TarrantCounty MedicalSociety

Everybody Bleeds

The Last Word

By Hujefa Vora, MD, Publications Committee Chair

This article was originally published in the May/June 2026 issue of Tarrant County Physician.

Most days, practicing medicine feels less like a profession and more like peacekeeping, holding together a small, fragile space where people can set everything else aside for a moment. By the time patients walk through my doors, they’re not just dealing with symptoms. They’re bringing the weight of their lives with them—their stressors, their opinions, their hopes and their fears—everything they’ve been hearing and arguing about outside. What I try to do, at least as I see it, is quiet that noise long enough for something real to happen between us.

Every day, I sit across from people who arrive with more than just physical complaints. They come in with thoughts and prayers—feelings shaped by conversations at home, stories on the news, and what they read online. Politics has a way of creeping into everything now, especially into places it doesn’t belong. What used to be simple conversations—“What hurts?” or “How can I help?”—can suddenly feel heavier, weighted by the world. Questions about treatment or cost become about fairness, about the system, about whether anyone is really listening.

That’s when I try to ground things again, quietly. Because in my exam room, it doesn’t matter if you’re Republican or Democrat, an immigrant or a fifth-generation American citizen, liberal or conservative, Christian or Muslim. Those labels may matter outside, and I know they shape people’s lives, but in this space, they are meaningless. In here, you’re a person, a human being who doesn’t feel well or who’s worried, and you came for help. That’s where we start.

Most people feel that shift, even if they don’t say it. There’s often a moment when the tension softens—shoulders drop, voices relax. The world outside doesn’t disappear, but for a few minutes, it stops being the center of everything.
Still, I see how worn down many of my patients are. There’s a shared fatigue that shows up again and again. It comes from feeling like nothing really changes. New laws, new leaders, new debates—but the same problems remain. Healthcare is still complicated. Costs are still high. Getting care can still be difficult. From their perspective, it can feel like everything ends up being the same.

And I understand why. From my side, I’m trying to treat each person as an individual while working within a system that doesn’t always allow for that. There are rules, approvals, and limits that shape what I can offer. Insurance determines which tests are covered. Policies affect which treatments are available. Sometimes I have to explain why something that makes sense medically doesn’t align with what’s allowed. That’s when I see it—that subtle shift. It’s the moment when a patient starts to feel less like a person and more like just another case moving through the system. Like they’re all the same. That’s when trust can begin to slip. And once that trust slips, everything else becomes harder.

So I push back against it, as gently as I can. Sometimes that means slowing down, asking one more question, or taking a little extra time to explain. Sometimes it means acknowledging frustration instead of trying to fix it right away. People can tell when they’re being rushed. They can also tell when someone is actually trying to understand them. Because the truth is, they’re not all the same. Every patient has a different story, different concerns, a different way of experiencing illness. Even when two people have the same diagnosis, it never means quite the same thing to them.

And yet, there is something that connects all of them—and all of us. It’s something I come back to when the room feels tense or distracted. I remind myself that everybody bleeds when they’re cut. It’s obvious, almost too simple, but it’s true. No matter who someone is or what they believe, they all share the same vulnerability. They all come in hoping for answers. They all feel uncertainty when something isn’t right. They all experience that quiet anxiety while waiting for results or sitting alone before I walk in. Pain doesn’t care about politics. Illness doesn’t ask about background. Hope and fear are universal. That’s the common ground I try to hold on to.

Keeping the peace in my office doesn’t mean ignoring differences. It means not letting those differences take over. If they do, they get in the way of care. My responsibility is to bring the focus back to the person in front of me and what they need in that moment. Sometimes that means gently redirecting the conversation. Sometimes it means listening without reacting. Sometimes it means allowing a moment of silence before continuing. I can’t fix the larger system from inside this exam room. I can’t make healthcare simple or fair in every way it should be. And I can’t resolve the political arguments people bring with them. But I can do something that always matters. I can make sure the person sitting in front of me feels seen. I can remind them—through how I listen and respond—that they’re not just another name on a chart. I can give them a moment where they’re treated as an individual, not as part of a category or a political debate. I can slow things down. I can explain what I know and be honest about what I don’t. I can give them space to ask questions. And sometimes, that’s enough to break through that feeling that everything is blending together. Because even if the world outside feels divided, loud, and confusing, this space can still be different. It can still be a place where people feel recognized, even if only for a short time. In here, the focus is simpler. In here, what matters most is the person in front of me—their story, their fear, their hope. And in our exam rooms, no two people are the same. This is the Last Word.

Advancing the Future of HIV Care in Our Community

Public Health Notes

By Kenton K. Murthy, DO, MS, MPH, AAHIVS
TCPH Assistant Director & Deputy Local Health Authority

This article was originally published in the May/June 2026 issue of Tarrant County Physician.

