Texas DO Volume 54, Number 1 - UNTHSC Scholarly Repository

University of North Texas Health Science Center
UNTHSC Scholarly Repository
Texas Osteopathic Physicians Journal
Special Collections
1-1-1997
Texas D.O. Volume 54, Number 1
Texas Osteopathic Medical Association
Follow this and additional works at: http://digitalcommons.hsc.unt.edu/topjournal
Part of the Osteopathic Medicine and Osteopathy Commons
Recommended Citation
Texas Osteopathic Medical Association, "Texas D.O. Volume 54, Number 1" (1997). Texas Osteopathic Physicians Journal. Paper 696.
http://digitalcommons.hsc.unt.edu/topjournal/696
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THIS IS NOT WHERE YOU WANT
TO PRACTICE DICTATION.
Your most import ant part ner is a n ex ib le.
professional liab ili ty ins urance pro-
co~ t -cffcc ti ve
gra m. Thnt's why you need DEAN. JACOBSON
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In your medica l practice. you respond to
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SERVICES. in a~:-.ocia.tion with Healthcare Insu rance
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Contidcnce and experience. Use yours to
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The onl\' fil/(mcia/ ser\'iceJ and immrtmce cuh ·isors
.
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DEAN. JACOBSON FI NANCIAL SERVICES
(8 17) 335-32 14
Dallas Metro (972) 445-5533
P.O. Box 470 185. Fort Worth. TX 76 147
(800) 32 1-0246
~~
In associat ion with:
Healthcare Insura nce Services. Inc.
,t Galtnt>J' Gru11p Ctm!pall)'
F.~!ll~i~(IIS
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fl~a:owzoos.·
·~1997
7&X/IS Z'.a
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...........................................
, '-"'"~ v~, "''-'.--"'' ntv MEDICAL ASSOCIATION
~
For Your Information
OSTEOPATHIC AGENCIES·
Amencan Osteopathic Association
WashmglonOffice
3121280·5800
8001611 ·1773
1011544·5060
800/961·9008
703/684·7700
8001366·1431
Amencan Osteopathic Healthcare Association
PhySICI!n'sChOiceMedicaiMalpractice
Dean. Jacobson Flnanctal Servtces
ForPremtum Rates,
Enrollment& Information
1·8001311-0146
TOMA Major Medicallnsurance
1·800/311-0146
TOMA Drsablli~ Insurance Program
1·8001311-0146
UNTHSC/Texas College of Osteopathic Medicine
817/735·1000
Dallas Metro419·9110
Med1care Otltce·
8001813·8868
Part ATelephone Unrt
903/463·4495
PartS Telephone Unrt
114fl66·7408
ProlileOuesbons
ProvrderNumbern:
114fl66·6161
EsUbltshednewphysrcran(solo)
Establrshednewphys<ran (group)
114fl66·6t63
A/lchangestoexrstmgprovider
114fl66-615B
number records
5111343·4984
Medrcard/NHIC
CHAMPUS/Generallnqurry
8001406·1833
Te<asMedrcalfoundatron
511/319·6610
Tolllree
800fl15·9116
Texas OsteopathiC Medical Association
512n08·TOMA
inTexas800/444-TOMA
fAX No. 512n08·1415
TOMA Physrcrans Assrstance Program
817/294·1788
in Texas 8001896·0680
fAX No. 817/294·1788
TOMAMed·Search
in Texas 800/444-TOMA
TEXAS STATE AGENCIES:
Texas Heanh and Human Services Commission
511/416·0366
Department of Health
511/458·7111
Te<as State Board of Medical E<aminers
511/305·7010
fAX No. 511/305·7006
Reg1stra!Jon
511/305·7010
Complamts On~
8001201·9353
Texas State Board of Pharmacy
511/305·8000
Texas Workers' Compensation Commission
511/448·7900
MedK:aiRevteWOIVtSton
511/440·3515
TexasHosprtaiAssocl!tron
8001251·9403
Texas Department of Insurance
511/463·6169
Texas Department of Protective and
Regulatory Services
511/450·4800
Stateo!Texas Poison Center lor
Doctors& Hospitals Only
713fl65·1410
800/391·8548
Houston Metro654·1701
FEDERAL AGENCIES:
Drug Enforcement Administration·
Forstatenarcoticsnumber
5111414·1000ext.1150
ForDEA number (form 114)
114fl67·7150
CANCER INfORMATION:
Cancer Information Service
713n91·3145
in Texas 8001391·1040
P/f1t1MR?f1997
.
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Page
TOMA Board of Trustees SJ:M)tlight
George M. Cole, D.O.
Texas Legislators Get Ready for 75 th Session
TOMA Accepting Nominations for
Disti ngui shed Service and Meritorious
Service Awards
Introducing Speakers for TOMA's 41st MidWinter
Conference and Legi slative Symposium
TSBME Adopts New Rules for Reporting
CME Activities
In Memoriam:
.........
Wayne R. Eflglish, Sr.
Roy J. Han·ey, D.O.
For You r Information .
A Message from the Texas ACOFP Presi dent . . . . • .
TOMA Welcomes New Members .............•.....
10
14
15
16
23
30
DEPARTMENTS
Calendar of Events .
ATOMANews.
Public Health Notes .
District Stars .
News from Osteopathic Hcahh System of Texas
4
17
. 20
21
24
~~~&~~
u
News from the University of North Texas
Health Science Center at Fort Worth
Membership On-the-Move . . . . . . . . . . . . . . . . . • .
Blood Bank Briefs for Physicians . . . . . . . . . . . . • .
Practice Locations in Texas . . . . . . . . . . . . . . . . . .
33
34
27
29
EXECUTIVE COMM ITTEE:
Arthur J. Speece. Ill. D.O .. President
R. Greg Maul. D.O .. D.O .. Presiden t-E lect
Ne lda N. Cunniff-Isenberg. D.O .. Vice President
William D. Hospers. D.O .. lmmcd ime Past Presiden t
T. Eugene Zachary. D.O .• Past Pres ident
Rodney M . Wiseman. D.O .. Chairman. Dept. of Prof. Affairs
Bill V. Way. D.O .. Chairman. Dept. of Public Affairs
Jim W. Czewski. D.O .. Chairman. Dept. of Dev. & Liai son
JIOA RD OF T RUSTEES:
Kenneth S. Bayles. D.O
George M. Cole. D.O.
Jim W. Czewski. D.O.
Joseph DciPrincipe, D.O.
J:lm c~ E. Froelich. Ill. D.O.
Willium J. Luguly, D.O
Hector Lopez. D.O
Jack McCarty, D.O.
Daniel Saylak . D.O
Monte E. Troutm:m, D.O.
Bill V. Way. D.O.
Rodney M. Wiseman. D.O.
Irvin E. Zeitler. D.O.
EX O FFI CIO MEMB ERS OF TH E llOA RD OF T RUST EES:
Mark A. Baker. D.O. , Speaker. House of Delegates
A. Duane Selman. D.O., Vice Speaker. House of Delegates
Joseph Montgomery-Davi s, D.O .. Board Consultant
for Health Affairs
SID Jeffery D. Morrison. Student Member
Mr. Terry R. Boucher. Executive Director
7E'XAS 'D.0. /3
Calendar of Events
7&'Xr/S 'D.tJ.
TUAS OSTEOPATHIC MEDICAl...s5ClaAT10N
January 1997
?&US t:J.O. is the official publication of
the Texas Osteopathic Medical Association.
Published eleven times a year, monthly
except for July. Subscription price is
$50.00 per year
?&US t>.O. does not hold itself
responsible for statements made by any
contributor. The advertising contained in
this magazine is not necessarily
endorsed by the Texas Osteopathic
Medical Association.
Printed by Cockrell Printing Company,
218 West Broadway, Fort Worth,
Texas 76104.
Published by
TEXAS OSTEOPATHIC MEDICAL
ASSOCIATION
VOLUME LIV - No. tJanuary ISSN 0275· t 453
Publication Office--1415 Lavaca Street
Austin, Texas 78701·1634
Phone: 5121708-TOMA or
1/800/444-TOMA in Texas
Fax No. 5121708-1415
Copy deadline - 1Oth of month
preceding publication
Terry R. Boucher, MPH
Executive Director/Editor
Robyn A. Shapiro
Associate Executive
Director/Associate Editor
FEBRUARY 7-11
Atlantic Regional Osteopathic Convent••
"Technology and Medicine''
Sponsored by New Jersey Association of
Osteopathic Physicians & Surgeons
Location: Tropicana Casino and Resorl
Atlantic City, NJ
Hours:
34 Category 1-A CME Houl'\
plus Workshops
Contact: New Jersey Association of
Osteopathic Physicians &
Surgeons
908-940-9000
14-16
10-11
4 1st Annual MidWinter Conference &
Legislative Symposium
Sponsored by Texas Osteopathic Medical
Association
Location· Fairmont Hotel. Dallas. TX
17.5 AOA Category
Hours:
1-ACME Hours
Contacl
TOMA. 800-444-8662;
512-708-8662:
FAX 512-708-14 15
23-28
Ski & CME Midwinter Conference
Sponsored by the Colorado Society of
Osteopathic Medicine
Location: Keystone Lodge & Resort,
800-258-0437. Code OA2RSCO
Hours
39 AOA Ca tegory
I-ACME Hou rs
Contact
Patricia Elli s, 303-322- 1752 or
800-527-4578
FAX 303-322- 1956
Paula Yeamans
Executive Secretary/Bookkeeper
MARCH 11 -16
Vanessa Kemper
Convention/Communications Assistant
34th Annual Convention and Scientific
Seminar
Sponsored by the American College of
Osteopathic Family Physicians
Location: The Dis neyland Hotel,
Anaheim, CA
Contact
American College of Osteopathic
Family Physicians
801).323-0794
Stephanie Boley
Membership Coordinator
Mary Ann Salazar
Receptionist
John Sortore
Field Representative
Lydia Kinney
Staff Writer
APRIL 9-12
Seventh Annual Update in Clinical Medicine
for Primary Care Physicians
Sponsored by University of North Texas
Health Science Center at Fort Worth
Location: Embassy Suites Resort. South
Lake Tahoe. CA
Hours
20 CME Hours
Contact
UNT Health Science Center.
Office of Continuing Medical
Education
817-735-2539
li th Annual Spring Update for the
Practitioner
Sponsored by University of North
Health Science Center at Fort Worth
Location: Dal las Fami ly Hospital,
Dallas, TX
14 C ME Hours
Hours:
Contact: UNT Heahh Science
Office of Continuing
Education
800-987-2CME (2263)
JUNE 12-15
D.O. Brand of Medicine
98th Annual Convention and Scientific
Seminar
Sponsored by the Texas Osteopathic Med
Association
Location Radisson Plaza Hotel and Tan
County Convention Center
Fort Worth. TX
Hours:
28 AOA Hours anticipated
Contact: TOMA
FAX 512-708- 1415
~-~~~J~
'V ~
Articles in the '?E%JtiS t:J.tJ. " that mention the Texas Osteopathic Medical Association's position on state legislation
are defined as "legislative advertising," according to Tex Govt Code Ann §305.027. Disclosure of the name and
address of the person who contracts with the printer to publish the legislative advertising in the "'7£'%,1$ "D.tJ. • II
required by that law: Terry R. Boucher, Executive Director, TOMA, 1415 Lavaca Street, Austin, Texas 78701-1634.
417&'X?4S Z'.O.
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TOMA periodically spotlights a board member for his or her work a11d
commihnent to the osteopathic profession in Texas. TOMA extends a sincere
thanks to every board member who has served or is serving as a member of
tile TOMA Board of Trustees.
Dr George M. Cole of Amarillo
stands finn m his belief that osteopathic
medtcme has advanced due to the efforts
1c M~ of earlier physicians who paved the way.
''Some of uc, lose sight of the gains made
and T1 by past leaders, and some even think that
m l"llwl r_,._nlP.r what they have achieved is onl y a result
of thetr own individual effo rts,'' he says.
"Nothing could be furth er from the truth
Each of us who has been blessed with an
education in osteopathic medici ne owes
a huge debt to previous physicians who
not on ly paved the way politically, but
also proved their com pete nce a nd
compa~~ i o n for treating patie nts,'' he
adds.
An active me mber o f the Texas
Osteopath ic Medical Association. Dr.
Cole has served as a member of the
Board of Trustees s ince 1996, and as a
member of the TOMA House of
Delegates since 1988. He has served on
various committees throughout the years
and is currently District I coordinator for
the Physicians Assistance Progra m.
In -;peaking of hi s involvement in
osteopathic oriented activities. Or. Cole
notes, '1 am glad to contribute in some
small way to the progress of TOMA.
Those who went before us paid our dues
for us, and I can only hope to ease the
path for those who succeed us. In my
opinion, the profession is stronger than
ever and will continue to grow because
of the dedicaLion of those who have
attai ned leade rship . Our ed ucators,
admini strators and physicians share a
common goal - helping the public allain
wellness through application of the
osteopathic principle. We are proud o f
our heritage. and I am always in awe of
the struggling pioneers who advanced
know ledge and public awareness of
osteopathy. There is no more noble
pursuit than to help our patients maintain
each God-given body to its optimal
condition."
Or. Cole is a 1975 graduate o f Kansas
"There is no more noble
pursuit than to help
our patients maintain
each God-given body
to its optimal condition."
City College of Osteopathic Medic ine
(now the University o f Health
Sciences/College
of
O steopathic
Medicine). He served his internship at
Lakeside Hospital in Kansas City.
Missouri . and completed an on.hopedic
surgery reside ncy at the University of
Health Sciences/College of Osteopathic
Medi cine a nd Dallas-Fort Worth
Medical Center, Grand Prairie. Dr. Cole
is board certified in Orthopedic Surgery
by the American Osteopathic Board of
Orthopedic Surgery; and board certified
in both Orthopedic Surgery and Spinal
Surgery by the American Academy of
Ne urologicaJ and Onhopedic Surgeons.
In addition, he is a Diplomat of the
American Academy of Neurological and
Orthopedic Surgeons and of the
National Board of Examiners for
Osteopathic Physicians and Surgeons.
Hi s memberships include TOMA
District I, of which he has served as
president si nce 1988; American
O steopathic Association ; American
Academy
of
Neu rological
and
Orthopedic Surgeons; Pacific Inte rMountain Spine Society: and F1ying
Physicians.
Or. Cole is a staff member of Palo
Duro Hospital in Canyon and an
advi sory board member of Amarillo
Rehabilitation Services. He also serves
as c hief of surgery. vice c hief of staff and
as a board member of Family Hospital
Center in Amari llo.
Dr. Cole maintain s a practice at
Famil y Orthopedics in Amarillo.
''Amarillo is a unique community and
we are pri vileged to live and work here."
he notes. ''The medical resources
available to both physicians and patients
are comprehensive and competit ive.
Opportunity exists for any type of
practice. from the most minor
subspecialty lO the broadest family
practi ce. We are blessed with two major
hospi tal s, the V.A .. and another hospital
under construction . Although there is no
exclusively D.O. facility. privileges are
available at all of the hospitals.''
Or. Cole believes the top problem
facing both allopathic and osteopathic
physicians today is the '"paradigm of
change concern in g the bus iness of
medicine. Experienced doctors are being
forced to confonn to treatment criteria
that sometimes bear little relationship to
the traditional me thods of patient
7E:US Z>.tl./5
benefits. Clerks in large buildings at the
end of an 800 number are telling us how
to practice, and how long it will rake for
our patients to leave our care. We are
increasingly told who to treat. how to
treat and how long to treat. Those who
are writing the rules never see patients.
never go to medical school and never
console the family o f a patient. These
c lerks are typicall y passing on the
instructions of someone even further
removed from the patient. but who still
is not a health professional. We are told
that the changes result from abuses in
the system that has nurtured Americans
since the revolution. Any fonn of serv ice
which generates the type of money
consumed in the entire country for
health care is going to be the target o f
vultu res of all ilk . Government ,
in surance companies and assorted
professional groups all have the gravy
train as a goal."
Dr. Cole feels that patient education is
essential in combating the proble m. "We
have the greatest opportuni ty and the
greatest challenge of our li ves to educate
our patients that they do have a choice.''
he states "On ly an uprising by
employees is going to save American
medicine fro m the disaster of central
planning. Whether it is government or
the big fi ve ins urance companies
making the rules. the public is
continuing to experience the growth of
managed cos1 contro ls administered by
people who have absolutely no interest
in one's wellness."
He stresses that "this is not an us
(doctors) or them (insurance companies)
c hoice. We must commit ourselves to
helping
pmien ts
inOue nce their
employers. We must commi t ourselves
to cost con trols establi shed through
coordination of hea lth care by the
pat ie m and his or her health provider. I
personally believe that the medical
sav ings plan is a marvelous approach
wh ich would cut costs by returning the
buying decision to the consumer. We are
always more careful when spending our
own money than if the bill is paid by
some unseen source.''
Dr. Cole is manied to Linda. who is
vice pres ident of the Auxiliary to the
Texas Osteopathic Med ical
tion . They are the parents of
age 28; Jackie. age 27; Clay. age 25:311
M issy. age 25. Dr. and Mrs. Cole a•
also the proud grandpare nts of Ty. ag'
eight months. W hen ti me allows. th
family enjoys gathering at Grand Lake
Oklaho ma, for boating a nd fish int
Additionally, Dr. and Mrs. Cole arc bot
pi lots and both play golf.
" I am very proud of our professio
and I continue to believe tha t there is n(
better way to make a living,'' states D1
Cole. "Once in a wh ile. not every wecl
or month. but occasionally. I have thE
opportuni ty to really make a d iffere nc•
in a patie nt's life. Many times over th1
years. I have rcnec ted that no matte
what the lawyers, administ rators am
legis lators do 10 us. I am ex tre m e ! ~
fortunate to be able to he lp people. Then
is no more noble calling, a nd we s houlc
thank God every day for the leaders wh(
have gone before us.''
TOMA salutes Dr. Cole for hi s servict
and commitment to the osteopathic
profession in Texas.
a
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Dr. Jim Czewski Earns Fellowship
Jim W. Czcwski. D.O .. was awarded
his fe ll owshi p by the Board of Directors
of the American Academy of Disabil ity
Eva lua ti ng Physicians at their Tenth
6/?EUS 'D.O.
A nnual Sc ie ntific Session in Tucson,
Arizona. on November 9.
T he A merican Academy o f D isability
Evaluating Physicians is the premier
organizat io n in th e d isabil ity and
im pairment fie ld. and the status of
Fellow is the highest hono r they bestow.
Dr. Czews ki is also board certified by
the American College of O steopathic
Family Physicians and recently earned
board cenification as a n Independent
Medical Exami ne r by the America n
Board
of
Independe nt
Medical
Exami ners.
He has recen tly opened Alpha
Ergonomics and hnpaim1en ts. Inc .. at
910 West Northside Drive, Suite C. in
Fort Worth. in response to the need for
quality evaluations of inj ured workers
under the Texas Workers' Com pensation
Commission system once they reach
maximum medical im provement. Alpha
Ergonomics and lmpai m1ents. Inc .. was
Guidelines ro £1•aluation of Pemument
lmpain11elll, 3rd Edition. 2nd Priming.
With th is in mi nd. Dr. Czewski notes
that A lpha Ergono mics a nd Impairments, Inc .. wi ll be ha ppy to assist an}
of your patients fo r their needs and send
you a thorough and com pre he nsive
report in a n exped ient manne r. He can lx'
contacted at 8 17-625-557 1
•
f/A?tUA~
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"""f!IIYoftil<bol
borawUI. OIIOaA
o rganized in May of 1996 fo r the
express purpose o f renderi ng impairment ratings and functional capacity
evaluations for these workers.
Dr. Czewski real izes that the re is a
large percentage of physicians w ho treat
Workers' Compensation patients. but do
not want the hass le of doing the
Impairment Rati ngs and assessing their
Max imum Medica l Im provement. In
Texas, it is a statutory requireme nt that
these ratings be done on each and evel)
Workers' Compen~atio n patie nt who has
been treated. as set fo llh in the AMA
1997
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DEAN, JACOBSON FINANCIAL SERVICES, LLC
A Registered Investment Advisor
LINSCO/PRIV ATE LEDGER •
Enjoy tile Up Markets
Wllile We're in Tllem
What a month. What a year. And
what an improbable market run.
