These articles originally appeared on the TAPM
website in 2004.
HOPE is a Resounding Success!
TAPM, together with
the Texas & New Mexico Hospice Organization (TNMHO), with additional support
from the Texas Partnership for End-of-life Care (TxPEC), sponsored HOPE (Hospice
Physician Essentials) for Medical Directors in Austin on 10/22/04. The
course, which was accredited for 7.0 hours of CME, covered a range of clinical
and regulatory issues that every Hospice Medical Director should know.
Exceeding the planners' most optimistic projections, over 45
physicians attended this program, representing the largest gathering of Texas
palliative medicine and hospice physicians at any stand-alone conference -- at
least of which TAPM is aware. While still being compiled at the time of
this writing, the presenters and program evaluations are uniformly good to
excellent.
The overwhelming feedback from this meeting is the desire,
repeated over and over again, that such meetings designed for palliative care
and hospice physicians continue, at least annually. The opportunity to
network with other physicians was invaluable to all.
TAPM to Cosponsor
Hospice Medical Director Fly-In
In response to
requests from multiple individuals and organizations, TAPM and TNMHO will host a
Hospice Medical Director Fly-In to be held October 22, 2004 in Austin.
This will be a one-day educational offering for all hospice medical directors,
regardless of experience, but the emphasis will be on helping new medical
directors understand the Medicare hospice benefit and eligibility, pain
management and other topics yet to be determined.
Click here for
more information
TSBME Amends "Chapter 190.
Disciplinary Guidelines"
A TAPM-sponsored effort requesting that the Texas State Board of Medical
Examiners (TSBME) modify its rules regarding proper prescribing to the benefit of
hospice patients across the state, resulted in the TAPM-suggested
language being published as offered, in the
April 23, 2004 Texas Register.
The TSBME formally gave final approval to this change at its June 4, 2004
meeting.
This was a joint effort of TAPM, TNMHO and TxPEC, with
special thanks going to Dr. Leigh Fredholm, Dr. Ronald Crossno and Dr.
Elizabeth McKinnis, who personally met with the TSBME staff to explain the
concerns.
The issue was that language in the
TSBME's rules, while aimed at curtailing internet prescribing, could be
construed to inadvertently restrict hospice medical directors from prescribing
for patients they had not personally examined. TSBME staff assured TAPM that
this was never their intent. The proposed language will correct this
concern. The rule follows with the proposal in
blue
as the last paragraph:
CHAPTER 190. DISCIPLINARY GUIDELINES SUBCHAPTER B. VIOLATION GUIDELINES
22 TAC
190.8 Violation Guidelines
When
substantiated by credible evidence, the following acts, practices, and
conduct are considered to be violations of the ACT. The following shall not
be considered an exhaustive or exclusive listing.
(1)
Practice Inconsistent with Public Health and Welfare.
Failure to
practice in an acceptable professional manner consistent with public health
and welfare within the meaning of the Act includes, but is not limited to:
(A) -
(K) (No change.)
(L)
prescription of any dangerous drug or controlled substance without first
establishing a proper professional relationship with the patient.
(i)
A proper relationship, at a minimum requires:
(I) establishing that the person requesting the medications is in fact who
the person claims to be;
(II) establishing a diagnosis through the use of acceptable medical
practices such as patient history, mental status examination, physical
examination, and appropriate diagnostic and laboratory testing. An online
or telephonic evaluation by questionnaire is inadequate;
(III) discussing with the patient the diagnosis and evidence for it, the
risks and benefits of various treatment options; and
(IV) ensuring the availability of the licensee or coverage of the patient
for appropriate follow-up care.
(ii) A proper professional relationship is also considered to exist between
a patient certified as having a terminal illness and who is enrolled in a
hospice program or another similar formal program which meets the
requirements of subclauses (I) through (IV) of this clause, and the
physician supporting the program. To have a terminal condition for the
purposes of this rule, the patient must be certified as having a terminal
illness under the requirements of 40 TAC 97.403 and 42 CFR 418.22.
"Advanced Clinical Track: sponsored by
TAPM at TNMHO Annual Session
In an effort to improve
and perhaps even restore physician attendance at the Texas & New Mexico Hospice
Organization's Annual Session, TAPM sponsored an Advanced Clinical Track.
This included the following topics:
Expanding Our Future: Access &
Values (Plenary Session by D. Schumacher, NHPCO President)
Hospice Eligibility & Hospice
Myths
Advanced Pain Management Topics
Legal Considerations in
Pronouncing & Certifying Death
Management of Dementia at the
End of Life
Palliative Management of
Cardiopulmonary Diseases
Is More, Better? The Case of
Expensive Palliation
The conference was attended by over thirty physicians with an
interest in hospice and palliative medicine. The track was open to other
TNMHO attendees, as well. The average attendance for each session was over
eighty individuals. CME was sponsored by TAPM, and the evaluation results
have been very good.
The TNMHO Board was so pleased that an offer was made to TAPM
to make this an annual event, with the emphasis still to be on more advanced
clinical topics aimed first and foremost at physicians. Consideration of a
separate "Hospice Medical Director Fly-in" was also discussed. This would
be a stand-alone, one-day session designed primarily for physicians with less
than two years experience in hospice or palliative care.
TAPM 2004 Annual Business Meeting
After the Advanced Clinical Track at
the TNMHO Annual Session, TAPM held its Annual Business meeting. Among the
items of business were discussion of future educational offerings, a review of
TAPM's financial status and formal recognition as a 501(c)3 nonprofit, and
installation and election of officers. Full minutes of the meeting will be
posted online.
Newly elected officers for the
2004-2005 year are:
President - Aaron Malakoff, MD from New Braunfels
President-Elect - Leigh Fredholm, MD from Austin
Secretary-Treasurer - Linda Tavel, MD from Houston
Past-President - Ron Crossno, MD from Rockdale
Appointed Committee Chairs
include:
Ethics & Bylaws - Marion Primomo, MD from San Antonio
Membership - Dennis Pacl, MD from San Antonio
Education - Paula Bessonett, MD from Tyler
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