>>SINGER: Hi, I’m Steve Singer, I’m the Director of Education and Outreach at the Accreditation Council for Continuing Medical Education.
>>DALRYMPLE: Hi, I’m Billie Dalrymple Director of Continuing Medical Education at the Texas Medical Association in Austin, Texas.
>>SINGER: Hi, Billie, welcome.
>>DALRYMPLE: Hello to you, thank you for inviting me.
>>SINGER: My pleasure. Today we’re going to talk about a unique perspective that you’re going to share about working at a physician membership organization and some novel things that you’re doing in order to both increase value for the membership, for the physician membership of your organization and also, help to achieve the mission of the organization within Texas to improve the health of people of Texas. So, tell me a little bit about the organization that you work at.
>>DALRYMPLE: Well, it’s called Texas Medical Association, we have about 47,000 members which is approximately 82 to 83 percent of the physicians who are licensed in Texas, so we’re pretty proud of that. We have a wide membership base including medical students, residents and practicing physicians. We have a number of physicians who are licensed who are members of our association who actually live in other states right now but they want to maintain their membership and license in Texas. We, I guess the focus of what TMA is offering our physicians right now are services and products around managing their practice. We feel like that’s a niche for us. And one of the things that we have embraced in the last few years is to support our physicians in their journey of trying to accomplish quality improvement in their practice.
>>SINGER: OK. So, explain for me just for a moment what is your role at the Texas Medical Association?
>>DALRYMPLE: At the Texas Medical Association I’m the Director of Continuing Medical Education and I work for a committee – a committee on continuing education – that oversees TMA’s function as an accredited CME provider and as an accreditor within Texas. And our committee reports to the larger council on medical education which oversees all educational functions as far as establishing policy on graduate medical education, continuing medical education, and undergraduate medical education.
>>SINGER: OK. So, as we talk and sort of explore this, the TMA’s role in support of physician practices, both from a practice management side and also, sort of as a component of that, the quality side, I’d be interested to know, sort of, as we go how your role in CME has sort of evolved or you know, how that it is connected to these efforts as you go forward.
>>DALRYMPLE: Well, I think, I’ve been at TMA for 25 years and one thing I’ve learned in the last few years especially is that I just need to know something about everything.
>>DALRYMPLE: that goes on within TMA but it helps us decide where the education ought to occur. And it helps us to be able to offer services or CME in all the areas that TMA decides to work in. Just for instance, one thing we’ve established on our Web site is a calendar. It’s called Deadlines for Doctors and it includes anything relevant to their practice. Like if CMS, the Centers for Medicare Medicaid Services, has deadlines for doctors to sign up for something or implement some of their policies, it will be listed on this calendar. And then, when you click on what it is all the resources that TMA provides to the physician to help them meet this deadline are there. And CME
>>SINGER: For reporting
>>DALRYMPLE: for reporting and CME is always or some sort of educational component is always part of that deadline. You know whether it’s HIPAA or coding or whatever it is we have other folks in the association who are on top of these deadlines and they put them on there and then the CME unit comes together to provide educational resource to support those things.
>>SINGER: So, if the calendar that you use is one example of how you are sort of identifying what are the things that your physicians need to be aware of or what are the things they need to participate in and providing them sort of resources and reminders sort of in the place where it would be helpful to them to have that resource. Can you provide an example of how you sort of looked at the environment and found a niche with regard to quality?
>>DALRYMPLE: Yes, definitely. In our governance we’ve established a council on healthcare quality and we’ve asked doctors to participate in that who are first interested in members of TMA but we also have consultants on the committee that work for insurance companies as well as someone from CMS. And we, and this council has made its charge to provide tools for the doctors. And the first thing that they’ve done is a set of prevention tools and they’re calculators. Where on a, let’s just say pneumonia, for example, you might click on that on our Web site and you would be given directions on what the codes would be for that and then your own patient data for that and the doctor can see right then if he’s met the quality standard and whether or not he’s going to get paid or reimbursed because of what he has done. So, that’s one example. We have a list, of the first category is prevention in medicine, and the second project that the council has taken on is to offer a poster, a quality poster project at our annual meeting, which is coming up in May. And what we have done is invited physicians in Texas to put together some information about any quality project that they have participated in
>>SINGER: within their practice?
>>DALRYMPLE: within their practice. This is real life what you have done would be a best practice for other physicians to be able to look at and describe it on a poster and be available to talk about it as well. And the content must be around on some aspect of quality measures such as safety, or patient efficiency those sorts of things, and we’ve actually designed it into a CME activity. So, the posters will be set up in a room we can invite participants to come read all of them and talk to the author of it and learn from what they’ve done. And we’ve offered it, we’ve said we would take a maximum of, I believe, of 30 posters. We’re hoping we have 10 on this first year’s.
>>SINGER: Right right
>>SINGER: So it’s growing
>>DALRYMPLE: So it’s growing, it’s growing. It’s growing, very excited about this. So, that’s one of the other initiatives, like I said the council is very young it’s only been established since 2011.
>>SINGER: As you are working to you know along this sort of continuum to integrate quality improvement into the things that you do and the services you offer your physicians and you mentioned you’re sort of developing a learning community where physicians are bringing their, the work that they’re doing and teaching others, and working with others. You had mentioned to me in an email that you are also going to become involved with the American Board of Internal Medicine’s choosing wisely program. Can you tell me a little bit more about that?
>>DALRYMPLE: Yes, this is a program that encourages physicians to really evaluate the tests and services they might provide for physicians and look at the ones that they might not choose, in the past they might have, there has begun to be evidence that there are some tests that really don’t help in diagnosis and in treatment of the patient. And those tests are being identified by the specialty societies from their very own practices as ones to consider. And so, TMA applied for the grant from ABIM to participate in this project and we were accepted by ABIM and now we are waiting for formal acceptance by our governing body for participation and ideas for how we might implement that in Texas.
>>SINGER: So, the plan is still in formation?
>>DALRYMPLE: It is.
>>SINGER: in terms of what you are going to do? But that’s exciting because it’s
>>DALRYMPLE: It’s very exciting
>>SINGER: it’s another opportunity for you sort of, you know, you said before or that you’ve learned in your 25 years that you need to know a little something about everything
>>DALRYMPLE: That’s correct.
>>SINGER: But the way of, that’s a very modest approach. Another way of sort of flipping that around for you is that you have insights to all these areas that you sort of within the CME function are bringing value to all these different areas by sort of integrating you know, your strengths in helping to educate and develop these sort of communities of learning within the program. OK. Thanks very much.
>>DALRYMPLE: You’re welcome.
This is a transcript of Addressing Physician Professional Practice in Flux.
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