Law and Order and Medicine Collide
“There is nothing more important to me
as a physician than your cancer treatment.
I’ve been in practice for nearly two
decades and have had the privilege of
telling many patients that there is life
beyond cancer. As president of The Center
for Cancer and Blood Disorders, I want to
lead by example, practicing a firm belief
that all patients should receive the finest
medical care available, with the same
concern and compassion as a cherished
member of the family.”
Ray Page, D.O., Ph.D.
President and Medical Oncologist
The Center for Cancer and Blood Disorders
Indeed, as in every aspect of society, the House of Medicine continually collides
with Law and Order. It is extremely difficult for physicians, who spend a zillion
hours on patient care activities, to dedicate additional time dealing with the
nuances of legislation and regulation that can directly impact patient care.
However, it is of extreme importance that physicians work with our lawmakers
to assure that we all get the best in healthcare delivery.
We just finished the 2017 Texas Legislative session, and I spent a lot of time on
Capitol Hill, phone calling, networking, and letter writing. Often our successes
are in squashing bad bills and making sure they don’t get passed. Others laws
are passed that impact physicians and patient care.
Physician Maintenance of Certification (MOC) has been a big issue nation-
ally for physicians for a number of years as the new certification process is
expensive, time consuming, conflicted, and does nothing to impact patient care
or the quality of the physician. To make things worse MOC has moved beyond
the self-regulation processes of our board certification agencies and have gotten
into interference of our ability to practice medicine. It has been a long battle
controlling these MOC boards and sometimes, with reticence, we have to get
legislative help.
I have presented at the House of Delegates (HOD) of the American Medical
Association, and my wife, Sheila Page D.O., has done the same as a delegate of
the American Osteopathic Association to achieve their support in resolutions
and policy that dissociate MOC from state licensure, hospital privileges, and
the ability to get on insurance plans.
Through the grassroots efforts of physicians at the Texas Medical Association
and the Association of American Physicians and Surgeons, physician-senator
Dawn Buckingham took the lead (and the heat) to get SB 1148 passed into
Texas law to control the tyranny of MOC. This is a huge win for the physicians
of Texas!
Texas also passed new laws that have set standards to assure safe telemedicine
services that are similar to in-person exams. I believe these laws will allow
safe expanded access to care, particularly in rural and underserved areas. We
must continue to assure, however, that Texas patients are cared for by Texas
physicians, where licensing with the Texas Medical Board is one of the most
stringent in the country.
Accordingly, in Special Session, our legislators agreed not to sunset the Texas
Medical Board, but more importantly elements of the Interstate Medical
Licensure Compact were successfully removed from that law, therefore our
doctors will not share a common license with doctors, say, from West Virginia
or Oregon who could potentially telemedicine their services.
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817-596-0637 or online at
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To learn more about cancer care issues or to consult with a physician
about a cancer diagnosis, contact us at 817.596.0637.
I have had a face-to-face meeting with one of the Medicare Medical Directors
and I am currently writing a resolution which I will present to the AMA HOD
to get into policy. I am confident we will get this “14-day rule” changed which
will be of great benefit to cancer patients across the country.
There is WAY more to discuss….for another time.
Nationally, I am currently working hard to change the “14-day rule” which is
adversely impacting our cancer patients. This impacts our cancer patients who
get tumor biopsies in the hospital and the cancer doctors want to do complex
modern molecular tests (which are expensive) to be able to best characterize
the cancer and guide treatment options. Currently, the Medicare rules state that
if these tests are done within 14 days of the hospital procedure then the cost
gets billed under the hospital bundle. Therefore, hospital pathology depart-
ments will not do the necessary tests until >14 days, thereby placing substantial
delays in the appropriate treatment of symptomatic cancer patients.
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