December 15, 2008
 

 
TOA President's Update: On Call Position Statement
  

By Timothy L. Beck, MD
President, Texas Orthopaedic Association

After we became aware of the impending AAOS Board of Directors' action on the On-Call Position Statement, the Texas Orthopaedic Association supported an initiative by the California Orthopaedic Association to make sure our voices were heard. COA and TOA were joined by 10 other states to form a 12 state coalition that came

together in just 7 days during the Thanksgiving holidays. These states represents nearly 50% of all AAOS Fellows.

This message from Tony Rankin, MD, President of the AAOS, regarding the recent Board-approved position statement on Emergency Orthopaedic Care shows us that AAOS is carefully listening to its members. We wish to thank Dr. Rankin and the AAOS Board of Directors, We also want to thank the leadership of the California Orthopaedic Society and their Executive Director, Diane Przepiorski, as well as John Gill, MD of Dallas for bringing this situation to our attention.

Dear BOC, BOS, State Society, Council on Advocacy, and Committee on Ethics Leadership:

I am writing to let you know that on Friday, December 5, 2008, the Board of Directors voted to approve a revised position statement on Orthopaedic Emergency Medical Care. A copy of the new-approved position statement can be viewed by clicking here.

During this process, which included a review of the 2006 AAOS-approved Position Statement, Board Project Team Statement, the Council on Advocacy revised statement, position statement revisions recommended by several state societies, and the AAOS Committee on Ethics, I requested 100 percent transparency. We received over 50 pages of comments from all orthopaedic constituencies which were shared with the Board. As a result of the comments received, it was clear that revisions would be necessary before this position statement could be considered by the Board.

Leadership from the Council on Advocacy, the Board of Councilors, and the Board of Specialty Societies met for several hours the day prior to the Board meeting to try to address the concerns of all the constituencies they represent. This position statement was the one that was brought to the Board, and was approved by secret ballot.

While it is sometimes said that the perfect is the enemy of the good, I believe that this statement represents the best of what leadership could agree to at this time. As was noted by some Board members this is the second time this statement has been revised in two years, and all position statements of the AAOS can be revisited whenever a change is warranted. So, this statement should be viewed as a "living document," and we will continue the dialogue as we address the orthopaedic emergency room call issue.

Thank you again for your participation in this process.

E. Anthony Rankin, MD
President,
American Academy of Orthopaedic Surgeons
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TDI-DWC: Revised DWC Form-032, Request For Designated Doctor
     

The Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) has revised the DWC Form-032, Request for Designated Doctor.

These changes are part of a continued initiative to improve the designated doctor process by:
• decreasing the number of Incomplete or Denied Requests by providing clear, detailed instructions to requesters;

• providing adequate space for requesters to provide required information; and

• ensuring the intent of Texas Labor Code §408.0041 is fulfilled.

Revised DWC Form-032 with Instructions:
Requesters of designated doctor examinations should begin using the revised DWC Form-032 immediately. The revised DWC Form-032 is available for download from the TDI website by clicking here.

Submitting the Form to TDI-DWC:
Submit the form by mail to:

Texas Department of Insurance, Division of Workers' Compensation
7551 Metro Center Drive
Suite 100, MS-603
Austin, TX 78744-1609

Or submit the form by fax to: 512-804-4121.

Do not send the completed DWC Form-032 or copies of the form to TDI-DWC field offices. TDI-DWC will continue to accept and process old versions of the form until January 1, 2009. On and after January 1, 2009, requests received on old versions of the form will be returned to the requester.

For assistance or more information about the revised DWC Form-032, contact TDI-DWC by calling 800-252-7031.
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Voluntary Treatment Planning Pilot Project Report
    

The Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) has published a report regarding a voluntary treatment planning pilot project (pilot) in the Texas workers' compensation system as a means of providing information to assist TDI-DWC in rulemaking for treatment planning based on Texas Labor Code (TLC) §413.011(g). The pilot was a result of a recommendation by system participants during an October 2007 stakeholder meeting soon after the Commissioner of

Workers' Compensation (Commissioner) repealed 28 Texas Administrative Code (TAC) §137.300, regarding required treatment planning. The purpose of the pilot was to examine whether treatment planning could be functionally implemented and to identify any barriers (e.g., conflicts with existing Division rules or statutory requirements, lack of system participant interest, cost of creating and reviewing a treatment plan) that would inhibit implementation or reduce the benefit of treatment planning.

The complete text of the report is located at this link.

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This Week In Texas: Mignon McGarry Memos
  

By Mignon McGarry
TOA Legislative Advocate
TOA Online Version: All Memos

 

December 10, 2008, Wednesday

In the recount in House District 105, Rep. Linda Harper-Brown (R-Irving) maintained a 19 vote lead over Democrat Bob Romano.  The

Texas Democratic Party has announced they will drop all legal challenges in the race so this result is final unless Romano takes the unlikely course of filing an election contest to be held in front of the full Texas House.  The Harper-Brown victory leaves the partisan split in the House at 76 Republicans and 74 Democrats.

The dominos continue to fall with regard to one of Texas' U.S. Senate seats.  Last week, U.S. Senator Kay Bailey Hutchison announced that she was forming an exploratory committee for a run for governor in 2010.  Hutchison has not said whether she will resign early or serve out her full term which expires in 2012.  This week, former State Comptroller John Sharp announced that he will run for the U.S. Senate during the next election for a Senate seat.  He will begin raising money after the first of the year.  Former Secretary of State Roger Williams plans to announce an exploratory committee for his own U.S. Senate run in the near future.  State Sen. Florence Shapiro (R-Plano) has already formed her exploratory committee and has begun raising funds to be used in that election.

Add one more candidate to the list of potential Speakers.  Rep. Byron Cook (R- Corsicana) has said he will be calling members of the House to discuss his candidacy.

The House Research Organization is an independent administrative department of the Texas House governed by a broadly representative steering committee of 15 House members elected by the House membership. The HRO is a nonpartisan source of impartial information on legislation and issues considered by the Texas Legislature.  The group recently issued a new report, Topics for the 81st Legislature, which highlights many of the issues that will be considered during the 2009 regular session.  You can take a look at the report by clicking on this link.

UPDATE: Texas Alliance For Patient Access (TAPA) Meeting

We attended the general meeting of the Texas Alliance For Patient Access (TAPA) on November 14, 2008. Among topics discussed were the effect of the recent elections on tort reform and anticipated attacks on tort reform in the upcoming legislative session.

With the partisan balance so close in the Texas House and the identity of the Speaker still up in the air, tort reform advocates have their work cut out for them. Tort reform advocates were urged to focus attention on new Democrats recently elected to the House, some of whom support business interests in their community. The importance of the Senate District 17 run-off election was emphasized since Democrat Chris Bell has a history of opposing tort reform legislation.

Representative-elect Dr. Mark Shelton (R-Ft. Worth) spoke to the group. Shelton told engaging stories about his personal experience with lawsuits and the importance of maintaining tort reform gains.

Brent Cooper, Mike Hull and John Tilly gave an update on the constitutional challenge pending in federal court in Marshall, Texas.

The Communications Committee released studies in September, near the fifth anniversary of the effective date of House Bill 4 and Prop. 12. The studies received a great deal of media attention. The need for a consistent message from medicine was emphasized as was the need to tell stories of patients and facilities that have benefited due to the reforms in 2003.

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