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Addressing Conscientious Objection in Healthcare

Insights from the 2023 Healthcare in a Civil Society Forum

by Liz Ramirez

The Tarrant County Academy of Medicine Ethics Consortium, in partnership with Tarrant County Medical Society, hosted Healthcare in a Civil Society on Saturday, February 25, 2023. The annual forum’s central theme focused on “Conscientious Objections in Health Care: Patient Autonomy and Provider Integrity.” 

TCMS President Stuart Pickell, MD, joined Steve Brotherton, MD, as HCS moderator and welcomed their keynote speaker, Farr Curlin, MD, at the University of North Texas Health Science Center.  

“Dr. Curlin is an internationally known expert on physician conscience and conscientious objection,” said Dr. Pickell. “He is particularly concerned with the moral and spiritual dimensions of medical practice, the doctor-patient relationship, and the moral and professional formation of physicians. His areas of expertise are medicine, medical ethics, doctor-patient relationship, religion and medicine, and conscience.” 

On the panel, Dr. Curlin was accompanied by panelists Maxine M. Harrington, JD; Alan Podawiltz, DO; and UNTHSC President, Sylvia Trent-Adams, Ph.D., RN. In the discussion, Preston “Pete” Geren, JD, moderated a panel about educational topics like state intrusion into practice, the effect of providers performing unethical acts, and how medical educators can train students to recognize moral injury. 

Participants had the opportunity to interact in small groups and prepare questions for the panelists during the breakout session, where panelists discussed the impact of government and institutional intrusion into medical practice, its effect on healthcare providers, and what providers can do to address it.  

“While this event targets medical professionals, anyone who has an interest in the doctor-patient relationship- how it has evolved, where it is heading and implications for the future of healthcare- will find this program helpful,” said Dr. Pickell.

The Tarrant County Academy of Medicine Ethics Consortium believes anyone in the community with an interest to improve healthcare can benefit from this program. The event wouldn’t be possible without the support of Blue Cross Blue Shield, Cook Children’s Medical Center, JPS Health Network, and the University of North Texas Health Science Center. 

TCMS Legislative Committee Kickoff

Join us for a night of fun and advocacy training as we kick off our 2023 TCMS Legislative Committee meeting.

In partnership with TMA lobby staff, you will learn about the top issues, challenges, and techniques we will use to advocate on behalf of physicians and patients during the upcoming session.

The TCMS Legislative Committee is one of the most active advocacy groups in all of Texas, and we need a strong bench of leaders who continue to be involved here in Tarrant County, Texas, and Washington D.C.  Please RSVP to Elizabeth Bowers at

Linda Siy, MD, named Texas Family Physician of the Year

Linda Siy, MD, of Fort Worth, Texas, has been awarded the highest honor among Texas family doctors by the Texas Academy of Family Physicians. She was named the 2022 Texas Family Physician of the Year during TAFP’s Annual Session and Primary Care Summit in Grapevine on Oct. 29. Each year, patients and physicians nominate extraordinary family physicians throughout Texas who symbolize excellence and dedication in family medicine. A panel of TAFP members chooses one as the family physician of the year.

“It truly is an honor to join the ranks of those who have received this distinction, and I’m very humbled to be considered with those distinguished colleagues who previously were Family Physicians of the Year,” Siy said as she accepted the award.

Siy has been a family physician for over 30 years, and currently practices at John Peter Smith Health Network at the Northeast Medical Home in Tarrant County, a practice she’s been a part of since 1995. She is also faculty at the University of Texas Southwestern School of Medicine, the University of North Texas Health Science Center/Texas College of Osteopathic Medicine, and the Texas Christian University Burnett School of Medicine.

Throughout her years in organized medicine, Siy has served on many committees and councils for both TAFP and the American Academy and has been president of the TAFP Foundation since 2017. She serves on the Acclaim Multispecialty Group’s Physician Board of Directors, and previously served as president of the Tarrant County Medical Society and TAFP’s Tarrant County chapter.

Siy has spent her career in medicine treating her loyal and multi-generational families of patients, many of whom are underserved, suffer from housing and food insecurity, and struggle with mental health and substance abuse. Many of her nominators mentioned her willingness to speak up and ask the questions others are too afraid to ask, as well as her dedication to teaching the next generation of family physicians.

