TarrantCounty MedicalSociety

President’s Paragraph

July 1st

by Shanna Combs, TCMS President

This article was originally published in the July/August 2022 issue of the Tarrant County Physician. You can read find the full magazine here.

As I write this, we are amidst graduation season for kindergarten, high school, college, and medical school; it is a time to celebrate the culmination of one of many of life’s journeys. By the time you read this, it will be another magical time of year that all medical professionals know . . . July 1. The time of year when medical students are starting their journey into medical school, or starting their clerkships and entering the clinical learning environment. It is also the time when newly minted doctors put on their crisp, long white coats and try out what it sounds like to say, “Hi, I’m Doctor So-and-so.” It is the time of year when the cycle of medical education continues to turn, and for those of us in practice, it is a time to reflect on our own journey in medicine. Below are some words of wisdom I have for the next generation of physicians.

First year medical students

Welcome to the profession! You have started the journey into the best career you can ever have. The path ahead will not be easy, and there will be many highs and lows. Always keep in mind the reason you chose medicine and enjoy the ride.

Clerkship students

You finally made it . . . you are out of the classroom and getting to do what you wanted to do when you started medical school – learn how to take care of patients. The hours will be long, and your brain will hurt from all the new knowledge, but you are finally starting the work that you signed up for. The best piece of advice I have is the same thing I was told at the beginning of my clerkship year: “You are paying for the privilege to be here . . . get your money’s worth.” There will be no other time in your career where the whole world of medicine is open to you.

Decisions you make are no longer about a, b, c, or d choices; there is now a human life attached to your decisions. There is a whole lot of grey in medicine and not every patient “reads the book.” Keep an open mind and learn as much as you can.

Residents

You are now a doctor . . . listen to the nurses. They can teach you many things and help you in times when you do not know what you are doing, or they can make your life a living hell.

You, too, were a medical student once and were taught by a resident who took you under their wing – or were dismissed by a resident who forgot where they came from. What type of resident do you want your medical student to see you as?

You now have the privilege to sign orders, write prescriptions, and perform procedures. All of this has an impact on a human life. Never forget that.

Attendings

The doctor who is not willing to say “I don’t know” or “I need help” is the most dangerous doctor out there. When another doctor asks for help, realize that they have reached the end of their knowledge base and are asking for your expertise.

It is called the practice of medicine, not perfection. You may have completed medical school, residency, and possibly even fellowship, but there is always something more to learn. When you do this, it is no longer just for your own education or to pass the test, but so you can provide the best care for your patients. They are the reason we do what we do.

Happy July 1 everyone!

Electronic Medical Records and Physician Burnout Survey

JPS Health Network is inviting physicians to participate in a research study that investigates how different specialties are affected by electronic medical record usage as it relates to clinician burnout.

This survey, “Electronic Medical Records and Physician Burnout: A Comparison by Specialty,” seeks to evaluate emotional and physical well-being, intention to leave medicine, and opinions regarding current EMR practices. If you are interested in participating, you can take the survey here.

TCU School of Medicine Announces the Tom and Joan Rogers Endowment Fund to Support Academic Excellence

By Maricar Estrella

Community leaders Tom and Joan Rogers have established a permanent endowment for the TCU School of Medicine to support the school’s innovative curriculum and the training of Empathetic Scholars®.

The Tom and Joan Rogers Endowment in Support of Academic Excellence for the School of Medicine will provide for the greatest needs and opportunities annually in medical education and physician training.

“I am incredibly grateful for this generous gift, which will empower current and future generations of innovative and talented students,” said Stuart D. Flynn, M.D., Dean of the TCU School of Medicine. “Two of the first people I met upon arriving in Fort Worth were Mrs. and Dr. Rogers and they welcomed me in such a gracious and warm fashion. Their generosity is emblematic of their character as they support our efforts to create physicians who are highly skilled and knowledgeable yet compassionate care givers. Our students are extremely fortunate to have Dr. Rogers, a luminary in caring for our children in Fort Worth, as a role model to emulate on the delivery of care with empathy, passion, and love.”

Tom Rogers, M.D., retired after a 50-year career as a pediatrician, has been referred to as “Fort Worth’s original Empathetic Scholar.” Mrs. Rogers is a longtime member of the TCU Board of Trustees. Their generous gift to create this endowment also supports Lead On: A Campaign for TCU, the university’s most ambitious philanthropic campaign in its nearly 150-year history.

Dr. and Mrs. Rogers, their daughter Kelly, and three grandchildren are TCU graduates.

