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A N e w Ye a r n u m b e r

In this issue: Get to Know Your DCMS President - Cynthia Sherry, MD

Legislative Update - The Issues Facing Lawmakers



j a n u a r y

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Cynthia Sherry, MD, is the Dallas County Medical Society’s 130th president and the third female to take on the role.

Dallas County Medical Society PO Box 4680, Dallas, TX 75208-0680 Phone: 214-948-3622, FAX: 214-946-5805 Email:

DCMS Communications Committee Roger S. Khetan, MD.............................................. C h a i r Gene Beisert, MD Suzanne Corrigan, MD Seemal R. Desai, MD Daniel Goodenberger, MD Gordon Green, MD Robert Gross, MD Steven R. Hays, MD C. Turner Lewis, MD David Scott Miller, MD Clifford Moy, MD

DCMS Board of Directors Cynthia Sherry, MD.......................................... President Jeffrey E. Janis, MD..................................President-Elect Jim Walton, DO................................Secretary/Treasurer Richard W. Snyder II, MD......... Immediate Past President Mark A. Casanova, MD Wendy M. Chung, MD Christopher A. Hebert, MD Michelle Ho, MD Todd A. Pollock, MD Kim M. Rice, MD Hampton Richards, MD Erin Roe, MD Christian Royer, MD

DCMS Staff Michael J. Darrouzet................... Chief Executive Officer Lauren N. Cowling................................ Managing Editor Steven Harrell.............................. Asst. Managing Editor Bearett Wolverton................................ Advertising Sales Articles represent the opinions of the authors and do not necessarily reflect the official policy of the Dallas County Medical Society or the institution with which the author is affiliated. Advertisements do not imply sponsorship by or endorsement of DCMS. ©2013 DCMS

According to Tex. Gov’t. Code Ann. §305.027, all articles in Dallas Medical Journal that mention DCMS’ stance on state legislation are defined as “legislative advertising.” The law requires disclosure of the name and address of the person who contracts with the printer to publish legislative advertising in the DMJ: Michael J. Darrouzet, Executive Vice President/CEO, DCMS, PO Box 4680, Dallas, TX 75208-0680.


Know Your D CMS Pr es ident

Introducing Cynthia Sherry, MD


2013 B oar d Mem ber s



2013 Millar d J. & R ober t L . Heath A wa rd Dallas County Judge Clay Jenkins

2013 Char les Max Cole, MD , L eader s hip Awar d

James Luby, MD

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A Matter of Perspective

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CEO Update

Awakening — Our Unique Role in Shaping the Future

Dallas Medical Journal (ISSN 0011-586X) is published monthly by the Dallas County Medical Society, 140 E. 12th St, Dallas, TX 75203.

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L egis lative Update

The Issues Facing Lawmakers

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submit letters to the editor to lauren@dallas-cms. org visit us online at • January 2013 •


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Introducing Cynthia Sherry, MD by Lauren Cowling, director of communications







doesn’t carry a big stick. She doesn’t need to — as the 130th president of the Dallas County Medical Society, her words carry the weight of a big stick. Perhaps Dr. Sherry’s subdued demeanor is a result of being the second oldest child (and oldest girl) of eight children. Her large family was vibrant, competitive and supportive. She describes her late father as a “big man — in personality and stature. He was honest and had a lot of integrity, and he was a leader and he instilled that into his children.” Dr. Sherry grew up all over the Midwest, until her father’s Mobil Oil career settled the family in Dallas in the late 1960s. Observing her mother’s work as a nurse inspired Dr. Sherry from a young age to go into the medical field. “My mother’s stories about medicine, doctors and the ‘noble’ profession inspired me to pursue this path,” she says. That inspiration and her desire to help people and improve lives led her to the University of Texas, where she finished her degree in psychology before heading to the University of Texas Medical Branch in Galveston for nursing school. Nursing school? “I didn’t finish nursing school,” she says. “I learned pretty quickly that I was interested in other things — more things. So, I left nursing school before clinicals started and came home to start at the University of Texas at Dallas to get my prerequisites for med school.” She spent 2 years at UTD earning a degree in chemistry. In addition to her degree in chemistry, Dr. Sherry had a good degree of chemistry with her husband to be, Dean, whom she met at UTD. They’ve been married since 1982, and the chemistry continues; he’s now a professor of chemistry at UTD. She completed medical school at the University of Texas Southwestern Medical School in 1983. After a residency in diagnostic radiology and fellowship in magnetic resonance imaging at Baylor University

Cynthia with Dean and Sarah and the family’s goldendoodle, Sandy.

