TarrantCounty MedicalSociety

TCU Medical Student Receives Award for Advocacy Work with AMA

By Prescotte Stokes III

Published by TCU School of Medicine on May 17, 2022. You can find the original here.

TCU School of Medicine student Anand Singh received the New Member Outstanding Involvement Award in AMA-MSS Region 3 by the American Medical Association – Medical Student Section.

In his role as the Co-Advocacy Chair of AMA-MSS Region 3 that includes medical schools in Arkansas, Kansas, Louisiana, Mississippi, Oklahoma and Texas, the first-year medical student has helped organize nationwide campaigns for the organization.

“I was extremely honored to receive this award alongside other incredible leaders in AMA-MSS Region 3,” Singh said. “Receiving this award inspires me to continue growing my involvement in the AMA-MSS and be an advocate for medical students, physicians, and patients.”

Singh has been a part of the MSS Region 3 Resolution Review Committee, the Logistics and Resources committee for the AMA-MSS N-21 Conference and the Committee on Legislation and Advocacy (COLA) since 2021. He was also one of the authors on four different resolutions presented at the AMA N-21 Conference held in November 2021.

“Through the Texas Medical Association (TMA)-MSS, I was part of the Ad-Hoc Committee to review resolutions for TexMed 2022 and I was primary author for one resolution and helped draft two other resolutions,” Singh said.

Singh is the current AMA delegate for the TCU School of Medicine. During National Advocacy week in October 2021, he helped organize a “Call Your Rep” event as well as social events to increase AMA engagement at the medical school. He also attends monthly Tarrant County Medical Society meetings to provide updates about the medical school, the AMA-MSS and TMA-MSS chapters he’s involved in.

“It really gives me the opportunity to connect and build relationships with local physicians in Fort Worth and all across North Texas,” said Singh. “I believe that there is power in a collective voice and organized medicine provides medical students and physicians the opportunity to advocate for change on a local, regional, and national level. This motivates me to work harder and give back by mentoring other students to find their voice through the AMA-MSS on healthcare advocacy topics they are passionate about.”

The Uvalde Crisis: Working Together for Real, Actionable Solutions

Statement from Texas Medical Association President Gary W. Floyd, MD:

The Uvalde, Texas, school shooting was shocking, and hit me at my very core as a pediatrician, father, and grandfather. I can’t put into words the emotions I felt at the time. But I can tell you the first action I took was to call my Texas Medical Association Board of Trustees colleagues and Michael Darrouzet, executive vice president of TMA, to say, “We have to do something for the Uvalde community. We need to take action to prevent these violent acts from ever happening in Texas again.” Ray Callas, MD, chair of the TMA Board of Trustees, did the same. Together we called for action.

I know you can relate to our reaction, because as physicians, we fix problems – we are trained to diagnose, treat, and heal. And that is exactly the approach TMA took in its response to the Uvalde crisis.

TMA went to work immediately to create the Mental Health Rapid Response Team, a coalition of 20 organizations ranging from state medical specialty societies, statewide leaders from community health centers, and social work and psychology organizations to state government resource leaders, such as the Texas Health and Human Services Commission (HHSC), Texas Child Mental Health Care Consortium (TCMHCC), Texas Division of Emergency Management, and Texas Department of Public Safety, to name a few. See the entire list of participants below. The coalition is co-chaired by Dr. Callas and me.

TMA already had its first meeting with the Mental Health Rapid Response Team to learn what resources are being deployed in Uvalde, what is needed, and how we can collectively help with the response without overwhelming the community or interfering with ongoing efforts by the state. We also started establishing short- and long-term goals for the coalition, focusing on the needs of the Uvalde community, first responders, communities all over Texas that also are dealing with this tragedy, and new legislation we can put before our legislators in January 2023. Being proactive is TMA’s primary goal, in the hope our efforts will prevent such situations from occurring again.

What we know: Uvalde currently is overwhelmed with offers to help with counseling. TMA’s goal will be to look longer-term, finding in-person counseling for Uvalde during the next year or two. HHSC has asked TMA to create a list of people who are willing to provide long-term counseling services in Uvalde. Eventually, we will need telemedicine services as well. TMA will soon publish information about how to get involved. Please keep an eye out for this.

