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Volume 11 | Issue 11
Inside This Issue
November Edition 2021
2020/2021 Sees Highest Demand for Nurse Practitioners By Phillip Miller, Merritt Hawkins
Study Links Brain Fog in COVID Patients to Poorer Outcomes See pg. 10
INDEX Legal Matters........................ pg.3 Oncology Research......... pg.4 Mental Health...................... pg.6 Healthy Heart....................... pg.9 Financial Forecast.............pg.11
Artavia Community Spotlight See pg. 12
S
ince early 2020, the global pandemic has wreaked havoc on medical professionals, health systems and the healthcare recruiting industry. It has been a time like no other. So it shouldn’t be a surprise that 2020/2021 saw some changes in demand for nurse practitioners, other advanced practitioners, and physicians across the United States. In fact, nurse practitioners (NPs) claimed the top spot as the most in-demand medical providers over the past year, based on Merritt Hawkins’ requests from hospitals and healthcare facilities around the country. These results in the new 2021 Review of Physician and Advanced Practitioner Recruiting Incentives represent the first time in the report’s 28-year history that the placement firm conducted more search engagements for nurse practitioners than for any other type of provider. “COVID-19 and other forces are
changing the dynamics of physician and advanced practitioner recruiting,”
assistants (PAs) was less than half what it was the previous year. The number of requests for certified registered nurse anesthetists (CRNAs) was also down year-over-year, likely due to a reduction in elective surgeries that occurred throughout the country during the pandemic. Yet, the average starting salaries for all three advanced practice roles saw an increase this past year. The demand and starting salaries for advanced practitioners NP starting salaries show increase Along with the significant increase in demand for nurse practitioners this past year (24 percent), the average starting salaries for NPs also showed strong growth in Merritt Hawkins’ most recent review of recruiting incentives. The average salary offer for NPs increased 12 percent year-over-year to $140,000 in 2020/2021. These numbers represent base salary or guaranteed income only, not accounting for any production bonus or benefits. The average starting salaries for nurse practitioners over the past five
COVID-19 and other forces are changing the dynamics of physician and advanced practitioner recruiting... NPs are coming into their own in a market that puts a premium on easy access to care and cost containment.
— Tom Florence, Merritt Hawkins said Tom Florence, president of Merritt Hawkins. “NPs are coming into their own in a market that puts a premium on easy access to care and cost containment.” The 2021 Review indicated that COVID-19 contributed to a 25 percent decline in demand for physicians, as many hospitals, medical groups, and other healthcare facilities shut down services and lost revenue. Yet, during this atypical year, the demand for nurse practitioners increased by 24 percent. Meanwhile, the demand for other advanced practitioners was down. The number of searches for physician
see Demand...page 14
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#AHA21
American Heart Association
Scientific Sessions One World. Together for Science. SATURDAY, NOVEMBER 13 - MONDAY, NOVEMBER 15, 2021 FULLY VIRTUAL EXPERIENCE Meet us in November online from anywhere through our virtual platform for the global cardiovascular event of the year! Reconnect with colleagues, experience breakthrough cardiovascular basic, clinical and population science updates, and immerse yourself in innovative solutions designed to help you in your daily practice at the American Heart Association’s Scientific Sessions 2021.
Learn more at ScientificSessions.org
November 2021
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Houston Medical Times
Page 3
Legal Matters Department Of the Treasury Issues New Advisory Regarding Ransomware Payments
By Denise K. Drake, J.D. & Lilian Doan Davis, J.D. Polsinelli, PC
H
ealthcare providers are increasingly finding themselves the target of ransomware attacks and, when this occurs, having to make difficult decisions, including whether to make a ransom payment. In situations in which the provider is unable to easily recover encrypted data from backups, it may feel as if it has no choice but to make payment in exchange for decryption keys. These decisions, however, are made even more complex due to OFAC restrictions and the fact that it may be difficult, if not impossible, to specifically identify the perpetrator of the attack. Recently. the U.S. Department of
the Treasury’s Office of Foreign Assets Control (“OFAC”) released its Updated Advisory on Potential Sanctions Risks for Facilitating Ransomware Payments (the “Updated Advisory”). The Updated Advisory follows on OFAC’s October 1, 2020 Advisory on Potential Sanctions Risks for Facilitating Ransomware Payments and provides additional guidance for companies that may make or facilitate ransomware payments. In the first portion of the Updated Advisory, OFAC reiterates the reasons why the U.S. government has, and continues to, strongly discourage anyone from paying a ransom demanded in a cyber-attack. In particular, OFAC notes that making a ransom payment does not guarantee that a malicious actor will reprovision a company’s access to data or refrain from further attacks against the company, and that the availability of payments may encourage malicious actors to perpetrate more attacks. OFAC also highlights that paid ransom money can be used to fund activities adverse to U.S. interests, and that the law prohibits any U.S.