Medical Center Dallas, Dr. Sherry has been in private practice since 1989. She since learned about the business of medicine while earning a master’s degree in medical management from Carnegie Mellon University in 1999. She decided to specialize in radiology after seeing in medical school how much pulmonologists could learn about a case from imaging. “I like reading mystery novels and trying to figure things out from clues, and radiology appeals to that part of my personality,” she says. “And I realized how much I enjoyed differential diagnostics — the ‘whodunit’ of medicine. I still enjoy that aspect of medicine tremendously.” Balancing being mother and a physician has had its difficulties, and Dr. Sherry credits her husband’s support for making it work. In addition to their shared chemistry, Dr. Sherry the husband is a professor of radiology at UT Southwestern. Although Dr. Sherry realizes she is the third woman to serve as president of DCMS in its 136-year history, she isn’t focusing solely on that. “We have more women physicians now,” she says simply, so a female DCMS president is not an aberration. And she believes that diversity is valuable. “It makes a group stronger,” she contends.

visit us online at • January 2013 •


Dean and Cynthia Sherry, MD, at last year’s Medical Student Dinner.

One of Dr. Sherry’s main goals as DCMS president is to get physicians to be cognizant of the changes the healthcare system is undergoing and to determine how they can be involved in every part of the process. Dr. Sherry is optimistic at the challenges ahead for 2013 and is not shying away from the responsibilities of her role. “Responsibility just means you have to work a little harder,” she says. She expects her year as DCMS president to be difficult, for her as president and for physicians as a whole, but she will address each challenge. “We’re facing a lot of fires,” she says. “Issues have to be dealt with, and I’m going to keep my finger on the pulse of those issues. “Medicine is changing,” she continues. “Physicians have to be more accountable to their patients, their employers and other physicians. We have to have a more transparent role in patient care, and we have to be involved at every juncture of that care.” One of Dr. Sherry’s main goals as DCMS president is to get physicians to be cognizant of the changes the healthcare system is undergoing and to determine how they can be involved in every part of the process. She


• January 2013 • Dallas Medical Journal

sees great opportunity for physicians to take the lead in decisions regarding health care. “Doctors are at risk if we’re not in the driver’s seat,” she says. “We need to be the ones designing plans and programs, and making decisions in regard to health care.” She sees these system changes as a chance for physicians to return to the basics. “This is an opportunity for physicians to renew their sense of idealism and to look back on why they became a doctor in the first place,” she says. “And to look at what it means to be a doctor in 2013.” Another goal, a bit farther-reaching, is to promote physician involvement with hospitals to solve common problems. “Times are changing,” she says. “Going down the old path again, as the hospitals seem to want to do, won’t take us into the future successfully. The recent decision to cease operations of Project Access Dallas has given the physicians, hospitals and patients of Dallas County an opportunity to find a new pathway to an innovative program that can be transformative for the Dallas medical community. Physicians and hospitals absolutely need to work together on this, and it is imperative that we build the model based upon a fair delegation of resources.” Although Dr. Sherry is a hard-worker and incredibly committed to her profession and all the ailments that come with it, she finds time for activities outside the hospital and dark imaging rooms. She says that most of her hobbies involve radiology. For the American College of Radiology, she serves on the Board of Chancellors, and leads the Commission on Leadership and Practice Development. She is the medical director and board chairman for the Radiology Leadership Institute. Dr. Sherry also is an avid reader (biographies and mysteries), a lover of good food, a scratch pianist, and a trained golfer. Or maybe that’s trained pianist and (almost) scratch golfer? Dr. Sherry finds time to play golf with her husband and siblings and uses the activity to travel to beautiful places around the world. Most recently, they traveled to Ireland and played a round. Dr. Sherry and her husband live in Dallas and have one daughter, Sarah, whom they were unable to convince to pursue a career in diagnostics. Dr. Sherry is in practice with Radiology Associates of North Texas, the largest radiology practice in Texas, and is chairman of the Department of Radiology at Texas Health Presbyterian Hospital Dallas, where she was the first woman president of the medical staff and a member of the hospital’s Board of Governors. She also serves as medical director of Body MR and CT at Southwest Diagnostic Imaging Center. She has been a DCMS member since 1984 and has served on various committees, as well as TMA committees and councils.