“I think what’s kept me in the game for so long at the place where I work now are those rewarding relationships with your patients, with your staff, with your colleagues,” Siy said of her career in family medicine. “It’s really not a job. It’s a calling.”

Network at the TCMS Card Swap

TCMS physicians, do you want to expand your network of colleagues? Then be sure to join us for our Referral Night & Card Swap!

The event, which will take place at TCMS on August 25, will give you the chance to mingle and then participate in a speed dating-style card swap. We hope you join us – it is a great opportunity to build connections with other doctors throughout Tarrant County.

Dinner will be provided, so be sure to RSVP to Melody Briggs by Friday, August 19. Details are included below.

JPS Health Network, Fort Worth ISD To Offer Free Sports Physical Exams for the New School Year

Physicians from JPS Health Network are offering free sports physicals for Fort Worth ISD student athletes on Saturday, May 21.

Fifty JPS physicians, including seven Sports Medicine Program fellows, Sports Medicine Program faculty members, and physicians in the Family Medicine Residency Program, will perform the exams. A comprehensive sports physical exam is required for Fort Worth ISD students to participate in athletics in the new school year. The free event is a convenient opportunity for students to get a checkup.

Also volunteering their time are more than 30 others, including JPS nurses, EMTs, and students from Texas College of Osteopathic Medicine, who will take vital signs. Other JPS team members have been enlisted to direct the students to various stations.

“We want to be involved in our community. We want kids to be able to participate in sports because it provides so many positives for our youth today,” said Sports Medicine Fellowship Program Director Michele Kirk, MD.

The mass physicals event has not taken place since 2019 due to the COVID-19 pandemic. Kirk noted that at past events JPS physicians have identified serious health problems in some teens while checking students’ readiness for sports. Athletes are referred to the appropriate physician providers for further evaluation and treatment in these situations.

JPS Sports Medicine physicians serve as team physicians for many high schools in Fort Worth ISD and Arlington ISD as well as being the team physicians for Texas Christian University, Texas Wesleyan University, and Southwest Assemblies of God University. They specialize in preventing, diagnosing, and treating injuries related to athletics and physical activities. To find out more about the JPS Sports Medicine program, visit

Physical examination and medical history forms must be completed and signed by a parent or legal guardian by Wednesday, May 18. All FWISD athletes wanting to participate must go through their school and athletic trainer. Parents will not be allowed to bring their children in for the physicals themselves.

Past TCMS President Assumes TMA Presidency

Find Texas Medical Association’s original press release here.

On Saturday, April 30, 2022, the Texas Medical Association (TMA) installed Gary W. Floyd, MD, a Keller pediatrician, as its 157th president. TMA’s House of Delegates policymaking body installed Dr. Floyd during TexMed, the association’s annual conference, in Houston this year. TMA elected him president-elect in May 2021.

“It’s an incredible privilege and responsibility – and very humbling – for the members of our TMA to entrust me to lead our great organization,” Dr. Floyd said.

Three tenets guide him: his work, faith, and family. He said the three principles have formed the internal value system by which he lives and works, serving as guardrails along his path from medical school to TMA president.

Dr. Floyd addressing the members of the Texas Medical Association as their newly-installed president.

Dr. Floyd is the fourth president to serve America’s largest state medical society during the ongoing COVID-19 pandemic. During his one-year presidency, he hopes to repair the mistrust of the medical profession that has grown as doctors and health care workers have battled COVID. He said to accomplish that, organized medicine should present a united front in the face of misinformation, while remaining professional and collegial.

“One of the biggest things we have to focus on … is finding areas of commonality,” Dr. Floyd said.

He explained those commonalities include “protecting the sanctity of the patient-physician relationship; allowing physicians to practice medicine without … interference from insurance or other payers or the government; protecting our patients as they seek assistance for delicate issues; and protecting our physicians as they try to render care to the best of their abilities.”

Dr. Floyd has been involved in TMA throughout his 43-year medical career. He chaired the TMA Board of Trustees, the association’s governing body, in 2020-21, having served seven years on the board.  

He also 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.

In addition to his TMA involvement, he previously served as president of the Texas Pediatric Society and the Tarrant County Medical Society, 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.

After the pandemic hit, Dr. Floyd began seeing fewer patients although he continues to be involved in medical management and organized medicine. His passion for medicine makes him a strong advocate for patients and physicians. His recipe for successful advocacy involves teamwork. One example, he said, was the agreed-to bill he helped TMA broker with advanced practice nurses and physician assistants in 2013. The Texas Legislature passed the landmark compromise, which led to an improved model for a team-based approach to health care, with physicians leading the team.

