March 26, 2007
 

TOA President's Update
  

By David Teuscher, MD
President, Texas Orthopaedic Association

The comprehensive tort reforms we helped pass in 2003 are under attack in the Texas Senate. You received an urgent message on Friday to call your Texas Senator and tell them to leave HB4 alone. If you have not done that, I request that you take the 5 minutes to call their Capitol office with that message. If you have made your call, please

get every one of your physician colleagues to do the same before it is too late.

SB468 by Senator Ellis (D) of Houston would remove the protections we won for emergency medical care as a willful and wanton negligence standard, replacing it with a much lower standard. This would certainly lead to more lawsuits for the emergency care we deliver, and ultimately less emergency call coverage for Texas patients. It would be a big step backwards, just at the time that the comprehensive reforms are showing the promise of stabilizing our crisis, and improving access to care for our patients.

As your President, I have sent a letter to Lt. Governor Dewhurst with a copy delivered to each Texas Senator. You can read the letter by clicking here.  Governor Dewhurst has expressed his willingness to help prevent this disaster from passing the Senate, so please do not contact his office now.

We have more meetings scheduled with the parties involved, but you must do your part. Below is the list of Capitol phone numbers for the Senate. Please read my letter, and then make your call, then recruit a dozen colleagues to make their calls today!        
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Texas District by District: Susan King
    

King was born into a fifth generation Houston family, attended Houston public schools and graduated from Robert E. Lee High School in Houston. Her Texas political roots also run deep since she is a descendant of the family of Francis R. Lubbock, 9th Governor of Texas.

A cum laude graduate of the University of Texas in Austin with a Bachelor of Science degree in nursing, she was also active in campus

life with memberships in Kappa Alpha Theta, Sigma Theta Tau, Angel Flight and the Longhorn Singers.

Returning to Houston, she worked assisting Dr. Denton Cooley in heart surgery at the Texas Heart Institute and eventually became Co-Director of the surgical unit at St. Luke’s Episcopal, Texas Children’s Hospitals, and the Texas Heart Institute which at that time was the largest group of operating rooms in the United States.

After marriage to Austin King, a native Abilenian, resident in training in otolaryngology and a fellow church member, they moved to Abilene to start his practice and together they designed and built one of the first ambulatory surgical centers in Texas. She has been co-owner and director of nursing at Elm Place Ambulatory Surgical Center for over 20 years.

Married for 30 years, she and her husband are the proud parents of three children, Helen Adair King Stockstill, Lewis Austin King, and Martha Jourdan King, who are graduates of Abilene public schools and have graduated from or attend Wake Forest University, Texas Christian University, and Trinity University. Susan and her family are members of First Central Presbyterian Church where she and her husband have taught Sunday school, and serve as Elders.

Always interested in singing and theatre, she has had major roles in multiple Abilene theatrical productions such as Sweeney Todd, Man of La Mancha, Steel Magnolias, and many others. She was employed as a performing artist for the arts and education program Young Audiences of Abilene for the past 8 years. Her other interests are quite varied and range from multiple certifications in scuba diving to graduating from the Jeff Cooper School in Gunsite, Arizona and currently holds a Concealed Handgun License.

Community service has always been important to King, and she has worked in fundraising and as a volunteer nurse for the Boy Scouts, member and community advisor for the Junior League, board member of the Abilene Philharmonic, Abilene Ballet Theatre and Abilene Community Theatre, and many other Abilene organizations. She was a recent finalist for the Athena Award for community leadership by the Abilene Chamber of Commerce. King is a member of the Farm Bureau and the NRA.

Interested in improved communications and community engagement, she ran unopposed twice for the Abilene Independent School District Board of Trustees in 1998 and 2002 and was eventually elected school board president. With the retirement of Bob Hunter, State Representative District 71, she sensed an even greater opportunity for service and was elected to that office which represents Taylor and Nolan counties. King, a Republican, is serving in her first legislative session.

Email Susan King to thank her for her work!
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This Week In Texas: Mignon McGarry Memos

By Mignon McGarry
TOA Legislative Advocate / Memos: Thu Mar. 22 & Tue Mar. 20, 2007
TOA Online Version: All Memos

 

March 22, 2007, Thursday
 On Wednesday the House Appropriations Committee passed their budget bill. Chairman Warren Chisum (R-Pampa) announced it is scheduled for

floor debate next Thursday, March 29th.

The bill contains $150.1 billion for the next biennium, this includes both state and federal money, and roughly half of it ($75.5 billion) is allocated for general revenue.

The House also passed a joint resolution on Wednesday which would extend the veto override power of the Legislature. The resolution would require the Legislature to reconvene for five days after the regular session ends in order to consider vetoes.

Currently the Legislature can override the governor’s veto with a two-thirds vote, but they must be in session. Since most major legislation is passed near the end of the session and the legislative veto override process is considered limited by most members, particularly since the Texas legislature only meets every other year.

