting that helps you accommodate further growth and drive your practice forward. Rana Camargo Senior Account Manager 210-771-7903 ranac@expressinfo.com www.expressinfo.com “Leaders in Healthcare Software & Consulting”
ATTORNEYS
Kreager Mitchell (HHH Gold Sponsor) At Kreager Mitchell, our healthcare practice works with physicians to offer the best representation possible in providing industry specific solutions. From business transactions to physician contracts, our team can help you in making the right decision for your practice. Michael L. Kreager 210-283-6227 mkreager@kreagermitchell.com Bruce M. Mitchell 210-283-6228 bmitchell@kreagermitchell.com www.kreagermitchell.com “Client-centered legal counsel with integrity and inspired solutions” ASSETT WEALTH MANAGEMENT
Bertuzzi-Torres-Fernandez Wealth Management Group (HHH Gold Sponsor) We specialize in simplifying your personal and professional life. We are dedicated wealth managers who offer diverse financial solutions for discerning healthcare professionals, including asset protection, lending and estate planning. Mike Bertuzzi First Vice President Senior Financial Advisor 210-278-3828 Michael_bertuzzi@ml.com Ruth Torres Financial Advisor 210-278-3828 Ruth.torres@ml.com http://fa.ml.com/bertuzzi-torres Will C. Fernandez, CEPA Senior Portfolio Advisor Financial Advisor 210-278-3812 wfernandez@ml.com https://fa.ml.com/texas/san-antonio/bertuzzi-torres-fernandez
BANKING
Broadway Bank (HHH Gold Sponsor) Healthcare banking experts with a private banking team committed to supporting the medical community. Thomas M. Duran SVP, Private Banking Team Lead 210-283-6640 TDuran@Broadway.Bank www.broadwaybank.com “We’re here for good.”
The Bank of San Antonio (HHH Gold Sponsor) We specialize in insurance and banking products for physician groups and individual physicians. Our local insurance professionals are some of the few agents in the state who specialize in medical malpractice and all lines of insurance for the medical community. Brandi Vitier 210-807-5581 brandi.vitier@thebankofsa.com www.thebankofsa.com Synergy Federal Credit Union (HH Silver Sponsor) Looking for low loan rates for mortgages and vehicles? We've got them for you. We provide a full suite of digital and traditional financial products, designed to help Physicians get the banking services they need.
Synergy FCU Member Services 210-750-8333 info@synergyfcu.org www.synergyfcu.org “Once a member, always a member. Join today!”
CLINICAL DIAGNOSTICS
Livingston Med Lab (HHHH 10K Platinum Sponsor) High Complexity Clia/Cola accredited Laboratory providing White Glove Customer Service. We offer a Full Diagnostic Test Menu in the fields of Hematology, Chemistry, Endocrinology, Toxicology, Infectious Disease, & Genetics. Robert Castaneda (CEO) 210-316-1792 Robert@livingstonmedlab.com Sean Villasana (Chief Scientific Officer, CSO) 210-237-8557 Sean@livingstonmedlab.com Joey Martinez (Director of Operations) 210-204-7072 Joey@livingstonmedlab.com Dwight Chapman (Account Manager) 210-591-2649 Dwight@livingstonmedlab.com www.livingstonmedlab.com/home “Trusted Innovative, Accurate, and STAT Medical Diagnostics”
Genics Laboratories (HHH Gold Sponsor) Genics Laboratories offers accurate, comprehensive and reliable results to our partners and patients. Genics Laboratories is committed to continuous research, ensuring our protocols are always at the peak of current technology. Yulia Leontieva Managing Partner, Physician Liaison (210) 503-0003 (Phone) yulia@genicslabs.com (Email) Kevin Setanyan Managing Partner (210) 503-0003 kevin@genicslabs.com Artyom Vardapetyan Managing Partner (210) 503-0003 www.genicslabs.com “Accurate results in record time.”
