Family Physicians, Internist
41 years of experience

Accepting new patients
North Texas Health Care Associates
601 Clara Barton Blvd
Ste 200
Garland, TX 75042
972-272-1400
Locations and availability (2)

Education ?

Medical School Score Rankings
University of Florida (1969)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Associations
American Board of Family Medicine

Affiliations ?

Dr. Couch is affiliated with 2 hospitals.

Hospital Affilations

Score

Rankings

  • North Central Medical Center
    4500 Medical Center Dr, McKinney, TX 75069
    • Currently 3 of 4 crosses
    Top 50%
  • Baylor Hosp Garland
  • Publications & Research

    Dr. Couch has contributed to 6 publications.
    Title Improving Delivery of Clinical Preventive Services: a Multi-year Journey.
    Date February 2008
    Journal American Journal of Preventive Medicine
    Excerpt

    BACKGROUND: Adults in the United States typically do not receive all recommended clinical preventive services (CPS) for which they are eligible, missing opportunities for prevention and/or early detection. A multi-year quality improvement initiative targeting CPS delivery in a fee-for-service ambulatory care network is described. METHODS: Since 1999, HealthTexas Provider Network (HTPN) has implemented multiple initiatives to increase CPS delivery, including a flowsheet, a physician champion model, physician- and practice-level audit and feedback, and rapid-cycle quality improvement training. RESULTS: From 2000 to 2006, "recommended or done" CPS delivery increased from 68% to 92%, and "done" from 70% to 86% (2001 to 2006). "Perfect care" composite performance increased from 0.19 to 0.51 (2001 to 2006). CONCLUSIONS: Long-term, multistrategy approaches can achieve substantial sustained improvement in CPS delivery throughout a large ambulatory care provider network.

    Title Drs. John F. Anderson, David J. Ballard, Carl E. Couch, and Peter A. Dysert Ii Discuss Clinical Transformation with the Editor. Interview by William Clifford Roberts.
    Date October 2005
    Journal Proceedings (baylor University. Medical Center)
    Title Who Supports Physicians in Malpractice Cases?
    Date May 2002
    Journal Physician Executive
    Excerpt

    Malpractice suits have a devastating emotional impact on physicians. Learn about a unique service offered by the HealthTexas Provider Network to help doctors deal with the shock and sadness.

    Title Effects of Protein Deficiency on Implantation and Embryogenesis in the Rat.
    Date November 1969
    Journal The West Indian Medical Journal
    Title Effectiveness of Diabetes Resource Nurse Case Management and Physician Profiling in a Fee-for-service Setting: a Cluster Randomized Trial.
    Date
    Journal Proceedings (baylor University. Medical Center)
    Excerpt

    Nurses with advanced training-diabetes resource nurses (DRNs)-can improve care for people with diabetes in capitated payment settings. Their effectiveness in fee-for-service settings has not been investigated. We conducted a 12-month practice-randomized trial involving 22 practices in a fee-for-service metropolitan network with 92 primary care physicians caring for 1891 Medicare patients >/=65 years with diabetes mellitus. Each practice was randomized to one of three intervention groups: physician feedback on process measures using Medicare claims data; Medicare claims feedback plus feedback on clinical measures from medical record (MR) abstraction; or both types of feedback plus a practice-based DRN. The primary endpoint investigated was hemoglobin A(1c) level. Other measures were low-density lipoprotein (LDL) cholesterol level, blood pressure, annual hemoglobin A(1c) testing, annual LDL screening, annual eye exam, annual foot exam, and annual renal assessment. Data were collected from medical chart abstraction and Medicare claims. The number of patients with hemoglobin A(1c) <9% increased by 4 (0.9%) in the Claims group; 9 (2.1%) in the Claims + MR group (comparison with Claims: P = 0.97); and 16 (3.8%) in the DRN group (comparison with Claims: P = 0.31). Results were similar for the other clinical outcomes, with no differences significant at P = 0.10. For process of care measures, decreases were seen in all groups, with no significant differences in change scores. Quality improvement strategies must be evaluated in the appropriate setting. Initiatives that have been effective in capitated systems may not be effective in fee-for-service environments.

    Title Impact of Clinical Preventive Services in the Ambulatory Setting.
    Date
    Journal Proceedings (baylor University. Medical Center)
    Excerpt

    Indicators of the performance of clinical preventive services (CPS) have been adopted in the ambulatory setting to improve quality of care. The impact of CPS was evaluated in a network of 49 primary care practices providing care to an estimated 245,000 adults in the Dallas-Fort Worth area through a sample chart review to determine delivery of recommended evidence-based CPS combined with medical literature estimates of the effectiveness of CPS. In this population in 2005, CPS were estimated to have prevented 36 deaths and 97 incident cases of cancer; 420 coronary heart disease events (including 66 sudden deaths) and 118 strokes; 816 cases of influenza and pneumonia (including 24 hospital admissions); and 87 osteoporosis-related fractures. Thus, CPS have substantial benefits in preventing deaths and illness episodes.


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