If the joint resolution passes both chambers, and there is overwhelming support in the Senate right now, it will go to the voters in November.
 

March 20, 2007, Tuesday
 We are past the halfway mark in this session, but the bulk of work is still ahead for the legislature.

Today, the first bill to pass both chambers landed on the Governor’s desk to await his signature or veto, (the governor can also decide to let legislation become law without a signature). The bill addresses a homeowner’s defense against intruders and would create a legal presumption that an intruder is there to cause death or great bodily harm, giving victims the right to use deadly force.

On Monday, a bill designed to restore funding for the Children’s Health Insurance program went to the House floor for debate and was returned to committee on a point of order. A point of order is a maneuver that can be fatal to a bill. In this case, we can expect to see the bill back on the House floor soon because the committee has time to correct the mistake.
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Please Keep Emergency Care Protections Intact
  

For years, we’ve had difficulty staffing our emergency departments; especially in rural Texas. An affirmative vote on SB 468 would only worsen that problem and hurt patients who need urgent and specialized care.

Doctors taking ER call work in a unique environment. Whether treating an unconscious victim of an auto accident or a diabetic woman in

delivery, those taking emergency call face high-risk cases and are forced to make snap judgment decisions.

For years, we’ve had difficulty staffing our emergency departments; especially in rural Texas. An affirmative vote on SB 468 would only worsen that problem and hurt patients who need urgent and specialized care.

Doctors taking ER call work in a unique environment. Whether treating an unconscious victim of an auto accident or a diabetic woman in delivery, those taking emergency call face high-risk cases and are forced to make snap judgment decisions.

It is a unique and perhaps inequitable situation, in that those who take emergency call must treat every patient who comes through the door irrespective of whether the doctor has previously seen the patient, knows the health history of the patient, knows of any allergies of the patient, speaks the patient’s language or can’t speak to the patient at all because the patient is unconscious.

In rural Texas, it may be a family physician that takes his or her rotation through the emergency department. Understand, this doctor is not board certified in ER, yet he or she must do the best they can to treat the patient in often the most trying and difficult of circumstances.

Prior to the passage of the 2003 reforms, our runaway legal system was running emergency care doctors out of our communities and consequently, patients were the ultimate victims; unable to get the care they needed when they needed it.

It was the hope of the 2003 legislation that doctors could get the protection they needed so that they could remain in practice to serve in emergency care.

Since the passage of the 2003 reforms, we have seen a gain in the number of doctors willing to take emergency call but by no means is the crisis over. The situation has improved but our hospitals still struggle to cover their emergency departments today.

Let’s not retreat. Let’s not shackle emergency medical care. Keeping the 2003 reforms intact will insure that a greater number of Texans get the care they need in their critical hour.

For this reason, we respectively urge that you vote “no” on SB 468.
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Study: Fragmented Care Poses Problems For P4P Initiatives
  

A study published in the March 15 New England Journal of Medicine raises questions about the effectiveness of pay-for-performance (P4P) initiatives under the current fee-for-service Medicare payment model, due to the dispersion of patients’ care among multiple physicians. P4P programs assume that claims data can be used to retrospectively assign patients to physicians or practices with primary responsibility for their care, and that physicians can be held responsible for a meaningful

percentage of the patients they treat and the visits they bill for.

The study found, however, that many different physicians and practices provide care to each elderly Medicare patient, so identifying which provider is responsible for which patient is difficult. Researchers examined Medicare claims from 2000 through 2002 among 1.79 million fee-for-service beneficiaries treated by 8604 respondents to the Community Tracking Study Physician Survey in 2000 and 2001. A median of 35 percent of beneficiaries’ visits each year were with their assigned physicians, and beneficiaries averaged seeing two primary care physicians and five specialists working in four different practices.

For more information click here.  The complete study can be viewed by clicking here.
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RED ALERT: Oppose SB468 - Please Contact Your Senator
 

Senate Bill 468 by Senator Rodney Ellis has been voted out of Senate State Affairs Committee and is headed to the Senate floor.

Senate Bill 468 would eliminate willful and wanton standard of negligence for health care liability claims arising out of the provision of emergency medical care.

Contact your legislator and let them know that you OPPOSE Senate Bill 468 because:
 

  • It is too early to roll back tort reform victories

  • Tort reform provisions like this need more time to work

  • Repealing this provision would discourage doctors from coming to Texas and would raise insurance rates for Texas doctors which have been coming down

 

The procedural rules of the Senate prevent us from knowing exactly when Senate Bill 468 will be heard on the Senate floor. Please see the attached list for contact information for the members of the Senate. If you are unclear as to who represents you in the Texas Senate, please go to Texas Legislature Online at www.capitol.state.tx.us and enter your address on the right side under “Who Represents Me”. Please call or email your Senator as soon as possible to let them know that you OPPOSE Senate Bill 468.

 

Helpful Links:

Texas Legislature Online re: SB468

Senate Members Contact Information

TMA Grass Roots Action Center
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