CREDENTIALS VERIFICATION ORGANIZATION
Bexar Credentials Verification, Inc. (HHHH 10K Platinum Sponsor) Bexar Credentials Verification Inc. provides primary source verification of credentials data that meets The Joint Commission (TJC) and the National Committee for Quality Assurance (NCQA) standards for health care entities. Betty Fernandez Director of Operations 210-582-6355 Betty.Fernandez@bexarcv.com www.BexarCV.com “Proudly serving the medical community since 1998”
FINANCIAL ADVISORS
Oakwell Private Wealth Management (HHHH 10K Platinum Sponsor) Oakwell Private Wealth Management is an independent financial advisory firm with a proven track record of providing tailored financial planning and wealth management services to those within the medical community. Brian T. Boswell, CFP®, QKA Senior Private Wealth Advisor 512-649-8113 SERVICE@OAKWELLPWM.COM www.oakwellpwm.com “More Than Just Your Advisor, We're Your Wealth Management Partner”
Elizabeth Olney with Edward Jones (HH Silver Sponsor) We learn your individual needs so we can develop a strategy to help you achieve your financial goals. Join the nearly 7 million investors who know. Contact me to develop an investment strategy that makes sense for you. Elizabeth Olney, Financial Advisor 210-858-5880 Elizabeth.olney@edwardjones.com www.edwardjones.com/elizabeth-olney "Making Sense of Investing"
Bertuzzi-Torres-Fernandez Wealth Management Group ( Gold Sponsor) We specialize in simplifying your personal and professional life. We are dedicated wealth managers who offer diverse financial solutions for discerning healthcare professionals, including asset protection, lending & estate planning. Mike Bertuzzi First Vice President Senior Financial Advisor 210-278-3828 Michael_bertuzzi@ml.com Ruth Torres Financial Advisor 210-278-3828 Ruth.torres@ml.com Will C. Fernandez, CEPA Senior Portfolio Advisor Financial Advisor 210-278-3812 wfernandez@ml.com https://fa.ml.com/texas/san-antonio/bertuzzi-torres-fernandez
Aspect Wealth Management (HHH Gold Sponsor) We believe wealth is more than money, which is why we improve and simplify the lives of our clients, granting them greater satisfaction, confidence and freedom to achieve more in life. Michael Clark, President 210-268-1520 mclark@aspectwealth.com www.aspectwealth.com “Get what you deserve … maximize your Social Security benefit!”
HEALTHCARE BANKING
Amegy Bank of Texas (HH Silver Sponsor) We believe that any great relationship starts with five core values: Attention, Accountability, Appreciation, Adaptability and Attainability. We work hard and together with our clients to accomplish great things. Jeanne Bennett EVP | Private Banking Manager 210-343-4556 Jeanne.bennett@amegybank.com Karen Leckie Senior Vice President | Private Banking 210-343-4558 karen.leckie@amegybank.com Robert Lindley Senior Vice President | Private Banking 210-343-4526 robert.lindley@amegybank.com Denise C. Smith Vice President | Private Banking 210-343-4502 Denise.C.Smith@amegybank.com www.amegybank.com “Community banking partnership”
HOSPITALS/ HEALTHCARE FACILITIES
Nexus Neurorecovery Center (HHH Gold Sponsor) A post-acute rehabilitation facility focusing on brain injuries. Programming provides individual and group physical, occupational, cognitive, and speech therapy. We help residents return to lives of productivity and meaning. Sydney Kerr Liaison 346-339-2654 skerr@nhsltd.com Caitlyn Tewksbury ctewksbury@nhsltd.com Justin Sanderson CEO 210-854-4732 jsanderson@nhsltd.com Nexus Neurorecovery Center 227 Lewis St, San Antonio, TX 78212 https://nexushealthsystems.com “To return patients to lives of productivity and meaning”
UT Health San Antonio MD Anderson Cancer Center, (HHH Gold Sponsor) UT Health Physicians, the faculty practice of UT Health San Antonio, provides our region with the most comprehensive care through expert, compassionate providers treating patients in more than 140 medical specialties at locations throughout San Antonio and the Hill Country. UT Health San Antonio Physicians Regina Delgado Business Development Manager (210) 450-3713 delgador4@uthscsa.edu UT Health San Antonio MD Anderson Mays Cancer Center Laura Kouba Business Development Manager (210) 265-7662 norriskouba@uthscsa.edu Cancer.uthscsa.edu Appointments: 210-450-1000 UT Health San Antonio MD Anderson Cancer Center 7979 Wurzbach Road San Antonio, TX 78229 Express Information Systems (HHH Gold Sponsor) With over 29 years’ experience, we understand that real-time visibility into your financial data is critical. Our browser-based healthcare accounting solutions provide accurate, multi-dimensional reporting that helps you accommodate further growth and drive your practice forward. Rana Camargo Senior Account Manager 210-771-7903 ranac@expressinfo.com www.expressinfo.com “Leaders in Healthcare Software & Consulting”
INSURANCE
TMA Insurance Trust (HHHH 10K Platinum Sponsor) TMA Insurance Trust is a full-service insurance agency offering a full line of products – some with exclusive member discounts and staffed by professional advisors with years of experience. Call today for a complimentary insurance review. It will be our privilege to serve you. Wendell England Director of Member Benefits 512-370-1776 wendell.england@tmait.org 800-880-8181 www.tmait.org “We offer BCMS members a free insurance portfolio review.”
