Archives
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House of medicine urges congressional action to avert Medicare payment cuts
By AAFP’s Federal Advocacy Team
The 2023 Medicare physician fee schedule includes a significant reduction to the Medicare conversion factor, which, absent congressional action, will result in approximately 4.5% in payment cuts for all Part B clinicians beginning January 1. These cuts, coupled with rising practice costs due to inflation and Medicare sequestration, are untenable and will place additional strain on primary care practices.
Family physicians cannot afford to take a pay cut in 2023, and patients deserve consistent access to high-quality primary care. We are urging Congress to act before the end of year to protect physicians and patient access.
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Give yourself the gift of better mental health in 2023
By Anticipate Joy
In a recent survey by the Commonwealth Fund, half of the physicians under the age of 55 in the United States reported being burned out, while 61% said they’ve experienced emotional distress since the start of the pandemic. In addition, 45% of U.S. physicians aged 55 or older plan to stop seeing patients within the next one to three years, according to the survey. These findings are not surprising considering the heightened levels of stress physicians endured because of COVID.
Family physicians are dealing with a high level of stress, which if not treated with mental health interventions, could have a negative impact on emotional stability. As clinical psychologists, we often encourage preventive mental health care to professionals in high-stress occupations. It is vitally important that family physicians make caring for their mental health a priority. Sadly, only 16% of physicians under age 55 said they sought professional help for a mental health problem since the beginning of COVID-19. That total declined to just 6% among older physicians who also reported emotional distress. Part of the reluctance to seek help is founded on a fear of how seeking mental health treatment could impact one’s ability to practice medically.
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AAFP urges Congress to avert Medicare payment cuts, fights expanded scope of practice for nonphysicians, and more
By AAFP’s Federal Advocacy Team
This month, the AAFP advocacy team has fought for family medicine on several important fronts, including a major effort to call for congressional action to avert impending Medicare payment cuts for physician services. AAFP president, Dr. Tochi Iroku-Malize, Dr. Patricia L. Turner, executive director/CEO of the American College of Surgeons, and Dr. Ryan Mire, president of the American College of Physicians, outlined the risks of not address looming Medicare cuts for physicians in an opinion piece for Modern Healthcare.
“Continued financial challenges, administrative burdens and staff shortages, coupled with outdated Medicare payment policies, make it more difficult for physicians to maintain their practices and operate in their communities…. Congress must take action to protect patients’ access to care by halting the payment cuts that will take effect Jan. 1.,” they wrote.
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Member voices: Let’s push for free medical school
By Larry Kravitz, MD, Natalie Close, and Jonathan Tao
To quote Robert Grossman, the dean of New York University Health, free medical school tuition “recognizes a moral imperative that must be addressed, as institutions place an increasing debt burden on young people who aspire to become physicians.”
Seven medical schools offer free tuition in the United States: NYU, Cornell, Columbia, UCLA, Kaiser Permanente, Cleveland Clinic, and Washington University, although only NYU, Kaiser Permanente, and Cleveland Clinic cover 100% of their students. Some schools, such as TCU, University of Houston, and Dell Medical School offered free tuition for their initial entering class.
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Funded delegate spots and scholarships available for NCCL
Each year, AAFP holds the National Conference of Constituency Leaders and Annual Chapter Leader Forum together in Kansas City, Missouri. NCCL representatives and ACLF attendees from across the nation gather to discuss various issues, suggest policies and programs to AAFP, and receive leadership training. In 2023, the conferences will be held May 9 - 11 and TAFP is looking for members to serve on the delegation or apply for scholarships to attend.
Texas Delegation to NCCL
Spots are available for 10 TAFP members to represent each of the five constituencies: new physicians (physicians who have been out of residency for seven years or fewer), women, minorities, international medical graduates, and LGBT physicians. TAFP reimburses up to $1,400 for expenses for each of the five delegate and five alternate delegates. In addition, TAFP offers two other opportunities to attend NCCL with funding. These scholarships will be awarded to one third-year resident and one minority physician.