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get to know yo ur

2013 board


Cynthia Sherry, MD DCMS MEMBER SINCE 1984 | SPECIALTY: RADIOLOGY what inspired you to go into medicine? The idea of having an intellectually challenging and rewarding vocation that allows me to help improve people’s lives if you weren’t a physician, what would you be? Fashion designer or musician earliest childhood memory: Sitting with my dad as he played popular tunes on the organ

Best vactation you’ve ever taken: Week-long sailing adventure in the Caribbean what was your favorite age and why? Middle age- after many years punctuated by the mileposts of a lengthy, highly prescribed education, it is probably the only time I felt like I had the freedom to open doors of my own choosing best concert you’ve ever been to: ZZ Top in the mid 70s

Jeffrey E. Janis, MD DCMS MEMBER SINCE 2004 | SPECIALTY: PLASTIC SURGERY if you weren’t a physician, what would you be? In order: 1) Rock star 2) Actor 3) Sushi Chef 4) Ice cream flavor inventor 5) the guy who writes stories on the sides of beer bottles

what is your biggest fear? Spiders and clowns, or, most of all, spiders dressed up as clowns

nickname: Kong

what was your favorite age and why? Two— does it get any better? everything is new and wonderful. I watch my two-year-old now and i’m jealous.

best concert you’ve ever been to: Eric clapton at the St. louis arena the week after Stevie ray died in the helicopter accident

describe yourself using three words: I am me.

Jim Walton, DO DCMS MEMBER SINCE 1990 | SPECIALTY: INTERNAL MEDICINE what inspired you to go into medicine? my father, a general practitioner in dallas, shadowing him in his office practice; making housecalls, nursing home visits and hospital rounds. The complex interplay between the social and clinical elements of medicine motivated me to become a general internist.

best concert you’ve ever been to: Andrea Bocelli

best vacation you’ve ever taken: A trip to Paris, France, with my wife to celebrate one of her milestone birthdays

biggest fear or phobia: Being in large crowds of people where I am expected to remember the names of friends, family members and colleagues, and introduce them to one another

if you were to perform in the circus, what would you do? Trapeze, because I always thought it would be fun to fly (always with a net)

visit us online at • January 2013 •


Christian Royer, MD DCMS MEMBER SINCE 2004 | SPECIALTY: ORTHOPAEDIC SURGERY what inspired you to go into medicine? My own knee surgery at 19 years old

best concert you’ve ever been to: Van halen, ou812 tour

strangest food you’ve ever eaten: Salad, why do people like that stuff?

describe yourself using three words: Manic / organized / perfectionist

if you were to perform in the circus, what would you do? Lion tamer

if you had one extra hour in the day, how would you use it? Work out more

Rick Snyder, MD DCMS MEMBER SINCE 1983 | SPECIALTY: CARDIOVASCULAR DISEASE What inspired you to go into medicine? My mom

if you weren’t a physician, what would you be? An economist, so i could fix health care

what was your favorite age and why? 20- the year i lived in France and had no family responsibilities. everything was so new and unknown at that time, filled with wonder and endless possibilities.

favorite book: “The ascent of money” by Niall Ferguson favorite bands: Guns & Roses, Journey, Kansas

Mark Casanova, MD DCMS MEMBER SINCE 2003 | SPECIALTY: INTERNAL MEDICINE if you weren’t a physician, what would you be? Park Ranger

describe yourself using three words: Passionate / dedicated / humorous

best vacation you’ve ever taken: Spiritual retreat to Assisi, Italy

if you had one extra hour in the day, how would you use it? Meditate in the morning

earliest childhood memory: Working with a speech therapist because of speech delays

favorite band: Ian Moore Band

Michelle Ho, MD DCMS MEMBER SINCE 2003 | SPECIALTY: INTERNAL MEDICINE What inspired you to go into medicine? My father, ching ho, a retired general surgeon. what book are you reading? “Fall of giants” by Ken Follett, an awesome read about the inner trappings of WWI

what was your favorite age and why? 40. Yes, physical things may start to fall apart, but with that maturity comes grace, confidence and a sense that you don’t have to run as hard in the race. There is an ease and contentment that comes with 40.

