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Medicine’s Future v o l u m e

In this issue: 36th Annual Medical Student Dinner - Photos from the event

Community - Gifts to the Giver

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About

the

Cover Photo

DCMS President Shelton Hopkins, MD, and Charles Mitchell, MD, greet Davinder Grover, MD, at the 36th Annual Medical Student Dinner on Aug. 21.

Dallas County Medical Society PO Box 4680, Dallas, TX 75208-0680 Phone: 214-948-3622, FAX: 214-946-5805 www.dallas-cms.org Email: lauren@dallas-cms.org

DCMS Communications Committee Roger S. Khetan, MD.............................................. Chair Robert Beard, MD Gene Beisert, MD Suzanne Corrigan, MD Seemal R. Desai, MD Daniel Goodenberger, MD Gordon Green, MD Steven R. Hays, MD Ludwig A. Michael, MD David Scott Miller, MD

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Pr es i de nt’s Pa ge Students and More

DCMS Board of Directors Shelton Hopkins, MD....................................... President Richard W. Snyder II, MD..........................President-Elect Steven R. Hays, MD..........................Secretary/Treasurer Stephen Ozanne, MD.............. Immediate Past President Garret Cynar, MD Sarah L. Helfand, MD Michael R. Hicks, MD Jeffrey Janis, MD Rainer A. Khetan, MD Dan McCoy, MD Todd Pollock, MD Cynthia Sherry, MD Jim Walton, DO

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Communi ty The Gift is to the Giver

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36th Annua l Medi cal S tude nt D i nner

DCMS Staff Michael J. Darrouzet................... Chief Executive Officer Lauren N. Cowling................................ Managing Editor Mary Katherine Allen........................... 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. ©2011 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.

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Phy s i ci an’s S potl i ght Ford Albritton IV - Aggie, MD

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Ins u rers Wi l l Stop Pay i ng y ou Jan. 1

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

Subscription rates $12 per year for members; $36, nonmembers; $50, overseas. Periodicals postage paid at Dallas, TX 75260.

Postmaster Send address changes to: Dallas Medical Journal, PO Box 4680 Dallas, TX 75208-0680.

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submit letters to the editor to lauren@dallas-cms. org visit us online at www.dallas-cms.org • October 2011 •

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D ear Colleagues, We need your input to make your Dallas County Medical Society even

better!

We’re

interested

in

your

feedback

regarding

D CMS’ advocacy efforts, communication tools and pieces, and membership events and services.

A s a memb er, you r opi ni on i s va l ue d. Please watch your e-mail for our short membership survey. Then complete it and return it to DCMS. D CMS is one of the best county medical societies in the nation, and with your help, we can make it even better! We appreciate you and thank you for your comments.

Roger Khetan, MD

Jeffrey Janis, MD

Lee Ann Pearse, MD

Chair, Communications

Chair, Membership

Chair, Legislative Affairs

Committee

Committee

Committee


President’s Page

Students and More One of the perks of being the Prez is that I was able to join a discussion/presentation on Aug. 21 at the annual DCMS Medical Student Dinner, held at the DoubleTree Hotel on Central Expressway. I wish all DCMS members could have been there. All those eager, bright young faces tinged with anxiety and showing intense interest in their studies and their calling — it was like being plugged into a wall charger. The format usually is one of a sit-down dinner at a hotel ballroom after an open bar. Ideally, each table has two physicians or physicians and spouses, and freshman medical students complete the table. During the meal, students pepper the physicians with questions about the upcoming ordeal of medical school and what they can expect upon its successful completion. The DCMS president welcomes the group and the AMA president-elect gives a talk. After closing remarks and encouragements to become active in organized medicine, everyone goes home. This year was different. On the dais we had Jeremy Lazarus, MD, the AMA president-elect, and we had Bruce Malone, MD, the TMA president. I had the privilege of sitting with them, asking questions and even chiming in on occasion. The questions were pretty general and allowed our guests to hit a number of points that were felt to be of use to this audience (the main one being, don’t sweat the small stuff or the future right now. Study and become a 2nd-year student). The decision to invite both guests partly was to experiment with a new format and to lessen the recent friction between the AMA and the TMA. I feel as if that second issue was lost on the students. As a group and at this stage, they simply don’t care about the TMA/AMA relationship. We have not done a follow-up questionnaire regarding the program, but it appeared to have been well-received (no fruit directed at the dais). Now we need to decide whether to continue this format or just to tweak it (e.g., perhaps a Q&A period or questions submitted and screened for common themes). Now on to the main point: you could have been there. We need vigorous participation from the membership to provide a strong sense of camaraderie and support to these young people who will soon don the mantle of physician. You don’t have to see yourself as an insightful mentor or gifted educator to be

