TarrantCounty MedicalSociety

Understanding Before Access: Why PATC Is Measuring Health Literacy More Intentionally

Project Access Tarrant County

By Kathryn Keaton

This article was originally published in the March/April 2026 issue of Tarrant County Physician.

At Project Access Tarrant County, we have always believed that the “access” in our name involves more than seeing a specialist—it also includes comprehension. A growing body of research confirms what community health organizations have long observed: Health literacy is directly tied to healthcare utilization, outcomes, and cost.

Health literacy, as defined by Healthy People 2030, is “the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”¹ PATC is uniquely positioned to help our patients improve health literacy not just for their PATC service, but also for their future lifetime of healthcare.

A 2025 systematic review found that limited health literacy is consistently associated with higher healthcare costs, increased hospitalizations, and greater emergency department use—all areas PATC aims to reduce in Tarrant County.² Literacy is not a secondary social factor; it is a healthcare variable. Health literacy influences how patients navigate outpatient, inpatient, emergency, and digital health systems (even more so in immigrant populations)—and PATC is changing how we approach this issue in our patient base.

Moving Beyond “High School or Not”
Historically, many healthcare systems—including safety-net organizations—have captured each patient’s education level in broad terms. Emerging research shows that education level alone does not reliably predict a patient’s ability to understand medical terminology, consent forms, referral instructions, or post-procedure care plans. Studies have demonstrated that even patient-facing surgical materials are frequently written above recommended reading levels.

A decade ago, the AMA and National Institute of Health recommended that medical materials be written at an eighth grade or below reading level,³ but today, most experts agree that material should be written at a sixth grade or below reading level.⁴

When written information assumes advanced comprehension, patients are placed at risk of misunderstanding critical instructions. Just last year, a PATC patient almost canceled her vital surgery because she mistakenly thought she was instructed to stop her diabetes medication for a full week leading up to her surgery. She had enough health literacy to question those instructions, but not enough confidence to question their accuracy.

To respond more intentionally, PATC is refining how we capture and evaluate education and health literacy across our patient population.

What We’re Changing

Narrowing our educational ranges
Rather than broad categories, we now collect more targeted education data. This allows us to examine patterns in referral completion, adherence, and communication preferences.
Identifying whether education occurred inside or outside the United States
Educational systems vary widely across countries. A high school diploma earned abroad may reflect a different exposure to English-language healthcare terminology or system navigation. Recent national research examining health literacy by Hispanic ethnicity reinforces this nuance.⁵
Implementing SAHL evaluations for each adult patient

PATC is incorporating the Short Assessment of Health Literacy (SAHL), a validated screening tool created in 2010 by Health Services Research that directly measures a patient’s ability to recognize and understand common medical terms.

Unlike education level, SAHL evaluates functional comprehension—an essential factor in specialty care navigation. The tool is curated in both English and Spanish, with other languages available.⁶

Why Literacy Directly Impacts Care
Health literacy affects:

Medication adherence
Chronic disease management
Completion of specialty referrals
Understanding of pre-procedure instructions
Post-surgical recovery compliance

Systematic reviews across multiple countries show that lower health literacy is associated with delayed care, increased acute utilization, and poorer chronic disease management—even in universal healthcare systems, insurance coverage alone does not eliminate access barriers.⁷

For uninsured patients navigating specialty referrals—often involving multiple providers, consent forms, preparation instructions, and follow-up plans—comprehension is foundational. When literacy gaps are not identified, missed appointments may be labeled as “noncompliance.” In reality, they may reflect confusion, fear, or uncertainty.

Connecting Data to Our Broader Health Literacy Efforts
Importantly, PATC’s shift is not just about collecting more data. It strengthens and informs our broader health literacy initiatives, including:

Simplifying written instructions
Evaluating readability of patient-facing materials
Reinforcing clear text-based communications (CareMessage)
Informing topics for future Salud en Tus Manos curriculum
Literacy is not just a patient issue—it is a system design issue. By measuring literacy more intentionally, PATC can ensure that communication strategies match patient needs.

Access Requires Understanding
Healthcare systems are becoming increasingly complex and digital. Artificial intelligence tools, online portals, and automated communications can enhance access—but only if patients can understand and use them effectively.

Access to care is not complete when an appointment is scheduled. It is complete when a patient understands what that appointment means—and what to do next.

By refining how we measure education and incorporating validated literacy screening, PATC is strengthening the foundation of specialty care coordination—because access begins with understanding.

References:

Office of Disease Prevention and Health Promotion, “Health Literacy in Healthy People 2030,” Healthy People 2030, U.S. Department of Health and Human Services, accessed March 12, 2026, https://odphp.health.gov/healthypeople/priority-areas/health-literacy-healthy-people-2030.
Francesca Tusoni et al., “What Is the Impact of Health Literacy on Healthcare Costs? A Systematic Review and Evidence Synthesis,” BMJ Open 15, no. 12 (2025): e108816, https://bmjopen.bmj.com/content/15/12/e108816.
Patrick J. L. Fitzgerald et al., “Readability of Patient Education Materials on the American Association for Surgery of Trauma Website,” Journal of Surgical Research (2014), https://pmc.ncbi.nlm.nih.gov/articles/PMC4139691/.
Cheryl A. Tucker, “Promoting Personal Health Literacy Through Readability, Understandability, and Actionability of Online Patient Education Materials,” Journal of the American Heart Association 13, no. 8 (2024): e033916, https://www.ahajournals.org/doi/10.1161/JAHA.124.033916.
Athena K. Ramos et al., “Health Literacy by Hispanic Ethnicity and its Association with Healthcare Experiences, Self-rated Health, and Quality of Life,” Journal of Immigrant and Minority Health (2026), https://doi.org/10.1007/s10903-026-01848-5.
Shoou-Yih Daniel Lee et al., “Short Assessment of Health Literacy—Spanish and English,” Health Services Research 45, no. 4 (2010): 1105–1120, https://doi.org/10.1111/j.1475-6773.2010.01119.x.
R Schönegger, C Von Reibnitz, and Hans-Peter Wiesinger, “Health Literacy and Healthcare Utilisation in Universal Healthcare Systems: A Systematic Review,” European Journal of Public Health 35, no. 4 (October 2025), https://doi.org/10.1093/eurpub/ckaf161.1476.

The Evolving Challenges in Medicine: A Look at the Long-term Impact of the COVID-19 Pandemic

Public Health Notes

By Catherine Colquitt, MD, TCPH Medical Director

This article was originally published in the March/April 2026 issue of Tarrant County Physician.

