Texas Medicine

Austin pediatrician Sandra Frasser, MD, learned early in her medical career that many of the biggest health problems patients face cannot be fixed by a trip to the doctor's office.

"We believe that standardizing those kind of processes will be easier for [those] providing care. Because one of the things we hear a lot is this lack of harmonization of processes and procedures, whether that's in care or measures or processes. That is a really important part of it."

Since her appointment in 2018, Texas Health and Human Services Inspector General Sylvia Hernandez Kauffman has homed in on using data analytics not only to prosecute fraud, waste, and abuse within the Medicaid program, but also to prevent it from happening in the first place. Texas Medicine spoke to Ms. Kauffman about what appears to be a shift in tone from this department as it also focuses on using the data it collects to educate physicians and other health care professionals on common billing mistakes.

The Vaccine Adverse Event Reporting System (VAERS) is the early warning system for vaccine safety in the U.S. While it's important for identifying vaccine side effects, the data it collects can be misunderstood.

Barriers stand in the way of physicians playing a greater role in addressing the social determinants of health, but awareness of those factors is increasing, and progress is happening.

A court decision siding with chiropractors is the latest of many scope tests in the legislature and the law.

The Texas Alliance for Patient Access (TAPA) announced in early March that Sen. Kelly Hancock (R-North Richland Hills) and Rep. Jeff Leach (R-Plano) would soon file COVID-19 liability legislation that would enhance liability protections to shield more physicians from lawsuits for care delivered during pandemics, hurricanes, and other catastrophic events that inject chaos into their good-faith medical efforts.

Congress in December 2020 passed surprise-billing legislation as part of a wide-ranging coronavirus relief bill, tying a bow on federal lawmakers' primary health care focus just prior to COVID-19. Texas already had set up its own system for state-regulated plans in 2019 with Senate Bill 1264, which took effect last year.

COVID-19 has made a booming illicit business - ransomware - boom even louder. And the more medical practices and organizations fall victim to ransomware cyberattacks, the more illustrative it becomes how important it is to prevent such an attack.

Testing is one of the best ways to combat HIV infection. The Centers for Disease Control and Prevention (CDC) recommends routine testing for patients between the ages of 13 to 64. Yet, fewer than 40% of eligible people have ever had an HIV test, according to a 2019 CDC study.

Physicians, especially pediatricians and family doctors, are trained to recognize signs of abuse and neglect and are legally obligated to report them. That is a vital approach for combatting the problem. However, physicians and other child abuse experts are turning more and more toward prevention.

Vaccines are one of medicine's best tools against cancer. The shots for human papillomavirus (HPV) and hepatitis B prevent a range of cancers and save thousands of lives each year. But anti-vaccine advocates have tried - incorrectly - to paint just the opposite picture in several ways.

TMA fights state budget cuts to preserve Texas' steady progress in building residency positions.

The uneven rollout of COVID-19 vaccines in December created at least one bright spot for Texas physicians: It highlighted how the state could make vaccination more efficient.

When Andrew Indresano, MD, got a subpoena in January 2019, he found it "a little shocking" and "really invasive." The Fort Worth orthopedic surgeon wasn't even part of the personal-injury lawsuit for which he was being asked to produce a backward-looking swath of documents.

Challenges to Texas laws governing end-of-life care, whether through legislative rewrites or judicial override, are nothing new. The recent success of those challenges is. In particular, two recent erosions have physicians like Houston palliative care specialist Mark Casanova, MD, chagrined and concerned about the future of doctors' role in end-of-life treatment.

Texas medical students have enjoyed some highly successful Match Weeks in recent years, but 2020 was the best since the Texas Medical Association Council of Medical School Deans began tracking match data in 2014.

Before March 2020, remote patient monitoring (RPM) was a tool endocrinologist Thomas Blevins, MD, used to help patients with diabetes track and regulate blood sugar levels and report the results back to him. But when the COVID-19 pandemic forced many doctors to turn to telemedicine, Dr. Blevins and the nine other physicians on staff at Austin Diabetes and Endocrinology had to rev up their RPM use.

On Jan. 21, 2020, the Centers for Disease Control and Prevention confirmed the first case of novel coronavirus, later named "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2), in the U.S. At the Department of State Health Services (DSHS) we realized it was only a matter of time before the virus arrived in Texas. By Jan. 31, we activated the DSHS State Medical Operations Center to prepare for the coming crisis.

It's no surprise that many physicians were among the more than 1.3 million confirmed COVID-19 cases in Texas last year. Texas Medicine spoke with three Texas physicians who contracted COVID-19 to learn how the disease affected them physically and impacted their outlook as caregivers.