We are faced with an extended, slow degradation of payment for services, whether that is Fee For Service or Pay For Performance or a salary. worthy to attend this event — simply by being present and being a physician, you are making a statement of support. You got through medical school, and these students aren’t yet sure that they will. Knowing that DCMS members cared enough to provide this event and to attend will go a long way in forming their sense of belonging to the Dallas medical community. From a selfish perspective, moreover, the benefits can be huge. The students’ obvious enthusiasm and absence of concern about PPACA or ACOs is infectious; they know they will be practicing good medicine in some system or other in the future. If you don’t want to attend because you believe that your view of the state of medicine would rain on their parade, then you need them more than they need you. They deliver on their end, big time. Let’s deliver on our end, also. Plan to attend next year’s Medical Student Dinner on Aug. 19, 2012. It will be worth your while. On another note, this year I have hoped to get a grip on “How to Streamline Private Medical Practice.” I’m going to share with you where I am so far. We are faced with an extendeed, slow degradation of payment for services, whether that is Fee For Service or Pay For Performance or a salary. No one expects the dramatic drop in Medicare fees because it would massively destabilize the medical delivery system. But why is that true? The medical care delivery system is like a big successful and bloated corporation that has just realized that its industry bubble is about to burst. At first there is panic, but then the system sees that changes can be made which allow it to continue to make and sell its product and take home a paycheck. Like all analogies, this one has multiple dissimilarities, but the point that changes should be made is true. European private practice primary care physicians usually have no office staffs — they see patients with no receptionist, no medical records clerk, and no nurse or other assistant. What hurdles stand in the way of our being able to cut our overheads by more than 50 percent? I’ll get back to you, and I hope that we can engender creative discussion of this issue. It’s crucial.

Shelton Hopkins, MD

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You’are invited to the 2011 dcms member roundup ! WHEN IS IT? Friday, Oct. 28, 6 - 9 p.m. WHERE IS IT? Eddie Deen's Ranch, 944 S. Lamar, Dallas, near the Dallas Convention Center WHAT TO EXPECT? Entertainment includes James Munton the magician; photo booth; 3-shot pool and basketball; face painting; kids craft station and goodie bags for all ages. This is a great evening to enjoy with your family AND to network with your physician colleagues.

RSVP BY FRIDAY, OCT. 21. Fax this form to 214.946.5805, or call Linda Doyle at 214.413.1437, or e-mail RSVP information to linda@dallas-cms.org. SAVE mE A SPOT! (PRINT NAME)

AND FOR mY SIDEkICk(S)! (PRINT NAMES)

E-mAIl

PHONE

(FOR REMINDERS)

The only cost is $7 to park your wagon. Dinner is FREE, thanks to our event sponsors DCMS CIRCLE OF FRIENDS, Texas Medical Liability Trust and TMA Insurance Trust. Event is hosted by Dallas County Medical Society.


“A 20-minute mammogram gave me a lifetime with my family.” At age 37, Angie Viscuso got her first mammogram – and a breast cancer diagnosis. “The cancer was so small that I wouldn’t have found it by myself,” she says. Treated at Baylor, and now cancer-free, Angie’s a big believer in early detection. “The mammogram really did save my life.”

