Contents tagged with president's letter
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What is a good doctor?
By Troy Fiesinger, M.D.
TAFP President, 2012-2013Although I missed the blockbuster 2011 Brad Pitt movie Moneyball, I recently read the book by Michael Lewis. Oakland A’s general manager Billy Beane, a promising high school prospect out of California, was drafted by the New York Mets the same year as Darryl Strawberry and Lenny Dykstra. Despite looking like a top prospect to the scouts, Beane’s major league career ended early while Strawberry and Dykstra won the 1986 World Series with the Mets. As the general manager of the Athletics, Beane struggled to define more accurately what makes a baseball player good. This got me thinking: How do I know I’m a good doctor?
I can point to the diplomas on my wall and tell you I went to good schools, but the U.S. News and World Report rankings are little more than opinion surveys with minimal hard data to back up their lists. I can show you a copy of my Texas medical license, but that just means I haven’t broken any laws nor received any complaints to the Texas Medical Board. You could look at my American Board of Family Medicine diploma, know that I have passed a national exam and do annual online education modules, and consequently assume I know something. You do not know, however, if I am better than the doctors across the street.
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So easy a child can do it
By Troy Fiesinger, M.D.
TAFP President, 2012-2013When we walked into the dentist’s office, my kids ran straight up to the computer to check in for their appointments. This was my first time to take them to the dentist, as my wife usually drives them. My son and daughter quickly entered their names on the touch screen, grabbed books, and took their seats. Freed from manually registering patients, the front-desk clerk monitored patient flow and welcomed everyone to the clinic with freshly-baked chocolate chip cookies.
Later that day, I went to my doctor’s office where I signed my name on a clipboard and patiently waited in the lobby as patients have done for decades. His office has the same electronic medical record as mine, but his clipboard system has not changed in decades. My clinic has an electronic medical record with a web portal and secure patient e-mail, but our patients still queue at the front desk to give their information to a clerk. At the gas station, I swipe my credit card and fill my gas tank without talking to another human being. At the airport, I walk up to the kiosk, insert a credit card, and print the boarding pass for the flight I checked in to the night before. We expect businesses to adopt the latest customer service technology and embrace their use while we keep our clinics in the technological dark ages, suspiciously questioning each new innovation. We complain about the inefficiencies of our EMRs but are slow to adopt innovations to improve the efficiency and ease of our patients’ visits to our offices. Are we so focused on our frustrations that we forget our patients?
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Defining the meaning of “meaningful use”
By I.L. Balkcom IV, M.D.
TAFP PresidentShhhh! Don’t tell anyone, but I am attempting to practice on my laptop so I might understand how to have a “meaningful” encounter with my patient. I have made progress in technology in that I even sent our chief operating officer, Kathy McCarthy, an e-mail this year—a proud moment in my technological infancy. Now I find myself immersed in a small screen with small print and myriad options for the EHR. As Peanuts would say, “ARRRGHH!” as I erase an entire page by accident.
Now for those of you who are fortunate enough to know all things computer or young enough to have grown up with iPhones, laptops, and MP3 players, I heartily congratulate you. Some of us less technologically gifted are still learning how to turn on these infernal machines and not to treat them like coke machines—beat and kick the “heck” out of them. I wish so often they would say something so I could keep up my tirade. Oh, I forgot. They do talk to you now.
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Protecting our most vulnerable
By I. L. Balkcom IV, M.D.
TAFP President 2012-2013Her name was not important. This little 6-year-old girl I had been called to examine in the emergency room now sat silently, flanked by her mother and mother’s boyfriend.
I was in my third year of residency and was summoned to evaluate this patient who I’d been told had fallen in the bathtub at home. She had a large bruise around her left eye.
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The chance of a lifetime
An excerpt from the inaugural speech of TAFP’s new president
By I. L. Balkcom IV, M.D.
