Dallas Medical Journal February 2012

v o l u m e 9 8 • n u m b e r 2 • f e b r u a r y 2 0 1 2

I n t h i s i s s u e :

PAD Physician Volunteers of the Year - Primary and Specialty Care Spotlights

2012 Installation Dinner - Photos from the event

Expanding Comfort Zones

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submit letters to the editor to [email protected]

About the Cover PhotoRobert W. Haley, MD, accepts the 2012 Charles Max Cole, MD, Leadership Award at the DCMS Installation Dinner.

Photo by Edd Eason

Dallas County Medical SocietyPO Box 4680, Dallas, TX 75208-0680Phone: 214-948-3622, FAX: 214-946-5805www.dallas-cms.orgEmail: [email protected]

DCMS Communications CommitteeRoger S. Khetan, MD ............................................. ChairRobert Beard, MD Gene Beisert, MDSuzanne Corrigan, MDSeemal R. Desai, MDGary Goldsmith, MDVeronica Hegar-Gonzalez, MD Daniel Goodenberger, MD Gordon Green, MD Steven R. Hays, MDC. Turner Lewis, MDDavid Scott Miller, MD

DCMS Board of DirectorsRichard W. Snyder II, MD ................................. PresidentCynthia Sherry, MD .................................President-ElectJeffrey E. Janis, MD .........................Secretary/TreasurerShelton G. Hopkins, MD ......... Immediate Past PresidentMark A. Casanova, MDWendy Chung, MDR. Garret Cynar, MDSarah L. Helfand, MDMichael R. Hicks, MDRainer A. Khetan, MDTodd A. Pollock, MDKim Rice, MDChristian Royer, MD

DCMS StaffMichael J. Darrouzet .................. Chief Executive OfficerLauren N. Cowling ............................... Managing EditorMary 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. ©2012 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, Dal-las, TX 75208-0680.

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.

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

23 President’s Page 2012 Installation Speech by Richard W. Snyder II, MD

26 Thank You for Your Support! DCMS Foundation Donors

29 Community In 2012, PAD Will Provide Care to its 10,000th Patient

30 2012 PAD Primary Care Physician Volunteer Sarah Helfand, MD

31 2012 PAD Specialty Care Physician Volunteer Howard Weiner, MD

34 Installation Dinner Photos

37 Book Review: In Search of Medicine’s Moral Compass by Robert M. Tenery Jr., MD

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President’s Page

Rick Snyder, MD

I want to thank the membership for the incredible honor and privilege to serve as the 129th president of the Dallas County Medical Society. As I prepared my remarks, I re-read the installation speeches of some of my predecessors. I particularly was impressed by Dr. Huber’s comments about how humbled and honored he was to be elected president.

Those of you who know me well, know that I don’t do humble very well. But as I reviewed on the DCMS Web site the 136-year history and role of our medical society, I realized that “honored” and “humbled” are exactly the right words. Founded in 1876, the Dallas County Medical Society now has more than 6,400 members and is the second largest county medical society in the country. For us, as the DCMS vision statement says, our vision is to promote “a healthy community.” The scientific, educational and innovative healthcare accomplishments in Dallas County during these 136 years truly are awe inspiring. DCMS played an integral role in many of these successes by helping create an environment of service, dedication and innovation in the pursuit of that “healthy community.” The presidents who led and shepherded the Society in these successes include pioneers and giants in our medical community.

Over the last couple months, I have been asked many times what I hope to accomplish as president of the Dallas County Medical Society. My answer is simple: I want our members to begin to feel uncomfortable. I want to get them out of their comfort zones!

We physicians are comfortable in the realms of science and education. That is our culture, and, to a large extent, the core of who and what we are. To be a physician, we have to be grounded and adept in science. And we are fairly comfortable with education. After all, the educational journey to become a physician takes an additional 7 to 12 years after college. We have to be comfortable with self-education because medicine is a rapidly, ever-evolving discipline that demands lifelong learning. But we also are comfortable with education as researchers, teachers and educators — teaching the next generation of physicians, and educating our patients and community about health, the nature of their illnesses, and treatment.

These are our comfort zones, and we practice our comfort zones of science and education daily in the exam rooms, operating rooms and hospitals. For much of medicine’s history, the quality of care depended predominantly on these two pillars. The history of success of the DCMS and the Dallas medical community resulted mainly from achievements in science and education.

