San Antonio Medicine October 2015

MEDICINE SAN ANTONIO

THE OFFICIAL PUBLICATION OF THE BEXAR COUNTY MEDICAL SOCIETY

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WWW.BCMS.ORG

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$4.00

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OCTOBER 2015

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VOLUME 68 NO. 10

What BCMS Does for You BCMS CIRCLE OF FRIENDS SERVICES DIRECTORY SAN ANTONIO, TX PERMIT 1001

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NON PROFIT ORG US POSTAGE

MEDICINE SAN ANTONIO

THE OFFICIAL PUBLICATION OF THE BEXAR COUNTY MEDICAL SOCIETY

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WWW.BCMS.ORG

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$4.00

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What BCMS Does for You The BCMS Value Proposition

By Stephen C. Fitzer, BCMS CEO/Executive Director ...12 BCMS President’s Message ..............................................8

OCTOBER 2015

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VOLUME 68 NO. 10

San Antonio Medicine is the official publication of Bexar County Medical Society (BCMS).

All expressions of opinions and statements of supposed facts are published on the authority of the writer, and cannot be regarded as expressing the views of BCMS. Advertisements do not imply sponsorship of or endorsement

by BCMS.

EDITORIAL CORRESPONDENCE: Bexar County Medical Society 6243 West IH-10, Suite 600 San Antonio, TX 78201-2092 Email: editor@bcms.org

BCMS News ....................................................................10 Bexar County Medical Society’s New Home ....................14 Bexar County Medical Library Association ......................16 Bexar County Medical Society Foundation ......................16

MAGAZINE ADDRESS CHANGES: Call (210) 301-4391 or Email: membership@bcms.org

BCMS Alliance..................................................................18 BCMS Meetings and Social Functions ............................19

SUBSCRIPTION RATES: $30 per year or $4 per individual issue

Communication tools available free to members ............20 Complimentary Concierge Auto Program ........................21 BCVI facilitates credentialing for healthcare providers ....22 BCMS General Counsel ..................................................22 BCMS PH&R Committee / Unsung Hero ......................................................................................24 Board of Censors / Board of Mediations......................................................................................25 BCMS Staff....................................................................................................................................26 Texas Medical Assoication resources available for physicians ....................................................27 BCMS Photos................................................................................................................................28 BCMS Committees........................................................................................................................30 Business of Medicine: Why do patients use EHRs? by Mohammed Sajedur Rahman and Dana A. Forgione ......................................................................................................................40 UTHSCSA Dean’s Message: by Francisco González-Scarano, MD ......................................................42 TMA Membership ....................................................................................................................................44 The Circle of Friends Program ................................................................................................................45 BCMS Circle of Friends Services Directory ............................................................................................46 Auto Review: Volkswagen Tiguan by Steve Schutz, MD ........................................................................52

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4 San Antonio Medicine • October 2015

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call (210) 690-8338 or FAX (210) 690-8638 Email: louis@smithprint.net San Antonio Medicine is published by SmithPrint, Inc. (Publisher) on behalf of the Bexar County Medical Society (BCMS). Reproduction in any manner in whole or part is prohibited without the express written consent of Bexar County Medical Society. Material contained herein does not necessarily reflect the opinion of BCMS or its staff.

San Antonio Medicine, the Publisher and BCMS reserves the right to edit all material for clarity and space and assumes no responsibility for accuracy, errors or omissions. San Antonio Medicine does not knowingly accept false or misleading advertisements or editorial nor does the Publisher or BCMS assume responsibility should such advertising or editorial appear. Articles and photos are welcome and may be submitted to our office to be used subject to the discretion and review of the Publisher and BCMS. All real estate advertising is subject to the Federal Fair Housing Act of 1968, which makes it illegal to advertise “any preference limitation or discrimination based on race, color, religion, sex, handicap, familial status or national orgin, or an intention to make such preference limitation or discrimination.

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BOARD OF DIRECTORS

OFFICERS James L. Humphreys, MD, President Leah Hanselka Jacobson, MD, Vice President Maria M. Tiamson-Beato, MD, Treasurer Adam V. Ratner, MD, Secretary Jayesh B. Shah, MD, President-elect K. Ashok Kumar, MD, Immediate Past President

DIRECTORS Jorge Miguel Cavazos, MD, Member Josie Ann Cigarroa, MD, Member Kristi G. Clark, MD, Member John Robert Holcomb, MD, Member John Joseph Nava, MD, Member Carmen Perez, MD, Member Oscar Gilberto Ramirez, MD, Member Bernard T. Swift, Jr., DO, MPH, Member Miguel A. Vazquez, MD, Member Francisco Gonzalez-Scarano, MD, Medical School Representative Carlos Alberto Rosende, MD, Medical School Representative Carlayne E. Jackson, MD, Medical School Representative Col. Bradley A. Lloyd, MD, Military Representative Rebecca Christopherson, BCMS Alliance President Gerald Q. Greenfield Jr., MD, PA, Board of Censors Chair Donald L. Hilton Jr., MD, Board of Mediations Chair George F. "Rick" Evans Jr., General Counsel

CEO/EXECUTIVE DIRECTOR Stephen C. Fitzer

CHIEF OPERATING OFFICER Melody Newsom Mike Thomas, Director of Communications August Trevino, Development Director Brissa Vela, Membership Director

COMMUNICATIONS/ PUBLICATIONS COMMITTEE Fred H. Olin, MD, Chair Jay S. Ellis Jr., MD, Member Karl W. Janich, MD, Member Karen C. McQueen, Alliance Member Jeffrey J. Meffert, MD, Vice Chair Esmeralda Perez, Community Member Rajam S. Ramamurthy, MD, Member J.J. Waller Jr., MD, Member Kenneth C.Y. Yu, MD, Member

6 San Antonio Medicine • October 2015

PRESIDENT’S MESSAGE

Why BCMS membership and participation is important to me

By James L. Humphreys, MD 2015 BCMS President

This month’s San Antonio Medicine theme is about membership in our broad-based physician support organizations at the local and state levels. In conjunction with that, I want to share a few thoughts of my own about why these groups are important to me.

Physician practices are something of a fragmented lot by their nature and mine is no exception. Outside of my own partners and a few fellow physicians I see at hospitals, my exposure to other doctors in the community would be highly limited if not for the networking activities I have available to me through the BCMS. The range of colleagues I have gotten to know, work with and learn from has grown exponentially because of the opportunities for collaboration that became available to me through BCMS membership and committee participation. This is equally true at the state level where attending TMA meetings and joining committees opened up whole new opportunities for me to share new perspectives and work collectively with a lot of smart doctors from across Texas.

There are lots of benefits to membership - from car buying programs to insurance plans and practice management tools - but the biggest membership value to me is the legislative advocacy provided on behalf of all Texas physicians by the TMA and, in our own backyard, by the BCMS which works

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hand in hand with the TMA lobby team. You may have heard me mention this before and, more likely, mention it frequently and at tiresome length, but if you don’t invest time in monitoring potential legislation you will come to regret it.

I can assure you as a first-hand witness that there are lots and lots of groups who want healthcare to be very cheap, or better yet free, and that demand that healthcare cost savings come directly out of our fees. These groups get bills filed every two years when our state legislature is in session and without the lobbying efforts of the county medical societies and the TMA to make sure our side of the story is heard, I absolutely believe that the practice of medicine in Texas would be in a much sorrier condition for everyone, physicians and patients alike.

The benefits of being a member over my years of practice are very obvious to me when I reflect on the topic and my medical career has been very much richer and more fulfilling because of the time I invest in both the BCMS and the TMA. I hope that you all find a similar value in your membership and that we will continue to be strong together.

James L. Humphreys, MD, is the 2015 president of the Bexar County Medical Society. He is a pathologist with Precision Pathology in San Antonio.

BCMS NEWS

Reception honoring U.S. Rep. Henry Cuellar

By Mary E. Nava, MBA Chief Governmental and Community Relations Officer

BCMS physicians, spouses, hospital representatives and staff pause for a photo with Congressman Cuellar (center, right).

On Sept. 2, a reception, hosted by Drs. Rudy Molina and David Shulman, was held at Club Giraud honoring Congressman Henry Cuellar (TX-28). A number of topics were discussed, including: the appropriations bill currently under review; ICD-10; the Texas Medicaid waiver; the SGR repeal and the Geographic Practice Cost Index (GPCI).

Many thanks to the event hosts and to the other BCMS members, spouses and hospital representatives in attendance.

For local discussion on this and other legislative advocacy topics, consider joining the BCMS Legislative and Socioeconomics Committee by contacting Mary Nava at 210-301-4395 or mary.nava@bcms.org.

Reception honoring U.S. Rep. Michael Burgess, MD held in San Antonio

By Mary E. Nava, MBA Chief Governmental and Community Relations Officer

BCMS physicians, Alliance members, staff and business representatives pause for a picture with Congressman Burgess (center, right).

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On Aug. 17, a reception was held in honor of Congressman Michael Burgess, MD (R-Lewisville) at the Omni Hotel Colonnade. A number of topics were discussed, including: the post SGR landscape, ICD-10, physician-owned facilities, federal spending and taxes, and the Geographic Practice Cost Index (GPCI).

Many thanks to all the physicians and Alliance members who attended.

For local discussion on this and other legislative advocacy topics, consider joining the BCMS Legislative and Socioeconomics Committee by contacting Mary Nava at 210-301-4395 or mary.nava@bcms.org.

BCMS

The BCMS Value Proposition

By Stephen C. Fitzer, BCMS CEO/Executive Director Why did you choose to practice medicine? Most of you will probably say that it is because you want to practice the art and science of medicine, help people, reduce suffering, make a difference in people’s lives and yes, make a living at it. When you decided to go to medical school, you had a vision of what it would be like. Now that you are a physician, you have realized that besides being a noble, sacred calling, medicine is a business. In fact, it is probably the most complex business there is because of all the regulations, varied interests and opportunities.

By now, you have realized that you can’t practice medicine alone. You need someone to make appointments, keep charts, file insurance, collect money, prepare patients for treatment, ensure you have enough supplies, and a thousand other tasks. You can control all these things as a team leader, but you may have also learned that being part of a group practice lessens the burden on the individual physician. It only makes sense.

Now enter the larger realm. Who watches out for your interests in the legislature? Who creates CME opportunities for you?

Who keeps you informed about trends in medicine? Who creates opportunities to get involved in creating and administering medical policy for all providers? Who takes care of community health issues? Who creates opportunities to interact socially with your peers? Who gives you a voice in the community? Who can give you access to people and methods for solving day-to-day problems in the practice of medicine? Organized medicine is the vehicle for collaboration and pursuing the common interests of physicians.

Most physicians belong to a specialty society to keep them up on technical skills in their medical niche. In fact, some physicians belong to multiple specialty societies to stay aware of developments. This makes total sense and is a demonstration of

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how physicians working together can share knowledge and experience to their mutual benefit and improve their craft.

The Bexar County Medical Society (BCMS) and the Texas Medical Association (TMA) are not specialty societies; they are geographical, community based societies with different purposes from specialty societies. BCMS and TMA are, for practical purposes, the same organization. To leverage influence, sync objectives and ensure commonality of purpose, TMA and all county medical societies in Texas act as a single organization at the state level while operating uniquely at the county level. This allows counties to meet local community needs but defend the practice of medicine at the state level where legislation, medical licensing, policing of insurance and the like take place. It just makes sense that some things are better handled at the state level, while some things are better handled at the county level.

TMA has the scale (50,000 members) to gain the ear of state and national leadership on issues of great importance to the practice of medicine. Sometimes, to increase clout, specialty societies join TMA on issues common between them and TMA to further influence state entities relative to medical affairs. The Texas legislature listens to TMA (and therefore local county medical societies by inclusion) on matters that impact patient care, physician practice and community health. No other physician organization in Texas has as much clout as TMA in influencing a physician’s practice of medicine.

We all remember the great battle fought for tort reform in 2003. Because TMA rallied physicians of all specialties across

BCMS

New BCMS building groundbreaking on March 30, 2015. L-R – Dr. Maggie Beato; Councilman Ron Nirenberg; Dr. Jim Humphreys; Dr. Gerardo Ortega; County Judge Nelson Wolff; Dr. Jayesh Shaw; Dr. K. Ashok Kumar; and Steve Fitzer.

the state to enable this sensible grounding of liability in the practice of healthcare, this reform passed and became law. It has served patients and providers well for 12 years now. But there are many other unheralded victories won each year through the efforts of TMA/BCMS to protect medicine; billing and collection issues, scope creep issues, tax issues, liability issues, medical science issues, moral issues, community health issues and more.

If there was no TMA and no County Medical Society, who would the state leaders listen to when making decisions? There would be no major, united physician voice. Therefore, the dominant voices would be those of financial and business interests.

Some may think that all this big-picture stuff will happen whether or not they are a member of TMA/BCMS. Well, it’s a bit like saying “Why Vote?! The chance that one vote will swing an election is unlikely, so why vote?” Well, if you don’t vote, then you are letting someone else determine your future, or at least the terms of your future. Shaping the future of medicine is EVERY physician’s charge. Protecting the practice of one specialty has its place, but the big picture of medicine requires every physician’s attention. Getting involved with TMA/BCMS gives each physician a bigger voice by influencing and educating, but also listening to other practitioners.