The opportunities, rewards, and privileges of practicing medicine are many, but the pressure of practice can at times be stressful or overwhelming. Our colleagues straining to cope may be reluctant to report or seek treatment for depression, anxiety, or substance abuse disorders. Many of these conditions have been exacerbated by the COVID-19 pandemic and its aftermath.

Tarrant County Public Health (TCPH) has for many years offered chronic disease self-management programs which host lay group support programs customized to each participant’s needs. These are facilitated by a trained lay leader with input from the rest of the support group and are tracked to mark progress on the journey toward successful chronic disease self-management, including anxiety, depression, and obsessive-compulsive disorder, among other chronic conditions. However, many physicians and other healthcare workers already feel too over-extended to participate in a time-consuming peer support program such as TCPH offers.

While healthcare worker (HCW) burnout is lower now than at the height of the COVID-19 pandemic, HCW burnout and stress have not returned to the pre-pandemic baseline according to most sources, including a large study of Veterans Health Administration (VHA) HCWs surveyed annually in 140 VA Medical Centers from 2018 to 2023. In response to survey data, the VHA implemented “several system-level programs to revise organizational practices and policies” to reduce or mitigate burnout. These include reducing workloads by hiring more staff, increasing telehealth and telework options, and introducing “whole health practices” in employee healthcare in which much attention is directed at mitigating the mental health impact of medical conditions and stressors at work or home affecting VHA employees.¹

Scientific Reports released a study evaluating anxiety
and depression among HCWs two years after the COVID-19 infection began. A remarkably high percentage (50.8 percent) of their sampled HCWs reported “long COVID,” which authors defined as “persistence of multi-system symptoms for more than twelve months, including fatigue, shortness of breath, brain fog, depression, and anxiety.” The authors used PHQ-9 and GAD-7 scales to assess anxiety and depression in HCWs two years after COVID infection (higher scores indicate more instances of anxiety and depression, while lower scores indicate fewer). They found that students had the highest PHQ-9 and GAD-7 scores, with doctors, nurses, and administrative staff reporting lower PHQ-9 and GAD-7 scores. Authors concluded that “policymakers and healthcare administrators should consider optimizing mental health support systems,” including “implementing regular mental health screenings, providing personalized psychological interventions, offering counseling services, reducing work-related stress, and promoting the use of mental health assessment tools to improve the psychological well-being” of healthcare workers, especially students and those who have long COVID.²

Center for Infectious Disease Research and Policy summarized a Morbidity and Mortality Weekly Report study of US HCWs surveyed online in 2022 and 2023 in which 26 percent of participants “reported symptoms of mental illness but only 20% sought treatment during the previous year, mainly because of difficulty getting time off from work and worries about confidentiality and cost.” HCWs were surveyed using PHQ-2 and GAD-2 tools and cited work stress, burnout, inadequate staffing, greater workload or job demands, fear of COVID-19, and COVID-19 misinformation as their leading stressors.³

Like our patients, we physicians escape through connections to our chosen online communities, but perhaps we should more often step out of our comfort zone to ask a colleague how they are doing in a manner which suggests that we really care to know, and this might lead to a colleague expressing concern for our well-being as well. Who among us is at risk for self-harm? According to actuarial data, the typical physician at risk is 45 years old; Caucasian; amid some marital discord or divorced, separated, or single; self-treating with alcohol or drugs; a “workaholic”; and a risk-taker. Our hypothetical colleague may also have chronic pain or some other serious medical comorbidity, is concerned about a looming change in status (financial, professional, social) and may be frankly overwhelmed by the increasing demands of work. Our colleague will likely also have access to medications or firearms with which to act.^4,5,6

Psychiatric concerns in physicians are often left unaddressed until far advanced just as we often under-diagnose psychiatric conditions in our patients. Furthermore, we may fear the possible professional repercussions of asking for help with a psychiatric illness, opening ourselves up to the scrutiny and judgment of physician health programs, credentials committees, colleagues, or lawyers.

It is my personal hope that we will all use our training, honed by the COVID-19 pandemic, to minister to those suffering and in pain in the ways unique to our healing arts. COVID-19 has changed us all in ways we don’t yet fully realize.

References:

Debra C. Mohr et al., “Burnout Trends Among US Health Care Workers,” JAMA Network Open 8, no. 4 (2025): e255954, https://doi.org/10.1001/jamanetworkopen.2025.5954.
Lin Zhang et all., “Anxiety and Depression in Healthcare Workers 2 Years After COVID-19 Infection and Scale Validation,” Scientific Reports 15 (2025): Article 13893, https://doi.org/10.1038/s41598-025-98515-w.
Mary Van Beusekom, “1 in 4 US Healthcare Workers Report Mental Distress During COVID, Survey Suggests,” Center for Infectious Disease Research and Policy, January 20, 2025, https://www.cidrap.umn.edu/covid-19/1-4-us-healthcare-workers-report-mental-distress-during-covid-survey-suggests.
Latoya Hill et al., Physician Workforce Diversity by Race and Ethnicity, Kaiser Family Foundation, July 22, 2025, https://www.kff.org/racial-equity-and-health-policy/physician-workforce-diversity-by-race-and-ethnicity/.
Daniel Saddawi-Konefka, Christine Yu Moutier, and Jesse M. Ehrenfeld, “Reducing Barriers to Mental Health Care for Physicians: An Overview and Strategic Recommendations,” JAMA 334, no. 10 (2025): 987–995, https://doi.org/10.1001/jama.2025.12587.
Hirsh Makhija et al., “National Incidence of Physician Suicide and Associated Features,” JAMA Psychiatry, published online February 26, 2025, https://doi.org/10.1001/jamapsychiatry.2024.4816.

I am a Doctor. . .

Feature Narrative

By Sergio Sanchez Zambrano, MD

This article was originally published in the September/October 2025 issue of Tarrant County Physician.

Recently, while evaluating annotations by a young medical student for potential publication in our journal, I objected to the fact that the author was referring to herself as a “provider.”

I do not know of ANY other profession as altruistic and generous as that of being a doctor.

I manifested my respect to the medical student for her generosity and the extent of her altruism. At that time, a Christmas present given to me by my wife came to mind—a copy of a poem written by Robert Louis Stevenson from Scotland (November 13, 1850–December 3, 1894). It is called “Eulogy of the Doctor.”

Robert Louis Stevenson’s prose is unique and needs no additional commentary; hence, I will simply “copy and paste.”