The Preventive Medicine Clinic (PMC), the oldest Ryan White HIV clinic in Tarrant County, has served the community continuously since its founding in 1991. In 2026, Tarrant County Public Health marks a significant milestone—35 years of delivering comprehensive HIV care, prevention, and patient support through this foundational program. In recognition of this milestone, PMC is undergoing a strategic transformation aimed at expanding access, enhancing quality, and delivering care in a more cost-effective and sustainable manner.

This evolution calls for a new identity—one that reflects not only where we have been, but where we are going. Today, we introduce Thrive Health. People living with HIV are no longer simply surviving; with the right care and treatment, they are thriving, and our new identity is meant to reflect this new era of care.

But we are not simply a rebrand; we are also entering a new phase focused on integration, innovation, and system-wide collaboration to address a persistent challenge: HIV incidence remains steady, and in some populations, is increasing. This moment calls not only for recognition of past success but for decisive action moving forward.

The Ryan White System of Care in Tarrant County
The modern HIV care system in the United States is built in large part on the foundation of the Ryan White HIV/AIDS Program, administered by Health Resources and Services Administration, an agency of the US Department of Health and Human Services. First established in 1990, the program was named after Ryan White, a young hemophilia patient who became a national advocate for HIV awareness after facing significant stigma and discrimination.

This program was designed to address a critical gap by ensuring access to HIV care for individuals who were uninsured or underinsured during a time when treatment options were limited and outcomes were poor. Over time, it evolved into a comprehensive system of care that supports medical treatment, medications, and essential support services.

Today, the Ryan White HIV/AIDS Program represents a multi-billion-dollar federal investment, with annual national funding of approximately $2.6 billion, supporting care for more than half of all people living with HIV in the United States. It has been widely recognized for achieving some of the highest viral suppression rates of any federally funded healthcare program.

In Tarrant County, Ryan White funding supports a coordinated network of clinics, including Thrive Health and other regional partners, delivering comprehensive care that includes HIV primary medical services; antiretroviral therapy management; rapid-start treatment for newly diagnosed patients; PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) services; case management; mental health and substance use care; oral health; pharmacy support; laboratory monitoring; and assistance addressing housing and transportation. Through this integrated model, HIV has been transformed into a manageable chronic condition, with significant improvements in life expectancy and reductions in transmission.

Local Epidemiology: A Growing HIV Burden in Tarrant County
Unfortunately, in Tarrant County, as in other parts of the United States, the burden of HIV continues to grow. In 2022, it was estimated that approximately 6,715 individuals were living with HIV in Tarrant County. By 2026, that number has risen to an estimated range of 7,500 to 8,000 individuals.
This increase is multifactorial and reflects a number of factors:

Ongoing HIV transmission

Improved survival due to effective antiretroviral therapy
Population growth within Tarrant County
The downstream effects of the COVID-19 pandemic, which disrupted routine healthcare delivery, reduced access to HIV testing and prevention services, and contributed to delays in diagnosis and linkage to care

Collectively, these factors highlight the persistent gaps in prevention and access that must continue to be addressed by healthcare and public health experts.

Why Continued HIV Screening Matters
Despite advances in treatment, HIV remains a significant public health concern. Routine screening is critical because early diagnosis allows for immediate initiation of therapy, leading to improved individual outcomes and reduced transmission through viral suppression. At the same time, a substantial number of individuals remain undiagnosed or are diagnosed late in the course of disease.

Tarrant County Public Health’s Disease Surveillance, Outreach, and Prevention (DSOP) team plays a central role in HIV and STD control efforts. Their work includes conducting field-based testing and outreach in high-risk populations, performing partner services and contact tracing, and leading comprehensive contact investigations for newly diagnosed HIV and syphilis cases. In addition, DSOP facilitates linkage to care for newly diagnosed individuals and actively works to re-engage patients who have fallen out of care, while collaborating closely with clinicians and epidemiologists to monitor trends and improve outcomes.

In addition, for several years, a key success in Tarrant County has been the implementation of opt-out HIV screening at JPS Emergency Department. This innovative program has led to the identification of numerous new HIV cases and has improved linkage to care at Ryan White outpatient clinics.
Building on this success, Tarrant County Public Health, in collaboration with the Tarrant County HIV Administrative Agency and key physician leadership from JPS, is actively working with other local hospitals to expand opt-out HIV screening across emergency departments throughout the region, with the goal of standardizing testing practices and improving early detection across multiple healthcare systems. These initiatives, if successful, could improve early detection of HIV and treatment of people living with HIV, thus helping to stop the spread of this disease.