In as little as 20 minutes, you could be screened for breast cancer. So schedule a digital mammogram today. Your life is worth the time.

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Call 1.800.4BAYLOR Visit www.BaylorHealth.com/CelebratingWomen

In addition to helping prevent your own breast cancer, join us in our cause to prevent breast cancer in all women. Come to the Celebrating Women luncheon to fight breast cancer on October 28, 2011. ©2011 Baylor Health Care System DCMS CE 8.11


Community

“The gift is to the giver, and comes back to him....” — Walt Whitman By Jim Walton, DO, MBA, Project Access Dallas Medical Director Over the Labor Day holiday weekend, I picked up my September edition of Harvard Business Review1 to find Michael Porter suggesting that three key healthcare economic myths need to be exposed and/or destroyed: • Myth 1 — Charges are a good surrogate for provider costs. • Myth 2 — Hospital overhead costs are complex to allocate accurately.

too

• Myth 3 — Most healthcare costs are fixed. Reading this article reminded me that some of the most thoughtful business leaders in the country are working diligently to figure out how to reform our healthcare system. However, one key issue not defined in the article was the fact that healthcare costs related to caring for the uninsured (and historically underserved) rise with increasing unemployment during economic recessions. Another key point is that if uninsured people with chronic illnesses delay care, the costs only increase because we eventually treat them for complications. It is one of our society’s greatest economic paradoxes as we debate how best to design a solution that might help rein in this one aspect of healthcare cost increases. As practicing physicians we feel some obligation to lend our ideas to these debates, with hope that our voices will bring reason to the ultimate solutions. However, this opportunity may feel more like a predicament. We might feel forced into doing this meaningful, but emotional, work on behalf of our profession and society, while not being paid anything extra for it. For some, this makes the decision to participate difficult. However, a recent book, “Linchpin,” by Seth Godin2, put forth a new argument for our intellectual and

emotional engagement. Godin’s perspective helped me see that physicians may be the most motivated and connected healthcare workforce with the most to offer to the debate. But many, if not most, of us might argue that we already give so much during our patient care time that we can’t be expected to contribute more, especially when we receive so little tangible reward for our time, energy and talent. Godin argues that we should consider looking at physician engagement in the discussion a little differently, and although we may see little return in actual year-end pay increases, we do benefit. “First, you benefit from the making and the giving,” he contends. “The act of the gift is, in itself, a reward. And second, you benefit from the response of those around you.” Our intellectual and emotional investment in the healthcare reform debate should be viewed as we would any other gift: it’s not our job to give, but rather, it’s our privilege. Entering the election season, I suspect that the next 12—14 months of healthcare policy debate will give each of us an opportunity to make meaningful contributions to improve health in our community. As we advocate for our patients, particularly the uninsured and historically underserved, we allow those around us to see the medical professional of Dallas giving. Additionally, if we make these important intellectual and emotional investments, we will benefit by the responses of others, the strengthening of our valuable asset, and the endurance of our reputation.

1 Porter, M., Kaplan R. How to Solve the Cost Crisis in Health Care, Harvard Business Review, Sept. 2011, pages 47-64.

2  Godin, S. Linchpin, “Are You Indispensable?” Portfolio/ Penguin, 2010, pages 81-82.

visit us online at www.dallas-cms.org • October 2011 •

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26th Annual

Conference of Professions

“Professional Ethics and Social Networking: Like?” presented by Carrie James, PhD

Research Director/ Principal Investigator at Project Zero at the Harvard Graduate School of Education

October 14 8 – 11:45 a.m Prothro Hall on the SMU campus Seating for physicians is limited to the first 50 registrants. Preregistration is required. To register you must call DCMS at 214.948.3622. For questions, contact Connie Webster, SVP of operations, at 214-413-1426 or connie@dallas-cms.org.

The University of Texas Southwestern Medical Center designates this educational activity for a maximum of 3 AMAPRA Category 1 Credit(s)™.

