What Arizona Docs are Saying...
By Miriam Anand, MD, Allergy Associates & Asthma Ltd, Adrienne Forstner-Barthell, MD, Arizona Advance Surgery, Pamela Frazier, MD, Pamela T Frazier MD, Brenda LaTowsky, MD, Clear Dermatology & Aesthetic Center, Ann Cheri Foxx-Leach, MD, Nocio Interventional Pain Management, Paul Lynch, MD, Arizona Pain Specialists, and Edward Patterson, MD, Panda Pediatrics and Adolescent Care
From Print Issue - Winter 2021
Providing the best care to my patients inspires me to improve. I spend time outside of clinic reading medical literature, speaking with peers about challenging cases or new technologies, and researching new and alternative treatments for patients. – Brenda LaTowsky, MD
My philosophy is to treat every patient as if they were my own mom or dad. While my care is driven by medical knowledge, it is important to remember you are treating a person. I became interested in pain management when I was in medical school, as I experienced my mother-in-law suffering from end-stage pancreatic cancer. I became completely enmeshed in her care and saw how vitally important it was to provide pain relief and comfort. I often still think of that as I meet with patients and their family members. I can see myself in their shoes and know how desperately they want help for their loved one. – Paul Lynch, MD
To improve my knowledge because of the trust that my patients have in me. We are mandated by the state to obtain a certain amount of continuing medical education. But, more importantly it is the patients that motivate me to stay current on medical issues and treatments. – Edward Patterson, MD
Access to affordable care. Even patients with insurances often have deductibles that are prohibitive. Another challenge is on the PCP side, as their care model is structured against giving patients needed time and attention and focused on seeing mass numbers to pay overhead. – Adrienne Forstner-Barthell, MD
The pandemic has increased depression, anxiety, substance abuse and loneliness. It has been a year of people feeling more troubled, depressed, and anxious due to fear, uncertainty and confinement. The inability to travel and see loved ones has been a major loss for many. The elderly and people who live alone are especially affected. At the same time, it has been more difficult to see mental health practitioners in person. The availability of virtual treatment has been very beneficial to maintaining health and wellness. – Pamela Frazier, MD
COVID-19, healthcare disparities, and the erosion of the independent practice of medicine by physicians are major health issues facing Arizona. – Ann Cheri Foxx Leach, MD
Another pandemic has continued to grow by exponential numbers. Initial data have shown that more drug overdoses occurred in 2020 than ever before, and Arizona has been hit particularly hard. The COVID-19 pandemic has highlighted where our healthcare system falls short in providing adequate treatment for those suffering from substance abuse disorders. As a pain management physician, I experience the struggle of finding appropriate resources to assist these patients, including inpatient services and behavioral health options. – Paul Lynch, MD
Q1: What motivates you to improve as a physician?
Q2: What do you see are the major health issues in Arizona?
Meet the participating Physicians:
Miriam Anand, MD, FACP, FAAAAI, FACAAI
Practice: Allergy Associates & Asthma, Ltd.
Phone: (480) 838-4296
Locations: Tempe, Mesa, and Chandler
Adrianne Forstner-Barthell, MD, FACS, FASCRS
Practice: Arizona Advanced Surgery
Phone: (602) 993-2622
Locations: Avondale, Chandler, Gilbert, Glendale, Mesa, Peoria, Phoenix, Scottsdale, and Sun City West
Pamela T Frazier, MD
Practice: Pamela T Frazier, MD
Phone: (480) 425-7927
It is important for physicians to have some level of involvement in the policy process. This includes at their place of practice/employment by participating on committees or in a leadership role and supporting those who advocate for us in public policy through membership in organized medicine. – Miriam Anand, MD
I would love to see more physicians in leadership roles. If a physician is not wanting to pursue a leadership role, then there are other ways to promote health equity. For instance, during the shutdown in Arizona my practice set aside several telemedicine slots for uninsured patients. – Brenda LaTowsky, MD
Physicians should first enlighten themselves regarding health equity issues then aspire to become leaders in conversations about health equity. – Ann Cheri Foxx Leach, MD
We have a duty to treat every patient with dignity and respect and advocate for patients who may not be able to advocate for themselves. With respect to patients suffering from addiction, I think it is imperative the physician treat these patients without prejudice or judgment. Physicians must also be a voice in their communities and healthcare systems, to ensure that underserved patients are made a priority and provided equal access to care. We cannot shy away from difficult conversations regarding the state of our healthcare system or be afraid to stand up against healthcare bureaucracy. I acknowledge this takes time, commitment, and work, but as healthcare professionals, this is what we are called to do. – Paul Lynch, MD
While this is less of an issue in the urban areas, there are parts of our state where there are no allergists available and patients must drive long distances to get this care. However, there have been several positive changes over the years that will help. For decades, there were no allergy/immunology training programs in Arizona and we now have two. We also have a few new medical schools in Maricopa County, but increased Graduate Medical Education (GME) funding will be important to increase available residency slots to keep more of the graduates practicing in Arizona. – Miriam Anand, MD
It will make it harder for patients to get an appointment with a psychiatrist. A growing population will also require psychiatrists to work with psychologists and social workers to provide patients with the combination of psychotherapy and medication management that is necessary to attain and promote mental health wellness as well as growth. For many psychiatrists there will be increased pressure to see more patients, narrowing many practitioners to medication management. – Pamela Frazier, MD
More residents mean more patients and more dermatologists in the area. I see this as a positive. I love to collaborate with others in the community and I think more dermatologists will lead to potentially more dermatology residents and the opportunity for sub specialization. – Brenda LaTowsky, MD
There will be more demand for services in the face of decreasing reimbursements from third-party payors. This creates the challenge for physicians to meet demands with limited resources. Meanwhile, patients are complaining about rising insurance costs and, in some cases, less comprehensive insurance policies or higher deductibles. This does not seem fair to patients or physicians. – Ann Cheri Foxx Leach, MD
Q3: What role should physicians play in promoting health equity?