November was undoubtedly the
surprise month of what has been an
equally surprising year in the
financial markets in general and the
equity markets in particular.
Between October 31 and November
30, the Dow Jones IndusUial
Average• rose 8.2 percent, the largest
one·month move since May, 1990,
according to USA Today.
On November 30, the Dow stood at
6~21 , up roughly 26 percent for the
year This of course followed 1995' s
well-documented increase of 33
percenL And this past October, on
the II th to be exact. we recognized
another milestone. It was the sixth
anniversary of the bottom of the last
bear market On October 11 , 1990,
the DnA completed its last 20
percent decline, bottoming out at
2365 .
The resulting bull market now
holds two extraordinary records: the
first is for largest percentage gain
( 152 percent), the second is for
longest period (2192 days) without a
10 percent correction, as reported in
the Dow Jones Investment Advisor.
And now -just as they did last year
at this time - many headlines are
appearing: "Daunlless Dow: Too
Far, too fastT' reads one. " Is the
Market Running Out of Room?"
reads another. All of them intimate
the same thing.
The DRA has
enjoyed a spectacular six year climb
which, cannot possibly, last any
longer.
On the other side of the coin,
stories are also being written about
how the unprecedented inflow of
assets from defined contribution
plans (e.g., 401(k) plans) could keep
MEMBER NASD/SIPC
this bull market running indefinitely.
These stories fall under the "this time
it's different" category.
An example of that inflow was
recenlly reported in The Kiplinger
Washington Letter. Assets in mutual
funds, they write, have increased
from $135 billion in 1980 to $2.8
trillion in 1995. More telling is the
fact that 75 percent of the money in
stock mutual funds today has been
placed since 1990.
All of this reporting, we believe,
has done one thing. Sent mixed
messages and created a degree of
confusion in the minds of many
investors.
To clear up any confusion, we' ll
concentrate on these two important
facts:
• The equity markets have
enjoyed a breathtaking bull run
that has undoubtedly made a good
deal of money for those who have
participated in them.
• None of the prognosticators,
not one single one of them, knows
exactly at what point or exactly at
what time this bull market will
peak.
What we believe is that this market
will peak; and that this peak will be
followed by a decline~ and that the
following decline will lead to a new
peak.
For this is the nature of
markets and of the companies which
participate in them.
At what time, of what length, and
for what duration the next decline
will be is anybody 's guess.
Now that's hardly earth-shaking
infonnation, but it can be very
lucrative for those who use it to their
advantage.
Nobody in the popular press wants
to report on the nature of markets,
because compared to interviewing a
so-called financial expert who 's
predicting the point at which the
current market will peak. it's not
sexy.
You don't hear people talking
about how they're using asset
allocation as part of a long-term
investment program at the company
They're too busy
holiday party.
speculating about the next sector
rotation.
And therein lies the rub. For
investing should not be about
speculation. Rather, and we tell all
our clients this, it should be a
continuous process that is cognizant
of, but not entirely driven by, a
market's current position.
There are many ways to take
advantage
of
investment
opportunities which exist in any
given market cycle. The first step is
recognizing - and enjoying - the up
markets, but knowing they don't last
forever.
So simple in concept .. so difficult
in practice.
•ne Dow Jones lndutrW Avence b an
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..,..
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Dallas
(972) 445-5533
Toll Free (800 ) 321 -0246
Investment
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offeftd
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Un.coiPrtnte Ledcer, a Registtrcd Broker/
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NASDISIPC.
This article is for general
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specific advice ot recommendations for any
individual. Consutt your attorney, a.ccountant, or
fltW'lcial acMsor with regard to your individual
situation.
Entire publication cop)'Tight of
Linsoo/Private Ledger Corp. 1994. AJI rights
~od.
Texas Legislators Get Ready for 75th Se
As this issue of the 7u.u t). tJ. goes to press, Texas
legislators are preparing for the opening session of the 75th
Texas Legislature. which convenes January 14. 1997. Once
again. TOMA wi ll be monitoring legislation of interest to the
profession and wilt keep the membership info rmed of any
the pat~en. t is in the facility. Upon denial of furthldi sclosure,
a phys1cian shall report to the Department of · t
Regu latory Serv ices the represe ntati ve's
informauon and request that the department obtai
order on the patient 's behalf.
4
action that may need to be taken on specific bills.
The following is a synopsis of prefi led bills relating to the
practice of medicine in Texas:
• House Bill 21 addresses liability for the donation of drugs
and medical devices to certain nonprofit organi zations. Thi s
bi ll holds hannless from liability a person who do nates a drug
o r device in good faith to a nonprofit health care organization
for use in providing free or reduced cost health care
• House Bill 22 relates to the civil liabi lity of certain
persons providing uncompensated health care and health
screening services. This bi ll, which amends the Civil Practice
and Remedies Code. specifies that a health care provider who
provides care to a pati ent without receiving d irect
compensation is not liable for personal injury to or death of the
patient arisi ng from that care if the patient has signed a written
statement. The written statement would acknow ledge that the
provider is providing health care witho ut direct compensation
and waives the right to recover damages. In addition, a health
screen ing clinic wou ld not be liable for personal injury to o r
death of a person if the clin ic posts a notice in a conspicuo us
place stating that the clinic is not liable for damages.
• House Bill 39 re lates to di scrimination in the
determination of eligibility for employment, occupatio nal
licenses, and health insurance coverage based on the use of
certain genetic tests and to limitations on the use of infonnation
deri ved fro m those tests. This bill addresses prohibitions in the
use of genetic information in a discriminatory manner by
employers, licensing agencies and insurers and prov ides rules
for the retention or destruction of genetic material samples.
• H ouse Bills 44 a nd 60 a nd Senate Bill 40 relate to
minimum cove rage under certain health plans fo r care
following the birth of a child. These bills stipulate that health
plans with maternity benefits must include coverage in a health
care facility for a mi nimum of 48 hours following a vaginal
delivery and 96 hours following a de livery by cesarean section .
• Sena te Bill 53 relates to coverage under certain heahh
benefit plans for newborns and adopted children. Thi s bill
provides full coverage for newborns and adopted children if
applicatio ns for coverage are made not later than the 31st day
after the birth date or the date the adoption is fina l.
• Senate Bill 55 relates to the regulation of the sale or
distribution of tobacco products and provides penaJties for
various offenses. Th is bill creates offenses for persons who sell
or give tobacco products to persons under age 18 and specifies
various types of signs that must be posted in stores that sell
tobacco products.
• Senate Bill 72 relates to the disclosure of certa in
information relating to certain patients of a physician. This bill
authorizes a physician to disclose to a patient's legally
authori zed representati ve his or her belief that the release of
certain infonnation would be hannful to a patient, e ither
physicall y. menta lly or emotionall y. The physician may
disc lose only whether the requested records exist and whether
8/?E:US ZUJ.
on certai n restrictions imposed by insurers on the Jrfonnam.:c
of professional hea lth care services
practitioners. These bi lls. which includes
o rganizations and preferred provider
health benefit plans from penali zing
~~:at~e~feb~n~ ~;e~~:~~!~~e o~or ~th~rwisct'sing
2) practitioner's own best professio nal judgment i
particular medication, treatme nt, or device
enrollee.
• Senate Bill 86 relates to parental notificatiojrior
abortion and provides cri minal penalties. Thi s b stip
that a physician may not perform an abortion on a 1 norunle\~
the physician gives at least 48 h.ours actual notice, person
.
01
by telephone. of the inten t to perform the abort.i01 o a paren•
or a court-appointed managing conservator or gu ian
• House Bill 108 relates to mstruction in cardi ulmonary
resusc itation for public school students. Thi s bil
Educatio n Code by providing specific instruction
the principles and techniques of CPR at least
seventh grade level or above
• Sena te Bill Ill relates to the exemption of
employees from professional licensing fees. This
state employees with license fee exe mptions.
• House Bill 11 7 creates the offen se of false ___. _0 _
about the AIDS o r H.IV status of an indi vidua~This
amends the Penal Code by creating a Class A m. emeano r
offense entitled "False Disparagement Relating to OS. and
HI V." An indi vidual who inte ntionally di eminate~o
information stating that another has AIDS or HIV nd euhe r
knows such informati on is false or does not know
true, commits this offense.
• Ho use Bill 145 addresses the wearing of
hospital uniforms by hospital employees
This bill would pro hibit the wearing of !
related businesses except in response to a medical tergency.
• H ouse Bill 164 relates to HIV testing of mot rs at the
time of de livery. This bill specifies that a blood samt for HIV
testing must be taken from a mother or from the
of the infant within 24 hours of delivery.
• Ho use Billl75 relates to the offense of barratfThis bill
when
amends the Penal Code by making it an ott
profes~ i o n a l s, which includes physicians. solicit e1 loyment
Solicitmg employment is defined as communicat wnh a
prospective client or a member of the prospect•
I
fami ly concern ing professional employment ~ ithin the s~o pe
licen se, registration, or
ansing
0 nofoutaofprofessional's
a particular occurrence or _event, or senes of occu rrences
c~rt 1fi cat i on
- ~ tunhf disclosu~t or events. or_conceming an ex isung problem o_f the prospective
lt!Dent or Plrcctive an: cl ient withm the . sco~e of the profess1onal s ll c~n_se,
lUCst fa; registration or c:ertlflcauon for the purpose of prov1dmg
protecti 11 professional serv1ces .
• House Bills 180 and 261 and Senate Bills 39 and 54
reportabli address access to certain obstetric or gynecological health care
to aiiO'II <;ervices under a health benefit plan. The bills provide women
medica with direct access to the services of an obstetrician or
a~ gynecologist without requiring referral from a primary care
r
ill phy~ic i an.
ha11
• House Bill213 relates to the composition and duties o f the
:lion radiation advisory board. Thi s bill sets forth the composition of
~ ltlate to '"rohibitia the radiation advisor:Y board to inclu~e a nuclear med ici ne
~oo the hformana specia list. a pathologtst, and a radiologtst :-vho are licensed by
the Texa.o; State Board of Medi cal Exam1ners. Duties of the
advi ..ory board include review in g and eva lu at in g state
radiation polic ies and programs.
• House Bill 219 relates to the licensing of agents for health
o maintenance organ izations. Thi s bill specifies that agen ts for
_ tik HMOs must be licensed under the Texas Agents Qualification
,..., m If:scri bing 1 ;md License Law for Agents of Legal Reserve Life Insurance
by I Companies before they can be authorized to do business in
T~'<aS
House Bill 220 relates to discrimination in employment
bao;;ed on certain perceived disabilities. Thi s bill amends the
Labor Code to define ..disability" as a mental or physical
1mprurment that substantiall y lim its at least one major life
acuv Jty of that individual, record of such an impai rment. or
bemg regarded as having such an impairment. Excluded from
the defimtion are addiction to alcohol. a drug. an illegal
"lUb'itance or a federally conlrolled substance; and a commun icable d1~a~c or infection including A IDS or HI V.
• House Bill 226 re lates to di spensing Sc hed ule II
controlled "lUbstances. Thi s bill prov ides reporting
reqUirements for pharmacists who di spense Schedu le II
pre~npuon~. and specifies that practitioners or researchers
may not be requi red to furni sh the name or identity of patients
or re\earch subjects to certai n agencies.
• House Bill 250 relates to mandatory premarital testing for
HIV Th1"l bill amends-the Health and Safety Code by requiring
pel'\on~ applying for a marriage license to submit ev idence to
the county clerk that each person has undergone a medical
procedure or te\t des igned to detennine if the person has A I OS
or HI V mfet:Uon. antibod ies to HIV, or infection with any other
probable cau\ati ve agent of AIDS .
• House Bill 262 relates to coverage under certain health
benefit plun\ for reconstructive surge ry incident to a
ma~tectorny. This bill speci fi es that hea hh benefit plans that
provide cove rage for mastectomi es must also provide coverage
for breast reconstruction .
• House Bill 263 relates to restricti ons on the use of certai n
genetic information by insurers. This bill restricts in surers from
u~mg geneti c information to reject, deny. limit. cancel. re fu se
to renew, increase the premiums for, o r otherwi se adverse ly
affect eligibility for or coverage under the policy or contract or
evidence of coverage. Insurers who use or reveal genetic
mfonnation or require an individual to submit to a genet ic test
comm1t an unfair practice and are liable to that individual. •
TOMA Accepting
Nominations
for Awards
The TOMA Board of Trustees is cu rrently accept ing
nom inatio ns for two awards - the Distingu ished
Serv ice Award and the Meritorious Service Award.
These awards represent the highest honor that TOMA
can bestow in recognition of outstanding service and
contributions to the osteopathic profession in Texas.
The Distinguished Service Award is presented to an
osteopathic ph ysician in recognition of outstanding
accompli shments
in
sc ientific,
profess iona l,
osteopathic education, or service to the osteopathic
profession in Texas. A candidate must be a member of
TOMA: a longtime member of his/her district society:
and a member of the A meri can Osteopathic
Association. Those ho lding an elective office in
TOMA are ineligible to receive the award during
his/her tenn of office.
The Meritorious Service Award is presented to a
non·OSteopathic physician in recognit ion of outstanding accomplishments in sc ientific. philanthropic or
other field s of public service to the osteopath ic
profession in Texas.
TOMA members or districts who wish to nominate
persons for these awards should complete a
nomination forn1. avai lable fro m Pau la Yeamans in the
TOMA office. and include pertinent biographical data
about the individual as we ll as infonnation about the
person 's accompli shme nt s that make him/ her
deserving of the award. The nomination must have at
least fi ve signatures of members in good standing of
the sponsoring district society. however. no member
holding an elective office in TOMA is eligible to sign
the nomination fonn . The form should then be sent to
the TOMA Executive Director. no later than March
28, who wi ll forward it to the TOMA Scholarship and
Awards Committee for consideration.
Upon receipt of a nomination form by the
Scholarsh ip and Awards Committee, a discreet but
thorough investigation as to accuracy of infonn ation
wi ll be canied out. After careful review. the committee
chairman wi ll nominate a cand idate, as recommended
by the committee. presenting necessary infonnation to
the Board of Trustees. An aftinn ative vote by threefourths of the members of the Board of Trustees will be
required to grant either award.
Rec ipients wi ll be notifi ed by the Board of Tru stees
and requested to attend TOMA's annual convention, at
which time the awards will be presented during the
President's Banquet.
Not more than one of each award will be granted in
any one year. Additionally. these awmds are not
necessarily annual awards.
7E~S'D. t'./9
Introducing Speakers for TOMA's 41st
MidWinter Conference and Legislative Symposium
DavidS. James, D.O., F.A.C.G .. wi ll
present ··H . Pylori Update"' as his topic
during TOM A's 4 1st MidWin te r
Conference and Legislative Symposium.
to be held February 14- 16 in Dallas.
Dr. James will prese-nt an overview of
He licobacter Pylori as the pri me
etiology of peptic ulcer disease and will
review disorders in which this organism
is present, but is not a pathological factor
in non-ulcer dyspepsia. Participants will also be updated o n the
latest di agnostic tools for establi shing the presence o f
Helicobacter Pylori as we ll as eradicmion therapy and foll ow-
up
Dr. James is an act ive practicing gastroenterologist at Tul sa
Regional Medical Center. Tul sa. Oklaho ma. He also serves as
a professor o f medicine at Okl ahoma State University College
of Osteopathic Medicine. director o f the Gastrointestinal
Center at Tul sa Regional Medical Center, and head of the
Di vision o f Gastroenterology at the same institutio n. Dr. James
is a graduate of the Uni versity of Health Sciences College of
Osteopathic Medicine in Kansas City, Missouri
" Common Fool Problems" will be
discussed by Tirnolhy C. Abigail ,
D.P.M.
This presentation will rev iew
common foot problems including new
treatment techniques for nail conditions,
heel pain. the arthritic foot and diabetic
wounds
Dr. Abigail practices in Garland and
Rockwall, and serves as director o f
medical education at Dallas Coumy Podiatric Extemship
Program and Residency and as an adjunctive clinical professor
at the Uni versity of Osteopathic Medicine and Health Sciences
- College o f Podiatric Medicine and Surgery, Des Moines,
Iowa. He is the president of the Dallas County Podiatric
Medical Soc iety.
Nancy A. Brown, D.O., will review
''Lupus: Diagnosis and Treatment" as
her topic during TOM A's MidWinter
Confe rence.
This presentation will be geared to the
primary care physician with an emphasis
on practicaL clinical approaches to the
diagnosis and treatment of Systemic
Lupus Erythematosus. Criteria for
di agnosis will be reviewed along with
methods for following the clinical course of this disease . Dr.
Brow n will al so o ffer practi cal and use ful laboratory
parameters as well as strategies for medical management.
Dr. Brown is a rheumatologist at Arthritis Care Clinic in
Okl ahoma City. A 1989 graduate o f Oklahoma State
Uni versity College of Osteopathic Medic ine, she is board
certified in Internal Medicine and Rheumatology.
10/?EUS %'.0 .
"Obsessive Compul sive Disorder'' is the topic to
presented by David A. Baron, D.O., F.A.C.N.
This lecture will deal with the incidence and
epidemiology of <?bsessive. Compul sive Disorder,
and contrast the disorder with other psychiatric :
describe its clinical presentation and provide
treatment strategieS.
Dr. Baron is a clinkal professor of psychiatry at Temple
Uni versity School of Medicine, chair of the Department of
Beha vioral Sc iences at FAES (a National Insti tutes of Health
affiliated graduate school). president of the Center for C lin ical
Research and Education, and a guest researcher at the National
Institutes o f Health. He is a graduate of the Philadelphia
College of Osteopathic Medicine.
" Repairing Photodamage'' is the topk
to be offered by Norman D. Guzick.
M.D.
Dr. Guzick will oulline the causative
factors in the process o f aging skin and
discuss how primary care physicians ia
the current era o f managed care can deal
with the e ver increasing emphasis oa
good looks. Skin aging with ilS distinct
componenlS will be reviewed along wilh
a description o f the various manifestations of aging skin and a
helpfu l system of classification. Dr. Guzick wil l also cover
treatment o ptions fo r repairing pho todamage, ranging from
sunscreens and mo isturizers through alpha-hydroxy acids and
topi cal tretinoin up to interventiona l methods, such as
che mical and other peels, laser resurfacing, soft tissue
aug mentations and surgery.
Dr. Guzick is in the private practice of dennatology in
southwest Houston and serves as ch ief of the Dennatology
Section of Memorial Southwest Hospital. He is also a clinical
assistant professor in the Department of Family Medicine al
the Uni versity of Texas Medical School at Hous10n. where ft
the past 20 years he has been responsible for the dem1atolo~
training of famil y practice residents. Dr. Guzick is a gradual
of the Uni versity of Texas Medical Branch at Galveston
Laurence W. Cunningham, D.O.
will present "Asthma Update 1997"
his topic.
Dr. Cunningham will review the 199f
~~~:~~=!· ~~~~ine;uf~~ tr~~~me~~~~ ~lc.~bayisan1110rnn.~
asthma. provide the stratification of
of bt
asthma into mi ld. moderate and severe
~ ltin2
catego ries, and discuss an objective "t5 as
assessment of airflow obstruction using peak flow meters and ~inna· 1
offi c.e spiro met.ry. Newer therapies_.for ast~ma, in.eluding beta· · y. and j~ an~
agoni sts. more potent inhaled cort1costero1ds and Leukotriene
ict mana
t
D receptor inhibitors, will be put mto perspecti ve with more Vniwr~lt ..~~~~ ~
tradttio nal therap1es.
Dr. Cunningham maintains a pulmonary/internal
practice in Jacksonville , Texas. He also serves as
clinical professor of medicine in the Division of
"Impotence: Update on Treatment Options" wi ll be
reviewed by Wayne Hey, D.O.
Th is presentation will outline the workup for impotence and
review the current treatments avai lable with their strengths and
weaknesses.
Dr. Hey is in private practice in Fort Worth at Dallas/Fort
Worth Urology Consultants. Board certified in Urologic
Surgery. he was the first osteopathic physician in Texas to
obtain ESWL (stone blasting) pri vileges. Dr. Hey is a 1975
graduate of Philadelphia Col lege of Osteopathic Medicine.
