Session Descriptions

Friday, January 27, 2023

8 - 9 a.m.

Hospital Medicine: From A to Z for Dummies
Martha Danhof, DO

This presentation will provide a comprehensive overview of the in's and out's of hospital medicine. The speaker will provide a history of the evolution of hospitalist medicine; how to approach admissions and determining which form of care - inpatient vs. outpatient care is best; how to efficiently review medical data to determine diagnosis and underlying conditions; and how to approach discharge planning. In addition, the speaker will discuss what information primary care physician's really need. nd what primary care physician's really need 

Objectives:

  • Learn the history of evolution of hospitalist medicine
  • Learn how to efficiently review information to admit a patient
  • Learn what PCPs need for the best follow up care 

9 - 10 a.m.

Amphetamines The Next Epidemic: What History Has Not Taught Us (OPIOID)
Helene Alphonso, DO; John Peter Smith Hospital

The prescription drug industry is using the exact same practices to boost Amphetamine sales as were used in the Opiate Epidemic. This presentation examines the evidence and proposes changes in practice to offset this trend before it is named an Epidemic.

Objectives:

  • Examine the history of stimulant use disorder
  • Examine the history of opiate use disorder
  • Identify trends and similarities in these epidemics and their iatrogenic components
  • Compare prescribing trends to ADHD treatment standards

10 - 10:30 a.m.

Break

10:30 - 11:30 a.m.

Fever in the Returning Traveler
Rob Allen, DO; UIW-SOM

This session will provide an overview of Tropical Medicine with an emphasis on work-up of travelers returning from tropical areas with fever and chills. Signs and symptoms associated with malaria, dengue, and other tropical diseases will be discussed.

Objectives:

  • Understand the importance of high index of suspicion in fever in the returning traveler
  • Understand the pathophysiology and common symptoms of malaria and dengue
  • Articulate the work-up of a febrile patient returning from a malaria-endemic area

11:30 a.m. - 12:30 p.m.

I Stuck My Neck Out for You!
Mindy Hansen, DO; UNTHSC-TCOM

This presentation will present clinical presentations, exams, workups and treatment algorithms for five of the most commonly presenting concerns of the neck and upper back. Each clinical presentation will also walk through starter progressions of function home movements and exercises that can be done by anyone.

Objectives:

  • Recognition of common etiologies of neck and upper back pain
  • Be able to engage your patients with basic functional tests that are both diagnostic and therapeutic
  • Understand when to employ imaging versus physical therapy versus medication management

12:30 - 1:45 p.m.

Lunch on your Own

1:45 - 2:45 p.m.

Please Don’t Sugarcoat It: The Future of Type 2 Diabetes Pharmacotherapy
Kristin Lutek, Pharm.D, BCACP, CDCES; Southwestern Health Resources

Diabetes is a complex chronic illness that poses significant healthcare burdens in terms of cost and management. Persons with diabetes are at risk for significant cardiovascular and renal complications, however, insulins and other traditional therapies, while beneficial for attaining glycemic targets, have lacked additional benefits for cardiovascular or renal protection. Newer therapies emerging within the last decade have demonstrated cardiovascular, renal, and weight loss benefits, and have allowed for down-titration and sometimes elimination of older therapies with often deleterious side effects.

This session provides an initial overview of existing guidance for pharmacotherapy in T2DM; will compare and contrast existing guidance with newly released ADA 2023 Standards of Care; and will conclude with an interactive case-based format providing the audience opportunity to discuss T2DM management scenarios relevant to daily practice.

Objectives:

  • Define current evidence based recommendations for T2DM pharmacotherapy from ADA 2022 Standards of Care
  • Summarize key changes for T2DM pharmacotherapy recommendations per ADA 2023 Standards of Care
  • Apply evidence-based recommendations in several patient cases to create plans for  simplification of complex T2DM medication regimens into safer, simpler, equally effective regimens using patient-specific factors

2:45 - 3:45 p.m.

Why Test the Brain?

