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Transcript of TCMS Austin Lifestyle Magazine #2
austinlifestylemagazine.com 79
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keep austin wellYour Guide to LivinG WeLL everY daY
80 austinlifestylemagazine.com
editor
Stephanie triggs
contributing writers
Philip Huang, md, mPH, Carole Barasch
photographers
Cover photographed by William Jennings
art director
tyler Lee
sales inquiries
contact us
about tcMs
the travis County Medical Society is a component society of the
texas Medical association, a statewide professional organiza-
tion of licensed physicians. its more than 3,100 members include
approximately ninety percent of all practicing physicians in the
Greater austin area. in addition to activities promoting high stan-
dards of medical practice, the Society provides representation and
advocacy for patients and physicians at all levels of government
and medicine.
contents
81 Letter from the editor
82 Collaborating for Children: a Plan to
Mobilize Health Care Professionals in the
Fight against Childhood obesity
84 Helping Haiti: First Hand accounts of
the earthquake aftermath
86 Bats return to austin: Know How to
Protect Yourself
88 tobacco use: Helping travis County
Quit for Good
Keep Austin Well
Your Guide to LivinG WeLL everY daY
Physicians you know, names you trust.
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austinlifestylemagazine.com 81
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lFrom tCMS
dear readers,
Congress recently enacted health system reform legislation that hopefully will expand
access to health care for millions of americans. However, the new law did not address
a looming problem that may threaten access to medical care for millions of patients on
Medicare – the government’s largest health care program that covers senior citizens and
people with disabilities, as well as military families covered by triCare.
the problem was created ten years ago in legislation that requires Medicare pay-
ments to physicians to be modified annually using the Sustainable Growth rate
(SGr) formula. While unintentional, the SGr formula is fatally flawed in that it man-
dates physician fee cuts almost every year. For a decade, Congress has only applied
temporary Band-aids by extending implementation of the formula, thus putting off
a permanent fix. this year Congress had the opportunity to fix the Medicare reim-
bursement formula once and for all as a part of the most sweeping health system
reform legislation in history. But they didn’t.
So ten years after SGr was created, its flawed formula actually took effect on april 1
with a 21% cut in Medicare reimbursement rates for physician services. it will drive
doctors with large Medicare practices financially into the red and possibly out of the
program. the last thing we doctors want is to have to tell our Medicare patients that
we can no longer afford to care for them.
on april 5, physicians and patients from across the state and nation united to
launch a petition drive led by the texas Medical association to collect 1 million
signatures. the petition simply asks Congress to stop the Medicare meltdown so
patients can choose their doctors and their doctors can stay in the program.
Congress knows about the problem. Congress knows that it jeopardizes access
to care for Medicare patients. and Congress knows they can fix it.
Please make your voice heard to ensure Medicare patients have a doctor to care
for them when they need one! Tell Congress to finish its work and permanently fix
the Medicare SGR formula. Go to www.ipetitions.com/petition/meltdown and sign
the petition today.
Live well, austin!
C. Mark Chassay, Md vivek Mahendru, Md
President, tCMS Chair, tCMS Public relations
Committee
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82 austinlifestylemagazine.com
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T he texas Center for the Prevention and treatment of
Childhood obesity (tCPtCo) has been established in austin
at dell Children’s Medical Center of Central texas, a member of
the Seton Family of Hospitals. Founded by Stephen Pont, M.d., M.P.H,
FaaP; Kimberly avila edwards, M.d., FaaP; and child psychologist
Jane Gray, Ph.d.; the tCPtCo will involve multiple elements neces-
sary to treat and prevent childhood obesity in our region, including
a multidisciplinary obesity clinic, education, advocacy and research.
the tCPtCo, funded through the generous support of the Michael
& Susan dell Foundation, represents a collaboration between dell
Children’s, the university of texas Southwestern Medical School at
dallas – austin Programs, ut austin and the texas Child Study Center.
the tCPtCo builds upon the success of the healthy living
happy living / Vida sana Vida Feliz multidisciplinary family-
based childhood obesity intervention at dell Children’s that cele-
brated its first anniversary in January. this clinician-led, ten-week
program has been presented to more than one hundred children
in the area, in both english and Spanish, since it began. Children
and their parents have been able to participate thanks to the sup-
port of multiple local and regional philanthropic foundations –
including generous contributions from the austin Community
Foundation, the rGK Foundation, the aetna Foundation and the St.