Christine Q uatro, D.O., will speak
on ''Rotation Defonnities of the Lower
Extrem ities.··
Thi s prese ntation will address
common hip problems in the pediatric
patient from newborn to adolescence.
including diagnosis of benign hip click.
developmental dislocation of the hip,
Legg-Calve-Perthes disease. slipped
ca pital femoral epiphysis and other
____ em'!' di\orders. Their pathophysiology. clinical presentation and
"'""""",e.~nging fill modalities of _treatmen~ ~ill be ~ut~ ined durin~ this lecture.
~ llpirhydfxy acids ao.
Dr Quatro IS a pracucmg ped1atnc orthopedist at Adolescent
:h 1 and Pedmtr1c Orthopedics, P.A .• in Hurst. She is curre ntly
tissu involved in a study regarding pediatric baseball pitchers at the
Te'a~ School of Baseball in Southlake, Texas. Dr. Qualro is a
,::~is
, *-------cu
so~~~~~~ O~teopathic
I
graduate of the University of Health Sciences College of
Medicine. Kansas City. Missouri.
'-- •II Fam1l Medicine I
Ed Kelsay, J.D., C.A.E.. w ill be
presenting a se minar entitled, ''Malpractice Loss Preve ntion for the
Osteopathic Physician."
During thi s seminar, Mr. Kelsay will
discuss listening as a loss prevention
skill : offer over 125 suggestions to help
medical professionals avoid professional
liability situat ions: and outline patient
relations as a loss prevention too l.
Mr. Kelsay is an attorney. medical association executive and
pre"'ident of his own medica l pract ice management se minar
and consulting fim1 , Ed Kelsay and Associates, Inc . He also
serves as the ma lpract ice loss preventi~n manager for
Oklahoma's physician owned professional hability insurance
company. and is an adjunct instructor on medical law and
practiCe management for the Department of Famil y Practice at
the University of Oklahoma Medical School. In 1986. he was
one of the first 17 association executives in the country to be
awarded the ASAE Fellow designation by the American
Society of Assoc iat ion Executives
ficati on a
and seven
objecti\'l
aD:
il· with
~r;..
A1,"
moo
tl me~icint
tH'I'e.tus assJ staD
Pul monar)
Sieve
P.
Buchanan,
D.O.,
F.A.C.O.O.G .,
will
speak
on
" Hirsutism: Evaluation and Treatment"
as his topic during TOMA's MidWinter
Conference.
Dr. Buchanan notes that at the
concl usion of this lecture, participants
should be able to recognize androgenic
changes in their fema le patients and
identify the subgrou p of patients whose androgenic signs
indicate increased risk for dyslipidemia and diabetes mell itus;
select appropriate lab tests for women with androgenic
disorders and interpret the results: understand the various
(X)tential approaches to treating androgenic disorders and
associated metabolic abnormalities: and recogni ze the
androgenicity of commonly used medications
Dr. Buchanan serves as associate professor and residency
director of the Department of Obstetrics and Gynecology at the
Uni versity of North Texas Health Science Center at Fort
Worth . He is also president of the American College of
Osteopathic Obstetricians and Gynecologists. Dr. Buchanan is
a 1982 sum ma cum laude graduate of Texas College of
Osteopathic Medicine
•
Humana Drops
'Gag' Clauses
Humana. Inc ., the Louisville. Kentucky· based health
maintenance organization. is eliminating gag clauses
from its contracts with doctors. The organization will not
enfo rce clauses in existing doctor contracts and wi ll omit
the language from new contracts.
In a news release announcing the decision. Humana
President Gregory Wolf stated, "These clauses were
never intended to hinder com munications, and to our
knowledge. did not do so. But if our physician panners
be lieve there is a problem. we in tend to fix it.''
Humanajoins the ranks of other HMOs dropping gag
clau~e language from its contracts due to physician and
consumer groups' complaints that gag clauses prevent
phy1.icians from recommending treatments not covered
by a patient's health plan.
7&'N4S 'D.0./11
HEALTH INSURANCE PORTABILITY
and ACCOUNTABILITY ACT
(H.R. 3103- Kassebaum/Kennedy)
Ftbr\JOI'Y 14
!llP"'
ReeePIIOII
,_M.m
comm011!
""IJ>Qfi
!~Pm
Change for the Better?
The final conference agreement states that the purpose of this legislation is "to improve portability and
continuity of health insurance coverage in the group and individual markets, to combat waste, fraud,
and abuse in health insurance and health care delivery, to promote the use of medical savings accounts,
to improve access to long-term care services and coverage, to simplify the administration of health
insurance. " The conference agreement was passed by the House on August 1, 1996, and the Senate on
August]. 1996. It was signed into law by the President on August 21.
Fego!OIO'
,_(OpJI\
~HOI
-lllP.I'fl
loloiiOfiO
fltrtrnllt!
!OOPm
EJ1b1Hol
a~5p.rn
Atlhmo tll
lOIJonct
SpONO'fC
dm#lrJ
February 15
lltoilcni
EJI"b1""
legorotl<
Health insurance for physicians has long been like sleeping on a "bed of nails."' However, recent state
legislation, along with the above federal legislation, has opened up numerous new options and alternatives
for physicians in the area of Health Insurance.
•
•
•
•
•
•
GUARANTEEDISSUE
PORTABILITY OF COVERAGE
GUARANTEED ACCESS AND RENEWABILITY
MEDICAL SAVINGS ACCOUNTS
DEDUCTIBILITY FOR THE SELF-EMPLOYED
LONG-TERM CARE INSURANCE
If you haven't reviewed your health insurance lately, now is the perfect time to do so. TOMA endorses
DEAN, J ACOBSON FINANCIAL SERVICES, LLC to handle the complexities and uncertainties of
the health insurance environment for you.
DEAN, J ACOBSON FINANCIAL SERVICES, LLC is recognized statewide for their expertise in
insurance and related areas So, regardless of your current situations with health coverage either
individually or group. call DEAN, JACOBSON FINANCIAL SERVICES, LLC today to find out how
these law changes may affect you.
Dean, Jacobson Financial Services, LLC
P.O. Box 470185
Fort Worth, TX 76147
(817) 335·3214
(972) 445-5533
800-321-0246
NtwSi oll
MG!~Ogt!l'
OOgloO
'H..,..
""'""
S!e111Yc
,_,..
,.,...,
"""""'
' -"'
-
Hlylao1 1
lj)Ml<>t<
tt~loltft
41st MidWinter Conference and Legislative Symposiul
Donna Hand, D.O., Program Chair
i
SCHEDULE OF EVENTS - 17.5 AOA Category 1- A Hours Available
:
riday, February 14
)J p.m.
• 8:30p.m.
~ )() p.m. -6:00p.m.
)() p m -8:30p.m.
JO p.m -645p.m.
1:30p.m. -2:15p .m .
Registration
Reception with exhibitors
Exhibit Hall Open
Common Foot Problems Tim Abigail, D.P.M .
Rotation Deformities orthe Lower
Extremities - Christine Qualro, D.O .
Exhibit Hall Break
Asthma Update 1997 La urance Cunningham, D.O
Sponsored by Allen & Honburys
division of G/oxo Wei/come. Inc.
-7.30 p.m.
-8:00p.m.
- 8 45 p.m.
2:15p.m. -3:00p .m.
3:00p.m . -3:45p.m .
3:45p.m . ·4:30p.m .
4:30p.m . -5:15p.m .
Impotence: Update on Treatment
Options - Wayne Hey. D.O .
Sponsored by Merck & Co .. Inc.
Obsessive Compulsive Disorder ·
David Boron, D.O .
Sponsored by Phormocio &
Upjohn, Inc.
Exhibit Hall Break
Lupus : Diagnosis & Treatment Nancy Brown, D.O
How to Treat Varicose Veins Alvin Mathe', D.O .
Sunday, February 16
on
aturday, February 15
-8:00a.m .
-4:00p.m .
- 5:1 S p.m.
- 9:00a.m .
7:30a .m . - 8:00a .m .
7:30a .m . - 1:15 p .m .
8:00a .m . - 10:30 a.m .
Breakfast with Exhlbltors
Exhibit Hall Open
Registration
NewStroteglestorRisk
Management In ObesityCraig Spellman. D.O .
Sponsored by Wyeth-Ayerst
10:30 a .m .- 10: 45 a.m .
10:45 a .m .· 1:15 p .m .
laboratories
)() a.m .
y
IOOOo.m.
Hirsutism : Evaluation & Treatment Si eve Buchanon , D.O .
Exhibil Hall Break
Repairing Photodamage Norman Guzick, M .D .
Sponsored by Orlho
Phormoceutlcat Corporation
H. Pylori Update - David James. D.O .
Sponsored by Astra Merck
Legislative Luncheon
Sponsored by Astra Merck
OO a.m . - J0-45 a .m .
45o m . JJ·JOa.m.
30a m. ·\2:15p.m
I Sp
m -I 30 p.m .
ContinentoiBreakfost
Registration
Malpractice loss Prevention for
the Osteopathic Physician ·
Ed Kelsey, J.D.
Re freshmen t Break:
Malpractice Lon Prevention for
the Osteopathic Physic ian (con't)Ed Kelsey, J.D.
HOTEL INFORMATION
This year's conference will be held ot the Fairmont Hotel in the
Do \los Arts District, 1717 N. Akard Street. Do \los, Texas 75201.
Reservations must be made no later than Tuesday, January 14,
1997 to receive the discounted group rate ol $89 plus tax, single 01
double occupancy. Call the Fairmont Hotel directly a t 800/5274727 or 214/720-2020 for reservations and be sure to mention you
ore with TOMA. For VALENTINE'S DAY- mok:e reservations at the
Pyramid Restaurant, which is one of Dallas ' finest dining spots.
when calling the Fairmont hotel.
Registration Form
Nome for Badge _ _ _ __
~ -----------------------------
State _ _ _ _
oone 1 - - - - 1 - - - -- -- - - - - - - -
Fox
Osteopa thic College
Registratio n Postmarked on or Beforel / 25/ 97
$175
$275
_ __
_ _ _- - ;
Zip----- - - - - - - - - -
1-----1 - - - - - - - -- - - -- - Graduation Year - - - - Registration Postmarked affet 1/ 25/ 97
$250
$350
!tOse reserve ____ extra ticke l (s) for the Legislative Luncheon on Saturday a! $25 each . (One ticket is included in the registration fee .)
tra Luncheon Tlcket(s} + S _ _ __
tTA l ENCLOSED
z
$ - --
-
ll:eturn this form with your payment In full to TOMA , 1415 Lavaca
Street, Austin , TX 78701-1634. All refund requests must be mode in
writing . Requests postmarked on or before January \4, 1997, witt
receive a refund minus a 25% handling charge . No refunds will be
mode offer January 14. 1997.
New Rules for Reporting CME Activities
Texas physicians are required to have completed 24 hours of
continuing medical education during the 12 months preceding
annual registration o f their medical license. With the adoption
of new rules by the Texas State Board of Medical Examiners
(TSBME). excess hours earned in one reporting period may be
applied toward the next two years' requirements. A max imum
of 48 excess credit hours may be carried forward and these
hours must be applied within the upcoming two years after
which they were earned. This requirement may be fulfill ed
through participation in both formal and informal CME
activities. Begi nning in January 1999. at least one o f the 12
formal hours must be obtained in the subject area of medical
ethics and/or professional responsi bility.
Presumed Compliance
A physician will be presumed to have complied with the
CME requirement if in the preceding 36 months he/she
becomes board certified or recertified in a medical specialty.
The Texas State Board of Medical Examiners has determi ned
that the activilies undertaken to become board certified or
recertified equal the 24 hours requirement. Since 24 hours are
required every 12 months, the board certifi cation process
would fulfill the licensure requirement for one year only.
Physicians in residency/fellowship training or who have
completed such training within six months prior to thei r
renewal application will satisfy the formal and informal CME
requirements by their residency or fellowship program
Retired Physicians
Retired physicians ''on official retired status·• with the
TSBME will not be required to report CME activities.
Physicians who are retired from practice but wish to retain an
acti ve license must meet the CME requirement.
Exemption Request
Exemptions are subject to the approval of the execut'ive
director of the Texas State Board of Medical Examiners and
must be requested in wri ting at least 30 days prior to the
expiration date of the license.
An exemption may be requested for the following reasons:
I . catastrophic illness
2. military service of longer than one year's duration
outside Texas
3. medical practice and residence of longer than one
year's duration outside the U.S.
4. good cause on wriuen application of the licensee that
gives satisfactory evidence to the board why the
physician is not able to comply
Formal Activities
At least 12 hours. including I hour of ethics education. must
be completed through participation in forma l CME activities,
but all 24 hours may be completed in this category. This
includes conferences, seminars, lecture presentations. grand
rounds. case conferences, self-st udy courses, etc .. which are
fom1ally designated for credit as:
I. Category I of the Physician 's Recognition Award o f the
American Medical Association
2. Prescribed credi t of the American Academy of Fam1 ·
Physicians
3. Category I A credi t of the American Osteopathic
Association
Brochures or promo tional materials for CME activities at
self instructional courses or materials will carry a specif
statement advisi ng physicians if the activity has been appro\l
fo r any of the above types o f credi t.
Documentation
1
Documentation of attendance at fo nnal CME acti vities cr;
be obtained from the S!Xlnsor of the activity in the form of
CME rcport·ing fonn , attendance cert ificate, CME transcript 4
letter of verification of attendance.
Documentation to verify attendance should not be submitte
to the Board o f Medical Examiners with the application f1
annual registralion . Doc ume ntation. however, should h
retained by the phys ician for reference in re~X>rting CME houJ
completed and in the event that veri fication is requested by tl
Board o f Medical Examiners in a random audit of complianc4
Informal Activities
Physicians may complete up to 12 ho urs (of the require
total 24 hours) by participating in infom1al CME acti vitie
..
,~---The fo llowing may be Te!Xlrted as informal hours:
• Conferences, seminars, grand ro unds, case conference
journal c_lubs. etc., not desig. nated for fom1al credit. Recor
activity title: date; and clock hours expended.
1e
1
"'nHnJ(.{l
Uttl U!
• Self instructional matenals or courses not designated fl
fonnal credit and self-assessment exami nations and review•
Record activity/course title: date o f use; and clock hoUJ
expended
• Reading clinically relevant medical journals or article
and use of literature search databases in connection with th
prov ision of patient care. Record name o f publication c
database utilized: date read/used; clock hours ex pended.
• Participation in patient care review acti vities (peer revie\
or hospital qualit y of care review commiuees).
• Research/preparat ion time for medic al prese ntation
de livered to practicing physicians o r physicians in training.
• Up to 10 hours may be clai med for: publication of
medical or medicall y related article: for each chapter of
medical or medically related book or other medical educati01
materials: preparation of an ex hibit displayed at a scientifi
medical meeting or other CME activity.
Articles must be publi shed in a recognized medical jounu
that is primaril y read by physic ians or o ther healtl
professionals. Credit may be claimed o nly once fv
publications or exhibits even if it is reissued in a changn
fonnat. Record the type of activity: date completed: and clo:l
hours expended.
lnfonnal acti vities are not always sponsor-verifiable. I
available, physicians should retain transcripts or cert ifi ca t~ o
attendance. If not available, a log sheet (available from tlk
TSBME) may assist in maintaining a personal record whid
could easi ly be submitted to the Board of Medical Examiner.
if requested.
1\llelMUil.
-~sla"'""
.,.;oeadlmeeir'l
~o~~~.o-tecil
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ViiJA. Turrrbow (C
Noncompliance
Failure to obtain and report 24 hours of CME at the time of
license renewal wi ll result in nonrenewal of the li cense until
the physician obtains and. reports the requ ired CME hours.
However, the executi ve director of the board may issue a
temporary license for a pe_riod of up to 90 days to the physician
who has not complied with the CME req uirement. Note that
this 90-day extension through the temporary lice nse is at the
discretion of the executive director and is not an automatic
grace period. The temporary license not only a llows the board
time to verify the accuracy of infonnati on related to the
physician's CME hours. but al~o a ll ows the physicia n an
opportu mty to correct any deficiency so as not_ to tenninate
ongomg patient care. Any CME hours obtamed after a
q phy~ician ·s renewal dale for the purpose o f satisfying the C ME
requ1rement for the preceding year's licensure renewal. if
above and beyond the 24 hours necessary for renewal, may be
used to meet the CME requirement for the curre nt year.
Failure to comply wi th the C ME requirement for renewal of
a license invokes the monetary penalty for late registrat ion. If
the CME requirement is met and repon ed within 30 days of the
license expiration date, there is no late fee and the physician
pays the $50 temporary license fe e plus the $300 renewal fee.
Between 31 and 90 days, the phys ician is assessed a late fee of
$50 111 addition to the temporary license fee and renewal fee.
After 90 days when the temporary license expires. penalti es
are detennined by the Board 's Di sc iplinary Process Review
~~m•
•
., C/?. -1-1-/0 ._."'
. R"" ~w
f,
Dear Terry:
S1nce 1980 I have worked very closely with the
osteopathiC profession in the state ot Texas. I have
helped doctors establish their insurance needs from
internshiP on into their practices. I have been to almost
every state convention, mid-year meeting and ACOFP
meet1ng in the state since 1987, not to mention
several other states and national meetings. I looked
forward to each meeting so that I could make new
tnends and renew the old ones. I nave always thought
of Texas as my second home.
It IS with deep sadness that I inform you that my
employment with the Physicians Choice group has
ended as ot N011ember 15, 1996. I hope to still
ma1ntain the friendship of the osteopathic profession.
I encourage all my doctors to maintain their
association with the Physicians Choice group and it I
can answer any questions, please do not hesitate to
call.
You all will always have a special place in my Mart.
May God bless you , your tamilies and the osteopathic
profession.
Sincerely,
Vicki A. Turnbow (Campos)
In Memoriam
Wayne R. English, Sr.
Wayne R. Engli sh, Sr.. father of Wayne R. English. Jr.•
D.O., passed away November 17. 1996. He was 97 years
of age.
Funeral services were held November 23 at Fi rst
Christian Church in Lemoyne, Pennsylvania, with burial
in Blue Ridge Me mori al Gardens, Lower Paxton
Township. PA
Mr. English was a retired teacher from John Harris High
School and had also taught with the Fresh Air program.
He was a member and fanner head elder of First
Christian Church in Lemoyne and had attended First
Christian Church in Texas. He was also a member of
Harrisburg Masonic Lodge 629. Harrisburg Consistory
and Zembo Shrine Temple .
Memorials can be made to Fi rst Christian Church. 442
Hummel Avenue. Lemoyne. PA 17043.
Besides Dr. Engli sh, survivors include six grandchildren
and three great-grandchildren.
Roy J. Har vey, D.O.
Dr. Roy J. Harvey of Kerrville passed away November
4. 1996. He was 83 years of age. Memorial services were
held November 7 in the Moore Audi torium at Mt. Wesley
Conference Center.
A graduate of the Kansas City College of Osteopathic
Medicine (now the University of Heahh Sciences/College
of Osteopathic Medicine). Dr. Harvey began his medical
practice in Michigan. From 1952-53. he se rved as
president of the Mich igan Assoc iation of Osteopathic
Physicians and Surgeons as well as a legislative agent for
the association. He was instrumental in the establi shment
of the fi rst state supported college of osteopathic medicine
at Michigan State Uni versity and taught cli nical training
and family practice medicine there.
In 1957 he moved to McLean. Virginia. to become the
coordinator for the American Osteopathic Assoc iation in
Washington. D.C. While there. he was acti ve in the
Virginia Osteopath ic Association.
Dr. Harvey served as the 1960-61 president of the
American Osteopathic Association
He moved to Kerrv ille in 1980 and served as president
of the Guadalupe Chapter of AARP. where he was active
in the 55 Alive defensive drivi ng program. president of the
Kerrvi lle Trailbl azers and pres ident of the Unitarian
Universalist Fellowship of Kerrville.
He was also very active in the Texas Osteopathic
Medical Association. of which he was a life member and
served on numerous committees throughout the years: and
TOMA District XVII. of which he served as president.