Undergraduate degree: BA in chemistry, honors thesis in physical chemistry

if you weren’t a physician, what would you be? Figure skater

Wendy Chung, MD DCMS MEMBER SINCE 1994 | SPECIALTY: PEDIATRIC INFECTIOUS DISEASE what inspired you to go into medicine? My younger sibling, who passed away from leukemia when I was in graduate school favorite part of practicing medicine: The satisfaction of positively impacting the health of others if you weren’t a physician, what would you be? a Starbucks Barista


• January 2013 • Dallas Medical Journal

undergraduate degree: Biology favorite book: “Better” by Atul Gawande favorite movie: “The Iron Lady”

Kim Rice, MD DCMS MEMBER SINCE 1994 | SPECIALTY: TRANSPLANT NEPHROLOGY what inspired you to go into medicine? My sister is a medical doctor and I wanted to be like her.

best concert you’ve ever been to: Prince circa 1984

strangest food you’ve ever eaten: squirrel- i grew up on a farm

what is your biggest fear? General anesthesia

earliest childhood memory: telling my mom to send my new baby sister back to the hospital

describe yourself using three words: Quiet / thoughtful / tired

Christopher Hebert, MD DCMS MEMBER SINCE 2005 | SPECIALTY: NEPHROLOGY what inspired you to go into medicine? The reality that I would never be able to run a 4.4-second 40-meter dash if you weren’t a physician, what would you be? Teacher/Coach

best vacation you’ve ever taken: World Cup in Germany, 2006 describe yourself using three words: Ambitious / competitive / compassionate favorite movie: “Braveheart” or “Hoosiers”

Todd Pollock, MD DCMS MEMBER SINCE 1990 | SPECIALTY: PLASTIC SURGERY what inspired you to go into medicine? Since i was young, i had a strong attraction to medicine. I was greatly influenced by observing the care, skill, and patience of my father, Harlan Pollock, MD if you were to perform in the circus, what would you do? tight-wire walker, it would be just like my current job

strangest food you’ve ever eaten: fried grasshoppers best vacation you’ve ever taken: salmon fishing the inside passage with my father, grandfather, uncles and first cousins favorite band: Sting

Hampton Richards, MD DCMS MEMBER SINCE 2000 | SPECIALTY: OB/GYN what inspired you to go into medicine? My Grandfather, who practiced as a General practitioner until he was 91, and my father, whom i work with every day at Walnut Hill Ob/gyn.

favorite part of practicing medicine: Hearing about the fascinating lives my patients live

if you had one extra hour of free time a day, how would you use it: In the kitchen with my family

favorite book: “Farewell to Arms” by Ernest Hemingway

if you weren’t a physician, what would you be? a chef

Erin Roe, MD DCMS MEMBER SINCE 2009 | SPECIALTY: ENDOCRINOLOGY what inspired you to go into medicine? My experience volunteering at free clinics while an undergraduate inspired me to pursue medical school.

earliest childhood memory: Visiting my mother in the hospital when my younger brother was born

if you weren’t a physician, what would you be? I studied voice (classical and opera) through college as my schedule allowed, so i probably would be working in the arts.

descibe yourself using three words: Full of energy best concert you’ve ever been to: Madonna

visit us online at • January 2013 •


The 2013

Millard J. & Robert L. Heath Award The M illa rd J. an d R ober t L. H ea th Aw ard honors a l a y p e r so n wh o h as p rov ide d out st and i ng l e ade r sh ip a nd ser v ice to med i ci ne and the co m m u n it y .

Clay Jenkins In the last few months, the 2013 Robert L. and Millard J. Heath Award winner has made his mark on the Dallas public health scene. Although the elected official works mostly in obscurity, Dallas County Judge Clay Jenkins raised his profile significantly when he took up arms (or airplanes) against the Culex tarsalis. Dallas County Medical Society has chosen to honor Judge Jenkins with the award for his work last summer in eradicating the mosquitoes that spread the West Nile virus to humans. DCMS’ immediate past president, Richard W. Snyder II, MD, nominated Jenkins to recognize him as the public official at the forefront of the county’s response to the crisis and for his respect of the opinions of DCMS leadership. As the leader of the county’s Homeland Security and Emergency Management Department, Jenkins brought together scientific resources from across the county, state and country to discuss whether and when to request aerial spraying from the state. While the number of people diagnosed with West Nile virus multiplied and Dallas County was declared the epicenter of the US epidemic, Jenkins worked with DCMS members and local, state and federal officials to quickly implement a countywide plan to conduct aerial spraying of the mosquitoes. “I gathered together the top scientists and listened to the debate,” he recalls. “I read articles and spoke to experts. I prayed about it and I went with science. I still don’t know God’s position on aerial spraying, but I think we made the right decision.” Within a few days of the decision to spray, the plan was underway. A few weeks later, on Aug. 30, the Centers for Disease Control and Prevention confirmed that he did make the right decision when it announced that analysis of the mosquito traps in Dallas County showed that 93 percent of the mosquitoes that carry the virus had been killed. Clay Jenkins puts much value on one’s character and integrity. Married, with one daughter, he is a family man who greets his mother from the dais when she attends the weekly Dallas County Commissioners Court meetings. But he’s also a “Dallas man” who gives back to the county in which he grew up. He ran for public office


