Health Enewsletter December 2015

View this email in your browser

Why rheumatology and dermatology?

Medical Assistants Shirley and Vicki use X-rays and bloodwork to help Dr. Chapman diagnose arthritis
Get your flu shots!

Bluff City Medical Society Lectureship 11/13/2015: Dr. James Hildreth, President of Meharry Medical College:     How HIV Disease Develops in the Body.

Emily Woodbury Confers with Dr. Woodbury

Dr. Woodbury and the 24 grassroots coffees with legislators this fall about healthcare legislation in Washington DC and Nashville TN

Rheumatology and Dermatology Associates
8143 Walnut Grove Road
Cordova TN 38018

View this email in your browser
Dr. George
Woodbury and Dr. Cathy Chapman
Rheumatology and Dermatology Associates
8143 Walnut Grove Road
Cordova, TN 38018
 (901) 753-0168

Dr. Woodbury explains: 
Why Rheumatology AND Dermatology?

Since the skin and the joints are both connective tissues in the body, there is actually a fair amount of overlap between Dr. Chapman’s specialty of rheumatology, and my specialty of dermatology. The word “rheumatology” means “the study of rheumatism, arthritis, and other disorders of the joints, muscles, and ligaments.” The word  “dermatology” means the study of the skin, hair, and nails. So our specialties are close cousins. Among the medical conditions that both of us treat is lupus, which is an autoimmune condition in which the body’s immune system attacks certain tissues, particularly the joints and the skin.

Psoriasis is another condition with a lot of overlap between rheumatology and dermatology, since it often first presents in the skin, particularly the scalp and the extremities. About 1/3 of psoriasis patients also have joint pain, particularly in the hands, the extremities, and the spine. We often treat psoriasis with what are call systemic agents—like methotrexate pills or biologic drugs—since after all psoriasis affects the whole body. Other conditions with overlap between rheumatology and dermatology include dermatomyositis, scleroderma, and vasculitis, as well as certain drug reactions.

Dr. Chapman and I have been in practice together since 1993, and ours is one of about six conjoined clinics of rheumatology and dermatology in the United States. We've also been nmarried since 1988.
George Woodbury Jr. M.D. 12/03/2015

Sorting out arthritis also  involves laboratory tests. Here Medical Assistant Shirley draws blood to help Dr. Chapman monitor the severity of a patient’s arthritis. 
Medical Assistant Vicki gets ready to do an X-ray to help Dr. Chapman diagnose a patient’s arthritis. Ultrasound also helps.


Flu shots!
Don’t forget to get your winter flu shot, which gives you some immunity against flu.


Rheumatology and Dermatology Medical Assistants Vicki and Shirley encourage families to learn about their skin conditions through both printed and on-line tools. The phrase is "improving patient engagement" in healthcare services. Knowledge is helpful in getting people better.

Drs. Chapman and Woodbury have many printed materials about joint and skin conditions. Ask us for for more background information on your condition.

Check out the American Academy of Dermatology web site or the American Society of Dermaotlogic Surgery web sites. 

Here Rheumatology and Dermatology Office Manager Lynn Moss confers with Emily Woodbury, medical student at Columbia University, and Dr. George Woodbury. Emily will be graduating in May of 2016, and is currently applying to programs in gynecology and obstetrics. She  envisioned the idea of this Health Enewsletter while in Youth Legislator in high school, at the Hutchison School, in Memphis. 


Dr. Woodbury met with Representative Antonio Parkinson on Friday 11/13/2015 (TN-98; Bartlett TN): This fall. Dr. Woodbury's been the matchmaker for the grassroots meetings of legislators with with physicians and medical students in Western Tennessee.  The topics of discussion have included:

The Payer Accountability/Healthcare Provider Stability Act: SB 937 by Watson; HB 963 by Lundberg: which bill, which I would SUPPORT: Limits how often a health insurance entity can make changes to either fee schedules or payment policies that affect provider reimbursement. This Act promotes stability in the practice of medicine.  