April Wiechmann, PhD; UNTHSC-TCOM

Cognitive impairment can be caused by many things. Early detection of changes can be vital when it comes to reversal of cognitive impairment or treatment. People of all ages can be tested, as age is not the only cause of impairment. 

Objectives:

  • Understand the purpose of neuropsychological testing
  • Learn when to refer a patient
  • Learn the different aspects of neuropsych. recommendations

3:45 - 4:15 p.m.

Break

4:15 - 5:15 p.m.

Risk Management in Modern Dermatology Therapeutics:  A Primer for the Non-Dermatologist
Edward Zabawski, Jr., DO, FAAD 

This session will provide an overview of the changing landscape in the management of medical dermatology therapeutics and the specific adverse event concerns that may present in an urgent care, emergency room, or general practice setting.

Objectives:

  • Become familiar with new medications and their risks and known adverse effects
  • Promote awareness of presenting signs and symptoms as possible manifestations of medications used in the management of complex medical dermatology patients
  • Appreciate the holistic approach to new chief complaints as the path to accurate diagnosis of adverse effects to newer medications used in dermatology patients.

5:15 - 6:15 p.m.

Cognitive Distortions in the Medical Provider
Theresa Murphy, LCSW; Methodist Family Medicine Residency Program

Cognitive distortions are common and physicians are not immune. This session brings the "C" to CBT to encourage physicians to examine how our own thoughts influence our patient care, office dynamics, and our professional satisfaction. Often, the phrase "physician well-being" can feel nebulous. This session will offer concrete therapeutic tools to improve helpful thinking in the provider.

Objectives:

  • Define cognitive distortions and list common cognitive distortions
  • Describe how thinking impacts emotions
  • Distinguish common physician unhelpful thoughts and apply alternate helpful thinking.
     

Saturday, January 28, 2023

8 - 9 a.m.

Project ECHO: All Teach and All Learn Using Geriatric Case Studies
Sarah Ross, DO; UNTHSC-TCOM

In this session, participants will learn the background and concepts about Project ECHO (Extension for Community Healthcare Outcomes). Participants will join an interactive, real-time, peer-to-peer learning session about deprescribing medications. In addition, participants will contribute in a collaborative problem-solving case study. The final portion of the session will provide the resources for accessing Project ECHO and ultimately empower practice team members in rural and underserved communities to provide specialty care to more people. 

Objectives:

  • Gain knowledge of Project ECHO as a collaborative model of medical education and care management
  • Participate in a real-time Project ECHO session about deprescribing medications in the older adult population and learn using a case study
  • Learn how to access Project ECHO resources

9 - 10 a.m.

Menopause, Don't Be Afraid!
Carolyn Quist, DO; UNTHSC-TCOM

During this presentation, the speaker will review the importance of treating menopause and the symptoms. She will discuss in detail treatment options as well as the risks and the pro's and con's of treatment. 

Objectives:

  • Be able to assign symptoms to hormone deficiency
  • Be able to distinguish synthetic from natural hormones
  • Be able to discuss treatment options with patients

10 - 10:30 a.m.

Break

10:30 - 11:30 a.m.

Celiac Disease: A Modern Day Understanding

Shahid Aziz, DO; Premier Specialty Associates

During this presentation, the speaker will review the epidemiology and pathogenesis of celiac disease. The speaker will then discuss how to diagnose and manage celiac disease, as well as present complications patients can experience from the disease.  

Objectives:

  • Understand the complex pathogenesis
  • Testing for celiac disease
  • Treatment of celiac disease

11:30 a.m. - 1 p.m.

TOMA Business Meeting and Luncheon

1 - 2 p.m.

Combat Physician Burnout: Physician Coaching as an Effective Lifelong Tool
Carolyn Moyers, DO, FACOG, NCMP; Sky Women's Health

Our medical culture emphasizes perfectionism, denial of personal vulnerability, and delayed gratification. Changes in the healthcare environment have created growing external pressures.

