Archives: September 2016

September 2016 Newsletter

Record Breaking Demand for Doctors in Texas Marking 13 years since landmark medical liability reform was passed, Texas had a record year for new physician applications, highlighting the demand that exists for physicians and a friendly liability climate. New physician applications increased last fiscal year to 5,544 – a three percent increase over the previous year’s record-setting number of 5,377, and double the number received when a medical liability crisis peaked in Texas in 2003. Not only are physicians attracted to the state by its liability climate, but an increasing senior population – and their need for greater access to care – has also been factor. According to the Texas Alliance for Patient Access (TAPA), the state’s 65 and above population has grown 50 percent over the course of the last 13 years. When the state passed comprehensive liability reform in 2003, the tide of physicians leaving the state reversed. “One hundred eighteen Texas counties have seen a net gain in emergency medicine physicians since the passage of reforms. That includes 53 counties that previously had none,” commented Howard Marcus, MD, the chairman of TAPA. “That turnaround would not have occurred without the passage of our landmark reforms,” he said….

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Athletic Trainer Bill Passes in House, Moves to Senate

Athletic trainers and sports medicine professionals are closer to receiving liability insurance protection while providing care to their athletes out of state. On Monday night, the U.S. House of Representatives passed the Sports Medicine Licensure Clarity Act (H.R. 921), which clarifies medical liability rules for athletic trainers and other medical professionals to ensure they are properly covered by their liability insurance while traveling with athletic teams in another state. The bill, sponsored by Reps. Brett Guthrie (R-Ky.) and Cedric Richmond (D-La.), now moves to the U.S. Senate. If it is passed there, it will only need President Obama’s signature to become law. The National Athletic Trainers’ Association (NATA) said more than 400 athletic trainers representing 48 states met with members of Congress this past summer to lobby for the bill, resulting in 17 additional bipartisan co-sponsors. “NATA is proud to have championed this legislation that will not only benefit our 43,000 members and the millions of patients they serve, but that will also support health care professionals all over the country, including our initial partners in this effort, the American Academy of Orthopaedic Surgeons and the American Medical Society for Sports Medicine,” NATA President Scott Sailor said in a statement….

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Liability suit seeks change to informed consent

A case before the Supreme Court of Pennsylvania could have major implications on how physicians obtain informed consent prior to a surgery. At stake in Shinal v. Toms, is whether a patient’s informed consent to surgery can be predicated on information provided in part by a physician’s assistant, as opposed to just the physician. Both the Medical Care Availability and Reduction of Error Act (MCARE) and common law have made it the physician’s duty to see that the proper information is conveyed, but the question is whether delegating tasks to qualified professionals is also within the bounds of the law and common medical practice. How the case unfolded In 2004, Megan Shinal underwent surgery to remove a tumor, but it regrew and by 2008 she was experiencing severe headaches and was referred to Steven A. Toms, MD, for a second surgery. This type of surgery—the removal of a craniopharyngioma, a very serious and recurrent rumor located deep in the base of the brain—is one of the most complex surgeries in all of neurosurgery. For this reason, there were numerous important surgical decisions to be made, some by the surgeon and some collaboratively with the patient. The major decisions were which…

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The healthcare policy changes spine surgeons would make

Here three surgeons discuss the policy changes they would make to improve the current healthcare industry landscape. Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.   Question: What healthcare policy changes would you make if you could? Ray Oshtory, MD, MBA, Pacific Heights Spine Center, San Francisco: Allow Medicare to collectively bargain drug prices for Medicare Part D benefits. Currently, Medicare sets payment rates for physicians, and other private insurers use Medicare’s rates as a benchmark for setting their rates. That is why physician reimbursement rates have not risen over the past two decades, for better or worse. Similarly, if Medicare were allowed to collectively bargain drug prices, other insurers would surely use Medicare’s rates as a benchmark, thereby driving down the cost of pharmaceuticals, and likely eventually implants and devices as well, if a carve out for these products was implemented. That one simple policy change would prevent the prices of pharmaceuticals from skyrocketing, examples of which have been filling the media lately. As a point of reference, Medicare Part D’s budget for 2015,…

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13-Years Post-Liability Reform, Texas Hits Another Record in New Physician Applications

Texas continues to be an attractive place to practice medicine. The state’s medical board finished is fiscal year last month having received a record number of new physician applications. Some 5,544 new applications were received, up 3% from the previous year’s record 5,377 applicants. Texas licensed 4,093 new physicians for the year. That figure is down 202 from the previous year but still the second highest on record. “We continue to trend in the right direction, said Austin internist Howard Marcus, MD, chairman of Texas Alliance For Patient Access, “yet there remains a strong demand for health care workers.” More than twice as many physician applications were received this year than at the height of the state’s liability crisis 13 years ago. Thirteen years ago this month Texas voters approved Proposition 12. The constitutional amendment affirmed the Legislature’s authority to set damage caps for hard-to-quantify pain-and-suffering-type awards in health care lawsuits. Within months the epidemic of lawsuit abuse was reversed and the exodus of physicians stopped; especially those practicing in the emergency department, said Marcus. “One hundred eighteen Texas counties have seen a net gain in emergency medicine physicians since the passage of reforms. That includes 53 counties that previously…

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