Guardian (★★★ Gold Sponsor) Live Confidently. Every financial dream deserves a well-crafted plan. Ned Hodge 210-332-3757 ned@nedhodge.com www.nedhodge.com | www.Opesone.com “Take care of today then plan for tomorrow”
Humana (HHH Gold Sponsor) Humana is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. Jon Buss: 512-338-6167 Jbuss1@humana.com Shamayne Kotfas: 512-338-6103 skotfas@humana.com www.humana.com
INSURANCE/MEDICAL MALPRACTICE
Texas Medical Liability Trust (HHHH 10K Platinum Sponsor) With more than 20,000 health care professionals in its care, Texas Medical Liability Trust (TMLT) provides malpractice insurance and related products to physicians. Our purpose is to make a positive impact on the quality of health care for patients by educating, protecting, and defending physicians. Patty Spann 512-425-5932 patty-spann@tmlt.org www.tmlt.org Recommended partner of the Bexar County Medical Society
The Bank of San Antonio Insurance Group, Inc. (HHH Gold Sponsor) We specialize in insurance and banking products for physician groups and individual physicians. Our local insurance professionals are some of the few agents in the state who specialize in medical malpractice and all lines of insurance for the medical community. Katy Brooks, CIC 210-807-5593 katy.brooks@bosainsurance.com www.thebankofsa.com “Serving the medical community.”
MedPro Group (HH Silver Sponsor) Rated A++ by A.M. Best, MedPro Group has been offering customized insurance, claims and risk solutions to the healthcare community since 1899. Visit MedPro to learn more. Kirsten Baze 512-658-0262 Kirsten.Baze@medpro.com www.medpro.com
ProAssurance (HH Silver Sponsor) ProAssurance professional liability insurance defends healthcare providers facing malpractice claims and provides fair treatment for our insureds. ProAssurance Group’s rating is AM Best A (Excellent). Mike Rosenthal Senior Vice President, continued on page 42 Visit us at www.bcms.org 41
Business Development 800-282-6242 MikeRosenthal@ProAssurance.com www.ProAssurance.com
INVESTMENT ADVISORY REAL ESTATE
Alamo Capital Advisors LLC (★★★★ 10K Platinum Sponsor) Focused on sourcing, capitalizing, and executing investment and development opportunities for our investment partners and providing thoughtful solutions to our advisory clients. Current projects include new developments, acquisitions & sales, lease representation and financial restructuring (equity, debt, and partnership updates). Jon Wiegand, Principal 210-241-2036 jw@alamocapitaladvisors.com www.alamocapitaladvisors.com
MEDICAL BILLING AND COLLECTIONS SERVICES
Wave Online (★★★ Gold Sponsor) Our team of professionals will act as your extended AR office enhancing your revenue through our proprietary metrics and claim management systems. In addition, you keep 100% control of your RCM. Contact us today for a no cost evaluation. Saranraj (Raj) Venkatesh Vice President – RCM | Sales and Client Relations 726-228-1097 saranraj@wavemt.com https://rcmwave.com/ “Innovation towards Solutions”
Commercial & Medical Credit Services (HH Silver Sponsor) A bonded and fully insured San Antonio-based collection agency. Henry Miranda 210-340-9515 hcmiranda@sbcglobal.net www.cmcs-sa.com “Make us the solution for your account receivables.”