“Supporting the School of Medicine is pretty much a ‘no-brainer’ for us,” the couple said. “So, when TCU helped establish the M.D. School, we were eager to support it in any way we could.”

“Getting acquainted with many of the faculty and staff and meeting some of the truly amazing students only increased our eagerness to be involved,” they said. “Texas is desperate for more doctors, and hopefully some of these graduates will also choose to stay in Fort Worth to practice. In establishing this endowed program fund for academic excellence, we are supporting medical education while investing in these deserving students through the tough years of becoming a doctor.”

HOW TO GIVE

Gifts of any size may be made to The Tom and Joan Rogers Endowment in Support of Academic Excellence for the School of Medicine by contacting University Advancement at 817-257-7800 or TCU Box 297044, Fort Worth, TX 76129.

Join Walk with a Doc on July 9th

Join our local chapter of Walk with a Doc this Saturday for a fun morning walking, talking about health, and meeting people in our community.

Here is what you need to know about the event:

• It will take place on July 9th, 2022
• The hour-long event will begin at 8:30am
• Walkers will start at LVTRise – 8201 Calmont Ave., Fort Worth, TX 76116

For more information, call Kate Russell, OMS-II, at 903-316-9392, or email her at KatherineRussell@my.unthsc.edu.

TMA Statement in Response to U.S. Supreme Court Ruling on Roe vs. Wade

As the Texas Medical Association digests and analyzes the full impact for Texas of the U.S. Supreme Court decision in Roe vs. Wade, President Gary W. Floyd, MD, issued the following statement today in response to the ruling.

“TMA remains committed to protecting the privacy and sanctity of the patient-physician relationship. TMA is unwavering in its stance against intrusions by government or other third parties that impede the patient-physician relationship, and any criminalization of acceptable and appropriate medical practices that may jeopardize that relationship or patients’ safety.

“Especially in high-risk situations, patients need to know their physicians will be there to care for them, and TMA will continue to work with state lawmakers to ensure a safe practice environment for physicians and their patients.”

Tarrant County Medical Leaders Host Inaugural Texas Street Medicine Symposium, Make Bid for 2023 International Street Medicine Symposium

On May 6-7, 2022, healthcare and service professionals, from physicians to social workers, met for the inaugural Texas Street Medicine Symposium at the Tarrant County Medical Society. The event was a success, and now, Fort Worth is making a bid to host the 2023 International Street Medicine Symposium.

Street medicine is centered around bringing comprehensive medical care to people who are experiencing unsheltered homelessness. The symposium, which had representatives from Fort Worth, Austin, and San Antonio, was an opportunity for street medicine teams and affiliate organizations to share ideas and opportunities.

“The practice of Street Medicine is often tied closely with state and local policies,” says Joel Hunt, PA. Hunt, who was one of the Symposium’s lead organizers, is the director of Acclaim Physician Group’s Street Medicine program. “Texas has a large, diverse population, and many Street Medicine teams spread across the state. Our goal was to give these teams a space to meet and share their experiences in hopes that best practices could be applied statewide.”

The meeting, which had around 70 attendees, was a collaborative effort between JPS Foundation, Acclaim Physician Group, Integrative Emergency Services, and TCMS. Street Medicine International founder Jim Withers, MD, spoke at the event, and a range of topics and resources were covered to empower those who interact with the homeless community, from opioid abuse treatments to housing access.

The event was well received, and participants left informed and challenged, but Hunt isn’t resting on his laurels – he is preparing to send in an application to host the 2023 International Street Medicine Symposium in Fort Worth. If his bid is accepted, the symposium, which will take place next fall, would bring hundreds of healthcare and social workers to Fort Worth for its duration. Hunt will need to turn the application in to the Street Medicine Institute by June 24, 2022.

“We hope to leverage our success with hosting this conference to put forth a strong application,” says Hunter Scarborough, MD, Hunt’s co-organizer for the Texas Symposium and an emergency medicine physician at JPS Health Network. “Fort Worth has the advantages of an easily accessible airport, big city amenities, and a local government supportive of health care and housing measures for persons experiencing homelessness.”

Hunt believes this event would energize and inform Tarrant County’s current street medicine initiatives.

“Showcasing the great work this community is doing would be fantastic,” he says. “Bringing in international experts to share their knowledge, wisdom, and experiences would allow us to in turn apply them to continue to improve our community.”

