Medical Society – Tarrant County Physician Online

Physician Suicide: Addressing the Crisis

President’s Paragraph

By Cheryl Hurd, MD, TCMS President

This article was originally published in the September/October 2026 issue of Tarrant County Physician.

It’s time to break the silence on physician suicide. This may be an exceedingly difficult topic for many of you; perhaps you have experience with losing a colleague or a loved one to suicide. Some of you may even have your own struggles. Unfortunately, physicians still have one of the highest suicide rates of any profession, with 300 to 400 physicians a year dying by suicide in the US.^3,7 Here are some staggering facts: one in six physicians has thought about or attempted suicide.⁴ Physicians in total die by suicide at twice the rate of the general population.^2,11 Suicide is the leading cause of death among male residents and the second leading cause of death among female residents.³ Medical students are three times more likely to die by suicide than their peers of the same age.^3,7 Our residents are suffering. Our students are suffering. And we are suffering.

“Physician, heal thyself” is a biblical proverb that is often taken out of context. It does not mean we should treat our own illnesses. Rather, it reminds us that physicians, too, must care for our mental and physical health by getting support from those who have the knowledge and training to help us. Too often, physicians continue caring for others while ignoring or delaying care for themselves—whether for something as minor as a cold or as serious as heart disease or suicidal thoughts. Even today, society often assumes physicians do not get sick or struggle with mental illness. Many of us were trained to believe that acknowledging illness could be seen as weakness, so we press on without seeking care, even as we expect our patients to do otherwise. Physicians who seek help may also fear consequences with licensure, credentialing, or patient trust.^3,7,13 Our self-reliance and perfectionism can make asking for help even harder. And although we are trained to recognize risk factors in our patients, we may miss them in ourselves or our colleagues. This potential blind spot is especially concerning because physicians share many of the same suicide risk factors as the general population, including mental health disorders, impaired relationships, and self-criticism.^1,5,7

Burnout from high workloads, time pressures, moral distress, and relationship discord is a real issue for physicians. There are additional institutional and regulatory pressures as well, often associated with administrative burden and an increased sense that autonomy is being lost.^3,6,7 Decreased efficiency and errors may also occur.^4,6 There is a perceived lack of psychological safety for physicians. Let’s face it, our cultural norms discourage vulnerability and seeking help for ourselves.^7,9,13 Yet the relationships we hold, the identities we carry, and the quiet pressures we internalize all play a role in suicide risk. So how can we help? I have a couple of ideas.

Last year at Burnett School of Medicine at TCU, several faculty, staff, and medical students had a fantastic session with the program manager for the Jordan Elizabeth Harris Foundation. She told the story of the foundation’s young namesake, Jordan Harris, who died by suicide shortly before graduating from college. Her parents created this foundation to help prevent others from experiencing the loss of a loved one dying by suicide. Not only was this educational, but it was also a training session on how to respond in these situations. Anyone can help prevent suicide. Just observing a physician, or anyone for that matter, in distress, and reaching out, can save a life. This training program is called QPR, which stands for Question, Persuade, and Refer. Like CPR, any person can be trained to effectively provide QPR—they do not have to be a healthcare professional. The American Hospital Association developed an entire guidebook that looked not only at data regarding healthcare worker suicide but also data about effective prevention strategies that hospitals could implement.12

Thursday, September 17, is National Physician Suicide Awareness Day (#NPSADay). This is now an annual opportunity to break the silence and raise awareness of mental health issues and suicide in physicians. A partnership between The Physicians Foundation, All In: Wellbeing First for Healthcare, and the Dr. Lorna Breen Foundation was formed to address physician suicide with a particular campaign called Vital Signs. This campaign is designed to train organizations, clinics, and even individuals in suicide prevention. In this campaign, Vital Signs refers to warning signs of impending physician decompensation or suicide. This partnership recommends a variety of prevention measures including recognizing warning signs, encouraging mental health reflection, sharing suicide prevention resources, checking in with physicians who do not appear to be doing well, removing intrusive mental health questions to licensure and hospital privilege applications, and creating a culture of well-being in organizations. They also have toolkits and even training slides for organizations to use (for free).^12,13,14

And let’s not forget our own TCMS wellness program, which I mentioned in my first President’s Paragraph. Our Tarrant County Medical Society Physician Wellness Program facilitates confidential, non-reportable help with coaching sessions and four complimentary counseling visits for members OR spouses, including couples counseling. The website is listed with the mental health resources I have shared below; it is sponsored by Tarrant County Academy of Medicine.

We entered this profession to heal—to listen to comfort, to save lives. Yet somewhere along the way, many of us learned to silence our own pain. We learned to wear resilience like armor, to treat vulnerability as weakness, and to fear that asking for help might cost us our careers. But silence has a cost. And too often, that cost is a life. Breaking the silence is not just an act of courage—it is an act of care. It is how we honor those we have lost, protect those still struggling, and reshape the culture of medicine into one that heals its healers. The question is no longer whether we should speak up. It is how we create spaces where speaking up is safe, supported, and sustained.