Q4: Arizona is growing rapidly. How will more residents impact your specialty?
Meet the participating Physicians:
Brenda LaTowsky, MD
Practice: Clear Dermatology & Aesthetic Center
Phone: (480) 398-1550
Ann Cheri Foxx Leach, MD
Practice: Nocio Interventional Pain Management
Phone: (480) 818-4314
Paul Lynch, MD
Practice: Arizona Pain Specialists
Phone: (480) 500-6038
Locations: Chandler, Gilbert, Glendale, and Scottsdale
Educate yourself about business, do not over commit financially when you get out of school. Most importantly always stay teachable and prepare to work harder and longer hours the first few years out of school to build your practice. Search out mentors and ask for advice and follow it- successful doctors got that way for a reason and most of us are happy to advise and help show others a good path. – Adrienne Forstner-Barthell, MD
We are fortunate to offer multiple medical school choices to students who want a career in medicine. Ours continues to be a dynamic, rewarding field. It offers opportunities for treating patients, doing research, and teaching. There are many challenges and rewards, offering different roles to physicians over the course of their careers. – Pamela Frazier, MD
Pursue what you love. If there is a specialty, fellowship or even technique or procedure that you want to pursue, do it. I feel so fortunate to love what I do. The days are so much easier if you have passion for your work, and this passion will get you through the hard times. Also, find a practice setting where you enjoy your coworkers. A positive and healthy workplace is so important and contributes to your mental health immensely. – Brenda LaTowsky, MD
Seek out a wide variety of experiences in various medical fields. There are many ways to help people that are fulfilling and a service to the community. -- Ann Cheri Foxx Leach, MD
I would advise aspiring physicians to be aware of physician saturation not only of physicians but of nurse practitioners. And that they should be committed to the medical care of patients as the reward and not as much financial. The field has many rewards in patient relationships and the trust they have for us as physicians. – Edward Patterson, MD
One of the issues that we face is that physicians often do not have a seat at the table when decisions are made that impact our ability to provide the best care that we can to our patients. History has shown us the impacts of this in relation to federal and state laws passed without physician input. Many have resulted in more “hoops to jump through” to care for our patients. Policies need to be developed that allow us to spend more time caring for our patients and less time documenting in the EHR, doing time consuming prior authorizations, etc. The recent E&M coding changes implemented by Medicare, while not perfect, are a step in the right direction. Changes that allow patients to have access to medical care and medications at reasonable costs are also needed. - Miriam Anand, MD
There needs to be reform of both the process to add new physicians to existing group practice insurance contracts (docs can end up shut out up to a year) and of the authorization of care for surgical services. – Adrienne Forstner-Barthell, MD
We need to support our physicians in practice. Physicians are at increased risk of experiencing burnout. Consequently, burnout must be recognized, confronted, and treated early to prevent mental illness and suicide which are at high rates for physicians. Better information about burnout and prevention must be included in medical school curriculum. Professional organizations for physicians, for example, MCMS, have an important role to play in providing guidance, education, and social involvement to physicians in training and practice. – Pamela Frazier, MD
I would love to see more control being put back in the hands of the physicians. On a political level, this would mean physicians had more say in policymaking. On an insurance-level, this would mean physicians would be involved in medical decision making for the patients. On a hospital-level, this would mean that physicians would be involved to decrease waste and increase quality of care. On an individual practice level, this would mean physicians would be adequately compensated so that they can spend more time with their patients. These are difficult things to achieve. However, if these changes are made, the quality of health care would go up dramatically. – Brenda LaTowsky, MD
Q5: Arizona now has six medical schools. What advice would you offer to aspiring physicians?
Q6: What policies or systemic changes are needed for physicians to provide better care?
DON'T FORGET TO CATCH THE NEXT WHAT ARIZONA DOCS ARE SAYING IN THE SPRING 2021 ISSUE
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