COVID-19 Vaccine Clinics for the Week of June 25

Tarrant County Public Health hosts numerous pop-up COVID-19 clinics across Tarrant County each week in partnership with public and private organizations listed below. Each site has the Moderna and Pfizer vaccines and at times the Johnson & Johnson. Children five and older are eligible for the vaccination. Parents need to bring proof of the child’s age and their own ID for the vaccination. Booster vaccinations are available at all of the vaccination locations.

TCPH would like to bring a COVID-19 vaccination clinic to businesses, churches and organizations in the community who are interested in hosting a pop-up clinic. It’s easy and free to host a clinic.

In addition to the vaccination opportunities below, the cities of Arlington, Fort Worth, Mansfield, North Richland Hills, Hurst, and Tarrant County College have also added opportunities for vaccinations. To find a local vaccine site, the County created a vaccine finder page: VaxUpTC website.

Pop-Up COVID-19 locations:

Everman Public Library
Saturday, June 25: 10 a.m. to 2 p.m.
100 North Race St.
Everman, TX 76140

Austin Company-Health Expo
Saturday, June 25: 11 a.m. to 4 p.m.
2029 North Main St.
Fort Worth, TX 76164

Greater Saint Stephen First Church
Monday, June 27: 1 p.m. to 5 p.m.
3728 East Berry St.
Fort Worth, TX 76105

Vaxmobile – Saint John Cathedral
Thursday, June 30: 9 a.m. to 4 p.m.
2501 East Berry St.
Fort Worth, TX 76105

Worth Heights Community Center
Thursday, June 30: 3 p.m. to 6 p.m.
3551 New York Ave.
Fort Worth, TX 76110

Lamar High School
Friday, July 1: 10 a.m. to 2 p.m.
1400 W. Lamar Blvd.
Arlington, TX 76012

Tarrant County Public Health CIinics:

Northwest Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
3800 Adam Grubb Road
Lake Worth, TX 76135

Bagsby-Williams Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
3212 Miller Ave.
Fort Worth, TX 76119

Southeast Public Health Center
Monday to Friday: 9 a.m. to 12 p.m. and 1 to 6 p.m.
536 W Randol Mill
Arlington TX, 76011

Main Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 6 p.m.
1101 S. Main Street
Fort Worth, TX 76104

Southwest Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
6551 Granbury Road
Fort Worth, TX 76133

Watauga Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
6601 Watauga Road
Watauga, TX 76148

The Vaxmobile is a partnership between Tarrant County Public Health and Trinity Metro to bring COVID-19 vaccines to underserved communities throughout Tarrant County. The 60-foot bus converted to a fully equipped mobile vaccine clinic, will make weekly stops in the areas with the lowest vaccination rates on Thursdays. Vaccinations are also available at the six Tarrant County Public Health clinics listed above every day of the week.

For more information go to coronavirus.tarrantcounty.com or call the Tarrant County Public Health information line, 817-248-6299, Monday – Friday 8 a.m. to 6 p.m.

Tarrant County to begin administering COVID-19 vaccine to infants and toddlers

Tarrant County Public Health will begin administering the COVID-19 vaccine to children six months to five years of age at all TCPH clinics, public pop-up clinics, and the Vaxmobile starting on Wednesday, June 22, 2022.

Both the Pfizer and Moderna vaccines will be available to protect this age group. Infants six months through four years of age receiving the Pfizer vaccine series will need to get two doses, three weeks apart, and a third at least two months later. The dosage of Pfizer for infants is one-tenth of the dosage for adults. The Moderna vaccine series for infants six months through five years of age will consist of two doses, four to eight weeks apart, and it will be a quarter of the dosage of Moderna for adults. A third dose of Moderna has been approved for immunocompromised infants in this age group, at least one month after the second dose.

The CDC now recommends the COVID-19 vaccine for children and adolescents six months of age and older. COVID-19 has become one of the top 10 causes of pediatric death, and tens of thousands of children and teens have been hospitalized because of the virus. While children and adolescents are typically at lower risk than adults of becoming severely ill or hospitalized from COVID-19, the effects of the virus are unpredictable. Vaccination is the best way to protect children from COVID-19.

The COVID-19 vaccine is safe and effective. Before it was authorized for children across age groups, scientists and medical experts reviewed safety and effectiveness data from clinical trials involving thousands of children.