person from engaging in a transaction, whether directly or indirectly, with a group or individual on its Specially Designated Nationals and Blocked Persons (“SDN”) List (or other block list). Related to this last point, OFAC reminds of its authority to enforce the law through both non-public responses like issuing a warning letter and public responses like imposing civil penalties. OFAC further reminds that, in the latter case, penalties can be imposed on a strict liability basis, meaning without regard to whether the company paying a ransom knew (or even had reason to know) its payment was legally prohibited. While OFAC has previously expressed its position regarding the payment of ransoms, including
reminders that companies who pay blocked individuals or groups risk breaking the law, the Updated Advisory provides some new guidance to those nonetheless making or facilitating payments. Specifically, in the second portion of the Updated Advisory, OFAC describes certain “mitigating” factors it will take into consideration when determining how to respond to an apparent illegal ransom payment. OFAC explains that where these factors are present, it will be more likely to utilize a non-public resolution (like a letter) than a public resolution (like a monetary penalty). OFAC identifies three (3) mitigating factors. see Legal Matters...page 14
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November 2021
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Oncology Research Smoking and Your Lung Health – It’s Worth Quitting For By Sanjay Sethi, M.D., Texas Oncology
“
soil that can create high levels of indoor radon exposure. Use radon detection kits and EPA-suggested companies to test your home for radon. Ask your physician about getting screened. Lung cancer is treatable and often preventable, but frequently diagnosed at later stages when it is more difficult to treat. That’s why screening for lung cancer is so important. People ages 50 to 80 with a history of heavy smoking, who smoke now or who quit within the past 15 years, and who have a 20 pack per year smoking history should consider a yearly low-dose CT scan to screen for lung cancer. While the symptoms for lung
cancer vary, common symptoms include chest pain made worse with deeper breathing, coughing, or laughing; coughing up blood, phlegm, or a persistent cough; and hoarseness or breathing trouble. If you are a current or former smoker, or are experiencing any of these symptoms, talk with your physician about whether you should be screened for lung cancer. Smoking and COVID-19 According to the FDA, cigarette smoking increases the risk of more serious illness from COVID-19. Because smoking can weaken your immune system and cause inflammation and see Oncology Research...page 13
RELAX
Quitting smoking is easy. I’ve done it hundreds of times.” You may have heard that old joke before. But there’s nothing funny about the real dangers of not giving up the deadly, addictive habit of smoking. The Federal Drug Administration (FDA) reports nearly 70 percent of current adult smokers prior to the COVID-19 pandemic have said they wanted to quit. Compound the addictiveness of nicotine with managing the stresses of life during COVID-19 and it appears the trend is moving in the wrong direction. The North American Quitline Consortium reported up to a 39 percent decrease in volume of calls seeking help in quitting smoking during 2020 compared to 2019.