However, that no longer is the case. Slowly, a third element has emerged that joins science and education in determining the quality of health care we experience. No longer do statistical P values and confidence intervals, guidelines and consensus statements reign supreme in determining the types of test or treatment we can offer our patients. COMFORT ZONE EXPANSION

I am a cardiologist, and our national headquarters for the American College of Cardiology is in Washington, DC. Etched in stone behind the front desk is the formula that represents this new reality: Quality care through science, education and advocacy. To appreciate the inclusion of “advocacy,” you have to appreciate the adage of location, location, location. For more than five decades,

the ACC had its headquarters in the relatively low-overhead area of Bethesda, the home of the National Institutes of Health. Five years ago it moved to the high-rent district of DC. The ACC moved from the epicenter of medical science (NIH) to the epicenter of politics (DC). This was no accident. The ACC realized that quality health care now and going forward will depend as much, if not more, on advocacy as on science and education. As the ACC grew, it became clear that to improve quality, the College would have to influence health policy.

The same realization occurred to other medical societies that now call DC home. And in Texas, it’s no coincidence that the headquarters of Texas Medical Association is in Austin, and not on the campus of one of our state’s fine medical complexes or medical schools. It is located in the state capital, the epicenter of our state political system, a mere touchdown pass or two from the state capitol building.

For a physician to be an advocate for patients requires much more than words. To quote the American College of Physicians Ethics Manual, “Physicians have an opportunity and duty to advocate for the needs of individual patients as well as for society.” The reality is that physicians will have as much impact on the health care our patients receive in legislative chambers and board rooms as in exam rooms and operating rooms. A colleague is fond of saying, “You doctors can treat one patient at a time or a whole state or country of patients at a time by getting out and being an advocate for healthcare reform.” If we physicians are serious about playing in the quality and access arenas of health care, we must advocate for positive change in healthcare policy.

Although being an advocate is not part of our training, it is a role with which we must become comfortable. Advocacy needs to become part of our culture. This is the one area where we doctors need to be more like lawyers. Now that is a scary statement, but when law students get out of law school, part of their culture, part of their genome, if you will, is that they will be active participants in the political process, regardless of their practice field.

Advocating for our patients is something for which we physicians are uniquely suited. Several years ago, a nationwide survey ranked the credibility of professions. Healthcare providers were at the top of this list, and by a significant margin over the clergy and judges. We need to leverage this credibility on behalf of our patients and society.

The stakes could not be and never have been higher. With health system reform, we are on the precipice of the most significant change in the delivery of health care since the institution of Medicare in the 1960s. Health care will consume massive resources in terms of money and providers, and we have insufficient amounts of each to meet the need. Total US healthcare expenditures average $2.6 trillion annually and consume 17 percent to 18 percent of our GDP. About 45 percent of total healthcare spending is by federal, state and local governments. Medicare costs $500 billion annually, which is 12 percent of the federal budget. In Texas, 31 percent of our state budget is devoted directly to health care, and some 40 percent of the more than 6,000 bills introduced each session are related to health care.

The predicted physician shortage is a work force bubble that will dwarf the financial bubble we just witnessed on Wall Street. Today 45 percent of cardiologists are over age 55, and demographics are worse for other specialties, such as family practice and internal medicine. This is occurring just when a large segment of the population is aging into Medicare eligibility and its peak need for medical care. Every day, about 10,000 baby boomers become eligible for Medicare. Health system reform will make health insurance coverage available for 31 million people who did not have insurance before.

However, coverage is not the same as access. And access to a waiting list is not the same as access to health care. Our shared vision of “a healthy community” must include timely access to quality, cost-effective health care. The problem we face is how we reconcile the demands of our patients and society for medical certainty and affordability. These two ideals often are divergent and mutually exclusive.

The resources to meet these challenges are limited, and the supply/demand considerations are not favorable. We have more health care available in terms of tests and treatments than we can afford. If the current rate of use continues, we’ll face massive shortfalls in manpower and financial resources.

The type of health care that will emerge and the type that we will experience ultimately will depend more on advocacy than on science and education. Already we are witnesses to both legislative and regulatory decisions that have had a major impact on health care that has nothing to do with a landmark scientific paper, a P value, or confidence intervals. Regardless of the expected Supreme Court

Installation Speech by DCMS President Richard W. Snyder II, MD, given Jan. 19


President’s Pagedecision regarding the constitutionality of our health system reform, the evolution is just beginning. Even if the Court upholds the bill, most of the decisions are yet to be made regarding how health care will manifest, on a federal, state and county level.

We all agree that change is coming and is much needed. But there are three types of change, as any physician knows when we interview our patients. We ask whether the patient’s symptoms are better, worse or about the same. We can ask the same about healthcare reform. It is debatable whether the path we are on is better, worse or about the same. Regardless, it behooves us as physicians to be involved in the process of change for the better for the benefit of our patients. As we’ve learned, if we’re not at the table, we’ll be on the menu.