Eulogy of the Doctor

There are men and classes of men that stand above the common herd the soldier, the sailor, the shepherd not infrequently, the artist rarely, rarelier still the clergyman, the physician almost as a rule.. He is the flower of our civilization and when that stage of man is done with, only to be marveled at in history he will be thought to have shared but little in the defects of the period and to have most notably exhibited the virtues of the race. Generosity he has, such as is possible only to those who practice an art and never to those who drive a trade: discretion, tested by a hundred secrets; tact, tried in a thousand embarrassments; and what are more important, Herculean cheerfulness and courage. So it is that, he brings air and cheer into the sick room and often enough, though not so often as he desires, brings healing.

There is nothing else that I could add other than encouragement to all the doctors, young and old, to remember that we are not providers. We are DOCTORS.

I am just saying . . .

The Winter Blues

President’s Paragraph

By Cheryl Hurd, MD, TCMS President

This article was originally published in the March/April 2026 issue of Tarrant County Physician.

As I was first writing this article, we were facing our usual “once a winter” storm with freezing temperatures, snow, and ice. Despite our best preparations, Texas just does not have the infrastructure to maintain business as usual during significant winter storms. Honestly, up to this point, it seemed like a pretty mild winter. And then the front came through with howling winds, record low temperatures, freezing rain that turned to sleet, and barely any snow, though some did fall. People stayed indoors in the warmth, but many I am sure enjoyed some “winter sports” with sledding on trash can lids and attempts to build snowmen.

However, it didn’t take long before people started feeling cooped up and wanting to get out. Thanks to telehealth, my clinic was able to provide care for patients during the following week while we awaited sunnier days and above-freezing temperatures. Patients were already mentioning that they felt a dip in their mood and lower motivation. Friends, family, and acquaintances over the years have sometimes mentioned things like this when the winter sets in. It happens only now and again, when people may want to stay home but still are interested in their usual activities. This is not seasonal affective disorder, a serious variant of clinical depression that often requires professional treatment. This is a fairly well-known phenomenon called “winter blues.” NIH-funded researchers have been studying both of these conditions for decades.

Patients were . . . mentioning that they felt a dip in their mood and lower motivation. Friends, family, and acquaintances over the years have sometimes mentioned things like this when the winter sets it. . . . This is a fairly well-known phenomenon called “winter blues.”

The winter blues tend to occur in colder and more northern (or southern if south of the equator) areas because it is a reaction to reduced sunlight and the changes of the season. Yet it can happen anywhere when the weather turns “dark and dreary.” According to the University of California-Davis Health, people still continue to function while experiencing a mood dip, minimal sadness, fatigue, and less motivation.¹ These feelings are usually mild and temporary, which is different from seasonal affective disorder. According to Dr. Matthew Rudorfer, an NIH mental health expert, the winter blues can be linked to something specific, like holiday stress or loss.²

What should we do or recommend if we or those around us have the snowy doldrums? It may seem obvious, but simple things like getting outside (dress appropriately!), opening your blinds/curtains for more ambient light, being social, and getting physical (the Jane Fonda kind, not the Mike Tyson kind) are all ways to get past this. The kids have it right—go sledding, have snowball fights, make a snow (or ice) man . . . and enjoy some hot cocoa when it’s time to relax. Because the seasons always change, and spring is on the way! Well, technically, in Texas, it’s already here.

References:

UC Davis Health, “Seasonal Affective Disorder, Winter Blues and Self-Care Tips to Get Ahead of Symptoms,” Cultivating Health (UC Davis Health Blog), November 29, 2023, https://health.ucdavis.edu/blog/cultivating-health/seasonal-affective-disorder-winter-blues-and-self-care-tips-to-get-ahead-of-symptoms/2023/11.
“Beating the Winter Blues,” NIH News in Health, January 2013, https://newsinhealth.nih.gov/2013/01/beating-winter-blues.

Let’s Talk About Money: Understanding Physician Practice Structures

TCU Student Article

By Prisca Mbonu, MS-IV

This article was originally published in the January/February 2026 issue of Tarrant County Physician.

During my medical school’s Preparation for Practice course, we examined the multidimensional aspects of the medical profession, which included everything from the business of medicine to health equity, patient safety, public health, and communication. One session, titled “Health System Structure and Why It Matters,” stood out as particularly interesting. In this session, we explored the complexities of health systems, such as the features, incentives, and organizational models that influence physician practice structures. We examined the advantages and disadvantages of various models from the perspectives of both physicians and patients, delving into topics such as compensation structures and the trade-offs of different practice settings.

There are various paths for physicians to consider when choosing their practice structure. Private practices offer autonomy but come with financial risks and administrative burdens. On the other hand, hospital or health system employment provides stability and resources, but often at the cost of clinical independence. Payer-owned practices emphasize cost-effective care but may create ethical tensions due to insurance policies, while corporate-owned practices promise growth and potential equality but can impose pressures to meet financial targets. Corporate entities like health plans, venture capital investors, private equity firms, and large employers are also rapidly acquiring physician practices, outpacing hospital ownership and fundamentally reshaping the employment model.¹ By 2022, 26.4 percent of physician practices were owned by corporations, compared to 27.2 percent owned by hospitals.² This shift is a game-changer both for how physicians practice and how patients receive care.

Physicians also have the option of working within nonprofit, for-profit, government-owned, or academic medical centers, each offering distinct advantages. Nonprofit institutions purport to prioritize community service while reinvesting surpluses into patient care and public health. For-profit institutions may emphasize efficiency and profitability, often with the goal of expanding services or increasing shareholder returns. Government hospitals emphasize serving specific populations, such as veterans, while academic centers integrate patient care with education, research, and innovation. Evidently, these organizational models encompass substantial variation in governance, incentive structures, and day-to-day clinical realities, requiring physicians to navigate differing priorities as they define their professional identities.

It is important to note, however, that the stated missions and structural principles of these practice and ownership models do not always reflect how organizations operate in practice. Considerable overlap and, at times, incongruence exist across settings. For example, nonprofit and academic centers may face financial pressures that shape productivity expectations and revenue-driven strategies, while for-profit or corporate-owned practices may support high-quality, mission-driven care despite profit-oriented frameworks. These dynamics are often influenced by broader market forces, regulatory constraints, leadership, and other contextual factors.

As a medical student preparing for my future, I find myself grappling with several important questions: Which organizational structure aligns best with my values as a physician and an individual? Should I work for someone else, or would I prefer to be “my own boss”? What will financially benefit me as a physician? How will my work-life balance be affected, especially as a woman considering starting a family? How will these choices impact my autonomy, how I’m able to practice my ethical values, and the care I can provide to patients? These questions loom large and require a great deal of nuanced thought. While I don’t yet have all the answers, I am grateful for the opportunity to begin to reflect on these questions as I plan my career trajectory.