MEDICAL SUPPLIES AND EQUIPMENT
Henry Schein Medical (HH Silver Sponsor) From alcohol pads and bandages to EKGs and ultrasounds, we are the largest worldwide distributor of medical supplies, equipment, vaccines and pharmaceuticals serving office-based practitioners in 20 countries. Recognized as one of the world’s most ethical companies by Ethisphere. Tom Rosol 210-413-8079 tom.rosol@henryschein.com www.henryschein.com “BCMS members receive GPO discounts of 15 to 50 percent.”
MILITARY
San Antonio Army Medical Recruiting office (★★Silver Sponsor) Mission: Recruit highly qualified and motivated healthcare professionals for service in the Army Reserves or Active Duty Army, in support of Soldiers and their families. 1LT Thomas Alexandria 210-328-9022 Alexandria.n.thomas12.mil@army. mil https://recruiting.army.mil/mrb/ “Service to Country, Army Medicine, Experientia et Progressus”
MOLECULAR DIAGNOSTICS LABORATORY
iGenomeDx ( Gold Sponsor) Most trusted molecular testing laboratory in San Antonio providing FAST, ACCURATE and COMPREHENSIVE precision diagnostics for Genetics and Infectious Diseases. Dr. Niti Vanee Co-founder & CEO 210-257-6973 nvanee@iGenomeDx.com Dr. Pramod Mishra Co-founder, COO & CSO 210-381-3829 pmishra@iGenomeDx.com www.iGenomeDx.com “My DNA My Medicine, Pharmacogenomics”
PRACTICE MANAGEMENT
Wave Online (★★★ Gold Sponsor) Our team of professionals will act as your extended AR office enhancing your revenue through our proprietary metrics and claim management systems. In addition, you keep 100% control of your RCM. Contact us today for a no cost evaluation. Saranraj (Raj) Venkatesh Vice President – RCM | Sales and Client Relations 726-228-1097 saranraj@wavemt.com https://rcmwave.com/ “Innovation towards Solutions”
PROFESSIONAL ORGANIZATIONS
The Health Cell (HH Silver Sponsor) “Our Focus is People” Our mission is to support the people who propel the healthcare and bioscience industry in San Antonio. Industry, academia, military, nonprofit, R&D, healthcare delivery, professional services and more! Kevin Barber, President 210-308-7907 (Direct) kbarber@bdo.com Valerie Rogler, Program Coordinator 210-904-5404 Valerie@thehealthcell.org www.thehealthcell.org “Where San Antonio’s Healthcare Leaders Meet”
San Antonio Medical Group Management Association (SAMGMA) (HH Silver Sponsor) SAMGMA is a professional nonprofit association with a mission to provide educational programs and networking opportunities to medical practice managers and support charitable fundraising. Lindsey Herman Nolan, MHR, CMPE, President info4@samgma.org www.samgma.org
REAL ESTATE SERVICES COMMERCIAL
Alamo Capital Advisors LLC (★★★★ 10K Platinum Sponsor) Focused on sourcing, capitalizing, and executing investment and development opportunities for our investment partners and providing thoughtful solutions to our advisory clients. Current projects include new developments, acquisitions & sales, lease representation and financial restructuring (equity, debt, and partnership updates). Jon Wiegand, Principal 210-241-2036 jw@alamocapitaladvisors.com www.alamocapitaladvisors.com
CARR Realty (HH Silver Sponsor) CARR is a leading provider of commercial real estate for tenants and buyers. Our team of healthcare real estate experts assist with start-ups, renewals, relocations, additional offices, purchases and practice transitions. Brad Wilson – Agent 210-573-6146 Brad.Wilson@carr.us www.carr.us “Maximize Your Profitability Through Real Estate”
RETIREMENT PLANNING
Oakwell Private Wealth Management (HHHH 10K Platinum Sponsor) Oakwell Private Wealth Management is an independent financial advisory firm with a proven track record of providing tailored financial planning and wealth management services to those within the medical community. Brian T. Boswell, CFP®, QKA Senior Private Wealth Advisor 512-649-8113 SERVICE@OAKWELLPWM.COM www.oakwellpwm.com “More Than Just Your Advisor, We're Your Wealth Management Partner”
STAFFING SERVICES
Favorite Healthcare Staffing (HHHH 10K Platinum Sponsor) Serving the Texas healthcare community since 1981, Favorite Healthcare Staffing is proud to be the exclusive provider of staffing services for the BCMS. In addition to traditional staffing solutions, Favorite offers a comprehensive range of staffing services to help members improve cost control, increase efficiency and protect their revenue cycle. Cindy M. Vidrine Director of Operations- Texas 210-918-8737 cvidrine@favoritestaffing.com “Favorite Healthcare Staffing offers preferred pricing for BCMS members.”