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AAFP advocacy win: Texas physicians now eligible for federal Public Service Loan Forgiveness
By Jonathan Nelson
The U.S. Department of Education has updated its eligibility criteria for the Public Service Loan Forgiveness Program so that physicians in Texas and California are now eligible to apply, a change that should attract more physicians to practice in safety net hospitals and specialize in primary care. The program is designed to discharge the remaining federal student loan balance for professionals working in public service for governmental and nonprofit organizations after they have made 120 payments on their loans.
The existing PSFL regulations inadvertently excluded Texas and California physicians who treat patients in private, nonprofit community hospitals, children’s hospitals, and rural hospitals from participating because state laws prohibit private nonprofit hospitals from directly employing physicians. In an August 2022 letter, AAFP urged the Department to modify existing PSLF eligibility requirements to support the inclusion of all physicians providing patient care at nonprofit hospitals regardless of employment type — direct employee or contract employee.
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Huntsville FP launches podcast to explore the future of primary care
By Jonathan Nelson
Need a new podcast to liven your commute? Lane Aiena, MD, hopes you’ll check out his new project, “Doc to the Future,” a half-hour podcast aimed at exploring the ever-changing field of primary care. The first three episodes just dropped on Apple Podcasts, Spotify, and other podcast services. Guests include TAFP CEO Tom Banning; medical director of Lone Star Family Medicine in Conroe, Daniel Porter, MD; and nationally recognized physician leader, Peter Valenzuela, MD.
The first three episodes constitute a deep dive into value-based care, a concept that drove Aiena to create the podcast. At this spring’s C. Frank Webber Lectureship and Interim Session, an executive from Blue Cross Blue Shield of Texas spoke to the TAFP Board of Directors about the company’s value-based care contracts and how they will likely affect patients and physicians over the next few years. Aiena, who was present for the discussion, says he left the meeting with many questions.
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AAFP leaders advocate for improved access to primary care and more this month on Capitol Hill
By AAFP’s Federal Advocacy Team
On October 12, AAFP’s president, president-elect, and board chair traveled to Washington D.C., to meet with members of Congress and their staff to advocate for key AAFP legislative priorities. Here’s what they discussed:
Stop Medicare payment cuts
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Alpine FP tells Public Health Committee to invest in rural health care
By Jonathan Nelson
Last week, Adrian Billings, MD, PhD, traveled from his home in Alpine, Texas, to Austin to testify on behalf of TAFP and the Texas Medical Association at a hearing of the House of Representatives Public Health Committee. The hearing focused on assessing the challenges rural Texans face when trying to access health care.
“I stand before you today privileged to advocate on behalf of rural patients and communities. I do not want to fail these incredibly resilient rural human beings,” Billings said.
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House Select Committee on Health Care Reform hears testimony on rising costs, price transparency
By Jonathan Nelson
The House Select Committee on Health Care Reform wrapped up two days of hearings last week in pursuit of their interim charge to provide policy solutions before the January start of the next Texas Legislature. Committee chair Rep. Sam Harless, R-Spring, kicked off more than 15 hours of invited testimony by outlining the committee’s charge.
“We are directed to look at the rising cost of health care and health care plans as well as transparency of health care plans, confusing and unequal pricing and more,” Harless said. “Our goal is to increase access and improve affordability for medical care for all Texans including the uninsured and the underinsured.”
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Is self-care selfish?
By Anticipate Joy
As a physician you may be struggling with caring for the needs of others, while prioritizing your personal needs and you may be asking, “Is self-care selfish?”
It’s a common question.