Approximately 50% of all medical students, residents, and physicians experience burnout; increasing medical errors and negatively impacting quality of care and professionalism. Burnout increases risk of depression, anxiety, substance abuse and suicidal ideation. According to the 2022 Medscape National Physician Burnout & Suicide Report, an average 10% of physicians have had thoughts of suicide.

Professional coaching, long utilized in the business world, provides a results-oriented and stigma-free method to address burnout, primarily by increasing one's internal locus of control. Coaching enhances self-awareness, drawing on individual strengths, questioning self-defeating thoughts and beliefs, examining new perspectives, and aligning personal values with professional duties. Coaching utilizes established techniques to increase one's sense of accomplishment, purpose, and engagement - critical to transforming burnout.

Objectives:

  • Recognize the signs of burnout in yourself and colleagues and identify tools to support you in work-life integration
  • Learn what physician coaching is and the data supporting its use in decreased burnout, increased retention, and increased engagement
  • Recognize how physician coaching is a tool available for lifelong use at work and at home to help you self-regulate, have more self-compassion, and see the many choices before you

2 - 3 p.m.

Diagnosis and Management of Bipolar Disease in the Primary Care Setting
Rohini Mehta, MD; UIW-SOM

This session aims to increase primary care physicians' comfort with identifying bipolar I disorder, bipolar II disorder and its variants. Additionally, high-yield management guidelines for these conditions will be reviewed.

Objectives:

  • Differentiate bipolar spectrum disorders from unipolar depression and psychotic disorders
  • Outline treatment strategies for bipolar depression and hypomania
  • Identify best practices for management of bipolar disorder in special populations

3 - 3:30 p.m.

Break

3:30 - 4:30 p.m.

Opioids: The Evidence and the Alternatives (OPIOID)

David Lindley, DO; Dozier Pain Management

During this presentation the speaker will review evidence of opioid tolerance, hyperalgesia, and efficacy for chronic (>3 mos) non-malignant pain; review evidence of intrathecal opioid delivery for chronic non-malignant pain; review evidence of intrathecal ziconotide non-opioid delivery for chronic non-malignant pain and review possible future non-opioid analgesics. 

Objectives:

  • Review mechanisms of opioid tolerance and hyperalgesia
  • Review mechanisms of action of possible future analgesic alternatives
  • Review clinical evidence evaluating opioid therapy for chronic (>3mos) non-malignant pain
  • Review clinical evidence evaluating opioid induced hyperalgesia 
  • Review clinical evidence evaluating intrathecal opioid intrathecal delivery for chronic non-malignant pain
  • Review clinical evidence evaluating intrathecal ziconotide non-opioid intrathecal delivery for
    chronic non-malignant pain

4:30 - 5:30 p.m.

Post-Roe: Implications for the Practice of Medicine in Texas (ETHICS)

John J. LoCurto, III, JD; UIW-SOM

Just as the structure of a cell, organ, or bone impacts its function, the law provides structure that influences how the health care system functions. Osteopathic physicians practicing in the post-ROE world face new legal challenges, not the least of which is understanding what the law is. To dispel confusion and clarify the issues, this session will contextualize Roe v. Wade, summarizing how it arose, evolved, and was ultimately overturned in Dobbs v. Jackson Women's Health Organization. The session will examine potential implications for those practicing medicine in Texas, now, and in the future.  

Objectives:

  • Contextualize and dispel confusion about Roe v. Wade and Dobbs v. Jackson Women's Health Organization
  • Clarify the law in Texas and how it may impact the practice of medicine in the state
  • Anticipate future implications for the practice of medicine in Texas.
     

Sunday, January 29, 2023

8 - 9 a.m.

The Anxiolytic Effects of Strength and Good Company
Dante Paredes, DO; UNTHSC-TCOM

During this session, the speaker will review the general operation of the septohipoocampus/behavioral inhibition system as it pertains to appropriate versus pathologic anxiety. The speaker will then use that background knowledge to discuss two specific interventions that care regulate anxiety, physical training, and the maintenance of one's social network.