TMA learned one valuable lesson from the COVID-19 pandemic: When we work together and learn from each other, we can be much more effective. We are taking that same approach now. This is not a problem we can fix quickly but one that will take time to properly diagnose, treat, and heal.

Please join TMA as we help the Uvalde community and our state to detect, prevent, and start fixing the many problems affecting our children and families in Texas.

Sincerely,

Gary W. Floyd, MD
President
Texas Medical Association

Mental Health Rapid Response Team

Association Participants

Child Psychiatry Access Network (CPAN is part of TCMHCC) – Laurel Williams, DO, CPAN medical director; Nhung “Noon” Tran, MD, Texas Pediatric Society liaison to CPAN and CPAN pediatric consultant; and Luanne Southern, TCMHCC executive director
Federation of Texas Psychiatry – Phillip Balfanz, MD; Eric Woomer, lobbyist and government affairs consultant; and Courtney Williamson
National Alliance for Mental Illness Texas – Greg Hansch, executive director
National Association of Social Workers Texas – Will Francis, executive director
Texas Academy of Family Physicians – Tom Banning, CEO/executive director
Texas Association of Community Health Centers – Jana Eubank, executive director
Texas Chapter of the American College of Physicians – Nicole Abbott, executive director
Texas Counseling Association – Jan Friese, executive director
Texas Hospital Association – John Hawkins, president/CEO; Steve Wohleb, general counsel; and Sara Gonzales, vice president, advocacy and public policy
Texas Medical Association – Gary Floyd, MD, president, and Ray Callas, MD, chair, board of trustees
Texas Nurses Association – Julia Menegay, interim CEO, and Dawn Webb, director of nursing practice and professional development
Texas Pediatric Society – Stacey Mather, executive director, and Clayton Travis, director of advocacy and health policy
Texas Psychological Association – Angie Guy, interim executive director

State Participants

Office of the Governor – Heather Fleming, advisor
Texas Child Mental Health Care Consortium – David Lakey, MD, chair
Texas Department of Public Safety – Steven McCraw, executive director/colonel, and Lt. Charles Havard
Texas Department of State Health Services – John Hellerstedt, MD, executive commissioner, and David Gruber, associate commissioner, regional and local health operations
Texas Division of Emergency Management – Nim Kidd, Chief
Texas Health and Human Services Commission – Cecile Young, executive commissioner, and Sonja Gaines, deputy executive commissioner for intellectual and developmental disability and behavioral health services

This statement was originally published by the Texas Medical Association on June 2, 2022.

TCOM to Host First Anniversary Walk with a Future Doc Texas Event Saturday

WHAT: Fort Worth residents of all ages are encouraged to lace up their walking shoes and join medical students and faculty from Texas College of Osteopathic Medicine for Fort Worth’s first anniversary Walk with a Future Doc (WWAFD) Texas event.
WHEN: Saturday, June 11, at 8:30 am (recurring monthly every second Saturday)
WHERE: LVTRise – 8201 Calmont Ave Fort Worth, Texas 76116 (Meet at the outdoor area behind the facility)
WHO: Dr. Maria Crompton, medical students, and any community members interested in participating
WHY: Walking is one of the simplest, best things people can do to live a long, high-quality life. WWAFD makes it easy by providing the time, place, motivation (a brief health information talk), and fellow participants for a fun walking experience.

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

The Walk with a Future Doc concept is simple: Physicians and medical stduents organize walks in their communities and invite their patients, their patients’ families, and community members to join them. Walkers will enjoy a refreshing and invigorating walk with Dr. Crompton and other health care professionals, who will provide support to participants and answer questions during the walk. Walk with a Doc Texas is overseen by a national nonprofit organization to get people active and healthy, and is backed by the Texas Medical Association (TMA) in Texas.

This is a FREE program, and preregistration is not required. Information about future walks will be announced on this chapter’s Walk with a Doc website.

Walk with a Doc is a nonprofit organization whose mission is to inspire communities through movement and conversation with physician-led walking groups. Walk with a Doc was started in 2005 by David Sabgir, MD, a board-certified cardiologist in Columbus, Ohio. To learn more, visit the Walk with a Doc website.