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Texas comptroller increases state revenue projection in advance of 88th Texas Legislature
By Jonathan Nelson
As Texas lawmakers prepare for the 88th Texas Legislature scheduled to begin January 10, 2023, they will have an estimated $27 billion in extra revenue to spend, according to a letter to state leadership last week from Comptroller Glenn Hegar. On top of that, the state’s “rainy day fund” will have swollen to $13.6 billion when the Legislature convenes, an increase of $3.5 billion since the comptroller’s last report. Inflation on consumer goods and high prices for oil and gas have led to unprecedented revenues from sales taxes for the state.
The July 14 letter detailed a revision to the comptroller’s Certification Revenue Estimate, which is presented to the Legislature in advance of each regular legislative session.
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Encourage future health professionals with HOSA
By TAFP COO Kathy McCarthy, CAE
I had the privilege of attending the HOSA International Leadership Conference on behalf of AAFP in June. HOSA-Future Health Professionals is a global organization with a mission to promote career opportunities in the health industry and to enhance the delivery of quality health care for all people. It includes middle school and collegiate students, but most attendees at the conference were high school students. The regional, state, and international conferences include business sessions to elect their leadership, educational seminars and workshops, and competitive events and exams. This was the first live international event for the organization since 2019 and there were more than 10,000 high school students from across the country and the world at the meeting (the lines at the Starbucks were a testament to size of the gathering).
AAFP has worked with HOSA the past few years to develop an exam and competitive event focused on family medicine, and my purpose for attending the conference was to help judge the first live competition. The high school students did at least two interviews with family physicians and medical students. The interviews along with their research informed a presentation on the specialty, the educational pathway, and more. They gave their presentations to a group of their peers before going to competitive events. In Texas, we have seven regions with competitions and a statewide event that had 18 competitors in the Family Medicine Physician event.
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TAFP statement regarding Roe v. Wade opinion
Statement by Texas Academy of Family Physicians President Mary Nguyen, MD, in response to the U.S. Supreme Court’s ruling regarding Roe v. Wade.
Like all health care, abortion is a deeply personal issue. Whether you are pro-life or pro-choice or somewhere in between, today's ruling by the U.S. Supreme Court will undoubtedly cause a great deal of confusion for many Texans and family physicians. While it will take time to fully understand how this ruling and existing Texas laws will affect patient care, I know family physicians will continue counseling their patients to make medical decisions together about what care is best for them.
The Supreme Court's decision to strike down Roe v. Wade ends a half-century of federal constitutional protection of abortion rights and allows each state to decide whether to restrict or ban abortion. In Texas, which already has a “trigger law” in place, that would mean a near total ban on abortion.
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Helping the doctors who help our children’s mental health
By TAFP President Mary Nguyen, MD, and Texas Pediatric Society President-Elect Louis Appel, MD, MPH
We urge all physicians to become educated about the ongoing mental health crisis our youth and families are facing. These are the facts none of us can escape in our busy practices: one in four children suffer from a mental health condition, 50% of serious mental health disorders have been diagnosed by age 14, and suicide rates continue to increase for young people. COVID-19 has only worsened these worrisome national trends.
Between 2016 and 2020, the number of children ages three to 17 diagnosed with anxiety grew by 29%, and depression jumped by 27%. Those numbers are expected to grow even more as young people recover from the COVID-19 pandemic. In 2021, the American Academy of Pediatrics declared a national emergency in child and adolescent mental health. In 2022 they released a Blueprint for Youth Suicide Prevention detailing prevention strategies designed to support pediatric health clinicians.
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Burnout a national problem; TMA Wellness Fund can help
By Tammy Wishard
In a recent advisory calling attention to health care worker burnout, U.S. Surgeon General Vivek Murthy, MD, highlighted the broad response the situation calls for: “We must ensure that every health worker has access to affordable, confidential, and convenient mental health care.”
If finances are keeping you or someone you know from seeking treatment for depression, anxiety, substance use, or other conditions, the Texas Medical Association’s PBF Wellness Fund is here to help overcome that barrier.