david’s Foundation – demonstrating broad and substantial com-
munity commitment, support and readiness for the development
and implementation of a childhood obesity center.
the clinical component of the tCPtCo will provide coordinated,
multidisciplinary care to treat the varied physical and psychosocial
conditions associated with overweight and obese children. experts
in pediatric medicine, pediatric psychology and behavior change,
nutrition and physical therapy will be involved in providing treat-
ment based on the most current, evidence-based recommendations
from the american academy of Pediatrics, the american Medical
association, and other national professional societies and institu-
tions. the multidisciplinary team will work together to individualize
treatment for each child and families will be integrally involved in fos-
tering, supporting and maintaining the needed behavioral, nutrition
Collaborating For ChildrenA Plan to Mobilize Health Care Professionals in the Fight Against Childhood Obesity
35%of students in grades
3 to 12
overweight or obese.
from our own
Austin ISD are
Health issues from excess weight include :Heart Disease, Stroke, High Blood Pressure Cancera
nd
with an expected cost 15.6 Billion Dollarsin two-thousand ten of $39 Billion in
75% of adultsw i l l b e OBESE in
2040
For the 1st time in American History...the lifespan of this generation
the lifespanof their parents<
Type 2 Diabetes, Asthma, Sleep Apnea, Gallblader Disease, Hypertension, Colon & Cervical Cancer, Congestive Heart Failure, Ovarian Cancer, Postmenopausal Breast Cancer Osteoarthritis and much much more....
Texas: fourty-six percent of kids meet daily recommendations for exercise and only twenty-two percent get theirrecommended servings of fruits or vegetables
austinlifestylemagazine.com 83
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and physical activity changes. the texas Child Study Center, an out-
patient mental health collaboration between dell Children’s and ut
austin educational Psychology department, will provide direct access
to mental health services for the center’s patients.
initiatives and best practices developed and implemented at the
tCPtCo will be disseminated to local practitioners by leveraging
resources already present at dell Children’s including lay and pro-
fessional publications, telemedicine and regional continuing medical
education events. in addition, the educational arm for the center will
specifically include education for current and future practitioners.
While the diagnosis and treatment of obesity and its comorbidi-
ties is a much-needed service that will be provided by the founding
clinicians, drs. Pont, avila edwards and Gray are well-aware that the
solutions to the childhood obesity epidemic must also include the
community outside the clinic walls. in line with the educational and
advocacy arms of the tCPtCo, the three clinicians joined with the
texas Pediatric Society (tPS) on Saturday, March 27, to launch the first
in a series of statewide training seminars that are designed to mobilize
health care professionals in the fight against childhood obesity. With
dr. avila edwards as the project lead, the tPS received a grant from the
national initiative for Children’s Healthcare Quality as part of the Be
our voice advocacy training initiative. through this initiative, funded
by a grant from the robert Wood Johnson Foundation, health care
providers are given the advocacy tools, resources and ongoing sup-
port needed to implement evidence-based strategies for community
change that will support obesity prevention. this project is imple-
mented in collaboration with the american academy of Pediatrics, the
California Medical Foundation and the robert Wood Johnson Center
for the Prevention of Childhood obesity.
research will be a core component of the tCPtCo to advance
knowledge, document success and expand services. the tCPtCo
anticipates obtaining direct funding for research projects and also will
collaborate and serve as a clinical translational research link between
the bench research at the dell Pediatric research institute and the
community/school-based research of Michael & Susan dell Center
for the advancement of Healthy Living, housed within the ut School
of Public Health, austin regional Campus.
For more information, please visit: the texas Center for the
Prevention and treatment of Childhood obesity (www.dellchild-
rens.net/healthyliving). empowering families to live healthy, happy
lives via the CL-e-a-r components :
• evidence based multidisciplinary CLinical treatment
• Patient, community, and student/trainee Education
• Community Advocacy and capacity building, through serving as a
resource and partner for health-related collaborative community
efforts
• novel Research to advance knowledge, document success and
expand services.
84 austinlifestylemagazine.com
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T he travis County Medical Society has a strong commitment to
community – close to home and far away – especially when
disaster strikes in the form of a hurricane or earthquake. after
a magnitude 7.0 earthquake hit Haiti on January 12, physicians,
hospitals and pharmacies donated needed medical supplies and
made financial contributions to relief efforts.
Medical teams including tCMS physicians traveled to Haiti with
various relief agencies to assist with the country’s medical needs.
