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Health Care Behind Bars, P. 20 NEWS OF THE TEXAS MEDICAL CENTER — VOL. 4 / NO. 3 — APRIL 2017 Health Care Behind Bars, p. 20 SPOTLIGHT: ELLEN OCHOA, p. 6 MEDICINE AFTER THE HOLOCAUST, p. 14 SILENT PROFESSORS, p. 28 YOUR HOME NOW YOUR HOME NOW YOUR RATE NOW FOR 1% AT URBAN LIVING UP TO 180 DAYS HoustonOwnIt.com 713-868-7226 West Side Villas La Branch Modern Museum Terrace Spring Branch East From the $530’s Museum District From the $470’s Museum District From the $460’s Hartman Court Skyline On Indiana Montrose Park Villas Rice Military From the $450’s Montrose From the $930’s Montrose $599,900 713-868-7226 5023 Washington Avenue www.UrbanLiving.com 1. Reserve You Home Now for 1% is for select developments that will be negotiated at the time of offer. Ask Urban Living for details. 2. Personalize Your Home Now at Urban Living is for select developments depending on available selection. www.urban Inc, TREC Broker #476135 3. Lock Your Rate Now up to 180 Days is contingent on full application, receipt of all required documentation, desktop underwriting, and approval through Verity Mortgage- Memorial. (An Equal Housing Lender. NMLS 70345) RETHINKING WHAT’S POSSIBLE TO GIVE HEART PATIENTS NEW OPTIONS. Physicians at Houston Methodist DeBakey Heart & Vascular Center are pioneering new solutions for patients with common to complex heart conditions. Through specialized programs, clinical trials and a commitment to challenging conventional thinking, our team of specialists are improving outcomes and providing new options to those who previously had none. Our team of physicians treats a variety of disorders, including: § Adult congenital heart disease § Coronary artery disease § Atrial fi brillation (AFib) § High blood pressure § Cardiac arrhythmia § Valve disease § Cardiac tumors For more information on our comprehensive heart services, visit houstonmethodist.org/debakey; or to schedule an appointment, call 713.DEBAKEY. TMC | PULSE Vol. 4 No. 3 April 2017 Executive Vice President, Chief Strategy Ofcer and Chief Operating Ofcer Connect William F. McKeon Vice President of Communications with Christen Bagley Pulse Editor Us Maggie Galehouse [email protected] Digital News Editor TMC Pulse Shea Connelly [email protected] Pulse is the award-winning monthly news magazine of the Texas Medical Center. Pulse is the voice for patients, families, Staff Writers researchers and health professionals in the medical center Alexandra Becker Shanley Chien and beyond. Christine Hall Britni N. Riley Photojournalist TMC.edu/news/ Cody Duty The TMC News website covers the latest news and events NEWSROOM happening at the Texas Medical Center’s member institutions. 713-791-8812 [email protected] ADVERTISING Felicia Zbranek-Zeitman TMC Today 713-791-8829 TMC Today, a weekly email, highlights the most recent [email protected] TMC News updates as well as upcoming events and stories DISTRIBUTION from external news sources. To sign up, click “subscribe” on the Daniel Martinez TMC News home page. 713-791-6136 [email protected] TMC Pulse is an award-winning monthly publication of the Texas TMC Social Media Medical Center in Houston, Texas. TMC’s social channels offer access to an established network Permission from the editor is required to reprint any material. of followers. Facebook | facebook.com/texasmedcenter Twitter | @TXMedCenter Instagram | @thetexasmedicalcenter 2 tmc» pulse | april 2017 Table of Contents april 2017 6 Spotlight: Ellen Ochoa, Ph.D. 12 10 Solutions 27 On the Side: Ready to Reset Dianna Riall, RN ................................. Electroconvulsive therapy (ECT) 35 Curated: Brandon Lack helps some patients with depression. Left: The Thymatron System IV 38 Field Notes records the brain’s reaction to ECT treatment. 40 Calendar 17 Med School at 40 ................................. Shasta Theodore, Ph.D., wants to expand access to health care for the underserved population. 30 Auto Play ................................. The Texas Medical Center is named an automated vehicle proving ground. 32 A Community Bridge ................................. Together, Cuney Homes residents and UH students learn to be community health workers. on the cover: Ofenders walking in the main hall of the Estelle Unit in Huntsville, Texas. tmc» pulse | april 2017 3 The Future of Health Care The American Health Care Act failed. So what sort of plan do Americans need? By Arthur Garson Jr., M.D., M.P.H. ny national health care overhaul to define, but going forward, legislators A must embrace the basic needs who want to rework Obamacare will of the individuals it aims to serve and have to get specific. acknowledge the particular challenges Providers should receive for the professionals and institutions pay based on the quality of care. providing the care. Physicians, nurses and other medical House Speaker Paul Ryan of Wisconsin at a news conference following a Republican party Under President