Survivors include hi s wife. Alberta Harvey: daughters.
Diane Howell of Columbus. OH. Jeanie Phi lip of Danby.
VT. Jill Roberts of Accident. MD: a son. Dan Harvey of
Ha milton. VA: seven grandchildren and six great·
grandchildren: sisters. Evelyn Falan of Paw Paw. Ml.lmm
Royce of Cadi ll ac. Ml: brothers. Chester Harvey of
Je ni son, M l and Clifford Harvey of Cadillac. MI.
Memori al contributions may be made to the Hospice of
Kerrville, 1404 Sidney Baker. Kerrville. 78028.
7&-xriS z:>.0./15
AOA Introduces Web Site
Affi liates of the A merican O steopathic Assoc iation
looking for infonnation can now access the AOA's new web
s ite at http :\\www.am-osteo-assn.org
Visitors to the AOA's web page have options from which to
choose. One area is for firs t time users, offering instructions on
navigating the site. Another area defines osteopathic medici ne,
explains the train ing and practice scope of osteopathic
physicians and provides heahh tips and career infonnation.
The third area, for D.O.s and osteopathic affil iates. incl udes
regularly updated data on AOA membership. public relations.
education and other topics of concern and interest
New OMT Brochure Available from AOA
The A merican Osteopathic Association has produced a
new brochu re e ntitl ed, ''OMT: Hands-On Care." The
brochure addresses a description of OMT and how it is
incorporated into the practice of osteopathic medicine ; the
ditTe rent disorde rs that can be treated with OMT; who can
benefit from OMT: a nd what a patient can expect du ri ng a
struc tural exam. Also included are c urrent research fin dings
supporting the use of OMT as we ll as historical
infonnation.
To order copies of ··QMT: Hands-On Care," contact the
AOA order department at 800-621 -1773, extension 740 I. The
cost is $ 15 per I00 broc hure.~;.
Unique Internet Feature Helps Citizens Participate
Texans for Lawsuit Reform (TL R). the s ta tewide
grassroots organi zation advocating ci vil j ustice reform. has
announced developme nt of a un ique Internet feature tha t
allows citizens to detennine the name and address of their
State legislators. '"T his is one more way we are trying to
build bridges between citi zens and their elected officials,"
said TL R founde r Richard Weekley
TLR's homepage at http://www.tortreform .com contains a
database link that allows Texans to enter their home address in
order to detcnnine the name and address of their state senator
and state representative. "Of course we want Texans to know
as much as possible about the fair and balanced civil justice
refom1s TLR supports and the need for these changes," said
Ken Hoagland, a TLR spokesman who also developed the site.
"But perh!lps even more important to the average ci tizen and the de mocratic process here in Texas - is the tool we have
built into this page that tells a citizen who their state elected
officials are and how to get in touch with them.'' he noted.
The TLR homepage is a contem-rich site thai outlines
lawsuit problems in the Texas civil justice system, defi nes
TLR 's proposed legislative solutions. provides researc h
material on that legislation. cites lawsuit case studies and
offers E-mail to the organi zations. as well as providing a
means of participating in the grassroots campaign to wi n
refonns in the next session of the Texas Legislature. The site
also contains the results of several public opinion polls on
lawsuit abuse and reform in Texas.
Texas Senator Wants to Increase HMOs' liability
Senator Da vid S ibley. (R-Waco), head of a Se nate
com mittee studying ma naged care in Texas. has re leased
new regula tory proposals. among the m a provision that
1 6/7E:US Z>.O.
would ma ke health mainte nance organizations liable for
bad medical decisio ns.
"Now a patient must sue the physician for malpractice and
sue the managed care organi zation for corporate negligence,"
Sibley said. " However, if the doctor acted appropriately, the
patient often can't recover from eithe r pany."
Under the new proposals. both panics would share the
liabili ty.
The commi ttee also recommended exped iting the complai nt
and appeals process in life-threatening cases: allowing limits
on the time it takes for a patient to schedule an appointment:
allowing an independent agency to issue repon cards on the
state's HMOs: and prohibiting managed care systems from
offering doctors fin ancial incenti ves to cut back on treatments
to save money.
"As the industry grows. we must make sure consume rs are
adequately protected," Sibley said. "These recommendat ions
provide these safegua rds, yet are fa ir to managed care
organ izutions."
TRICARE/CHAMPUS Announces Web Page
TR ICA RE Sta nda rd/C H A M PUS (O ffi ce o f Civ ili a n
Health a nd Medical Program o f the Uni formed Serv ices)
in fo nnation is now available o n the ho me page of the
assistant secretary o f de fe nse for health affairs. w hic h ca n
be found at www.ha.osd.mil.
Users can fi nd infonnation by looking under the T RICA RE
heading and then findin g the TRICA RE support offi ce. Users
will gai n access to a varie ty of TR ICARE Standard/
C HAMPUS infonnation incl uding manuals. ne ws releases,
be nefi ciary and provide r handbooks. program sta tistics.
C HAM PUS maximu m allowable rates and more.
Comp Alert
Notification of MM/1/mpairment Rating Disputes
Effecti ve Octobe r I. 1996, in surance carrie rs and
represented inj ured workers must fi le the TWCC-32, "Not ice
of Maximum Medical Im provement/I mpairme nt Rating
Di spute," to noti fy the Texas Worke rs ' Compe nsati on
Commi ssion about disputes on ce rtifications of the da te of
maximum medical improveme nt and/or assigned impairme nt
ratings. lnsumnce carriers and represented injured workers
were allowed an additional 60 days fro m the date of the TWCC
advisory (November 8. 1996) for securing, distributing and
using this panicular form . Proper completion and timely filing
of thi s form will const itute compliance with the provisions of
Rule J30.5(a) if a copy of the fonn is sent to the other party the
same time it is filed with the TWCC.
This fonn establi shes a unifonn me thod of notifying the
TWCC about these types of disputes a nd w ill e nable the
TWCC to process these disputes in a ti mely and efficient
manner. In the past, these disputes have been filed in various
ways which caused delays in the selection of designated
doctors. While the failure to use this form may not result in a
detennination that the pan y has waived its right to dispute, so
long as a ti mely dispute is othe rwi se fi led. it may result in
inadverte nt delays in processing the dispute.
An un represented injured worke r may notify the TWCC
about a muximum medical improvement a nd/or irnpaim1e nt
rat ing di spute in any timely manne r. However, this form may
also be used by the injured worker or anothe r person to
docume nt the dispute for processing purposes.
lo,
ATOMA News
What ATOMA Means to Me
By Dodi Speece, ATOMA
President~elect
1 called Mary Luibel last month and asked her to write a few words on what ATOM A meant to her, which foll ow. She very
cheerfu ll y agreed, say ing she didn 't know if she could put it all on paper.
My Auxiliary. W!,atJt Has Meant to tlte
'.hove been all Al<>iliary lllember for 52 ,
rO~teoPath,c
Aux,ftary '"•eting of the Te.ras Associ"'''"' o )ears. I first wellt to an
IIO>v TOMA, as a'""' br,de frotn F/onda At
Physic,ans,
"' FerriS, Texas, a to"'" of I 5{}() oeo
. ,,. tl//fe, George Practiced
George "'a s ""J' acfi>•e '''
located 20 nules south of Dallas.
D. 0. s "'ife. "!fier breakfastth
a/fended Y first conv.,ll,on as
111
18 lllost
"'"'eet'''lls
0111 the dal' W! ef!;st.'ay, George Satd to""· "Ma'J: I om
0
"!!ierfindh
>vhat
",:. You Co
the Al<riliory llleethlg.'"0
I
a room of co'"Piete stra?: '" 'J;'d:•here the llleet,llg >vas held,
and kind to llle that I >vas lllost I l!ers.
they ll•ere so gracious
elected
"'PPy to }0111. Not Only that, bu 1 >vas
I "'atll to 8it·e You some ;easons ' I I
.. .
1 of
"'Ost/if!Jilling Parts of,lly life. "'Y ,,. A'<r'ftal'les have been one
J 8.,"11 able to help Illy '""bands ,r .
"let
b bl
Pro,esston. "!!ier all, if I had llot
1 1a01D 0 I
and excith'l!life t
hm•e had the II'Ondetfill
2) The last111g frielldsh;ps 1 ha ,
, as rougt, lis closer together
1 all O>•er the coulltry have bee"
"''J:
'''IJ' spec,(,f.
'e '"a"
Jj It has bee" a lear,"''ll '"Per;
F, .
T(fuJ7·
i.
th~A,,)t,,,
ellte~ed
til~
SecretaiJ·-Treas,,~rt
~o
~"e''e<
at~cl,llarried l· , .~'t,/:/'It;;,/,e;~~;'i,d ll~t
:o~'J,~tau,:;e"c~
to lllake a Speecl, bifore I
ence. or IIIStance, I hm•e learned ho>v
shaky; t ·.,, lear/fed ho"' to
'"'"'Out feehllg scared alld
a !freat
deal
about
respollsihtlit
,
and l '>•e lear/fed
Our Auxiliaries hm•e do,,. ,),; ,IIIJselfllltneetu,gs;
.
11
11
the AAOA Scholarsl,p Flllld 11•1/:1
th'"lls. such as spollsor,''e
•ducmion; Plac,,,8
"!Jed llla11y .O.O.s co'"Piete
"'o""s through ATOMA a"d laMA D . s '"many '""soo'"es: alld ra,:red
for lltally
ProJects.
E>•etytlllilg about the Au.nfiaiJ• '"
e;; Illy life '"ea"'"ll· To realty
accollllt all "'Y r'<IJ·ons "'OII/d tak;s
£";1J•t l,llg I '""'e g;.,.,, I hm•e recei> •e d
"' tlus lllaga,,,,e.
.feel sorry for D. 0. s "'i>•er ll •ho do llot" I ' .
to offer
11/is.rh;g a bet.'
eo IOe 11'/lc/1 AIL<Ift{,l'les hm•e
the;~
Tit~)' {If~ l~al/y
~"'•'{":
Oste~>all;,c ~,;.as
":r~ct/j
~;)tl~re:;ol'/;"' '"~ded
Mary Luibe/ (Mrs. George;
After I received her note, I felt a little guilty that I had not
wntten a few words of my own.
When Jnn and !married, I didn't know anyone in the area.
Darlene Way took me under her wi ng and made me go to the
ATOM A Di strict V meeting with her. In Di strict V, we have a
separate room for our meetings while the physici ans have
thei r meetmgs. The more I we nt. the more I got to know the
other spou~es and formed some close and la sting friendships
over the years. On the state level, Peggy Rodgers call ed and
asked me a number of years ago to be on her Board of
Trustees. At first I refu sed; I didn 't want to become in volved.
Fmally I relented and said OK. ''if it 's an easy job.'' I have not
regretted it since.
As a member and offi cer of ATOM A. I have the
opportuni ty to help my husband 's chose n profess ion. which
has all owed me to have my horses and farm. I have the
opportunit y to meet and get to know other spouses (male and
fe male) from across the state. It offers the chance to network
with other spouses who have the same office/insurance
problems, if one is acti ve in the physician's office. The
pluses far out weigh the minu ses of spending very little time
and money.
Thank you, Darlene and Peggy. for not taking no for an
answer and getting me in volved.
7&'Xr/S 'D.fJ./17
In the News
Dr. Richard Hall Retires
Richard M. Hall. D.O .. of Eden. was
recently featured in his local newspaper
on the occasion of his retirement from
34 years of medical practice - nearly 25
of them spent in what he calls ''a love
affair with the community of Eden:·
''I really love this county and the
people. I'm going to miss seei ng new
patients every 12 to 15 minutes." said
Dr. Hall.
Dr. Hall was lauded for leaving the
"communi ty's medical industry in much
beuer shape than when he came:' He
was in practice in Groom in 1972 when
a former Groom residen t who had
moved to Eden called and asked him to
consider moving to Eden. which at the
time had no physician. ''There were six
doctors in Groom and none in Eden:'
said Dr. Hall . 'They had had physicians
off and on for 15 years but no one
consistently. We said a lot o f prayers fo r
four days and then we dec ided to come
down here."
He noted that the community was so
eager to have the Halls that I I ranchers
showed up in Groom with trucks and
trai lers and moved the Halls "lock. stock
and barre l." In addition. when he and his
wife. Myrt le. chose a house. the
commun ity bu ilt an addition onto the
home to make room for the fi ve of their
seven children still li vi ng at home
From 1972 to 1974. Dr. Hall was the
town's onl y physician. He was on call
almost non-stop, and said the work j ust
about killed him . The first time he had to
transfer a pat ient. a wreck victim. to San
A nge lo. Eden had no emergency
medical service. so the vict im had to be
transferred in a hearse from the funeral
home.
Al most 25 years later. Eden has three
ambulances and three paramedics and
there is no shortage o f physicians. In
1974 Dr. John Boyd joined his practice
and Drs. Joseph Fe ldhaus and Theresa
Boyd have also si nce joined.
" We have been fortunme," said Dr.
Hall. "Concho County Hospital is one o f
the few rura l hospitals that still exists
and is still in the black."
A graduate of Kirksville College of
Osteopathic Med icine. Dr. Hall interned
18/?EUS 'D.O.
at Kirksvi lle Osteopathic Hospital. He
entered private practice in T urkey in
1963. prior to moving his practice to
Groom in 1964. and to Eden in 1972.
Dr. Hall has bee n a very ac ti ve
member of the Texas Osteopathic
Medica l Assoc iat io n. serv mg as
president from 197 1-72. as a member o f
the Board of Trustees and the House o f
Delegates. and as chai r and member o f
TO MA
co mmittees
nu merous
throughout the years. He has also been
acti ve in TOM A District IV. serving as
pres ide nt from 1990-93 and as the
current vice president.
O ther membershi ps and act ivi ties
include me mber of the American
Osteopathic Associati o n; assoc iate
member of the American College of
Osteopa th ic
A nesthes io log ists:
American College of Osteopath ic
Family Physicians: Texas Soc iety o f the
America n College o f Osteopat hic
Famil y Physicians. o f which he served
as pres ident from 1989-90. is a life
member and the pennanent chainnan of
the Credenti als Comm ittee: clinica l
associate professor in the Departme nt of
General Practice at the Uni versity o f
North Texas Health Science Center at
Worthffexas
Co ll ege
of
Fo rt
Medic ine;
A me ri can
Osteopathi c
Osteopathic Associati o n of Spo rts
Medici ne; member of the State Rural
Medical Education Board; and fellow of
the Ameri can Coll ege of General
Practice.
TOM A extends best wishes for a
wonderful retirement.
Myrtle Hall Honored
as Citizen of the Year
Myn le Hall was one of two local
citizens honored as Citizen of the Year
by the Eden Chamber of Commerce.
She was recogn ized for almost a quarter
century o f service a nd dedication to
Eden and Concho County.
Mrs. Hall is a graduate o f Pampa High
School and West Texas State Uni versity.
She served as business manager fo r the
Eden Medical Clinic fo r 19 year. as
county director fo r the American Cancer
Soc iety for eight years. and o n the
library board for 18 years. For six years
Mrs
City Counc il a nd durin g that tit!
represented the county on the Co ne!
Vall ey Counc il o f Governments. ~
which she served as secrctary-treasun.
She has served on local. di strict and sta
Parent Teacher Associatio n boards ar
has been acti ve in the Auxili ary to tl
Texas Osteopathic Med ical Associatim
Editors note: Due to Dr. and Mr
Hall's special interest in rural healt
care, they wish to coutinue to support
by providing ftmmcilll llssistance 1
deserving students who oth erwi~
would not be able to participate br a
osteopathic medical Cllreer.
Please consider sending your taJ
free donation, payable to Texo
ACOFP, to tire following addres'
Texas Society of tire American Co/leg
of Osteopathic Family Physicians, v,
Richard and Myrtle HaiURural Healt.
Scholars/rip Fund, Attentio11: Jam
Dw rkle, 1415 Ltn·aca Street, Austi"
TX 78701.
correct account. Th ese sclrolarship;J
will be awarded to premedical
and osteopathic medical stw
you /rave questions, contllcl
Du~tkle, Texas ACOFP Executifl
Director, at 800-444-8662; or Clrarllf
R. Hall, D.O., at 915·752-6992
9 /5-646-8541.
TSBME to Require
Ethics Training
for Physicians
The Texas State Board of Medical
Examine rs has adopted Ru le 166.2
which will requ ire that o ne hour of the
annu al requi re me nt of 24 hours ~
Conti nuing Med ical Educatio n (CMEI
be com prised of ethics training (startifll
in 1999). Al so included in the ru le is 1
provision to allow physicians to CarT)
over excess fom1a l CME hours fo r t\1.(1
years.
•
Medigap Rates Becoming
Too Costly for Many
Dr. George Luibel Awarded
AOA's Highest Honor
A study sponsored by Families USA reveals that Med igap
insurance premiums increased 30 percent in 1995 in some
states. making it diffi cult fo r many to afford. States with the
highest inc~ases in premiums "':ere Texas and <:Jhio. 30
percent ; Flonda, 29 percent: Georg.a. 26 perce.nt; A n zona, 23
George J . Luibel , D.O .. of Fon Worth. was awarded the
American Osteopathic Association's hig hest honor during its
I 0 I st A nnual Convention and Scien tific Sem inar. held
October 7· 11 in Las Vegas.
The AOA's Di st inguished Se rvice Ce rtificate was
presented to Dr. Luibe l in recognition of his outstanding
service in osteopathic med ical education and organization
Dr. Luibel's accompl ishments are lengthy and impressive.
He is past president of the AOA: American Academy of
Osteopathy: Texas O steopathic Medical Association; and the
Kirksv ille Osteopathic Alumni Assoc iation.
He is rec ipient o f TOM A's Di stingu ished Service Award:
the Texas College of Osteopathic Med icine's Fo unde rs'
Medal : and in 1988. was named Educator of the Year by the
AOA and the National Osteopathic Foundation.
Dr. Lui bel is one of the three founders of the Universi ty of
North Texas Health Science Center at Fort Worthffexas
College of Osteopathic Medicine, and was instru men ta l in
transforming the Fort Worth Osteopathic Hospital into the
Osteopathic Medical Center of Texas.
In nominating Dr. Luibel for the AOA's Distinguished
Service Certificate. TOMA told the AOA Board of Trustees.
"George J. Luibcl, D.O .. exempl ifi es the qualities everyone
see ks in a physician. He has dedicated hi s professional and
personal life to serving mankind ... He draws upon all the
facets of hi s li fe - med icaL spiritual , professional. persona l.
political and civic - to enrich everything he touches.''
•
percent; Colorado, 20 percen t; and North Carolina, 19 percent.
"This is a threatening prospect for o lder Americans who are
o;imply trying to make ends meet.'' sa id Families USA
Execut1 ve Director Ron Pollack ... Many of ou r nation's elderly
are going to be squeezed o ut of the Mcdigap market.'' He n01ed
that the study's find ings were part icularly a lanning because
during the past sess io n. congressional leaders cons idered
nming Medicare premiums in the debate o n how to save the
program. ln addition. the rising costs are difficu lt fo r seniors
"ho rely on Social Security benefits . w hich rose 2.6 percent in
19\15.
The o;tudy exam ined rates of the two largest Medi gap
pro'viders. Prudential and Blue Cross/Blue Sh ield. which serve
50 percent of the market. In Flo rida . annual premiums for bas ic
Prudential Medigap coverage averaged $483 in 1995. and
$585 tn 1996. Prude ntial attributes the 1996 price increase to
more daims and higher Medicare deductibles.
Gen Dallek. author of the study. auributes the increase to
CO">b to providers and a general trend of healthy se niors
'>Witch mg to HMOs. whi ch means that those who remain with
traditiOnal coverage tend to have mo re cost ly illnesses covered
by Medigap polic ies. "The problem with HMOs is that a one·
'>1/e-fit.-..-all formula may not be the ri ght c hoice for seniors
~•th chrome and dtsabling conditions:· said Dallek.
•
THANK YOU!
TOMA would like to thonk the following "Texas Stars" who have contributed abor·e tire $1,000 donation level:
R1chard Ander'ion, D.O.
