Contents tagged with perspective
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The Power of the Preceptorship
By Travis Bias, DO, DTM&H
In middle school, I aspired to become a DJ. Because this required me to take the least amount of math. Despite this original goal, I started my time at Southwestern University as a pre-med student and headed to UNTHSC Texas College of Osteopathic Medicine to begin my medical education. A career as a physician stood perfectly at the intersection between intellectual challenge and service to others.
I was drawn into medicine to make a difference. The calling of a medical career can be heard as young as 18. It requires determination, a selfless heart, and compassion no matter the situation. Between the ages of 22 and 26, however, a young physician-in-training must decide which specialty he or she would like to be practicing from age 30 until retirement. This decision shapes career options and powerfully influences the future lifestyle, and thus capacity for relationships, growing a family, and personal balance and well-being. This choice in path, like in other careers, also affects potential lifetime income. Thus, specialty choice is not to be taken lightly, especially given the growing burden of educational debt that young medical graduates face.
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Texas Family Physician - Vol. 65 No. 4, Fall 2014
Go to the TFP archive
View the virtual issue
President’s letter
Perspective
CONTENTS
Embracing change in the ValleyA small group of independent primary care docs in and around … more
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More than meets the eye: Value of small practices shouldn’t be ignored
By Lloyd Van Winkle, MD
For years, we’ve been hearing about the decline — even death — of the small primary care practice, but I’m here to say that obituary is premature, if not flat-out wrong. When a recent study published in Health Affairs touted the value of small practices, I didn’t need convincing. I’m a small practice owner and have been for nearly 30 years.
The study found that primary care practices with one or two physicians had one-third as many preventable hospital admissions compared to practices with 10 to 19 physicians. The study also reported that smaller practices achieved their impressive results despite caring for a higher percentage of patients with chronic conditions than larger practices.
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Hospice experience can be rewarding
By Lloyd Van Winkle, M.D.
It used to be that when I had a patient whose health was declining and he or she was nearing the end of life, I would direct the patient to hospice care.
Hospice would take responsibility for the patient’s care, and I would receive updates by phone. I might go by and see the patient once or twice. Ultimately, I would be notified that the patient had died, and I would call the family to offer my condolences.
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Let’s be bold for family medicine
By Janet Hurley, M.D.
It’s time for boldness in family medicine. As I turned to hug Jim Martin, M.D., at the last TAFP C. Frank Webber Lectureship, I was touched by his heartfelt concern. He and other dedicated leaders before me have endeavored to set the stage for family medicine to have its time in the spotlight. Yet many family physicians do not seem willing to demonstrate the leadership skills or “fire in the belly” during this pivotal time of health care change.
In the past, family physicians were seen as feeder mechanisms for the procedural and hospital cash machine. We were disrespected in the academic centers and our value was minimized by payers and the Relative Value Scale Update Committee. Specialists desired our referrals for lucrative procedures that are reimbursed under an inflated fee-for-service price. The hospitals have been hiring family physicians to ensure referral sources to their admission beds, imaging centers, and operating rooms. But the day of reckoning is coming for that payment methodology.
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Banding together helps small practices achieve PCMH recognition
By Lloyd Van Winkle, M.D.
When the topic of practice transformation comes up, one of the most frequent questions we hear is, “What about the little guy?” How are small practices expected to overcome the additional work and expense needed to achieve patient-centered medical home recognition?
This is a valid question, but the answer might be simpler than you think. For my small practice, the solution was to find strength in numbers. And that didn’t require anything as complex as joining an accountable care organization or an independent practice association.
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A better way to value family physicians’ work
By Richard Young, M.D.
Ms. M was a 68-year-old Hispanic female who had not seen Dr. Smith (not his real name) in nearly a year. She had run out of her diabetes, high blood pressure, and cholesterol medications months before.
Ms. M had other concerns in addition to these three chronic diseases and the practical difficulties she faced filling her prescriptions. She asked Dr. Smith to help her with her foot pain and knee pain. She was told by another doctor at an ER that she had visited for a non-urgent problem a few months prior that her blood potassium level was low. She expected Dr. Smith to address her heartburn, recent weight gain, bad teeth, and an additional but distinctly different abdominal pain. She wanted a test for her kidney function, for which Dr. Smith had to spend a couple of minutes trying to figure out why she was concerned about her kidneys in the first place and the results of blood tests at other facilities such as her recent ER visit. Dr. Smith also spent several minutes explaining the need and importance of osteoporosis screening, which she ultimately declined.
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Shine your light in service to your specialty
By Janet Hurley, M.D.
Chair, TAFP Commission on Health Care Services and Managed CareAs I look with uncertainty to the future health care landscape and talk with fellow family physicians, I find many of us fearful of what the upcoming years will bring. I admit there are times when I get discouraged too, when it seems like things are too difficult to fix or that the problems are too big to solve. It’s in those moments that I realize we are living in a fallen world and the temptation is strong to just hide or give up. But God does not call us to hide our worries; he calls us to shine our light to the world around us. So I ask you, what does your light look like?
We are all called to be leaders to some degree, either in our families, our practice, or our government. Some will move on to state and national leadership realms, but it is okay if not all of us do that. How do you use your gifts and talents? Are you befuddled with frustration and worry? Have you hunkered down in seclusion? To squander our gifts and talents is like burying the best of ourselves in the sand. We’ll look back and wonder where the “good old days” have gone and realize that our health care system is no longer recognizable to us and that we have been left behind, frustrated and broken. Each of us has gifts and talents that should not be left unused.
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Texas Family Physician - Vol. 63 No. 4, Fall 2012
Go to the TFP archive
View the virtual issue
President’s letter
Member news
Perspective
CONTENTS
A workforce imperative: Change medical educationTwenty years ago, TAFP called for … more
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Overwhelmingly, stakeholders support family medicine residencies
By Clare Hawkins, M.D.
TAFP President-electWith another legislative session underway, our Academy is poised to make great gains for family medicine and recoup budget losses from 2011. We’re building on a decade of work educating legislators and the public about the value of family medicine, but it’s evident that our work particularly since the last session has led to a deeper understanding of the current and coming crisis in the primary care workforce.
This summer TAFP held a legislative training seminar in Austin and attendees of that conference formed the core of a new Key Contacts program. These leaders actively share resources provided by the Academy with their state representative and senator, which include not only our own policy briefs and legislative magazine features, but editorials and news stories from the major daily newspapers. People are “getting it.”
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