Healthy Vision 2020
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Healthy Vision 2020
Bringing into focus a clear and distinct view of the rest of this decade in Texas health care. Offering a sharp perception of what lies ahead and what we must change to keep us all healthy.
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Artificial death extension: It means that I actually care

Instead of offering artificial life support to these patients, I will be offering artificial death extension.

 

Texas physicians abide by the Code of Medical Ethics, which includes “First, do no harm.” For this reason, TMA supports the Texas Advance Directives Act (TADA). Its aim is to allow patients to make their care preferences known before they need care, and to protect patients from discomfort, pain, and suffering due to excessive medical intervention in the dying process. The time may come when all that can be done for a patient is to alleviate pain and suffering, and preserve the patient’s dignity. For physicians, this is about medical ethics and providing medically appropriate care. 

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One in Five U.S. Adults Smoke, Tied for All-Time Low

One in Five U.S. Adults Smoke, Tied for All-Time Low | Healthy Vision 2020 | Scoop.it

Twenty percent of U.S. adults say they smoked a cigarette in the past week, tying the all-time low in Gallup trends since 1944. Recent declines in smoking are steepest among young adults, those aged 18 to 29, and those in the East.

 

Physicians must continue to emphasize the importance and power of personal responsibility in patients’ health outcomes. Over the past century, public health interventions have effectively reduced and, in some cases, eliminated illness and death. We must use education and preventive medicine measures to go further – to curb the need for the complex treatment required once a preventable condition develops. Each occurrence of preventable chronic disease is costly to Texas’ government and businesses, to our economy, and to our people.

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Health-Care Reform and the 'Doctor Shortage'

Health-Care Reform and the 'Doctor Shortage' | Healthy Vision 2020 | Scoop.it

How many doctors are needed to serve the population, and what the impact of health care reform would be on that, are much debated but hard to measure, an economist writes

 

Texas has a large, growing population that is growing sicker and needs more and better-coordinated health care services. Unfortunately, Texas – even more than most of the rest of the country – needs more physicians and other health care professionals. .

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Healthy Vision 2020 - The Basic Tenets

Make your own slide show at Animoto.

A very short (30-second) video to remind you what Healthy Vision 2020 is all about. Read the whole document at http://www.texmed.org/healthyvision

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Texas tries to get between you, your doctor

Texas tries to get between you, your doctor | Healthy Vision 2020 | Scoop.it

In a recent letter to the state, the Texas Medical Association, joined by other medical groups, said Texas is about to embark on a plan for providing medical care to low-income women that will impose a “gag order” on discussing abortion even on...

 

The ability of physicians to act in their patients’ best interests must not be compromised by outside – and sometimes competing – economic, political, and social pressures. Yet lawmakers and other nonphysicians progressively are inclined to delineate the details of the interaction between physicians and patients. Physicians will increasingly face nonphysicians’ attempts to mandate what tests, procedures, and treatments they must – or must not –provide to their patients. 

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NQF endorses cancer, care-coordination, disparities measures | Modern Healthcare

NQF endorses cancer, care-coordination, disparities measures | Modern Healthcare | Healthy Vision 2020 | Scoop.it

NQF endorses cancer, care-coordination, disparities measures | Modern Healthcare...

 

In modern health care, evidence-based medicine (EBM) is good medicine.

 

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Six Main Reasons Physicians Are Dropping Medicare Patients

"September 1, 2012 is the current deadline for physicians who wish to opt out of Medicare —and record numbers are doing just that. According to a recent survey by the Texas Medical Association, the number of Texas physicians accepting Medicare patients dropped from 78 percent in 2000, to 58 percent in 2012. Texas is one of the few states that keeps Medicare opt-out information. HHS' Office of Inspector General (OIG) in January reported it couldn't pin down the extent of the problem nationally because Medicare and its contractors don't keep adequate data on physicians who opt out.

Why are so many physicians opting out of Medicare?"

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Health care act is expected to magnify Texas doc shortage

Health care act is expected to magnify Texas doc shortage | Healthy Vision 2020 | Scoop.it

Health care providers scrambling to find more nurses are calling Novak, a vice dean at the UTHSC's School of Nursing, asking to hire recent graduates or even partner with current students so they can work part-time while finishing their classes.