In a world where medicine is increasingly intertwined with business, we can no longer shy away from conversations about compensation and career structure. Many of the physician-led panelists at the session emphasized how essential this knowledge is—something they wish they had received earlier in their training. For medical students who will likely graduate with substantial student loan debt, these conversations also carry important financial implications. Overall, the course session on health system structures provided insights into the diverse organizational and financial models shaping both our future careers and patient care. Understanding these options is crucial in helping us determine not only how we want to work, but who we want to be as physicians and individuals.

References:

AHA Center for Health Innovation, Evolving Physician-Practice Ownership Models: Implications and Considerations for Hospitals and Health Systems, Market Insights Report (2021), https://www.aha.org/system/files/media/file/2020/02/Market_Insights_MD_Ownership_Models.pdf
Dailey, Eliza, and Sarah Roller. “Implications of the New Era of Physician Employment: 2023 Update on the Physician Landscape.” Advisory Board. April 1, 2023. Updated May 12, 2023. https://www.advisory.com/topics/physician/2023/04/a-new-era-of-physician-employment

TCMS Committees and Programs Review: Find Your Passion and Join Us in Making a Difference in Medicine

Feature Article

By TCMS Staff

This article was originally published in the January/February 2026 issue of Tarrant County Physician.

There are a variety of reasons that doctors choose to join TCMS; usually, new members will point to one defining thing that encouraged them to get involved. Perhaps they view our advocacy as critical, or they believe that we provide important networking opportunities. Maybe they wanted help with billing or more extensive chances for leadership roles. But whatever reason brought them here, when doctors choose to actively participate in the society, they find there are many more reasons to be part of TCMS than the one that drew them in the first place.

So here is our committees and programs review, your chance to learn of the opportunities that lie before you. We have a number of specialty committees and programs you can participate in, and we encourage you to join the one you find most compelling to use it as a springboard for upping your impact on medicine.

Allied Health Scholarship Committee
TCMS and its members, in partnership with TCMS Alliance, have an exciting opportunity to support the education access of allied health students through the Allied Health Scholarship Committee. This committee awards scholarships to qualified undergraduate students in Tarrant County who are actively enrolled in allied health training programs. It meets three times a year to discuss the applications received, choose the preliminary interviewers, interview the chosen candidates, and then decide on what amount is given to each final scholarship recipient. A student is also chosen to receive the Murphy Award—the largest monetary amount of all the scholarships offered—named after the donor, James A. Murphy, MD.

In 2025, the committee awarded $49,400 to students based on financial need and scholastic achievement. This was divided between 17 students from four different Tarrant County colleges and universities—all of whom we believe will make a big impact on the patients of Tarrant County with their future careers! We look forward to 2026 and the opportunity to meet and connect with even more schools, shaping the future for allied health students in our county. To get involved or get more information, contact Melody Briggs at mbriggs@tcms.org.

Board of Advisors
Each month, our executive committee meets to discuss the highlights of the healthcare community, the progress on TCMS projects, and goals for the future. When you participate with the Board of Advisors, you have a chance to get a full picture of TCMS and its role in Tarrant County, including its partnership with public health, emergency services, medical schools, residency training programs, charitable organizations, and local community leaders. This gives you a front-row seat in the efforts made to advocate on behalf of physicians
This monthly gathering is open to member physicians, residents, students, and other healthcare personnel. For more information on attending, email Melody Briggs at mbriggs@tcms.org.

Ethics Consortium
The Ethics Consortium meets monthly and is a diverse, non-partisan group of people interested in healthcare and ethics. Its mission is to improve the health and well-being of the diverse communities that make up North Texas by assisting in the application of ethical values to current healthcare issues through educational programming and advocacy efforts that encourage civil conversation and dialogue.

Healthcare in a Civil Society is an annual forum that seeks to engage leaders of varying perspectives in a civil conversation that focuses on the healthcare issues that are important to our community and is devoid of the rhetoric that often undermines these conversations in the media. This year’s event focuses on caring for the whole patient and takes a close look at where spirituality and the delivery of care intersect. The event will include a breakout session for audience participation and engagement and a panel discussion featuring leaders from various sectors to further the conversation. If you are interested in joining or would like more information on the Ethics Consortium, call TCMS at (817) 732-2825.

Legislative Committee
The Legislative Committee works to build the critical relationships necessary for effective medical advocacy. Though the committee certainly participates in the First Tuesdays at the Capitol events during the legislative session, it is also committed to fostering relationships with legislators and educating them on the issues year-round. In addition, for physicians who would like to get involved but feel unsure about talking to legislators themselves, it’s a great opportunity to build the knowledge and skillset to be a powerful advocate on behalf of your patients and your practice. You are surrounded by expert advocates! Members of the committee also make up a ready response team for issues that may arise between sessions, allowing TCMS to quickly navigate legislative challenges. For more information about the Legislative Committee and its goals, contact Brian Swift at bswift@tcms.org.

Committee on Physician Health and Wellness
The TCMS Committee on Physician Health and Wellness (PHW) promotes the health and well-being of physicians, recognizing that physicians are at least as vulnerable, if not more, to issues of substance abuse (including alcoholism) and mental disorders as their patients. The committee supports the early recognition, evaluation, and treatment of physicians with these conditions, and their monitored recovery. As part of this, the committee supports the work and activities of the Texas Physician Health Program and the Texas Medical Board.
The function of the PHW Committee is three-fold: 1) to promote physician health and well-being; 2) to ensure safe patient care by identifying physicians who may have potentially impairing conditions; and 3) to advocate for physicians while maintaining confidentiality and the highest ethical standards.

As advocates, the committee members help with interventions, referrals for evaluation and treatment, if necessary, and monitor attendees upon their return from treatment. It supports widespread education for physicians, family members, and support staff regarding possible impairments.

Through the TMA PHW Assistance Fund, financial assistance is available to physicians who cannot afford treatment for depression, chemical dependency, or other problems or whose families need short-term living expenses while a physician receives treatment. Donations to the fund are appreciated and are tax-deductible.

Our local committee consists of physicians who have special interest and experience in supporting those who are struggling, and it is available to consult with individuals and institutions locally that have questions or problems in this area. For more information about how you can participate or receive assistance, contact Kathryn Keaton at kkeaton@tcms.org.

Project Access Tarrant County
Project Access was formed in 2011 to facilitate surgical and specialty care to low-income, uninsured residents of Tarrant County who do not qualify for county or other resources. Since then, PATC has coordinated over $22 million in donated healthcare services, helping thousands of patients access life-changing and life-saving treatment.