• January 2013 • Dallas Medical Journal

“I don’t look at situations ideologically, but pragmatically,” Jenkins says. “How do we get this done in the best interest of 2.5 million people?” simply because he wanted to give back to the community that’s blessed him with so much. His family values serve him well as administrator of the Dallas County Commissioners Court, the county’s fivemember body that oversees the county’s business. As in his own family, he wants everyone in court to follow the rules, disagree politely and play well with others. “I don’t look at situations ideologically, but pragmatically,” Jenkins says. “How do we get this done in the best interest of 2.5 million people?” This common-sense approach enabled Judge Jenkins to carefully balance all sides of the aerial spraying debate, and lead local governments toward a decision that saved lives. Jenkins grew up in Dallas and Waxahachie, and earned his undergraduate and law degrees at Baylor University. Although the county judgeship is his first foray into elected office, he served as an education aide to the late senator and Texas Supreme Court Justice Oscar H. Mauzy; an intern to Congressman Martin Frost (D-Dallas); an LBJ intern to the late US Senator Lloyd Bentsen; and a clerkship with the Texas Supreme Court. He later established the law firm of Jenkins and Jenkins, with offices in Dallas and Waxahachie. He began his first term in office on Jan. 1, 2011. Now, a few months after the crisis and upon receiving the Heath Award, Jenkins still acknowledges the community effort in the face of the West Nile virus epidemic. “Everyone performed,” he says. “It was due to the work of a few good people that this got done — this decision saved lives. But, ultimately, the information brought to light by DCMS saved lives.”

The 2013

Charles Max Cole, MD, Leadership Award The M a x C ole Lea der sh ip Award recogni zes a D C M S m e m b er for ou tsta n din g servi ce to t he p ro f e ssio n of medicin e an d to t he com m uni t y. The f ir st a wa rd was g iv en to Charl es Max C ol e, MD, in 1 9 8 5 for h is n u merou s cont ri but i ons on t he n a t io n a l, sta te an d local l evel s. Dr. Col e d i e d o n Ju n e 1 , 2 0 0 9 , a t th e age of 95. James Luby, MD, is a modest man. The only way to know about his accomplishments during a lifetime in medicine is from those who have worked with him and learned from him. He’s not one to insert his experiences into a conversation, but his colleagues are quick to point out his wealth of knowledge. “With his lifetime of academic achievement as a virologist, Dr. Luby exemplified quiet courage in his leadership through the West Nile virus outbreak, through his actions which were spurred by his experience and deep convictions,” says DCMS board member Wendy Chung, MD. That combination of humility, knowledge and compassion garnered Dr. Luby the Charles Max Cole, MD, Leadership Award for 2013, as selected by the DCMS board of directors. Dr. Luby put into action his deep desire to help others and solve problems by becoming a physician. The son of a housewife and railroad man, he didn’t necessarily know a lot of doctors when he was growing up. But he says he always wanted to become a doctor; the choice of a profession was easy. Dr. Luby and his two brothers grew up in Chicago. He stayed close to home for undergraduate and medical school, receiving his medical degree at Northwestern University in 1961. He came to Parkland Hospital in 1961 because of Parkland’s good reputation and because he wanted a change of scenery. He returned to Chicago for 2 years of residency before being drafted into public health and work at the Centers for Disease Control and Prevention as an Epidemic Intelligence Service Officer in 1964. Dr. Luby says that, initially, he wasn’t very interested in public health. But his interest grew as his work at the CDC evolved. “The CDC is very important and it’s a great place to work,” he recalls. “It provides superb opportunities. I was able to see the best of public health and preventive medicine in practice.” A few years later, Dallas residents were the beneficiaries of Dr. Luby’s work at the CDC. In 1964 he traveled with the CDC to Houston to study the St. Louis encephalitis outbreak. He called the experience “very dramatic and a good introduction to the problem. It gave me a chance to see how a large epidemic could occur in a modern urban setting and how people rose to meet the challenge.” By 1966 Dr. Luby was back in Dallas and at Parkland Hospital as chief resident. His time at the CDC had prepared him for the summer of 1966, when Dallas experienced its outbreak of St. Louis encephalitis. “We were better prepared in Dallas than in Houston because the outbreak here was discovered earlier than the Houston outbreak,” he says. However, the 1960s infections were less serious than the West Nile virus outbreak of Summer 2012.