Physician advocacy benefitting our patients has many forms and occurs at many levels. Healthcare advocacy plays out at the federal, state and county level, and our Dallas County Medical Society, led by our advocacy director, Tracy Casto, plays an active role in all of these. At the county level, for example, the Commissioners Court has a major impact on access to health care for the uninsured, which for Dallas County represents 30 percent of the population, or 600,000 people. The Court oversees Parkland hospital, which can care for only about half of these people. The remaining people must seek care at other private and not-for-profit community hospitals. One of DCMS’ major goals this year is to build on the relationships with the county commissioners and advocate for these patients.

Healthcare advocacy also is practiced in the regulatory, judicial, insurance, and hospital arenas. All have an important impact and play a vital role. Many healthcare policy decisions are not derived from a legislature, but from a regulatory agency, such as the state and federal Department of Health and Human Services, through policy and rule making. We physicians must be involved in all these sectors.

Advocacy is a skill that is not foreign to physicians, just dormant. One time I persuaded my physician wife to accompany me to DC for the annual cardiology legislative session. She was a little reluctant, explaining that meeting with lawmakers is not something at which she excels. During the first of eight meetings with lawmakers, she sat quietly and listened. In the second meeting, she got in a few juicy sound bites. By the third, she took over the discussion, and I don’t think I got a word in. Talking with our legislators and congressional representatives is as easy as that.

TORT REFORM FIGHT

Our physician community is fortunate to have physician advocates we can emulate. The constitutional amendment on tort reform that passed in 2002 was a fight won through advocacy, not from a scientific paper or guideline. Our reform is the envy of the country, and the model of the US House medical tort reform bill.

But tort reform would not have happened without our legislative advocacy champions at TMA and people like Dr. John Gill. He crafted the essentials of the formula on a napkin at 2 a.m. in a state senator’s Capitol office. Again, no P values or scientific papers played a role.

Before tort reform, only two medical malpractice carriers were left standing in the state. Two thirds of the state’s 254 counties had no obstetrician. In Dallas County, Methodist Dallas Medical Center closed its neurosurgical program and exited the Level 1 trauma system because the state’s hostile med mal environment drove the neurosurgeons from the state. At Medical City, my own hospital, our CV surgeons’ coverage was cancelled on 30 days’ notice because their carrier was leaving the state. This same surgical group had been featured in USA Today the year before for having the best one-year transplant survival rate. Yet they had to resort to getting med mal insurance on a day-to-day basis for an entire month. And for an entire month, if I approached a surgeon about a patient who needed a bypass, the surgeon told me, “I don’t know yet if I have insurance tomorrow to help you.” Patient care and patient access were impacted significantly by factors that had nothing to do with science or education.

I see examples of physician advocates who have put in countless hours serving their community in Drs. Lee Ann Pearse, Craig Callewart, and Steven Hays. These people are my inspiration and role models from whom I learn continually. But we need more of these

role models. We need to get more physicians out of their comfort zones and advocate for their patients in order to pursue DCMS’s vision statement of “a healthy community.” We need to make places like the Capitol building in Austin as familiar as our own hospitals, and legislators like Pete Sessions as familiar as our own patients.

CHALLENGES IN 2012

Once these physicians are out of those comfort zones, what issues do we want to confront in 2012? Our challenges are numerous and involve adverse economic, administrative, regulatory, and political forces. Some are so menacing, so anxiety provoking, that we do not dare speak their proper names; we refer to them by abbreviations or as acronyms. They are familiar to most of us: SGR, PPACA, ACO, HMO, UPL, CMS, MedPAC, RUQs, and RACs. Perhaps the most menacing is the deceptively benign sounding IPAB (not to be confused with an iPAD, but it may be just as ubiquitous and ever much the game changer, although not for the better). The Independent Payment Advisory Board will homogenize how we evaluate and treat our patients. The unique relationship between physician and patient will be rendered almost meaningless and replaced by a third party.

Other obstacles to care that we will want to tackle involve pithy buzzwords and expressions such as medical loss ratios, economic credentialing, cost conundrums, appropriate use, and regional disparities of care. Emerging local challenges include the recently approved Medicaid 1115 waiver and the uncertainty this waiver has created in the use of up to $250 million federal dollars per year by Dallas hospitals. These dollars had been used to offset some of the cost to care for the uninsured and Medicaid patients in our county. The uncertainty about how these dollars will be used can have a major impact on how Dallas hospitals care for these populations, especially with the expected explosion of Medicaid populations envisioned with healthcare reform in 2014.

DCMS will be involved in significant and innovative projects in 2012. The Society will expand its use of social media to connect with the membership through Facebook and Twitter, not only by CEO Michael Darrouzet but also by the president. Another exciting project will be the emergence of the North Texas health information exchange, which will go online around summer time. DCMS is a pioneer of the 13-county information exchange that will allow the exchange of basic healthcare information across hospital and physician providers. The HIE will improve quality of care while decreasing cost by limiting unnecessary duplication of tests and admissions. The innovative Project Access Dallas, operated by DCMS, ironically may benefit from the Medicaid 1115 waiver by becoming eligible for significantly more federal dollars. This could enable explosive growth in PAD and allow it to greatly expand its mission of caring for the working poor.