The stubborn truth about lung cancer is that it remains the deadliest cancer in Texas and the United States. Smokers are around 25 times more likely to develop lung cancer. November, Lung Cancer Awareness Month, is the right time to learn more about the risks of lung cancer – even if you don’t smoke – and get the support you need to prioritize your lung health. Know the risk factors. While smoking is the most important risk factor for lung cancer, there are others: • Breathing in secondhand smoke can increase your risk of lung cancer. • People with a parent or sibling who had lung cancer have a higher-than-average risk, even if they are nonsmokers. • People who live or work in certain conditions where they are exposed to substances like radioactive gas, asbestos, arsenic, or radon, have an increased risk of developing cancer. In fact, radon is the second leading cause of lung cancer in the U.S. Some homes are built on
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In the Heart of the Medical Center
Houston Medical Times
Page 5
Texas A&M Health, Houston Methodist Formalize Agreement to Fund Center for Health & Nature New Funding Commitment from The Founding Organizations Will Help Advance The Center’s Research And Education On How Nature Impacts Human Health By Lindsey Hendrix
T
exas A&M University Health Science Center (Texas A&M Health) and Houston Methodist have formalized an agreement to support the Center for Health & Nature. The agreement establishes core funding for the center, which drives research to study the impact of nature on health with evidence-based programs that complement the full continuum of health care: prevention, treatment and recovery. “It is nice to see the strong vision and commitment of the three organizations,” said Bita Kash, PhD, MBA, FACHE, co-director of the center, a collaboration between Texas A&M Health, Houston Methodist and Texan by Nature. “As someone who researches health outcomes, health policy and management,
it is quite exciting to have the infrastructure to build a research team around understanding nature as an intervention, as the medicine towards better health outcomes.” As part of the agreement, Texas A&M Health and Houston Methodist will each commit $125,000 per year to support the center. The funding will be used to hire dedicated leadership to create community connections, accelerate research and foster collaborations. Although the center has been engaged in research and education since it first launched in 2018, this new core funding will strengthen and focus the center’s work. “A lot of what we’re doing at the center is establishing the relationship between improvement in human health and time spent in nature,” said Jay Maddock, PhD, FAAHB, co-director of the center. “There’s a lot of questions
around that in terms of for who and for how long. We want to know what aspects of nature are essential— sounds, smells, sights. Does virtual reality have a similar impact? And the second question is how do we encourage people to spend more time in nature?” It may feel intuitive that nature is good for our health, but scientific evidence is still being compiled to support the idea. The goal of the Center for Health & Nature is to substantiate the link between nature and enhanced health. The result of the center’s research will be to produce evidence-based programs that can be used alongside traditional therapies to
enhance healing, prevent disease and improve recovery from illness or injury, both within the health care setting and as part of lifestyle intervention. These programs will impact patients with a wide range of illnesses and conditions as well as health care workers. “Conserving nature is good for everyone,” said Cynthia Pickett-Stevenson, Board Chairman of Texan by Nature. “Texan by Nature believes that our long-term health and prosperity are dependent upon our natural resources. The evidence see Nature...page 14
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Built Around You November 2021
Houston Medical Times
Page 6
Mental Health Substantial Mental Health Impact From COVID-19 Measures Found in New Research
F
indings from new University of Texas Medical Branch research suggest a substantial mental health impact of COVID-related mitigation measures such as stay-at-home orders. The study, which was published today in the JAMA Network Open, found an increase in the use of psychiatric medications coinciding with the COVID-19 pandemic among both men and women, with a substantially higher increase among women. “We hope that this study highlights the disproportionate effect of the ongoing COVID-19 pandemic, sex as a priority in research on the COVID-19 pandemic and the need for interventions to address these sex disparities in the consequences of the pandemic,” said Dr. Sadaf Milani, Department of Internal Medicine assistant professor and one of the study’s authors. Using data from Clinformatics Data Mart, one of the largest commercial health insurance databases
November 2021
in the United States, researchers identified qualified enrollees and their prescribed medicine from Jan. 1, 2018 to March 31, 2021. The study focused on prescriptions of benzodiazepines, Z-hypnotics and serotonergic drugs, which are commonly used to treat insomnia, anxiety and depressive disorders. Benzodiazepine prescriptions decreased from Jan. 2018 to March 2021, except for a slight increase from January 2020 to April 2020 among women; Z-hypnotic prescriptions increased from Jan. 2020 for women and from February 2020 for men through October 2020; and serotonergic prescriptions increased from January 2018 to April 2020 for men and to October 2020 for women. The study noted that the decrease in benzodiazepine may be explained by current efforts to reduce its prescriptions. Women had a higher rate of prescription use for all three psychiatric drug classes and larger changes in prescription rates over time compared
to men, the data showed. “The substantially higher impact of the ongoing pandemic on women underscores the need for all providers across all settings of medical contact with women to incorporate a screening process for mental health conditions in their routine practice,” Milani said. “This is especially critical in moments of natural disasters, which our study suggests disproportionately impact women than men – vis-à-vis psychological toll.” The study discusses several factors that may explain why women are disproportionately affected, including having higher rates of mental health conditions, comprising more than 75% of health care workers and serving as
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primary caregivers with an increased burden of childcare due to closures of schools and childcare centers during the pandemic. “Providers and patients should have heightened awareness of the substantially higher rates of occurrence of anxiety, depressive symptoms and sleep disorders – both short- and long-term – in women compared to men, especially during periods of natural disasters, social disruptions and economic upheavals leading to school closure and social isolation with heavier load of childcare falling on women,” Milani said.
