The President’s Paragraph

Moving Forward

The third part of a three-part series about physician involvement in advocacy.

by Tilden L. Childs III, MD, TCMS President

My goodness! What a year this has been so far. I hope everyone has persevered to the best of their ability. The re-opening of our economy has begun, and much needs to be done to restore some sense of “normal” to our practices. Hopefully, we can also all start resuming some of the pleasant social activities to which we are accustomed, at least to some extent, in a safe and responsible way.

As we begin to re-focus and start looking forward to next year’s legislative session, I want to present the final article of my three-part series on participation in organized medicine, advocacy, and the legislative process. In this article, I want to give you a flavor of “where the rubber meets the road,” or, as some say, “see how the sausage is made.” In my first article, I discussed some of the options that you, acting either as an individual or through participation with your medical societies, have available, particularly at the state level. Now I would like to share with you some examples of how individuals in our community have participated in the legislative process in Texas.

However, before we get to that, I have a few thoughts for your consideration for the upcoming Texas legislative session (87R – 2021) beginning in January 2021. As you are aware, 2020 is an interim year during which issues are identified and discussed, policies are formulated, and bills are drafted in preparation for bill filing late in 2020 and early in 2021. Prior to the COVID-19 crisis, redistricting was considered to be the top issue. It now looks like this will be put on hold. The overriding issue, in my opinion at this time, will likely be the budget. Inherent in this will be the necessity for organized medicine to be on guard and be proactive in preventing/mitigating budgetary cuts that affect patient care and physician practice viability in Texas. This is something that everyone will have an opportunity to participate in. Although Texas has a large Economic Stabilization Fund (rainy day fund), it may not be sufficient to prevent budgetary cuts. Additionally, participation in the legislative process promises to be unique and challenging, given the current atmosphere of social distancing as we reopen society. Whether traditional legislative hearings and committee meetings and legislative assemblies will occur as they have in the past remains to be seen. For example, the Virginia House has been meeting outside on the grounds of the state Capitol beneath large white event tents. Good luck to Rep. Charlie Geren on figuring this out for Texas.

“Inherent in this will be the necessity for organized medicine to be on guard and be proactive.”

Assuming you have followed the processes I outlined in my first article regarding participation and advocacy, and that you now understand what a complicated and arduous process it can be to develop policy (as I described in my second article), you are now ready to take the next step. Being knowledgeable and informed on specific issues, plan to meet with your state representative and senator or their staffs during session, either one-on-one or as part of a group to discuss the pertinent bills pertaining to your issues. A good opportunity during session, as I discussed previously, is to go with your county medical society through the TMA First Tuesday’s program. Next, identify which members are on the House and Senate committee(s) that are likely to hear your bills of interest. To the extent possible, get to know these committee members and share your thoughts with them or their staffs, again either individually or through your group representation. 

You then need to show up at the capitol to attend and participate in committee hearings. The Texas Legislature Online (TLO) website (https://www.capitol.state.tx.us/) has many uses, including providing notification of times and locations of the specific committee hearings and their agendas. Once onsite, register your position on your bill or bills of interest being considered in hearings that day. This is easy to do and is done just prior to the hearing. Consider providing testimony at committee hearings. This is done in the form of either written or oral testimony. To prepare for oral testimony, I have a homework assignment for you: I recommend that you review previously recorded testimony. The TLO website allows searches of the House and Senate committee meetings archives by date and committee, and I have included this information in the following examples. A notable one from the previous session (86R – 2019) was the contentious issue of balance billing. As Chair of the Council on Legislation, Dr. Jason Terk admirably represented the TMA in testimony before the Senate Business & Commerce Committee (B&C) on March 21, 2019, against SB 1264 as written. I highly recommend reviewing this recorded testimony online (search TLO Senate archives by date and committee or view at https://tlcsenate.granicus.com/MediaPlayer.php?view_id=45&clip_id=14013) beginning at time 2:08:25. This is an excellent example of now only how adversarial the process can be but also how important it is to be part of the process. An example of a more friendly encounter, particularly for a first-timer (both me and the lady who followed me),  on a relatively non-contentious issue can be found by searching TLO House archives for the House Insurance Committee meeting on March 5, 2019 (or at https://tlchouse.granicus.com/MediaPlayer.php?view_id=44&clip_id=16400), beginning at time 1:35:43, where I testified on HB170 relating to mammography coverage. The TCMS and the TMA can provide further insight and assist you in preparing to testify as well. A number of Tarrant County physicians have testified over the years and this has been integral to the legislative successes achieved by the TMA. 

In closing, I hope you have gained an in-depth understanding of the role we can and do play in the legislative process. Participate in your local, state, and national medical organizations. Inform yourself on the issues. Help formulate policy. Advocate for your position.  Make your voice heard by being part of the legislative process through active participation at the Texas capitol, as I have described in this article. You can do it! You can make a difference in the future of Texas medicine.

Thank you and stay safe!

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