To try and fail is at least to learn. To fail to try is to suffer the loss of what might have been." ~ Benjamin Franklin

Worry is the interest paid by those who borrow trouble.                             George Washington

IN THIS ISSUE, FOR YOU:
ON THE SCHEDULE AND DISTRICT MEETINGS
PRIMARY CARE
QUALITY BENEFITS OF E.H.R.
HOSPITALISTS AND PCPs:  A DELICATE BALANCE
MEDICAL INSURERS AETNA, CIGNA AGREE TO PAY FOR ONLINE DOCTOR VISITS
AOIA LAUNCHES NEW PREMIUM PROFILE SERVICE
AOA HEALTH POLICY NOTES
IOM URGES NATIONWIDE CLINICAL PRACTICE GUIDELINES
MEDICATION UNDER A MICROSCOPE
FLU VACCINE PROTECTS AGAINST 27% OF TEXAS CASES
E-MAIL -- IS IT A GOOD THING?
LAUGHTER IS A PART OF THE HUMAN SURVIVAL KIT

ON THE SCHEDULE AND DISTRICT MEETINGS:

District 7                   Thursday, Feb. 21st, 6:30 p.m.
                               Fleming's Prime Steakhouse and Wine Bar
                               320 East 2nd Street
                               Austin, TX
                               TOMA / ATOMA Presidential Visit

District 13                 Tuesday, February 26 - 6:30 P.M.
                               Culpepper's Steak House
                               309 East I-30
                               Rockwall, TX

District 9                   Wednesday, Feb. 27th, 6:30 p.m.
                               Johnny Carino's
                               4904 N. Navarro Street, 
                               Victoria, TX

District 19                 Thursday, Feb. 28th
                               La Barranca Restaurant
                               Laredo, TX
                               TOMA / ATOMA Presidential Visit

District 5                   Thursday, Feb. 28th, 6:30 p.m.
                               Mercury Grill,
                               11909 Preston Rd. #1418, Dallas, TX
                               Delegates for the TOMA House of Delegates will be finalized!

District 8                   Thursday, Feb. 28th, 6:30 p.m.
                               Omni Marina, in Padre Ballrooms A & B
                               Corpus Christi, TX

District 18                 Tuesday, March 4th, 6:30 p.m.
                              Cheeves Brothers Steak House
                              14 East Avenue A
                              Temple, TX 76501

   
March 1-2, 2008      "Ligamentous Articular Strain Techniques" Advanced Course
                             presented by the Dallas Osteopathic Study Group
                             Doubletree Hotel-Campbell Centre, Dallas, TX 75206
                             Contact: Conrad Speece, D.O. course director, 
                             214-321-2673       cjspeece@yahoo.com
                             CME: 16 hours OMM category 1-A anticipated from AOA

April 24, 2008           DO Day on the Hill, Washington, D.C.
                             American Osteopathic Association (AOA)
                             Registration forms can be found at D.O. Online.

April 26, 2008 (Saturday) TOMA House of Delegates
                                   Sheraton Hotel, 701 E. 11th St. (I-35 & 11th St.), Austin, TX

National Doctors' Day   March 30, 2008
Administrative Professionals Day  April 23, 2008
National Volunteer Week:  April 27-May 3, 2008

PRIMARY CARE

In the past decade, the number of U.S.-trained physicians working to become primary care docs has fallen, but the shortfall has been more than made up for by a growing number of osteopathic docs and foreign-trained physicians, a Government Accountability Office report says.

Between 1995 and 2006, the number of U.S.- educated physicians in primary care residency programs fell from 23,801 to 22,146, while the number of international medical school grads in the programs rose from 13,025 to 15,565, reported the Wall Street Journal. The number of osteopaths rose from 1,748 to 3,163. Overall, the number of primary care physicians rose between 1995 and 2005 in both absolute and per capita terms, the Journal added.

From:  Physician News Digest NEWS BRIEFS - TEXAS EDITION,  http://PhysiciansNews.com

QUALITY BENEFITS OF E.H.R.

While an EMR can simply be used to digitize existing paper methods, it also has the potential to accomplish tasks that are difficult, if not impossible, to do with paper charts. For example:

Point-of-care reminders: Your EMR can easily be configured to generate point-of-care reminders based your patients' age, sex, or disease. This function can always remind you or your staff to do an overdue foot exam or to collect an HgA1c reading on your diabetic patients, even if they have come in for a sore throat. It's not easy to do that with paper charts when you are seeing 20 to 30 patients per day.