Auxiliary to the Texa'i Osteopathic
Medtcal A~o~K:1at10n
Mark Bal.er. D.O
Dr and Mf\. John Bowling
Dr. and M". Fmnl Bmdley
Mary Burnell, D.O.
George Cole. D.O.
Nelda CunmtT- I.,.,nberg. D.O.
Jim C7.ewslu. 0.0
William Dean
On. Cynthia and Gregory Don
Carl E. Everen. D.O.
AI E. Faigm, D.O.
D. Dean GatTon!. D.O.
Samuel B. Gan1, D.O.
Myron l. Glickfeld. D.O.
Drs. Donna and Wendell Hand
M111M~ 1997
Healthcnre ln.!.urancc Scrvicc'i
Dr... Harry and Linda Hcrn::tndez
Joel D. llolliday, D.O.
Hou\to n O<,teopathic Hmpi ta l
Foundation
Jake Jacob<,on
Con.-..tancc Jenkins, D.O.
William R. Jenkin'>. D.O.
Dr'i. Elvn a nd Royce Keilers
Victorija LauciUS, D.O.
Dr. and Mr-. . Harold Lew1<,
Lubbock 0'1tcopathic Fund, Inc.
R. Greg Maul. D.O.
Dr. and Mrs . Jack McC:u1 y
Dr. and Mr... . Carl Mitt en
Darcld R. Morri s. D.O.
On•. Ann and Bill Nolen
Osteopathi c Health Sy~tem of Texas
Dr. and Mr.. Robert Peters, Jr.
Or. <md Mrs. Donald M. Peterson
Dr. and Mrs. RandaJI Rodgers
Dr. and Mrs. Daniel Saylak
A. Duane Se lman . D.O.
T.R. Sharp, D.O.
o. .
Sparks
teopathic Foundation
Dr. and Mrs. Arthur J. Speece
Wayne Stocb.eth
Texa;ACOFP
TOMA District II
TOMA District V
TOMA District X
TOMA District XV
Kenneth R. Watkin'i. D.O.
Boll V. Way. D.O.
Dr. and Mr:,. Rodney Wiseman
Dr. and Mn;. T. Eugene Zachary
7&USz:>.O.I19
Public Health Notes
"Tobacco & Health Affects: In Consideration of Local Smoking Ordinance "
By Alecia Anne Hathaway, M.D. , M.P. fl., F.A.C.P.M.
Introduction: The City of Fort Worth is studying the
possibi lity of introducing a public smoking restrict ion
ordinance. As the city proceeds in exploring this maner. I
prepared the follow ing fact sheet and position paper to aid in
this process. In reviewing the vol ume of infonnation available
on tobacco/health and enacted ordinances, I n01ed the largest
concern and objection to a public smokin g restriction
ordinance was fear of adverse economic impact, primarily fo r
restaurant merchants. Review of the literature suggests other*
wise <Assessment of the Impact of a 100% Smoke-Free
Ordinance on Resta urant Sales- West! ake Hills Texas 19921994 CDC MMWR 1995·44: 369-3721. Local experience
with Arlington's smoke-free ordinance wou ld suggest a positive impact. As advocates for the community's health, we shou ld
all be interested in seeing a smoke-free ordinance for the City
of Fort Worth. whether or not we, ourselves. might be smokers
• A report o f the Centers for Di sease Control and Prevention
notes that 25 percent of all adults smoke cigarettes (89 percent
started in childhood). The percentage of underage African
American males who smoke has do ubled- from 14 percent to
28 in the five year period. 1990-1995.
• Nicotine is the most addictive chemical known to man.
• The national h~a_hh c_are budge_t is over one trillion do llar' l, 1,vrmrntl)~i)ta0Ct
annually (a $300 b•lilo n mcrease smce 1990). Tobacco related
mortality and morbidity may account for at least half ($500
bill ion. 9 percent GNP).
Discussion
Mortality & Cost Statistics
• In 1994. 25.900 Texans died from smoking-re lated
diseases: one out of every fi ve deaths in the state.
• In 1993. a total o f 374.064 years of potential life were lost
due to individuals dyi ng from smoking-related diseases (males
259,269 years; fema les 114.795 years).
• Smoking attributable costs in Texas during 1993 are
estimated at nearly $5 billion for adul ts 35 years and o lder:
Direct Heahh Care Costs·
Indirect Mortality Costs
Ind irect Morbid ity Costs:
• In February. 1994. theAmeriam Journal of Public Health
reponed that in Texas. the estimated number of smokers 12·18
years of age is 202.871; and the estimated number of cigarettt:
packs sold illegally to minors annually is 20.22 mi ll ion. Both
of these statistics rank Texas second only to California.
$ 1,449.2 16,661
3,217,4 11, 126
453.524.380
To1al tobacco attributable costs: $5. 120, 152, 167
(data from Office of Smoking & Health , 1995).
• The average age of first cigareuc use is 12.8 years: first
spit tobacco use is 10 years. It is estimated that 365.525
children in 7th through 12 grade currentl y use tobacco in
Texas.
• Costs attributable to smoking total more than seven times
the state taxes collected from cigarette sales.
• Eighty-nine percent of adult dai ly smokers sta rted
smoking by age 18:7 1 percent were already daily smokers by
thai age (National Household Sun•eys on Drug Abuse, 199/ ).
• Eighty percent of all teenage smokers want to and have
tried to quit : only 1.2 percent succeed (Teenage Artillldes and
Pmctices Sun·ey, 1993).
• Current use of tobacco in Texas youth in grades 7-12
increased by 16 percent from 1992 to 1994 ( 1994 Texas School
Sun•ey of Substance Abu.5e - TCADA)
• A lmost three million U.S. adolescents 12-18 years of age
were reported to have smoked over 28 million cigarettes a day
for the year 199 1. despite the fact that ill.l states now ban sale
of tobacco products to persons under age 18
It is well establi shed that tobacco and tobacco smoke are
hazardous to a person's health. The tobacco industry itse lf
conducted extensive research confirming this fact well known lrto them in the 1960s and '70s - lo ng before it was understood
by the sc ientific community. The Brown and Willi amson
Tobacco Corporation and its parent company. BAT l ndustrie~
(form erly Briti sh American Tobacco Company of the United ~----:
Kingdom). the second largest pri vate cigarette manufacturer in
the world. conducted detailed research at th is time on the
addictivencss and carcinogenesis of tobacco in an effort to
develop a less ''dangerous'' cigarette. I ,384 docume nts were
recovered detailing thi s research and the knowledge the
tobacco industry did not d isclose.
While direct exposure to tobacco products has lo ng been
established to cau se ill health effects. indirect exposure to ,__ _ ___.
tobacco through inhalation of secondary smoke has more
recently been established. In addition, research has suggested !fty"'"""'bm aodJ
that secondary tobacco exposure through breast mil k to leli!BrtWD\RN.
nursing infants may occur. Chj ldren who live in a home where ~c.!MIItlll. 10\IAQ
smoke is routinely present suffer from respiratory e lements ~~~.Gioloo.t.:
three times more often than chi ldren who live in a smoke- free d<lltl•sltdeW
ho me . Adults suffer increa sed incidence of respi ratory
•milrllt-·1·
illnesses from secondhand smoke exposure; and now there is
re,m~b)evidence suggesting that secondhand smoke may also act as a
weaker ri sk factor in the development of coronary vascular ""''•MOOtc1~kim.:
disease (direct tobacco use has been identi fied as a major risK lof Snufh.AJO\JA o.u;
<11SI>tieyBay0s.theAl
factor).
In considering the health and safety o f o ur citizens and 'lbk:li~the­
possible intervention s of public tobacco use through a local AhomltOOocedbyDr~
smoking restriction ordinance, we should clearly identify the $pe.,,IIJ.D.0.,111dTo
goal to be achieved and the target population to affec t.
""lOr. Mr. Boucher and
Short of a national tobacco use ban, it probably is not :i>l~~tmaner.,,HMOs, l
appropriate in the present legal climate to prohibit tobacco use ·~missues.
among adults if it does not place another person's health at risk lt,• ...,ncedtltati.q
or present a clear nuisance factor. Anti-tobacco ordinances
•lot & lunch .,th til
1
nr ~mob:l ,
achieve their greatest health impact by being aimed at
restricting youth access to tobacco products. Youth are not
eq uipped to make an infonned choice regarding nicoti ne
addiction and tobacco use (recall that onl y 1.2 percent of the 80
percent who try to quit succeed). Most ordinances are geared
toward prohibiting sales to minors (persons under 18 years of
1.., 18 age) and restricting secondhand smoke production in public
places. The underlying philosoph y appears to be one
attempting to protect children from uninfonned choices and
designed to protect both ch ild ren and adu lts from the ill effec[s
of secondhand smoke.
Enforcement of both prohibitions against the sale of tobacco
products to minors and smoking in public pl aces has been a
1c troublesome endeavor. People who do not comply with rules
prohibiung smoking have to be asked by the proprietor of an
establishment to comply or leave; not unti l they choose to
~ome bel ligerent can the proprietor or manager enl ist Jaw
enforce ment a3sistance. Present ly. the Health Department's
Consumer Heal th Di vision has authority to issue citations to
e1itabli3hments and people not in com pli ance with local laws.
The limitatiOn of thi s approach. however. is obvious in terms of
dealing \\ nh a citizen who chooses to smoke in a smoke free
em·1ronment. It may be prudent when considering any tobacco
rc\triction ordinance to make "possession'' and use of tobacco
unlawful for the minor simil ar to alcohol drinking laws. The
approach shou ld be given reasonable consideration.
Un less an ordinance can be reasonably enforced. pause
mi ght be given to undertaking it at all. However, even a weak
ord inance cou ld be the beg inn ing of declaring a stand
consistent with the City of Fort Worth's "Our City, Ou r
Chi ldren" campaign. It can provide a greater avenue for antitobacco hea lth awareness and education campaigns to reduce
the number of new teen smokers among our citizens. As noted
before, nicotine is the most addict ive compound known to man
and reduction of its use can be more pos iti ve ly accomplished
through preventi on of this addict ion occurring in childhood.
This is a primary prevention focus which proves more effic ient
with respect to allocated resources and results achieved.
Secondary and tertiary prevention of tobacco use is more
costly in ascending order (i.e., secondary prevention effons encouraging people to quit be fore they become ill; tert iary
prevention - encouraging people to quit after they have
suffered ill health effects of tobacco).
However. with regard to any smoking restriction ordinance
being adopted (in conjunction with an education campaign).
we can anticipate greater numbers of adults who may choose
to quit. We need to ensure ample numbers of smoking
cessation programs are avai lable to suppon such persons in
their efforts.
If further infonnation or discussion is desired. please contact
Dr. Alec ia A. Hathaway at 8 17-87 1-7208.
•
* District Stars *
News from
TOMA!ATOMA District VI
By Mrs. jerry W. Smith (Joy)
Fifty-two member:.. and guests of TOMA/ATOMA District
VI met at Brennan'\ Restaurant on November 12. 1996.
Dr. Carl M1tten. TOMA District VI president, introduced the
gue~t speaker. Glover O.L. Johnson. Jr.. M.D. Or. Johnson
pre\e nted a slide lecture entitled. "Chro notherapies
Card1ova~oeu l a r Di liease" (and staying alive). The program and
dmner were sponsored by Searle Pharmaceuticals and our
ho\tess wa~ Monica Morris.
Joy Smuh, ATOMA District VI pres ident. introduced !i.pecial
gue" Shirley Bayles. the ATOMA president. Her goal for tlle
year i\ to increase the membership and activities of ATOM A.
Alw introduced by Dr. Mitten was TOMA President Arthur
l Speece. Ill. D.O., and Terry R. Boucher. TOMA Execu tive
Director. Mr. Boucher and Or. Speece updnted mtendees on
leg1\lative matters, l-IMOs, new codi ng in structions nnd other
important issues.
It was announced that Lois Campbell is the chairperson for
''Meet & Lunch with the Authors, " a benefit for the
Scholarship Fund for the Harris County Osteopathic Medical
Society. Dr. Dewey and Lois Campbell planned to sponsor the
event at their home on November 23. at which time local
authors would ha ve the opportunity to visit and di scuss thei r
wri ting. We were infonned that TOMNATOMA District Vl
wou ld receive a percentage of monies received from books sold
at thi s event. Everyone was encouraged to support this benefit.
Al so men tioned was Career Day. to take place at local high
sc hoo ls. The calendar dates for District VI meetings are
Janu ary 14 . March 18 and May 13. Locat ions will be
announced.
Dr. Mitch Porias. a local osteopathic ophthalmologist, is a
volunteer with Benevo lent Mi ssions. This is an international
org;.mizntion that provides eye and dental care to the people of
Boli via, El Salvador and Honduras. So far. Dr. Porias has made
fi ve trips to these areas. Contact Dr. Pori as if you are interested
in volunteer work
•
7Z~S
ZJ.()./21
News From the National Osteopathic Foundati
Ethan R. Allen , D.O ., Named
1996 Educator of the Year
Ethan R. Allen. D.O.. founding chair of the board of
directors of the College of Osteopathic Medicine of the
Pacific. now the Western University of Health Sciences
(WUHS), has been named 1996 Educator of the Year by the
National Osteopathic Foundation and the American
Osteopathic Association. Dr. Allen accepted the award during
a ceremony held at the recent AOA House of Delegates
meeting in Nashville.
Dr. Allen was nominated by WUHS' Dr. Mitchell Kasovac
in recogni tion of his contributions to osteopathic medicine and
educat ion. and 10 public health . TI1e award is given annually to
one outstand ing educator in osteopmhic medicine who
exempli fies and encourages the principles of the profession.
Dr. Allen is the 14th recipient of the NOF/AOA Educator of
the Year award
Dr. Allen has been in private practice for 42 years, and since
1985 has been the sole owner of the Osteopathic Medical
Clinic in Norwalk. California. He is a member of the American
College of Osteopathic Family Physicians. a life member of
the AOA and a member of the Osteopathic Physicians and
Surgeons of California. He has been a member of the
Osteopathic Progress Fund since 1982. a JXISition he was
elected to by the AOA House of Delegates.
He received the 1983 Physician of the Year award from the
Osteopathic Physicians and Surgeons of Cal ifornia. an
honorary Ph.D. in 1982 from the College of Osteopath ic
Medicine of the Pacific, and a commendation from the Los
Angeles County Board of Supervisors for 20 years' service in
its drug treatment program. Currently, he is president of the
Los Angeles Centers for Alcohol & Drug Abuse. Recovery
House. in Sante Fe Springs, California. In 1984. he was
appointed commissioner to the Cali fornia Heahh Manpower
Policy Commission.
Educator of the Year recipients are selected by one of the
nation's colleges of osteopathic medicine (on a rotating basis).
in conjunction with the NOF Osteopathic Progress Fund/Seals
Committee. comprised of osteopathic physicians. osteopathic
educators and AOA representatives.
NDF Accepting Applications for
Zeneca Pharmaceuticals Grant
The Zeneca Pharmaceuticals Underserved Healthcare
Gram, an award of $5,000 to $10,000 administered by the
National Osteopathic Foundation and funded by a grant from
Zcneca Pharmaceuticals, is now open to receive applications
o~teopath i c medical students in their third year of studies may
appl y.
The scholarship was established to encourage osteopathic
medical students to practice in underserved or minoril)
populations, and recipients must demonstrate thi,
commitment. Minority students arc encouraged to apply. but
participation is not restricted to those students.
"'This scholarship fits perfectly w ith the osteopathic med ical
philosophy of serving rural and underserved popu lations.
said Mike Levin. NOF Executive Director. "We arc pleased
that Zeneca has made it happen."
Applications must be received by January 3 1, 1997
Finali sts will be interviewed and recipients selected by NOF',
Committee on Educational Grants. Awards are di sburserl
during the fourth year or osteopathic medical studies.
An award presentatio n will be held at Zcneca's companl
headquarters in Wilming10n. Delaware. Upon completion of
the first year of practice, recipien ts must submit a written
reJXlrl on their experiences in underserved areas and what the)
would do to improve care to the underserved in America. The
paper will be submitted to the osteopathic medical press fa
publication to encourage othe r stude nts to se rve thl\
population.
Application details may be obtained by contacti ng NOF
headquaners at 5775G Peachtree· Dunwoody Road, Suite 500.
Atlanta. GA 30342: phone 404-705-9999: FAX 404-252·
0774.
New Bristol-Myers Squibb Award Aimed at
Osteopathic Residents
The National Osteopathic Foundation annou nces a new
awards program sponsored by the Bri sto i·Myers Sq uibb
Company, to be awarded for the first time in 1997-98. The
Bristol·Myers Squ ibb Outstanding Osteopathic Resident
Awards Program was created to recogni zed those residenll
who serve as examples to mhers. Wi lli am D. French. directOf
or Medical Relations at Bristol·Myers Squ ibb. said the
program rewards those who ex hibit exemplary characteristics
or a good osteopathic physician. Such characteristics inclu<k
compassion. leadership. commitment to the osteopathi..:
philosophy. commitment to patient care and to communi!),
and commitment to education/enrichment of self and others.
Osteopathic physicians currently in the second or third
of an American Osteopathic Association·approved resident)
program in the primary care speciahies of Family Practice,
Internal Medicine and Pediatrics are eligible for the award
Through a grant from Bristol-Meyers Squibb Company, the
NOF awards $2,000 to each recipient. Award recipients will
receive a travel grant to attend the Annual Convention and
Scientific Seminar of the AOA, as well as the an nua l scient if~~:
session of his or her specialty college, where the awards will
be presented.
The first application process is ope n this winter. Contact
NOF headquarters for more infom1ation.
I
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News From Osteopathic Health System of Texa
OMCT OHers First External Heart in County
High-risk heart patients recovering from cardiac surgery
have a better chance for survival with the arrival of the
AB IOMED BYS 5000, a new cardiac support system recently
acquired by Osteopathic Medical Center of Texas. OMCf is
the first facility in Tarrant County to offer patients this
lifesaving technology.
After a bypass. transplam or open-hean surgery. the BVS
5000 external heart replaces the pumping functions of the
patient's weakened heart by movi ng the blood to vital organs,
allowi ng for an easier recovery. The resting heart has time to
heal its tissues whi le the mechanical heart completely su pports
the pati ent's circulation
''The BVS 5000 is a temporary bridge for patien ts wi th
imperative or poor hearts." said Albert O livencia-Yurvati.
D.O., a cardiovascu lar and thoracic surgeon on staff at OMCT.
'"Ninety-eight percent of the world's heart pat ients who
experience postcardiotomy ventricular fai lure probably would
have died before this technology was in place:· Dr. Yurvati
contends. "Now there will be a 46 percent s urvi val rate. which
is expected to rise as the use of the external heart increases
duri ng the next fi ve to seven years.'"
Dr. Yurvati was instrumental in bringing the first BVS 50<X'l
to Tarrant County in August. as part of a joint program between
OMCT and the UNT Health Science Center in Fort Worth .
The Food and Drug Admini stration has ce.rtified Dr. Yu rvati
for external heart implantation and staff training. Four to six
times annually. Dr. Yurvati trains cardi ac specialists and
intensive care nurses on the BVS 5000 system at the UNT
Health Sc ience Center, where Dr. Yurvati is clinical associate
professor in the Surgery Department
Exercise Program Helps Special Populations
Get Up & Running
Ed Turner never exercised before his quadruple bypass
surgery. But in the four years si nce then . the 76-year-old has
learned to cat healthier. lost 26 pounds and works out twice a
week for 40 to 60 minutes.
It 's all part of OMCT's Phase Ill Spec ial
Populations/Cardiac Rehab program. where patients learn
about the benefits of leadi ng a healthy lifestyle through a
supervised. but non-monitored, exercise program.
Phase Ill Special Populations/Cardiac Rehab is targeted
primari ly toward senior citizens and those with special health
concerns- including card iac patients and people wi th diabetes.
high blood pressure and arthritis.
'"We want to let physicians know this is more than just a
cardiac rehab program."' said Allen Barnes. R.N .. Phase Ill
program director. "We can handle any debilitating condition
that can be helped through exercise."
The program began speci fi cally to address the tong-term
fitn ess needs of cardiac patients, but has expanded within the
last year to meet the special needs of other patients.