“All I wanted was help and to be treated like a human.”

A Project Access Tarrant County Patient Spotlight

By Allison Howard

“Rebecca” wasn’t looking for a miracle – she just needed to see a gynecologist. The 47-year-old mother of three was suffering from abnormal uterine bleeding. Her problem eventually became so severe that she had to quit her full-time job as a phone salesperson because she was drained emotionally and physically.

“I suffered a lot,” Rebecca says. “I was in a very dark place . . . I could not even drive because I was not well in all aspects of my life.”

But in spite of her clear need, between her financial limitations and immigration status, Rebecca was faced with a resounding chorus of “Nos” as she struggling to find the help that could turn her life around.

“I was crying all of the time because I could not find anyone to help me,” she says. “I was having constant bleeding that would last months. All I wanted was help and to be treated like a human.”

Eventually, she was able to receive mental health support through Health Services of North Texas. Through this program she was connected to a psychiatrist who began helping Rebecca manage her anxiety and depression. They also referred her to Project Access.

Dr. Carolyn Quist, a Project Access volunteer, agreed to take Rebecca’s case. After finding numerous cysts on both of Rebecca’s ovaries, she determined that they needed to be removed. She performed the surgery at Baylor Surgicare in Fort Worth, and anesthesia was provided by U.S. Anesthesia Partners.

“She took really good care of me, and she always asked how I was doing emotionally, which I believe she did not have to do, but she still asked,” says Rebecca of Dr. Quist. “She is not only an amazing doctor, but she is also a wonderful person. She explained everything to me thoroughly and patiently. I will never be able to repay all of the help she has given me.”

Currently, Rebecca is still gaining strength as her body heals, but her overall health is much improved. She has hope for the future, and gratitude for those who said “Yes” to her when she needed it most.

“Project Access is an awesome team, and I will always be thankful for their help,” she says. “Knowing that they offer help for people like me makes me so happy.”

Let’s Go Mobile!

Public Health Notes

By Catherine Colquitt, Tarrant County Public Health Medical Director

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

Tarrant County Public Health (TCPH), with its long history of providing vaccinations and testing in response to outbreaks and exposures, is rapidly expanding mobile operations to meet more testing, vaccination, treatment, screening, surveillance, contact tracing, and risk reduction education needs in our rapidly growing county.

TCPH staff and leadership have learned much during the COVID-19 response about taking services “local.” We have benefitted greatly from working with such partners as county, regional, state, and federal government agencies, as well as first responders, municipalities, the Tarrant County Medical Society, school districts, colleges and universities, primary and secondary private schools, preschools, childcare facilities, places of worship, and municipal and state emergency management and preparedness experts.

Responding to the need for mobile services with COVID-19 has reshaped healthcare delivery and has redefined preventive risk reduction and early/expedited treatment strategies for communicable diseases. It may also help us to move closer to the health equity we wish to achieve in our county and beyond. The COVID-19 pandemic has exposed disparities in access to vaccines, testing, accurate COVID-19 information, and expert advice regarding COVID-19 risk reduction strategies (masking, social distancing, practicing cough and hand hygiene, self-isolating when ill, quarantining after COVID-19 exposure, and vaccination).

As of March 24, 2022, some 2,894,773 COVID-19 vaccinations have been administered in Tarrant County, with 1,338,110 people (66.24 percent of eligible Tarrant County residents) having received one dose, and 1,179,080 people (58.37 percent of eligible Tarrant County residents) being considered fully vaccinated with one Johnson and Johnson vaccine or two doses of mRNA vaccines.¹

Essential clinical services offered by TCPH include immunizations; HIV testing, prevention, and treatment; STD screening and treatment; tuberculosis treatment; screening and contact investigations; drug treatment for latent tuberculosis infection; travel medicine clinics for advice; and vaccinations essential for safe international travel. We believe that a hybrid approach to the delivery of these services is vital to addressing health equity and access issues that could otherwise interfere with our objective of safeguarding the public’s health. We continue to operate our brick and mortar clinics across the county, but we must be nimble to serve communities which can’t easily access services in our fixed locations. We have a highly visible VaxMobile (an articulated city bus provided by our Fort Worth Transportation Authority partners), and we have purchased five mobile immunization trailers customized for the purpose. We have also purchased a 26-foot-long mobile van in which we can see clients for education, testing, and treatment.