At the county, BCMS level, you have all the benefits of being

part of TMA, combined with the opportunity to influence medical affairs locally. BCMS also offers services and benefits at the county level that cannot practically be carried out at the state level. Committees that bring together all facets of medicine in our community are formed locally, including public health, emergency preparedness, socioeconomics, legislative, medical-legal, physician health and rehabilitation, communications, censors, mediations, etc. This gives physicians opportunities to get involved and effect change. The committees in turn impact statelevel committees and councils at TMA. BCMS also provides local services including things such as a concierge automobile buying/leasing/financing service, social events, CME events, speaking opportunities, discounts on services, community service opportunities, philanthropic opportunities, local San Antonio Medicine magazine, weekly communications and much more.

After your group practice, organized medicine is one of the only opportunities you as a physician have to combine your voice with those of others and influence the conditions under which you practice. Turning away from this collaboration, crossing your fingers or just leaving it to someone else to do is a foolhardy strategy. TMA/BCMS gives you scale and makes your voice heard.

Join, participate and prosper! visit us at www.bcms.org

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BCMS

Bexar County Medical Society’s New Home The new building for BCMS is the place where physicians will meet, collaborate, strategize and socialize. It is located at 4334 N. Loop 1604 between Lockhill Selma and N.W. Military Highway. The new building will be open to all member physicians as a resource and will be a place where they can hold meetings and where they can receive and give direction for the betterment of the delivery of medicine.

The building houses BCMS, its 501(c)3 charitable companies (BCM Library Association and BCMS Foundation), the BCMS Alliance, the BCVI credentialing business, the Auto Program, the Circle of Friends liaison, as well as all the staff that serve physician members. Committee meetings will be held here as will social events. It is open to physicians as their house, a place that pays tribute to the practice of medicine and the Society’s historical impact in Bexar County.

The BCMS staff will be moving into the new building early next year. A grand opening is tentatively being scheduled for next spring.

How to Give Please make a hassle-free, completely painless, absurdly easy, 100 percent — tax deductible, and greatly appreciated donation today!

The Bexar County Medical Society accepts gifts via check, credit card, cash, stock, or other tangible assets, to the BCMS Capital Campaign.

Gifts can include multi-year pledges, monthly debits, bequests, and year-end gifts.

Major donors will be recognized on the Donor Wall in the lobby of the new building and in various other ways.

Mail donations to: Bexar County Medical Library Association 6243 W. IH-10, Ste 600 San Antonio, TX 78201 All donations are 100 percent tax deductible.

Please make the check payable to Bexar County Medical Library Association, Tax ID 74-0510530.

For more information call 210-301-4383.

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BCMS

Bexar County Medical Library Association The Bexar County Medical Society (BCMS) began as a shared library used by Bexar County physicians. This takes it all the way back to 1853. Before there was an executive director managing the affairs of the Society/Library, there was a head librarian.

The Bexar County Medical Library Association, officially established in 1920, was reorganized in 1982 and again in 1997. It is a non-profit corporation organized exclusively for charitable, educational and scientific purposes. All active practicing physician members of the Bexar County Medical Society are members of the Library Association.

In 1968, the Library donated its extensive collection of historically significant and valuable books to the Medical School for the Dolph Briscoe Library and the P.I. Nixon collection in particular. As a result of this major donation, all Medical Society members have access to the Medical School’s library. Although few books remain in the Medical Society’s library, there is quite a collection of medical journals.

The Library Association provides a charitable venue for cosponsorship of conferences, symposiums and other medically related educational programs.

Today, the information age has reduced the need for physical books and magazines, so the original purpose of the Library has

changed. Now the Library serves as the entity that not only stores and displays historical books and equipment, but manages the building for the benefit of all BCMS affiliated companies and organizations. This includes BCMS itself, the BCMS Alliance, Bexar Credentials Verification Inc., the BCMS Foundation and BCMS Real Estate Holding Company. The Library is also the entity that provides free continuing medical education (CME) to member physicians at general membership meetings along with opportunities to meet together in committees to guide the paths in areas like socioeconomics, emergency medicine, physician-tophysician issues, physician-patient issues, physician health and rehabilitation, publication of physician news, etc.

The BCM Library Association is sustained largely through donations from physicians, companies and individuals who support the practice of medicine. The Circle of Friends program is the entity that receives donations to enable the continued operation of the BCMS building and support of its sponsored activities.

Physicians are invited to use the BCMS Library Association building for their purposes in providing medical care and in the ambassadorship of medicine.

Bexar County Medical Society Foundation The Bexar County Medical Society Foundation was founded in 1995 with a grant from the Methodist Foundation. Its original mission was to encourage students finishing high school to consider a profession in a medical field. It is in the common interests of physicians, hospitals and patients to ensure future staffing needs for the practice of medicine are met. Over the past 20 or more years, the BCMS Foundation has given away many hundreds of thousands of dollars in scholarship monies to graduating students with plans to serve in a medical field. In addition, the Foundation has given large sums to the medical school to help BCMS, BCMS Alliance and BCMS Foundation scholarship recipients meet the needs of medical students.

The Foundation achieves its goals by wisely investing the Foundation’s endowment fund, as well as by holding fundraising events such as galas and golf tournaments and with donations from Bexar County businesses who support the Foundation’s mission. Philanthropy is part of the practice of medicine, and BCMS is proud to support and encourage future providers.

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BCMS ALLIANCE

Bexar County Medical Society Alliance The Bexar County Medical Society Alliance offers community outreach events, social functions and support events for physicians and volunteer opportunities.

The BCMS Alliance was founded as the Auxiliary to the Bexar County Medical Society on Oct. 29, 1917, at the Menger Hotel “to create fellowship among the families of physicians and to foster activities in benevolent, philanthropic, charitable and patriotic endeavors.” As the Alliance enters its 98th year, a hearty welcome is extended to new members and an invitation to physicians and their spouses who are not yet members to join the Alliance.

In 2015, the Alliance continued its philanthropic endeavors, which include “Be Wise…Immunize” program, “Hard Hats for Little Heads” outreach and the Junior Volunteer Council (JVC).

The JVC, which was created in 2014, is composed of high school-age students who are children of members of the BCMS Alliance and/or BCMS. It is a student volunteer organization for

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those youth interested in serving the Bexar County community in a volunteer capacity.

New and old members are encouraged to sign up and serve as an Alliance committee chair or committee member. Committees include Doctor’s Day, Book Club, Yearbook, Hospitality and others. In today’s world, time is precious. Any level of participation is welcomed.

Alliance events each year typically include the BCMS/BCMS Alliance Officer Installation, a New Member Welcome Luncheon, and a Past President’s Luncheon.

When the Texas Legislature is in session, Alliance members also participate in TMA’s First Tuesdays’ program.

BCMS EVENTS

BCMS

Meetings and Social Functions The Bexar County Medical Society’s first and foremost mission is to protect the general practice of medicine and most importantly to protect the physician/patient relationship.

General Membership Meetings – Some of the BCMS meetings during a calendar year are designed to provide Elizabeth and Dr. Jose Benavides enjoy dancing at the Installation continuing medical education (CME), free of charge, to of Officers. member physicians. These are called general membership meetings and there are usually two to three of them per and is open to physicians, physician spouses, Circle of Friends year. They typically deal with issues that affect most of our memsponsors, and supporters of medicine. It honors women in medbers and medicine generally. These meetings are free to BCMS icine, including a speaker, a fashion show and great lunch. This members and are frequently underwritten by generous supporters is a fundraising event that has a small charge attached to it for atof physicians and medicine. tendees.

Installation of Officers – The newly elected officers and Board BCMS Auto Show – BCMS has been offering a free concierge of Directors of BCMS, the BCMS Alliance, and the BCMS automobile service to its members for over 30 years. In October Foundation are celebrated in January of each year. This is a fun, of each year the San Antonio car dealers bring their newest modwell-attended, social event open to members and spouses honorels to the medical society building for display. Members and their ing these dedicated volunteers with great food, short speeches, families are invited to attend to socialize, inspect the latest model and lots of mingling. Again, this event is frequently underwritten cars and enjoy great food and music. This event is also a sponby generous supporters of physicians and medicine. sored event free to members.

New Member Welcome – This is a complimentary, well-atRockport Fishing Trip – BCMS organizes a fishing trip to tended social function honoring new members of the Bexar Rockport each year for BCMS members and guests, along with County Medical Society. It is held in nice venues and comes sponsors. The cost of the trip is paid for by each attendee includwith great food and social interaction. The program is minimal, ing housing, meals, fishing guides, etc. It is usually limited to but may include something like recognizing student scholarabout 25-30 individuals because of the limited availability of fishships given away by the BCMS Foundation and BCMS Aling guides. liance. This event is underwritten by generous supporters of Please contact BCMS at 210-301-4391 with any questions you physicians and medicine. may have, or see the details online at www.BCMS.org.

Women in Medicine – This is a large, fun event held each fall visit us at www.bcms.org

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BCMS

Communication Tools Available Free to Members Physician & Medical Directory The BCMS Physician & Medical Directory is published annually

by BCMS as a service to our membership. In it is found valuable physician contact information, NPI numbers, committee and staff information, health services information and much more, carefully gathered to help your practice run more efficiently. One copy is provided free of charge to each member. Additional copies of this important guide also are available for a nominal fee.

Find a Doctor Online and by Phone The BCMS Physician Referral Service is a free community benefit that pairs patients with physicians. The “Find a Doctor” physician referral service on the BCMS website (www.bcms.org) offers patients the names and photos of member physicians and important information, including specialties, whether accepting new patients, types of insurance accepted, business hours, languages spoken, etc.

BCMS receives hundreds of calls to 210-301-4391 and online “Find a Doctor” searches each month by patients needing a physician(s). From the “Find a Doctor” page online, visitors to our website can also find information about whether they may qualify for Texas benefits like Medicaid, CHIP, SNAP (food stamps) or cash help for families (TANF).

Online Classified Advertising BCMS offers free, medical-related classified advertising on its website (www.bcms.org) for members seeking employment, selling equipment, offering space for rent, looking to buy or sell a practice, etc.

DocBookMD DocBookMD is a smartphone platform designed by physicians for physicians. DocBookMD provides doctors on the go an exclusive, HIPAA-compliant professional network to connect, communicate and collaborate.

Features include: • On-demand, encrypted messaging • Multimedia collaboration enabling users to securely send images of X-rays, EKGs or wounds • A directory of county medical society colleagues and a pharmacy directory • Use on multiple devices including iPhone, iPad, iPod Touch, or Android • Physician members can also add their “care team” to communicate in a HIPAA-compliant manner.

monthly, San Antonio Medicine is distributed to more than 4,500 physicians and medical professionals throughout Bexar County by mail and both the current issue and archived issues are available to read online. These physicians and health professionals, in turn, contribute articles to the publication in the spirit of advancing medical knowledge and strengthening the bonds of the local physician community.

Members of the BCMS Communications/Publications Committee approve editorial content for San Antonio Medicine. Each monthly issue typically includes monthly thematic articles, medical society news, lifestyle features, practice management information and more.

Subscriptions to San Antonio Medicine are free of charge to society members. Additional subscriptions are available for purchase by calling 210-301-4391. For more information, email editor@bcms.org.

Communication Tools and Services Available for Members for a Nominal Fee The Bexar County Medical Society can help you communicate with members of BCMS through our complete mailing service or by purchasing mailing labels, distributive faxes or distributive email services. These services allow you to communicate such announcements as the opening of your new practice or a recent relocation to a new practice, etc.

Complete Mailing Service Features • BCMS takes care of stuffing, addressing envelopes, and affixing postage and delivering to the post office • Mailing addresses updated continuously • Printed labels • Sorted mail to specific audiences such as specialties, zip codes, age, gender, and ethnicity Benefits to Users • Hassle free, efficient and cost effective mailing services • Assurance of up-to-date data • No paying for nonessential information • Specific market targeting Book Binding Services Do you still prefer books to online or electronic journals? The BCMS Bookbinding Service is for you. Drop off your journals at BCMS or call to make arrangements for us to pick them up and we will handle getting them bound for you to put on your bookshelves.

San Antonio Medicine Magazine San Antonio Medicine is the BCMS monthly print magazine, with news and features oriented toward physician-members. Published 20 San Antonio Medicine • October 2015

For more information or to take advantage of these services please email membership@bcms.org or phone 210-301-4371.

Complimentary Concierge Auto Program The BCMS Concierge Auto Program has been serving physicians, family and staff for over 32 years!

Thousands of vehicles have been delivered without hassle or red tape. Our concierge service takes your vehicle specifications and locates the perfect vehicle. You get the MSRP and BCMS price before you make a trip to the dealership. You don’t have to endure hours of negotiating or back-and-forth trips between a sales representative and a manager to get the best deal.