"'This is basically a life enhancement program ,"' Barnes said .
2417&:1'AS t:>.O.
"We design and supervise individual exercise
answer questions on health topics. medicine and nutrition: a t:l
o ffer patients a place to socialize. Ou r patients have a lot
birthdays behind them. They aren't in critical health. but th
do have special needs and fears a nonnal health club might r1
be able to address. They want to have a safety net in ca
anything happens: H ~re. there's no wait .~or an ambulance -ttL!dtll• 51gnu1E ::::
emergency room IS nght down the hall.
Phase II results speak for the value o f the program. " I
seen people come in wi th whee lchairs who left walking. S01
of them have been able to throw away their c<.~ ne s," Bam
explained.
Any age group can parti ci pa~e in Phase III Speclr[~JJcODYtJ/ htr/100«.
Populations/Cardiac Rehab. but patients must ha ve a doctor
referral and stress test before starting the program. n
program costs $30 a month for ind ividuals and $45 a month f1
thiC Health Founda
coup les. For more informat ion on Phase Ill Speci1 . 0 ~~ etoits8oard
Populations/Cardiac Rehab. call A llen Barnes at 8 1 7-73~
re . HcalthliN.
6404.
111<~
~
t
\loocn<fllllldllc-
Physician Promotes Osteopathic Philosophy
in Ground·Breaking Book
~ill)"~~
llll!i<:~""""b)To
Dr. Mary An~ Block._staffphysicio. :,oiu~Ua"~
at OsteopathiC M e~1 ca l Cent~ r o
,ury r1 ~
111 1
Texas.
has
rece1ved
nat10m
D'iallbediiDCI*
attentio n fo r her g round-brea kin: thbcrboW SUit SCIIII
book. No More Ritalin. Trearirt. st~tmdk:alle\cb. 1
ADHD \Virhour Drugs. A Mother
fled~ acctJIIUII
Story/A
PhysicianS Approacl n:stmpub:l!ee~pmm:t ·
Kensington Press. New York. In th the OHF Board of~
book. Dr. Bl ock . outlines ~~ rtthrUnilersltyofTeQl
app~o~c h to tre~ll~ g A t~ entwr Elubli~ In l98S, d:t fJ
Def1c 11
Hy peractiVIty
D1 sordt
(AD HD). an approach s he credits to the osteopath!
phi losophy.
"As an osteop_athic physician. I was taught to look for aD.,~IIom Ci~ Clinic Fill y
treat the underlymg cause of the problem . rather than to coH
S 0
up the symptoms with a drug."' Dr. Block said. A persom ba)nall\tsofSoubJ
experience helped give Dr. Block this insight. In her book. sh Jet~ dr)- ft 111111
recall s how prescription drugs made her daughter seriously t, lira! diffmom f!XIId
when the medication was used to cover up the symptoms of•
ly.DrJooS!\tn\fl
underlying medical problem. Ready to give up o n the medicin
S1\ora,oog i~ thr a
altogether. Dr. Block discovered an osteopathic physic ian wb cq;thic Fanuty Medicme
not only helped her daughter. but also inspired her to becom
Ciry and be i~ f1ut
an osteopathic physician.
:\anh La} Cbaban
At age _39. she began her first year at Texas College n ftdrilillt~also~ope
Osteopath~c Medicine (now the Uni versity o f North Texa. ~il)' b home l
10
Health Sc1en~e Center at Fort Worth). Las t year, Dr. Blod II llllrrugranb_ and an a1
won the Lathes' Home Jouma/'s "My Mom 's One Smar .ftmg Asian-A~ ~
Lady'' contest for going to medical school to save her daughter
.20 prrcen of
1
Dr. Block now serves as medical director of th< ~· -' ·"'"Center in Bedford, Texas. a clini c for the treatme nt of
health pro?lems in ch ildren and adults. In add ilion, s he ha:l Jnmu_nity and~-- ........ 410
been a nat1onal speaker o n the subject of ADHD for severl ~ illtts residtnr.~~~.a f
years and presented this topic at the Weslern
J:about
Osteopath!c Co~ference . and at the American College of
Osteopathtc Fam1ly Prac~Jtioners.
Her recent presentation at a workshop sponsored by
Osteopathic Health System of Texas brought one of the largest
commun ity responses to date , with nearly I ,()(X) reservati ons.
Dr. Block is currently sc hedu ling national workshops for
both physicians and the public, with the first workshops
ulkalth 4•b mitJht·~ planned in southern Cal ifornia.
Since her book was released, Dr. Block has conducted
numerous radio, TV and newspaper interviews and has
appeared at signing eng~gements at bookstores. ''I am so
pleased to be able to offer mformation to these parents who arc
desperately looking for answers, as I once was.'' Dr. Block
explamed. "I believe every child deserves a chance to reach his
or her full potential."
To schedule an inten•iew with Dr. Mary A'm Block, or to
recei}.'t a copy of her book, please call Th e Block Center at
The clinic is one of 12 operated in the Osteopathic Family
Medicine Clinic network. ''One of our primary missions with
the clinic network is to be located in neighborhoods ncar the
families we serve" said Joan Anderson. VP of Corporate
Communications.
Jon Sivoravong, D.O., graduated from the UNT Health
Science Center at Fort Worth in 1993 and is board cert.ified by
the American Board of Family Physicians. Originally from
Vient iane, Laos, Dr. Sivoravong came to the United States in
1975 when he was II years old. fleeing Laos with his uncle
after the Communi sts took power. He was raised by a foster
family in Branson, Missouri.
Today, Dr. Sivoravong resides in Grand Prairie with his
wife, Samantha. and their son. Brandon. A staff physician at
OMCT. he also is a faculty member at UNT Health Science
Center in the Family Medicine Department.
•
817-428-1495.
Osteopathic Health Foundation
Elects Three to its Board
The Osteopathic Health Foundation board elected Kay Day.
Rosie Moncrief and John Chalk, Jr.. at its October 28 meeting.
Kay Day is a leader in reaJ estate and property management.
In 1987 she was recognized as one of the top five women
entrepreneurs m the state by Texas Business magazine.
Community volun teer Rosie Moncrief focuses her time and
energy on a variety of concerns - includ ing AIDS. mental
lllne~\ and abused women and chi ldren. Mrs. Moncrief works
wtth her hu!.band, State Senator Mike Moncrief. on issues at
both ~;tate and local levels.
Certified public accountant and attorney John Chalk. Jr..
bnng\ h1!. probme experience and expertise in estate planning
to the OHF Board of Directors. He rece ived his Jaw degree
from the Uni~ver;ity of Texas Law School in 1991.
btablished 111 1988, the foundation receives and manages
chantable contributions benefiting Osteopathic Medica l
Center of Tcx33.
Haltom City Clinic Fills Void for Asian Patients
Many native~ of Southeast Asia shy away from the doctor's
ofllce because lhey are intimidated by language barriers and
cultural differences found here in the United States.
Fonunately, Dr. Jon Sivoravong speaks their language.
Dr. Sivoravong is the med ica l director of the new
<hteopathic Family Medicine Clinic at 1916 Beach Street in
Haltom City and he is fluent in Eng lish, Lao and Thai.
Phonesavvanh Lay Chan thani vong, the cl inic's receptionist
and medical assistant, also speaks both English and Lao.
Haltom City is home to a large popu lation of Southeast
A\tan 1mm1grants, and an add iti ona l 15,000 to 20,000 Lao\peakmg Asian-Americans Jive throughou t the Metropl ex.
Now, aOOut 20 percent of Dr. Sivoravong's patients are
Southeast Asian immigrants.
Dr. Sivoravong said, ,; I am so pleased to join thi s growin g
community and to provide a full range of healt h care services
for all tts residents, including the Asian-Americans from my
homeland."
State Insurance
Regulators Taking
HMO Complaints
The Texas Department of Insurance is now accepting
complaints about quality of care provided by health
maintenance organizations directly from physicians.
The respons ibility for hand lin g complaint s was
uansferred from the state health department to TDI on
September I.
Leah Rummel. deputy com mi ssioner of HMO and
Utilization Review for TDI. says physicians may
register complaints with her office by telephone or in
writing. The telephone number is (800)252-3439. The
address is Texas Department of Insurance. Consumer
Protection III-lA. P.O. Box 149091. Austin. TX
78714-9091.
Rumme l says complaints are investigated by her
staff, which includes a registered nurse. An HMO found
to ha\'e violated patient protection rules established by
TDI last year is then notified and given an opportunity
to make corrections. If the HMO does not. she says. the
case is forwarded to TD I's enforcement division. and
the HMO faces penalt ies ranging from a fine to
revocation of its cct1iticati on.
TDl has already received several complaints from
patients. Rummel says. but few physician complaints.
Most of the comp laints invo lve access to care.
con tinuity of care or delayed care.
TO I's patient protection rules apply to all HMOs
except those acting as third-party administrators for
self-fu nded ER ISA plans. She estimates that on ly about
20 percent of the HM Os in Texas fall into that category.
7E-:tJIS V.0./25
Self'S TipS &TidingS
Driving the Cyberhighway Can Benefit
Your Practice
For some practices. the purchase of a fax machine ~as a giant
step and by now. you may have found that li ving Without a fax
would be difficult. Yet the same practices that get the latest
diagnostic equipment. clinical regents and newest clinical
technology are as scared of getti ng on the Internet as they are of
geuing a root canal. We have found that the $20 a month we pay
for Internet access saves us four times that much each month
just in fax and long distance expenses.
What are some of the benefits of your practice bei ng on the
Internet? There is no way for us to list them all , but some of
them in which you may be interested are:
• E-Mail. Instead of having to wait on medical records,
patient charts, X-rays. EKG strips, etc .. you c~n get them almost
instantaneously without having the poor quahty fou nd on faxes.
Also. you can greatly cut your postage costs by us.ing E-ma~l.
since there is no additional cost associated wHh E-matl.
regard less of size.
• Program updates. You no longer have to wait for weeks to
get updates to your favori te software programs (accounting.
accounts payable. word processors, etc.). as the update can be
attached to your E-mail.
• Information. Disease sites where you can immediately
download new information on di seases. symptoms and
treatments. ranging from cancer to AIDS to influenza
• Society infonnation. Yes. the AOA. AMA, ACOFP, SMA,
TMA and hundreds of other societies and associations have web
si tes with va luable information fo r their members and
prospective members. including bulletin boards for you to place
open questtons.
• Recruitment. Are you looking for a P.A. , N.P.. R.N. or
another physician fo r your practice? You may be surprised at
what or who you will find on the web. Yes, even Locum Tenens
are found on the web.
• Dan 's management articles. We have recently started
publi shing articles on coding. co ll ections, new patient
information forms, modifiers and marketing on our site on the
Internet. We are presently working on a system whereby we can
post all of our newsletters and give each o f our retai ner diems
a password to access the site.
How difficult is it to get on and navigate the web? Not
difficult at all: We do advise against using one of the pay-bythe-hour servtces. Instead, call up one of the local Internet
providers in your area. Some of our favorites are Gower Net for
East Texans. AashNet or Cyberhighway in the DFW area and
AT&T Worldnet in other areas.
If you do log on, please make sure you send us your E-mail
address as we are planning on bonus items for ourcliems we can
access through the web. We would very much like to be able to
immediately click on send after fi nishing our newsletters,
instead of having to wait for the pri nter to fini sh pri nting all of
the copies. printing labels. stuffing envelopes and attaching
postage. This not on ly saves us money but also speeds up the
de li very of the infonnation to your practice. On top of that, we
are investigating a way to put our annual updates for your
26/?Z'ZAS 'D.O.
oonself&Associares
practice into a fonnat that may be more bene~cial to you. so a<· ~:;fc,- ==~~
to allo~ you to down~oad the numbers d1rectly i ~to yow
trd:llllt 111 tft!t.
accountmg program. Th1s would greatly reduce the lime your .1_• ..ftf111!{CIIt .........
staff spends on updating your fee schedules each December~
January. We are also going to uy to put our past newsletters oo
the web. in a site known only to our retainers, so that if you
cannot find a subject, you can access a search program that will
take you right to the subject you are looking for on our site.
ICD9 Codes are Stilt a Problem
We cont inue to get calls from doctors and staff concerning the
ICD9 c?<~e denials from ~edicare and Medicaid. Some office•
have mt sinterpreted Medtcare:s new rt_tles to mean that evel')'
ICD9 code must have~ or 5 d1gi ts. whtch is not tnt~. If there i'
not a 4th or 5th digit tn the IC D9 book for a particular code,
don't invent one. Along the same tines, don't drop off a digit.
Another common problem is having each procedure code on
a claim reference the same ICD9 code, which is usuall y a problem in the practice's computer software instead of the personnel
or staff. If the office visit is due to diabetes and the trigger point
or OMT is due to the soma1ic dysfunction , then make sure your
staff and your billing serv ice knows this. Otherwise, you will
find you are getting denials on your claims unnecessaril)
Communicating lhe appropriate ICD9 code reference to the
procedure code has never been as important as it is now.
ts•~;idJ9 ctxk
~:[Jct.wehaltlnsl
t~
tCD9c<KitSOII,Ih... ,.JiYJIV
· "'
l!ilreChanges
!"'*dletxt""Mol<>
"'"""""'""'
oCahf-•bqic>
~~~-u~IIIICf'ltt.dl
,.....,..~.,~clc<1ro
.. .........gdOI
~r~cdtbN.•illlll
•"""""'rtpM>'
Medicare Gone to Solo Line Item
:at«••"'-o"ech~
In the past. you were allowed to list multiple procedures 3.\
one line item and indicate multiple services on Medicare claim~
Not any more. Just as Medicaid starring requiring solo lin~
items on their claims, Medicare has adopted the same policy.
Consequently, if you give three trigger point injecti~ns. you
should ha.ve trigger point code 20550 listed three ttmes on
differentltnesontheclaim
.
~
~lmagend.
ICI'IIIqlbe·
.
aad
2S rooM
ICfG
·:in:c.JrrHCFA's8ure.
1997 Coding Changes
'"tlllilalioo """'i""*
In some years, we do not expect very many changes to the
:as~~
1
CPT, ICD9 or HCPCS codes, but that is not the case for 1997
YeaR.
We expect changes from 1996 to 1997 to be phenomenal. so "~ Gll&ill&ialrtu~
are adv ising you to order your 1997 books (all three). While
Qe)' IISmJ • •
there are dozens of sources for these books. we person all)
~ axlt
prefer PM IC. Not on ly are the books color coded, but the Co
has been very good about getti ng the books ou t in a time!)
11
manner. We suggest you call 800-633-7467. extension 569 'Aci:atPI)1fcwf'lrlm:.
(Mary). have a credi t card handy and order the following (ow ¥:i.llltrl~~
clients receive a discount); 1997 CPT codebook. 1997 HCPCS l.ll.ll•ilcrt~ Pldl:li
codebook and 1997 JCD9 codebook
In addition, there is one other 1997 ICD9 codebook that w~
suggest you obtain from UNICOR Medical at 800-825-742 1
The EASY CODER is an alphabetical listing of all diagnoses in
the easiest format we have ever seen. You do not have to haw
clinical train ing in order to find the codes in this easy-to-uSt
~~~ as the abbreviations and acro nyms are listed with the:
Billing for Consults can Either Help or Hurt You
W hether you are an orthopedist, podiatri st, interni st
gastroenterologist. cardiologist or a family physician , billing f«
consultations can either help or hun you, depending on yow
L
U)~itstilfllllaskl~~·f~
charts and the requesting practice. Consults reimburse about 70
percent more than new patient office visits, but is that first
encounter a consult or a turnover of care? Even if you do
everything you are supposed to do in documenting the service as
a request for an opi nion and returning a prognosis/diagnosis
report back to the requesting physician, if the other pract ice has
it as a referral of care in their chans, you will lose in an audit.
For this reason, it is vital that you educate your colleagues as to
the correct wording and semantics they have to use on their
patient charts.
ICD9 Code for Flu Shot
Medicare will pay for codes 90724 and G0008 with most
valid ICD9 codes, but to ensure they don't change the rules on
03 m mid~tream and catch us by surprise, we are advisi ng all our
cl ients to use ICD9 code V048 for both of these procedure
codes In fact, we have instructed our claims filing personnel to
over-ride any ICD9 codes on the claims they keypunch for these
serHces and use only code V048 .
A couple of interesting tidbits that we discovered recently
mclude the fact that Medicare is now testing the TCPIIP
Protocolm Californi a, in hopes of allowi ng physicians to submit
their clam\s via the Internet, thereby reducing all long distance
charges a~soc i a ted with electronic transmission.
Another mteresti ng note is that Texas Medicare has put into
place new edits that will notify you of denied claims via
electromc acceptance reports the mo ment you transmit them.
mstead of waiting two weeks for an EOMB .
E&M wilh Ventilation Management
11
"'
HCFA ha~ ruled on billing for and reimbursement of
Evaluation and Management services on the same day as
Venulat10n Management and it's not in the physician's favor.
E\len u~ing the -25 modifier on the E&M code won't make a
difference. per HCFA's Bureau of Policy Development. Per their
letter, ventilation management is a ''medical dec ision making
funct ion and, as such. is already included in the definiti on of Lhe
ho~pual daily care codes." With this in mind, you need to review
your mdividual reimbursement level to detennine if you make
more money using a hospital daily care code or a ventilation
management procedure code.
ICD9 Code for PPV
Medicare pays for Pneumonia Vacci ne for patienlS who are at
high mk of pneumococcal disease and have not had one in fi ve
year-,, or when the patient is unsure of their vacci nation status.
Wh1le we do not profess to understand the clinical tem1inology
of "h1gh mk," we do see that Medicare pays for the PPV when
the code V03.82 is u<.;ed with the procedure codes 90732 and
G0009
Are You Asking for a Driver's license?
If you are still not aski ng for a dri ver's license and making a
copy of 11 for your chart, you are asking for trouble. Patients
have learned that they can come into your practice, fill out your
new patient fonn with erroneous infonnation. get treated.
probably get a few detailer samples and leave without paying.
For your own protection, make a copy of it , compare the
picture to the patient and keep it in the chart.
•
News from the
University of North
Texas Health
Science Center
at Fort Worth
UNT Health Science Center
Participates in Major Study
of High Blood Pressure
Officials at the Un iversity of North Texas Health Science
Center at Fort Won h have announced the institution's
participation in a major study of more than 8,()(X) patients in
the U.S. and in Scandinavia with hypenension and a type of
heart enlargement known as left ventricular hypen.rophy
(LVH).
The study wi ll evaluate whether there are benefits of trying
to reverse LVH , which affiiclS some 13 milJion people in the
U.S. The condition is often caused by chronic high blood
pressure and is an imponant cardiac health risk factor.
Frederick A. Schaller, D.O., chief of cardiology and
associate professor of medici ne at UNT Health Science
Center. is the principal cl inical investigator for the study. ''We
think this project wi ll help provide the medical conununity
with a definitive answer to one of the most imponant
questions facing cardiology today: does attempting to reverse
LVH help to reduce deaths?" he said. Co- investigator of the
study at UNT Health Science Center is Muriel Marshall , D.O ..
associate professor of fa mily medicine.
The study wi ll enroll 3,000 patients in the U.S. so that the
effects of two medi cations can be compared. Both are
marketed in the U.S. for reducing high blood pressure. The
study is sponsored by Merck & Co .. lnc .. the distributor of one
of the drugs.
Cand idates for the clinical investigation are men and
women between the ages o f 55 and 80 who have hypertension
and LVH.
"Since most patienlS don't know they have LVH . that
diagnosis wi ll be made as part of our screening procedure.''
said Dr. Schaller.
Medical evaluations. tests and medications associated with
the study at UNT Health Science Center are free of charge to
pati ents who volunteer to partici pate. The study • called LIFE
for Losanan Intervention For Endpoint - is expected to
continue for fi ve years. Dr. Schaller said.
Persons interested in participating in the study or seeking
additional infonnation should call the UNT Health Science
Center's Office of Clinical Research at 8 17-735·0256.
In addition to the LIFE study, physicians and surgeons at the
UNT Heahh Sc ience Center are participating in some 20 other
clinica l research projects, including in vest igations into
improved treatments for cervical disc di sease. chronic pain,
ulcers, stroke and arthritis.
