We Might be Done With COVID-19, But It Is Not Done With Us

A message to the community from Tarrant County physicians

The current surge in COVID-19 cases in the Tarrant County area is having serious consequences that could impact patient outcomes.

  • Hospitals are currently at, or over, their staffing capacity with very few open ICU beds available across Tarrant County.
  • Doctors, nurses, and other healthcare professionals are straining to meet the overwhelming needs in the hospitals.
  • COVID-19 hospitalizations aren’t just a problem of the unvaccinated, they also strain the resources that are needed to treat other medical conditions and emergencies.

To avoid this, we urge the community to recognize this current crisis and take the simple and familiar steps that are proven to be effective against the spread of COVID-19.

  • We must continue to wear our masks, wash our hands, and be cautious about how we gather.
  • Because the Delta variant is the most contagious variant yet and has the potential for spread by both vaccinated and unvaccinated individuals, we encourage everyone to wear a mask in public while indoors and outdoors when unable to socially distance.
  • In addition, those who are not fully vaccinated should limit gathering with those outside of their household, especially while indoors.

Vaccination is the safest and most effective way by which we can protect ourselves from this deadly virus and get back to normal.

  • With over 350 million doses of COVID-19 vaccine given in the U.S., evidence of the safety and effectiveness of the vaccines is overwhelming.
  • Being fully vaccinated results in an 8-fold reduction of having symptomatic COVID-19, a 25-fold reduction in being hospitalized and a 25-fold reduction in death from COVID-19. We strongly encourage every eligible person to get vaccinated – immediately.

As a community, we are at a tipping point. Let’s move in the right direction.

  • Each one of us can do our part to stop the spread, break the cycle, and defeat this pandemic once and for all. The choice is ours.

The Tarrant County Medical Society is a membership organization for the physicians serving the Tarrant County community. TCMS has been dedicated to the improvement of the art and science of medicine since 1903.

Ten Tarrant County Physicians Start New Terms in TMA Leadership Positions

Ten Tarrant County physicians have begun new terms of service in Texas Medical Association (TMA) leadership positions.

TMA leaders elect or appoint TMA physicians and medical students to one of TMA’s 25 boards, councils, and committees. They are responsible for studying health care-related issues and making recommendations on important health care policy affecting Texas patients and their physicians.

All of these physicians are members of the Tarrant County Medical Society.

Tilden L. Childs III, MD, a diagnostic radiologist in practice for 41 years; reelected to the TMA Council on Legislation.

Shanna M. Combs, MD, an obstetrician-gynecologist in practice for nine years; appointed chair of TMA’s Committee on Membership and reappointed to the committee, and reappointed as a consultant to TMA’s Committee on Reproductive, Women’s and Perinatal Health.

Cheryl L. Hurd, MD, apsychiatrist in practice for 19 years; reappointed as a consultant to the TMA Committee on Physician Health and Wellness.

R. Larry Marshall, MD, a rheumatologist in practice for 32 years; appointed to TMA’s Committee on Continuing Education.

G. Sealy Massingill, MD, an obstetrician-gynecologist in practice for 32 years; appointed as a consultant to the TMA Council on Science and Public Health, and reappointed as a consultant to TMA’s Committee on Reproductive, Women’s, and Perinatal Health.

Matthew M. Murray, MD, a pediatric emergency physician in practice for 31 years; reappointed to TMA’s Committee on Health Information Technology.

Stuart C. Pickell, MD, an internist and pediatrician in practice for 21 years; elected to TMA’s Council on Medical Education, and reappointed as a consultant to the TMA Council on Health Service Organizations.

Drew Elizabeth Rainer, MD, an obstetrician-gynecologist in practice for four years; elected to TMA’s Council on Medical Education.

Angela D. Self, MD, an internist in practice for 19 years; reappointed to TMA’s Committee on Patient-Physician Advocacy.

Linda M. Siy, MD, a family physician in practice for 28 years; reelected to TMA’s Council on Legislation.

Read the descriptions and responsibilities of each TMA council and committee.

TMA is the largest state medical society in the nation, representing more than 55,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.

TCMS Pediatrician Voted in as TMA President-Elect

Gary Floyd MD picture

Gary W. Floyd, MD, a Fort Worth pediatrician and longtime member of the Tarrant County Medical Society, was elected president-elect of the Texas Medical Association  on Saturday, May 15. TMA’s House of Delegates governing body announced elections during TexMed, the association’s annual conference, held virtually this year due to the pandemic. He will serve in this role for one year before assuming the presidency of America’s largest state medical society in 2022. 