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• October 2011 • Dallas Medical Journal

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ANNUAL FUND DRIVE

To learn more about programs we support, visit our Web site at www. dallas-cms.org/communityhealthprograms.cfm Or donate online at www.active.com/donate/11campaign For additional information contact: Jackie Campbell, director of finance, Dallas County Medical Society, at 214.413.1428 or campbell@dallas-cms.org

Every 9-1/2 minutes someone in the US is

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visit us online at www.dallas-cms.org • October 2011 •

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First-year medical student Foster Hays and his father, Steven Hays, MD Caption

DCMS President Shelton Hopkins, MD, and AMA President-elect Jeremy Caption Lazarus, MD

Caption Stephen Ozanne, MD, with a student

36 Annual Medical St udent Dinner th

DCMS physicians hosted first-year medical students at the 36th Annual Medical Student Dinner on Aug. 21. Approximately 300 students were welcomed into the family of medicine by DCMS members. Students and members alike enjoyed dinner and a panel discussion led by DCMS President Shelton Hopkins, MD, featuring AMA President-elect Jeremy Lazarus, MD, and TMA President Bruce Malone, MD. Next year’s dinner is scheduled for Aug. 19.

A student learns the ropes from Duane Barnett, MD. Caption

Caption

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Caption

Discussion featuring Bruce Malone, MD; Jeremy Lazarus MD; and Shelton Hopkins, MD

Shelley Hall, MD, hosted a table of students with husband, Richard W. Snyder II, MD

• October 2011 • Dallas Medical Journal


A student with Cynthia Sherry, MD Caption

A student exchanges contact information with Robert Gunby, MD. Caption

DCMS President Shelton Hopkins, MD; AMA President-elect Jeremy Lazarus, MD; and TMA President Bruce Malone, MD

George and Sharon Bakos, MD Caption

Vernil and Charles Mitchell, MD, hosts a table of students as they’ve done at every Medical Student Dinner since 1975.

Caption

ACaption student enjoys time with Roland Black, MD, and Philip J. Huber Jr., MD.

Leyka Barbosa, MD, visits with a group of students. Caption

visit us online at www.dallas-cms.org • October 2011 •

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FACT: Physicians earn more money per hour in the clinic and the O.R. — practicing the skill of medicine — than they can playing accountant, coder or office manager. Delegation is the key of every successful business enterprise.

Credentialing: All SPA Contracts include delegated credentialing and recredentialing. This allows you to contract with many plans by completing only one application and allows you to keep your credentials updated with many payors through only one entity. Ancillary Services: SPA has group purchasing rates for medical supplies, medical waste disposal and other services for SPA members. This helps you to keep your overhead

costs low. Value: All of these benefits come from a physician-run IPA for less than $80 per month. Want to find out more? Call us at 214-346-6623, or visit us at www.spa-dallas.com. We can help you get back to the practice of medicine in 2011.

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2012 PAD Volunteer Physicians of the Year Award Nominations Do you know a physician who should be rewarded for leadership and/or involvement in volunteerism and community service in relation to Project Access Dallas or other DCMS Foundation community service projects? DCMS wants to recognize a Project Access Dallas primary care physician and specialty physician who demonstrate compassionate care for the uninsured. Nominations will be accepted through Oct. 15 from Project Access Dallas physicians who volunteer, the charitable clinics at which PAD physicians volunteer, and DCMS staff who work with PAD physicians. To obtain a nomination form visit www.dallas-cms.org or contact Marilyn Haspany, PAD Physician Network Director, at Marilyn@dallas-cms.org or 214.413.1455.

Physicians on the DCMS Community Service Committee will select the winners, who will be announced at the DCMS Installation Dinner on Jan. 19.