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Utilize TAFP resource for mental health support from home
By Anticipate Joy
It’s 2022 and sad to say the stigma surrounding seeking mental health services is still alive and well. Despite well-intended efforts to reduce the stigma, many people continue to see mental health issues as a sign of weakness, leaving those who suffer from mental illness feeling alone in their struggle. However, if mental health is a concern for you, you are far from alone. In 2019, 20.6% of U.S. adults experienced mental illness, representing 51.5 million people or one in five adults. 5.2% of U.S. adults experienced serious mental illness, representing 13.1 million people or one in 20 adults. Mental illness is more common than you might believe, demonstrating that you are not the only one struggling.
Of particular concern, as a result of the COVID-19 pandemic, early evidence suggests the rate of depression in physicians across age groups is 25%. A study evaluating barriers to treatment for physicians found that 70% of physicians with moderate to severe depression reported “getting an appointment that fits my schedule” as a major barrier to mental health treatment.
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Attention students: Attend AAFP’s National Conference in July
Once a year, family medicine residents and medical students come together to engage in real talk about family medicine with family medicine leaders, educators, and recruiters at the National Conference of Family Medicine Residents and Medical Students, held July 28 – 30 in Kansas City, Missouri. This year’s conference will inspire attendees to choose a dynamic career in family medicine — one that literally can take you anywhere. Attendees will hear from nationally recognized speakers.
National Conference also offers:
- An Expo Hall with 400 exhibitors including residency programs, physician employers, medical missions, fellowships, government agencies, and more.
- Workshops on topics such as career planning, health policy and advocacy, leadership and development, and research.
- The ability to influence AAFP policy and develop leadership skills in the student and resident congresses.
- Enhance your clinical skills, such as providing trauma-informed care, understanding reproductive and maternal care in family medicine, learning procedures, and more.
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New events at this year’s C. Frank Webber Lectureship and Interim Session
By Samantha White
If you haven’t yet registered for the upcoming TAFP C. Frank Webber Lectureship and Interim Session happening April 8 – 9 in Austin, there’s no time like the present! In addition to the incredible 16.25 CME credits offered Friday and Saturday and our standard council meetings happening Friday morning, we have a series of exciting firsts for TAFP on Saturday.
Our first Member Assembly at Interim Session will take place at breakfast and include a great discussion on trends in health care from author Peter Valenzuela, MD, MBA. Attendees will receive a copy of his new, insightful book Doc-Related.
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Texas House Speaker appoints House Select Committee on Health Care Reform
By Jonathan Nelson
Texas House Speaker Dade Phelan announced interim committee charges for the 87th Legislature on March 10 including several items of interest to family physicians and their patients. The speaker also announced the creation of two special interim committees, one on health care reform and the other on criminal justice reform.
“The interim charges are the result of my conversations with House colleagues from across the state, many of whom have concluded there is more work to be done to reform the state's health care and criminal justice systems,” Speaker Phelan said in a press release. “That’s why I have formed two interim committees to devote special attention to these issues, which I consider of utmost importance heading into the next legislative session.”
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MEMBER VOICES: The future of family medicine
By Larry Kravitz, MD, and Lily Cormier
Such high hopes when it all began in 1970, with a new specialty that renamed itself and decided to take primary care seriously. Family medicine is now more than 50 years old, with 133,000 physicians in the United States. Where will it all be 50 years from now?
There is an old African proverb, “Until the lion learns to write, every story will glorify the hunter.” We see our medical past in terms of our victories, but we minimize our failures. So we do as well with the future; we expect to build on our successes, and don’t understand that our failures tag along and can poison the wellspring of our dreams. As long as we keep applying the template of our distorted past to our expectations of the future, we will never see it coming. The future threatens to run over us from behind as we’re squinting our gaze to a glorious distant horizon. The future is all around us right now, but it is clouded by the rose-colored lenses we insist on wearing. We don’t need a false prophet nor do we need a harbinger of doom, but there are two conflicting futures ahead and we need to embrace them both.