“It’s an incredible privilege and responsibility – and very humbling – for the members of our TMA to elect me to be the spokesperson for our organization,” said Dr. Floyd. “I will never tire of advocating for our patients and our physician members.”

TMA’s president is the organization’s primary voice to external audiences and to physician members – for advocacy and policy efforts, and in news interviews.

Dr. Floyd has been very involved in TMA and other organized medicine organizations throughout his 42-year medical career. He chaired TMA’s Board of Trustees governing body for the past year, having served in that body for seven years. He led the board in a “disaster board” function last year, temporarily acting on urgent business in place of the association’s policymaking body since the pandemic prohibited an in-person House of Delegates meeting. Board members explored a new diversity initiative as well.

“As chair, I led our board to initiate a task force to study equity, diversity, inclusion, and racism,” he said. “I believe our TMA needs to seriously address these issues as we move further into the 21st century.”

Dr. Floyd also was reelected today by the TMA house as a delegate representing Texas in the American Medical Association House of Delegates. He has chaired the TMA Council on Legislation and served on the association’s Council on Constitution and Bylaws, and the Select Committee on Medicaid, CHIP, and the Uninsured. Dr. Floyd also was a district chair of TEXPAC, TMA’s political action committee.

Dr. Floyd has several objectives planned for his presidency next year, which mirror long-term goals of the association.

“My goals include aggressively protecting against intrusions into the practice of medicine by those who have not done the necessary training, in order to protect our patients and unsuspecting citizens in Texas,” he said. He also lists defending Texas’ liability reforms and defending against intrusions into what he calls “the sacred bond” between physicians and their patients. He believes in protecting physicians’ autonomy to make medical decisions with and for their patients. 

The pediatrician assumes the presidency as Texas continues to vaccinate against COVID-19 and return to normalcy in life and patient care.

“I actively practiced pediatrics over 40 years, but with the COVID pandemic, I retired from daily patient care,” he said. He continues to be very involved in medical management and organized medicine, however.

During the pandemic, TMA distributed millions of personal protective equipment masks to Texas physicians. TMA also guided many doctors in adopting telemedicine to remotely care for patients and provided other information and support for physicians to survive and thrive during the pandemic.

Dr. Floyd previously served as president of the Texas Pediatric Society and TCMS, and he was active in the American College of Physician Executives, and the Society for Pediatric Emergency Medicine. He is a fellow and board member of the American Academy of Pediatrics.

Dr. Floyd graduated from The University of Texas Medical Branch at Galveston and completed his pediatric residency at Children’s Hospital of Oklahoma, University of Oklahoma Health Science Center. He pursued his undergraduate studies at The University of Texas at Austin.

Board certified by the American Board of Pediatrics, Dr. Floyd has practiced in various settings in Texas and Oklahoma including general pediatrics, academic pediatrics, and  pediatric emergency and urgent care, and he has worked in administrative medicine and government affairs. He was the John Peter Smith Health Networks chief medical officer and executive vice president of medical affairs, then executive vice president of government and alumni affairs.

Active in the First Baptist Church of Keller, Dr. Floyd has been married 47 years to Karen Floyd, whom he met when they were in high school. “She is my best, most trusted friend,” he said. The couple has two married daughters, Holly Peterson, married to Ben Peterson, and Neely Pedersen, married to Craig Pedersen, DO, and two grandsons, with another due in October.

TMA is the largest state medical society in the nation, representing more than 55,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.

AMA President Joins TMAF Gala as Honorary Chair

Susan Rudd Bailey, MD, TMA past president and current American Medical Association president, will serve as honorary chair of the TMA Foundation’s virtual gala, Superheroes: Meeting the Challenge, which is scheduled for Friday, May 14, 2021, during TexMed 2021, TMA’s annual meeting. The gala helps make TMA’s population health, science, and quality of care programs possible.

“Clearly the COVID-19 pandemic has called on physicians like no other threat has in our lifetimes,” Dr. Bailey said. “It’s with great pleasure that I join the TMA Foundation gala to recognize and celebrate the courage physicians have shown because of their singular dedication to the health of their patients.”

Dr. Bailey is an allergist in private practice and has been with Fort Worth Allergy and Asthma Associates for more than 30 years. She has a long history of service in organized medicine, having served as TMA vice speaker and speaker and as board chair and president of the Tarrant County Medical Society.

“Please join me, the gala-co-chairs, and the TMAF board by attending this virtual gala, which comes at a time when we need to remain strong and follow where the science leads us. The continued strength and resolve of our physician heroes is needed to see us to the very end of this pandemic,” Dr. Bailey added.