•
7&-XAS 'D.0./27
Medicare
Deduclibles lr
HMO/State Administered Plan
Vaccination Update
CDC lnlroduces New Vaccine Schedule
The Centers for Disease Control and Prevention have
accepted the Advisory Commiuee on Immunization Practice's
recommendation to change the routine childhood polio
vaccination schedu le.
For maximum heahh benefits, CDC recommends that
children in the U.S. receive two doses of inacti vated pol io
vaccme (IPV, 2 and 4 months of age) followed by two doses of
oral polio vaccine (OPV, 12·18 months and 4-6 years). With
this IPV/OPV schedule, the four-dose schedu le of OPV,
currently routinely recommended, and the alternate four-dose
schedule of IPV remain available and acceptable options to
parents and heaJth providers.
The new IPV/OPV vacc in e sc hedule combines the
-
ad"antages of both vaccines and reduces the risk of vaccine-
a.NJC!ated paralytic polio (VAPP) from OPV use. No VAPP
--.. cases are known to occur following IPV. Further, OPV
~dmimstered after IPV provides population-level intestinal
1mmuruty to prevent wild poliovirus spread.
~
~ ... -
~
_
~
1
~
1
HHS Plans Ca mpaign lor Vaccinations
The Depart ment o f Health and Human Services has
unve1led a campai gn using publi c serv ice announcements
de.;agned to improve childhood immuni zatio n rates. HHS
Secretary Donna Shalala noted that the ai m of the program is
to raise doub~ in parents' minds about whether or not their
children have received adequate inoculations against disease.
•
prompung parents to double-check with doctors.
Medicare Parts A & B
Deductibles Increase Slightly
The 1997 deductible for Medicare Part A is $760. an
mcrease of S24 over the 1996 deductible of $736. The
I
I
deductible for Pan B is $43.80. a $ 1.30 increase over the 1996
monthly prem1um. According to the Department of Health and
Human Services. the small increases for 1997 rencct the fact
that Increases in Medi care spe nd ing were lower than
prev1ously projected.
•
Medically Underserved
Community-State Matching
Incentive Program
Can Help Rurals
With Recruiting Expenses
Start-up costs for communities setting up a physician in
practice may be reimbursed by the State of Texas under a new
program designed to increase the number of primary care
physicians practicing in Medicall y Underserved Areas.
The MedicaJly Underserved Community-State Matching
Incenti ve Program will provide up to $25,000 in state fund s to
match a community's level of fin ancial commitment toward
setting up a new primary care physici an practice. Start-up
money can be used for " reasonable costs incurred by a
physician to establish a medical office and anci llary facilities
for diagnosing and treating patients," according to proposed
rules publ ished in the April 12 Texas Register.
El igible co mmuniti es are those located in Medi call y
Underserved Areas o r serving Med icall y Underserved
Populations. as detem1ined by lhe U.S. Department of Health
and Human Services or the Texas Department of Health.
Eligible physic ians are those in fami ly/ge neral practice.
general pediatrics. general internal med icine. or ge neral
obstetrics/gynecology who are currentl y lice nsed to practice in
the state of Texas. who have com pl eted an accredited
residency program within the past seven years, and who have
contracted with the community to provide fu ll -time primary
care for at least two years.
The Texas Department of Health Bureau o f Commun ity
Oriented Primary Care is administering the program, and wi ll
issue a Request for Application each year. Funds will be
distribuiCd on the basis of several indicators of need. such as
lack o f primary care practitioners and primary health care
clinics, and designation as a primary care Health Professional
Shortage Area for at least the past five years.
For more infonnation . contact the TDH Bureau of COPC at
512-458-711 1, extension 6552.
•
Membership On- The-Move
z
=JI
"If an osteopathic physician ever has a problem. no organization or any other g roup is going to be there with
support and help like TOMA can and will. "
T. Eugene Zachary, D.O.
UNTHSC!fCOM, Dept. of Family Medicine- Fort Worth
If you know a physician who is not a member of TOMA , please encourage them to become a part of the only
organization that works solely for osteopathic physicians. Inform them of the fantastic privileges, services and
benefits they can receive by becoming a member. Call Stephanie Boley at the TOMA office at 800-444-8662 and
she wi ll mail an application anywhere!
?EUSV.0./29
New Members
TOMA would like to welcome tire fo llowing new members will! were approved
at the DecemberS, / 996, /Joard of Trustees meet111g:
Regular Me mbers
Monte D. Allen, D.O .. Gastroenterology. 8407 Crownwood Dr.. Laredo.
78045. Medical education: University of
North Texas Health Science Center at
Fort Worthffexas College of Osteopathic Medicine (UNTHSCffCO~).
1991 . Internship: Osteopathic Medtcal
Center of Texas (OMCT). Fort Worth.
1991-92. Internal Medicine residency:
OMCf. 1992-94. DOB 5-26-58
Scott W. Barclay, D.O. , Family
Practice, 3300 Western Center. #114,
Fort Worth, 76 137. Medical education
UNTH SCffCOM, 1993. Internshi p:
OMCT. 1993-94. Fami ly Practice residency: OMCT and UNTH SCffCOM,
1993-96. DOB 8- 13-68
Esther G. Cruz, D.O., Fami ly
Pract ice. 11 3 12 Perin Beitel. San
Antonio. 782 17. Medical educat ion:
Kirksville College of Osteopathic Medicine. Kirksvi lle. MO. 1993. Internship·
Dallas Family Hospital. Dallas. 199394. Family Practice residency: Bay Area
Medical Cen ter, Corpus Christi. 199496. OOB 3-22-64.
Pamela A. Driskell, D.O., Famil y
Practice. 750 N. Freeway. Fort Worth.
76 102. Medical education: UNTHSC/
TCOM, 1986. 1nternship: OMCT. 198687. DOB 11 -9-54.
Paul Thomas Duncan, D.O.. Famil y
Practi ce. 8 13 Parkway, Georgetown,
78628. Medical educat ion: UNTHSC/
TCOM. 1993. Internsh ip: Bay Area
Medical Center, Corpus Christi, 199394. Fam il y Practice residency: Bay Area
Medical Center. 1994-96. DOB 3-15-50.
G len non Raymond Einspunicr,
D.O .. General Surgery. 6300 Regional
Plaza. #250, Abilene. 79606. Medical
education: Kirksvi lle College of Osteopathic Medicine. Kirksville. MO, 1982
Internship: Normandy Osteopathic, St.
Loui s. MO. 1982-83. General Surgery
residency: Chicago Osteopathic Hospital. 1983-87. DOB 4-15-54
Rudy F. Fason, D.O.. Family
Practice. 442 1 Avonshire Lane. Plano.
75093. Med ical education: UNTHSC/
TCOM. 1995. Internship: Tri -City
Hospital. Dallas. 1995-96. DOB 9-12-48.
l'aul Joseph Garcia, D.O .. Internal
Medicine. 3829 Bonnie, Fon Worth ,
76 11 6. Medica l education: UNTHSC/
TCOM. 1993. lntcmship: OMCT. 199394. Internal Medicine residency: OMCT.
1993-96. DOB 8-6-64.
Charles Gibson, D.O .. Family Practice. 1500 S. Main. Fort Worth. 76 107.
Medical education: UNTHSCffCOM.
1993. Internship: Joh n Peter Sm ~th
Hospital. fort Worth. 1993-94. Fam~ly
Practice residency: John Peter Srmth
Hospital. 1994-96. DOB 12-2 1-6 1.
.
Stephen A. Gla ser, D.O .. Family
Practice. 2300 High land Vi llage Rd..
Suite 310. Lewisville, 75067. Medical
education: UNTH SCffCOM. 1984.
Internship : Doctors Hospital. Columbus,
OH. 1984-85. Family Practice residency:
Doctors Hospital. 1985-86. DOB 8-6-53.
David A. Gray, D.O., Pediatri cs.
4 102 24th St.. Suite 406. Lubbock.
79424. Medical education: UNTHSC/
TCOM. 1993. Internship : Childrens
Medical Center. Dallas. 1993-94.
Pediatrics residency: Childrens Medical
Center. 1994-96. DOB 9-2-57.
Da vid Lawr ence Grice, D.O..
Dermatology. 1609 Craighton Ct..
Arl ington. 760 12. Medical education:
UNTH SCffCOM. 1989. In ternship:
Dallas/Fort Worth Medica l Cen ter,
Grand Prairie , 1989-90. Dennatology
residency: Dall as/Fort Worth Med ical
Center. 1993-96. DOB 2-28-62.
Anne E. Hath cock, D.O. , Famil y
Practice. 4725 Well ington. Greenv ille ,
75401. Medical ed ucation: UNTHSC/
TCOM. 1985. Internship: OMCT. 198586. Family Practice residency: TCOM.
1985-89. DOB 5-4-58.
David P. Hill , D.O .. Family Practice.
R.R. 4. Box 27, Cuero. 77954. Medical
education: UNTH SCrfCOM, 1993.
Internship : OMCT. 1993-94. Family
Practice residency: OMCT. 1993-96.
DOB 8-29-55
Byron John Marr, D.O .. Diagnostic
Radiology. 46 18 Grand Lake. Corpus
Ch risti . 784 13. Medical education:
Oklahoma State Universi ty College of
Osteopat_hic M~dic in e. Tul s~, OK, 1989.
lnternsh1p: . Tn-City Hospllal. Dallas.
1989-90. D1agnostic Radiology residency: Mt. Clemens General Hospital. Mt.
Cleme.ns. Ml, 1990-94. _DOB 6-22-63
Al_vJ.n Joseph Mathe, D.O., Internal
MedJcme a~d Vascu lar Medicine, 3500
Camp Bow1e Bl.vd .. Fort Worth, 76 107.
Medtcal ed ucatJon: UNTHSCffCOM,
1989. Internship : Ri chmond Heights
General Hospi tal. Richmond Heights,
OH. 1989-90. Internal Medicine residency : Cleveland Clinic Foundation.
1990-93. DOB 12-28-6 1
Jack A. Maxwell, D.~. . Fam1
~ctice. 2300 _H i~hland Y1 ll age }{
Sulle 310. LeWISV Ille. 75067. Medlt
educatio_n: UNTHSC'!COM. 19~
Internship:. Metropolitan Hospu)
Gran? Rap1~s. MI. 1984-85. Fa~'',
Pract ice res1dcncy: Doctors H osp1~
Columbus. OH. 1985-86. DOB 7-28-:
Mark S. Maxwell , D.O ... Neur
surgery, 110 1 N. 19th St.. Su1te II
Abilene. 7960 1. Medica l cducati1
University of Health. ~ciences. Colle
of Osteopathic Med1C1ne. K~nsas C1
MO. 1987. Internship: Pon tmc Ostt
pathic Hospital. Pontiac, MI. 1 987-~
General Surgery. Neurosurgery residt
cies: Pontiac Osteopath ic Hospit
1988-9 1, 199 1-95. DOB 11 - 15-54.
R. Wade McKenna, D.O., Orth
ped ic Surgery. 11 0 1 Eag le Dm
Decatur. 76234. Med ical educatiL
College of Osteopathic Medicine
Oklahoma State University. Tulsa. 0
1990. Internsh ip: Dallas/Fort W01
Medical Center, Grand Prairie. 1990-l
Orthopedic Surgery residency: Dall;
Fort Worth Medical Center. 199 1-<
DOB 3- 14-63.
Crady Mark McMahan, D.(
Fami ly Practice. 109 Creekside C
Kennedale. 76060. Medical educati(
UNTHSCffCOM. 1993. Family Pn
tice residency: Methodi st Dallas. 19S
96. DOB 8- 18-64
David Byron Morehead, D.(
OB/GYN. 42 1 N. Tom Green. Odes
79761. Medical educati on: UNTHS
TCOM. 1992. OB/GYN residenc
Texas Tech. Odessa. 1992-96. DOS
25-63.
Owen Murray, D.O., Correcti01
Medicine. 2702 Town Grove C
Kingwood. 77345. Medical educatJ(
Chicago College of Osteopathic Me•
cine. Ch icago. IL, 1988. lntemsh
Chicago Osteopathic Hospital. Chica}
IL. 1988-89. Fami ly Practice residen•
Borgess Hospital. 1989-9 1. DOB 7
61.
Maria Brusca Patten, D.O., Physh
Medicine and Rehabilitation , 15
Howard Drive. Tyler, 75701. Medl•
ed ucat ion: Coll ege of Osteopatl
Medic ine of the Pacific, Pomona, C
1992. Intern ship : Hi ghland Genet
Hosp ital. Oakland , CA, 1992.1.
Phys ical Medic ine & Rehabi litall
Medicine residency: Stanford Univer..
Hospital. 1993-96. DOB 8-24-53.
o.o
..
D
·0 ·· Fill
--~~lage I
t \THJ:rrr:oM M«1
I~
Hl)l.
· 008 7-~~
D.O .. ~.
Robert Allen Paul, D.O., Family
Practice. 4359 Lanark , Fori Worth.
6
7 I09. Medical educa~ion : UNTH~C/
TCOM. 1993. InternShip: Presbyten an/
St. Luke's, . Denve r, CO , 1993·_94.
Family Pracuce residency: Presbyten an/
St Luke's, 1994-96. DOB 12-21-65 . .
David Ross . R1chards, D.O.: Card1·
ology. #8 Med1cal Par~way. SUJte ~ 06:
Dall as. 75234. MedJcal educatJ~n.
UNTHSCfTCOM, 1988. lntern shtp :
Doctors Hospital. Colurn~us, OH . 1988·
89. Internal Medicine res1dency: Baylor
College of Medicine. 1989-92. DOB 5-
St.. Sune 5_62 .
edu(-. Robbye Glynn Richards, D.O .•
CQI t-'am ily Practice, 3640. Watonga, ~ort
•1 ( Worth.
76 107. Med1ca l ed uca ti o n:
0. LNTHSCfTCOM. 1993 . Interns hi p:
"lorthea~t
Community
Hospita l.
Bedford. 1993-94. Famil y Practice
Hu~_ Re<.,Jdency: Columbia HEB , 1994-96.
II jj 1-1 DOB 8-2-35.
D.O.. U:
Da'"id Paul Schwartz. D.O .. Family
Eaglr 0. Practice. 140 Southern St., Corpus
J educo Chri.sti. 78404. Medica l education:
Umver<olt)' of Med1ci ne and Hea lth
Sc ience<;. College of Osteopathic
Mrdicme and Surgery. Des Moi nes. lA.
!991. lnternsh1p: Memorial Medical
1:.1 Center. Corpus Christi. 199 1·92. Fami ly
l""1 Pracllce residency: Memorial Medical
Center. 199~-94. OOB 9-1 1-55.
· 0 Dal id Allen Stone, D.O .. Genera l
1
• d!
Surge!). 3230 Camp Bow1e Bl vd., Suite
«h.. C. Fort Worth. 76 107. Medica l
. Fmml) t education: Ch•cago College of O~teo·
Dalla.' pathic Medici ne. Ch icago. IL. 1974.
lntcm.,hip: BoL~ford General Hofipital.
• D. Fannington H1lb, Ml , 1974-75. General
Gk. Surgery rec; idency: B01sford General
~11 Ho,pttal. 1975-79. OOB 3-3 1-48.
110..
\\illiam Aaron Thcker, D.O ..
00 Orthopedics and Spi ne Surgery, P.O.
Box R48, Portland . 78374. Medi ca l
educauon: Kirkwille College of
O'teopathic Med1ci ne. Kirksville. MO.
1988. lntemsh1p: CaMn City Hospital.
Car.on City, MI. 1988-89. Orthopedic
Surgery re'idency: Dal las· Fort Worth
01 1hi41 ~pital . Clul Medical Center, Grand Prairie. 199 1·95.
re'-' DOB 8-26-59.
OOB
William Robert Umstalld , D.O ..
Fam Ji y Practice, 950 W. Uni verfiity.
.a Pat •n, IJ.O.. ~: #102, Georgetown. 78626. Med ical
bilitauon. educat1on: UNTHSCffCOM, 1979.
75701 M~ lntcrmhip: Mt. C lemen s Ge ne ral
of O~lt:1'f\' Ho~pital, Mt. Clemen.;, Ml 1979·80.
Pon>l"' DOB 7-4-52.
land (Jtl. Jerry C. Wasserstein, D.O., General
1 ~- Pract1ce, 6042 Wigton. Houston. 77®6.
Med1cal e~ucation : Chicago Col lege o f
O,teopath•c Medicine, Chicago, JL.
l974 lntem..,hip: Stevens Park Ostco-
pathic Hospital. Dallas. 1974-75. DOB
5- 11 -48.
George K. Wilcox, D.O.. Internal
Medi cine. 39 13 Bur Oak Dri ve. Kill een,
76542. Medical educat ion: UNTH SC/
TCOM. 1993. Internship: Brooke Army
Medical Center. San Antonio. 1993-94.
Internal Med icine res idency: Brooke
Anny Medical Center. 1994·96. DOB 5-
2
4
6
5
Reinstated Members
J. Robert Gershon, D.O .. Denton.
Alliliate Members
Delia Aymond·Bandy. Nutri · Westl
Texas. P.O. Box 755. Manchaca, 78652
Associate Members
James Roger Coc hran . 6628
Crest way Dr., San Antonio. 78239.
Non-Resident Associate Members
W. Keith Con ner, D.O.. 17493
Fruitpon Rd .. Spri ng lake. Ml 49456.
Randall Stanton Hall, D.O .. 4855
Champions Way. Columbus, GA 3 1903
Intern/Resident Members
Ro nald Buczed, D.O.; Char les
Reed Burk, D.O.; Charles Allen Cole,
D.O.; Rebekah J, Cote, D.O.; Ellen
Marie Dahl, D.O.; Victor Valdecanas
Dizon, D.O.; Darrly Brett George,
D.O.; Barbara Ma rgaret Hair, D.O.;
Eric Alex Hegybeli, D.O.; Roman
Kesler,
D.O. ;
Katie
K.
Mastrogiovanni, D.O.; Lisa Lynette
McShane, D.O.; Michael E. M uncy,
D.O.; Ha Thi-Bich Nguyen, D.O.;
Noel C. Nye, 0.0.; Keith Palmer
Pensom, Jr., D.O.; Maria D. Ponse,
D.O; Scott Daniel Robinson, D.O.;
Brent Wayne Sanderlin, D.O.; J oseph
Edward Saucedo, D.O.; Anita V.
Sha h, D.O.; Moin Ahsan Shaikh,
D.O.; Jill Elisa S impson, D.O.; jeffrey
All en Swanson, D.O.; Yasrnin P.
Tejani, D.O.; Helen K. Wendlandt,
D.O.; and Steven Mark Wilder, D.O.
•
Ten Years Ago
in the ''7 e.m4- 'D.tJ. "
• TOMA wa!\ bu;,y mal-..mg plan<., for Jt <., 88 th Annual Convention, to be
held Apnl 23·25. in Au-.tm . Progmm chainnan was Jim W. Czewski, D.O.
• Due\ \tatcment\ for 1987-88 hit the mail. For the fourth year in a row.
Ted C . Alexander. Jr.. D.O., was the fil"\t member to pay his TOMA dues.
• Joel D. Holliday. D.O .. became the fil't O\teopath ic physician to assume
the pre\ldcncy of the Texa.;, Stille Board of Medica l Examiners since its
organin.n ion in 1907. Ponnerly 'v ice pre\ident of the TSBME. Dr. Holliday
a<.,.,umcd the pre..,idcncy fo lio" ing the I'C\Ignation of it!, fonner preside nt.
• The American 0\tcop;.Uhic A-,..,ociatiOn purcha...,cd an 18·StOT) office
buddmg m Chicago. barely a block. ~may from ih locatio n for the past 40
ycar"i. The move wa' planned for Inter in the s ummer.