We are ready, willing, and coming soon to your neighborhood. Remember, “Public Health is Where You Are”!

References

1.Data from Texas Dept of State health Services COVID-19 Dashboard
https://dshs.texas.gov/coronavirus/AdditionalData.aspx

JPS Health Network, Fort Worth ISD To Offer Free Sports Physical Exams for the New School Year

Physicians from JPS Health Network are offering free sports physicals for Fort Worth ISD student athletes on Saturday, May 21.

Fifty JPS physicians, including seven Sports Medicine Program fellows, Sports Medicine Program faculty members, and physicians in the Family Medicine Residency Program, will perform the exams. A comprehensive sports physical exam is required for Fort Worth ISD students to participate in athletics in the new school year. The free event is a convenient opportunity for students to get a checkup.

Also volunteering their time are more than 30 others, including JPS nurses, EMTs, and students from Texas College of Osteopathic Medicine, who will take vital signs. Other JPS team members have been enlisted to direct the students to various stations.

“We want to be involved in our community. We want kids to be able to participate in sports because it provides so many positives for our youth today,” said Sports Medicine Fellowship Program Director Michele Kirk, MD.

The mass physicals event has not taken place since 2019 due to the COVID-19 pandemic. Kirk noted that at past events JPS physicians have identified serious health problems in some teens while checking students’ readiness for sports. Athletes are referred to the appropriate physician providers for further evaluation and treatment in these situations.

JPS Sports Medicine physicians serve as team physicians for many high schools in Fort Worth ISD and Arlington ISD as well as being the team physicians for Texas Christian University, Texas Wesleyan University, and Southwest Assemblies of God University. They specialize in preventing, diagnosing, and treating injuries related to athletics and physical activities. To find out more about the JPS Sports Medicine program, visit jpshealthnet.org/get-care/services/orthopaedics.

Physical examination and medical history forms must be completed and signed by a parent or legal guardian by Wednesday, May 18. All FWISD athletes wanting to participate must go through their school and athletic trainer. Parents will not be allowed to bring their children in for the physicals themselves.

The Delicate Dance of Disseminating Information

By Siri Tummala, MS-II

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

“Cranial nerves two through twelve intact. Sensation is absent to light touch in right C5 and C6. Strength five out of five in bilateral upper and lower extremities. Bilateral hyperreflexia noted in patellar reflexes. No gait abnormalities,” I recite to my neurology preceptor. I quickly tap my right foot in nervous anticipation of disseminating the physical examination findings and their implications to the patient.

Context is everything. One year ago, abnormal neurological findings on an Objective Structured Clinical Examination (OSCE) would excite me. It was a free space to explore various pathologies in depth without fear of harming the patient. But this is not an OSCE. Gone are the days when hired actors pretended to be patients with medical cases. This is the real world with patients experiencing debilitating symptoms presenting to clinics. Now, abnormalities are not just an opportunity to see topics I learned in class or in a textbook last year come to life. Rather, abnormal physical exam findings in the real world can have devastating effects on individuals’ lives and on their overall wellbeing.

Informing patients about abnormal findings that warrant further imaging is not an easy task. I take a deep breath and knock on the door. I calmly deliver the news that his neck pain, hyperreflexia, as well as his numbness and pain in the middle and pinky fingers necessitates an MRI of the cervical spine for evaluation of possible cervical degenerative disc disease.

“So, I won’t know if I have that disease until I get the MRI?” asks the patient.

“Yes, that’s correct. Imaging is a tool we can use to confirm our clinical findings,” I reply.

The patient’s body starts to reflect the stress he feels from this information. Sweat beads form on his forehead. His brows furrow. His lips quiver.

“But it won’t be until a couple of weeks that I can get the MRI and have the results back,” he worriedly says.