Perhaps no acronym or buzz word will generate as much attention in 2012 as the evolving concept of physician-hospital alignment. This relationship between hospitals and physicians is reflected in a spectrum of models, from the employment model to the physician-hospital ownership equity models, with numerous variations and permutations in between. Tighter physician hospital alignment is believed to be a prerequisite in re-emerging capitation models of reimbursement, such as ACOs, as proposed under health system reform. Improving the alignment between physicians and hospitals is thought to result in greater coordination of care, thereby improving quality, decreasing errors and redundancy, and lowering costs. I think all parties agree that greater physician-hospital association, no matter what the model, is beneficial, will improve quality and will lower costs. But we must be careful. In discussions of relationships and models of physician-hospital integration, we must never lose sight that our ultimate alignment is with the patient. The physician-patient alignment is a relationship that must never be supplanted, never superseded, no matter what model of healthcare delivery is in vogue. We must always advocate that the alignment between the physician and patient reigns supreme.

With that I again thank the members and staff of DCMS for this honor and privilege. Despite considerable adversity, through the Society and through our roles as scientists, educators and advocates for our patients, we have much opportunity. Timely access to quality, cost-effective health care is within our reach, and a healthy community is in sight.


RSVP by Friday, Feb. 24.

Sunday, March 4Studio Movie Grill

(Royal Lane and Central Expressway)

1 p.m. — Networking Social2 p.m. — “Dr. Seuss’ The Lorax”

Lunch, popcorn and drinks will be served during the movie.

$10 Per Person

Credit Card Number:

Card Type: VISA MC AMEX DISC Exp. Date: Security Code:

Fax credit card payments to 214.946.5805 or mail checks payable to DCMS, PO Box 4680, Dallas, TX 75208.

Contact Linda Doyle at 214.413.1437 or [email protected] if questions.

DCMS members and their immediate family are invited to attend an afternoon movie with DCMS!

DCMS Member Name: Family Members Attending:


Thank You for Your SupportDCMS acknowledges the donors below for their generous contributions to the

2011 DCMS Foundation Annual Fund

DireCtor Dr. Phil & Karen Berry

Dr. & Mrs. Nirmal Jayaseelan

Karanjit Singh Kooner, MD

Robert M. Kuhne, MD

Timothy Dale Nichols, MD

Dr. Tim & Cecilia Norwood

Dr. & Mrs. William Weaver

benefACtor Dr. & Mrs. D.A. Barnett

Drs. Cristie Columbus & Clayton Roberts

Guy K. Driggs, MD

Shelton G. Hopkins, MD

Jeffrey Edward Janis, MD

David J. Pillow Jr., MD

Murray C. Rice, MD

Baylor Health Care System In Recognition of Richard Naftalis, MD, Volunteer in Medicine

Baylor Health Care System

Cambridge Walnut Hill Tenant Physicians On behalf of all tenants at Physicians Medical Center of Dallas

Darling Family Foundation In Appreciation of Cheryl C. Kinney, MD

Kathleen Barry Erdman, MD

HCA North Texas Division

Methodist Health System

Parkland Health & Hospital System

Texas Health Resources

Tom Thumb Safeway

UT Southwestern Medical Center

ProjeCt ACCess DAllAs

Stephanie Hurn Elmore, MD

Gordon Green, MD, MPH In Honor of Roland Black, MD

Steven Ray Hays, MD

Drs. Lannie & Linda Hughes

Drs. Bill & Meribeth Stevens

James W. Walton, DO

exeCutive

Cardiology and Interventional Vascular Associates In Honor of their Friends and Referring Physicians