TAFP President, 2011-2012In 1987, as I was graduating from the Columbus medical center’s residency program, I thought I was hot potatoes. We were good. The 12 of us just thought that we were it. I felt like I could do a Caesarean section with a teaspoon. There was no body cavity I couldn’t align. We felt like we could just do it all.
So, armed with that knowledge, I set off in the world. I happened to be going to a meeting at the Capitol one day, and as I checked in at my hotel, I was puffed up pretty good. I signed in: “Dr. I. L. Balkcom, IV, M.D.”
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Payment reform starts with family doctors
By Melissa Gerdes, M.D.
TAFP President, 2010-2011Adequate payment for primary care health services has long been an issue for family medicine. The absence of adequate payment has affected our specialty in numerous ways, including forcing physicians to see too many patients too fast, causing student interest in family medicine to decline, and leading practicing physicians into non-clinical careers. This migration of physicians away from family medicine has a negative effect on the public and our patients. According to the Commonwealth Fund, countries that have a lower proportion of primary care physicians to patients have populations with higher morbidities and poorer health outcomes.
Our current payment system is volume-driven, where physicians are paid more for doing things to patients than for doing things for patients. Research shows that doing more things to a patient does not automatically result in improved health outcomes. In fact, such practice very often results in worsened health outcomes. How do we migrate away from the volume basis?
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Members work to advance family medicine and TAFP’s strategic initiatives
By Melissa Gerdes, M.D.
TAFP President, 2010-2011I devote this column to our Academy members and friends. The Texas Academy of Family Physicians is, after all, only as good as our membership.
As you will recall, TAFP held a strategic planning retreat in August 2010. We began with the anticipation that we would design a three-year plan, but it soon became a one-year plan. The group identified so many items needing urgent attention that the timeframe necessarily shortened. A physician champion paired with a TAFP staff person to design and implement each action item. Now, seven months later at Interim Session, we are well on our way to accomplishing our goals. The entire strategic plan can be viewed on www.tafp.org.
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Lessons from the past guide the future
An excerpt from the inaugural address of TAFP’s new president
By Melissa Gerdes, M.D.
TAFP President, 2010-2011As your president for the next year, I will live and advance our vision and mission. I will be your faithful servant, listener, and even cheerleader. Fortunately, I have some experience in each of these roles. I am sure you have heard of the book “All I Really Need to Know I Learned in Kindergarten.” I like to say much of what I really need to know to be a family physician, I learned before medical school.
My very first job at McDonald’s prepared me well for service. I was born in Chicago where the famous Hamburger University is located. Consequently, I got to work with many young recently trained managers for the company. McDonald’s is actually all about brand recognition and service, concepts I very much respect and push forward in my job today.
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Reflections on a year as president
By Kaparaboyna Ashok Kumar, M.D., F.R.C.S.
TAFP President, 2009-2010It has been truly a privilege and an honor to serve as your president. This year was fast-paced, exciting, and full of accomplishments. It was a great year and I have many wonderful people to thank for it.
First, I would like to thank my wife, Elaine, and my children, Priya and Nikhil, for their love and affection, patience and understanding, and for their support without which I would not have been able to take up the responsibilities of this office.
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The long road ahead
By Kaparaboyna Ashok Kumar, M.D., F.R.C.S.
TAFP President, 2009-2010It’s been more than a month since President Barack Obama’s health reform package became the law of the land, and we’re still dealing with the political and policy fallout. The legislative process and the yearlong debate have been painful, and remind us why it’s often better not to see the making of the sausage. As physicians, we can disagree about the appropriate roles for the market and the government in the distribution and financing of health care, but we should also begin considering the law apart from the partisan battlefield and analyze what its actual ramifications might be for our patients and our practices.
Throughout the legislative process, AAFP was engaged in the debate at the highest levels, working to fend off ideas that would have been detrimental to physicians and patients, and making the case that investing in primary care will result in better health outcomes and reduced cost. Lawmakers heard and understood that message.
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