 

Physicians must be the backbone of such a complex system of care if it is to be cost-effective. Otherwise, the state’s efforts to increase preventive care, improve medically necessary treatment for the chronically ill, and reduce inappropriate emergency department utilization will falter. Physicians also play an important role in helping develop and partnering with the public health system. This partnership can enhance local coordination of care, disease surveillance, access, and health promotion.

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Noting challenges, doc groups laud medical homes - Modern Physician

"Two large physician organizations are praising the patient-centered medical home  model as a way to provide more-coordinated care, engage patients and families,  and improve healthcare quality."

 

TMA supports the use of the PCMH model in Medicare, Texas Medicaid, and commercial insurance plans. Public and private payers have, increasingly, been looking to this model as a way to reduce fragmented care, lower costs, avoid repetitive and costly procedures, and improve patient outcomes. Given the budget constraints that Texas faces and a growing population with unique health care needs, the PCMH offers the potential for Medicaid cost savings as well as improved patient outcomes and physician and provider satisfaction.

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Tort reform has had just the impact we desired

Tort reform has had just the impact we desired | Healthy Vision 2020 | Scoop.it

In 2003, Texas was facing a real crisis, one that we met with a specific solution.

 

Texas Gov. Rick Perry describes the benefits of Texas' 2003 medical liability reforms and why we need to steadfastly defend them 

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A Doctor Shortage Means Less Access

A Doctor Shortage Means Less Access | Healthy Vision 2020 | Scoop.it

Although our 2003 liability reforms have brought an influx of new physicians, the current supply won’t be able to keep up with the demand, especially if the Patient Protection and Affordable Care Act (PPACA) withstands constitutional scrutiny. We need more physicians and other health care professionals working in all parts of the state, especially in rural and border Texas. We need to invest more in our medical schools and graduate medical education training programs. We should not fool ourselves into thinking that allied health professionals – who haven’t gone to medical school – can fill the gap as independent practitioners. Instead, we need to work on building physician-led

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Doctors Should Screen All Adults for Obesity, U.S. Panel Says | Healthland | TIME.com

Doctors Should Screen All Adults for Obesity, U.S. Panel Says | Healthland | TIME.com | Healthy Vision 2020 | Scoop.it

With more American adults qualifying as obese than ever before, doctors should be screening all adult patients for unhealthy weight, says a government panel.

 

The obesity epidemic, and the ever-younger age groups that it strikes, threatens Texas’ physical and fiscal health. Texas’ continually expanding waistline correlates to our health care cost demands. Obesity is responsible for 27 percent of the growth in health care spending. Treating obese patients costs 37 percent more than treating normal-weight patients

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Doctors should screen patients for obesity: panel

NEW YORK (Reuters Health) - Doctors should check weight and height for all patients to determine if they're obese and refer them to intensive diet and exercise programs if necessary, according to new guidelines...

 

Overweight and obesity contribute to diabetes, hypertension, heart disease, cancer, and stroke. Texas has an easy-to-see obesity crisis. Some 66 percent of Texas adults are obese; the United States average is 63 percent. During the past three decades, obesity rates in children have more than tripled in the country. Today, 32 percent of Texas children (ages 10-17) are obese.

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Interactive: Healthy Food Scarcity

Interactive: Healthy Food Scarcity | Healthy Vision 2020 | Scoop.it

This map shows the percentage of food retailers that offer healthy options by census tract, as calculated by the Centers for Disease Control and Prevention in 2011. To give a sense of the poverty level in the area, the CDC’s data is combined with estimates from the American Community Survey to show how many households received benefits from the Supplemental Nutrition Assistance Program or were below the poverty line but did not receive SNAP benefits in 2010.

 

TMA supports increased funding for improved access to health foods.

 

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Détente in Scope-of-Practice Issue for Physicians, APRNs? « D Healthcare Daily

"The TMA and the Coalition for Nurses in Advanced Practice appear to have reached a détente in advance of the 2013 legislative session.

 

"Since 1989, Texas has had a site-based model for advanced practice registered nurses (APRN). More than 20 years created a polyglot of physician oversight regulations—some based on geographical distance, others based on care delivery, and still others based the number of APRNs. The inefficiency of current regulations for both nurses, who have been trained to prescribe independently, and physicians, who sometimes must travel to remote locations, is becoming more intolerable as the state faces increasing shortages of healthcare providers."

