Guest Post: Pass a statewide smoke-free workplace law

By Kenneth Cooper, MD, MPH
Founder and Chairman
Cooper Aerobics Center, Dallas
 
Imagine working at a place where each employee is required to spend a full shift working in a room where the air contains 70 known cancer-causing chemicals, including formaldehyde, benzene and arsenic. As a condition of employment, the employee must consent to this environment or choose to work elsewhere.

Many Texans would say this is an intolerable situation that should not be allowed under any circumstances and that a business owner could never get away with knowingly putting employees at risk.

Thus it is hard to believe that thousands of Texans’ lives are put in danger each day in this exact way — those who make their living in restaurants, bars and other workplaces across the state that allow smoking. These employees are exposed to secondhand smoke day after day because there are no statewide protections in place.

One of the most dangerous health hazards in America today — one that is entirely preventable — is secondhand smoke. As the third-leading cause of preventable death in the United States, secondhand smoke kills 3,400 Americans through lung cancer and about 46,000 through heart disease annually.

In the past 55 years that I have been practicing medicine, I have seen the detrimental effects of secondhand smoke exposure, including asthma, allergies, throat and mouth cancers and bronchitis — not to mention lung cancer and heart disease. I have worked with many patients dedicated to living long and healthy lives through regular exercise, healthy diets and other preventive techniques, only to be diagnosed with one of these life-threatening diseases — all because they were unwillingly exposed to secondhand smoke. It is a disgrace that other people’s actions can cause such significant and preventable harm.

Few actions by state lawmakers will have a greater positive impact on the health and well-being of Texans than passing a statewide smoke-free workplace law. This law will protect employees and customers from the dangers of secondhand smoke, saving thousands of lives and millions of dollars for taxpayers. It is important for voters to understand the facts and benefits of a smoke-free workplace law as they make decisions on the future leadership of our state.

In addition to the health benefits, the numerous economic benefits this legislation would provide to our state are undeniable. Businesses, employees and taxpayers would all benefit from statewide smoke-free legislation because of insurance coverage, health care costs and other direct and indirect costs of secondhand smoke exposure. In fact, a 2011 study estimates that a statewide comprehensive law against smoking in the workplace would benefit the Texas economy by more than $400 million in health care costs and productivity savings each biennium.

Opponents argue that business owners have a right to choose whether they want to allow smoking inside their establishment. While I respect that business owners have the right to make decisions on behalf of their business, that right should not override an individual’s right to not have his or her most private property — their lungs — harmed by the choices of others. Businesses should not continue to put their employees in harm’s way.

Many cities have adopted comprehensive ordinances that prohibit smoking in indoor workplaces, but unfortunately many Texans live in unincorporated cities or rural areas where no entity exists to pass or enforce this type of legislation. Without a statewide smoke-free workplace law, millions of Texans will remain unprotected from secondhand smoke exposure.

Last session, Texas was closer than ever to passing this legislation, thanks to the tireless work and dedication of many of our state’s leaders and thousands of others who continue to actively voice their support for the legislation. The involvement of concerned Texas voters throughout this election cycle is critical to ensure our state’s leaders make this issue a priority in 2013.

Kenneth Cooper, MD, MPH, specializes in preventive medicine and is founder and chairman of the Cooper Aerobics Center in Dallas.

U.S. Physician Compensation Among Lowest

The United States may have a reputation for having one of the most expensive health care systems in the world, but it apparently is not because of physician payments.

According to a study released in May by Jackson Healthcare, physician compensation in the United States is among the lowest of the major western nations.

Payments to physicians accounted for 8.6 percent of total health care costs in the United States in 2011. That was about $216 billion of the $2.5 trillion spent on health care. Only Sweden spent less on overall health care costs dedicated to physician compensation with 8.5 percent allotted to the costs of paying doctors.

Germany topped the list for physician compensation, with 15 percent of its health care costs going to pay physicians. Australia was next at 11.6 percent, France at 11 percent, and the United Kingdom at 9.7 percent.

"As we continue to debate how to reform health care, many often blame physicians' salaries for driving up the cost of health care," said Richard L. Jackson, chair and chief executive officer of Jackson Healthcare. "What this illustrates is that the compensation for American doctors is not what is driving up health care costs in our country."

The data was provided by Overseas Employment Development Board and a 2011 Physician Compensation Survey by Jackson Healthcare, a health care staffing and technology company.

Tarrant County Physicians Provide Free Care to Uninsured Texans

When an uninsured, low-income Texan gets sick, affordable and comprehensive medical care often is hard to find. Project Access Tarrant County (PATC) aims to change that. Last September physicians from the Tarrant County Medical Society created PATC to ensure patients who do not receive health care through regular health insurance, Medicare, Medicaid, or TRICARE can get the care they need.

Since its creation, PATC has recruited more than 200 physician volunteers who have donated more than 500 hours caring for patients enrolled in the program. PATC goes beyond providing routine medical care. The program establishes a medical home for all its patients. In addition, it provides specialist referrals; surgeries; lab, radiology, medication, and translation services; and navigation services for accessing public benefits. PATC also helps individuals regain independence so they can return to work, care for their family, and interact with their community.