Physician volunteers partner with PATC by seeing a limited number of patients in the comfort of their own office and in the course of their normal clinic day. Volunteers determine how many patients they are able to accept each year, and surgery is scheduled at facilities where volunteers have existing privileges. All care coordination including hospital and ancillary services is provided by Project Access staff so the physicians can focus on providing care.

PATC’s highest areas of need are general surgery, breast surgery, gynecology, orthopedic surgery (hips and knees), and pulmonology; although all specialties are always welcome. By volunteering with PATC, physicians play a critical role in improving health outcomes for patients who would otherwise go without care, while strengthening the health and well-being of our local community.
You are invited to learn more about how your expertise can make a meaningful difference—on your terms, within your existing practice, and with full support from the experienced PATC team. To learn more, contact Kathryn Keaton at kkeaton@tcms.org.

Publications Committee
The Publications Committee meets bimonthly to review submissions for TCMS’s journal, the Tarrant County Physician. All TCMS members are welcome to submit articles for consideration. The committee is devoted to selecting content that is meaningful to our readers—the medical community throughout Tarrant County.

We are incredibly grateful not only for our bimonthly authors, but also for those who write feature articles. From topics spanning the practice of medicine and legislative issues to anecdotes about historical figures and unique excursions, many TCMS members have shared their interests through articles that were published in the journal. The committee members give a resounding “Thank you!” to all contributors, and they have two requests: send in more submissions and consider joining the committee. The only way the journal can successfully represent all TCMS physicians is if members from different backgrounds and experiences write about the things that are meaningful to them, and joining the team that reviews content allows you to augment the voice of your fellow physicians in a powerful way. If you are interested in joining the Publications Committee or submitting an article for review, please contact Allison Hunter at editor@tcms.org.

Women in Medicine Committee
The TCMS Women in Medicine Committee’s goal is to promote networking and collegiality and present ideas and solutions for issues specifically affecting female physicians in Tarrant County. Now several years into its formation, the committee’s events have provided platforms for empowering and educational speakers, round tables, and CMEs. And from time to time, mixers, soap making, and yoga have made the itinerary! To join the think-tank behind these events, contact Brian Swift at bswift@tcms.org.

We hope you found one or more groups that grabbed your attention. And if you’re still unsure, don’t worry! Click this link, mark the topics you find interesting, and we will send you more information about committees or programs where you can make a difference doing the things you care about.

Mental Health in Medicine: A Call to Lead

President’s Paragraph

By Cheryl Hurd, MD, TCMS President

This article was originally published in the January/February 2026 issue of Tarrant County Physician.

Hello everyone, my name is Cheryl Hurd, and it is my honor and privilege to serve as the 2026 TCMS president. I am a psychiatrist who has been in active practice for nearly twenty-five years, but I have also been a medical educator for the majority of that time. (I am also an English Lit major, so the “President’s Paragraph” is likely to become much longer than a paragraph. . . .) I want to thank the many presidents before me who have written articles and stories that have amused, enlightened, and inspired me. I admire the passion (and compassion) as well as the courage of my predecessors. I can only hope to aspire to the same level of dedication to my theme as they did to theirs.

My mission has always been to provide the highest quality and evidenced-based care to patients while training the next generation of physicians in best practices. Easy buzzwords to write, but they’re sincere nonetheless. As a psychiatrist, mental health is at the forefront of my mind. Mental health has long been marginalized, treated as secondary to physical illness, and burdened by stigma. Yet the evidence is clear: Mental health is inseparable from overall health, and its neglect undermines our patients, our communities, and ourselves.

I have chosen to make mental health advocacy the defining theme of my tenure. This is not just a matter of professional responsibility; it is a moral imperative. TCMS should be among those leading the way in ensuring that mental health is recognized as a cornerstone of care in this county and throughout the great state of Texas.

Millions of people struggle with depression, anxiety, trauma, and substance misuse; this includes us as physicians. Suicide remains a leading cause of death among young people, and burnout continues to erode the well-being of healthcare professionals. We still lose as many as 400 attending physicians to suicide a year.¹ Residents and medical students are facing the same challenges. These realities are not just statistics—they are the lived experiences of our patients, colleagues, families, and ourselves.

The pandemic further exposed the fragility of our mental health infrastructure. The sequelae of the pandemic included an explosion in mental health disorders across our country. Demand for services surged, yet access remained uneven despite the adoption of telepsychiatry. Rural communities, marginalized populations, and children bore disproportionate burdens. I was president of the medical staff at JPS from the beginning through the height of the pandemic, and I saw firsthand the devastation that was wrought on the physical and mental well-being of the healthcare workforce. My most important service as medical staff president during that time was to bolster our physicians and other providers, provide resources, give updates, and instill hope when despair seemed to overwhelm us. The infrastructure could not meet the demands, and it often still doesn’t.

So, I would like to focus on expanding equitable access to care for all; integrating mental health into primary care, schools, and workplaces; and leading a conversational shift that normalizes open discussions about mental health across our practices and communities. Through advocacy we can advance reforms that treat mental health with the same seriousness as physical illness, expand the workforce with training and support for all physicians (not just mandate PHQ-9 and GAD-7 questionnaires at every visit), strengthen school partnerships to provide early intervention, invest in community clinics, expand telehealth to close gaps in underserved areas, and promote research and innovation that drive evidence‑based solutions.

As physicians, we still carry unique credibility in shaping public discourse. When we speak openly about mental health—whether in clinical settings, community forums, policy debates, or even podcasts—we dismantle stigma and inspire change.

We must also look inward. Physician burnout and moral distress remain pressing concerns that negatively impact physician well-being. By prioritizing mental health within our own profession, we model resilience and compassion for the broader healthcare system. TMA, our state medical association, has developed many resources in service of our members for these very issues. Many county societies have done the same, as have we at TCMS. I encourage everyone to visit the Physician Wellness website and learn more about our efforts: https://www.tcam.org/physician-wellness.

I know that I am asking a lot of all of you, and it won’t be easy. There are many financial constraints and competing interests that limit the expansion of services. We have a workforce shortage that hinders access, and the stigma of mental illness persists (particularly when it is related to substance use disorders). Differences in healthcare policies and funding priorities can complicate efforts to expand mental health services, but collaboration can help bridge these divides. These challenges are not insurmountable. With advocacy, innovation, and determination, we can overcome them.

Mental health is about people. It is about the child struggling with anxiety, the veteran coping with trauma, the parent balancing stress, and the physician facing burnout. By focusing on mental health, we confirm that every individual’s well-being matters.

As president of our medical society, I call upon each of you—physicians, educators, researchers, and advocates—to join me in this work. Together, we can elevate mental health, ensuring that it is recognized as a fundamental component of healthiness and a shared responsibility of the medical community.