 

The increase in the number of specially trained health care professionals is good for Texans. TMA believes that a physician-led team approach to care, with each member of the health care team providing care based on his or her education and training, is key to ensuring that patients receive high-quality care. Maintaining the integrity of the health care team, under the physician’s overall direction, is good for patient care. TMA strongly supports physician-led teams utilizing a number of health care professionals, each bringing important skill sets and training to patient care. Team care requires cooperation and collaboration among all professionals, with a focus on quality, measureable outcomes, and efficient utilization of resources.

 

This growth, along with the narrow political interests of a small number of allied health professionals, has spurred calls for Texas to grant them more independent practice. Such an expansion in their scope of practice not only would exacerbate Texas’ physician shortage, it likely would increase costs and utilization, and could endanger the safety of our patients. The Texas Medical Practice Act was created more than 130 years ago to protect Texans from people who called themselves “doctor” but who did not have the skills, training, or education to warrant such a title. The act, administered by TMB, clearly defines the practice of medicine and the educational qualifications necessary to diagnose, independently prescribe, and direct patient care – and to be held accountable for that care.

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In U.S., Majority Overweight or Obese in All 50 States

In U.S., Majority Overweight or Obese in All 50 States | Healthy Vision 2020 | Scoop.it

A majority of American adults in all 50 states are either overweight or obese in 2012. West Virginia residents are the most likely to fall into one of these weight groups (69.3%), while Coloradans are least likely (55.1%).

 

The rise in overweight and obesity is affecting the bottom line of Texas employers. The Texas Comptroller’s Office found that in 2009, obesity cost Texas businesses an estimated $9.5 billion, due to higher employee insurance costs, absenteeism, and other effects. Left unchecked, obesity could cost employers $32.5 billion annually by 2030.

 

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Issue Brief: Analysis of Obesity Rates by State - Trust for America's Health

Issue Brief: Analysis of Obesity Rates by State - Trust for America's Health | Healthy Vision 2020 | Scoop.it

Report: Texas is one of 12 states with obesity rates of 30 percent or more.

 

The obesity epidemic, and the ever-younger age groups that it strikes, threatens Texas’ physical and fiscal health. Texas’ continually expanding waistline correlates to our health care cost demands. Obesity is responsible for 27 percent of the growth in health care spending. Treating obese patients costs 37 percent more than treating normal-weight patients.

 

The rise in overweight and obesity is affecting the bottom line of Texas employers. The Texas Comptroller’s Office found that in 2009, obesity cost Texas businesses an estimated $9.5 billion, due to higher employee insurance costs, absenteeism, and other effects. Left unchecked, obesity could cost employers $32.5 billion annually by 2030.

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Remove abortion advice 'gag order'

Remove abortion advice 'gag order' | Healthy Vision 2020 | Scoop.it

Talk about coming between patients and their doctors.

 

The ability of physicians to act in their patients’ best interests must not be compromised by outside – and sometimes competing – economic, political, and social pressures. Yet lawmakers and other nonphysicians progressively are inclined to delineate the details of the interaction between physicians and patients. Physicians will increasingly face nonphysicians’ attempts to mandate what tests, procedures, and treatments they must – or must not –provide to their patients. 

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ACP: Federal, state laws limit better care - Modern Physician

ACP: Federal, state laws limit better care - Modern Physician | Healthy Vision 2020 | Scoop.it

"A paper released by the American College of Physicians highlights state and  federal laws that it says limit physician-patient communication and present  roadblocks to better care."

 

The ability of physicians to act in their patients’ best interests must not be compromised by outside – and sometimes competing – economic, political, and social pressures. Yet lawmakers and other nonphysicians progressively are inclined to delineate the details of the interaction between physicians and patients. Physicians will increasingly face nonphysicians’ attempts to mandate what tests, procedures, and treatments they must – or must not –provide to their patients.

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Solo practice physicians: 'I'm not dead!' | Healthcare Finance News

Solo practice physicians: 'I'm not dead!' | Healthcare Finance News | Healthy Vision 2020 | Scoop.it

"The impending demise of solo physician practice has been predicted for several years now. In early July, recruitment firm Merritt Hawkins put the proverbial nail in the coffin of solo physician practice by declaring it officially dead. But like the old man in 1975’s “Monty Python and the Holy Grail” protesting “I’m not dead!”, doctors aren’t ready to be hauled off for burial."