In the words of patients:

“PATC is an awesome program, and I am grateful I was given the opportunity to see a specialist. Before seeing a specialist, I was a prisoner in my home. Thinking about what PATC has done for me makes me want to cry, and this program has given me my life back. ”

“For the last three years, I’ve been losing my vision, and for the last year, I could only see blurry images out of my right eye. I give thanks to God I was able to get help from the program (PATC) because I am finally able to really see my grandchildren. I can make out their faces, and that makes me happy. I know that after I recover I will gain some of my independence back because I won’t need someone to hold my arm everywhere I go. I look forward to going out more often and not staying home for the fear of falling. I feel truly blessed, and give a million thanks to everyone from the program, especially to the doctors who went out of their way to help me.”

The experience is rewarding for Tarrant County physicians too. “I thoroughly enjoyed being able to help provide necessary care for a PATC patient. Working with PATC was seamless, and I will be happy to continue to provide my services to those who need it in Tarrant County. I know that I cannot make a massive change locally or internationally, but to the person that I help, it is massive,” said a physician volunteer. “This is what medicine is really all about,” said another.

Other Project Access programs are available through the Collin, Dallas, Denton, Harris, and Travis county medical societies.

Related: Filling the gap: Community partnerships securing access to health care - Fort Worth Business Press

Better Care, Better Health, Better Value … and PSA Testing

Vince Fonseca, MD, MPH, FACPM, is founder of the Population Health Institute of Texas and director of medical informatics at Intellica.

Only by physicians working together with our peers, patients, employers, insurers, health care organizations, and community groups will we get better care, better health, and better value in Texas. We, and the nation, have a long way to go along this journey, but we can see what the next steps should be.

The latest U.S. Preventive Services Task Force (USPSTF) recommendation on PSA prostate cancer screening provides a good opportunity to work on these issues. The benefits of prostate cancer screening and treatment in a cohort of 3,000 55- to 69-year-old men for 10 years are very small: zero to three lives saved. The harms in this cohort are much larger: Ninety to 120 men will develop erectile dysfunction or urinary incontinence; six men will experience a serious cardiovascular event (e.g., heart attack); one man will develop a serious blood clot; and one man will die of surgical complications. This is why USPSTF recommends to not routinely screen men but to engage the patient in shared decisionmaking about whether to initiate or continue PSA screening …and why Otis Brawley, MD, chief medical officer of the American Cancer Society (ACS), agrees with the new recommendation.

So how do we put this into practice? Whether or not to be screened is a decision each man should make once he understands the facts and based on his own values and preferences. It will take a persistent, committed, multitargeted effort to do better in decreasing the impact of cancer in Texas, especially related to prostate cancer. Even after the 2008 USPSTF recommendation to not do PSA screening routinely in men over 75 years old, 60 percent of men over 75 had PSA testing in 2010, according to the Center for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System … the same proportion as before the recommendation in 2006. The 2012 USPSTF recommendation, without supporting activities, is likely to return similar results.

Website Shines Light on Human Brain, Debunks Myths

BrainFacts.org, a website created by The Kavli Foundation, the Gatsby Charitable Foundation, and the Society for Neuroscience offers insights into one of the most fascinating and complex organs — the human brain. The site provides up-to-date, scientifically reviewed information on the brain, including new discoveries in neuroscience, information about neurological and psychiatric diseases, and educational material for teachers.

BrainFacts.org also debunks popular myths about what exactly happens inside our brain. For instance, despite commonly held beliefs, listening to classical music will not make your baby smarter (although playing an instrument might), and solving crossword puzzles will not keep your brain young (but physical exercise will).

Half of Overweight Teens at Risk for Heart Disease

A new study by the Centers for Disease Control and Prevention revealed that half of overweight teenagers and 60 percent of obese teenagers in America have at least one risk factor for heart disease. These risk factors include high blood pressure, high cholesterol, and high blood sugar levels. The study also found that since 1999, the percentage of diabetic or prediabetic teens in the United States rose from 9 percent to 21 percent. Teenagers diagnosed with these health conditions are at risk for heart diseases that usually affect only older generations — diseases like heart attack and stroke.
 
Read more.

Texas Physicians to Tackle Medicine's Top Issues at TexMed

More than 1,500 physician leaders and health care experts will convene in Dallas Thursday through Saturday for TexMed 2012 — the Texas Medical Association’s annual conference. Participants will examine critical health care policies on the state and national level and discuss strategies to help physicians care for patients in a time of change. Some of the proposals before the association’s policymaking House of Delegates include:

• Work to make sure rules governing the state’s Women’s Health Program “do not interfere with physicians’ ethical and legal obligations to provide medically accurate, candid, and unbiased advice to obstetric patients”;
• Require clarity for the public regarding the difference between physicians and other “doctors”;
• Repeal payment cuts to physicians who care for “dual-eligible” (Medicaid/Medicare) patients;
• Make “smoke-free Texas” a top legislative priority for 2013;
• Restore funding for state family planning services and the Women’s Health Program;
• Lobby to generate more residency slots and regain full funding for the Physician Education Loan Repayment Program;
• Improve access to vaccines provided through the state’s adult immunization’ program; and
• Work with the Department of Public Safety to streamline processing of controlled substance permit applications.