Houston Medical Times
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WHOSE INTERESTS does your malpractice insurer have at heart?
Yet another Texas medical liability insurer has transitioned from focusing on doctors to focusing on Wall Street. This leaves you with an important question to ask: Do you want an insurer that’s driven by investors? Or do you want an insurer that’s driven to serve you—one that’s already paid $120 million in awards to its members when they retire from the practice of medicine? Join us and discover why delivering the best imaginable service and unrivaled rewards is at the core of who we are.
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Hospital News MD Anderson and the Rare Cancer Research Foundation Launch Collaboration to Accelerate the Development of Treatments for Rare Cancers
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he University of Texas MD Anderson Cancer Center and the Rare Cancer Research Foundation today announced the launch of a collaboration designed to accelerate the development of new treatments for rare cancers by empowering all patients in the United States to contribute tumor samples directly to MD Anderson for translational research efforts. This initiative is designed to overcome a major obstacle that has long prevented significant progress in rare cancer research — the lack of available samples. The Rare Cancer Research Foundation will use its Pattern.org online engagement platform to enable patients to donate tumor biopsies and surgical samples for research purposes.
With these samples, MD Anderson researchers will perform comprehensive analyses and will work to develop laboratory models that can be used to pursue new therapeutic strategies for rare cancers. New discoveries then can be used to design and launch clinical trials to evaluate these strategies for patients in need. “The development of new rare cancer treatments is often stymied not by hard scientific questions but rather by the lack of patient models and datasets necessary to conduct research,” explained Mark Laabs, founder and chairman of the Rare Cancer Research Foundation. “We are delighted that this collaboration will empower patients nationwide to contribute their samples and medical
information to cutting-edge work at MD Anderson and to accelerate the development of new treatments for rare cancers.” Rare cancers are defined as those with fewer than 40,000 new cases diagnosed annually in the U.S. Taken together, rare cancers represent roughly 25% of all cancer cases and are the leading cause of cancer-related deaths. The Rare Cancer Research Foundation is committed to advancing research for these cancer types through strategic investments and innovative collaborations. MD Anderson is a world leader in the diagnosis and treatment of these cancers; more than 5,000 patients with the rarest diagnoses seek treatment at the institution each year.
UTMB Celebrates 130th Anniversary
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ne hundred and thirty years ago, 23 students and 13 faculty gathered on Galveston Island and began a tradition of improving health through education, research and patient care. It was the first class meeting of the state’s first medical school. Now with more than 3,500 students and nearly 14,000 employees, The University of Texas Medical Branch will mark its 130th anniversary on Oct. 5, 2021. “Over the years, UTMB has weathered many storms and celebrated many triumphs,” said Dr. Ben Raimer, president ad interim of UTMB. “We have trained generations of health care providers and biomedical scientists and have made countless research discoveries. We see the benefits of that training and research during the COVID-19 pandemic and future generations will reap the benefits of the hard work, education and research happening on our campuses today.” In 1891, UTMB had one hospital – the original John Sealy Hospital, made possible through a $50,000 bequest from its namesake. Today, UTMB is a comprehensive health system with four campuses and 90 clinics throughout the region that serve thousands of patients every year. The university also operates an extensive Correctional Managed Care program. UTMB’s educational options have also grown from the original medical school and soon after a nursing program, to now the School of Health Professions and Graduate
November 2021
School of Biomedical Sciences. Soon UTMB will be adding a School of Public and Population Health to the academic enterprise. UTMB currently offer 59 accredited residency and fellowship programs and will soon be adding a 60th with a new Emergency Medicine residency. And its internationally recognized research enterprise includes the Galveston National Laboratory. “All of this growth and success has been possible because of one thing,” Raimer said. “Our people have been a shining beacon of hope and healing for the communities we serve. I want to thank our students, faculty and staff, along with countless friends, philanthropists, elected officials and the University of Texas System Board of Regents, who have believed in our mission and supported us unwaveringly throughout our history.” Among the long-time supporters of UTMB is The Sealy & Smith Foundation, which carries on the giving legacy of the Sealy family and will celebrate its centennial in 2022. Because of the ongoing pandemic, UTMB will not host a large, public gathering to commemorate the 130th anniversary, but instead will have a series of smaller celebrations for employees and students at each of the four campuses. The celebrations will begin on the Galveston Campus on Oct. 5 and will continue on Oct. 8 on the Angleton Danbury, Clear Lake and League City campuses.