Our participating dealerships understand the value of “red carpet” treatment for sales today as they work to win your business in the future. We have third generation buyers who use the Auto Program just like their parents and grandparents have over the years. Saving money never gets old.

Financing is available through cooperating lenders with current rates as low as 1.65 percent for new vehicles. Their low rates are even offered for pre-owned vehicles as old as 2006 models! But be assured, if the dealer/manufacturer offers a lower special finance rate (like 0 percent), then the lowest rate will always be made known to

BCMS AUTO PROGRAM

you. (Rates change and are subject to approved credit; the 1.65 percent requires a credit score of 740 or higher). Residents and medical students are always assisted with the purchase of a vehicle and the securing of financing even where there is limited credit history.

Commercial leases are available for those physicians who use a vehicle for business more that 51 percent of the time. This lease works for more expensive vehicles (over $50,000), as standard IRS mileage rates cover vehicles under $50,000. This lease offers a “bargain buyout” at the end of the term and has no mileage limits.

In October each year, the Society holds the annual BCMS Auto Show at the parking area adjacent to our offices, where dealers display over 100 new vehicles. That, combined with good food, cold drinks and live music, makes for a great evening.

Questions? Call Phil Hornbeak, BCMS auto program director, at 210-301-4367.

visit us at www.bcms.org

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BCMS

BCVI facilitates credentialing for healthcare providers Bexar Credentials Verification Inc. (BCVI), the credentials verification subsidiary of the Bexar County Medical Society, slashes the time, aggravation and expense of verifying the necessary credentials on San Antonio physicians for the area hospitals and managed-care organizations that require them.

The objective of credentialing is to ensure the highest quality care for patients through the detailed verification and review of a physician’s background, training and experience. All physicians must go through a formal credentialing process to gain “privileges” with the locations and health plans through which they treat patients.

Primary source verification involves contacting the original source of education, training, licensure and other physician and allied health professional credentials. BCVI provides primary source verification of credentials data that meet The Joint Commission (TJC) and the National Commission for Quality Assurance (NCQA) for Credentialing Verification Organizations criteria for healthcare entities.

Last year, BCVI’s systems and files were reviewed for accuracy and quality control by the NCQA. BCVI received the highest possible scores with no adverse findings in any category for which it applied for certification.

“BCVI is the industry leader for health facility primary source verification,” said BCVI director of operations Mary Jo Quinn. “Our goal is to overwhelm our current customers with satisfaction and to encourage those who are currently not part of the team to join.”

Among BCVI’s local participants are area hospitals, healthcare facilities, surgery centers and group practices.

To learn more about BCVI, contact its director at 210-582-6355, email mjquinn@bexarcv.com or visit http://www.bexarcv.com/.

BCMS General Counsel In the practice of medicine as well as in the administration of affairs relative to its practice, physicians often find themselves in need of legal advice.

Rick Evans has served as the general counsel for BCMS for over 35 years advising the Society, its leadership, its physician members and staff to operate within safe, legal guidelines. The general counsel also provides guidance to members on how they should approach legal matters or whom they might consider employing as counsel, whether the physicians are plaintiffs or defendants. This guidance is free to physicians. While BCMS’ general counsel is not seeking to represent individual physicians per se, he does serve as a valuable resource to physician members as they decide how to respond to legal matters they encounter while practicing medicine.

Evans is the founding partner of Evans, Rowe & Holbrook in San Antonio. A graduate of Marshall College of Law, he has been exclusively dedicated to the representation of physicians and other healthcare providers for 36 years.

22 San Antonio Medicine • October 2015

visit us at www.bcms.org

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BCMS

BCMS PH&R Committee

The Physician Health and Rehabilitation (PH&R) Committee’s goal is to encourage and guide doctors with substance use disorders in order to facilitate the recovery of the impaired physician. PH&R is a confidential committee of physician colleagues that identify and facilitate recovery success for other physicians whose abilities are impaired by alcohol or drugs, through support and monitoring, to help the impaired doctor to return to practice and home life free of alcohol and drugs. We help these doctors learn how to cope with the stresses of modern medical practice with a manner of living which is safe, calm, and at peace without the need for their former coping mechanisms which led them into an addictive lifestyle.

The BCMS PH&R Committee provides responsible, confidential advocacy to designated medical boards, hospital PH&R committees, credentialing authorities, and others at the request of the participants who maintain compliance within our program. The PH&R Committee monitors physicians to ensure they are safe to practice medicine.

The BCMS PH&R Committee has set the standards for other programs across the state. In the 26 years of its existence the committee has helped hundreds of physicians successfully recover while keeping patients safe. Those being helped are able to safely practice medicine and return to their families and practices whole again and renewed.

More information is available at www.bcms.org/committees/phr.html, by calling 210301-4373 or emailing PH&R@bcms.org.

Dr. Oliver Johnson, the current chair of the PH&R Committee, is a Board Certified Anesthesiologist in private practice with Star Anesthesia for the past 26 years. He has been chairman of the BCMS PH&R Committee since 1999. He lives in San Antonio with his wife and 6 children. He is a photographer having traveled to France, Italy, Sicily, and around the US on photoshoots with other photographers. His work appeared in the San Antonio Medicine magazine in the February 2015 edition.

Recognition (Unsung Hero) The members of the Bexar County Medical Society have often expressed how invaluable their staff members are to their practice.

An office manager is the person that often supervises the office staff, ensures superior customer service, and manages the medical billing team. These unsung heroes are the right hand of the practicing physician. They ensure that all functions of the office are in order.

For that reason, BCMS created the Unsung Hero Award as a way to recognize the hard work, dedication and commitment of the office staff in the physician practices.

This program allows the physicians to show their appreciation for the contributions these staff members offer to them. Recognizing the contributions that these employees make to the physician practice encourages hard work, dedication and loyalty to the practice.

In the long run, this recognition helps the physician members of BCMS have a solid foundation to offer the best patient care and trust that their staff members will work hard to support them.

If you would like to recognize a staff member in your practice, please visit the BCMS website at www.bcms.org and click on the Member Services tab or call Brissa Vela at 210-301-4371.

24 San Antonio Medicine • October 2015

BCMS

BCMS Board of Censors The BCMS Board of Censors supervises the medical ethics of members and offers members counseling when warranted. This board examines applicants for membership, investigates allegations of code of conduct violations and charges if and when indicated. The Board of Censors works with the Board of Mediations to ensure each case is properly investigated, examined and adjudicated.

As provided in the Texas Medical Association Hearings Procedures Manual, the Board of Censors shall have the authority on its own initiative to investigate suspected violations of the code of conduct and to refer charges when indicated after thorough investigation. The board shall receive the investigative charges of unethical conduct made against Society members by another member, and shall, upon request, review the findings of the Board of Mediations and make proper disposition of each case.

Board of Mediations The BCMS Board of Mediations receives, investigates and mediates complaints from patients, insurance companies and the general public brought against Society members, including matters of unprofessional conduct, ethical violations or other matters involving the physician/patient relationship.

The most common complaints received on behalf of the public include: Inability to directly communicate with the physician. This comes up frequently as patients commonly expect to be able to just call up their physician whenever and have him or her put on the phone immediately. In reality, of course, we recognize that a physician must be able to run their practice efficiently. This is a difficult problem but it can be minimized by ensuring that the front office staff which fields the phone calls can answer questions reasonably and are able to triage incoming calls effectively and courteously.

Poor front desk attitude/customer service. This is similar in many respects to the first item in this list. Bear in mind that patients are either ill at the time of their visit and probably not at their best or have been shuffled through the medical bureaucracy and may have had to make one or more office visits to even get into your office. They may have been sitting in your waiting area for a while (or even quite a while) unless they had the first appointment of the morning. It is especially important for your front office staff to be as efficient, patient, and understanding as they can be to minimize patient dissatisfaction.

Inability to obtain medical records. Patients often don’t understand HIPAA and other regulatory requirements governing the handling of medical records. This lack of familiarity can cause a great deal of frustration for the patients and your staff. At the initial request for records it is important for your staff to be clear about the specific legal requirements to obtain the records and to then set and meet appropriate expectations.

Physician arrogance/poor bedside manner. Your best bet is to be as friendly and polite as you can. Remember the old saying, you can avoid more TMB administrative hearings with honey than you can with vinegar.

Cannot find a physician accepting government insurance. This is a problem that will likely only get worse as reimbursement drops in concert with the relentlessly increasing regulatory burden. This is a business and philosophical decision for each practice.

Board of Censors and Board of Mediations members are elected and must have been members in good standing with BCMS for at least 10 years. For more information on how either board can assist you please call 210-301-4371. visit us at www.bcms.org

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BCMS STAFF

Your BCMS staff...

Working for you everyday.

Seated around the table (L-R) Brissa Vela, Betty Murphy, Patsy Ramirez, Betty Fernandez, Lucy Escobar, Mary Nava, Mary Jo Quinn, Alice Sutton, Melody Newsom, Yvonne Nino, Cindy Barron, Terry Colwell, Liz Ramos. Standing (L-R) Mark Lachenauer, Kris King, Clemente Sanchez, August Trevino, Steve Fitzer, Phil Hornbeak, Al Ortiz, Ismael “Smiley” Flores, and Mike Thomas.

26 San Antonio Medicine • October 2015

BCMS

BCMS physicians and staff meet with State Rep. Lyle Larson (second from right).

Texas Medical Association Resources Available for Physicians As a member of TMA/BCMS there is a wealth of resources available to help you in your practice. Many of these resources are available free as a benefit of membership while others that help with more complex issues in your practice are available for a minimal cost.

The newest FREE resource is an ICD-10 Code Search Tool which can help with the migration to ICD-10. This free Members Only tool provides you and your staff with the ability to apply the right ICD-10 coding at the point of patient contact, improving the rate of accepted claims and reducing frustration. Using a combination of keyword filters, anatomical locations, gender, and age, the tool offers a highly intuitive way to build a narrow list of billable ICD-10 codes based on user preferences.

Having trouble with insurance related problems? TMA has the Hassle Factor Log program available to you. The collection and analysis of member complaints continues to benefit members by allowing TMA to document and respond to reimbursement hassles.

TMA helps resolve issues with insurance companies by meeting regularly with Medicare, Medicaid, health care payment plans, and large insurers to discuss specific problems brought to their attention

through the Hassle Factor Logs.

Have an urgent question that you need answered? The TMA Knowledge Center is available to you by calling 800-880-7955 or by email at knowledge@texmed.org for answers and information about regulatory compliance, coding, seminars, workers’ comp, claims payments, legislative priorities, etc.

The TMA Education Center offers convenient, one-stop access to the continuing medical education (CME) Texas physicians need.

Log in using your TMA website username and password to automatically receive member pricing. There are over 31 online categories to select from or you can request TMA experts to come to your practice to provide CME onsite. The categories range from billing, documentation, EMR/HER, legal, leadership, human resources, quality, just to name a few. You can also view and print the materials you need.

TMA has a very knowledgeable and professional staff, a great legal team and legislative advocacy team that are resources for you when you need them.

For information about these and all the other resources available to you as a member visit www.texmed.org. visit us at www.bcms.org

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BCMS BCMS Groundbreaking Ceremony on March 30, 2015.

L-R – Former Shavano Park Mayor David Marne; BCMS CEO Steve Fitzer; San Antonio Mayor Ivy Taylor; City Councilman District 8 Ron Nirenberg; County Judge Nelson Wolff; BCMS Immediate Past President Dr. K Ashok Kumar; and current BCMS President Dr. Jim Humphreys.

Jayesh Shah, MD, and Rajam Ramamurthy, MD, at the New Member Welcome event.

Gary Nelson, Dr. Paul Geible and Dr. Brian Schulze pose with the “Catch of the Day” at the BCMS annual fishing trip.

28 San Antonio Medicine • October 2015

Drs. Otto Kruger, Roberto San Martin and Albert Sanders catch up at the BCMS Family Picnic.

Lan-Anh Ngo, MD, Chelsea Jewette and Chelsea Clinton, MD, get ready for their runway debuts at the Women in Medicine Celebration and Fashion Show.

BCMS Dr. Jesse Moss and friends having fun at the BCMS Installation of Officers event.

BCMS physicians meet with Texas House Speaker Joe Straus.

Members and guests of the BCMS Medical Dinosaurs with past BCMS President Rajam Ramamurthy (center), MD. L-R – James Forster; Estrella de Forster, MD; Jose Benavides, MD; Albert Sanders, MD.

visit us at www.bcms.org

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BCMS COMMITTEES

BCMS Committees Each year, BCMS members are given the opportunity to participate in a rich diversity of committees that impact the practice of medicine in Bexar County, Texas and beyond.

Because active participation in BCMS strengthens the voice of organized medicine, we encourage all members (including medical students, residents and fellows) to participate on BCMS committees and help make an impact on the role BCMS plays in the medical community.

Membership Committee Membership is the heart and core of any organization and BCMS is no different.

For over 150 years, the Bexar County Medical Society’s membership has been instrumental in innovating, growing and developing the honored practice of medicine in our community.

When BCMS was chartered back in 1853, there were legitimate fears about the practice of medicine.