TMAF’s gala will take place as a virtual event from 7 to 8:15 pm (CT) Friday, May 14, with a preshow from 6:30 to 7 pm. It will feature a silent auction, special messages to the health care superheroes in Texas, entertainment from Austin musicians, a party Box for guests and more.

 Purchase your table or tickets  or call (800) 880-1330, ext. 1664, or (512) 370-1664 today for more intormation.

Call to Action: Tell Us Your Worst Prior Authorization Stories ASAP

The vast majority of Texas physicians agree that the prior authorization process is burdening your practices and hurting your patients. Now is the time to tell your story.

TMA is lobbying on your behalf this legislative sessions. Equip them with your nightmare prior authorization stories so they can tell legislators the real, serious complaints of their constituents.

Please submit your stories via TMA’s secure email portal as soon as possible.

“Physicians already know all too well the burdens and harm that can occur when insurance company impose prior authorization requirements,” TMA President Diana L. Fite, MD, said. “Our lawmakers need to do more to make sure our patients get the medicines, tests, and treatments that they need, when they need it.”

Share your stories to defend your patients and your profession.

A reminder as you submit your story: It is important for you to ensure that your submission complies with state and federal laws, including, as applicable, the HIPAA privacy rule. HIPAA’s safe harbor list of 18 de-identification requirements is available here.

Getting to Know Angela Self, MD – 2021 TCMS President

by Allison Howard

This piece was originally published in the January/February issue of the Tarrant County Physician. You can read find the full magazine here.

Dr. Angela Self always had an independent spirit. At age 17, fresh out of high school, she left her home in Las Vegas to make a life for herself in New York. As she was growing up, Dr. Self did not dream of becoming a doctor, but she never shied away from an adventure. Looking back, she thinks the decision to pursue Medicine shouldn’t have been such a surprise. When she was 14, Dr. Self volunteered as a candy striper at Southern Nevada Memorial Hospital (now University Hospital), and shortly after she moved to New York, she began working as a dental assistant. “Maybe it was a foreshadowing, but I had never even considered that I would go into Medicine,” says Dr. Self. 

The idea to shift directions came suddenly. One day, after assisting with a procedure, Dr. Self began questioning her path. She was filled with a desire to care for patients directly in a capacity where she could serve as their advocate. Medical school came to her as the obvious answer, but she knew it would be a long, winding path. She did not yet have an undergraduate degree so she approached the decision thoughtfully. “Through a process of prayer, and seeking, and volunteering at my ambulance corps, I really felt a strong leading that I was to go to medical school. Once I knew I was going, there was no question in my mind from that moment.” When she felt confident that this was her future, she quickly began making changes to prepare for the long years of study that lay ahead.

Dr. Self realized that she would need a flexible job to support her education, one that would give her freedom to go to classes during the day. She was also hesitant to step away from the clinical interactions she had with patients as a dental assistant. “I thought, it’s going to be eight years before I can do anything,” remembers Dr. Self.  “Here I had been working as an oral surgical assistant, a dental assistant. I had been in ORs with an oral surgeon and had been able to do hands-on things.” Because of this, as she began attending classes at a local community college and continued to work full time, Dr. Self also received training as an EMT and a paramedic. 

She joined South Orangetown Ambulance Corps in 1987. It was an exciting but hectic time. Dr. Self had three different jobs at that point and picked up extra shifts on the ambulance whenever possible. She worked nights, clocking an average of 60 hours a week while still taking a full load of classes. Despite her long work hours, she was hesitant to slow down. She transferred to Pace University in 1990 and graduated with a BS in Biology in 1992. 

At that point, Dr. Self ran into some barriers. She applied to medical school in New York but ended up being waitlisted. Because of her extreme work hours, she had not been able to maintain a 4.0 GPA. Dr. Self was concerned that this would stop her from going to medical school; it was the first time she began to doubt that she had made the right decision. She considered several alternatives, such as pursuing social work, becoming a pharmacist, or even getting an advanced nursing degree. 

“Dr. Angela Self is an amazing colleague who I have the pleasure to work closely with on many projects. She is compassionate, honest, hardworking, and has everyone’s best interest at heart. I have the utmost confidence that she will represent Tarrant County Medical Society with dignity, compassion, and will be an overall amazing leader.”
Neerja Bhardwaj, MD

Then, a new opportunity arose. “A friend that went to St. George’s in Grenada suggested that I apply there,” says Dr. Self. She knew it would be a big change—Dr. Self hadn’t planned to leave New York for medical school, much less the U.S. Still, she was intrigued. “I had a couple of friends that I really admired that were going to St. George’s,” she shares. They were very positive about the school, so she decided to apply. She was accepted into the program and began classes in 1994. 