Dr. Floyd believes successful advocacy does not happen overnight; it depends on unwavering, grassroots commitment. “It’s not that you have special abilities,” he said, “it’s just that you keep showing up.”

Dr. Floyd is board certified by the American Board of Pediatrics. He has practiced in various settings in Texas and Oklahoma including general pediatrics, academic pediatrics, and pediatric emergency and urgent care. He was the medical director for pediatric emergency services at Cook Children’s Medical Center for 15 years. Dr. Floyd later became John Peter Smith Health Network’s chief medical officer and executive vice president of medical affairs, and then executive vice president of government and alumni affairs.

A graduate of The University of Texas Medical Branch School of Medicine at Galveston, Dr. Floyd 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.

Dr. Floyd has been married 47 years to Karen Floyd, whom he met when they were in high school. She introduced him to Christianity – a faith that he said kept him calm when he found himself in chaotic pediatric emergency departments and intensive care units, with patients sometimes on the brink of death.

The couple has two married daughters, Holly Peterson, married to Ben Peterson; and Neely Pedersen, married to Craig Pedersen, DO; and three grandsons.

A Texas Trailblazer – May Owen, MD, a Medical Pioneer and TMA’s First Female President

By Sean Price

Originally published in Texas Medical Association’s December 2021 issue of Texas Medicine. It was republished with TMA’s permission in the March/April 2022 issue of Tarrant County Physician.

On May 27, 1936, May Owen, MD, answered a scientific riddle in a speech before the Texas Medical Association, explaining research that would soon make her a statewide celebrity. 

The name of the paper she read that day, “Peritoneal Response to Glove Powder,” sounded vague to nonexperts. But the other clinical pathologists who gathered to listen understood that Dr. Owen had uncovered that a common medical practice posed a threat to patients.  

The mystery started nearly 16 months earlier when a fellow Fort Worth physician alerted Dr. Owen to the case of a 19-year-old woman with unexplained fibrous membranes and tumorous nodules growing in her abdomen. The woman had had her appendix removed two years previously, and something about that operation had gone wrong.  

After months of research, Dr. Owen proved that the unusual growths plaguing the woman had been caused by the talcum powder used at the time to coat surgical gloves. Human tissue couldn’t absorb the powder, so if just a little bit inadvertently fell into a wound during an operation, it caused infection, scar tissue, and other problems.  

Dr. Owen read her paper before a mostly appreciative audience that gave her a standing ovation, according to her biography, May Owen, MD, by Ted Stafford, which is the source for most of this article. But when most of the crowd sat down, one man remained standing and began to shout. 

“I have been sitting here listening to this woman spout off about the dangers of glove powder,” he said. “I don’t believe a word she has said.” 

He continued ranting until the meeting’s chair ruled him out of order and told him to be quiet. Later that day, Dr. Owen won an award from the Texas Society of Pathologists, just one of many she would earn, including an honorary doctor of science degree from her alma mater, Texas Christian University (TCU). 

The man’s outburst rattled Dr. Owen, reminding her of just how far she had come as a woman in medicine – and how far women like her still had to go to win acceptance. But she never lost confidence in herself or her findings. 

“I knew if I lived to be 100, that [discovery] would be my most important contribution to humanity,” she recalled.  

The research forced surgical glove makers to switch to a starch-based powder the human body could absorb. Texas newspapers clamored to interview this “woman doctor” – partly because her work had caused such an uproar and partly because so few women physicians existed anywhere at the time. 

Dr. Owen’s pioneering work continued in the decades to come, making her the first female president of the Texas Society of Pathologists in 1946, the first female president of the Tarrant County Medical Society in 1947, and the first female president of TMA in 1960. 

She had help from friends and relatives during her difficult rise from poor farm girl to honored Fort Worth physician, and that made her a conscientious mentor to hundreds of young physicians and people interested in medical careers. 

One of them was Margie Peschel, MD, who started her career in Fort Worth as a resident in 1959, when women were still rare in the medical profession. She later became a pathologist who ran what is now Carter BloodCare from 1976 to 1997. 

“I always felt lucky to be in Tarrant County because Dr. Owen set the example that women are welcomed,” she said in an interview with Texas Medicine.  