PresiDent’s CirCle


Robert K. Bass, MD

Richard Edward Block, MD

Lacy Edmundson, MD

C. Gilbert Falke, MD

Keller P. Greenfield, MD

ShanShan Huang Hsu, MD

Harwin B. Jamison, MD

Carey G. King Jr., MD

Eva Klima, MD

Philip D. Korenman, MD

Maria E. Lorente, MD

Patrick Nduyari Olomu, MD

Bobby Louis Temple, MD

Robert Mayo Tenery Jr., MD

Tich Ngoc Truong, MD

MisCellAneous DonAtions

DCMs founDAtion GenerAl funD

Ernest Poulos, MD In Memory of Michael Kurilecz, MD

bAylor obGyn resiDents funD

Dr. Tim & Cecilia Norwood

Jane Farrar Admire, MD

James A. Ball, MD

James G. Brooks Jr., MD

Theodore W. Bywaters Jr., MD

Dr. & Mrs. Fred Ciarochi

Brian M. Cohen, MD

Ralph Charles Disch, MD

Alexandra Dresel, MD

Steven V. Foster, MD

Gabriel Fried, MD

Kenneth David Glass, MD

Fe Q. Gonzaga, MD

Dr. & Mrs. Murray Gordon

Wayne H. Gossard, MD

Robert D. Gross, MD, MBA

Dr. & Mrs. Robert T. Gunby Jr. In Memory of Mainord Todd, MD

Dr. & Mrs. Robert W. Haley

Sarah Lynn Helfand, MD

Thomas Gary Johnson, MD

Michelle Boymann Kravitz, MD In Honor of her Father, Benjamin Boymann

Dr. & Mrs. Terry Latson

Thomas Willingham Newsome, MD

Dr. & Mrs. Lee R. Radford

Kim M. Rice, MD

Alfred J. Rodriguez, MD

Leslie Harold Secrest, MD

Florence Shafiq, MD

Cynthia Sherry, MD

Dr. & Mrs. Troy R. Smith Jr.

Lisa L. Swanson, MD

Albert G. Tesoriero, MD

Ann Marie Trowbridge, MD

Rebecca B. Weprin, MD

Donor


We relentlessly defend, protect, and reward the practice of good medicine.


Community

We relentlessly defend, protect, and reward the practice of good medicine.

Each month I review requests from physicians seeking help for their uninsured patients And each month I find myself impressed by the compassion and concern that our colleagues show people who are in need. The notes below are from physicians as they applied to help some of their patients through Project Access Dallas:

• “Needs Medical Oncology ASAP and Needle Biopsy of Liver Mass — DX: Liver Mass”

• “Needs help with MRI costs — DX: Chronic Paroxysmal Hemicrania”

• “Unemployed, spouse self-employed and can’t access insurance — DX: Uncontrolled Diabetes”

• “Unemployed for over one year — DX: Uncontrolled Hypertension”

PAD exists to support Dallas County physicians as they care for some of the poor and underserved residents of our community. PAD provides every patient with:

• A primary care medical home

• Specialty care physician consultations

• Ambulatory surgery

• Pharmaceutical support

• Care Navigation support

• Laboratory and radiology services

This extensive list of services gives more than 2,000 physicians the confidence that they are not on their own when they choose to help those patients in their practices who can’t afford the health care they need. PAD is led by the DCMS board of directors and the Community Service Committee, which directs the PAD-dedicated DCMS staff as they provide services to over 3,000 Dallas County residents each month. In 2012, PAD will see the 10,000th patient receive care through the generosity of the Dallas County medical community.

PAD has altered the narrative of DCMS’ history over the last 10 years by the sustained commitment of the DCMS physician leadership and its volunteers. 2012 begins our second decade of service as healthcare reform continues to change the healthcare delivery landscape.

Thank you for your commitment and service. If you’d like to join your colleagues in PAD, contact Marilyn Haspany, PAD director of physician network, at 214.413.1455 or [email protected].

By Jim Walton, DO, MBA, PAD Medical Director

In 2012, Pad Will Provide Care to its 10,000th Patient

v i s i t u s o n l i n e a t w w w . d a l l a s - c m s . o r g • F e b r u a r y 2 0 1 2 • 2 9

Sarah Helfand, MD


Long-time physician volunteer Sarah Helfand, MD, has been selected the 2012 Project Access Dallas Primary Care Physician Volunteer of the Year.

A PAD volunteer since 2002, Dr. Helfand works tirelessly at Healing Hands Ministry, sees PAD patients in her office, and serves on the PAD Leadership Committee at Methodist Hospital Dallas. At DCMS, she serves on the Community Service Committee and the board of directors.

Dr. Helfand says that volunteering has been a critical part of her life since her youth and that helping others is just part of her family’s culture. Her husband and son also boast a fairly long list of volunteer activities.

“My faith plays a part in why I volunteer, and it is a way to show other people love,” she says.

Dr. Helfand loves being a pediatrician and loves her patients. She sees her job as a unique blend of all she enjoys.

“I like the mental stimulation of medicine and figuring out puzzles, like with a challenging case,” she says. “I also like helping people. Medicine is the perfect marriage of the things I enjoy. It is just something the Lord put on my heart to do. It is fun to help out other people in any way I can. I’ve heard other people say that volunteering blesses the giver as well as the receiver — and that is true.”

Aside from her time at Healing Hands Clinic, Dr. Helfand volunteers with the Dallas County Medical Reserve Corps. She is among the 222 physicians who supplement emergency response services in staffing medical clinics in shelters for displaced populations after a natural or manmade disaster. As an avid cook, she enjoys her membership in Farmer’s Market Friends, which finds her volunteering at events the group organizes; and she is active in her church, Kessler Community Church.