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“Our collaboration with the Rare Cancer Research Foundation allows rare cancer patients having surgery anywhere in the U.S. to join in the research effort by contributing excess tumor tissue, giving them the opportunity to truly make an impact on the entire community of these patients,” said Andy Futreal, Ph.D., chair of Genomic Medicine at MD Anderson. “Each piece of data or model generated is a potentially transformative tool that can advance our understanding and bring us closer see Hospital News...page 13
Memorial Hermann Katy Hospital Announces Opening of Third Cardiac Catheterization Lab
M
emorial Hermann Katy Hospital recently opened its third cardiac catheterization lab, giving patients even more access to leading-edge cardiovascular treatments and procedures. “By adding this space, it allows us to take on a higher volume of patients needing heart and vascular care in the Katy area,” said Jerry Ashworth, SVP and CEO of Memorial Hermann Katy and Memorial Hermann Cypress Hospitals. “We pride ourselves in serving the community so that our patients can get the highest quality care while close
to home. We are constantly looking for ways to expand our space and services to better serve Katy and Greater Houston.” The Katy Area Chamber attended a ribbon cutting in the new space with the clinic staff and affiliated physicians at Memorial Hermann Katy Hospital. Memorial Hermann Health System’s Heart & Vascular Services are dedicated to the detection, treatment and prevention of diseases of the heart throughout Greater Houston. To learn more, please visit Heart & Vascular Service.
Houston Medical Times
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Healthy Heart American Heart Association’s 2021 Scientific Sessions Goes Virtual
A premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science By The American Heart Association
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he American Heart Association will present this year’s Scientific Sessions 2021 as a fully virtual experience Saturday, November 13 through Monday, November 15, 2021. The Resuscitation Science Symposium and the Quality of Care and Outcomes Research Scientific Session, being held in conjunction with Scientific Sessions, have also moved to fully virtual formats. The decision to shift to an all-digital experience - from the previously planned blend of in-person and virtual experiences - is a consequence of the continuing surge of the Delta variant of the COVID-19 virus. The Association has offered Scientific Sessions, a premier global exchange of the latest scientific advancements, research and
evidence-based clinical practice updates in cardiovascular science, to health care professionals and researchers worldwide, since 1925. The meeting typically draws thousands of scientists and medical professionals from around the world, and this year will mark the second time in nearly 100 years that Scientific Sessions will be fully virtual. This approach helps ensure the health and safety of Scientific Sessions attendees by reducing travel and multi-day, large public gatherings. Many health care professionals have been forced to suspend travel in order to attend to urgent patient and clinical needs in their home communities. The Association’s leadership and its volunteer-led Committee on Scientific Sessions Programming is committed to creating a meaningful
virtual event, based on the success of last year’s Scientific Sessions, as well as its other digital-first meetings. Scientific Sessions 2021 will once again provide a robust and meaningful scientific exchange in an all-virtual format while ensuring this important content remains easily accessible to health care professionals and researchers worldwide. The Association believes the virtual format may increase access and the reach of the event to international attendees who are not able to travel and attend in person. “Together with my colleagues on the sessions program committee, we remain dedicated to providing rich, cutting-edge and valuable scientific content in a fully virtual experience. More than 500 sessions are planned for three full days of the latest
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cardiovascular, resuscitation and quality of care research. The digital experience will be interactive and compelling. We look forward to engaging online in November for the 2021 Scientific Sessions: One World - Together for Science!” said Manesh R. Patel, M.D., FAHA, volunteer chair of the Association’s Committee on Scientific Sessions Programming, and a professor of medicine, the Richard Sean Stack, M.D. Distinguished Professor, chief of the division of cardiology and chief of the division of clinical pharmacology at Duke University School of Medicine in Durham, North Carolina. Visit professional.heart.org to learn more and sign up.