I sense his uncertainty, and I spend twenty extra minutes with him. I calmly explain that it is normal to feel anxious about the unknown. I further explain that imaging is a helpful tool we can use to confirm our clinical findings. I reassure him that physical exam findings and imaging results together will allow us to formulate an efficacious treatment plan to fulfill his goal of improving his symptoms.

Our job as healthcare professionals transcends purely applying medical knowledge to real-life settings. The quality of the medical information we give patients is valuable only if it is delivered in an understandable manner that takes into consideration how that information affects their daily lives. If the pathology is prioritized over the patient, medical care will not suffer, but the patient will. Given that our primary duty is to ensure the wellbeing of patients, patient encounters are more fruitful when extra time is spent explaining the importance and relevance of the information. It takes years to fully master medical topics for medical students who spend all day studying and are constantly immersed in the material. It is not a fair expectation to assume that patients will recognize the significance of and be able to apply health recommendations without a clear and thorough explanation by the caregiver. Patients are real people, and this recent encounter reminded me that entering medical settings is a vulnerable situation that requires physicians to acknowledge their experiences with care and compassion.

TCU Medical Student Launches Barbershop Talk Therapy in Fort Worth

Antonio Igbokidi, a second-year medical student at TCU School of Medicine, brings Black men together to discuss mental health at a Fort Worth barbershop.

By Prescotte Stokes III

Originally published by TCU School of Medicine on May 10, 2022.

Creating a space for African American men to come together and have open dialogue about mental health is something that Antonio Igbokidi, a second-year medical student at TCU School of Medicine, had been trying to organize since he arrived in Fort Worth in July 2020.

However, he didn’t want to use a random space for this kind of communal gathering. He wanted it to be a place where Black men could let their guard down and speak freely. Igbokidi turned to a place that has been one of the cornerstones of the African American community since the early 19^th century, a barbershop.

“When I think about my childhood and my dad he spoke a lot more at the barbershop than he did at home,” Igbokidi said.

Igbokidi held his first Barbershop Talk Therapy session at Lake Como House of Fades Barbershop in Fort Worth in April. The event was done in collaboration with the Fort Worth ISD Family Action Center.

Igbokidi, who serves as the as the National Diversity Research Committee Co-Chairperson for the Student National Medical Association (SNMA), wanted the men involved to come out of the session feeling a sense of camaraderie.

“It’s all about figuring out ways to get men of color to have raw, vulnerable and organic conversations about mental health,” Igbokidi said. “Figuring out how to destigmatize and demystify mental health.”

Igbokidi was joined by members of the TCU School of Medicine SNMA Chapter as well as Brian Dixon, M.D., assistant professor at TCU School of Medicine.

Dr. Dixon is a psychiatrist with his own private practice in Fort Worth. He helped guide the discussion among the two dozen of men that came to the barbershop.

“It’s always fun to be in the classroom but to see one of my students actually out in the community doing some amazing work connecting people is amazing,” Dr. Dixon said.

For two hours, Igbokidi and Dr. Dixon, led the discussion where the participants talked freely about issues among Black men, young and old, in their community. The group shared their thoughts on crime, love, relationships, fatherhood, jobs and more.

“As a psychiatrist I’ve heard a lot in my day,” Dr. Dixon said. “But today was really poignant because it came from Black men and people who look like me. I’m really glad that they were felt safe enough to be in this space and share and that they trusted me with that honesty.”

Igbokidi also collaborated with the Black Heart Association to offer free screening for cardiovascular disease for anyone attending the session. Michael and Tara Robinson, co-founders of the Black Heart Association, were happy to be a part of something to help ease the hearts and minds of Black men.

“Everything flows through the heart whether it be mental or emotional,” Michael said. “As African American men we’re raised in a culture where we’re taught to be strong. Even as young boys there’s not a space for us to have safe conversations and be vulnerable.”

The men were able to get their glucose levels, cholesterol, blood pressure and risk of heart disease checked. The Black Heart Association has a mobile heart center where they go to barbershops, and other places, around Tarrant and Dallas Counties and offer free screenings for heart disease.

“We know that mental health plays a part in heart disease so this event was like the perfect marriage between what we do and what Toni is doing,” Tara said.