From farm to medical school 
Dr. Owen was born in 1892 in Falls County, just southeast of Waco, the sixth of eight children. She grew up doing hard work on the family cotton farm, and her parents, Jack and Lilli Owen, allowed her to go to school only after her morning chores were done.  

Dr. Owen’s mother died when she was nine years old, and her father – whom she describes in her biography as autocratic and demanding – became even more so. He put more chores on his daughter and scoffed when she told him she intended to be a doctor.  

“Get that silly idea out of your head right now,” she recounted him saying, according to her biography. “Your place is here on the farm. We will not discuss this matter anymore. Do you understand?” 

Dr. Owen’s father tolerated her finishing school up to seventh grade, but only the intervention – and financial assistance – of an older brother allowed her to go first to high school and then to college at TCU in Fort Worth, graduating in 1917. In 1921, she became the first woman to graduate from what is now the University of Louisville School of Medicine in Kentucky. 

Dr. Owen’s father did not actively prevent his daughter’s education, but he also never helped it and never acknowledged her accomplishments. Nor did he answer the many letters she sent after she became a physician.  

“Her father never honored her,” Dr. Peschel told Texas Medicine. “It was sad. We would drive from Fort Worth to Austin for TMA meetings, and she shared things like that – that her daddy never did recognize her.” 

During the 1920s and 1930s, Dr. Owen worked mostly as a pathologist for Terrell’s Laboratories in Fort Worth, and the owner – Truman Terrell, MD – was her friend and mentor. He loaned her the money to attend medical school. She also did advanced study at the Mayo Clinic in Rochester, Minn., and Bellevue Hospital in New York.  

Despite her intense training, some fellow physicians – frequently older doctors – still refused to accept her medical opinions. In one case, when a surgeon argued that she was wrong, Dr. Owen found a clever way to win him over. 

“I split the specimen in half and did my examination on one section and reported my findings to the surgeon,” she told her biographer. “The other half was sent to the pathologist at Massachusetts General Hospital in Boston. When his report came back, it agreed precisely with what I had reported. After a while the people who had doubted my ability and competence began to accept my work without question.” 

Dr. Owen also earned the respect of veterinarians early in her career because her rural background gave her an understanding of animals and farming. In 1931, a vet at the Fort Worth Stockyards asked for her help in identifying a mystery disease that was killing sheep. Some suspected anthrax. But Dr. Owen discovered that the molasses cake being fed to the sheep to fatten them up was giving the animals diabetes. This discovery changed the way sheep were raised worldwide. 

Despite what coworkers recount as a crushing work schedule, she remained active in all levels of organized medicine, and she encouraged medical students and young physicians to join organizations like TMA. By the time Dr. Peschel became a pathologist in 1964, Dr. Owen knew just who to talk to to get her colleague assigned to committees in TMA and other medical organizations. 

“She was so active,” Dr. Peschel said. “She introduced me to everybody at TMA and the pathologists in the state. She just knew all these people. She was an excellent mentor.” 

Dr. Owen expressed a deep debt to the people who helped her get a start in medicine. 

“I know I could never have done it alone,” she said in her book. 

As TMA president, Dr. Owen established TMA’s Physicians Benevolent Fund to help physicians in times of distress. She led the charge with a $2,500 contribution of her own, and since 1961, the fund has distributed more than $4.38 million in financial assistance.  

“We all know of cases where our colleagues have suffered illness, death, or other misfortunes,” Dr. Owen said to TMA board members when requesting the fund’s creation.  

She contributed money to students individually and also helped establish the May Owen Irrevocable Trust through TMA to provide low-interest loans to medical students. When Texas Tech University Health Sciences Center in Lubbock opened in 1973, Dr. Owen helped provide the library’s first 20,000 volumes and established the school’s first endowed chair. 

In old age, Dr. Owen continued to work hard until her health failed. She died on April 12, 1988, at age 96.  

“She said, ‘We should all be so lucky to work at something we love until the day we die,’” Dr. Peschel said. “She did that.”

TCMS Gold-Headed Cane Nominations Open for 2022

Physicians, nominations are now open for the 2022 Gold-Headed Cane Award, which is given annually to an outstanding TCMS member who has made a significant impact on our medical community.

To be eligible for the award, a nominee must be a current member of TCMS and have been a TCMS member for at least 15 years. You can find the list of members who are eligible here.