Below are excerpts from their experiences.
January 16By the time we hit the ground in
Port-au-Prince, we had a well-
organized team of sixteen.
there were ten physicians,
two surgical techs, three nurses,
and one pastor/photographer. i
took the approach that this is a
military operation and i mentally
put on a “suit of armor” to be able
to do what i knew was ahead. i
thought i had seen it all, and
have been in a lot of situations
over the years − in india, africa,
and even my residency in down-
town detroit couldn’t prepare me
for the utter devastation i saw,
inflicted on so many. it’s what i
would imagine the aftermath of
large-scale war would look like.…
as the week ended, that bul-
letproof armor was soaked with
tears and sweat − my tears and
my sweat, mixed with those of
patients and team members
who would now become lifelong
friends. there was no protection
from the love and suffering of the
Haitian people and both pierced
my heart, changing it forever.
the moment i arrived home, i
started planning my return to
Mission of Hope with my wife.
We are in it for the long run!
tiMotHY C. GueraMY, Md
Medical Park Orthopaedic Clinic
www.facebook.com/
austinmedicalreliefforhaiti
January 28today our team members have
been in town helping at the gen-
eral clinic. they saw over one
hundredpatients in the clinic
at MoH today; mostly general
medical issues, several fore-
arm fractures, distal radius frac-
tures in kids. they are having
some amputees coming back
for evaluation. there is more
time for organization of long
term medical care at MoH. the
goal is to get patients where they
need to be and the long term
care that they will need to have.
JoeL H. Hurt, Md
Texas Orthopedics
http://txortho.blogspot.com
February 1We departed the dominican
republic by bus and crossed into
Haiti in the early morning hours,
arriving in Port-au-Prince mid-
morning.the devastation, loss
of human lives, and destroyed
property was mind-numbing.
united nations’ cars and vari-
ous aid groups and personnel
were ubiquitous. tent cities were
everywhere.
in the following days, we
held clinics in three different
areas, serving more than 1,200
gracious and deserving Haitian
patients. We were able to offer
pain relief, sleep aid medication,
vitamins, antibiotics, wound
care,immunizations against
tetanus and piperazine,(a liquid
medication taken by mouth for
the treatment of intestinal para-
sites). in addition, we distributed
food donations to each family.
david vander Straten, Md
CommUnityCare
February 15it was a hurried start, with lost
bags and found bags – touch
down! Looking out amongst the
rubble and trash everywhere, you
see lines of people celebrating
a national day of prayer. the air
is warm and dusty. orientation
was filled with fear and disbelief
as our hearts went out to those
involved in the earthquake stories
we heard. there was calmness
despite the circumstances amid
the patients in the ward many of
which had neglected fractures
and infected wounds. i worked
on a twenty year old who lost both
parents; her foot will never be
the same. the team worked well
together today. the night time is
cooler with few mosquitoes. now,
it’s time to rest.
J. Brannan SMoot, Md
Texas Orthopedics
www.facebook.com/mohhaiti
Helping HaitiFirst Hand Accounts of the Earthquake Aftermath
above, top: Patients waiting to be seen
by the medical team. Note the number
of fractured bones from falling cinder
blocks; above, middle: Team members
stayed in tents on the Mission of Hope
compound. The building has a small
kitchen, three bathrooms, and nor-
mally holds about 25 guests. 75 people
were using the facility at a time; above,
bottom: Tim Gueramy, MD, Joel Hurt,
MD, and the OR Team operating on a
young girl.
austinlifestylemagazine.com 85
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A ustin is once again home to the largest urban bat colony in
north america. While bats contribute greatly to our eco-
system, you need to know how to protect yourself around
these animals.
Bats can enter homes, apartments and businesses through
unscreened windows and open doors and will generally leave on their
own if given the chance. if you find a bat in a room, open windows,
turn on lights, and then leave the room and close the door to keep
children and pets out of the area. it can take up to 18 hours for a bat
to leave a resting place, so you may have to check the area every few
hours to see if the bat has departed.
do not try to catch a bat you find in a room unless testing is neces-
sary because a person or pet has been sleeping in the room while the bat
was present. if you must remove the bat from its resting place, wear thick
leather gloves and carefully place a wide-mouthed cup, jar, or can over
the resting bat. Carefully slip a piece of cardboard between the opening
and the resting surface then take the container outdoors to release the bat.