Although Dr. Helfand volunteers with many organizations throughout Dallas, she says that PAD stands alone.

“PAD offers an easy way to volunteer my services,” she says. “I can see as many or as few patients as I want. And the PAD staff is always available to help.”

She says that the PAD team makes the program unique. “With PAD and the other physicians who volunteer, it makes treating

a ‘charity’ patient as easy as treating a patient with insurance. There’s not really a difference for me, but there is for the patients — PAD patients are appreciative and grateful for their care and for the chance to be heard.”

Dr. Helfand’s colleagues also appreciate her, and agree that she is a vital part of PAD and an excellent choice for physician of the year. This award includes a free year of membership dues to DCMS and TMA.

Project Access Dallas Primary Care Physician Volunteer of the Year2012

Marilyn Haspany, PAD director of physician network, Sarah Helfand, MD, and Cheryl Prelow, PAD vice president

Howard Weiner, MD


For Howard Weiner, MD, the act of volunteering comes naturally. In fact, it could be genetic, considering that while growing up, he shadowed his surgeon father as he cared for patients who could not pay for their care.

Dr. Weiner’s proclivity to help those in need has resulted in his being chosen the 2012 Project Access Dallas Specialty Care Physician Volunteer of the Year. Dr. Weiner is a gastroenterologist at Digestive Health Associates of Texas and has been in private practice for more than 25 years. He was nominated by PAD staff and will receive a free year of DCMS and TMA dues for the award.

Dr. Weiner has been a valuable part of the PAD team since he started volunteering in 2002. Since that time he’s also been influential with hospital leadership at Texas Health Presbyterian Hospital Dallas, by encouraging other physicians to volunteer and by fostering a spirit of volunteerism among his office staff and colleagues.

Dr. Weiner became interested in medicine at a young age, growing up with a father who was a general surgeon in Dallas. He went to the University of Pennsylvania where he pursued a career in architecture, and applied to medical school unsure whether he would get in. He was accepted to the University of Texas Southwestern Medical School in Dallas, where he finished his studies in 1977.

Although his father never pushed him into the medical field, he did let his son tag along on rounds while growing up. Through that experience the youngster saw that taking care of people who couldn’t pay for their care was just part of his father’s job. More than once the surgeon received payment in the form of an animal — Dr. Weiner remembers a horse showing up at their house one day, but only for that one day.

His passion for caring for those who cannot pay for their care was ignited after a visit to the Venice Family Clinic in California about 20 years ago. The clinic was started by members of the area’s medical community to provide ongoing services for those unable to pay for care.

“I always wanted something like that in Dallas, and then Project Access Dallas came along,” Dr. Weiner says. “PAD makes it incredibly easy for doctors. Medicine is a team sport and PAD puts you on the right team with the right people.”

Interaction with patients is Dr. Weiner’s favorite part of practicing medicine, especially when they express appreciation for his care. He recalls one woman he treated early in his career who couldn’t pay for his services. Dr. Weiner had told his patients that he would be taking time off to get married and go on his honeymoon. Soon after that, the woman he was treating for pancreatic cancer sent him a note and $5. Dr. Weiner says that for someone who couldn’t afford treatment, that was a monumental and thoughtful gift—and that he still has the money.

Aside from practicing medicine, Dr. Weiner is an avid outdoorsman and hiker. He’s hiked in Greenland, Iceland, Ecuador, and Australia, plus in various spots throughout the United States. His favorite site is the Grand Canyon, where he is a member of the Grand Canyon National Park Foundation’s board of directors.

Dr. Weiner has been married to his wife, Karen, for 23 years and they live in Dallas.

Project Access Dallas Specialty Care Physician Volunteer of the Year 2012


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Brent Patterson, MD

Humberto De Los Santos, MD

April Day, MDWayne Burkhead, MDJoseph Behan, MDKim Allen, MD

Chrisette Dharma, MD

Grace Kumar, MDHaskell Kirkpatrick, MDErin Kane, MD

Misti Grimson, MDE. Nelson Forsyth, MD

Dennis Newton, MD

Armando De Fex, MD

Charles Loehr, MD

Michael Harris, MD

Ruben Velez, MD

The DCMS board of directors established two Project Access Dallas (PAD) awards in 2009. The awards were designated for a primary care physician and a specialty care physician. Physicians are nominated by the Project Access Dallas physician volunteers, charitable clinic staff, and PAD staff. Selection is based on the physicians’ outstanding contributions to PAD during 2011, plus their leadership and community service in other DCMS Foundation projects.

Each nominee is recognized for encouraging a culture of citizenship and service in our community and working to improve the quality of life for the uninsured.

DCMS congratulates these physicians on their nominations, and thanks them for their work for Project Access Dallas.