But thanks to the vision and leadership of a group of pioneering physician leaders, the Texas Medical Association (TMA) was formed to regulate medical education in Texas and help patients in need of care. Dr. George Cupples, a very well-known and respected San Antonio physician, was one of the founders of TMA and BCMS and became the very first president of BCMS in 1853.

Since then, the Bexar County Medical Society has focused on providing the required training of its physician members and the education of the local community to prevent deceitful and improper patient care. It also provides a forum for Bexar County physicians to meet and discuss the needs of the medical profession and the advances in medicine.

Today, BCMS physicians continue to support their peers through their membership and the many opportunities that BCMS provides for them to be involved in the medical community including: Networking Opportunities. By joining the Bexar County Medical Society you will be provided with many opportunities to create and deepen existing personal relationships. Your membership will allow you to establish ongoing relationships with your peers. These business relationships will inevitably serve as a great source of advice, referrals, inspiration and friendship.

Continuing Education. Bexar County Medical Society physician members strongly believe in the term of “knowledge is power.” Throughout the year we offer several options for continuing education general membership meetings. There are also legislative update sessions that the Texas Medical Association offers 30 San Antonio Medicine • October 2015

as well as online webinars on trending medical topics.

Member exclusive online resources. A member only benefit which includes exclusive contents such as best practices recommendations via the Weekly Dose e-newsletter, job postings, classified ads, etcetera.

Opportunity to lead. By becoming a member of the Membership Committee you will be part of a great tradition of leaders and visionary physicians who have helped shape and support the practice of medicine in Bexar County since 1853.

For more information about the membership committee and how to become part of it, please contact Brissa Vela, BCMS membership director at 210-301-4371.

Stephen Ramirez, MD, and Lance Jackson, MD, enjoy networking at the New Member Welcome event.

BCMS COMMITTEES

Members of the BCMS Executive Committee after their selection by the Nominating Committee: L-R: Maria Tiamson-Beato, MD, Jayesh Shah, MD, Adam Ratner, MD, James Humphreys, MD, K. Ashok Kumar, MD, Stephen Fitzer, and Leah Jacobson, MD.

Nominating Committee It is the charge of the BCMS Nominating Committee to study the challenges and leadership requirements of the organization.

Meetings of the committee are held at least two times a year and as often as necessary.

As outlined in the BCMS bylaws, the structure of the Nominating Committee consists of the two immediate living past presidents, president-elect, the chairs of, or a designee from, the Board of Mediations and the Board of Censors, and two at-large members elected by the membership. The past president once removed serves as chair. The vice chair is the immediate past president.

Each year, in accordance with the BCMS bylaws, nominations are sought for leadership positions for the upcoming year (or years, depending on the position) for BCMS. Leadership positions that are filled by elections are president-elect, vice president, secretary, treasurer, three members of the Board of Directors, two members of the Board of Censors, five members of the Board of Mediations, two at-large members of the Nominating Committee, and approximately one-half of the delegates and alternate delegates to the Texas Medical Association (TMA).

Each of the candidate’s qualifications are reviewed and approved by the BCMS Nominating Committee prior to notifying the membership of the slate of nominees for their consideration and vote. Qualifications for the various positions include officers of the Society (president-elect, vice president, secretary and treas-

urer) must be active, dues paying members who have been members of the Society for a minimum of five years and for the office of president-elect, candidates must have served a minimum of three years in an elected position or as appointed chair of a BCMS committee.

For the Boards of Mediations and Censors each position is elected for a term of three years and the member receiving the largest number of votes at the time of election shall become the chair of the board during the third year. The vice-chair will be the person receiving the second highest number of votes at the time of election. Nominees for the Boards of Mediations or Censors have to be active members in the Bexar County Medical Society for at least 10 years.

Delegates and alternate delegates to TMA serve for a term of two years with no limit to the number of terms they serve.

Occasionally a situation arises when a change to the BCMS bylaws or constitution needs to be considered. Amendments can be proposed by the Board of Directors, or by a petition endorsed by any 25 members eligible to vote. At that time, the Nominating Committee becomes the Constitution and Bylaws Committee and the committee evaluates as to appropriateness for inclusion in the Bylaws of the Society. After fulfilling its responsibility, the Committee will issue a report to the Board of Directors on proposed amendments. visit us at www.bcms.org

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BCMS COMMITTEES

BCMS Legislative and Socioeconomic Committee Survey after survey shows that the No. 1 reason physicians join the Bexar County Medical Society is to support organized medicine and have a strong political voice.

The BCMS Legislative and Socioeconomics Committee is charged with the following actions: • Develops, contests, monitors and implements legislative policy at the local, state and federal levels • Studies, recommends, monitors and engages in activities related to the socioeconomics aspects of medical practice management, regulations and managed care issues, including participating in meetings/forums with health plans • Meets with elected officials of the Texas Legislature and Congress to keep them informed on medicine’s issues • Participates in meetings with members of the Texas House of Representatives and Senate during First Tuesdays visits to the Capitol in Austin during legislative sessions • Works closely with the Texas Medical Association (TMA) to develop and support the TMA legislative agenda TMA’s First Tuesdays program began in 2003 with the 78th Legislative Session. During each legislative year, physician members and BCMS Alliance members join together and visit with each of the House and Senate members from San Antonio in their Austin offices. First Tuesdays attendees witness first-hand how they can make a difference through their participation to make their voices heard on medicine’s issues affecting patients and physicians. Also during First Tuesdays, our group joins with other TMA and TMA Alliance members from around the state. Everyone walks together to the Capitol; physicians wearing their white coats. The impression created by a sea of white coats in the halls of the Capitol is talked about repeatedly by legislators and their staffs.

During legislative sessions, issues may arise that require additional actions such as writing letters and making phone calls to legislator offices; attending hearings to register our position on legislation or testifying in person in support of or against legislation under consideration and/or displaying support for legislation of importance to medicine being carried by our legislators in San Antonio or other parts of the state.

During the interim sessions, committee members meet with elected officials on an individual basis to continue discussions on

32 San Antonio Medicine • October 2015

issues of importance to medicine. These meetings are informal, and are an opportunity for physicians to visit face-to-face with incumbents and candidates to get to know each other and learn about each other’s stand on issues.

To learn more, visit www.bcms.org/advocacy or to join the committee, contact Mary Nava at mary.nava@bcms.org.

Physicians meeting with Rep. Joe Straus, R-San Antonio, at the BCMS offices.

BCMS physicians meet with State Rep. Justin Rodriguez.

BCMS COMMITTEES

Delegation Committee at work reviewing resolutions prior to TexMed.

BCMS Delegation to TMA The BCMS Delegation to the Texas Medical Association (TMA) is a group of elected members who serve as voting delegates, representing Bexar County in the 472-member TMA House of Delegates, the legislative and policy-making body of the TMA. Presently, the Bexar delegation is officially represented by 37 voting members. Each county medical society (CMS) is allotted one delegate per 100 practicing members or a fraction thereof. The number of delegates allotted can fluctuate as delegate count is dependent on the number of members in active practice each year.

Alternate delegates round out the delegation and stand ready to fillin and move up to delegate status, in particular during the TMA’s annual meeting, TexMed, where it is crucial that as many voting delegates be in attendance as possible, in order to adequately conduct the business of the House, and, especially if we have a physician delegate who is running for an officer position within the TMA House of Delegates, as we did this year with the re-election of David Henkes, MD to the TMA Board of Trustees.

Additional votes for each county medical society delegation come from the ex-officio categories: members of the Board of Trustees, 15 councilors, Texas delegates and alternate delegates to the American Medical Association, members of the Council on Legislation and chairs of the other councils, delegates from the Young Physician Section, International Medical Graduate Section, Resident and Fellow Section, and Medical Student Section, and delegates of selected specialty societies.

The county medical society delegations to TMA are the grassroots levels of organized medicine. Each year, physicians across the state are given the opportunity to serve on TMA committees and councils. It is in these groups that policies are developed and new ideas surface. In Bexar County, we look to our delegation to identify people willing to serve on these committees and councils. An idea or recommended change in ex-

isting policy can be presented in the form of a resolution to the BCMS Delegation to TMA. If the delegation agrees with the resolution, it is then voted on and moves on to the TMA House of Delegates for consideration during the next House of Delegates meeting.

The BCMS Delegation to TMA meets three times per year: one meeting is to review all BCMS resolutions submitted for consideration; another meeting is to review the TMA House of Delegates Handbook, which the Delegation reviews and takes a position on all resolutions submitted from around the state. All of this work leads up to TexMed, which culminates in the final vetting (in reference committees) of resolutions under consideration for adoption by the TMA House of Delegates.

There are always alternate delegate spots available. If you would like to join this group of leaders please contact Mary Nava at mary.nava@bcms.org.

visit us at www.bcms.org

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BCMS COMMITTEES

Dr. Lloyd Van Winkle volunteers his time helping Hurricane Katrina evacuees.

BCMS Emergency Preparedness Committee The Bexar County Medical Society Emergency Preparedness Committee works in conjunction with the San Antonio Metropolitan Health District (SAMHD) and with other San Antonio medical and emergency organizations to coordinate physician volunteers for significant, but unexpected, emergency situations affecting the community.

As a physician, regardless of specialty, you and your practice will be affected by any disaster impacting the community. The San Antonio area is vulnerable to natural disasters, especially tornadoes, floods and hurricanes, as well as to physically destructive man-made events such as air or rail crashes, chemical releases, radiological emergencies and infectious disease outbreaks. Each of these would require somewhat different responses. However, San Antonio is also a major hub for receiving evacuees from disasters elsewhere in our region.

The focus of the Committee includes organizational efforts to prepare for hurricane evacuations to Bexar County from various Texas coastal areas. The committee has also worked to create more detailed information on physician office preparation for pandemic flu and a variety of terrorist scenarios that also could occur in Bexar County. It is anticipated that Committee preparation 34 San Antonio Medicine • October 2015

will allow for a ready source of information that physician offices can rapidly assimilate in order to make decisions about how or if to participate in various disaster/terrorist situations when the time comes and to have a template to prepare for a pandemic flu episode.

The Committee meets six times per year and considers strategies to ensure staff resources and society processes are sufficiently organized to respond when the need arises. There are also additional opportunities to meet and participate with the other local planning committees and organizations such as the SAMHD, the Medical Volunteer Coordinating Committee (MVCC), Southwest Texas Regional Advisory Council (STRAC), as well as others.

The Committee develops a list of volunteers to contact when the need arises and also provides Incident Command System (ICS) ICS-100, 200, 700 training. These courses are available free online at http://bcms.org/committees/EmergPrep.html.

As a volunteer, you have the right to say “yes” or “no” to any requests for your services. You also have the right to decide how far you are willing to travel and how long you are willing to serve.

If you would like to sign up to be a potential volunteer, call Melody Newsom at 210-301-4363 or email bcms@bcms.org.

visit us at www.bcms.org

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BCMS COMMITTEES

Women In Medicine Committee The Women In Medicine Committee (WIM) was formed to help female society members build camaraderie with other female physicians and network within the organization, as well as to build community leaders.

Dr. Josephine Kingsley became the very first female physician to join the Bexar County Medical Society in 1873 and since then the influence and leadership of the female physicians in Bexar County has yielded great leaders. Amongst them is Dr. Diana Burns-Banks who became the first African American Board President of the Bexar County Medical Society in 2006. She is a well-known boardcertified pediatrician in San Antonio who has also served as a past chief of staff at Santa Rosa Children’s Hospital and has recently joined the Bexar County Hospital District Board of Managers. She was nominated by Bexar County Judge Nelson Wolff.

Dr. Rajam Ramamurthy was the very first Indian female Board President of the Bexar County Medical Society in 2004. She has held the titles of vice-chair of the American Medical Association Medical Graduate Section and has been the medical director for the Premature Infant Development Program at University Health System. She has also served as a professor of pediatrics at the UT Health Science Center in San Antonio.

The Women in Medicine Committee supports the efforts of the Bexar County Medical Library by fundraising to support the building of the new BCMS Headquarters.

We thank you for your interest and dedication to organized medicine! For more information on how to join the committee please call Brissa G. Vela, membership director, at 210-3014371.

Members of the committee pose after enjoying the fashion show and shopping.

L-R – Lan-Anh Ngo, MD; Leah Jacobson, MD; Linda Banta, MD; Chelsea Clinton, MD; Nancy Bryant, MD; N. Carol Dornbluth, MD; Maggie Beato, MD; Wendy B. Kang, MD 36 San Antonio Medicine • October 2015

BCMS COMMITTEES

Leaders of the delegation from the BCMS sister city medical association from Kumamoto, Japan visit with former BCMS presidents (pictured in their white coats) – Drs. Manuel Quinones, Don Gordon and Robert San Martin, chair of the BCMS International Committee.

BCMS International Relations Committee The Bexar County Medical Society has three international sister-city relationships. Under the leadership of the physician volunteers on the International Relations Committee, BCMS currently has sister medical society relationships with Kumamoto, Japan; Chennai, India; and Monterrey, Mexico.