Looking back, Dr. Self realizes that she could have applied to other U.S. medical schools, but she has no regrets. Living in Grenada gave her the opportunity to learn hands-on about diseases that are rarely seen in the States, due to Grenada being a developing country. She also gained some wonderful mentors at the school, including Dean of Students Dr. C.V. Rao.  “He taught us, he mentored us, he watched out for us, and remains a friend, I think, to everyone who ever went there.”

While in medical school, she was on call for student emergencies. She also continued picking up shifts as a paramedic whenever she was on breaks. It was difficult to work so much while completing her education, but the benefit of financial security coupled with the valuable patient care experience made it worthwhile. 

Dr. Self moved back to the U.S. in 1996 to complete her clinical rotations, working between New York and Baltimore. She graduated from medical school in 1998 and began an internship in anesthesiology at the Medical College of Virginia in Richmond. Though anesthesia was appealing, she had a passion to care for geriatric and terminal patients, so she believed her future was in oncology. 

At this time, Dr. Self had a big life change—she gave birth to her daughter, Whitney. She took ten months off to care for her young child, until they moved to Texas. At that point, Dr. Self completed her internal medicine residency at St. Paul Hospital in Dallas. It was a difficult time to be going through the intensity of residency.  “It was really hard to go every day because I felt I was robbing my daughter of having a mom,” says Dr. Self. She is grateful to her mother for taking care of Whitney, filling the gap when Dr. Self couldn’t be there.

As she completed her residency, Dr. Self fell in love with primary care. She was also ready to focus on her future. “I needed to commit to motherhood and Medicine, and I felt I could do that by doing internal medicine,” says Dr. Self. When she finished the program, she joined a private practice. Dr. Self worked as an internal medicine physician for 15 years. She was employed at three different clinics throughout that time; at one point, she worked for David Pillow, MD, a well-known pillar of the Tarrant County medical community. “Dr. Pillow taught me that patients will tell you what’s wrong if you just listen,” says Dr. Self. He helped her to avoid developing tunnel vision when treating her patients. “His physical exams were amazing. He taught me so many things that you never learn in medical school.”

Dr. Pillow’s guidance along with an extensive background in emergency care made Dr. Self a strong diagnostician. She was quickly able to discover the root of a problem, especially when critical treatment was required. Twice, she was able to get patients immediate care when they came to appointments mid-heart attack, even though their symptoms were irregular. Because she wanted to serve older patients, whenever she joined a new clinic, the Medicare patients were sent her way. “I got the ones with heart failure, liver disease, lung disease, and cancer, and then I got involved with hospice. That fulfilled that longing in me to work with end-stage patients. I did get to do what I wanted after all.”

Still, there was a downside to private practice; it was difficult to manage financially. “Medicare didn’t pay that much, and geriatric patients take a lot more resources, need a lot more time, so you see fewer in a day and reimbursement is lower, but it was what I was passionate about so I did it as long as I could.”

Eventually, Dr. Self made the move to working in administrative medicine. She has been on the other side of care for about five years now; currently, she is working for an accountable care organization. Though she misses taking care of patients, there are many advantages to her current role. “I can advocate for more people in an administrative role than in a primary care practice, where I might have one to two thousand charts, so I can affect one to two thousand lives in practice,” shares Dr. Self. “Now I can affect many more lives.” One of her focuses is improving the patient experience in post-acute settings.

While the change may seem dramatic, Dr. Self has been involved in organized medicine her whole career and has seen the impact of physicians advocating for their profession. She has been a longtime member of TCMS. In the early 2000s, she helped to review cases for the Public Grievance Committee. Dr. Self became more involved during the 2014 Ebola crisis. She was impressed by the way TCMS, TMA, and the AMA worked together to protect patients and physicians, and she knew that was something she wanted to be a part of. “Ever since then, I’ve made attending TCMS’s monthly board meetings part of my job negotiations!” 

Dr. Self Is an active member of the TCMS Board of Advisors and the Women in Medicine Committee; she also attends TMA and TCMS meetings whenever possible. “(TCMS board member) Gary Floyd says, ‘Good doctors take care of their patients. Great doctors take care of their patients and their profession,’” says Dr. Self. “Being part of organized medicine is helping to take care of your profession. When doctors go down to Austin and speak with lawmakers in their white coats, it changes the way that we are viewed.”