San Antonio Army Medical Recruiting office (HH Silver Sponsor) Mission: Recruit highly qualified and motivated healthcare professionals for service in the Army Reserves or Active Duty Army, in support of Soldiers and their families. 1LT Thomas Alexandria 210-328-9022 Alexandria.n.thomas12.mil@army.mil https://recruiting.army.mil/mrb/ “Service to Country, Army Medicine, Experientia et Progressus”
2022 Audi Q3
By Stephen Schutz, MD
The Audi Q3 is a small luxury crossover vehicle that competes with the BMW X1, Mercedes GLA, and Lexus NX. While the Q3 is small, it’s a lot bigger than it used to be, which is a good thing because now Audi’s smallest SUV is a more logical purchase in this competitive market niche.
How small was the previous (first generation) Q3? It was so small that sitting in the rear seats was comical for anyone taller than 5’9” or so. I’m 6’2” and I had to tilt my head to one side uncomfortably when I tried out the rear seats. Luggage space was minimal too.
The prior Q3 looked good though. It was a classic “outside-in” design job where stylists created an attractive shape and the engineers had to make do with the resulting diminutive interior. And not only was it better looking than its competitors back then, but it also looks better than its successor.
Which isn’t ugly, by the way. Boxy with all of the Audi styling elements that we’ve come to know and (mostly) love, the Mk2 Q3 is best described as a 3/4 size Q5 with some modest alterations.
That should come as no surprise as the Q5 is Audi’s best-selling vehicle, and it continues to sell strongly despite being almost completely unchanged since it launched way back in 2009. If I were in charge of Audi, I’d make the Q3 look like the Q5 too.
While more spacious than the previous model, especially in the back seat where I’m now able to sit normally, the new Q3’s interior is still relatively small. Luggage space behind the rear seats is 24ft3 with the rear seats up and 48ft3 with them folded down (for the record the prior Q3 had just 17ft3 of luggage space behind the rear seats).
Realistically, if size were the only thing that mattered, then the $38,000 base price Audi Q3 wouldn’t sell any copies at all. But size isn’t the only relevant thing in this market.
In fact, for most customers it’s all about the luxury experience. With that reality in mind, the cabin of all Audis is very nice, and that’s the case with the Q3. All of the materials that you see and touch are of higher quality than a similarly priced (and probably larger) vehicle from a mainstream manufacturer, and the gauges and controls are also better. When you sit behind the wheel of an Audi (BMW, Mercedes or Lexus) there’s a premium feel that makes the extra money you pay worth it. And typically, you’re treated better at the dealership too. Isn’t that type of experience one of the reasons (or the reason) we work so hard as physicians? It is for me.
Anyway, driving the Q3 is pleasant but not exciting. Since the Q3 sits on the same platform as the VW Golf, everything is geared for a middle of the road driving experience not athleticism. Its sweet spot is zipping around town running errands or commuting, but B-roads are also handled well. Interstate driving is just Ok with the Q3; it’s not like it falls apart there, but the open road isn’t where the Q3 really wants to be.