Tracking data: Quality -- at least for the government and payers -- is all about data. EMRs give you the ability to not only aggregate your data so you can evaluate your own performance, but they can also determine whether your quality interventions are actually having any effect. While paper charts will never crash due to a software glitch, they're lousy at producing and aggregating data.

From:  Physicians Practice Tech Doctor, by Physicians Practice®, www.PhysiciansPractice.com.

HOSPITALISTS AND PCPs:  A DELICATE BALANCE

With the number of hospitalists rising, office-based physicians are (gratefully or begrudgingly) getting accustomed to using them.  However you feel about hospitalists, they're not going away. Here's what's happening in the field and a look at how the rapid growth of this medical specialty is likely to affect you-if it hasn't already.

http://medicaleconomics.modernmedicine.com/memag/Medical+Practice+Management:+Business+Operations/Hospitalists-and-PCPs-A-delicate-balance/ArticleStandard/Article/detail/490682?contextCategoryId=44475

From:  Medical Economics, www.ModernMediciModernMedicine.comne.com

MEDICAL INSURERS AETNA, CIGNA AGREE TO PAY FOR ONLINE DOCTOR VISITS

http://www.dallasnews.com/sharedcontent/dws/dn/latestnews/stories/021508dnbusonlineappointments.373c4df.html

AOIA LAUNCHES NEW PREMIUM PROFILE SERVICE

The American Osteopathic Information Association (AOIA) launched its new Premium Profile Service earlier this week. The Official Osteopathic Physician Profile report is recognized by all national accrediting organizations as the primary source for verifying osteopathic education, postgraduate training, and board certification.  Over 50,000 AOIA profiles are sent to hospitals, managed care organizations, licensing boards and other health care entities annually. The new "Premium Profile" will alert credentialing clients automatically of any updates to postdoctoral training information as well as board certification status for up to one year from the date of order. This will assure that the credentialing files on DOs are kept current and will streamline the credentialing process.

AOA HEALTH POLICY NOTES

A Congressional Budget Office report cites technological advances as the single biggest factor causing rapid growth of health care spending in the US, which has tripled twice over the past 40 years and now accounts for 15% of our GDP, according to the 2/5/08 CQ HealthBeat.

The Congressional Budget Office has issued a report examining geographic differences in health care spending for similar patients across the US, using primarily Medicare data, and suggesting options around payment, incentives, and generating better information to achieve greater efficiency.

IOM URGES NATIONWIDE CLINICAL PRACTICE GUIDELINES

The Institute of Medicine is recommending that Congress establish a new national program to evaluate the effectiveness of healthcare products and services, and "end confusion" about what works best for patients. A new report from the institute asserts that providers and payers are overwhelmed with information about clinical effectiveness and are struggling to sift through it all. Multiple organizations are offering sometimes duplicate or competing guidelines on myriad clinical conditions, while other conditions have no guidelines at all, according to the report. Regional disparities, lack of consensus about the most effective interventions and waste are costing billions, the report said. Establishing a national program to identify the most effective healthcare services would lead to better, more efficient and consistent care nationwide, the institute concludes. The institute's 16-member committee of providers, insurers and academics recommends that Congress direct HHS to establish a program with the authority, resources and expertise necessary to set priorities for evaluating clinical services and conduct systematic reviews of the evidence. "A system coordinated by a single, national entity that can prioritize and coordinate these evaluations would enable us to sort the wheat from the chaff and make sense of it all," Barbara McNeil, M.D., IOM committee chairwoman and head of the department of healthcare policy at Harvard Medical School, said in a written statement.
 
From:  Modern Physician Online, byModern Physician, www.ModernPhysician.com

MEDICATION UNDER A MICROSCOPE
Studies Raise Questions About Drugs' Efficacy Against Disease

By Rob Stein, Washington Post Staff Writer, Tuesday, February 19, 2008

A series of surprising findings about some of the most widely accepted assumptions in medicine has renewed debate about how aggressively doctors use drugs to prevent and treat some of the nation's leading health problems.

http://www.washingtonpost.com/wp-dyn/content/article/2008/02/18/AR2008021801942.html?wpisrc=newsletter&wpisrc=newsletter&wpisrc=newsletter
From:  The Washington Post, www.washingtonpost.com:

FLU VACCINE PROTECTS AGAINST 27% OF TEXAS CASES
Dallas Morning News - February 20, 2008

Local health experts are bracing for a worse-than-expected flu season, after discovering this year's influenza vaccine protects against fewer than 30 percent of the cases diagnosed in Texas. "If this vaccine is not working as well as we'd hoped, it has the makings of being one of the worst years for flu," said Dr. R. Doug Hardy, infectious disease specialist at Children's Medical Center Dallas and UT Southwestern Medical Center. Normally, the vaccine protects against 70 percent to 90 percent of the flu viruses that hit the U.S. In Texas, this season's vaccine protected against nine of 33 influenza samples - or 27 percent.
click here for more:  http://www.dallasnews.com/sharedcontent/dws/dn/latestnews/stories/022008dnmetfluvaccine.39775f2.html

E-MAIL -- IS IT A GOOD THING?