HealthPAC Board: Call for nominations Physicians interested in county politics can feed their need through HealthPAC, the DCMS political action committee. The DCMS board of directors is taking nominations through Oct. 31 for HealthPAC board appointments. If you’re interested in Dallas County politics and public health issues, contact Tracy Casto, DCMS director of public affairs and advocacy, at Tracy@dallas-cms.org or 214.413.1427. HealthPAC is led by a five-member board of directors, which meets a few times a year, sometimes via conference call. The $28 annual HealthPAC dues are used to support candidates or public health campaigns approved by the board. The board can make endorsements in any countywide race, including Dallas County Commissioners Court, Dallas County District Attorney, and civil district court judges. Board members will serve 1- or 2-year terms.

visit us online at www.dallas-cms.org • October 2011 •

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visit us online at www.dallas-cms.org • October 2011 •

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An illness when he was a college freshman changed the course of Ford Albritton’s life. He went from a prelaw student at the University of Oklahoma to a premed student at Texas A&M University. Having grown up with a father and grandfather who were A&M alumni, Ford wanted to try something different. So he had enrolled at Oklahoma, and planned a career as an attorney in music production or oil and gas exploration. Then his appendix ruptured.

DCMS Physician Spotlight

F ord A lb ritton IV — A ggie, M D

by Tracy Casto, director of public affairs and advocacy

“I got massively ill,” he recalls. “After I had surgery and came home, I wasn’t getting any better. I went to the doctors here and they found I was septic because of Ford Albritton IV, MD an abscess.” This turn of events turned his interest to medicine. “I got a glimpse of medicine,” he says. “My dad had wanted to be a pediatrician, and I had thought about that, too. I thought about what I would do if I had it to do over again. Then I had an epiphany — I do have it to do all over again. I instantly switched gears and decided to go into medicine.” He worked on ophthalmological and orthopaedic research in medical school, but discovered he enjoyed endoscopic sinus surgery more — it had new procedures and equipment, and fed his desire to explore new areas. After graduating with honors from A&M, he completed his residency and internship at Emory University, where great mentors emboldened and encouraged him. And where he unintentionally influenced a group of surgeons to wear cowboy boots in the OR. “I started wearing boots at Emory because I was missing Texas,” he says. His colleagues couldn’t believe the boots were comfortable. “I told them that the boot holds the foot at an angle and in a restful position, good in hourslong surgeries. Suddenly, a mass of surgeons was wearing boots.” Dr. Albritton is chairs the Department of Otolaryngology Head & Neck Surgery at Texas Health Presbyterian Hospital of Dallas. He also serves as board chairman of the Texas Institute for Surgery. His practice at Presbyterian is a homecoming of sorts when he was growing up in Dallas, he received all his health care at that hospital. His areas of expertise include sinus and rhinology, minimally invasive surgery, balloon sinuplasty, and thyroid surgery. With some 38 million people affected by sinusitis in the United States, he has a busy practice. He’s performed thousands of balloon sinuplasties, and he teaches the procedure to other physicians. He’s studying the feasibility of doing balloon intervention in the office, under local anesthesia.

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“It would increase access to patients with sinus disease but who are deathly afraid of anesthesia,” he explains. Until the new era of sinus treatments began in 1996, he says that people undergoing sinus surgery lost a lot of blood and were hospitalized for days. In the mid-1980s, an Austrian physician took an orthopaedic telescope and put it in someone’s nose — he was called a “nasal astronomer.” He could see openings in sinuses and do limited and effective surgeries on the sinuses through the telescope. It was much safer than traditional surgery. “The newest techniques are minimally invasive,” Dr. Albritton says. “They preserve the most tissue. We see improvements in symptom scores of about 52 percent — that’s significant. With newer techniques, we may get better improvement. One study showed a 72 percent improvement in symptomatic score.” Dr. Albritton supports a tiered approach regarding the invasiveness of a procedure vs. the severity of the disease when treating a patient. “I’m passionate about it,” he says about balloon sinuplasty. “There’s a big misconception regarding sinus surgeons, that we operate on anything and everything. But sinus disease is a combination of factors, from inflammation to anatomical. If the disease is not severe, can we get away with a remodel, rather than a resection, of tissue?” He’s working on studies that would demonstrate this possibility. He wants to develop an algorithm that categorizes sinus diseases into 50 or 60 subtypes and includes which medical regimen works best for each subtype. Dr. Albritton has several patents at various stages in the years-long approval process. The first is a hearing supplement to help fill a gap in therapy. He says science suggests that antioxidant therapy can delay hearing loss. “The hypothesis is that a carefully controlled and designed nutritional supplement wouldn’t hurt and may help,” he says. “Patients kept asking for something to assuage the fullness, dizziness or ringing in their ears, and there was nothing.” Dr. Albritton also is working on a nasal medication that relates to sugars and their role in reducing paralysis of cilia in nasal passages. This line of treatment has been successful in improving lung function in patients with cystic fibrosis, and because the nasal passages are lined with the same type of tissue, he posits that the same medication may work in the nose. Dr. Albritton can empathize with his patients because