• LcgblatOI"\ were prc·liling bill' for the 70th Texas Legis lature. A
\ampling of bill\ mcluded Senate Bill 32. creating the Medical Radio logic
Technolotmt Ad\ i\ory Board to 'crYe il\ an adYi"oof)· board to the Te~as
Board of llcalth; Senate Bill 35. to :uncnd the Te\:t>, Controlled Substances
Acl hy adding the <.,ale of !\yringc\ and sett ing fc>11h recordkeepin g
rc..,pon'lhilitic\: Hou\C Bill 84. amending the Medica l Practice Act by
adding acupuncture practllioncf\ to the li't of tho>,e exe mpt from law;,;
regulating the practice of med ici ne: a bill to cstabli..,h a 'tate Iotter}: and a
billliled by the TSBME, wh1ch would require physician<, to cam 150 hours
of CME every three year-, ,
7&MS Z>.<'./31
BIO(
TEXAS STARS
"Managemel
The following people have made pledges or have contributed to TOMA 's Building Fund Campaign. These people ar;
known as 11 Texas Stars" because of their commitment to the osteopathic profession.
Margi<B.f
IIOW
Roben B. Finch, D.O.
Rene Acuna. D.O.
Bruce Addison, 0.0
Ted C. Alexander, Jr., D.O.
Richard Anderson. D.O.
Sara Apsley-Ambriz, D.O.
Gerald F1anagan. 0 .0
Charles E. Fontanier, D.O.
ATOMA
James Froelich, 0 .0
ATOMA District II
Jake Fuller
Aus-Tex Printing and Mailing
Mark Baker, D.O.
Rita Baker
Elmer Baum, D.O.
Kenneth Bayles, D.O
James Beard,D.O
Terry Boucher
Jan Bowling
John R. Bowling, D.O.
Daniel Boyle, D.O.
Frank Bradley, 0 .0
Joanne Bradley
Dale Brancel.D.O.
Robert Breckenridge. D.O
John Brenner, D.O.
Lloyd Brooks, D.O.
Mary Burnett, D.O.
Jeffrey Butts. D.O.
D.Y. Campbell, D.O.
Catherine Carlton. D.O.
Ross M. Carmichael, D.O.
John Cegelski. D.O
Robert Chouteau, D.O.
William Clark. D.O.
George Cole, D.O.
Samuel Coleridge, D.O
Robert Collop, D.O.
Ralph Connell, D.O.
Robbie Cooksey. D.O
William Cothern. D.O.
Michael Cowan. D.O.
Nelda Cunniff- Isenberg. D.O.
Jim Czewski. D.O.
Don Davis. D.O.
William Dean
George DeLoach. D.O.
Robert DeLuca. D.O.
Joseph DeiPriocipe, D.O.
Doctors Hospital
Iva Dodson
Cynthia Dott. D.O.
Gregory Dott, D.O.
Janet Dunkle
Bradley &mes. D.O
Wayne R. English. Jr.. D.O
Carl Everett. D.O.
AIFaigin. D.O.
Virginia Farrar. D.O.
D. Dean Gafford. D.O
Samuel B. Ganz, D.O.
David E. Garza, D.O.
Mark Gittings, D.O.
Myron L. Glickfeld, D.O.
Brent Gordon. D.O
Charles Hall. D.O.
Richard Hall, D.O
Donna Hand, D.O
Wendell Hand, D.O.
Patrick Hanford, D.O.
Jane Harakal
Patrick Haskell, D.O.
Vernon Haverlah, D.O.
Healthcare Insurance Services
Tony Hedges, D.O
Harry Hernandez, D.O.
Linda Hernandez, D.O.
H.S. Hewes, D.O.
Wayne Hey, D.O.
Frederick Hill, D.O.
Teri Hill-Duncan, D.O.
Bret Holland, D.O.
Joel D. Holliday, D.O
William D. Hospers, D.O.
Houston Osteopathic Hospital
Foundation
Bobby Howard, D.O
Christopher Hull, D.O
Lewis lsenberg
Jake Jacobson
Constance Jenkins, D.O.
William R. Jenkins, D.O.
V.L Jennings, D.O.
Daniel Jensen
William R. Jones, D.O.
DawnKeilers
Elva Keilers, D.O.
Royce Keilers, D.O.
Alex Keller, D.O.
Earl Kinzie. D.O.
Brian Knight, D.O
Jere Lancaster, D.O.
Victorija Laucius. D.O.
Edward J. Leins, D.O.
Nei l Levy, D.O
A. Ray Lewis, D.O
Harold Lewis, D.O.
Roy B. Fisher, D.O.
Richard Friedman, 0 .0
Peggy Lewis
John Longacre, D.O.
Hector Lopez. D.O.
Lubbock Osteopathic Fund, Inc.
Edward Luke. 0 .0
Richard Male. Jr.• 0 .0
Marion Merrell Dow, Inc.
Masterpath Groves Pathology Consultants
James Matthews. D.O
R. Greg Maul. D.O.
Robert G. Maul. D.O.
Cindy McCarty
Jack McCarty, D.O.
James McLaughlin. D.O.
lvriMcssinger. D.O
Linus Miller,D.O
CarlMitten, D.O
Lois Mitten
John Mohney, D.O.
Joseph P. Molnar. D.O.
Joseph Montgomery-Davis, D.O.
Rocco Morrell, D.O., P.A.
Dareld Morris, D.O
Ray Morrison, D.O
Ira Murchison. D.O
Gary K. Neller, D.O.
Ann Nolen. D.O.
Bill Nolen, D.O.
Henry Norrid, D.O.
Osteopathic Health System of Texas
Elizabeth Palmarozzi, D.O.
Alice Pangle, D.O.
Michael Parisi, D.O
Robert Peters, Jr., D.O.
Ruby Peters
Donald Peterson, D.O
Wilma Peterson
Dean L. Peyton, D.O.
William Pollan, D.O.
R. Mark Probst, D.O.
Paul Proffitt, D.O.
Bill Puryear, D.O.
Daniel L. Rader, D.O.
David Randell. D.O.
H.H. Randolph, Jr., 0 .0
Jeffrey Rettig. D.O.
Merilyn Richards
John Riggs, D.O.
Peggy Rodgers
Randall Rodgers, D.O
Steve E. Rowley, D.O.
J.MichaelRussell , D.O.
Celina A. Sanchez
Mario Sanchez, D.O.
Richard Saunders, D.O.
John Sawtelle, D.O.
AmySaylak
Daniel Saylak. D.O.
Huben Scadron. D.O.
Jdf Schmeltekopf
Kristin M. Sears. D.O.
A. Duane Selman. D.O.
T.R. Sharp. D.O.
Rick Siewert, D.O.
Sarah Smiley, D.O
George Smith, D.O.
Selden Smith, D.O.
Jerry Smola, D.O.
John Sortore
Sparks Osteopathic Foundat1rr
Arthur J. Speece. D.O.
Dodie Speece
Kevin Stahl, D.O.
Robert Stark. D.O.
Wayne Stockseth
Ray and Edna Stokes
Student Associate Auxiliary
Summit Bancshares. Inc.
J. Ross Tanner. D.O.
H. Sprague Taveau, D.O.
Texas ACOFP
R. Russell Thomas, Jr.. D.O
TOMA Districtll
TOMA District Ill
TOMA District V
TOMA District VI
TOMA District VIII
TOMA District X
TOMA District XII
TOMA District XV
Monte Troutman, D.O.
Stephen F. Urban, D.O.
Christopher Vanderzant, D0
Kenneth R. Watkins. D.O.
Bill V. Way. D.O.
Bill E. Weldon. D.O
Craig D. Whiting, D.O.
Dean Wiennan, D.O.
Arthur Wiley, 0 .0
Peter Wiltse, D.O.
Marie Wiseman
Rodney Wiseman, D.O.
James Woodruff, D.O
Capt. Benjamin Young, D.O
Steven Yount, D.O.
Nancy Zachary
T. Eugene Zachary. D.O
lrvinZeitler, D.O.
Victor Zima. D.O
John R. Zond, D.O.
If you would like to contribute to the Building Fwrd and become a "Texas Star," call Paula Yeamans at 800-444-866)
Please note that contributions received three weeks prior to each issue may not appear until the following issue.
3217EUS ?:>.0 .
flA?e71A;F!f
111
fAMILY MEDICI
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Blood Bank Briefs for Phvsicians
"Management of Fetal and Neonatal Alloimmune thrombocytopenia "
Margie B. Peschel, M.D., Medical Director, Carter Blood Center, Fort Worth, Texas
FetaVneonatal alloimmune thrombocytopenia (FMA IT) is
similar to that of Rh Hemolytic disease of the newborn (HDN)
and results from maternal alloinununi zat ion agai nst fetal
platelet antigens. In contrast to HDN, FMAIT often affects the
first child . Fetal thrombocytopenia may be responsible fo r
intracerebral hemorrhage, leading to death or neurological
-.equelae. The risk of life-threatening hemorrhage necessitates
prompt diagnosis and effective therapy.
During pregnancy, the mother who lacks a speci fi c platele t
antigen becomes alloi mmunized against this antigen on feta l
platelets, which is inherited from the father. In Caucasians, the
human platelet antigen HPA -Ia (PI A I) antigen is far the most
common antigen implicated in FMA IT. When anti-plate let
ant1body is made by the mother"s B cells, they can cross the
placenta and recognize fetal platelets as targets. Thromboc ytopenia can occur very early in pregnancy. After birth the
thrombocytopenia usuall y disappears within o ne to three weeks.
Mo1..t cases of neonatal alloimmune thrombocytopen ia
u~ually pre<,ent uncxpectantJy with thrombocytopenia and ri sk
of hemorrhage at birth. The treatment of choice is transfusion of
Q)
FAMILY MEDICINE PHYSICIAN
Experien(e the best of all worlds •..
by combtnlf"IQ leactung and prachce In an idyllic, private school environmeot.
Our lflfOIIment iS Increasing as a resuh olour Innovative programs and inspirllg
COIMidment to S8I'Mg lhe health needs ol corrmun~ies-on a local and global
tcale The UniverSity of Health Sciences • College of Osteopathic Medicl(le
(UHS-COM) Is currently seeking a board certified Family Physician with a
pus.on lot academic medicne In both ill didactic and c*Mcal fields. The
candidate we select wll spend 50% ol hlslher time participating In clinical
tea<:hlng actrvitllafor Family Medicine students, Interns, and residents. Addilionat rtsponsblilles inClude assisting wit\ teaclling Physical Diagnosis, Osleo·
palhte Dlagnosti/Treatment, and other programs and possible participation In
OOCARE outreacll program v.tllctl sends students and physicians to Me rico to
brJIQneeded health care aetviCfiS to people livilg in primitive and Isolated areas
of the Yucatan.
Hyou are mrrwrutted to Integrity In education and promotion ol prmary cate, we
lnvitll you to submrt your credentials lor consideration. Salary and rank wil be
coownensurate \'lith experience and qualifications. Send your CV to:
Anthony Dekker, D.O., Chair
Family Medicine
Search Committee
UHS.COM
2105 1ndependence Blvd.
Kansas City, MO 64124·2395
1·80Q.234·4UH5
Allirtn~~tiveActiolv'Equai~I~Employtr
compatible platelets in which the mother is the best donor. The
maternal platelets are washed to remove the anti-platelet
anti body and irradiated to prevent Graft vs. Host Disease
(GVHD). The maternal platelets are the first choice since
approximately 98 percent of the population is HPA- la positi ve.
The management of subsequent pregnancy is very exacting
because of the high rate of recurrence and the high risk of more
severe clinical manifestatio ns, especiall y intracerebral
hemorrhage. The means of detecting and assessing severity of
fetal thromboc ytopenia is by performing percutaneous
umbilical blood samplin g (PUBS). If the fetu s is
thrombocytopeni c, then therapy of platelet transfusion s in
utero may be begun . Pl ate lets may be collected from the
mother, then washed and irradiated and transfused during the
pregnancy (intrauterine transfu sion) when indicated. Plate lets
are co llected from the mother immediately prior to delivery in
order for the platelets to be available at time o f delivery.
The remarkable progress in fetal medicine has enabled
acc urate determination of the fetal status. permitti ng
improvements in fetal diagnos is and therapy. Ln transfu sion
medicine there is remarkable progress in platelet immunology
and a better understanding of the natural history of FMAJT.
Thi s progress has led to the development of antenatal therapy
and better management of FMAIT. The antenatal management
of fetal/neonatal all o immune thrombocytopenia is still
evolving.
•
References:
Kapftm C. Fo"stier F. Daffos F. Tchemia G. \\Titers A: Management
offetal and llt'OIIlltaf alloimmunt- thrombocytopenia. Transfus Mnl Re11
/O.·ZJJ-UO. /996.
Buut.'l JB. McFclrfwul JG. Berkowil: RL: Alltenatal mtmagemellt of
Jettd affoimmw1e tlrrombocytoJwnill. Transfus Med Re11-l: 149-162. /990.
Medicaid Osteopathic
Certification Act
Passed by Congress
Congress has passed legislati on correc tin g th e
fail ure of Medicaid law to mention osteopathic board
ce rtificntion of physician s in order to treat Medicaid
preg nant women and ch ildren. House Resolution 179 1.
unanimo usly passed by Congress. now recogni zes
osteopathi c board cen ification as well as allopathic
board ccnification .
The overs ight in the Medicaid law occ urred in 1990.
whe n ame ndm ent s we re passed that establ ished
Medica id quality standards for phy sic ians who treat
c hildre n and pregnant women.
7&US Z>.0./33
Opportunities Unlimited
PHYSICIANS WANTED
FORT WORTH A REA FP-GP CLIN IC
needs an additional GP for full or pan
time. No 08. no hospital required.
8 17-924-7978. (02)
DALLAS/FORT WORTH/MIDCITI ES
AREA - Family Practice needs Primary
Care Physician. BC/BE in a busy onephysician practice. Get to know us, let us
know you Locum Tenen as an introduction
to a permanent position . Fax CV to
DeAnne Joll y at 8 17-28 1-6364. (07)
PHY SICIAN WANTED - Famil y
pract ice, BCIBE. Fu ll-time minor emergency clinic in Central . TX. No call or WE
hours. $ \40-ISO K + % + benefits. Call
Bobby Snyder at 8 17-634-6999. (08)
BOARD CERTIFIED FAMILY PRAC-
TITIONER to join 2 Fami ly Practitioners
in establ ished Grand Pmirie metroplex
practice. Li ght hospital (Baylor- Irving). no
08 . Flexible work schedule (currently
rotating work 2 days with 3rd day off). No
weekend office. S hare ca lls. M anaged
Care ex perience a plus . Call Jeff
Thomp so n at 972-262- 14 25 o r
8 17-429-47 11. ( 10)
POS IT ION IMMEDIATELY AVA ILABLE IN HURST for mature. stable. well
trained osteopathic physic ian who has
exceptional OMT skills and is imbued in
Osteopathic Princ iples and Philosophy.
Large fam ily pmctice with focu s on pai n.
headaches. arthrit is. geriatrics. physical
therapy. rehabilitation , and comprehensive
hea lth care. Good financ ial arrangements
Call: Jack Royder, D.O. , F.A.A .O., or
Joyce. at 8 17-428-0090. ( 12)
MED ICAL DIRECTOR PRIMARY
CA RE - The City of Austin, Health and
Human Services Department, Primary
Care Divisio n has a full -time fX)sit ion
available. Will be resfX)nsible for directing
and de li vering healthcare to the underserved population of Austin and Tmvis
County. Requires at least two years of
:tdminis trati ve/leadership
experience.
Must have comple ted a three year
residency program in e ither FP or IM and
be Board Certified. Excellent salary and
benefits. Contact Philip Brown, Health
and Human Services Departme nt. 2 100 E.
St. Elmo. Austin. TX 78744: 512-7073288: 800-299-0265 ; 512-707-5403 FAX:
EOEIM/F/D. ( 15)
PHYS IC IAN-OWNED EMERGENCY
GROUP - is seeking Full o r Part-Time
D.O. or M.D. e mergency physicians who
practi ce quality e mergency medicine.
BC/ BE e ncouraged, but no t required
34/?EUS Z>.O.
Flexi ble sche dules. competiti ve salary
with malpractice provided. Send CV to
G lenn Calabrese. D.O .. FACEP. OPEM
Associates. P.A .. 49 16 Camp Bowie Bl vd ..
Suite 208. Fort Worth. 76 107. 8 17-73 18776. FAX 8 17-731-9590. (16)
DOCTOR NEEDED in various parts of
Texas to work sma ll hospital emergency
rooms on weekends. Also. full- time/pantime primary care opfX)rtunities available.
For more information. ca ll Je rry at the
Lewis Group at 800-460-8 159. (20)
FAST TRACK C LI N IC OPENED
JA NUARY. 1996 - Primary Care Physician needed. Flex ible -"Chedu le with
ma lpractice prov ided and com petit ive
s:tlary. Send CV to: OPEM A .. ~ociates.
P.A .. 4916 C:nnp Bowie Bl vd .. #208. Fort
Wo"h. TX 76 107: 8 17-731-8776: FAX
8 17-73 1-9590. (24)
DALLAS/FORT WORTH/H OUSTON
- Physician Opportunity to work in low
stress. office based practice. Regu lar office
hours. Lucrative salary plus bcnefi l3. No
call. no weekends. and no emergencie~;
Please call Li sa Cole at 800-25-1-6425 or
FAX CV to 2 14-256- 1882. (25)
FAMILY PRACfiCE - Solo pmctitio ner needed to provide primary care in a
med ica ll y unde rscrved :trea. The two
c urre ntl y
prac tici ng
primary care
physicians are too busy and need he lp. A
progressive, 52-bed hospita l in East Texas
has office space available. Dallas and
Tyler a re c lose e nough for shopping.
din ing and referring. Income g uarantee for
the first year and mov ing expenses
provided . Call Bill Rowton. Ad mi ni strator.
m 903-962-4242. (27)
DA LLAS - GP needed to work parttime in a low stress env ironment. 9-6. MF. No call . no hospital. Contact Pat
Has kell. D.O .. at2 14-638-4923. (33)
AMBULATORY FAMILY PRACTICE
has opportunities for FTIPT BC/BE FP.
Full benefi ts package for FT including
malpractice. paid time off. expenses for
CME/Lic. fees. Flexible schedu le. no
night call . no hospita l work , no
administrat ive hassles. Enjoy the li festyle
afforded by the Metroplex. Please FAX
CV to 8 17-283- 1059 or call Shannan at
8 17-283- 1050. (36)
FAMILY PRACTICE D.O.,- Prnct;ce
OpfX)rtunities for physicians at 54-bed
fac ility in beautiful Tyler, Texas. Act ive
staff of over 30 physicians with 8
specia lties represe nted. Office space
available ncar hospital or may s hare
estubli shed very act ive prac tices in
Fl
OFF ICE
B UI
EQU IPMENT FOR SALE.
Ho uston. Many D.O .s in trel.l
requiring a D.O. to purchase. -}c<~r
budding nc:tr Col umbia Ht ital I
Primarily
minority
pall t
~
Medicare/Medicaid adults a
Pl ea~e ca ll 281 -497-3788
infonnatio n. ( 14)
GU LF COAST C LI NIC -
Grow ing Community. Hrtttal
nu~mg ho me three blocks : uy
(]JO'i'itble purchase in future). t tuL
Kumm at 5 12-758-3660. ( 17}
WANT TO BUY A PRACT ['I h
omrl
QBC system w/Ep'iOn printer. t.year- :
mrely used - like new con. ' ion C
2 14-87 1-7979. (Q.I)
PRACTICE FOR SALE? you h
ever thou g ht of se lling.
a ..e c.
me today! Mick Guen~r. 0 C
2 14-868-9085. (28)
FOR SALE - McManis
le. u
con tinous ly fo r 40 ye· ; (_,
naugahydc upholstery in g()()o ondll
Also. an old. but well running
need~; some upholstery. Con
Nelson, D.O ., in San P
2 10-822-0232. (3 1)
FOR SALE - L:tte model
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William H. "Country" Dean, CFP
Don A. "Jake" Jacobson, CLU, ChFC
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Toll Free
(817) 335-3214
(972) 445-5533
(800) 321-0246
TEXAS OSTEOPATHIC MEDICAL ASSOCIATION
1415 Lavaca Street
Austin, Texas 78701·1634
ADDRESS CORRECTION REQUESTED
ANNOUNCING
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Protecting the financial rewards of a lifetime of work can be almost as difficult as achieving
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