Recently, I have encountered several circumstances where e-mails between doctors, as well as staff members, have resulted in misunderstandings and subsequent problems. Case in point: A certain physician sent a meeting request via e-mail to two of his colleagues. He understood that the meeting would be between himself and the two other physicians. Unfortunately, the two others assumed that they would be meeting between themselves; they were quite surprised when the first physician showed up at their meeting! A simple phone call would have made the matter clear from the start.  I am sure you have had, or know of, a similar experience. For whatever reason, it's becoming increasingly commonplace to communicate with colleagues using e-mail rather than using the telephone or -- gasp! -- initiate personal contact. I find it truly amazing that people think nothing of e-mailing a coworker whose desk is 20 feet away. I realize that in some cases, such as setting up meetings or confirming receipt of documents, e-mails may be necessary or logical. But what has happened to getting up from our desks and walking around the corner just to talk?

E-mailing can sometimes take on a more sinister note. One of the practices for which I was consulting experienced a situation where an employee responded to a coworker's e-mail query with another question. The coworker interpreted the response completely out of context, took offense, and escalated the interaction into a huge brouhaha that required the intervention of senior management. The loss of productive work time was tremendous, not to mention the loss of good will between staff members. Again, a simple phone call or direct interaction could have avoided the whole fracas.

So, with that in mind, here are a few hints to smooth out your e-mail experience:

Procedural:
Keep messages brief and to the point.

Use cc: and bcc: appropriately and judiciously. Address your e-mail only to those who really need to receive your message. Do not copy your e-mail to your entire address book!

Use "Reply all" only when absolutely necessary. E-mails can quickly stuff a person's inbox, many of which never should have been sent at all.

Use the subject field to indicate content and purpose, for later reference.

Never send jokes or personal information. Office e-mail is for office use only.

Be aware that when you respond to a "threaded" e-mail, you are continuing a long and cumbersome message. Is this necessary? Cut what you don't need.

Be wary of using abbreviations such as BTW (by the way) or TTYL (talk to you later), since not everyone will know what you mean.

Also be careful with "insider" symbols such as -Q, which I understand means "smoker," but who knows for sure?

Personal:

Take time to spell-check your e-mails before clicking "Send." How does it make you look if your message is littered with misspelled words and poor use of punctuation?

Don't use e-mail as a way to avoid personal contact.

Keep in mind that tone cannot be heard in an e-mail. The recipient may misunderstand you even if you use italics or underlining.

ALL CAPS IS CONSIDERED SCREAMING.

Remember, e-mails can be saved by others and used when they feel necessary. E-mails are legal documents and may potentially surface in a dispute.
 

From:  Physicians Practice Pearls, by Physicians Practice www.PhysiciansPractice.com.

LAUGHTER IS A PART OF THE HUMAN SURVIVAL KIT                                     (David Nathan)

Q: What do you call George Washington's false teeth?
A: Presidentures!

"One woman's Titanic is another woman's Love Boat."                Carrie Bradshaw on Sex and the City

We brought our newborn son, Adam, to the pediatrician for his first checkup. As he finished, the doctor told us,

What word is always spelled incorrectly?

Doctor: Nurse, how is that little boy doing, the one who swallowed ten quarters?
Nurse: No change yet.

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ADVOCATE DO MEDICAL LIABILITY COVERAGE FOR DO's

TOMA members want and deserve the best service and rates for their Medical Liability Insurance, which is why TOMA has selected Advocate, DO to be their exclusive Medical Liability Insurance carrier.  Advocate, DO offers full coverage, aggressive claims management, pro-active risk management, 24/7 customer support and competitive rates.  Plus, you can mid-term your policy with Advocate, DO's Continuous Policy and make monthly payments with no interest charges or surplus fees.

With the Continuous Policy, you will automatically receive a 10% discount and are eligible for additional discounts and credits.  Prior acts coverage and part-time coverage are also available.  Please visit www.advocatedo.com for additional information.

Advocate, D.O.

Underwritten by Advocate, MD Insurance Company of the Southwest Inc.

800-686-2734 or 512.275.1830