Trump, health workers should be paid a base salary conference at the Capitol on March 15, 2017. Credit: AP Photo/Andrew Harnik care in America was poised for change. for their level of expertise, along with a But the bill to repeal Obamacare—the bonus that corresponds to the quality of American Health Care Act (AHCA), care they deliver. Berwick; fund a streamlined electronic their physicians salaries. All should. sometimes called Trumpcare— The fee-for-service model—in which health records system, which could This could save from $190 billion to never even made it to a vote. House doctors bill based on the procedures generate $81 billion in eventual yearly $300 billion per year. Republicans pulled the bill in late March used to treat a patient—should be a savings, according to Rand, a global The next big health care overhaul— because they knew it wouldn’t pass. So, thing of the past, as it encourages nonprofit think tank; and attack chronic or the insurance industry itself—should for now, Obamacare stays. unnecessary tests and procedures. disease, which would help reduce emer- create catastrophic plans that can be As we pause in this race to reinvent Currently, providers spend just gency room visits, readmissions and bought by anyone. The design of the the way Americans receive care, let’s 55 percent of their time caring directly unnecessary admissions to facilities. plans is not trivial: The plans would take a moment to outline the baseline for patients, while the rest of the time is cover accidents, of course, but when tenets of any sustainable health plan consumed by administrative tasks. We would they start covering heart failure? that intends to serve the common good. need well-functioning electronic health The challenge is that these plans would People deserve access to afford- records that streamline care instead of With the AHCA off the table, at need to be affordable, which means a able, adequate health care. When we adding time and hassles. Finally, health least for the present, Americans are left low premium plus a low deductible. talk about “access” to health care, we systems should receive payment in a with Obamacare. Now what? The mistake of Obamacare is that mean that a patient should be able to way that encourages innovation and Obamacare expanded Medicaid less expensive plans typically have see the right medical practitioner, at rewards value. to the poor between ages 19 and 64. higher deductibles. the right time and in the right place. The American health care system Many legislators did not realize that The only way insurers can stay That place may be via email or video; should improve cost and quality, and about two-thirds of the people who are afloat is if healthy people buy their it is certainly not an emergency room, increase life expectancy in patients. uninsured actually work, but could not plans. We know from our Texas Medical unless the patient is experiencing a true Cost and quality must be considered afford the premiums and the deduct- Center-Nielsen survey that 96 percent health emergency. together. We don’t want to reduce cost ibles, now totaling about $6,500 for a of people across five states said they “Affordable” refers to the total only to have quality suffer. According to single person. would buy insurance if it was affordable. out-of-pocket cost for which a patient Donald Berwick, past administrator of Medicaid expansion and the pre- Let’s not just stare at the future, is responsible—the premium plus the the Centers for Medicare and Medicaid mium subsidies totaled about $190 bil- let’s do something. Let’s put bipartisan deductible. Ideally, these costs should Services, we waste one-third of our lion per year—and with current prices, groups together to consider these and be no more than five to 10 percent of a health care dollars—about $1 trillion per amazingly, that wasn’t enough. other ways to reduce cost. The health of patient’s income: for lower incomes, it year—on overtreatment, failures of care Really, the only way to deal with the nation depends on it. should be five percent. For example, if coordination, failures in execution of this problem is to make health care and a patient earns $20,000 a year, then, he care processes, administrative complex- health insurance less expensive. We Arthur “Tim” Garson Jr., M.D., M.P.H., is or she should expect $1,000 in out-of- ities, pricing failures, fraud and abuse. could start by paying doctors salaries director of the Texas Medical Center’s pocket expenses. This is not the case If we could just save 15 percent of this and giving bonuses for quality of care, Health Policy Institute. Parts of this with Obamacare, which costs $6,449 for waste, we could pay for the uninsured. eliminating the perverse practice of essay have been published previously someone who makes $20,000. That’s Here are three ideas: pay physicians a paying doctors for every procedure in The Hill.
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