James Luby, MD

“This recent outbreak was an intense experience,” Dr. Luby says. The Dallas crises differed in the weather leading up to the summer infestation; the Trinity River had flooded in 1966 vs the Dallas area was under drought conditions in 2012. Also, in 1966 the cases seemed to congregate in a controlled area and more in the lower socioeconomic areas of town, and in 2012 the cases seemed to have no relationship to an area’s economic status. In both Dallas outbreaks, Dr. Luby was at the forefront of research, and assembled a group of infectious disease experts to study the data and determine a solution to the problem. His efforts peaked the moment he thought, “We should do more. What else could be done?” He then approached DCMS for help. ”I wanted to empower Dallas County to do more with our help and our info,” he says. The infectious disease experts with whom Dr. Luby had met submitted a letter to Dallas County officials advocating the aerial spraying of mosquitoes. The DCMS board of directors agreed that more was needed to stop this epidemic, which by August had killed nine people in Dallas County, and Dr. Luby was ready for the fight. The fight, specifically, was for the county to terminate ground spraying for mosquitoes and to implement aerial spraying, last done in Dallas County in 1966. Dr. Luby spoke to the Dallas County Commissioners Court and offered expert opinions to countless other public officials and media. Throughout this, he had one goal — to educate the public and dissipate its fear. His efforts led to a reduction in illnesses, disabilities and deaths in 2012, and will be crucial to future interventions against dangerous vectors. “His push to open this closed system, based on his longstanding preparation and on his understanding of the scope of the impending emergency, not only led to a reduction in illness, disability and mortality, but paved the way for a much smoother response the next time,” says Shelton Hopkins, MD, DCMS chairman of the board and longtime friend and colleague. “In essence, this success would not have happened without Jim Luby’s long-term study and understanding of the issue, his early recognition of the severity of this outbreak, and his dogged determination to see it through the political system.” Dr. Luby’s humility prevents him from taking much credit for the positive outcome of his actions. He’s quick to thank multiple colleagues, and sums up his work on last summer’s public health crisis as, “No problem.” It may not have been a problem for him, but it was certainly a problem for millions of mosquitoes.

visit us online at • January 2013 •



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Support us, as we support you.

DCMSA is your social connection to the Dallas medical community.

Join the Alliance today and take full advantage of daytime, evening and weekend events that offer you and your family: · Support systems · Activities for adults, teens and children · Friendships · Business networking · Personal development · Advocacy for healthier communities The Dallas County Medical Association Alliance and Foundation is committed to advocacy, service and support of our medical family and community. We are a relevant force, reflecting a variety of backgrounds and interests, as well as professional and volunteer pursuits.

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visit us online at • January 2013 •


Your DCMS/TMA membership renewal was due Dec. 31, 2012.  If you have not paid your 2013 membership dues, renew online or  contact Linda Doyle, director of membership, at 214.413.1437 or for more information.


• January 2013 • Dallas Medical Journal


A Matter of Perspective By Jim Walton, DO, MBA Medical Director, Project Access Dallas The news of PAD’s imminent 2013 closure swept through the medical community in early December. For those of us connected to this program over the last 10 years, the news brought with it the painful acknowledgement that sometimes good work must end to provide room for something new. As I thought about what I might write to capture the significance of this moment, I wanted to share the following story: While seeing a newly enrolled PAD patient recently, I was reminded that the hurt I sometimes experience pales in comparison. JR is a 40-year-old Hispanic male who recently had been discharged from a local hospital with heart failure. By the time I saw him, his heart problem was controlled on three medications (all generics on the $4 prescription list). For $12 a month, JR was resuming a more normal life. As I listened to his story, the sadness and brokenness of his voice captured my attention. During the exam I noted the typical tattoos over his still muscular frame and, in almost a whisper, he described his 20+-year journey as a young man, running the streets of East Dallas high on methamphetamines and alcohol. Several stints in jail and mandated drug rehabilitation could not persuade him to eliminate his dangerous behavior and, as his health deteriorated, he was forced to move back in with his mother, no longer able to work because of very little stamina. He said that a feeling of suffocation had caused him to seek medical attention last spring. He now understood that his heart condition was caused by his drug abuse and self-destructive behavior. As tears rolled down his cheeks, his sorrow and grief came flooding into the exam room, filling the space between us, and he was hoping I wouldn’t judge him. And as he expressed his regret and fear, he no longer was just another gang member who was “reaping what he had sowed”; he simply was another human who needed comforting. So, I did something very unnatural for me … I stood and embraced him … and while holding him close until his tears stopped, I whispered that he was going to be “just fine.” I hoped that my confident reassurance would help the hurt he was feeling, but, more importantly, I hoped I communicated my sincere commitment to journey with him over the course of his illness. I am grateful for the people who have worked over the last 12 years to give me (and so many others) the opportunity to have moments like the one I had with JR. The closure of PAD won’t change my commitment, or most of your commitments, to the poor and uninsured patients in our community. And because we desire excellence in both our leadership and community service, we now must recommit ourselves to improve on the work we accomplished over the last 10 years. May we take a moment to look backward and celebrate, and then move forward together. visit us online at • January 2013 •