“What mental health needs is more sunlight, more candor, and more unashamed conversation.” —Glenn Close

References:

John Matheson, “Physician Suicide,” American College of Emergency Physicians https://www.acep.org/life-as-a-physician/wellness/wellness/wellness-week-articles/physician-suicide#:~:text=Each%20year%20in%20the%20U.S.,and%20alcohol%20and%20substance%20abuse;.

A DO Dilemma

TCOM Student Article

By Jared Sloan, OMS-II

This article was originally published in the January/February 2026 issue of Tarrant County Physician.

January to February can be a tough time for many people: The air is cold, holiday street lights are taken down, New Year’s resolutions are abandoned, and osteopathic medical students are deciding whether they want to take double the amount of national licensing exams. While taking the USMLE (United States Medical Licensing Examination) Steps 1 and 2 is not a new expectation of osteopathic students, recent changes, including the formation of a single accreditation system, which fully merged the previously separate osteopathic and allopathic residency accreditation pathways in 2020, as well as the transition of STEP 1 to pass/fail scoring, have left many students scratching their heads and biting their nails at the thought of even more high-stakes exams. Early in their education, students are forced to make a career-defining choice: Should I take both the DO and MD licensure exams if it improves my residency outlook?

Since 1995, osteopathic students have taken the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) as their primary means of gaining licensure. With the large overlap in content between COMLEX and the USMLE (the main difference being the inclusion of osteopathic-specific content), many professional medical societies have stated that the COMLEX is a perfectly acceptable alternative to the USMLE. However, this decision truly lies with individual residencies. Typically, osteopathic students who take STEP do so because it is required for the residencies they are interested in. But for the many year-two students who have not decided on a specific specialty, myself included, this decision is far from simple. Although many of my classmates and I are drawn to specialties that are historically “DO-friendly,” we are also aware that there is still much of medicine we have yet to experience. Many students don’t discover the field of medicine they are passionate about until their clinical rotations, but we must decide to take STEP 1 before we ever step into those roles. Students feel that by choosing not to take STEP they are closing doors to future programs before they even know about them. Many feel it is wiser to “play it safe” by taking the extra licensing exam. At the heart of this dilemma is the tension between what is technically sufficient for licensure and what is perceived as necessary to remain competitive across an increasingly uncertain residency landscape.

Unfortunately, students seeking mentor guidance on this matter often hear conflicting opinions from faculty and experienced osteopathic physicians. With the advancement of the osteopathic profession, many mentors insist that students should not feel pressured to take unnecessary exams. Others concede that, while COMLEX is becoming more accepted, there remains a very real preference for the STEP exams. Students are left with ambiguous answers and are told what they already know, namely, that choosing to take the extra exam depends on what specialty they are interested in.

How does the new pass/fail status of STEP 1 impact this predicament? Now that allopathic schools emphasize STEP 2, should second-year students feel free to skip the stress of STEP 1 and take STEP 2 only if they feel it is necessary? Yes, and some do exactly that. Many, however, are terrified by the idea of taking what feels like the most important test of our lives without taking its predecessor. While the core competencies of COMLEX and USMLE are similar in many ways, it is well known that there are differences in the style of writing and focus areas between the exams. With so much riding on STEP 2, students continue to feel pressured to prepare as best they can, which includes taking STEP 1.

Regardless of which licensure a medical student takes, almost all students would agree that these exams are hard. Fatigue, stress, and financial cost all increase when students choose to take more national boards. I know that I, and many students, worry how this increased burden will impact our performance. Taking an extra exam means risking failure on our core licensing exam or risking failure on an exam that was never necessary in the first place. Ultimately, we as medical students are high achievers, and many of us are willing to put in this extra work if it means more opportunities in the future.

Despite numerous residencies stating that they will review a COMLEX Level 2 score under the single accreditation system, students remain keenly suspicious that STEP 2 functions as a silent requirement. DO students are left wishing that our standard licensing exams were fairly considered but realize there is no way to enforce a fair consideration of COMLEX. Looking ahead, many osteopathic students are hopeful for one of two future outcomes. The first possibility is that the National Board of Osteopathic Medical Examiners (NBOME) could move toward standardization with the USMLE (potentially by accepting a unified licensing exam supplemented by osteopathic-specific assessments). However, given the NBOME’s longstanding commitment to a distinct osteopathic licensure pathway, this outcome appears unlikely. What feels like the more plausible future is that COMLEX scores will become more routinely considered by residency programs as familiarity increases. While this shift may already be underway, it will take time to fully materialize. As a result, although future osteopathic students may ultimately face fewer barriers, for the foreseeable future, many cohorts will continue to navigate a residency application in which the expectation of STEP remains firmly in place. As I look toward my future, I see a wide range of possibilities, possibilities that may quietly close if I choose to ignore this silent requirement.

2026 Tarrant County Medical Society President Cheryl L. Hurd, MD

Feature Article

By Allison Howard Hunter

This article was originally published in the January/February 2026 issue of Tarrant County Physician.

Dr. Cheryl Hurd, a psychiatrist committed to both clinical care and medical education, believes that organized medicine is the foundation that supports every other part of medical practice. But she’ll be the first to admit that she didn’t realize its importance early on.

“I was a student member of TMA, but I never did anything,” she says. The same was true during her residency in Arizona. But after years of participation, Dr. Hurd’s advice for medical students and residents is simple: Don’t just join—get involved.

When she returned to Texas and entered private practice, it was as the only psychiatrist in her medical group. Feeling alone, she rejoined TMA and immediately found connection in colleagues, committees, and a whole psychiatry track of support she didn’t know she was missing. “The camaraderie was huge,” she says. “I finally didn’t feel like the only one.”

Dr. Hurd’s involvement in organized medicine also offered practical benefits: TMLT insurance, CME funding, and—most importantly—the chance to advocate. Advocacy, she says, is what allows physicians to push back against excessive regulation, protect physician-led teams, and fight for the future of the profession.

She’s candid about the challenges physicians face. “Healthcare is regulated more than almost any other industry,” she says. Yet advocacy has delivered real wins: tort reform, increased medical education funding, and—critically for her field—expanded mental health funding in Texas even during budget-cut years.
“That’s why advocacy matters,” she says. “It protects us, it protects our patients, and it keeps our profession alive.”

And, as she found, those who advocate for you also have your back at the toughest of times, sometimes in ways that are less obvious than legislative wins. In 2020, when physicians were on the front lines of the COVID-19 pandemic and PPE was scarce, putting healthcare professionals at greater risk, Dr. Hurd was surprised to receive a box from TCMS.