Physician-Led, Patient-Centered, Team-Based Care: Healthcare works on a day to day basis in Tennessee because doctors work together with nurses. Legislation called Physician-Led, Team Based Care(SB521 by Hensley/HB861 by Harrison) would establish that the physician is the head of the healthcare team. Oppsing legislation called the Nurse Independent Practice legislation as introduced by Rep. Joanne Favors of Knoxville would enable nurses to practice without oversight by physicians. This proposed change would do a disservice to our state’s population by creating confusion on the part of patients, and it would erode patient confidence in their healthcare team by establishing multiple captains.
Tenncare Audits of Primary Care Physicians:
The Affordable Care Act established
the need to expand primary care services and established an incentive program whereby primary care physicians could be paid at the higher Medicare rate for services to Medicaid patients (i.e. Tenncare). The Center for Medicare and Medicaid Services thereafter wrote up audit regulations for the incentive program, which ran for 2013 and 2014. CMS’ rules for this incentive program were unfortunately written in an unfair way so that the physicians had to be either board-certified in a primary care specialty; or they had to provide 60% of their office services (CPT codes) as either office visits or vaccines. Bloodwork and X-rays would count against this 60%, if the doctor was not board certified. The Bureau of Tenncare started audits in early 2015. Unfortunately, all Tennessee doctors in Tennessee participating in this incentive program were audited in 2015, and 350 of the 900 doctors failed the audits, resulting in "recoupments."These actions by CMS and Tenncare will certainly eliminate primary care services from communities at need. Representatives Steve Cohen and John Deberry are both working on this problem.
Tort Reform:
Constitutional Amendment on Caps for Non-Economic Damages: With two court cases challenging the 2012 tort reform law, several Tennessee legislators are looking at the process of adopting a constitutional amendment that allows the General Assembly in Nashville to set caps on non-economic damages, as has been done in Texas, where there is currently a surge in physicians applying for licensure because of a more stable liability climate there.

Patients for Fair Compensation: this is a group out of Georgia which is seeking to gut our existing medical liability system in Tennessee, which is currently based upon medical negligence, and to replace that system with the principle of “medically avoidable harm.” This group seeks to do away with trials, juries, and lawyers. Unfortunately, this is an experimental change that has not happened in any other state, and it will certainly result in escalation in the number of claims filed, in the number of cases introduced into the databank, and also in the costs of defensive medicine. Patients for Fair Compensation's proposed changes are not a healthy direction for Tennessee to take. 
Motorcycle Safety Helmet use should be preserved in our state: we would not like to see existing state law change on the requirement that motorcycle riders wear helmets. But certain individuals have been asking the legislature to make the wearing of helmets optional.

Ban on Indoor Tanning:
Melanoma is the only one of the top 7 most frequent cancers whose incidence is rising in the US (by about 2% a year, from the Skin Cancer Foundation’s on-line Fact Sheet). About 1 American dies every 57 minutes from melanoma, and use of indoor tanning dramatically increases the risk of melanoma. The Tennessee Dermatologic Society is currently asking the legislature to ban tanning in Tennessee below the age of 18, as has been done in Louisiana, North Carolina, and 11 other states. As a dermatologist, this legislation would seem to make good sense to me.
 George Woodbury Jr. M.D. (12/06/2015)


Dr. Woodbury attended the Tennessee Dermatologic Society meeting, in Nashville TN November 13th to the 15th. Topics covered there included connective tissue diseases in the skin, management of atopic dermatitis, and medical politics.
Here he visits with (left to right) Lisa Albany, State Policy Committee, American Academy of Dermatology Association, Washington DC; Angela Allen, Specialty Societies, Tennessee Dermatologic Society, Nashville TN; and Adrian Rodriguez MD, Nashville Skin and Cancer, Tennessee Dermatologic Society President 2014-2015.


Emily Woodbury designed our practice's grassroots logo to illustrate
that people benefit most when patients and healthcare personnel work together in a team-wise approach. Everything comes together in a big circle.

For questions, comments, or if you would like to
be added to our email list, please email “”or call 1-901-753-0168.
George Woodbury Jr. M.D. (12/06/2015)