November 2021
Houston Medical Times
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Professional Science Master’s
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BIOSCIENCE & HEALTH POLICY
New Study Links Brain Fog in COVID Patients to Poorer Outcomes, Develops Scoring System for Prognosis cute confusional state, more commonly known as delirium or brain fog, in COVID-19 patients is linked to longer hospital stays, higher likelihood of needing intensive care and higher likelihood of death, according to new research from the University of Texas Medical Branch. The research, which was published in the Cureus Journal of Medical Science, looked at the impact of ACS on patient outcomes and on how medical providers could better identify patients who needed higher levels of care. “We wanted to have a better
A
were associated with higher likelihood of developing ACS, which in turn was associated with higher mortality,” Rai said. “These patients should be aware of their higher risks for COVID associated poor outcomes.” ACS patients also experienced a significantly higher need for ICU transfer and often had a longer hospital stay compared to non-ACS patients, the study showed. By understanding the overall impact of ACS in COVID-19 patients, the study aimed to evaluate the use of ACS at presentation or during hospitalization in determining a
way for risk stratification in inpatient COVID admissions,” said Dr. Prashant Rai, Department of Neurology assistant professor and the study’s corresponding author. “We also wanted to address the impact of potential history of neurological diseases may have on COVID outcomes.” The study reviewed the UTMB electronic health system to identify hospital inpatients with a confirmed diagnosis of COVID-19 between March 1 and July 13, 2020 – 245 patients were identified, with 37 demonstrating ACS. Patients who demonstrated ACS were significantly older, had higher comorbidities and exhibited more frequent history of at least one neurological diagnosis, such as dementia, when compared to COVID-19 patients who did not demonstrate ACS. “Prior history of neurological conditions such as dementia and epilepsy
patient’s prognosis. The study proposed a scoring system that can help identify patients with ACS who may require ICU level care earlier in the course of their illness. This scoring system is based on neurological history and age of the patient. “Not only could this study help with better risk stratification of COVID patients, in resource poor conditions it may also help guide candidates who are more likely to develop poor outcomes and thus may benefit from aggressive management,” Rai said. While there are several studies that delve into neurological symptoms of COVID-19 and a handful of studies that suggest worse outcomes with neurological comorbidities, this particular study highlights the importance of the use of ACS in predicting overall outcomes for hospitalized patients.
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Page 11
Financial Forecast How to “Break Up” with Your Financial Professional And Find an Advisor Who Is A Better Fit By Grace S. Yung, CFP Midtown Financial Group, LLC
W
hether they are business or personal, relationships don’t always work out. When needs aren’t being met, or it is simply time for a change, just like patients may switch to another doctor, investors may change to another financial advisor. Ending a relationship can sometimes be difficult, though. So, if you’re considering a change in your investment or retirement planning, what is the best way to go about “breaking up” with your current advisor
Your Current Financial Professional If you’ve had a bad experience with your current financial advisor and/or they have been involved in legal, ethical, or disciplinary actions, then it may go without saying that it’s time to move your account(s). But if you have an “okay” relationship, there are some important steps you can take to make the overall process easier for you and them, such as: − Letting the advisor know why you are moving your business away from them − Having a written termination agreement; sometimes a transfer form will suffice − Know what exit fees may be charged by your current advisory firm − Obtaining – or gaining access
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and moving to another who may be a better fit? When Should You Consider Changing Financial Advisors? There are several situations that might cause you to start looking for a new financial advisor. These will oftentimes include: − Your current advisor is nearing retirement, moving out of the area, or going to a different firm that you don’t want to do business with − You have more of a “transactional” relationship with your current advisor (such as just buying and selling stocks and mutual funds), but you now need more comprehensive / sophisticated planning − The current advisor isn’t staying up-to-date with changes in the industry – including financial laws and regulations, as well as new strategies that could enhance your portfolio or future retirement income generation − The relationship is just not a good fit Steps to Take When Splitting with
to – copies of your account and financial records − Revoking any trading authority you have with your current advisor or financial firm How to find a New Financial Advisor that is the Right Fit? It is also essential that you make a wise choice before committing to a new financial processional. With that in mind, consider the following: − How long they’ve been working in the financial services industry − What area they specialize in (such as retirement income planning, wealth management, etc.) − Whether the advisor is a CERTIFIED FINANCIAL PLANNERTM or fiduciary − What other professional licenses and/or designations they have earned − Whether they have had any disciplinary actions taken against them