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• January 2013 • Dallas Medical Journal

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CEO Update: Aw a k ening —

O u r Un iqu e Rol e i n Shapi ng the Fut ure

by Michael J. Darrouzet, DCMS CEO/EVP

As we begin 2013, the Dallas County Medical Society remains the second largest county medical society in the United States, and we enjoy an active and growing membership. We do not take that for granted. During the last 12 months, unity among physicians through DCMS created some of the most intense advocacy work in our history. Thanks to each of you; the strong leadership by our president, Rick Snyder, MD; the DCMS board of directors; and all our committees, DCMS enjoys a strong role in the community and is well-positioned for another year of supporting the finest profession on the planet. Being CEO of the Dallas County Medical Society provides me with a unique perspective on the healthcare industry, the role of physicians, and how patients and the community view the profession. It’s my privilege to share this view with DCMS’ elected leaders as they make critical decisions that change lives in North Texas. A lot has been written this year (and I mean a lot … thank you, Dr. Snyder, who broke records for number of words on a President’s Page, turning many pages into novellas) about DCMS’ work with issues including West Nile virus, Project Access Dallas, and the 1115 Medicaid Waiver. These efforts are textbook cases of professional advocacy. This is the way professional organizations are supposed to work. That is why you pay dues, and DCMS is committed to making good use of every dues dollar. We look forward to continuing this strong advocacy under the presidency of Cynthia Sherry, MD. As we approach the profound changes in health care in 2013 and 2014, I see a clear trend in the attitudes of physicians that inspire me and the DCMS staff, best described by the word “awakening.” DCMS members, and physicians all over Texas, are awakening to three key principles: the power of, and need for more, professional integrity that distinguishes physicians from most other healthcare leaders; the importance of demanding moral and ethical decision-making in health system reform; and medicine’s continuing acceptance of the responsibilities of protecting patients from harm in the face of such chaos. Patients trust physicians — more so than any other group — to guide them through the changes ahead. The more intense the reform gets, the more physicians are waking up to their unique role in shaping the future of health care. Speaking of waking up, I have to share two analogies that came up during recent discussions about the future

of Project Access Dallas. References were made to two movies that became symbolic of such an awakening. The first movie “The Matrix,” which came out in 1999, told the story of Neo, a man who begins to question the everyday “world” he thinks he lives in and soon awakens to discover the truth. Neo begins a journey to awaken others, and soon he and his friends find themselves fighting those who are trying to control their world. If you haven’t seen this movie, see it, and think of the thousands of physicians who are beginning to awaken to their destiny to protect the fundamental freedoms of private practice, as well as protecting the physicianpatient relationship. The second movie is more mainstream — “Star Wars.” This movie classic also tells the story of a dwindling but strong society, with rock-solid core values, facing the demise of its culture at the hands of a huge and terrifying empire. The scene referenced in the DCMS discussion was of Ben Obi-Wan Kenobi, the aging Jedi leader, in a sword fight with Darth Vader. As Obi-Wan’s friends look on in shock, he lowers his Lightsaber, allowing Vader to strike him down. It’s a powerful scene because of his personal sacrifice. Obi-Wan created the basis upon which he became more powerful and so the Jedi could continue their fight. What does this have to do with medicine? It may seem dramatic, but these indeed are perilous times for physicians and the practice of medicine. Decisions made by physicians in this environment will have a huge impact on the future of medicine in our county and in our nation. Physicians across Dallas County make sacrifices every day to keep their practices open, to serve one more uninsured patient. DCMS is fully aware of their struggle. The decision to close our successful program, Project Access Dallas, heralds our responsibility to embrace sacrifice, suffering the loss of something we built with the community. Despite this loss, we must not give up on those in need, those in the battle. DCMS will become a stronger advocate for physicians and patients in 2013. We will be a more powerful organization, seeking justice and fairness for all physicians and patients. On behalf of the entire staff, I thank you for your membership and the trust you place in us as we work on your behalf. May you and your families have a successful 2013.