Thrive Health: A Transformational Model for Integrated, Cost-Effective, High-Value Care
The transition from PMC to Thrive Health represents a deliberate transformation aligned with Tarrant County Public Health’s broader effort to become a more efficient, high-performing public health system. The previous clinic identities no longer fully reflected the scope or impact of services being delivered, and the 35-year anniversary provides an appropriate moment to evolve into a more unified and forward-looking model.

This transformation is driven by a focus on improving operational efficiency, returning to a physician-centric model of care, and optimizing the use of existing staff to increase patient throughput and enhance care delivery. At its core, the redesign is aligned with the Triple Aim of Healthcare—improving quality, expanding access, and reducing costs.

From a quality perspective, Thrive Health is expanding preventive services, including increasing vaccination rates—particularly among HIV PrEP patients—and incorporating routine Pap smears for eligible women in the STD clinic who have not been screened within recommended intervals. From an access standpoint, the move toward a team-based care model is expected to increase patient volume and reduce barriers to care.

In parallel, several targeted care initiatives are being implemented. A Rapid Restart Program is being developed to identify patients who have been out of care for six months or longer, with coordinated efforts from front desk staff, patient navigators, and case managers to reconnect these individuals to care and to overcome barriers. For appropriate patients, providers will review prior records, order necessary labs, and facilitate expedited re-initiation of antiretroviral therapy, including the use of home-based care teams when appropriate.

Alongside expanded vaccination efforts, preventive care is being strengthened through the integration of cervical cancer screening. Thrive Health is initially focusing on high-risk populations such as patients on PrEP before scaling to broader clinic populations. Together, these initiatives represent a shift toward a more proactive, population health-driven model of care.

Launching the Tarrant County HIV Care Collaborative
While Thrive Health celebrates 35 years of service in Tarrant County, we recognize that this work cannot be done alone. Our success and longevity is built on strong partnerships with fellow Ryan White HIV providers, including JPS Healing Wings, CAN Community Health, and AIDS Healthcare Foundation.

To further strengthen these collaborations, Tarrant County Public Health is launching the Tarrant County Ryan White HIV Care Collaborative—a first-of-its-kind initiative bringing together Ryan White providers across the region. This collaborative will serve as a platform for regular discussions on local HIV trends, ongoing education in prevention and treatment, and enhanced coordination of care across systems. A central priority will be improving linkage-to-care efforts through closer integration with DSOP and epidemiology teams.

Together, this unified approach represents a critical step toward reducing HIV transmission and improving health outcomes across Tarrant County.

Looking Forward
Thrive Health’s legacy demonstrates that coordinated HIV care works. However, continued innovation, collaboration, and system redesign are essential to meet the evolving needs of our population.

The future of HIV care in Tarrant County will be found in collaborations that deliver high-value, patient-centered care that allow individuals to lead healthy, fulfilling lives. By working together, we can move closer to ending the HIV epidemic—one patient, one system, and one collaboration at a time—because when we work together, we thrive.

Beating the Stigma: The Challenges in Treating Substance Use Disorders

President’s Paragraph

By Cheryl Hurd, MD, TCMS President

This article was originally published in the May/June 2026 issue of Tarrant County Physician.

By the time you all read this article, I hope you will have had a chance to listen to some of Tarrant County Medical Minute’s many interesting podcast episodes. I recently had the privilege of being invited as a guest on the podcast (you can find my episode here), which TCMS launched in 2025. It was fun, and I also found it to be an opportunity to continue to highlight mental health and advocacy. As I’ve mentioned before, mental health is marginalized and stigmatized but so essential to overall health. I appreciated the opportunity to talk about this on the podcast, fulfilling one of my promises to speak openly about mental health issues.

So, today we are going to talk about an even more stigmatized mental health issue—substance use disorders. They are far more common than many of us realize. According to the Substance Abuse and Mental Health Services Administration in their National Survey on Drug Use and Health in 2023–24, nearly 48 million Americans age 12 and older, or about one in six people, meet criteria for a substance use disorder in any given year.¹

Texas mirrors this national statistic. Alcohol use disorder accounts for the largest proportion, followed by drug use disorders involving marijuana, stimulants, opioids and more. State‑level estimates from the National Survey on Drug Use and Health indicate that roughly one out of seven Texans meets criteria for a substance use disorder each year.² While this is slightly lower than the national average, it still represents millions of people across our state whose health, relationships, and economic stability are affected. In a state as large and diverse as Texas, the collective impact of these conditions is substantial: it affects healthcare utilization, workforce participation, public safety, and even community well-being.

For physicians, this data shows what is already evident in clinical practice. Substance use disorders frequently coexist with chronic medical conditions, complicating diagnoses and treatments while increasing the risk of poor health outcomes. For legislators and policymakers, the numbers highlight the scope of the issue and the importance of continuous investment in prevention, early identification, evidence‑based treatment, and long‑term recovery support. And for the general public, the message is both sobering and illuminating: substance use disorders are common, treatable medical conditions, not moral failures or character flaws.