“I opened it up and it was five hundred N-95 masks,” she says. “Just this whole box of N-95s. And then there was an email. It was from TCMS, saying, ‘Hey, we’re trying to help you.’ And they sent it to every single member; they sent every member a box because they wanted to protect us.”

Dr. Hurd credits that support as the reason she got even more involved, leading to her serving as our 2026 TCMS president. She saw in TCMS a reflection of her own ideals—a mission to care for patients, physicians, and the physician-patient relationship.

But it is the physicians like Dr. Hurd who give our medical society its heart, inform its values, and guide its vision.

“Dr. Hurd is the intelligent and compassionate doctor that you would wish to take care of your dearest loved ones,” says Helene Alphonso, DO, a friend and mentee of Dr. Hurd. “As a mentor, she nurtures lifelong learning at every level of medical education. She advocates for her patients and fellow physicians with countless hours and innovative solutions. . . . We can’t wait to see how her leadership in the Tarrant County Medical Society will shape the future.”

Though Dr. Hurd is now passionate about all things medicine, growing up, she did not want to be a doctor—or a teacher or a dancer or even a veterinarian (though she does have a major love for animals). No—at six years old, Dr. Hurd was determined that she was going to be a lawyer. She held on to this dream all the way through college, where she earned both a bachelor’s and a master’s degree in English from SMU, still convinced that law school was her next step.

It was during those years of study that Dr. Hurd met her husband, Howard. They had a good plan: he would go to medical school, and she would go to law school. Still, she decided to defer for a year because his education was taking him to Houston, while Dr. Hurd’s was taking her to Austin. As newlyweds, this separation was hardly appealing, and with law school only taking three years against medical school’s four, the choice was easy for her to make.

Dr. Hurd had planned to work in editing or proofreading for the year, but with a competitive job market and no connections in a new city, she had a frustrating lack of success. One day, she asked her husband if she could join him for his classes to give her something to focus on aside from the unfriendly job market, so he brought her along. She was immediately enthralled.

“A couple of weeks into his school, and I’m sitting there in the classroom taking more notes than he is,” Dr. Hurd says, laughing. “And I just thought, ‘Wow—this is fascinating. Why did I never study this?’”

Quickly, her decision was made—medicine was her future. In a short time, a passion grew into something she knew would sustain her in the years ahead.
Dr. Hurd and her husband were both accepted to Texas Tech’s School of Medicine, so they made the move to Lubbock. A couple of years later, Howard matched to a general surgery residency in Temple, Texas, so she transferred to A&M College of Medicine to complete her clinical rotations. When she graduated in 1998, she began her psychiatry internship at Good Samaritan Regional Medical Center in Phoenix, Arizona. Her training was unique—a joint internal medicine and psychiatry program that allowed her to combine the specialties that most interested her.

After her internship and four years of residency, Dr. Hurd was more than ready to begin practicing as a fully qualified psychiatrist. She and her husband knew they wanted to come back to Texas—the question was simply where they would land. Having their friends and family here was a huge draw for the young couple, but they were also motivated by positive legislation for medicine.

“With tort reform in 2003—that’s when I graduated residency—I was thinking it would really be nice to not have escalating malpractice costs,” Dr. Hurd says. “They’d still get money if I actually did something wrong, but the goal was that all the frivolous lawsuits would go away. And by and large, they have.”

They settled in Brownwood, Texas, where Dr. Hurd set up a psychiatry solo-practice collaborating with a larger organization of specialists. She was the only psychiatrist in the area, and she also consulted at the county hospital. At first this kept Dr. Hurd quite busy, but her practice slowed down after the financial crash of 2008. Soon she moved to Fort Worth, where she joined UNT Health Science Center and UNT Health, although her clinical assignment was at JPS. She later transitioned to Acclaim Physician Group when it was formed, and she stayed there until 2022. Throughout that time, her role grew from serving as the consult medical director to being the psychiatry program director and vice chair of education.

Though she was involved in education through TCOM and JPS, she maintained an active full-time practice. However, when she began serving as TCU Burnett School of Medicine’s psychiatry clerkship director, she stepped back from her role at JPS and joined Connections Wellness in a part-time role.

“At Connections Wellness, I still have a clinical job where I see patients and precept students,” says Dr. Hurd. “And then I had my role as psychiatry clerkship director. I do the behavioral health year-one lectures, clinical skills, and things like that. So, I’m all things psychiatry at the School of Medicine.”

Though Dr. Hurd treasures her role within medical education, she did not seek it in the early days of her career. When opportunities first arose in education, she turned them down in favor of focusing on her clinical practice.

“I thought, ‘No, I’m just going to go out and save the world one patient at a time,’” she remembers. “‘I’ll do clinic and just be a doctor, be a practicing physician. That’s what I was trained for.’ When I started at JPS, I just thought I’d be a psych consultant like I was at the county hospital down in Brownwood. So, I show up, do my orientation, and they’re like, ‘Here’s your team.’

“I went, ‘Team? What team?’ I had a resident, I had an intern, I had students. I just tried to base my precepting on some of the best preceptors I’ve had in my training. So that’s how I got involved and learned that I really loved it.”

Much like her discovery of medicine, Dr. Hurd considers this unexpected assignment another act of serendipity—one that was to her benefit, as it was (and is) for the many residents and medical students who have been under her tutelage.

Her colleague, Debra Atkisson, MD, has seen Dr. Hurd make a big impact both in education and practice throughout her career.

“I have known her for more than fifteen years and have observed her dedication to her patients and the medical students and residents she has taught,” says Dr. Atkisson. “She has provided our community and the state of Texas with outstanding education about psychiatry. . . . We are very fortunate to have Dr. Hurd serve as our president for Tarrant County Medical Society.”

Dr. Hurd has had variety in the roles she has held throughout her career, but they have all hinged on one overarching goal: supporting mental health for physicians and patients alike. This has involved making petitions both to TMA and the Texas Medical Board, being involved in mental health legislation through First Tuesdays, and serving on councils and boards supporting mental health—including TMA’s Physician Health and Wellness Committee, where Dr. Hurd served for the maximum nine-year term, including two years as vice chair and two years as chair.

Though progress has been made in mental health support and treatment, she sees that much more lies ahead.

“I want to continue to work on reducing the stigma and also try and get more involvement in the community itself to support and encourage and grow mental health access.”

But the problem goes beyond the average patients—physicians struggle greatly when it comes to accessing mental health.

