"I am confident the Physician Services Organization for Patient Care will save local practices," said Stephen L. Brotherton, MD, president of the Texas Medical Association (TMA). "Texas doctors are determined to make health care better and more affordable for Texans.

"To do that, we need to shift the balance of power away from the government and the large hospital systems, and back to the patients and their physicians."

In addition to TMA, the Dallas County Medical Society (DCMS) and Harris County Medical Society (HCMS) are key members of the Physician Services Organization for Patient Care. The center will bring in new and existing physician groups, health plans, and technology vendors as needed to test and develop effective new care models.

"The health care landscape is changing dramatically for solo physicians to large group practices," said DCMS President Cynthia Sherry, MD. "This new organization will help all types of physicians deal with this great change. DCMS is proud to partner with TMA to provide these essential tools to physicians. Together we will help physicians meet quality benchmarks for patient care, leverage information technology, and compete successfully in changing financial models. The real winners will be patients."

"The Physician Services Organization for Patient Care will provide services to help physicians navigate the changing health care delivery system," said HCMS President Russell W. H. Kridel. "The best use of a physician's time is in directly taking care of the patient one on one, not in dealing with red tape, reporting measures, and compliance regulations. This is exactly what is needed to maintain the sacred patient-physician relationship. It's very exciting to see new innovative projects like this that can help physicians spend more time with their patients."

The organization will offer services that bolster physicians' clinical and financial autonomy, tailored to a practice's current level of sophistication. A key element will be providing physicians easy access to data to measure and improve their clinical performance and their financial viability.

"This is a physician-driven enterprise to improve patient care," said TMA Board of Trustees member Dan McCoy, MD, who chaired the task force that developed the project plan. "The Physician Services Organization for Patient Care will use the latest technology and data analytics tools to bolster the bedrock of our profession: the patient-physician relationship."

For example, one service might help physicians comb through their data to identify chronically ill patients who need extra help to stay as healthy as possible and stay out of the hospital. Another might align primary care physicians and specialists to better coordinate the care they provide to their common patients.

"The market is shifting rapidly. Physicians are under tremendous pressure to change what they've been doing. But no one is helping them do that," Dr. Brotherton said. "This is a very high priority."

Added Don Read, MD, of Dallas, a member of the TMA Board of Trustees, "This is the most important thing TMA has done since tort reform."

About the Texas Medical Association:TMA is the largest state medical society in the nation, representing more than 47,000 physician and medical student members. It is located in Austin and has 120 component county medical societies around the state. TMA's key objective since 1853 is to improve the health of all Texans.

About the Dallas County Medical Society: DCMS unites and empowers physicians to support the health of all residents in the metropolitan region. DCMS is a professional organization of approximately 6,400 local physicians, medical students, and residents dedicated to serving Dallas area patients.

About the Harris County Medical Society: HCMS, established in 1903, is the professional society for physicians in Harris County. It is the largest county medical society in the nation, with a membership of more than 11,000 physicians and medical students. Its mission is to be the leading advocate for its member physicians, their patients, and the community, in promoting the highest standards of ethical medical practice, access to quality medical care, medical education, research, and community health.

Contacts: Steve Levine (512) 370-1380; cell: (512) 750-0971; email: Pam Udall (512) 370-1382; cell: (512) 413-6807; email: Brent Annear (512) 370-1381; cell: (512) 656-7320; email: Lauren Cowling, DCMS; (214) 413-1447; cell: (214) 215-0060 Jennifer Snyder, HCMS; (713) 524-4267; email:

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SOURCE Texas Medical Association

The son of a Kenyan man, Obama said the tour helped him, and the family members who accompanied him, to "fully appreciate the magnitude of the slave trade." He was joined by first lady Michelle Obama, daughters Malia and Sasha, his mother-in-law, Marian Robinson, and a niece, Leslie Robinson.

The president said Thursday's trip also reminded him of the importance of standing up for human rights worldwide.

"This is a testament to when we're not vigilant in defense of human rights what can happen," Obama said after the tour. "Obviously, for an African-American, an African-American president, to be able to visit this site, I think, gives me even greater motivation in terms of human rights around the world."

Obama spent about a half-hour touring the salmon-colored slave house, including seeing the small holding rooms that separately held male and female Africans before they were loaded onto ships bound for the Americas. He spent about a minute peering through the Door of No Return, and went back for a second long look after his family had a chance to peek out too.

Later, at a state dinner with Senegal's president, Macky Sall, Obama said he and Mrs. Obama "will never forget" the Goree Island visit.

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What's a motorcade called when it travels on water? Try a floatercade.

Obama arrived on the island aboard La Signare, a 73-foot, blue-and-white launch decorated with Senegal's green, yellow and red flag and a banner that said "Welcome President Obama."

There were six boats in all, including smaller boats for Secret Service agents and other security officials, White House staff and the media.

U.S. reporters traveling with the president dubbed the flotilla a "floatercade."

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Tourists who come to Goree Island usually spend most of their time trying to avoid trinket-sellers and peddlers who swarm visitors from the moment they set foot off the ferry, plying them with beaded necklaces and offers of guided tours.

But the city went to great pains to clean up in anticipation of Obama's visit. Sandy lanes were swept clean of trash. The beach appeared to have been raked. Even the peddlers seemed to have been part of the cleanup effort too.

Instead of the usual mob, only a few hawkers greeted a ferry that docked the day before Obama arrived.

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Before arriving on the island, Obama, who is a lawyer, told a meeting in Dakar of judges from the region that he disappointed his late grandmother by going into politics.

She wanted him to be a judge.