Nominees for the Project Access Dallas Physician Volunteer of the Year Awards 2012


2012 Installation DinnerTheTMA President Bruce Malone, MD, adminsters the oath of office to Richard W. Snyder II, MD, as past DCMS presidents look on.

TMA President Bruce Malone, MD, and DCMS Past President Fred Ciarochi, MD

Robert Heath and Congressman Pete Sessions, recipient of the Millard J. and Robert L. Heath Award


Roberta and Don Read, MD, with James Scoggin Jr., HCA North Texas President

DCMS Board Member Christian Royer, MD, and wife, Melanie

Mike Helfand; PAD VP Cheryl Prelow; Sarah Helfand, MD; and DCMS CEO/EVP Michael Darrouzet

Robert W. Haley, MD, accepts the Charles Max Cole, MD, Leadership Award

DCMS Immediate Past President Shelton Hopkins, MD, accepts his Past President’s Medallion from DCMS Past President Stephen Ozanne, MD.

Drs. Charles Mitchell and John Gill


1 in 5 personsliving with HIV does

not know it.

l People accessing health care are NOT routinely tested for HIV.

l Persons unaware of their HIV infection are unable

to benefit from care.

Learn more at

www.testtexashiv.org

message no 2 bcms sa medicine.in2 2 10/30/11 8:34:05 PM

TRMC invites you to work here and grow your practice.

Contact Administration at 972-892-4404 to open a confidential dialogue.

TEXAS REGIONAL MEDICAL CENTER AT SUNNYVALE THE CUTTING EDGE OF OPPORTUNITY

ARE YOU LOOKING FOR THE PERFECT FIT?A thoroughly modern facility just 15 minutes east of Downtown Dallas

Currently providing patients a full array of specialty surgeries including:

• Bariatrics • ENT (including pediatrics) • Cardiothoracic and Vascular • Endoscopy • General • Gynecology

• Orthopedics • Pain Management • Plastics • Podiatry • Spine • Urology

We invite you to consider becoming a part of our culture of success.

3 6 • F e b r u a r y 2 0 1 2 • D a l l a s M e d i c a l J o u r n a l v i s i t u s o n l i n e a t w w w . d a l l a s - c m s . o r g • F e b r u a r y 2 0 1 2 • 3 7v i s i t u s o n l i n e a t w w w . d a l l a s - c m s . o r g • F e b r u a r y 2 0 1 2 • 3 7

Likelihood of outcomes and cost/benefit ratios are the driving forces that are “depersonalizing” this noble profession. These changes did not come from the failures in healthcare delivery, but from the successes. Although the literature is filled with historical documentation of the breakthroughs and discoveries of the science, there has been a paucity of collated information that studies the evolution of the delivery side of medical care.

The book outlines the evolution of the various aspects of healthcare delivery — the changing role of the physician, liability, marketing, managed care, organizational

representation, healthcare reform and more. It explores the founding principles laid down by past generations of physicians and why these tenets are still important today. This introspective search into our history not only gives one insight as to what those principles are, but also the whys.

The book is available only in the eBook format because of its low cost, easy accessibility and portability. With just a click of the finger, the user has ready access to a myriad of information.

Painted on the side of an old brick building in Santa Fe, NM, are the faded words: Without our history, we have no future.

The medical profession is not just about the science. It’s also about its people — the physicians,

nurses, allied professionals and the support staff who dedicate their lives to caring for the sick

and injured. While facing the demands of an exploding patient population, compounding tech-

nological advances and increasing funding constraints, these individuals are being forced to

push the limits of the core principles upon which this profession was built. “In Search of Medi-

cine’s Moral Compass” is an easily accessible reference for all those in the delivery of health

care by chronicling from where the art of healing came and the importance of the tenets that

separate medicine as a profession from a trade.

In Search of Medicine’s Moral Compass

v i s i t u s o n l i n e a t w w w . d a l l a s - c m s . o r g • F e b r u a r y 2 0 1 2 • 3 7

Robert M. Tenery, MD, the author of this reference book, is the third in three generations of physicians whose careers span the last 100 years. Dr. Tenery, an ophthalmologist, began his writing career when he authored commentaries dealing with events that were affecting the healthcare profession. The expertise he acquired from representing medical organizations on a local, state and national level led him to become a monthly contributor to a nationally distributed periodical, American Medical News, from 1990-1998. Toward the end of his tenure, he decided to put down on paper a more comprehensive look at the evolution of his profession.

In practice for more than 36 years, Dr. Tenery points out the relevance of the lessons he learned while trailing his grandfather and father during his youth. His compelling stories remind the reader that even a century after his grandfather set out on horseback to care for the sick and injured, with only a small bag of potions and a caring heart, one constant remains — the patient in need.