Her fellow physicians look forward to seeing her in this new role as president. “Dr. Angela Self is an amazing colleague who I have the pleasure to work closely with on many projects. She is compassionate, honest, hardworking, and has everyone’s best interest at heart,” says Neerja Bhardwaj, MD, a palliative care physician practicing in Dallas. “I have the utmost confidence that she will represent Tarrant County Medical Society with dignity, compassion, and will be an overall amazing leader.”

In the next year, Dr. Self hopes to grow physician membership and participation in the Medical Society. She believes in the power of banding together to give doctors a voice for their profession and their patients. She also wants to serve as a resource, particularly for independent physicians who are struggling with the fallout from COVID-19. She thinks providing opportunities to connect with other physicians is an important part of this support. “Talking with other doctors who have experienced the same things helps,” shares Dr. Self.  “I’ve been there.” All of this ultimately comes together for one purpose: to serve patients excellently and effectively. 

When advising those who are considering going into Medicine, Dr. Self encourages getting as much exposure as possible before taking the leap. “Make sure you have fully answered the ‘why’ for medical school,” says Dr. Self. “Make sure it is something you are passionate about.” Shadow a physician, work as a scribe—whatever it takes to make sure you have found your calling in life. It isn’t an easy path, but it can be incredibly rewarding. “There is nothing else I would rather do.”

When Dr. Self is not working or attending meetings, you might find her volunteering at the Cornerstone Assistance Network. Even though she doesn’t currently practice in a clinic, Dr. Self still enjoys getting to treat patients, especially those who are struggling to access care. In her free time, Dr. Self loves traveling and going to live concerts. Last year she was able to attend the Eric Clapton Guitar Festival. “It was amazing and made me realize that I love the Blues. I didn’t know I loved the genre before that!” A highlight of her trips is always searching for the best lattes in hole-in-the-wall cafés. Dr. Self loves coffee—she even runs a blog to talk about her caffeinated discoveries (you can read some of her stories at coffeebyangela.com). 

She enjoys going on these trips (when there isn’t a pandemic!) with friends and family. Dr. Self has the most fun when her daughter can come along, but Whitney is pretty busy these days. She is currently working on completing her undergraduate degree with the goal of applying to medical school in the near future. 

We are excited to support Dr. Self as she prepares to lead us as we serve the citizens of Tarrant County and the community of Medicine.

Installation of Angela Self, MD – 2021 TCMS President

Join us as we install Angela Self, MD, as TCMS’s 2021 president. The ceremony will take place over Zoom at our January Board of Advisors meeting, which will be held Wednesday, January 27, 2021, at noon.

If you would like to participate, email Melody Briggs at mbriggs@tcms.org.

From the Director

The challenges of 2020 changed us, but they did not stop us. A look at how PATC adapted during unprecedented times.

By Kathryn Narumiya, PATC Program Director

Happy New Year!

One year ago, few would have thought that in just weeks, our places of business, worship, and pleasure would be severely limited or closed. Fewer still could have predicted the profound effect this would have on patient access to medical care.

Project Access Tarrant County was similarly affected. Sometimes we wondered how the program would continue. But, true to PATC tradition, we evaluated, collaborated, and devised a plan that fits our current reality.

Instead of attending in-person intake sessions with PATC staff, patients now complete the process virtually. Instead of delivering documents to the office, patients fax or mail them. And while some of our patients have had to be creative in how they access the necessary technology (who hasn’t?), every one of them has been able to make it work.  

Reflecting on 2020, we are amazed at how much we were able to accomplish given the shutdowns and hospital limitations. PATC coordinated 382 medical appointments for 105 patients, including 20 surgeries and other hospital procedures during a period when access for even paying patients was severely limited.

We are always grateful for our volunteers and partners, but this year, we are especially thankful for our generous volunteers who continued to see patients and provide charity care during a time of uncertainty.

As I write this, hospitals are reaching capacity (again) and are postponing and canceling surgeries and procedures. As a result, PATC has several patients whose cases are on hold indefinitely. But this time, we know how to proceed. We have a plan and we will continue to take each day and each moment one step at a time until we reach the other side.  

TCMS Physician COVID-19 Vaccine Event

Join us on Friday for our TCMS Physician COVID-19 Vaccine Event. In partnership with Tom Thumb/Albertson, we will be providing Moderna vaccines for TCMS members and their clinical staff who participate in direct patient care.

Members, if you did not receive the email or need additional information, contact Melody Briggs at mbriggs@tcms.org.