All current TCMS members have the opportunity to nominate one candidate for this award. You can make your nomination or learn more here.

All nominations must be received by April 22, 2022.

TCU Medical Student and TMA/TCMS Member Anand Singh Elected to AMA Student Board

By Prescotte Stokes III

Read the original article here.

The American Medical Association-Medical Student Section (AMA-MSS) Region 3 executive board recently elected Anand Singh, a first-year medical student at TCU School of Medicine to serve as the Co-Advocacy Chair.

The AMA-MSS Region 3 includes medical schools in Arkansas, Kansas, Louisiana, Mississippi, Oklahoma and Texas.

“My job is to learn about what different health care policies are being passed in these different states,” Singh said. “And spread that news and raise awareness among medical students because as we all know these policies impact everyone from students to physicians and patients.”

Singh will oversee the Region 3 advocacy committee and lead advocacy initiatives to engage region chapters.

He will also work with the Advocacy Subcommittee of the Committee on Legislation and Advocacy (COLA) to help our region engage with events like National Advocacy Week (NAW) and the Medical Student Advocacy Conference (MAC). He will also support the Membership Chair and Secretary in reaching out to local chapters to highlight advocacy endeavors and provide advocacy updates in AMA-MSS Region 3 monthly newsletters.

“Policy writing is very niche and not every physician has to do that but the way this connects with the medical school is how they teach us to be an advocate for your patients,” Singh said. “And growing that idea on a larger scale its advocating for your population. Not only talking to physicians you’re talking to legislative members, congress members and kind of impact a larger audience that’s a really great opportunity as future physicians.”

The Medical Student Section (MSS) aims to be a voice for medical students’ across the AMA to help improve medical education and advocating for the future of medicine.

Join Forum TOMORROW Addressing the Impact of Political Polarization on Healthcare

Tomorrow, Feb. 19, 2022, the Tarrant County Academy of Medicine Ethics Consortium, in partnership with the Tarrant County Medical Society, will host their annual Healthcare in a Civil Society symposium.  This year’s program, “Polarization and the Erosion of Public Trust in Healthcare,” is an interactive event that takes an in-depth look at the impact of political polarization on healthcare.

“Our nation is beset by radical polarization,” says Stuart Pickell, MD, TCMS president-elect and chair of the consortium. “Historically, healthcare policy has been one topic on which we have been able to find common ground. What happened to transform it from something broadly bipartisan to incredibly divisive? This event will explore how we got to this point and begin to chart a path forward.”

The goal is to engage leaders of all perspectives in a civil conversation centered on the healthcare issues that are important to the Tarrant County community without the rhetoric that often undermines these conversations. This hybrid in-person/Zoom event will be held at the UNT Health Science Center from 8:30am to 1:00pm and provides continuing education credit for multiple healthcare disciplines.

While this symposium highlights discourse between community leaders, anyone who is interested in this critical topic is welcomed and encouraged to join the conversation. Those who are interested in participating can register here.

The event includes a breakout session allowing participants to explore the issues more deeply in small groups. A number of topics will be addressed, including:

  • How the media can influence public opinion and promote polarization
  • The impact of polarization on the public trust and public health
  • How polarization creates conflict (e.g., in how people refer to science as an absolute) and how to manage it
  • How people in health care professions can mitigate the effects of polarization within their spheres of influence when talking with patients

The event will be moderated by former congressman and current Sid Richardson Foundation President Pete Geren, who will be joined by panelists Bob Lanier, MD; Erin Carlson, DrPH, MPH; Tracey Rockett, PhD; and TCMS Secretary-Treasurer Triwanna Fisher-Wickoff, MD. The keynote speaker will be public affairs consultant and presidential historian Kasey S. Pipes, and the event will also feature Dr. Pickell and UNT System Chancellor Michael Williams, DO, MD, MBA.

The Tarrant County Medical Society is a professional organization that has been dedicated to the improvement of the art and science of medicine for the residents of Tarrant County since 1903. TCMS serves over 4,000 physicians, residents, medical students, and Alliance members, and is a component society of the Texas Medical Association.

Tarrant County Academy of Medicine was incorporated as a 501(c) (3) organization in 1953 to work in conjunction with the Tarrant County Medical Society. TCAM was created to enhance medical education, support community wellness, and preserve Tarrant County’s rich medical history.