Objectives:

  • Discuss the general operation of behavioral inhibition system (BIS) and threat detection
  • Recontextualize normal and pathologic anxiety within the context of the BIS
  • Review the evidence for how general physical preparedness/perceived strength can regulate anxiety
  • Review the evidence for how the quality of social relationship can regulate anxiety

9 - 10 a.m.

OMT for Athletes
Tucker Leigh, Jr., DO, CAQSM; SHSU-COM

This session will equip the learner with principles to properly assess athletes for somatic dysfunctions based on sport or exercise-related activities and develop treatment plans including OMT to address issues that commonly present in the athletic population.

Objectives:

  • Outline amount of training spent by college athletes per week
  • Describe specific applications for osteopathic manipulative treatment (OMT) in the athletic population
  • Identify biomechanics in particular sports that place a given athlete at increased risk of developing somatic dysfunction
  • Construct an appropriate treatment plan for an athlete with a specified condition 

10 - 10:15 a.m.

Break

10:15 - 11:15 a.m.

STI Screening in Primary Care
Craig Boudreaux, DO; SHSU-COM

During this session, we will explore the latest concepts involving the acquisition of a patient-centered sexual health assessment in order to optimize the sexual health of our patients. In addition, we will review the recently updated guidelines for STI screening from the CDC and the ACS.

Objectives:

  • Outline the components of a comprehensive sexual health assessment
  • Implement a patient-centered, integrated approach to gather sexual health
  • Incorporate self-assessment of bias in gathering the sexual health history
  • Demonstrate positive, affirming and non-judgmental approach to gathering a sexual health history
  • Provide behavioral counseling to optimize sexual health
  • Address non-infectious sexual health concerns
  • Describe current STI screening recommendations 

11:15 a.m. - 12:15  p.m.

Management of Fever in Children
Beatrix Bansal, MD; UT Southwestern

This presentation will discuss current recommendations in the management of fever in children.

Objectives:

  • Understand management of fever from birth to 90 DOL
  • Understand management of fever up to 3 years old
  • Discuss special circumstances in pediatric fever management

12:15 - 1 p.m.

Box Luncheon

1 - 2 p.m.

2023 Physician Fee Schedule Final Rule: An Overview
Cynthia Penkala, CMM, CMPE, CMSCS, CPOM; American Osteopathic Information Association

On November 1, 2022 the Centers for Medicare and Medicaid Services (CMS) released the CY 2023 Medicare Physician Fee Schedule (MPFS) final rule. The MPFS final rule includes updates and policy changes for Medicare payment policies, payment rates, and other Medicare Part B issues. The provisions of this final rule will take effect on January 1, 2023. This presentation will highlight the major provisions that will impact the practicing physician.

Objectives:

  • Identify the impact of the 2023 conversion factor
  • Learn about the expanded E&M codes and guidelines
  • Gain knowledge of relevant updates and policy changes

2 - 3 p.m.

How to Protect Yourself in Today's Practice Environment (ETHICS)

Jeff McDonald, JD and Jon Porter, JD; McDonald, Mackay, Porter & Weitz, LLP

This presentation will discuss ways to protect yourself, your staff and your patients through documentation in 2023. The speakers will review documentation of patient records and documentation on receipt. In addition, they will address disposition and disposal of drug samples.

Objectives:

  • Understand the in's and out's of documentation
  • Learn ways to minimize risk
  • Understand TMB rules

3 p.m.

Adjourn

 
Accreditation

The Texas Osteopathic Medical Association is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians. 

The Texas Osteopathic Medical Association designates this program for a maximum of 22 AOA Category 1-A credits, including 2 opioid and 4 medical ethics/risk management credits, and will report CME commensurate with the extent of the physician's participation in this activity. 

The TOMA 67th MidWinter Conference has been planned and implemented in accordance with the accreditation requirements and policies of the AOA Council on Continuing Medical Education. Attendees can earn 1 CME credit for every 60 minutes of educational time.