The International Relations Committee works with the City of San Antonio to encourage international relations, potential affiliations, liaisons, and cooperative agreements with other medical societies throughout the world. This results in educational opportunities and cultural exposure for physicians as they understand better how medicine is practiced elsewhere around the globe.

The Kumamoto sister medical society relationship began in 1992; BCMS became a sister society of the Kumamoto City Medical Association and, in October, Dr. and Mrs. Neal Gray

and others flew to Kumamoto to sign the agreement. While there, Dr. Gray presented a lecture on U.S. medicine and spoke of the history of BCMS. The Chennai sister city relationship was established in 2008, when a delegation of physicians from Chennai came to San Antonio to formalize a cooperative agreement.

The Monterrey sister medical society relationship was established in 2014 when Dr. Roberto San Martin traveled to Monterrey to sign the Declaration of Cooperation with Colegio de Médicos Cirujanos del Estado de Nuevo León A.C. Participation on the International Relations Committee as well as travel to visit these international destinations is open to all members, and families are invited to travel with physicians on these international trips.

Medical Legal The Medical Legal Liaison Committee is a joint committee of the San Antonio Bar Association and the Bexar County Medical Society. Comprised of attorneys and physicians, the Committee focuses on issues common to law and medicine and further deal with potential or real conflicts between members of the two organizations comprising the Committee. Committee members are physicians and attorneys who have an interest in medical legal affairs. The education, training, and experience of its members enable the Committee to promote cooperation between the component societies and provides advice and assistance on common issues that may affect their members.

Through its resources, the Committee may make recommen-

dations to their respective societies in order to educate and assist healthcare and legal professionals.

The purpose of the Committee is to promote mutual respect, understanding and cooperation between the medical and legal professions. It develops an inter-professional code of ethics; reconciles differences between the professions when they arise; and promotes cooperation between the professions through discussions, conversations, debate, and written proposals Physician members are welcome to join the committee based upon interest in medical legal situations and information. This Committee meets at various local restaurants (Dutch treat) on the fourth Thursday, quarterly, beginning in January. visit us at www.bcms.org

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BCMS COMMITTEES

BCMS Communications/Publications The Communications/Publications Committee for the BCMS provides editorial direction and guidance for the San Antonio Medicine magazine. The monthly magazine is a service to the members of BCMS providing news, features and commentary on topics and issues of interest to the local medical community.

The committee meets regularly with the editor of the magazine to determine the themes for future issues and to review submitted articles.

The committee’s major function is brainstorming ideas and providing the give-and-take necessary for their development.

Occasionally, everyone is asked to read a submitted piece to see if it is suitable for publication. The meetings are not formal – no “Robert’s Rules of Order” – and everyone has a good time while eating a light supper and getting out about an hour or so later.

Members of the committee are not required to write articles

for the magazine, but they can if they decide they want to do so.

Most members have contributed material because it’s a subject that intrigued them. We’ve had pieces about members’ hobbies, travels, reminiscences, opinions of current events and interests that they happen to have that others don’t know much about.

Some of the most important contributions our members make occur when a theme is chosen and they know someone in the community who is an expert on the subject. Then they help us get in contact with that person and convince him or her to write it up for us.

The committee meets the first Wednesday of each month (unless it’s a holiday) at 6:15 p.m. in the BCMS office. Come and try us out…you don’t have to wait until next year. For more information, contact the BCMS staff editor who works with us: his contact info is below. Fred Olin, MD, is the chairman and he or the editor can be contacted at 210-582-6399.

San Fernando Health Fair BCMS Public Health and Patient Advocacy Chair John Nava, MD, discusses diabetes prevention at the San Fernando Health and Safety Fair.

Public Health and Patient Advocacy The BCMS Public Health and Patient Advocacy (PHPA) Committee is charged with evaluating and making recommendations to the BCMS Board of Directors and members about public health issues affecting our community and patient population.

Their most recent initiative undertaken was the prevention and control of cardiometabolic diseases (diabetes, hypertension, dyslipidemia and cardiovascular disease) as their priority community initiative. Working alongside numerous community organizations, the Committee hopes to assist in the prevention and control of cardiometabolic diseases in the community.

In past years, PHPA has been instrumental in community immunization programs and in planning for possible public health crises such as disease (H1N1, Ebola, etc.). Thinking about the present and future health of our community allows physicians to provide quality health care for their patients and serve the public.

38 San Antonio Medicine • October 2015

BUSINESS OF MEDICINE

Why Do Patients Use EHRs?

By Mohammed Sajedur Rahman and Dana A. Forgione

Electronic Health Records (EHRs) are expected to have a significant impact in transforming the healthcare professions. While physician practices and healthcare organizations are increasingly adopting EHRs (with some federal prompting), we don’t know a whole lot about why patients do, or do not, use this potentially helpful technology. There’s been a lot of EHR research on providers, but not very much on patients.

That changed recently with a groundbreaking study that focused entirely on patients.1 It used an “integrated causal predictive model incorporating theories from Information Systems, Health Psychology, and Organizational Psychology to understand the health-related factors as well as technology-related factors influencing patient’s behavioral intention to use EHRs.” That’s a mouthful, but the important issue for addressing meaningful use of EHRs is that it gets to the heart of patient behavior.

The study examined 44 variables, grouped into 12 major categories: (1) perceived information control, (2) perceived vulnerability, (3) perceived severity, (4) perceived self-efficacy, (5) perceived health information privacy concerns, (6) perceived health information security concerns, (7) perceived health benefits, (8) general health orientation, (9) cues to action, (10) perceived severity of illness, (11) behavioral intention, and (12) demographic/control variables. They were framed into a survey that was subjected to focus-group analyses, pilot testing, and passed with flying colors just about every rigorous validity test know to modern science. Then, with the cooperation of several healthcare organizations in the San Antonio area, 368 patients and other subjects were surveyed, and state-of-the-art statistical analyses were performed.

The upshot? Well, first let me tell you my personal (i.e., Forgione’s), informal replies: Passwords. Trust. Priorities. What do I mean? I mean at last count, I have more than 158 passworded venues that I have to keep track of. And they keep changing on me. I just cannot cope with any more passworded venues. When I receive an email from my physician about taking a look at my EHR, the minute it asks me to set up a username and password, I exit. I just can’t cope with any more passwords. Am I a-typical?

40 San Antonio Medicine • October 2015

Maybe. Next, Trust. I trust my doctor. I don’t feel a compelling need to check-up on my EHR data. Maybe that’s dumb, or just plain lazy. I know there are errors in every other electronic record I have. So eventually I’ll probably feel compelled to check on my EHR info too. But it hasn’t become a problem…at least not yet.

Which brings us to number three: Priorities. It’s not at the top of my priority list yet. I can hardly keep up with all my emails. I skim what looks like the most important messages, and have well over 10,000 emails I’ve never even opened (ouch, this is embarrassing). I suppose when a problem comes to my attention, I’ll get motivated to check my EHR info.

But now, the real results. Most of the tested factors were statistically significant, but the outstanding issues were … can you guess?

Information privacy and security concerns. People are worried about the privacy and safety of their health information. And no wonder. Healthcare.gov got hacked. The Vermont ACA health insurance exchange got hacked, several major health insurance company databases got hacked. Why, even the company that produces hacking software for government and law enforcement agencies, itself got hacked! By the way, all their confidential client list info got posted to the Internet and we discovered they were selling their hacking software to countries they weren’t supposed to be selling it to. So, maybe hacking the hackers was a good thing…

Well, anyway, one variable that had a moderating (but nonsignificant) effect was “severity of illness (health status emotion)” perception. When a patient gets sick or injured, they go to their doctor. If they’re severely sick or injured, they’ll have more billing and health records issues and thus more motivation for their family or support individuals to check their EHR. The issue with this one was likely that only one survey question was used to measure the effect, and it probably should have been multi-dimensional.

Oh well, it shows further work needs to be done in this area and leaves room for future follow-up studies. Researchers have to work too, you know.

Nonetheless, among the health-related factors, patients’ health benefit perceptions were found to have the strongest influence on their behavioral intention to use the EHRs, followed by cues to ac-

BUSINESS OF MEDICINE tion (in other words, what’s in it for me). The patients’ general health orientation and self-efficacy perceptions were also found to have a positive influence on behavioral intention, but the influences were not statistically significant. In addition, patients’ information control perceptions, vulnerability perceptions, and self-efficacy perceptions were found to be significant antecedents to their health information privacy and security concerns.

If you’d like to take a look at the survey, just let us know (Mohammed.Rahman@utsa.edu; dana.forgione@utsa.edu). And if you are interested in having your patients participate in future EHR surveys, it’s a great way to help demonstrate meaningful use of your EHR, because you’d be showing that you have actively sought input from your patients about your EHR and their perceptions about using it. That can lead you to ways to make it more valuable for your patients and your medical practice. And that’s really what it’s supposed to be all about, isn’t it?

on research projects with the School of Medicine, Department of Cardiothoracic Surgery, at the University of Texas Health Science Center San Antonio. His research interests are in healthcare information systems, as they relate to costs and quality of care.

Mohammed Sajedur Rahman, Ph.D., is an Assistant Professor of Information Systems at the Emporia State University in Kansas. He is a recent doctoral program graduate from the College of Business at the University of Texas at San Antonio. He has worked extensively

1 Rahman, M.S. 2015. Understanding Factors Influencing Intention to Use Electronic Health Records (EHRs): An Integration of Multiple Theoretical Perspectives. Doctoral Dissertation. College of Business, University of Texas at San Antonio, San Antonio, TX.

Dana A. Forgione, Ph.D., CPA, CMA, CFE is the Janey S. Briscoe Endowed Chair in the Business of Health at the University of Texas at San Antonio. He is also an Adjunct Professor in the School of Medicine, Department of Cardiothoracic Surgery, the Department of Pediatrics, and in the School of Public Health, all at the University of Texas. He previously held a joint appointment in the School of Pharmacy at the University of Maryland, where he taught in the Doctor of Pharmacy program. His research interests are in international comparisons of healthcare payment systems, costs and quality of care, as well as financial management for hospitals and physician practices.

visit us at www.bcms.org

41

UTHSCSA DEAN’S MESSAGE

UT School of Medicine Update: It’s About Teen Health

By Francisco González-Scarano, MD

Between 1991 and 2013, the teen birth rate in the United States declined by an impressive 57 percent. The rate has declined in the 50 states and among all racial/ethnic groups, and is credited to decreased sexual activity among teens as well as increased access to contraceptives. However, though there is progress throughout, it has been uneven.. In Texas, the rate has decreased, but as of 2013, Texas was ranked 5th in the nation for most teen births per 1,000 females aged 15-19. New Hampshire is ranked 51st (out of the 50 states plus the District of Columbia) with the fewest teen births.

Despite the mediocre ranking for Texas, San Antonio’s teen birth rate has been on a significant downward trend, especially during the last five years. A great deal of the local credit goes to our own UT Teen Health led by Kristen Plastino, MD, Associate Professor of Obstetrics and Gynecology, and to the many community partners she and her team have recruited in their quest to reduce teen pregnancy. The Department of Obstetrics and Gynecology has created a comprehensive support system for teens called UT Teen Health, which has led to a significant reduction in teen birth rates on the south side of San Antonio.

Teenage births are associated with higher school dropout, poverty, and incarceration. According to the San Antonio Metropolitan Health District, in 2012 Bexar County residents spent nearly $60 million on the associated costs of teen childbearing including child welfare, health care, lost revenue and incarceration expenses. Reducing the teen birth rates has been a goal at all levels of government.

In 2010, Dr. Plastino was awarded a $10 million 5-year grant from the Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services, Office of Adolescent Health (DHHS/OAH) to lead a community-wide initiative with the goal of reducing teen pregnancy on the south side of San Antonio and evaluating educational approaches to changing adolescent sexual behavior. She put together a ‘dream team’ of nurses and education specialists who set out on a mission of discovery and development to assess the need, plan, pilot, and execute evidencebased practices that would accomplish these goals.

The south side community-wide initiative collaborated with government, non-profit and community partners, setting the goal to reduce the teen birth rate in the catchment area by 10 percent by 2015. What they actually achieved was a 24 percent reduction. Dr. Plastino is quick to credit the community and the partnerships that it took to achieve such a difficult accomplishment. The community includes many different groups: schools, churches, Bexar County, 42 San Antonio Medicine • October 2015

the City of San Antonio and many other organizations, including University Health System and the San Antonio Metropolitan Health District, which embraced their approach and became trusted and effective partners in this effort.

Dr. Plastino’s focus is to create and sustain evidence-based programs, practices and systems, for addressing the issue of teen birth. They are on the right path. To continue this trajectory, she was recently awarded two additional federal grants totaling $13.75 million over the next five years from the Department of Health and Human Services.

There is no doubt in Dr. Plastino’s voice when she describes why she thinks they have been so successful, noting that access to preventive care is one of the most crucial aspects of their work. She also emphasizes having an open mind and working with the stakeholders to address their needs. This is in contrast to many programs that simply dictate curricula and do not consider the needs of a specific population, system, or culture.