Quattro All-wheel drive, an 8-speed automatic transmission, and a 2.0L turbocharged four-cylinder engine are standard on every Q3. Nevertheless, two versions of that 2.0L engine are available: the base 40 model puts out 184HP, while the higher-spec 45 is good for 228HP.
The Q3’s fuel economy figures are 23 MPG City and 30 MPG Highway for the 40, and 21 City and 28 Highway for the Q3 45.
Tech-wise, Audi equips most Q3 models with an 8.8-inch touchscreen MMI infotainment system that features Apple CarPlay and Android Auto. A larger 10.1-inch touchscreen is also available as an option, which is what I would select. SiriusXM satellite radio, wireless charging, a 15-speaker and a 680-watt Sonos stereo system are also available as options.
As always with German cars, options and option packages can get complicated and expensive. The smart thing to do is keep a lid on extras and work with BCMS’ Phil Hornbeak to get your best deal.
The 2022 Audi Q3 is a compact luxury SUV that compares favorably with the BMW X1, Mercedes GLA and Lexus NX. It is certainly small, but if luxury is more important to you than size, then it merits a close look.
As always, call Phil Hornbeak, the Auto Program Manager at BCMS (210-301-4367), for your best deal on any new car or truck brand. Phil can also connect you to preferred financing and lease rates.
Stephen Schutz, MD, is a board-certified gastroenterologist who lived in San Antonio in the 1990s when he was stationed here in the US Air Force. He has been writing auto reviews for San Antonio Medicine since 1995.
11911 IH 10 West San Antonio, TX 78230 Coby Allen 210-696-2232
Kahlig Auto Group
Bluebonnet Chrysler Dodge Ram 547 S. Seguin Ave. New Braunfels, TX 78130 Matthew C. Fraser 830-606-3463
Land Rover San Antonio 13660 IH 10 West San Antonio, TX Cameron Tang 210-561-4900
Kahlig Auto Group
North Park Mazda 9333 San Pedro San Antonio, TX 78216 John Kahlig 210-253-3300
Kahlig Auto Group
North Park Subaru 9807 San Pedro San Antonio, TX 78216 Raymond Rangel 210-308-0200
Audi Dominion 21105 West IH 10 San Antonio, TX 78257 Rick Cavender 210-681-3399
Northside Ford 12300 San Pedro San Antonio, TX Marty Martinez 210-477-3472
Kahlig Auto Group
North Park Lexus 611 Lockhill Selma San Antonio, TX Tripp Bridges 210-308-8900
Mercedes Benz of Boerne 31445 IH 10 West Boerne, TX James Godkin 830-981-6000
Kahlig Auto Group
North Park Subaru at Dominion 21415 IH 10 West San Antonio, TX 78257 Phil Larson 877-356-0476
Northside Chevrolet 9400 San Pedro Ave. San Antonio, TX 78216 Charles Williams 210-912-5087 Chuck Nash Chevrolet Buick GMC 3209 North Interstate 35 San Marcos, TX William Boyd 210-859-2719
Northside Honda 9100 San Pedro Ave. San Antonio, TX 78216 Paul Hopkins 210-988-9644
Kahlig Auto Group
North Park Lexus at Dominion 25131 IH 10 W Dominion San Antonio, TX James Cole 210-816-6000
14610 IH 10 West San Marcos, TX 78249 Mark Hennigan 832-428-9507
Kahlig Auto Group
North Park Lincoln 9207 San Pedro San Antonio, TX Sandy Small 210-341-8841
Mercedes Benz of San Antonio 9600 San Pedro San Antonio, TX Al Cavazos Jr. 210-366-9600
Cavender Toyota 5730 NW Loop 410 San Antonio, TX Gary Holdgraf 210-862-9769
9455 IH 10 West San Antonio, TX 78230 Douglas Cox 210-764-6945
Kahlig Auto Group
North Park Toyota 10703 Southwest Loop 410 San Antonio, TX 78211 Justin Boone 210-635-5000