Igbokidi plans to continue the mental health sessions with his next stop being in the historic Stop 6 neighborhood in Fort Worth.

“I’ll have these same conversations whether or not they are larger or smaller,” Igbokidi said. “Just being able to have these conversations is going to bring healing. It’s going to bring understanding and it’s going to allow the communities to become stronger.”

Data Transfer Problems Burdensome for Practices, TMA Tells Feds

By Joey Berlin

Originally published by the Texas Medical Association on May 11, 2022.

The federal government is trying to standardize data sharing so electronic health records (EHRs) across the country can all speak the same language. The Texas Medical Association is telling the government to keep working on it.

TMA submitted comments on the draft of version 3 of the United States Core Data for Interoperability (USCDI), which aims to establish data-sharing standards “for nationwide, interoperable health information exchange.” USCDI updates come from the Office of the National Coordinator for Health Information Technology (ONC), which released the version 3 draft in January. The first version of USCDI became part of certain EHR certification criteria.

In an April 27 letter to ONC, TMA offered several suggestions on how to improve the proposed new version, including:

Assign “applicable vocabulary standards” to any data elements added to the USCDI so there’s an established way to refer to those data across EHRs. “Adding nonstandard elements will result in an enormous amount of vendor and end-user work that will simply create nonstandard data that are difficult to transfer. It also will create an excessive amount of rework in the future once applicable vocabulary standards are set for these data elements,” TMA said in the letter.
Test EHR vendors and users to ensure a smooth transfer of data from previous USCDI versions 1 and 2. TMA told ONC it is hearing from physicians already frustrated “because of the manual manipulation of data received [from EHRs] that places additional burden on practice staff who are already stretched thin.” Information that a physician receives from a hospital, TMA said, “is not always in a human-readable format or is so limited as to be not useful or actionable.”

In fact, then-TMA President E. Linda Villarreal, MD, and Ogechika Alozie, MD, chair of TMA’s Committee on Health Information Technology, urged ONC to delay finalizing and requiring the new USCDI version “until EHR vendors prove their users are able to functionally use USCDI versions 1 and 2 and that all data elements” are streamlined.

Hernia Surgery Changes a Family’s Future

A Project Access Tarrant County Patient Spotlight

By Allison Howard

“Patricia” has one main goal in life: to love and provide for her three young children. But when the single mother suffered from a painful umbilical hernia, it caused so much physical stress on her body that she was unable to work. And though she still trudged through family activities, the pain made her emotionally distant. Everything important to her was being compromised, and she worried about their future – especially that of her seven-year-old, who has special needs.

“The pain was bearable in the beginning, but as time went on it was getting worse, and my belly button was sticking out,” Patricia says. “I fortunately did not have to go to the ED, but I did resort to pain medication for relief.”

She knew continually taking pain medicine was not a good long-term option, so Patricia went to Mission Arlington for treatment, thinking she might have ovarian cysts. Instead, she found out about the hernia and that she would need surgery. In that moment, she was overwhelmed by fear.

“I did not have the money,” she says. “And who would take care of my kids? How would they be provided for? A lot of thoughts came racing through my mind.”

Then Patricia was connected to Project Access, and everything began to change. She realized she wouldn’t face the financial avalanche of paying for a surgery she couldn’t afford, and she was going to finally get help for the pain that was holding back every part of her life.

Patricia was connected to Project Access volunteer Dr. Mohamad Saad, who agreed that she needed surgery. He performed it at Texas Health Arlington Memorial Hospital, and anesthesia was provided by U.S. Anesthesia Partners – Arlington Division.

Now as Patricia heals from the hernia repair, she tries to put the impact into words.

“The surgery was done perfectly,” she says. “I don’t have any pain anymore, and when I have my menstrual cycle, it is normal. It is no longer heavy or overbearing. I can do anything now; I feel amazing!”

She thanks God for using the doctors and Project Access to provide much-needed care and prays that all who helped continue to be rewarded for their service. “I will always be grateful for everything Dr. Saad has done,” Patricia says. “I am so thankful for the support I received since day one and for guiding me through the process. I would not be where I am now without PATC.”