• never handle a bat – alive or dead – with your bare hands!
• Keep people and pets away from a sick, injured, or dead bat and
call animal control at 3-1-1.
rabies exposure occurs only when a person is bitten or scratched
by a potentially rabid bat or other animal, or when abrasions, open
wounds, or mucous membranes are contaminated with the saliva,
brain, or nervous system tissue of a potentially rabid animal.
it may take several weeks or longer for people to show symp-
toms after being infected with rabies. the early signs of rabies can
be fever or headache, but this changes quickly to nervous system
signs such as confusion, sleepiness, or agitation. once someone
with a rabies infection starts having these symptoms, the person
usually does not survive. this is why it is critical to talk to your doc-
tor or health care provider immediately if any animal bites you –
especially a wild animal.
if you or anyone you know could have been in contact with a bat,
please call the austin/travis County Health and Human Services’ disease
and Surveillance unit at 972-5555 or your local health care provider.
The Bats Return to AustinKnow How to Protect Yourself
CaroLe BaraSCH
Manager-Communications & Community Development
Austin / Travis County Health & Human Services
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D id you know that tobacco use remains the single greatest
cause of preventable disease, disability and death in the
nation, texas, and travis County? tobacco use is a major
risk factor for multiple cancers, heart disease, stroke and lung dis-
ease. approximately twenty-four thousand adults die of a smoking-
attributable illness annually in texas. that is more than die from aidS,
heroin, cocaine, alcohol, car accidents, fire, and murder – combined.
For every one person who dies from tobacco-related causes, there
are twenty more people who are suffering with at least one serious
illness from smoking.
Smoking is also a health threat to nonsmokers. Secondhand
smoke contains a complex mixture of over four thousand chemicals,
more than fifty of which are cancer-causing agents (carcinogens).
Secondhand smoke is associated with an increased risk for lung can-
cer and coronary heart disease in non-smoking adults. Because their
lungs are not fully developed, young children are particularly vulner-
able to secondhand smoke. exposure to secondhand smoke is associ-
ated with an increased risk for sudden infant death syndrome (SidS),
asthma, bronchitis and pneumonia in young children.
in addition to the health-related costs of tobacco use, it also costs
our businesses and taxpayers money. in 1999, tobacco-related dis-
ease cost the state approximately $10 billion ($4.5 billion in direct
medical costs and an additional $5.5 billion in lost worker produc-
tivity). in 1998, about 15% ($1,265,000,000 or $543.87 per recipient) of
all Medicaid expenditures were spent on smoking-related illnesses
and diseases.
despite all these risks, approximately 18.5% of adults in travis
County still smoke cigarettes. that is why it is a tremendous opportu-
nity for our community to be receiving $7,473,150 in federal stimulus
funds from the Centers for disease Control and Prevention over the
next two years to decrease tobacco use and decrease exposure to sec-
ondhand tobacco smoke. the grant focuses on policies, systems and
environmental changes to reduce the burden of chronic disease.
the austin/travis County Health and Human Services department
(a/tCHHS) is the lead agency for this effort and activities are being
designed to prevent and reduce tobacco use by working with com-
munity partners in schools, worksites, health care settings, faith-based
organizations, retail settings and the media.
Key activities will be to: assist major health care providers and
substance abuse facilities in referring to telephone quitline ser-
vices or to other local community cessation services; reduce youth
access to tobacco products and marketing; implement extensive
media education campaigns to promote a tobacco-free lifestyle and
counteract tobacco industry promotions; and promote worksite and
other tobacco-free settings in an effort to protect the public from the
harms of secondhand smoke and increase access to clean air.
if you want to quit using tobacco products today or you are taking
the first steps toward quitting and need assistance, there are resources
for you. Contact Megan Cermak, program coordinator for a/tCHHS’s
austin tobacco Prevention and Control Coalition for more informa-
tion and resources at 512-972-6763 or [email protected].
texas Quitline Call 1-800-YES-QUIT for free advice and counseling on how
to stop smoking. The Quitline is open from 7 am–9 pm Monday
through Thursday, 7 am–7 pm on Friday, and 8 am–4:30 pm Saturday
and Sunday. Austin residents also are eligible for free nicotine
replacement therapy through the Quitline.
Tobacco Use:Helping Travis County Quit for Good BY PHiLiP HuanG, Md, MPH
Medical Director / Health Authority
Austin/Travis County Health and Human Services Department