 

The ability of physicians to act in their patients’ best interests must not be compromised by outside – and sometimes competing – economic, political, and social pressures. Yet lawmakers and other nonphysicians progressively are inclined to delineate the details of the interaction between physicians and patients. Physicians will increasingly face nonphysicians’ attempts to mandate what tests, procedures, and treatments they must – or must not –provide to their patients.

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Too Few Doctors in Many U.S. Communities

Too Few Doctors in Many U.S. Communities | Healthy Vision 2020 | Scoop.it

Even as the new health care law expands insurance coverage, another problem faces many areas of the country: a lack of physicians, particularly primary care ones.

 

Texas has a large, growing population that is growing sicker and needs more and better-coordinated health care services. Unfortunately, Texas – even more than most of the rest of the country – needs more physicians and other health care professionals. Although our 2003 liability reforms have brought an influx of new physicians, the current supply won’t be able to keep up with the demand. We need more physicians and other health care professionals working in all parts of the state, especially in rural and border Texas. We need to invest more in our medical schools and graduate medical education training programs. We should not fool ourselves into thinking that allied health professionals – who haven’t gone to medical school – can fill the gap as independent practitioners. Instead, we need to work on building physician-led health care teams that can safely meet the diverse needs of the Texas population. 

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House Bill to Press for One-Year SGR Delay

House Bill to Press for One-Year SGR Delay | Healthy Vision 2020 | Scoop.it

If passed, the delay in implementation of the sustainable growth rate formula would allow Congress to get past the uncertainties presented by the up...

 

Since the turn of the century, nothing has so regularly and completely vexed and frustrated physicians more than our annual game of chicken with Congress over Medicare payments.Without a robust network of physicians to care for the millions of patients dependent on Medicare, the program will not work. TMA's proposals:

- Repeal the broken SGR. Enact a rational Medicare physician payment system that works and is backed by a fair, stable funding formula.

- Fix the broken Medicare physician payment system before giving additional increases to any other providers.

 

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Physicians Weigh In on SGR Debate

Physicians Weigh In on SGR Debate | Healthy Vision 2020 | Scoop.it

Five physician group representatives added their voices to the sustainable growth rate debate at a Congressional roundtable about Medicare payments.

 

"Every year, the flawed sustainable growth rate, or SGR,  leads physicians to fear dramatic reductions in their Medicare payments,"  Baucus stated in his opening remarks. "Next year physicians will face a 27% cut  if we don't act. While Congress has intervened to prevent these cuts each year,  it is time we develop a permanent solution.

"We need to repeal SGR and end the annual ‘doc fix' ritual.  The year-in and year-out uncertainty is not fair to physicians or the Medicare  beneficiaries who need access to their doctors."

 

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Design a standardized form for all medical reporting

Design a standardized form for all medical reporting | Healthy Vision 2020 | Scoop.it

Despite my exclusive use of an electronic medical record, I still receive dozens of medical communications on paper every day.

 

Many times, government agencies and payers put demands on physicians that disrupt workflow. These demands come on top of the already extensive disruptions and intrusions physicians experience. As they decide or are required to move from a paper to an electronic health record, Texas must carefully consider the impact of any new regulatory burdens placed on the physician practice, especially when many of these burdens do nothing to improve care quality. For instance, to achieve the goals of “meaningful use,” the federal government requires that physicians have a system that tracks patients’ height, weight, and blood pressure as part of “structured data.” This is required even if the physician practices a specialty where height and weight play little or no role in the medical care they provide to patients. Do patients really want to be weighed at the ophthalmologist when updating their eyeglass prescription? According to the federal government, if a physician “believes that one or two of these vital signs are relevant to their scope of practice, then they must record all three vital signs in order to meet the measure of this objective and successfully demonstrate meaningful use.” Texas should not repeat the mistakes of the federal government.

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Need for doctors expected to become more acute in Texas | Health | Dallas-Fort Worth Lifestyl...

Need for doctors expected to become more acute in Texas | Health | Dallas-Fort Worth Lifestyl... | Healthy Vision 2020 | Scoop.it
The healthcare law makes primary-care workers even more vital.
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