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It's OK to ask for a little help from your friends
By Anticipate Joy
Do you ever find yourself feeling alone in dealing with various personal and professional life stressors? As a result, do you find yourself turning inward and isolating? The National Academies of Sciences, Engineering, and Medicine found that social isolation is associated with about a 50% increased risk for dementia and other serious medical issues.
It’s important to keep in mind, not only is loneliness a high-risk factor for depression, but it is also a risk factor for heart disease, Type 2 diabetes, and arthritis.
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The future of family medicine and primary care ain’t what it used to be
Fast moving market changes pose challenges and opportunities for family doctors in every sector
By Tom Banning, TAFP CEO
I love a good Yogi Berra quote to start off a column and few have ever been as appropriate as this one is for family physicians today: The future ain’t what it used to be.
Changes in the health care marketplace here in Texas and across the country pose significant challenges and opportunities for our members, whether they practice in rural or metropolitan communities, regardless of where they fall on the broad spectrum of practice types. I believe addressing these changes is among the most pressing issues we face as an Academy.
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TAFP Past President Glen Johnson dies
By Samantha White
TAFP Past President Glen Royce Johnson, MD, passed away February 20, 2022, at his home in Pinecrest, Florida.
After completing medical school and residency at Howard University, Johnson joined AAFP in 1976 and quickly rose the ranks in both AAFP and TAFP. He served as a TAFP alternate delegate then delegate to AAFP’s Congress of Delegates in the late 1980s and early 1990s, and became the first Black physician to serve as TAFP president in 1986. Johnson was a director on the AAFP Board of Directors, then AAFP vice president in the early and mid 1990s, and eventually served as AAFP’s alternate delegate then delegate to the American Medical Association in the late 1990s and early 2000s.
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TMA fund supports medical families in crisis
TMA fund supports medical families in crisis
By Tammy Wishard
A dedicated physician finds himself struggling with dementia in his later years, with his wife by his side caring for him. To provide needed income, the Johnsons (not their real name) sell their home and relocate to their smaller vacation residence in another part of the state, leaving behind lifelong friends.
Funds dwindle as the couple makes needed accessibility updates to the home and pays for health insurance. As the days and months pass, and with no support from family, the wife begins to wear down from her role as caretaker. She needs a break. Mrs. Johnson reaches out to TMA’s Physicians Benevolent Fund (PBF) for assistance, and PBF fills the need, providing funding for respite care so she can have a few hours each week to tend to her needs.
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Putting mental health tools in the hands of primary care physicians
Access psychopharmacology clinical support with The Waco Guide
By Zach Sartor, MD
We are living amid a mental health epidemic. One in five people experience mental illness yearly, and the volume of mental and behavioral health disorders will increase in the future due to the impacts of the COVID-19 pandemic.
Primary care is the de facto mental health system in the United States. Primary care clinicians serve most patients receiving treatment for mental illness, prescribing a majority of psychotropic medications in the process. However, two-thirds of family medicine physicians cannot connect their patients with essential mental health support services. Therefore, most behavioral health care services occur in the primary care office. Although the situation is dire, this challenge represents an opportunity to provide high-value mental health care in the primary care context. Family medicine can lead the way forward.
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MEMBER VOICES: A physician mom's take on telemedicine
By Sabari Sundarraj, MD
I know most of us have started adapting to the new way of life in our practice. However, some of us are still skeptical. I'm hoping to reach out to the skeptical ones among us.
The reason I say that is I was in your shoes as I started my career in a brick-and-mortar practice. In 2017 when my twins were born and after a short parental leave, I returned to work. I was starting to get tired of watching my nanny’s videos during lunch hour on their developmental milestones rather than being there to enjoy them. I give kudos to all the physician moms who did it, who are doing it, and who will do it, but it is not my cup of tea.
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