Jun 16, 2009

Texans Help Set AMA Position on Health System Reform

For nearly three hours this afternoon, the AMA House of Delegates worked diligently on about 200 words. What should American medicine say about health system reform, especially after President Obama's historic visit to the house the day before? Should they condemn the "public plan," or just say what the AMA wants?

The Texas delegation to the AMA was actively involved in this debate, urging at every turn that the message stay positive -- what AMA wants, not what it opposes. TMA delegates spoke passionately at the microphone and huddled with colleagues from other states.

Just when it looked like Texas and her allies had prevailed, time was called. The house was unable to finish its business today and must pick up where it left off on 9 am Wednesday morning.

Below is a photo collage of the day's discussions ... from a Texas perspective, of course.


Marshall Burt said...

You've put out a press release which says in part......"The demand for health care is great. However, the region also has one of the lowest rates of physicians per capita....."

If such is the case, why did the Texas Medical Association oppose HB 607 and it's companion SB433, the bills that would provide those people in McAllen and across the state with direct access to Physical Therapy. It would have increased patient access to health care. Would have cut in half the cost of care.

Money and protecting your turf are far more important to the Texas Medical Association than the well being of patients. Your actions, your campaign donations, and your destructive influence on legislation that benefits Texas patients drowns out your public image related rhetoric.

Steve Levine said...

Thanks for your note, Marshall. It's really a question of patient safety. TMA believes the scope of practice of allied health practitioners should not exceed what is safely permitted by their education, skills, and training.

Most physical therapists provide excellent care and treatment. But, quite frankly, PTs are not MDs. As many of our physician members who were once allied health practitioners (RNs, PharmDs, chiropracters, etc...) say, "We didn't know what we didn't know. And that was scary."

Marshall Burt said...

Safety issue. In this coming era of Evidence Based Medicine, can you provide evidence to support your belief system. Of the 16 states that have direct access, can you name some where there has been "a safety issue". The evidence suggests otherwise. Many countries have had direct access for several decades. Can you name some countries where there is "a safety issue". When will you know what you don't know. Is that an indefinit situation?

Marshall Burt said...

[from the Journal called....Military Medicine....Volume 172 #4....April 2007....page 440 - 445....J.D.Childs et al]

The study was completed in Texas [Fort Sam Houston, San Antonio]

"The purpose of this study was to describe knowledge in managing musculoskeletal conditions among physical therapists in the uniformed services based on their educational background and preparation."

".....physical therapists in the uniformed services demonstrated higher scores than medical students, physician interns and residents, active duty military physicians, and all physician specialists except for orthopedists."

Marshall Burt said...

Do any of the statements below speak to "a safety issue"........

"The doctors do not always know best and often fail to provide the appropriate care."
[Consumer Reports On Health..April 2002 -- When Doctors Don't Know Best]

"We understand the clinical implications of conditions such as tendinosis and stress fractures and can make the diagnosis, but we treat them imperfectly."

Robert Leach MD
Editor.....American Journal Of Sports Medicine
Volume 28 #3......2000.....page 281

"Clinicians reported that.......primary research evidence only accounted for 24% of management plans in Patellofemoral pain syndrome [knee pain] and 14% in Achilles tendinopathy."

"Practitioners practised evidence based medicine in under 50% of cases."

British Journal Of Sports Medicine.......Volume 39 #12......December 2005..........912 - 916
I R Murray
How evidence based is the management of two common sports injuries in a sports injury clinic?

"824 physicians completed the survey. Nearly all (93%) reported practicing defensive medicine."

Journal of the American Medical Association.....Volume 293 #21.....June 1, 2005.....page 2609-2617
D.M. Studdert, et al
Defensive Medicine Among High-Risk Specialist Physicians in a Volatile Malpractice Environment

"....too many doctors and patients are making decisions without the benefit of latest research."

{President Barack Obama...Speech to the American Medical Association --- June 15, 2009]

Marshall Burt said...

One might start to think that State Senator Nelson's constituents, once properly educated, may begin to have a problem with her support for TMA and its position on Direct Access [sooner or later].

Perhaps the item below is another "patient safety" situation from which Texans need to be protected.......

"Low Back Pain is the most prevalent of musculoskeletal conditions."
"Both orthopaedic surgeons' and family physicians' knowledge of treating Low Back Pain is deficient. Orthopedic surgeons are less aware of current treatment than family practitioners."

Spine.....Volume 34 #15....July 1, 2009....page 1600 - 1603
A.S.Finestone et al
Orthopaedists' And Family Practitioners Knowledge of Simple Low Back Pain Management

Marshall Burt said...

To medical doctors in Texas who would like to see an increase in patient access to physical therapy, cost reduction for orthopedic care in Texas that reduce costs for average patients as well as for tax payers [medicare and medicaid].

Physical Therapists have begun the first steps toward truly organizing to bring Direct Access to the state of Texas.

They could use your help.