Tarrant County Public Health Clinics:

Northwest Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
3800 Adam Grubb Road
Lake Worth, TX 76135

Bagsby-Williams Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
3212 Miller Ave.
Fort Worth, TX 76119

Southeast Public Health Center
Monday to Friday: 9 a.m. to 12 p.m. and 1 to 6 p.m.
536 W Randol Mill
Arlington TX, 76011

Main Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 6 p.m.
1101 S. Main Street
Fort Worth, TX 76104

Southwest Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
6551 Granbury Road
Fort Worth, TX 76133

Watauga Public Health Center
Monday to Friday: 8 a.m. to 12 p.m. and 1 to 5 p.m.
6601 Watauga Road
Watauga, TX 76148

COVID-19 causes respiratory illness with cough, fever and shortness of breath and may lead to bronchitis and severe pneumonia. For more information go to the TCPH coronavirus page or call the Tarrant County Public Health information line, 817-248-6299, Monday – Friday 8 a.m. to 6 p.m. and Saturday 10 a.m. to 2 p.m.

Medicine Has No Borders

by Aiyana Ponce, OMS-I

This article was originally published in the May/June 2022 issue of the Tarrant County Physician. You can read find the full magazine here.

As a high schooler attending a medical magnet school, my first patient interaction came early, but the lesson I learned that day has influenced the type of physician I hope to become. Nervously, I greeted my first patient, Laura, and informed her that I would be assisting the nurse that day. I helped with her bath and brushed her hair with care, just as I brushed my own mother’s hair when she was hospitalized. Laura was blind and her tracheostomy tube prevented her from speaking, but despite that initial disconnected feeling, I was told, “The goal should be to take care of the patient as if she were your own family member.” That goal was to serve with compassion and empathy. These words have remained with me each time I have interacted with a patient. I took lessons such as this one with me after graduating and made it my mission to maximize my impact on others while serving my community.

Over spring break this year, I participated in a medical mission trip to Guatemala with 35 of my peers. Over the course of five days, we traveled by air, sea, and land to visit Santa Maria de Jesus, Magdalena Milpas Atlas, Monterrico, and San Juan, where we saw over 600 patients. Upon arrival at the pop-up clinic locations that were normally schools or church community rooms, there was often an impressively long line that formed before doors opened. Patients waited hours to be seen each day, and that was a humbling sight.

As a first-generation American raised in the U.S.-Mexico border region and a native Spanish speaker, I served as a link between patients, physicians, and medical students. My responsibilities were to initially take patient’s vital signs and blood glucose readings and then discuss their medical history and chief complaints so I could give the information to the attending physicians volunteering with us. Other days, I had the opportunity to work with a student partner and conduct full patient interviews. We would present our differential diagnoses to one of the attending physicians and work alongside the patient to create the best plan of care. On one of these days, I noticed that a patient came in particular distress. Upon my initial analysis, I noticed that he had what I call “working hands.” Large, dry, and calloused, they resembled the hands of my construction laborer father. As soon as I introduced myself by saying, “Buenos días, mi nombre es Aiyana,” his demeanor changed entirely. One moment he was shyly nodding and following the motions, and the next he looked up, seemingly comforted by familiar words. He, like many others, opened up and provided critical information necessary for his recovery. This change in demeanor occurred patient after patient, and I began realizing how incredible it was to contribute to the enhancement of patient care that would otherwise be limited by communication barriers. I am proud of my work as a translator, but I learned that there is far more that goes into quality of care than a shared language. Though some physicians and students were limited by language, I witnessed spectacular uses of eye contact, hand motions, diagrams, and body language – all of which portrayed a genuine desire to connect with and educate patients. Everyone seemed to have an impeccable awareness of their patients’ needs and feelings, despite their differences.

As soon as I introduced myself by saying, “Buenos días, mi nombre es Aiyana,” his demeanor changed entirely. One moment he was shyly nodding and following the motions, and the next he looked up, seemingly comforted by familiar words.

It is a privilege to be entrusted to care for the life of another human being and I do not plan on taking such a responsibility lightly. It is important to acknowledge that one does not need to travel to faraway lands to serve those in need, as many underserved individuals are likely residing minutes away from us right now. In the future, I will continue to participate in mission trips abroad in addition to serving the local community, wherever I go!

Check out D CEO Healthcare’s interview with TMA President Dr. Gary Floyd

As part of their “Conversation With” series, which highlights leaders in the North Texas community, D CEO Healthcare sat down with TMA President Dr. Gary Floyd to discuss a range of topics – from restoring trust in medicine to transgender care and legislative priorities. Here’s an excerpt:

“When the public health emergency is declared over, over a million people will lose coverage in Texas. We’ve been trying to work with our legislators about targeted plans to extend coverage. We would like to continue to cover children from birth through six months and expand it to have 12 months of eligibility; We would like to cover pregnant moms postpartum for 12 months. We are trying to improve payment for delivering Medicaid services that haven’t been changed in over 20 years.”

You can read the full interview here.