Dr. Plastino’s team spent a full year on needs assessment - talking to people, conducting focus groups with parents and teenagers, and asking community leaders and teachers for their opinions. The team works with everyone involved in the process of providing education to adolescents: school boards, administrators, teachers, parents and youth. They also have multiple advisory boards that include teens and members of the more than 20 community partners, to build community support and provide end user and stakeholder feedback.

It has been a grassroots effort from the ground up, with Dr. Plastino and the School of Medicine’s guidance providing accurate medical advice, evaluation and continuous quality improvement.

The team has provided this guidance using a five-pronged approach that focuses on community mobilization, evidence-based programs, stakeholder engagement and education, sustainability and access to clinical preventive care for teens. The program truly encompasses and supports the lives of teens. Helping teens to identify their own dreams and goals and to discover the pathway to accomplish those goals is as much a part of the program as explaining the myths and facts of sexually transmitted infections. In 2014, Dr. Plastino received an award from the CDC for reaching the highest number of youth with evidence-based programs: approximately 12,500 teens.

Dr. Plastino cites that another important component is the trust she has with the different groups and community partners. This foundation has been built through transparency and collaboration.

Her team is open about what they are doing and how they plan to

UTHSCSA DEAN’S MESSAGE go about it, including allowing pre-review of any materials, curriculum, videos or activities that are used. They take care to ensure that the community partners are fully aware and have opportunities to provide feedback about the program materials.

Dr. Plastino circles back to access to preventive health care as a crucial component of prevention programs. As a mother of four, she’s keenly aware of the healthcare needs of our youth, and the deficiencies.

She reminds us that sexual health is simply a part of a teen’s overall health. If we are not engaged in overall adolescent health and wellness, we will not pick up on adolescent sexual health needs.

We have learned that, for the most part, if teenagers are not injured, in need of vaccinations, or due for a physical examination because of participation in sports, they do not go to the doctor during the middle and high school years. Healthcare professionals need to utilize these unique visit types to ask teens about their sexual health and provide anticipatory guidance and education. It is as important as asking if they wear their seatbelt or if they are safe at home. Even more remote is the concept of an adolescent having a “medical home” where they can receive a wide range of screening and preventive care. Although more common now in adult health care, a medical home for teens is still a new concept.

The new grants build on current momentum and provide funding to expand UT Teen Health programs to nearly 18,000 teens across

Bexar County, and to begin building the capacity of groups working with high risk teens in juvenile justice, foster care, and those who are pregnant and already parents in the entire state. Dr. Plastino hopes their success can be replicated not just in the state, but all over the country, as evidence for proven behavior change is developed. Her group is seeing decreased sexual activity and increased contraception adoption – and a change in the community systems that adopt them.

The goal is to sustain programs by training local facilitators to deliver them so that by 2020 the infrastructure and programs will be in place to continue the positive work they have started.

We congratulate Dr. Plastino and the program partners for their efforts and success, as well as recognize Dr. Robert S. Schenken, Professor and Chairman of the Department of Obstetrics and Gynecology for his strong support of all aspects of Dr. Plastino’s work..

Learn more about the program at their website: http://www.UTTeenHealth.org Francisco González-Scarano, MD, is dean of the School of Medicine, vice president for medical affairs, professor of neurology, and the John P. Howe III, MD, Distinguished Chair in Health Policy at the University of Texas Health Science Center at San Antonio. His email address is scarano@uthscsa.edu.

Introducing a new 10,000 Platinum Sponsor - BBVA Compass Bank

Please support this sponsor as they support us. visit us at www.bcms.org

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TMA

TMA Membership Gives You and Your Colleagues a United Voice

By Michael Battista, MD

“Join the ranks of organized medicine, choose how engaged you want to be and how much time you can commit. You don’t have to be on every council and committee, but you have to start with membership.”

– Michael Battista, MD

TMA MEMBERSHIP

Want to learn more about the benefits of TMA membership?

Clemente Sanchez, TMA’s membership development manager, can help. Clemente, based in San Antonio, is available to visit your practice or answer any questions you may have about TMA or BCMS. He can be reached at 512-809-9811 or clemente.sanchez@texmed.org.

44 San Antonio Medicine • October 2015

As an 18-year member of the Texas Medical Association and Bexar County Medical Society, I’ve learned physician involvement in organized medicine is essential to our success—and the future of medicine.

By working together, we can provide a unified voice for our patients and advocate on behalf of our physician colleagues. When I speak with legislators, they always ask what TMA thinks about an issue. This is why a united voice is so important. Effective advocacy starts with organized medicine.

When I join an organization, I try to be very active.

I’m a member of the TMA Council on Socioeconomics, and the TMA Foundation Leadership Society. I also serve as a consultant to TMA’s Committee on Maternal and Perinatal Health. I’m district chair of TEXPAC, TMA’s political action committee, a delegate to the Bexar County Delegation to TMA, and a member of the BCMS Legislative Committee. I make the time to honor these commitments, but I understand not everyone can immerse themselves to the same degree. My message to my busy colleagues is this: Join the ranks of organized medicine, choose how engaged you want to be and how much time you can commit. You don’t have to be on every council and committee, but you have to start with membership.

Join your local county medical society, specialty society, TMA and national groups. These memberships will allow you to connect with colleagues who are actively engaged and working on issues that matter to you. They will get your message carried forward.

I work with MEDNAX, a provider of maternalfetal, newborn, pediatric subspecialty, and anesthesia physician services. MEDNAX, and its affiliated practice, PEDIATRIX, are both TMA 100-percent membership groups, and there’s definite value in full membership. Full group participation allows every member to be represented. A sub-set of our physician group participates in both BCMS and in TMA, and this ensures we all have a voice.

Now is the time for us to focus on working together.

I encourage you to get involved today. For more information on the work TMA does on your behalf, or to join, visit the TMA website.

CIRCLE OF FRIENDS

The Circle of Friends Program The Circle of Friends Program was started to fulfill two needs: One helps physicians who are concerned about the amount of dues they pay.

This program helps fund activities and services of the Medical Society through non-dues revenue. Another is the need of businesses to present their services and products to physicians regarding both their medical practices and private needs in a more effective way, thus benefiting both parties. Circle of Friends members advertise in the society magazine, newsletters, directories, website and mailings. They also attend BCMS events, giving them an opportunity to interact with physicians in a more informal setting which does not interrupt their practice operations.

Did you know?

• The Circle of Friends sponsorship program is one of your benefits as a member of the Bexar County Medical Society.

Consider the Circle of Friends program (COF) as a high-quality, concierge-level purchasing club for physicians.

• As a BCMS member you can find exclusive discounts on premium products and services that you and your practice use every day.

• Our Circle of Friends are conveniently listed on the BCMS website under Member Services / Purchasing and Service Directory and as a monthly listing in San Antonio Medicine magazine under BCMS Circle of Friends Services Directory.

• Did you know using the Circle of Friends program benefits you directly? Circle of Friends supporting donations help to keep the cost of your dues down. These donations also help BCMS to provide you with quality member benefits.

• Circle of Friends members generously sponsor our events by providing and underwriting event locations and amenities, such as catering, music and door prizes.

• All Circle of Friends sponsors have been reviewed through the Better Business Bureau (online business review and search).

Why put your trust in outside or off-the-web companies?

• All Circle of Friends sponsors pledge to provide BCMS members with the highest level of quality, personalized services and products focusing on you, the physician.

Helping Doctors Save Money The Bexar County Medical Society makes every effort to use the Circle of Friends sponsors at every opportunity. By using Circle of Friends products and services we are able to save money and encourage the business community to participate with and support the Bexar County Medical Society.

Look first to the Circle of Friends program for any service that you and your practice may need. Support the Bexar County Medical Society by supporting sponsors that support us!

For more information or to participate in the Circle of Friends program, please contact August Charles Trevino, development director, at 210-301-4366 or email august.trevino@bcms.org. visit us at www.bcms.org

45

BCMS CIRCLE OF FRIENDS SERVICES DIRECTORY Please support our sponsors with your patronage; our sponsors support us.

ACCOUNTING FIRMS Padgett Stratemann & Co., LLP (HH Silver Sponsor) Padgett Stratemann is one of Texas’ largest, locally owned CPA firms, providing sophisticated accounting, audit, tax and business consulting services.

Vicky Martin, CPA 210-828-6281 Vicky.Martin@Padgett-CPA.com www.Padgett-CPA.com “Offering service more than expected — on every engagement.”

Sol Schwartz & Associates P.C. (HH Silver Sponsor) We specialize in areas that are most critical to a company’s fiscal well-being in today’s competitive markets.

Jim Rice, CPA 210-384-8000, ext. 112 jprice@ssacpa.com www.ssacpa.com “Dedicated to working with physicians and physician groups.”

BANKING

BBVA Compass (HHHH Platinum Sponsor) Our healthcare financial team provides customized solutions for you, your business and employees.

Commercial Relationship Manager Zaida Saliba 210-370-6012 Zaida.Saliba@BBVACompass.com Global Wealth Management Mary Mahlie 210-370-6029 mary.mahlie@bbvacompass.com Medical Branch Manager Vicki Watkins 210-592-5755 vicki.watkins@bbva.com Business Banking Officer Jamie Gutierrez 210-284-2815 jamie.gutierrez@bbva.com www.bbvacompass.com“Working for a better future.”

Amegy Bank of Texas (HHH Gold Sponsor) We believe that any great rela-

46 San Antonio Medicine • October 2015

tionship starts with five core values: Attention, Accountability, Appreciation, Adaptability and Attainability. We work hard and together with our clients to accomplish great things.

Jeanne Bennett 210- 343-4556 jeanne.bennett@amegybank.com Karen Leckie 210-343-4558 karen.leckie@amegybank.com www.amegybank.com “Community banking partnership.”

BB&T (HHH Gold Sponsor) Checking, savings, investments, insurance — BB&T offers banking services to help you reach your financial goals and plan for a sound financial future.

Chris Sherman 210-247-2978 csherman@bbandt.com Ben Pressentin 210-762-3175 bpressentin@bbandt.com www.bbt.com

Broadway Bank (HHH Gold Sponsor) Healthcare banking experts with a private banking team committed to supporting the medical community.

Ken Herring 210-283-4026 kherring@broadwaybank.com www.broadwaybank.com “We’re here for good.”

Frost (HHH Gold Sponsor) As one of the largest Texas-based banks, Frost has helped Texans with their financial needs since 1868, offering award-winning customer service and a range of banking, investment and insurance services to individuals and businesses.

Lewis Thorne 210-220-6513 lthorne@frostbank.com www.frostbank.com “Frost@Work provides your employees with free personalized banking services.”

IBC Bank (HHH Gold Sponsor) IBC Bank is a $12.4 billion multibank financial company, with over 212 facilities and more than 325 ATMs serving 90 communities in Texas and Oklahoma. IBC BankSan Antonio has been serving the Alamo City community since 1986 and has a retail branch network of 30 locations throughout the area.

Markham Benn 210-354-6921 MarkhamBenn@ibc.com www.ibc.com “Leader in commercial lending.”

Ozona Bank (HHH Gold Sponsor) Ozona National Bank is a full-service commercial bank specializing in commercial real estate, construction (owner and non-owner occupied), business lines of credit and equipment loans.

Lydia Gonzales 210-319-3501 lydiag@ozonabank.com www.ozonabank.com

The Bank of San Antonio (HHH Gold Sponsor) We specialize in insurance and banking products for physician groups and individual physicians.

Our local insurance professionals are some of the few agents in the state who specialize in medical malpractice and all lines of insurance for the medical community.

Brandi Vitier 210-807-5581 brandi.vitier@ thebankofsa.com www.thebankofsa.com

SSFCU (HHH Gold Sponsor) Founded in 1956, Security Service provides medical professionals with exceptional service and competitive rates on a line of mortgage products including one-time close construction, unimproved lots/land, jumbo and specialized adjustable-rate mortgage loans.

Commercial Services Luis Rosales 210-476-4426 lrosales@ssfcu.org Investment Services John Dallahan 210-476-4410 jdallahan@ssfcu.org Mortgage Services Glynis Miller 210-476-4833 gmiller@ssfcu.org Cadence Bank (HH Silver Sponsor) Cadence Bank is a full-service financial institution serving commercial, consumer, treasury and wealth management clients in Texas and the Southeast.

Margarita Ortiz, 210-764-5500 maggie.ortiz@cadencebank.com Steve Edlund, 210-764-5573 steve.edlund@cadencebank.com http://cadencebank.com “Explore Cadence Bank’s innovative financing options and treasury management solutions.”

Firstmark Credit Union (HH Silver Sponsor) Address your office needs: Upgrading your equipment or technology • Expanding your office space • We offer loans to meet your business or personal needs.

Competitive rates, favorable terms and local decisions.

Gregg Thorne SVP Lending 210-308-7819 greggt@firstmarkcu.org www.firstmarkcu.org Generations Federal Credit Union (HH Silver Sponsor) Generations provides a wide array of innovative products including loan, deposit and investment solutions for personal and commercial banking needs.