Substance use disorders do not exist in isolation. National data consistently demonstrates high rates of co‑occurring mental illness as well.¹ This overlap reinforces the need for integrated approaches to care that address the whole person rather than fragmented systems that separate “mental health” from “substance use.” The stigma surrounding substance use disorders mirrors the stigma that has historically marginalized mental health conditions—just as depression and anxiety were once dismissed as weaknesses rather than illnesses, substance use disorders continue to be judged rather than treated.

Stigma remains one of the most powerful barriers to care. It delays seeking help, discourages honest conversations between patients and physicians, and shapes policies that emphasize punishment over treatment. When individuals fear judgment, they are less likely to disclose substance use concerns, less likely to engage in treatment, and less likely to experience recovery. This is true no matter what walk of life you stem from, no matter what profession you are in. Reducing stigma is thus a clinical, ethical, and public health imperative.

Texas‑specific health data further illustrates the downstream effects of untreated substance use disorders, including alcohol‑related hospitalizations, drug‑related overdoses, and preventable deaths.² Even when prevalence rates are slightly lower than national averages, the absolute number of affected individuals places significant strain on healthcare systems and communities. These outcomes are not inevitable; evidence‑based prevention strategies, timely access to treatment, and sustained recovery supports have been shown to reduce morbidity, mortality, and costs.³ The key is that these initiatives have to be adequately funded and broadly accessible.

It is essential to treat substance use disorders as seriously and compassionately as other chronic illnesses. This includes speaking openly about prevalence, acknowledging the role of stigma, and advocating for systems of care that are based on scientific evidence rather than outdated assumptions. If one in six Americans—and one in seven Texans—are affected, then nearly every family, workplace, and community has a stake in how we respond. As physicians, policy advocates, and community leaders, we have both the opportunity and the responsibility to lead with data, compassion, and transparency. By reframing substance use disorders as the common, treatable health conditions they are, we can achieve these goals of reducing stigma, improving access to care, and improving the health and well-being of the populations we serve.

For physicians, the message should be clear: substance use disorders are common and addressing them as part of routine medical care should be best practice. Screening and brief, non-judgmental conversations about substance use should be normalized in our clinical settings. How we ask and how we respond do matter. Framing substance use disorders as treatable medical conditions like the evidence shows will increase patient disclosures, increase their engagement in treatment, and ultimately lead to their trust in us. We must lead the shift from judgment to treatment by insisting that substance use disorders are met with evidenced based care, equitable insurance coverage, and our compassion—not silence or shame.

“We, as a culture, have not fully acknowledged how much help is needed. The only real shame is on us for not being willing to speak openly. For continuing to deny that mental health is related to our overall health. We need to start talking, and we need to start now.”
– OPRAH WINFREY

References:

Blaire Bryant, Naomi Freel, and Emily Steckler, “SAMHSA Releases New 2024 Data on Rates of Mental Illness and Substance Use Disorder in the US,” National Association of Counties, July 28, 2025, https://www.naco.org/news/samhsa-releases-new-2024-data-rates-mental-illness-and-substance-use-disorder-us.
“Substance Use Disorder Statistics,” Drug Policy Facts, accessed May 4, 2026, https://www.drugpolicyfacts.org/node/4476.
Johanna Bellon et al., “Association of Outpatient Behavioral Health Treatment With Medical and Pharmacy Costs in the First 27 Months Following a New Behavioral Health Diagnosis in the US,” JAMA Network Open 5, no. 12 (2022): e2244644, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799220.
Substance Abuse and Mental Health Services Administration, “National Survey on Drug Use and Health (NSDUH): 2023 National Releases,” SAMHSA, accessed April 1, 2026, https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health/national-releases/2023.
Substance Abuse and Mental Health Services Administration, “State Estimates of Mental Health and Substance Use,” accessed April 1, 2026, https://nsduhweb.rti.org/respweb/estimates.html.
Li-Tzy Wu, He Zhu, and Udi E. Ghitza, “Multicomorbidity of Chronic Diseases and Substance Use Disorders and Their Association with Hospitalization: Results from Electronic Health Records Data,” Drug and Alcohol Dependence 192 (2018): 316–23, https://doi.org/10.1016/j.drugalcdep.2018.08.013.
Lauren R. Ray et al., “Combined Pharmacotherapy and Cognitive Behavioral Therapy for Adults With Alcohol or Substance Use Disorders: A Systematic Review and Meta-analysis,” JAMA Network Open 3, no. 6 (2020): e208279, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2767358.

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;.