he deals with allergic rhinitis and has had surgery on his septum to improve his breathing. Ten years ago when he was undergoing surgery for his snoring, the surgeon discovered a cyst in the back of his pharynx. It was cancerous. “It gives me a perspective if I have to tell a patient he has cancer,” he says. “I understand what he’s going through.” Project Access Dallas Volunteer Dr. Albritton is a great champion for Project Access Dallas, and has been since its inception in 2002. When he is asked to provide additional help, he’s quick to offer to see more patients. He has pledged to see 15 patients a year and consistently meets or exceeds that pledge. He says his Christian faith propels him to volunteer with PAD. “We have a big problem in health care, and if all of us come together, we can knock a big chunk of it out,” he says. “I was given a certain ability, and I need to use it for a bigger purpose than I can comprehend. Our duty is to help people. Selfishly, I get a lot of satisfaction from the work, and from when patients say, ‘Thank you’ and write me letters. For most patients, I can do something to help them. I’ve done sinus surgery on a patient and he gets better. I’m not going to see a dime for it, but it’s what we should do. “I’m using the gifts that God gave me — to take care of others. It’s stewardship.” Biker, Artist, Vinyl Recycler His professional life centers on sinuses, while his nonwork time is split among bicycles, art and music, plus appreciation of wine and travel. “The gadget guy in me loves the technical aspects of riding,” he says. He completed the Hotter ‘n’ Hell 100 bike ride in Wichita Falls in late August, when the finish-line temperature was 107 degrees. He rode his weekly total (about 100 miles) in one outing and completed the ride in 8½ hours. He and a few of his biker friends hope to start a racing team for a new charity — Team TKO (Take Cancer Out) — to raise money to provide childcare subsidies while the children’s mothers undergo cancer treatment. Dr. Albritton’s mother was an art history major, and her side of the family includes many artists. He paints abstract expressionism in oil, water color, and mixed media. “Originally I painted because I had to put art on my walls,” he says. He travels to New York often and enjoys the creativity of the city’s bohemian music scene. He jokes that he’s into “vinyl recycling.” Although his mother had saved many of the LPs he had when he was younger, the albums all warped. Now he offers to “take your old vinyl LPs and see that they’re disposed of in an environmentally friendly way.” Third-generation Aggie The Albritton name is well-known among Aggies. Dr. Albritton’s grandfather, Ford D. Albritton Jr., funded and oversaw construction of what became the Albritton Bell Tower in College Station. The 138-foot tower has become an integral part of Aggie tradition and the major entryway into the academic core of campus. The tower contains Westminster chimes and 49 carillon bells. The bells weigh 17 tons — the largest weighs more than 6,000 pounds, and the smallest weighs 28 pounds. On the clock face, in place of the Roman numeral IV, the Albritton tower has “IIII.” Discussion on Aggie blogs