visit us online at • January 2013 •


Legislative Update: T he I ssu e s F ac in g L aw m ak e rs by Tracy Casto, director of public affairs and advocacy

With legislators returning to the Capitol in January, Texas physicians are preparing for another tough session fighting for their patients. Physician leaders at TMA’s Advocacy Retreat in December discussed the issues expected to dominate the 83rd legislative session and the issues they want legislators to address. Although healthcare issues will occupy a key spot on the agenda, the lawmakers’ attention will be split among several critical concerns. During the TMA Advocacy Retreat in December, State Rep. Todd Hunter (R-Corpus Christi), a long-time supporter of physicians, offered his views on the upcoming session. He served in 1989 through 1997, then again starting in 2008. After the members are sworn in on Jan. 8, the pace is slow for a few weeks. “In January, not a lot occurs,” Hunter says. “Committees generally get picked at the end of January or early February. In the middle of February, the committees start working. If your bill isn’t done by late April, it isn’t going anywhere. In May, the cutoffs hit. That’s procedure.” Hunter is chair of the House Calendars Committee, whose 15 members decide whether a bill gets to the House or Senate to be voted on. Regardless of when a bill hits Calendars, if it can’t get through Calendars, it’s finished.


• January 2013 • Dallas Medical Journal

“It’s a unique system,” Hunter says. “A lot of antimedicine bills make it to my committee. Calendars is a good gatekeeper; a stopgap committee.” Of the 6,000 bills introduced last session, his committee had to be familiar with about 1,000 of them. Regardless of the issues the Legislature will deal with, Hunter says the top issues for the Legislature should be: Health Care “Unfortunately for you, not many people know what you do,” he says. “They don’t know health care. I was at a function where I was asked about Obamacare, which didn’t make sense because I’m a state representative, not a congressman. You need to watch what Massachusetts does because it has a system that takes the doctor out of the equation; you have to watch to keep that from creeping into the Legislature. “Texas is going to be pro health care and pro

physician … on the House side,” he says. “I can’t speak for the other side.” He says that members of both houses need education about medicine’s interests. In the House, 40 of the 150 members are true freshmen, and about 20 others have served just one term. Most face a steep learning curve. “People don’t know the difference between optometrists and ophthalmologists,” he says, and likened the confusion or misinformation about those professions to the issues dentists share with dental hygienists. Water The foremost issue facing Texas this session is water — its necessity, scarcity and ownership. “There’s a pending federal lawsuit that will determine the flow of creeks and river beds. It’s Abilene vs Houston vs Uvalde vs San Antonio vs Corpus Christi … who gets the rights to the water? This will be a big issue. We’ve never tackled anything like this.”

Hunter urges physicians: “Do not give up on the system. Do not give up on Texas. Do not give up on government. Do not give up on the Legislature.” Education A strong proponent of higher education, Hunter says the Legislature needs to promote it more. “Colleges and universities are our foundations for knowledge and our research arms for physicians,” he says. “Lawmakers have to get off this kick of giving a negative image of public ed and higher ed. Why do we want negative clouds over the institutions that are teaching us and our kids? “The education funding system has been placed in the courts. There will be an appeal and it will come back to the Legislature. There may be a special session.” He advised physicians to watch legislators diligently during school funding discussions so they do not bring medical care into the sales tax realm. “When you talk funding of public schools, you have to figure out how to pay for it,” he cautions. Tort Although Hunter doesn’t foresee lawmakers addressing tort issues this session, “you have to watch out,” he warns. “You have to make sure the legislators don’t create a new cause of action against medical providers just because someone had one bad incident out of 1,005.”

A Legislator’s Advice to Physicians

Meet with your legislators. Get to know us. You’re not going to agree with everything we say; we’re not going to know everything. If you can’t meet with us, please call us. If you have an issue, we have to hear from you. If you call us, we know you’re there. We take notes of who calls us. If you can’t meet with us and you can’t call us, please write us. The only thing I tell you is … get our names right. My name is Todd Hunter. I am a state representative, not a congressman. If I voted wrong on a bill, I get “Dear Toad Hunter.” Know that we’re all just people. I’ve been in and out of the House twice. I went back in knowing what I was going to get into, but I got back in because I thought there was going to be an inexperience glut. I know you’re busy and you’re taking care of patients, but get to know us.

visit us online at • January 2013 •



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• January 2013 • Dallas Medical Journal

For more information or to sign up, contact Tracy Casto, director of legislative affairs and advocacy, at 214.413.1427 or


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