BCMS CIRCLE OF FRIENDS SERVICES DIRECTORY Continued from page 37 Yvonne "Bonnie" M. Aguilar 210-229-1800 bonnie.aguilar@ mygenfcu.org www.mygenfcu.org “For this generation and the next.”

RBFCU (HH Silver Sponsor) 210-945-3800 businesslending@rbfcu.org www.rbfcu.org St. Joseph's Credit Union (HH Silver Sponsor) A credit union providing savings, checking, IRA, club and CD accounts, plus auto, signature, lines of credit, MasterCard and real estate loans.

Armando Rodriguez 210-225-6126 arodriguez@sjcusatx.net www.sjcusatx.com “Better rates on auto loans, signature loans and Platinum MasterCard.”

BIOMEDICAL WASTE DISPOSAL

BioMedical Waste Solutions, LLC (HHH Gold Sponsor) Save costs on your medical waste disposal! BioMedical Waste Solutions provides a compliant, reliable and low-cost service.

Wes Sonnier 1-877-974-1300 Wes@BioMed-Disposal.com Joe Loyacano 1-877-974-1300 Joe@BioMed-Disposal.com www.BioMedicalWasteSolutions.com “BCMS members save 10 percent off or one free month! Request a free quote in 10 seconds at www.BioMedicalWasteSolutions.com.”

CONTRACTORS/BUILDERS/ COMMERCIAL

Huffman Developments (HHH Gold Sponsor) Premier medical and professional office condominium developer.

Our model allows you to own your own office space as opposed to leasing.

Steve Huffman 210-979-2500 Shawn Huffman

210-979-2500 www.huffmandev.com

ELECTRONIC MEDICAL RECORDS

RC Page Construction, LLC (HHH Gold Sponsor) Commercial general contractor specializing in ground-up and interior finish-out projects. Services include conceptual and final pricing, design-build and construction management. Single-source management from concept to completion ensures continuity through all phases of the project.

Clay Page 210-375-9150 clay@rcpageconstruction.com

Greenway Health (HHH Gold Sponsor) Greenway Health offers a fully integrated electronic health record (EHR/EMR), practice management (PM) and interoperability solution that helps healthcare providers improve care coordination, quality and satisfaction while functioning at their highest level of efficiency.

Stacy Berry 830-832-0949 Stacy.berry@greenwayhealth.com www.greenwayhealth.com

CUSTOM HOME BUILDERS

FINANCIAL SERVICES

Diamante Custom Homes (HHH Gold Sponsor) Diamante Custom Homes: Experience your new custom homebuilding process through San Antonio’s leading design-build firm. Over two decades of streamlining the balance between your budget and your dreams. The name you know from the builders you trust!

Keith Norman 210-341-6430 knorman@diamantehomes.com www.diamantehomes.com “Special promotions for all BCMS members – call us today!”

Northwestern Mutual Wealth Management (HHHH Platinum Sponsor) Comprehensive financial planning, insurance and investment planning, estate planning and trust services.

Eric Kala, CFP, CLU, ChFC Wealth Management Advisor 210-446-5752 eric.kala@nm.com www.erickala.com

ELECTRONIC DOCUMENTATION AND TRANSCRIPTION SERVICES

Med MT, Inc. (HHH Gold Sponsor) Narrative transcription is physicians’ preferred way to create patient documents and populate electronic medical records.

Ray Branson 512-331-4669 branson@medmt.com www.medmt.com “The Med MT solution allows physicians to keep practicing just the way they like.”

Aspect Wealth Management (HHH Gold Sponsor) We believe wealth is more than money, which is why we improve and simplify the lives of our clients, granting them greater satisfaction, confidence and freedom to achieve more in life.

Jeffrey Allison 210-268-1530 jallison@ aspectwealth.com www.aspectwealth.com “Get what you deserve … maximize your Social Security benefit!”

Frost Leasing (HHH Gold Sponsor) As one of the largest Texas-based banks, Frost has helped Texans with their financial needs since 1868, offering award-winning customer service and a

range of banking, investment and insurance services to individuals and businesses.

Laura Elrod Eckhardt 210-220-4135 laura.eckhardt@frostbank.com www.frostbank.com “Commercial leasing for a doctor’s business equipment and vehicle.”

Bob Davidson New York Life (HH Silver Sponsor) Dedicated agent at New York Life helping physicians and medical professionals achieve their financial dreams.

Bob Davidson 210-321 1445 rdavidson02@ft.newyorklife.com www.linkedin.com/in/bobdavidsonnyl “Taking care of those who take care of us.”

Retirement Solutions (HH Silver Sponsor) Committed to providing comprehensive, reliable consultation to help you navigate the complex world of retirement planning.

Robert C. Cadena 210-342-2900 robert@retirementsolutions.ws www.retirementsolutions.ws

HIPAA COMPLIANCE SERVICES Cyber Risk Associates (HH Silver Sponsor) Cyber Risk Associates provides HIPAA compliance services designed for small practices, offering enterprise-quality privacy and security programs, customized to your needs.

David Schulz 210-281-8151 DAS@CyberRiskAssociates.com www.CyberRiskAssociates.com

HIPAA/MANAGED IT/ VOIP/SECURITY

Hill Country Tech Guys (HHH Gold Sponsor) Provides complete technology services to many different industries, specializing in the needs of the financial and medical industries. Since 2006, our goal has always been to deliver relationship-based technology services that exceed expectations.

Bill Gower 877-315-0788

Continued on page 48 visit us at www.bcms.org 47

BCMS CIRCLE OF FRIENDS SERVICES DIRECTORY Continued from page 47 Bill@hctechguys.com http://hctechguys.com/ “IT problems? Yeah… we can fix that!”

HOSPITALS/ HEALTHCARE SERVICES

First Choice Emergency Room (HHH Gold Sponsor) The nation's oldest and largest network of independent freestanding emergency rooms. Patients seen almost immediately; board-certified physicians and emergency-trained registered nurses. In-house CT scanner, ultrasound, digital X-ray and COLA/CIA accredited on-site lab to handle emergencies 24/7/365.

Hardy Oak Boulevard 24-hour 210-451-8340 Nacogdoches Road.

24-hour 210-447-7560 Tezel Road 24-hour 210-437-1180 www.fcer.com “Check-in online — free, easy, fast!”

Methodist Healthcare System (HH Silver Sponsor) Palmira Arellano 210-575-0172 palmira.arellano@mhshealth.com http://sahealth.com/ Seasons Hospice and Palliative Care (HH Silver Sponsor) Seasons Hospice and Palliative Care engenders hope in the lives of its patients and their family members. We are here for you.

Deb Houser-Bruchmiller Executive Director 210-471-2300 dhouser@seasons.org www.seasons.org Select Rehabilitation of San Antonio (HH Silver Sponsor) We provide specialized rehabilitation programs and services for individuals with medical, physical and functional challenges.

Miranda Peck 210-482-3000 mipeck@selectmedical.com http://sanantonio-rehab.com “The highest degree of excellence in medical rehabilitation.”

HUMAN RESOURCES

Warm Springs •Medical Center •Thousand Oaks •Westover Hills (HHH Gold Sponsor) Our mission is to serve people with disabilities by providing compassionate, expert care during the rehabilitation process, and support recovery through education and research.

Central referral line 210-592-5350 “Joint Commission COE.” Elite Care Emergency (HH Silver Sponsor) 24/7 full-service, no-wait, freestanding ER with board-certified physicians and RNs offering Elite Care advantage for patients.

Marketing Liaison Dlorah Martin 509-592-7998 dmartin@elitecareemergency.com Marketing liaison Kylyn Stark 210-978-4110 kstark@elitecareemergency.com www.elitecareemergency.com “When seconds count, Elite Care can make ALL the difference.”

48 San Antonio Medicine • October 2015

Employer Flexible (HHH Gold Sponsor) Employer Flexible doesn’t simply lessen the burden of HR administration. We provide HR solutions to help you sleep at night and get everyone in the practice on the same page.

John Seybold 210-447-6518 jseybold@employerflexible.com www.employerflexible.com “BCMS members get a free HR assessment valued at $2,500.”

INSURANCE

Blue Cross Blue Shield of Texas (HHH Gold Sponsor) Edna Pérez-Vega 210-558-5162 Edna_Perez-Vega@bcbstx.com www.BCBSTX.com

Frost Insurance (HHH Gold Sponsor) As one of the largest Texas-based banks, Frost has helped Texans

with their financial needs since 1868, offering award-winning customer service and a range of banking, investment and insurance services to individuals and businesses.

Bob Farish 210-220-6412 bob.farish@frostbank.com www.frostbank.com “Business and personal insurance tailored to meet your unique needs.”

Humana (HHH Gold Sponsor) Humana is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care.

Jon Buss: 512-338-6167 Jbuss1@humana.com Shamayne Kotfas: 512-338-6103 skotfas@humana.com www.humana.com

Texas Medical Association Insurance Trust (HHH Gold Sponsor) Created and endorsed by the Texas Medical Association (TMA), the TMA Insurance Trust helps physicians, their families and their employees get the insurance coverage they need.

Wendell England 512-370-1746 wengland@tmait.org James Prescott 512-370-1776 jprescott@tmait.org John Isgitt 512-370-1776 www.tmait.org “We offer BCMS members a free insurance portfolio review.”

Catto & Catto (HH Silver Sponsor) Providing insurance, employee benefits and risk-management products and services to thousands of businesses and individuals in Texas and the United States.

Crystal Metzger James L. Hayne Jr. 210-222-2161 www.catto.com Joel Gonzales Agency Nationwide (HH Silver Sponsor) Joel Gonzales 210-275-3595 www.nationwide.com/jgonzales

INSURANCE/MEDICAL MALPRACTICE

Texas Medical Liability Trust (HHHH Platinum Sponsor) Texas Medical Liability Trust is a physician-owned healthcare liability claim trust providing malpractice insurance products to the physicians of Texas. Currently, we protect more than 17,000 physicians in all specialties who practice in all areas of the state.

TMLT is a recommended partner of the Bexar County Medical Society and is endorsed by the Texas Medical Association, the Texas Academy of Family Physicians, and the Dallas, Harris, Tarrant and Travis counties medical societies.

Patty Spann 512-425-5932 patty-spann@tmlt.org www.tmlt.org “Recommended partner of the Bexar County Medical Society.”

MedPro Group (HHH Gold Sponsor) Medical Protective is the nation's oldest and only AAA-rated provider of healthcare malpractice insurance.

Thomas Mohler, 512-213-7714 thomas.mohler@medpro.com www.medpro.com

The Bank of San Antonio Insurance Group, Inc. (HHH Gold Sponsor) We specialize in insurance and banking products for physician groups and individual physicians.

Our local insurance professionals are some of the few agents in the state who specialize in medical malpractice and all lines of insurance for the medical community.

Katy Brooks, CIC, 210-807-5593 katy.brooks @bosainsurance.com www.thebankofsa.com “Serving the medical community.”

NORCAL Mutual Insurance Co. (HH Silver Sponsor) Since 1975, NORCAL Mutual has offered medical professional liability coverage to physicians and is “A” (Excellent) rated by A.M. Best.

Patrick Flanagan

BCMS CIRCLE OF FRIENDS SERVICES DIRECTORY 844-4-NORCAL pflanagan@norcal-group.com www.norcalmutual.com ProAssurance (HH Silver Sponsor) ProAssurance helps you control your professional risk and navigate today’s changing medical environment with greater ease — that’s only fair.

Keith Askew, 512-314-4368 Kaskew@proassurance.com Mark Keeney 512-314-4347, ext. 7347 Mkeeney@api-proassurance.com www.proassurance.com “A.M. Best-rated A+ (Superior), ProAssurance treats you fairly.”

The Doctors Company Medical Malpractice Insurer (HH Silver Sponsor) We relentlessly defend, protect and reward the practice of good medicine. As the patient safety industry leader, we proudly offer a comprehensive selection of CME opportunity and risk-mitigation resources.

Kirsten Baze 512-275-1874 KBaze@thedoctors.com www.TheDoctors.com

INTERNET/ TELECOMMUNICATIONS

Time Warner Cable Business Class (HHH Gold Sponsor) When you partner with Time Warner Cable Business Class, you get the advantage of enterpriseclass technology and communications that are highly reliable, flexible and priced specifically for the medical community.

Rick Garza 210-582-9597 Rick.garza@twcable.com “Time Warner Cable Business Class offers custom pricing for BCMS Members.”

IT SUPPORT/VOIP/ CLOUD SERVICES

ICS (HHH Gold Sponsor) ICS® is a Texas-based provider of business technology integration solutions, including managed IT

support, business telephones, VoIP communications, video conferencing systems, surveillance cameras, and voice/data cabling.

Family owned since 1981.

Daniel Simons 210-581-9020 daniel.simons@ics-com.net Robert Foehrkolb 210-225-5427 rfoehrkolb@ics-com.net www.ics-com.net “Providing IT, voice and video solutions for business.”

LABORATORY SERVICES

PGX TESTING (HHH Gold Sponsor) PGX Testing is a multi-faceted diagnostics company currently offering pharmacogenomics, urine toxicology, women's health testing, cancer screening, and wellness testing to the medical profession.