has it that Mr. Albritton thought the “IV” too closely resembled “tu” (as Aggies refer to the University of Texas). This is news to Dr. Albritton who immediately Dr. Albritton at play and work. calls his grandfather about it. Mr. Albritton explains simply that “IIII” was the European way to write the Roman numeral for 4, and that the clock face and carillon were made in a 300-year-old foundry in France. “Texas is a great school,” he says. “I root for UT at all games, except when they play A&M.��� Before he began the family’s Aggie allegience, Dr. Albritton’s grandfather had been set to go to the University of Texas and even had a dorm room. Then he joined some buddies on a weekend trip to A&M. “He loved it,” Dr. Albritton says. “He switched to A&M, and he passed that passion on to his children.” Dr. Albritton’s children (Anna Kate, 6; and Drew, 10) may be the fourth generation of Albrittons at A&M. But, he hasn’t indoctrinated his children into being Aggies. “They self-indoctrinated,” he says.

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CONTINUE THE CARE LONG-TERM ACUTE CARE HOSPITALS • NURSING AND REHABILITATION CENTERS • TRANSITIONAL AND SUBACUTE CARE • ASSISTED LIVING CONTRACT THERAPY SERVICES • HOME CARE • HOSPICE


Insurers Will Stop Paying You Jan. 1 Th at doomsd ay h e ad l i n e w ill c om e t ru e if y o u d o n o t u pg r ade y our electroni c bi l l i n g s ys te m s t o c om p ly w it h t h e H IP A A 5 010 e lect ronic c la i ms stan d ar d s . I f yo u d o n ’ t do so b y Ja n . 1, 2012, M e d ic a re , Medicaid, a n d the com m e rc i al i n s u r anc e c a rrie rs w ill n o t p a y y ou r c la ims. The U.S. Department of Health and Human Services requires all “covered entities” (physicians, clearinghouses, insurers, and others with access to digital personal healthcare data) to convert to the new 5010 transaction set by Jan. 1. These are the electronic transactions used to transmit patient, physician and provider data among those covered entities. Despite what you may have heard elsewhere, the Centers for Medicare & Medicaid Services will not delay the deadline. It will remain Jan. 1. TMA established the 5010 Resource Center on the TMA website to help you make the conversion. It includes background information on the issue; questions to ask vendors; contact information for EHR, practice management and clearinghouse vendors; information on how you can finance upgrades to your existing system or purchase a new system and an action plan. The switch from Version 4010/4010A1 to Version 5010 is part of the ICD-10 conversion that takes effect Oct. 1, 2013. It involves updated codes and transactions standards that will cover improvements to electronic claims, insurance eligibility verification, claim status inquiries, requests for authorizations, and electronic remittance data. Unlike Version 4010, Version 5010 accommodates the ICD-10 code structure. The changeover will require equipment upgrades and comprehensive staff training. ICD-10 will fundamentally change the way you practice medicine. ICD-9 has only some 14,000 codes, while ICD-10 has more than 68,000 codes. In some instances, the number of codes that could be used for the same diagnosis has increased exponentially. For example, CMS says there are nine potential location codes for pressure ulcers under ICD-9-CM, while ICD-10-CM has some 125 codes. The ICD-9 codes show broad location but not depth, whereas the ICD-10 codes show specific location as well as depth. TMA is planning hands-on workshops and training for physicians and staff in early 2012 to help physicians switch from ICD-9 to ICD-10. Check the TMA website for updates. TMA currently offers a variety of training options, including webinars and ICD-10 “boot camps.”

Why Prepare NOW for 5010? • Avoid claim rejections. • Prevent payment delays or loss. • Plan for appropriate transition time. • Budget for additional expenses. • Make sure you get paid for the care you provide after Jan. 1, 2012.