Married to his high school sweetheart since 1964, Dr. Tenery and his wife, Janet, have two children and four grandchildren. When he is not caring for his patients or lecturing at the University of Texas Southwestern Medical Center at Dallas, the family enjoys all that Santa Fe, NM, and the surrounding area has to offer. He is a former TMA and DCMS president, and has been a DCMS member since 1975.


O F N O R T H T E X A S

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1937-2012

The 110 physicians of Radiology Associates of North Texas areproud to celebrate our 75 year commitment to excellence in radiology!

Our 14 outpatient imaging centers, 24 hospital locations and unparalleled subspecialtydepth provide you and your patients with a level of care that is unmatched in North Texas.

Thank you for partnering with us in the care of your patients.


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Pack your bags and head to CareNow.At CareNow, we understand what it takes to be a physician. That’s why we offer excellent compensation packages for all of our physicians. Base salary is an hourly rate, so you’re paid for every hour you work. We also offer a generous bonus program and numerous other benefits.

Front: Drs. Cynthia Sherry, President-elect, Shelton Hopkins, Immediate Past President, Rick Snyder,

President, Jeffrey Janis, Secretary/Treasurer. Back: Drs. Todd Pollock, R. Garret Cynar,

Wendy Chung, Mark Casanova, Sarah Helfand, Kim Rice, Michael Hicks, Rainer Khetan and

Christian Royer.

2012 DCMS Board of Directors

March 01Federal Agency: Deadline to Opt Out of Medicare

March 01Private Payor: BCBSTX Policy on Payment for Claims Using National Drug Codes (NDCs)

March 31HIPAA 5010 Electronic Transaction Standards: CMS Announces Version 5010 Enforcement Discretion Period

April 15Federal Agency: IRS Estimated Tax Payment Due

May 15State Agency: Texas Franchise Tax, Reports & Payments

June 01Federal Agency: Deadline to Opt Out of Medicare

June 15Federal Agency: IRS - Estimated Tax Payment Due

June 30 E-Prescribing Hardship Exemption. File now to avoid a 1.5% Medicare penalty in 2013.

June 30E-Prescribing Penalties. File 10 e-prescribing claims to avoid a 1.5% Medicare penalty in 2013.

September 01Federal Agency: Deadline to Opt Out of Medicare

Visit www.texmed.org/doom for background information, regulations, penalties and incentives, and suggested steps to help you meet the compliance dates.

Upcoming State and Federal Compliance Dates

Texas Medical Liability Trust TMA Insurance Trust

DIAMOND

PLATINUMThe Medical Protective Company

Global Healthcare Alliance

GOLDAmerican Physicians Insurance Company

Southwest Diagnostic Imaging Center

Allscripts Healthcare Solutions, Inc.CareCloud

Goldin, Peiser & PeiserLincoln Harris, CSGParanet Solutions

Rebecca Harrell, Medical Office SpecialistShaw & AssociatesThe Health GroupUnited Texas Bank

SILVER

The Dallas County Medical Society is offering a valuable benefit to help members with their medical practices—DCMS Circle of Friends. This program provides information about

medical-related businesses that serve Dallas-area physicians.

For questions about DCMS Circle of Friends contact Mary Katherine Allen, business development manager, at [email protected]

join the circle

in

Peace of mind for you and your practice

INSURANCE FOR TEXAS PHYSICIANS

Office Overhead Expense

Up to $35,000 per month is available!

Office Overhead Expense Insurance is issued by The Prudential Insurance Company of America, 751 Broad Street, Newark, NJ. This coverage contains certain limitations and exclusions; please see the certificate booklet for full details. If there is a discrepancy between this document and the certificate, the terms in the certificate will prevail. Contract series 83500. 0192427-00002-00 Ed. 1/12 TMA-53709

Protect your medical practice from the unforeseen

Disabilities can strike without warning, affecting not only your health, but also your ability to keep your practice running while you are recuperating. If you were to become disabled and could not work, how would you cover office expenses, such as employee salaries, rent, taxes, and utilities?

Office Overhead Expense Insurance, issued by The Prudential Insurance Company of America and endorsed by the TMAIT, can help pay for regular monthly office expenses to keep your medical practice operating if you were unable to work due to a disability.

Exclusively for TMA Members

• 24/7 coverage

• Benefits for total or partial disability

• A customized policy to fit your needs

• Coverage you can keep if you move out of Texas

• Potential tax-deductible premiums

Plan provisions

• An increased maximum monthly benefit amount to $35,000

• Coverage you can retain up to age 75

• An expanded list of eligible overhead expenses to reflect the changing practice environment

•TMA Members can now apply up to age 70

• Physicians who are medically approved for coverage before age 40 can increase coverage up to $5,000 within five years of their approval date without having to provide proof of good health. All coverage increases must be exercised prior to age 45 and a member’s total coverage cannot exceed the plan maximum of $35,000.

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Dallas Medical Journal February 2012

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