Table of Contents -- November 2003



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Vol. 99 No. 11  

COVER STORY  

Learning All Over Again
You learn a lot in medical school, and when you begin practicing medicine, you have to keep learning because the rules keep changing. New guidelines for what constitutes hypertension. Changing recommendations for when a woman should get a mammogram. Revised guidelines for screening for breast, cervical, or prostate cancer. The list goes on. Physicians who don't keep up will be practicing outdated medicine.

By Ken Ortolon

MEDICAL ECONOMICS  

There They Go Again
Some insurance companies have come up with a new tool in their never-ending quest to get rid of physicians who they decide are costing them too much money in treating patients. It's a software program called Symmetry. Once again, physicians' judgment about what's best for their patients is colliding with the bottom line. 

By Walt Borges

PUBLIC HEALTH  

Sticking It to the Kids
Stung by last year's flu outbreak that shut down schools in Texas, the Advisory Committee on Immunization Practices and the American Academy of Pediatrics have changed their recommendations for flu vaccines this season to include a broader range of children.

By Ken Ortolon

LAW  

The Empire Strikes Back
PacifiCare of Texas Inc. has unveiled a new strategy in its three-year battle in bankruptcy court over its responsibility for making good on the unpaid claims of tens of thousands of physicians whose claims were processed by an independent practice association (IPA). It has decided to sue 40 physicians who were associated with the IPA and its management companies.

By Walt Borges

SCIENCE  

Patient, Medicate Thyself
Making drugs like Claritin and Prilosec available over the counter without a prescription seems like a good deal for consumers. The drugs cost more, but people can get them without seeing a doctor. Some critics say it may be bad for their health to get drugs without consulting a physician. The central question is whether it's good medicine.

By Ken Ortolon

MANAGING YOUR PRACTICE  

HIPAA: Confusion From the Get-Go
The transition from one Medicaid state contractor to a new one at the end of 2003 has some unforeseen consequences for Texas doctors struggling to comply with new electronic transactions requirements of the Health Information Portability and Accountability Act (HIPAA).

E-Mail Medicine
At what point should you begin accommodating your technologically advanced patients who prefer you contact them exclusively by e-mail? Medem has some answers.

Aetna Opens Up
Aetna Inc. has illuminated the often dark and mysterious process of how its automated claims-processing programs edit and bundle physicians' claims. It's offering physicians an Internet tool called Clear Claim Connection that enables them to see how the Aetna claims-processing system handles billing codes.

www.texmed.org: TMA Online  

ROUNDS  

Anatomy of a Victory
License Renewal Fees Going Up
TMA Summit Celebrates Victories, Lays Out Future Challenges
Two Common Diabetes Drugs May Cause Heart Failure
CMS Posts NCCI Edits on Internet
TMA Knowledge Center Has the Answers
PBF Helps Medical Families Through Crises
TMA Physician Services Offers On-Site Coding Class With CME
HCMS Wins Rotary Honor

JOURNAL  

The Anomalous Health Status of Texas Border Counties (abstract)
By Richard W. Homan, MD, MA

Physicians' Views and Practices of Smoking Cessation (abstract)
By Shaohua Hu, MD, DrPH; Alfred L. McAlister, PhD; Angela F. Meshack, DrPH; and Jeremy A. Margolis, PhD, MS

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