Charlie Rodkey Sr. charlie@pgxt.com 210-218-8610 Ryan Rodkey ryan@pgxt.com 210-323-7717 Ron Inselmann ron@pgxt.com 210-382-7761 www.PGXT.com Clinical Pathology Laboratories (HH Silver Sponsor) Mitchell Kern 210-229-2513 mkern@cpllabs.com www.cpllabs.com

MARKETING SERVICES Digital Marketing Sapiens (HH Silver Sponsor) Healthcare marketing professionals with proven experience and solid understanding of compliance issues. We deliver innovative marketing solutions that drive results.

Irma Woodruff 210-410-1214 irma@dmsapiens.com Ajay Tejwani 210- 913-9233 ajay@dmsapiens.com www.DMSapiens.com Know Your Doctor SA (HH Silver Sponsor) Increase your practice’s unique marketing/communications program. Connect with SA commu-

nity through video, advertising, PR and medical opinion e-news.

Limited to 300 physicians.

Lorraine Williams 210-884-7505 LWilliams@KnowYourDoctorSA.com www.knowyourdoctorsa.com

MEDICAL BILLING AND COLLECTIONS SERVICES

DataMED (HHH Gold Sponsor) Providing your practice with the latest compliance solutions, concentrating on healthcare regulations affecting medical billing and coding changes, allowing you and your staff to continue delivering excellent patient care.

Betty Aguilar 210-892-2331 baguilar@datastreamllc.net www.datamedbpo.com “BCMS members receive a discounted rate for our billing services.”

Commercial & Medical Credit Services (HH Silver Sponsor) A bonded and fully insured San Antonio-based collection agency.

Henry Miranda 210-340-9515 hcmiranda@sbcglobal.net www.cmcs-sa.com “Make us the solution for your account receivables.”

MEDICAL SUPPLIES AND EQUIPMENT

Henry Schein Medical (HHHH Platinum Sponsor) From alcohol pads and bandages to EKGs and ultrasounds, we are the largest worldwide distributor of medical supplies, equipment, vaccines and pharmaceuticals serving office-based practitioners in 20 countries. Recognized as one of the world’s most ethical companies by Ethisphere.

Tom Rosol 210-413-8079 tom.rosol@henryschein.com www.henryschein.com “BCMS members receive GPO discounts of 15 percent to 50 percent.”

MEDICAL TRAINING/ HANDS ON

LINRON® Bioskills Training Institute (HHH Gold Sponsor) LINRON® is dedicated to providing hands-on medical training to healthcare professionals who want to improve their clinical skills and offer their patients the latest in treatment modalities while using state-of-the-art medical equipment and technology.

Yolanda S. Garza, RN 210-572-2434 yolanda.garza@linrontraining.com www.linrontraining.com

MENTAL HEALTH EDUCATION AND CONSULTING

The Ecumenical Center (HHH Gold Sponsor) The Ecumenical Center provides faith-based counseling and education for healing, growth and wellness. The center is a catalyst, bringing together community leaders in research, education, ethics, medical and mental health professions.

Mary Beth Fisk 210-616-0885, ext. 215 mbfisk@ecrh.org www.ecrh.org

MERCHANT PAYMENT SYSTEMS/CARD PROCESSING Heartland Payment Systems (HH Silver Sponsor) Heartland Payments is a true cost payment processor exclusively endorsed by over 250 business associations.

Tanner Wollard 979-219-9636 tanner.wollard@e-hps.com www.heartlandpaymentsystems.com “Lowered cost for American Express; next day funding.”

OFFICE EQUIPMENT/ TECHNOLOGIES Dahill (HH Silver Sponsor) Dahill offers comprehensive document workflow solutions to help healthcare providers

Continued on page 50 visit us at www.bcms.org 49

BCMS CIRCLE OF FRIENDS SERVICES DIRECTORY Continued from page 49 apply, manage and use technology that simplifies caregiver workloads.

The results: Improved access to patient data, tighter regulatory compliance, operational efficiencies, reduced administrative costs and better health outcomes.

Ronel Uys 210-805-8200, ext. 10105 ruys@dahill.com www.dahill.com

in a luxurious resort-quality environment.

Shane Brown Executive Director 210-305-5713 hello@ legacyatforestridge.com www.LegacyAtForestRidge.com “Assisted living like you’ve never seen before.”

STAFFING SERVICES

ORGANIZATIONS CRIT USA (HH Silver Sponsor) Ricardo Guzman Hefferan 210-257-6260 guzman@teletonusa.org www.teletonusa.org

REAL ESTATE/ COMMERCIAL Endura Advisory Group (HH Silver Sponsor) Endura Advisory Group specializes in representing physicians and clients in the purchase, lease, sale, management or sublease of commercial real estate.

Vicki Cade, CCIM 210-366-2222 Mobile 210-827-7640 vcade@endurasa.com Teresa Corbin 210-366-2222 tcorbin@endurasa.com www.endurasa.com

REAL ESTATE/ RESIDENTIAL Kuper Sotheby's International Realty (HH Silver Sponsor) My hometown roots are based in Fredericksburg while my home away from home is San Antonio. Local knowledge — exceptional results.

Joe Salinas III 830-456-2233 Joe.Salinas@SothebysRealty.com JoeSalinas.com “Embrace your new life ...

I'll help you become a connoisseur.”

SENIOR LIVING Legacy at Forest Ridge (HH Silver Sponsor) Legacy at Forest Ridge provides residents with toptier care while maintaining their privacy and independence,

50 San Antonio Medicine • October 2015

Favorite Healthcare Staffing (HHHH Platinum Sponsor) Serving the Texas healthcare community since 1981, Favorite Healthcare Staffing is proud to be the exclusive provider of staffing services for the BCMS. In addition to traditional staffing solutions, Favorite offers a comprehensive range of staffing services to help members improve cost control, increase efficiency and protect their revenue cycle.

Brody Whitley Branch Director 210-301-4362 bwhitley@ favoritestaffing.com www.favoritestaffing.com “Favorite Healthcare Staffing offers preferred pricing for BCMS members.”

TRAVEL CONSULTANTS Alamo Travel Group (HH Silver Sponsor) Locally owned travel agency for over 30 years, offering personalized travel services for your next family vacation, business travel needs or group travel. American Express Travel Network representative.

Mary Jo Salas, 210-593-5500 msalas@alamotravel.com www.amazingjourneysbyalamo.com “See what a difference we can make for you!”

As of July 14, 2015 To join the Circle of Friends program or for more information, call 210-301-4366, email August.Trevino@bcms.org, or visit www.bcms.org/COf.html.

THANK YOU

to the large group practices with 100% MEMBERSHIP in BCMS and TMA ABCD Pediatrics, PA

Renal Associates of San Antonio, PA

Clinical Pathology Associates

San Antonio Gastroenterology Associates, PA

Dermatology Associates of San Antonio, PA

San Antonio Kidney Disease Center

Diabetes & Glandular Disease Clinic, PA

San Antonio Pediatric Surgery Associates, PA

ENT Clinics of San Antonio, PA

Sound Physicians

Gastroenterology Consultants of San Antonio

South Alamo Medical Group

General Surgical Associates

South Texas Radiology Group, PA

Greater San Antonio Emergency Physicians, PA

Tejas Anesthesia, PA

Institute for Women's Health

Texas Partners in Acute Care

Lone Star OB-GYN Associates, PA

The San Antonio Orthopaedic Group

M & S Radiology Associates, PA

Urology San Antonio, PA

MacGregor Medical Center San Antonio

Village Oaks Pathology Services/ Precision Pathology

MEDNAX Peripheral Vascular Associates, PA

WellMed Medical Management Inc.

Contact BCMS today to join the 100% Membership Program! *100% member practice participation as of September 15, 2015.

North Park Mazda 9333 San Pedro Ave. Ancira Chrysler 10807 IH-10 West Gunn Acura 11911 IH-10 West

* Gunn Infiniti 12150 IH-10 West

Cavender Toyota 5730 NW Loop 410

Ingram Park Auto Center 7000 NW Loop 410 Mercedes-Benz of Boerne 31445 IH-10 W, Boerne Ancira Dodge 10807 IH-10 West

Cavender Audi 15447 IH-10 West

Cavender Buick 17811 San Pedro Ave. (281 N @ Loop 1604)

Ingram Park Auto Center 7000 NW Loop 410

Northside Ford 12300 San Pedro Ave.

Ancira Jeep 10807 IH-10 West Ingram Park Auto Center 7000 NW Loop 410

* North Park Lexus 611 Lockhill Selma

Tom Benson Chevrolet 9400 San Pedro Ave. Gunn Chevrolet 12602 IH-35 North

Ancira Nissan 10835 IH-10 West

* Ancira Volkswagen 5125 Bandera Rd. North Park VW at Dominion 21315 IH-10 West

Ingram Park Nissan 7000 NW Loop 410

North Park Lexus Dominion 21531 IH-10 West Frontage Road Cavender GMC 17811 San Pedro Ave.

Batchelor Cadillac 11001 IH-10 at Huebner

Mercedes-Benz of San Antonio 9600 San Pedro Ave.

North Park Toyota 10703 Southwest Loop 410

Gunn GMC 16440 IH-35 North

Ancira Ram 10807 IH-10 West * North Park Lincoln/ Mercury 9207 San Pedro Ave.

* Fernandez Honda 8015 IH-35 South Gunn Honda 14610 IH-10 West (@ Loop 1604)

Ingram Park Auto Center 7000 NW Loop 410

North Park Subaru 9807 San Pedro Ave. Ingram Park Auto Center 7000 NW Loop 410

North Park Subaru at Dominion 21415 IH-10 West

visit us at www.bcms.org

51

AUTO REVIEW

Volkswagen Tiguan

By Steve Schutz, MD

The past few years have been difficult for Volkswagen. Life was good for the German automaker from 2009 to 2012, thanks to a new factory in Chattanooga, Tenn., and American-ized Jetta and Passat sedans.

Sales doubled during that time and there was good reason to think they’d keep growing. But that’s not what happened. Instead, VW brand sales have tanked in recent years, and they’re only just now starting to rebound.

What happened? My sense is that understated sedans like the Jetta and Passat were perfect for the Great Recession, but once the economy rebounded buyers were more interested in luxury vehicles, crossovers, and 52 San Antonio Medicine • October 2015

SUVs, products that VW didn’t really offer.

(Cheaper fuel prices obviously accelerated that trend.)

I also think that Volkswagen wasn’t helped by the fact that Audi dealers, with all of their cool new products, usually sit right next to VW stores. How many buyers walked onto a VW showroom looking for a Passat and drove out with an Audi Q5? I have no way of knowing, but I’ll bet the number is a lot bigger than zero. And a lot bigger than Volkswagen would be willing to admit.

To turn things around VW is developing a new slate of crossovers - think Honda HRV, Ford Escape, and Toyota Highlander fighters - and re-focusing on the vehicles

they already sell - like the compact Tiguan crossover. Similar in size to the Escape, the Tiguan has had limited success in our market due primarily to its price-size ratio, which has been too high. Predictably, Volkswagen has been focusing its attention on that area and now the Tiguan offers more aggressive pricing as well as better financing and leasing deals. (As always, Phil Hornbeak has the latest on that.)

The Tiguan is not new. It debuted in the U.S. in 2009 and is due to be replaced in a year or two, but with more aggressive pricing is worthy of consideration. While the design was unassuming six years ago and virtually invisible now, it is not ugly. But it is a re-

AUTO REVIEW

minder of how the styling of small crossovers, like the Lexus NX and Mercedes GLA, have become much more extroverted these days.

Not surprisingly given its German pedigree, the Tiguan is a pleasure to drive. Responsive and agile accurately describe what the Tiguan is like on the road, and it’s that on-road athleticism that differentiates this vehicle from its competitors. Having said that, Volkswagen’s diminutive crossover is most comfortable zipping around town or hustling over rural backroads. To be a true long-distance champ, the Tiguan would need a longer wheelbase and more sound deadening. In which case I guess it would be a Touareg.

Again, this is a small crossover, so interior space is not abundant. Nevertheless, the quality of the interior materials and ergonomics are excellent, especially since Volkswagen updated its infotainment system for the 2015 model year.

Pricing for Tiguans starts at just over $27,000 for base S models and goes up to around $40,000 for loaded R versions, but as noted above, deals are there to be had as VW aggressively chases market share.

After some tough times, Volkswagen has changed its approach to the U.S. car market. New crossovers are being developed as quickly as possible, and dealers are dealing. Will better products and more aggres-

sive pricing be enough to turn things around? After watching what those changes did for VW’s sister brand, Audi, I’m going with yes.

Steve Schutz, MD, is a board-certified gastroenterologist who lived in San Antonio in the 1990s when he was stationed here in the U.S. Air Force. He has been writing auto reviews for San Antonio Medicine since 1995.

For more information on the BCMS Auto Program, call Phil Hornbeak at 3014367 or visit www.bcms.org. visit us at www.bcms.org

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54 San Antonio Medicine • October 2015