“We’re the last ones to go seek help,” she says. “There used to be punishment for physicians with their licensure when they were under treatment. So, they didn’t seek treatment, or they felt like they couldn’t be honest about treatment. And there’s been a huge effort to flip that narrative and get physicians to understand it’s actually okay to get treatment, and this is thanks to both the TMA and the Texas Society of Psychiatric Physicians, after much work and many, many years.”

As she begins her term as TCMS president, Dr. Hurd does so with the goal of continuing this mission.

“One of my goals is to get the community more informed of opportunities for mental health support,” she says. “We are also trying to work on increasing access and bringing more behavioral health and mental health programs to the area.”

Those who know her believe Dr. Hurd will thrive in this role and ably utilize the opportunities it provides.

“I knew of her leadership at the Texas Medical Association, where she served on the Physician Health and Wellness Committee,” says Angela Self, MD, who has been friends with Dr. Hurd for many years. “She works tirelessly for her patients and for the practice of medicine. . . . She sacrifices many hours volunteering, advocating for the improvement of healthcare for physicians and patients across the country.”

As Dr. Hurd looks toward the future, she does so remembering the many physicians who have impacted her career. Carol Nati, MD, was a great mentor for Dr. Hurd, especially during her time at JPS. Dr. Atkisson encouraged her to get involved with TCU’s School of Medicine and Connections Wellness, and Greg Phillips, MD, helped give Dr. Hurd the drive she needed to get more involved with TCMS. Dr. Hurd credits these physicians—alongside many others, and her ever-supportive family— for helping her become the doctor she is today.

Though medicine always keeps her busy, Dr. Hurd loves spending time with her husband; their two children, Dawna and Perry; and their dogs (they always have several, and there is usually a rescue in the mix). If she has a spare moment, you’ll probably find her reading a book—all genres are welcome!—or joining in a multiplayer computer game that her husband got her involved in years ago. She’s now the only one in her family that plays, but through it, she has developed a network of friends spanning the globe.

“It’s kind of fun to have long-term friendships that are not based on just your circle,” says Dr. Hurd. “It gets us out of our comfort zones in those boxes we live in, where we only do things with people who are pretty much like us.”
Dr. Hurd is eager to widen her scope of friends and colleagues even further in the year ahead as she partners with physicians and other change-makers to make a difference for medicine in Tarrant County and beyond.

“I’m excited to see what we accomplish for medicine in 2026,” she says. “There’s a lot of work to be done!”

Project Access Tarrant County: 2025 in Review and Building Toward 2026

Project Access Tarrant County Update

By Kathryn Keaton

This article was originally published in the January/February 2026 issue of Tarrant County Physician.

Another year has come and gone at Project Access Tarrant County (PATC), and as we close out 2025, we reflect on a year marked by both meaningful growth and strengthened community collaboration. Through the efforts of our volunteer physicians, hospital partners, and community collaborators, PATC continued its mission of bridging gaps in specialty and surgical access for uninsured residents of Tarrant County.

Patients Served and Clinical Impact
In 2025, PATC supported 243 patients through specialty and surgical care that would otherwise have been treated through emergency departments or would have gone untreated. These services included surgical care in general surgery, gynecology, colorectal surgery, urology, orthopedic surgery, cardiology, gastroenterology, ENT, and ophthalmology, as well as other non-surgical specialties. Despite continued high demand, we eliminated our gynecology waiting list, leaving only general surgery with a significant waiting period.

“I never thought this type of help existed for people in my condition. Even though I work, I don’t have health insurance and cannot afford medical care. I do all kinds of jobs; I don’t look for handouts. I am beyond thankful.” – Joe, 74, prostatectomy

Provider Engagement & Volunteer Leadership
None of PATC’s impact is possible without our network of volunteers. In 2025, over 60 physicians donated their expertise as well as ten hospitals and surgery centers. Our ancillary partners are vital as well, providing required imaging, anesthesia, pathology/labs, physical therapy, and other services. Volunteers see patients in their own offices and choose the maximum number of patients they see annually.

“Volunteering for Project Access is easy. PATC sends physicians the workup needed for patients vetted for our specialty. We just show up and treat the patient!” – Omar Selod, DO; Physical Medical and Rehabilitation and Project Access Tarrant County volunteer

Program Innovation & Process Improvements
In 2025, PATC expanded our technological capabilities. We broadened our patient communication tools to reduce no-shows and improve follow-up adherence and continued integration of CareMessage for appointment reminders, health and disease education, and multi-lingual patient support. In addition, we introduced Salud en Tus Manos (Health in Your Hands), in-person classes that address a variety of social drivers of health issues that our patients face. Thirty-one patients attended four classes held over 2025, and more curriculum is being added for 2026.

“Because of this class, I feel more confident in asking my doctor questions so I can better understand my diabetes care.” – Yolanda, Salud en Tus Manos “How to Communicate with Your Doctor” attendee

Community Value & Financial Stewardship
The collective value of donated care in 2025 is estimated at $1.5 million, reflecting both the generosity of our volunteers and the community’s investment in equitable access. Despite these high service levels, operational efficiency has kept PATC’s cost per surgical procedure coordination at approximately $1,500.

By facilitating specialty care, PATC reduces unnecessary emergency department utilization, prevents costly complications, and supports patient well-being beyond the clinical encounter, underscoring the value of collaboration and reflecting strong stewardship of both financial and human resources.

“The emergency department is the least efficient and most expensive way to deliver gynecologic care. Hemorrhaging women are transfused and sent home, only to return the next month when their menses return. Project Access identifies these suffering women and connects them with the definitive care—usually hysterectomy—they need. My role as the volunteer surgeon is made incredibly easy. Project Access coordinates the facilities, supplies, OR staff, and nursing—all I have to do is operate.” – Michelle Arevalo, MD; Obstetrics and Gynecology and Project Access physician volunteer

Challenges and Lessons Learned
While 2025 brought significant milestones, we also encountered challenges—including our wait list in general surgery, variable engagement across certain ZIP codes, and continued navigation barriers tied to social determinants of health. We are using these insights to expand patient education efforts and approach partnerships from a data-informed angle.

2026 Goals & Momentum
As we enter 2026, PATC is focused on expanding our capacity to meet growing needs. Our priorities include recruiting new physician volunteers—especially general surgeons—as well as expanding patient education related to social drivers of health.

With continued support from physicians and partners across the county, we anticipate a year of elevated impact and strengthened patient outcomes. We thank our physician community for their commitment and look forward to what we can achieve together in 2026.

“This experience changed my mentality—that there are people that may not know someone but still care about them. Sometimes people aren’t willing to donate five minutes of their time, so the doctors giving their services and time is incredible.” – Marisa, 48, hysterectomy