see Financial Forecast...page 13
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Community Spotlight
ARTAVIA Community Announces New Homesites and Designs
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RTAVIA, the newest master-planned community in the Montgomery County/Conroe Area announces the release of new 40’ and 45’ wide homesites. These new sections of homesites will feature new designs by Coventry Homes and David Weekley Homes on the 40’ lots and Highland Homes and Perry Homes on the 45’ lots. Homes and additional lot sizes in ARTAVIA are offered by J. Patrick Homes, Lennar, Ravenna Homes and Westin Homes. “Over 200 new homesites are just releasing and buyers can find out more about the new home designs and pricing by visiting our model homes,” said Lisa Connell, Marketing Director of AIRIA Development® Company, the developer of ARTAVIA. “In addition to the new sections, each of
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our builders has homes under construction that will be ready for end of year move-in.” Amenities in ARTAVIA are already in place and ready for residents to enjoy. At the heart of ARTAVIA is Dapple Park, a 13-acre community park, overlooking a five-acre lake where you can launch your own kayak or rent paddleboats. The contemporary-style clubhouse features event rooms, a 24-hr FitCenter and the Palate Café, a one-of-a-kind community restaurant that promotes community gathering. Surrounding it are thoughtfully designed areas promoting imaginative play, outdoor living and an active lifestyle including a
meditation rain garden, splash pad, nature exploration zone, event lawn, playground and an extensive trail system with outdoor fit stations. The ARTAVIA Lifestyle Team is on-site to manage regularly scheduled events, classes and activities for residents and for future residents waiting on their new homes to be built. The community is just minutes from many Hospitals and Healthcare
• Integrating the Montessori method into the public school curriculum • Currently offering Pre-K thru 4th • Open enrollment until positions fill
facilities located on I-45. ARTAVIA is an ideal location for healthcare providers looking for a new home with a short commute to work. ARTAVIA recently received the prestigious National’s Silver Award for Master-Planned Community of the Year by the National Association of Home Builders (NAHB) National Sales see ARTAVIA ...page 13
• Comprehension Stem Program • Character & Leadership Development • High Tech – 7 computers per classroom
2319 N. GRAND BLVD., PEARLAND, TX. 77581 www.hmps.net | 281-485-2500 November 2021
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Oncology Research Continued from page 4 damage to cells in your body, you are less able to fight against diseases like COVID-19. Quitting smoking at any age helps lower your risk of lung cancer and is the single most important thing you can do to prevent cancer. If you are ready to quit smoking, talk to your primary care physician, invite loved ones to support you in kicking
the habit, and check out resources like the Quitline, a hotline supported by the Texas Department of State Health Services, at 1-877-937-7848. Quitting smoking is rarely easy to do. But that’s true of many of the most worthwhile things in life. Every step you take to protect your lung health is a step in the right direction.
Hospital News Continued from page 8 to effective new therapies.” MD Anderson established its Rare Tumor Initiative in 2019 to comprehensively characterize rare tumors throughout the course of each patients’ care. In 2021, the institution launched a translational research platform with the Broad Institute of
MIT and Harvard, designed to create a catalog of rare cancer models and to provide a data resource for researchers in the field. The current collaboration will integrate with these efforts to further accelerate the pace of research and generate much-needed therapeutic insights.
Financial Forecast Continued from page 11 − How they are compensated (i.e., by commission on products sold, a flat advisory fee, or via a percentage of assets under management) − If they work only with individual investors or also with business accounts, such as providing employee benefits for medical practices It can also be helpful to contact some of the advisor’s clients and inquire about their experience. Doing so can help you to better anticipate
what to expect in terms of the advisor’s style, communication methods, and accessibility. Are You Planning to Change Financial Advisors? If you are not happy with the relationship you have with your current financial professional – or if you’re simply seeking a better fit – make sure you do your “homework” so you can make a successful transition.
ARTAVIA Continued from page 12 and Marketing Council (NSMC). Additionally, AIRIA Development Company, the developer for the ARTAVIA® community, won the Greater Houston Builders Association Grand PRISM Award for Developer of the Year. Located north of the Grand Parkway, midway between I-45N and US 59N, and east of FM 1314 on SH 242 ARTAVIA will bring approximately 5,200 homes to the
area, and plans include over 120 acres of mixed-use, commercial and retail properties. Students living in ARTAVIA attend Conroe ISD. With its convenient location, ARTAVIA affords access to a long list of employment, medical, retail and recreation destinations. For more information, directions and updates, visit artaviatx.com.