Do this NOW • Contact your vendors — for your practice management system, electronic health record system, and/or your claims clearinghouse — to ensure your software is upgraded for 5010 compliance. • Check the 5010 Update pages for Medicare, Medicaid and health insurance payers. • Identify changes to data reporting requirements. • Once you have the upgrades, test the system to ensure claims are going through — whether you process through a clearinghouse or directly with the payer. • Identify potential changes to existing practice work flow and business processes. • Identify staff training needs. • Budget for implementation costs, including expenses for system changes, resource materials, consultants, and training. • If you are looking for a new system, consider upgrading to a companion practice management/ electronic health record system. Your HIT Regional Extension Center might be able to help with planning. Visit www.texmed.org/5010 to learn how to prepare to upgrade your practice management or electronic health record system, how to develop an action plan, and the impact on your business functions. Article reprinted with permission from the Texas Medical Association.

visit us online at www.dallas-cms.org • October 2011 •

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18 Pain Relievers

D.R.S. is a network of highly experienced independent businesses and professionals offering medically related products and services specific to physicians. Members are selected for their high standards and uncompromising service.

Accountant (CPA) / Tax Services Paula Allgood, CPA……Beaird Harris & Co, P.C. 972.503.1040……PaulaA@bh-co.com Lori A. Eads, CPA……Bland, Garvey, Eads, Medlock + Deppe, P.C. 972.231.2503……leads@taxsmart.com Design / Build Medical & Dental Contractor Grady Herzog……Structures & Interiors Inc. 817.329.4241……gherzog@structures-interiors.com Electronic Medical Records Leslie Warren……EMR Advisory Group 972.898.5671……lwarren@emradvisorygroup.com Employee Benefits Amy Rickman……Lockton Dunning Benefits 940.380.1245……ARickman@lockton.com Financing / Banking Gary West……BB&T 469.791.4502……GMWest@BBandT.com Financial / Estate / Insurance Planning Mark A. Trewitt, CFP®, CLU, ChFC, AEP Integrated Financial Solutions Group 972.312.1337……mark@ifsgllc.com Linen / Laundry Services Gary W. McDaniel……ImageFirst 214.769.6677……gmcdaniel@imagefirst.com Legal Services Michael H. Saks*……Wright, Ginsberg, Brusilow, PC 972.788.1600……msaks@wgblawfirm.com *Not board certified by the Texas Board of Legal Specialization

Legal Services cont. W. Darrell Armer*……Looper, Reed & McGraw, PC 214.922.8923……darmer@lrmlaw.com *Board Certified-Health Law by The Texas Board of Legal Specialization

Marketing / Public Relations Barbara Steckler……Concepts in Medical Marketing 972.490.7636……barbarasteckler@yahoo.com Medical Malpractice / Commercial Insurance James Patterson, CIC, AAI……Agapé Healthcare Partners Metro 817.329.4200……jim@agapeins.com OSHA Compliance Jessica James 469.360.1367……jsscjames@aol.com Personnel Recruitment Jan Harris, CPC……J. Harris Co. Personnel Services Inc. 214.369.9545……j.harrisco@verizon.net Practice Management / Billing / Consulting David Loomis……The Health Group 972.792.5700……dloomis@thehealthgroup.org Promotional Products / Wearables / Filing Systems Nance Lindstrom……Safeguard Business Systems & Promotional Products 972.596.8282……rich.nance@verizon.net Real Estate (Commercial) M.W. (Hugh) Resnick……Pizel & Assoc. Commercial Real Estate 972.404.0008……hugh@pizel.com Telecommunications Charlie Hubbard, PMP……HUBCO Communications, Inc. 469.293.3081……chubbard@gohubco.com

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At least 32 million U.S. households own insurance policies that aren’t right for them. 1

Make sure you have the right insurance to help you protect the life you’ve worked so hard to build. 1. Insurance Information Institute. “Changes in Your Life Can Mean Changes in Your Insurance, Says the I.I.I.,” Press Release, January 22, 2007.

Talk to a TMAIT Advisor about insurance for you, your family, and your medical practice. We can help you choose the right coverage from an array of plans, including medical, dental, vision, life, short-term disability, long-term disability, long-term care, and office-overhead expense. Call 1.800.880.8181

Request a quote at www.tmait.org

contact@tmait.org



Dallas Medical Journal