Still, even though he let her down her by becoming a politician, he said she would be happy to know "that a group of judges are willing to meet with me even if I'm not one myself."

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As Africans awaited news about the health of ailing former South African President Nelson Mandela, Michelle Obama urged a group of middle school students to draw on his strength as they grow up to possibly become leaders in their own right. Mandela, 94, who fought against his country's former system of white-minority rule and was imprisoned for 27 years, is in critical condition in a South African hospital.

Mrs. Obama urged the students to make their lives worthy of the sacrifices of people like Mandela.

"I want you to think about this. If President Mandela could hold tight to his vision for his country's future during the 27 years he spent in prison, then surely you all can hold tight to your hopes for your own future," she told the students at Martin Luther King Middle School in the Senegalese capital of Dakar.

"If President Mandela could endure being confined to a tiny cell, being forced to perform back-breaking labor, being separated from the people he loved most in the world, then surely, all of us, we can keep showing up and doing our best showing up for school each day, studying as hard as you possibly can," she said. "Surely, you can seize the kind of opportunities Mandela fought for for all of us. Surely, you can honor his legacy by leaving a proud legacy of your own."

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Associated Press writers Rukmini Callimachi in Senegal and Darlene Superville in Washington contributed to this report.

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Follow Julie Pace on Twitter: http://www.twitter.com/jpaceDC

FORTALEZA, Brazil, June 27 (Reuters) - World and European champions Spain overcame Italy 7-6 in a penalty shootout after surviving an energy-draining Confederations Cup semi-final that ended goalless after two hours in sapping heat and humidity on Thursday.

Substitute Jesus Navas converted the winning penalty past Gianluigi Buffon after Italian defender Leonardo Bonucci skied the 13th penalty of the shootout with the score level at 6-6 at a spellbound Estadio Castelao.

All the previous 12 penalties had been converted with players from both sides displaying nerves of steel as the tension increased.

Antonio Candreva began what was effectively the fourth act of a classic match when he planted the ball past Spain goalkeeper Iker Casilla and after that, 11 others stepped up and dealt with the mounting pressure before Bonucci's kick ended up in Row Z.

The Spanish players found their last dregs of energy to celebrate wildly as they set up a final against Brazil on Sunday at the Maracana in Rio de Janeiro.

Brazil, who beat Uruguay 2-1 in Wednesday's semi-final will be looking for their third successive Confederations Cup title and fourth overall.

The tournament, which is being used as a test event for next year's World Cup finals in Brazil, has been shrouded in controversy with the matches overshadowed by riots and protests about social issues and the cost of hosting the World Cup.

DISTINCT PERIODS

The atmosphere in the stadia, however, has taken soccer fans' minds off the chaos outside and Thursday's semi-final between the Euro2012 finallists was no different as the game fell into four distinct acts.

Italy dominated the first half before Spain got back into the game in the second.

The world champions then asserted themselves in extra time, while the denouement was the penalty shootout that appeared as if they could last all night until Bonucci's miss.

"They were on top, especially in the first half, but we showed our strength and in the second half, we ironed out some problems and the match became more balanced," Spain coach Vicente Del Bosque said.

"We were the better team in extra time and we had the luck in the shootout, but that's the way it goes. You can't rehearse penalties, you just have to go for it."

Italy coach Cesare Prandelli felt his side, who were hammered 4-0 by Spain in the Euro2012 final, had moved on since then.

"This match was a great test for us and we passed it, despite the result," Prandelli said.

We were convinced how we needed to play in both tactical and technical terms and we did that especially in the first half.

"Spain are ahead of us and have been forging their path for years now, but we must forge our own path and keep going.

"I think we are on the right track."

Italy were disadvantaged in the buildup to the match when striker Mario Balotelli went home injured and he was missed in front of goal, especially in the first half when Italy wasted three good scoring chances all from headers.

Christian Maggio had the best chance after 36 minutes when he headed straight at Casillas, but Prandelli's decision to switch his formation to 3-5-2 with a five man midfield anchored by Andrea Pirlo gave them the early advantage.

The Italians also stifled much of the usual creativity from Spain midfielders Andres Iniesta and Xavi and their first half chances were limited to just Pedro firing wide after two minutes and Fernando Torres shooting wide after 37 minute.

Emanuele Giaccherini hit the post for Italy in extra time and Xavi did the same for Spain four minutes before the final act unfolded in the shootout.

(Editing by Greg Stutchbury)

The 36-year-old Australian said he signed a contract with the German company "that extends over several years" and that he will compete in the Le Mans 24 Hours and World Endurance Championship next year.

"I'm very much looking forward to this new challenge after my time in Formula 1," Webber said in a statement. "Porsche will undoubtedly set itself very high goals. I can hardly wait to pilot one of the fastest sports cars in the world."

Webber has struggled this season, failing to win a race and is currently fifth in the drivers' championship, 63 points behind teammate Sebastian Vettel.

Webber first raised doubts about his future with Red Bull after Vettel ignored team orders and overtook him for victory at the Malaysian Grand Prix.

Red Bull confirmed that Webber is leaving but has yet to say who might replace him. Among the favorites would be Lotus Driver Kimi Raikkonen, who is good friends with Vettel.

"I am sure Mark thought long and hard before making what has no doubt been a very difficult decision," Red Bull Principal Christian Horner said. "His achievements in Formula One are extensive and I am sure he will continue to push hard and build on that record until the end of the season.

"We support Mark's decision, he has been an excellent addition to the team since joining us in 2007 and we wish him all the best in the next stages of his career."

Since joining F1 in 2002, Webber had won nice races and had 36 podium places during a career that also included stints with Williams and Minardi. He has already raced at Le Mans twice.