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Demand
Continued from page 1 years: • $140,000 average NP salary in 2020/2021 • $125,000 average NP salary in 2019/2020 • $124,000 average NP salary in 2018/2019 • $129,000 average NP salary in 2017/2018 • $123,000 average NP salary in 2016/2017 Trends in PA starting salaries Although the number of search requests for physician assistants was down significantly over this past year, the average starting salaries for PAs increased by 14 percent, from $112,000 to $128,000. The 2021 Review noted the following salary trends over the past five years: • $128,000 average PA salary in 2020/2021 • $112,000 average PA salary in 2019/2020 • $110,000 average PA salary in 2018/2019 • $101,000 average PA salary in 2017/2018
Legal Matters
Continued from page 3 First, OFAC will consider a company’s implementation of a regulatory compliance program. The program, OFAC instructs, should be risk-based and account for the possibility that a ransom demand may involve a malicious actor on the SDN or other block list. Second, OFAC will consider a company’s “meaningful steps” to reduce the risk of cyber extortion. Here, OFAC suggests it will look for measures that decrease the likelihood that a company finds itself in a position where it needs to consider paying
Nature
Continued from page 5 provided by the Center for Health & Nature will further prove the benefit of caring for these resources as a critical component of our health.” Although core funding is provided by Texas A&M and Houston Methodist, Texan by Nature provides conservation expertise and access to in-kind contributions as well as staff November 2021
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• $115,000 average PA salary in 2016/2017 Trends in CRNA starting salaries Merritt Hawkins’ data shows that the demand for CRNA placements was down nearly 10 percent year-over-year, but candidates’ average salary offers still saw a small increase (3.3 percent). Here are the average starting salaries reported for nurse anesthetists over the past five years: • $222,000 average CRNA salary in 2020/2021 • $215,000 average CRNA salary in 2019/2020 • $197,000 average CRNA salary in 2018/2019 • $194,000 average CRNA salary in 2017/2018 • $202,000 average CRNA salary in 2016/2017 In all of the above specialties, these numbers reflect the incentives that advanced professionals are offered to attract them to new practice settings rather than what they may actually earn and report on their tax returns. The range of incentives detailed in Merritt Hawkins’ annual Review may be used as benchmarks for evaluating which recruitment incentives are customary and competitive in today’s
market. NPs and PAs contributing to team-based care There are over 270,000 NPs practicing in the United States today, according to the American Association of Nurse Practitioners (AANP), with 78 percent of them delivering primary care. By contrast, about one-third of the more than 120,000 PAs practicing in the United States work in primary care, while two-thirds work in specialty areas, according to the American Academy of Physician Assistants (AAPA). The 2021 Review reports that NPs and PAs are playing a growing role in team-based care, caring for patients, coordinating the efforts of all members of the team, and allowing doctors to focus on the most complex patients and procedures. Their ability to educate patients, ensure patient compliance, reduce costs and enhance patient satisfaction makes them an ideal resource for value-based delivery systems. Many NPs and PAs are also growing into leadership positions that will be critical for the transition to quality-based care.
a malicious actor, such as regularly updating anti-malware software and maintaining offline backups, and points to the Cybersecurity and Infrastructure Security Agency’s (CISA) September 2020 Ransomware Guide as a resource for organizations looking to take such meaningful steps. Third, OFAC will consider a company’s decision to self-report a ransomware attack to OFAC, law enforcement, and other regulatory agencies, and to thereafter fully cooperate with any investigation from these groups. OFAC suggests a company should report an and provide all relevant details as soon as possible. Given the frequency with which ransomware events are occurring and
the difficulty in specifically identifying the perpetrator of the attacks, organizations should strongly consider following the guidance, including taking meaningful steps to adopt or improve cybersecurity practices. Through improved cybersecurity, an organization can hopefully avoid finding itself in a position in which it feels that it must make a ransom payment, but if it becomes necessary, by taking such steps, OFAC may be more likely to forego issuance of a public monetary penalty if it later turns out that payment was made to a blocked person or entity.
and resources that help advance the center’s mission. Texan by Nature advances conservation through building collaborative action, acting as an accelerator for conservation projects and a strategic resource for industry and communities. The evidence discovered by the Center for Health & Nature will play a pivotal role in helping Texan by Nature and partners advance future conservation initiatives and better understand their benefits. Current research projects at the center include designing systems to
prevent physician and nurse burnout; evaluating the effects of a virtual window on hospital patients’ health and well-being; evaluating whether virtual reality gardening and nature settings can alleviate pain and stress as an alternative to pain medications; evaluating the kinds of green space that most positively impact pedestrian health; and examining the effects of travel to natural environments on overall health and well-being.
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