“The journey of a thousand miles begins with a single step.”
– Lao Tzu

References:

H. Makhija, J. E. Davidson, K. C. Lee, A. Barnes, A. Choflet, and S. Zisook, “National Incidence of Physician Suicide and Associated Features,” JAMA Psychiatry 82, no. 5 (2025): 451–458, https://doi.org/10.1001/jamapsychiatry.2024.4816.
D. Duarte, M. M. El-Hagrassy, T. C. E. Couto, W. Gurgel, F. Fregni, and H. Correa, “Male and Female Physician Suicidality: A Systematic Review and Meta-analysis,” JAMA Psychiatry 77, no. 6 (2020): 587–597, https://doi.org/10.1001/jamapsychiatry.2020.0011.
H. H. McClafferty, D. K. Hubbard, D. Foradori, et al., “Physician Health and Wellness,” Pediatrics 150, no. 5 (2022): e2022059665, https://doi.org/10.1542/peds.2022-059665.
Jon McKenna, “Medscape Physicians and Suicide Report 2025: ‘A Lot More Still Needs to Be Done,’” Medscape, February 21, 2025.
K. J. Gold, T. L. Schwenk, and A. Sen, “Physician Suicide in the United States: Updated Estimates from the National Violent Death Reporting System,” Psychology, Health & Medicine 27, no. 7 (2022): 1563–1575, https://doi.org/10.1080/13548506.2021.1903053.
Constance Guille and Srijan Sen, “Burnout, Depression, and Diminished Well-Being among Physicians,” New England Journal of Medicine 391 (2024): 1519–1527, https://doi.org/10.1056/NEJMra2302878.
S. B. Harvey, R. M. Epstein, N. Glozier, K. Petrie, J. Strudwick, A. Gayed, K. Dean, and M. Henderson, “Mental Illness and Suicide among Physicians,” The Lancet 398, no. 10303 (2021): 920–930, https://doi.org/10.1016/S0140-6736(21)01596-8.
US Preventive Services Task Force, “Screening for Depression and Suicide Risk in Adults: US Preventive Services Task Force Recommendation Statement,” JAMA 329, no. 23 (2023): 2057–2067, https://doi.org/10.1001/jama.2023.9297.
M. A. Oquendo and A. Porras-Segovia, “Barriers for the Research, Prevention, and Treatment of Suicidal Behavior,” Current Topics in Behavioral Neurosciences 46 (2020): 25–40, https://doi.org/10.1007/7854_2020_159.
S. K. Doupnik, B. Rudd, T. Schmutte, et al., “Association of Suicide Prevention Interventions with Subsequent Suicide Attempts, Linkage to Follow-up Care, and Depression Symptoms for Acute Care Settings: A Systematic Review and Meta-analysis,” JAMA Psychiatry 77, no. 10 (2020): 1021–1030, https://doi.org/10.1001/jamapsychiatry.2020.1586.
C. Zimmermann, S. Strohmaier, H. Herkner, N. Niederkrotenthaler, and E. Schernhammer, “Suicide Rates among Physicians Compared with the General Population in Studies from 20 Countries: Gender-Stratified Systematic Review and Meta-analysis,” BMJ 386 (2024): e078964, https://doi.org/10.1136/bmj-2023-078964.
American Hospital Association, “Suicide Prevention in the Health Care Workforce,” accessed August 10, 2026, https://www.aha.org/suicideprevention/health-care-workforce.
American Medical Association, “Preventing Physician Suicide,” updated August 7, 2025, https://www.ama-assn.org/practice-management/physician-health/preventing-physician-suicide.
The Physicians Foundation, “Campaign: Vital Signs,” accessed August 10, 2026, https://physiciansfoundation.org/research/campaign-vital-signs/.

Public Health Infrastructure at Work: Lessons from Ebola, New World Screwworm, Cyclospora, and the 2026 World Cup

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 September/October 2026 issue of Tarrant County Physician.

As physicians, we spend much of our careers focused on the patient in front of us. Public health often focuses on the patient we never see: the illness that was prevented, the outbreak that was contained, or the emergency that never materialized. When the system works as intended, its greatest successes can look like nothing happened.

The summer of 2026 has provided four very different reminders of why that infrastructure matters: a rapidly expanding Ebola outbreak in Central Africa, the return of New World screwworm to Texas, a large rise in cyclosporiasis associated in part with iceberg lettuce, and the successful completion of the largest FIFA World Cup in history. Each event required a different response, but all depended on the same foundation: timely clinical recognition, laboratory capacity, surveillance, clear communication, and coordination across jurisdictions and disciplines.

Ebola: A Global Threat Requiring Local Readiness
The current Ebola outbreak is caused by Bundibugyo virus, one of the Orthoebolaviruses that can cause severe hemorrhagic disease. As of August, the Democratic Republic of the Congo had reported over 4,000 confirmed cases and 1,916 deaths. The outbreak had become the largest Ebola outbreak recorded in the country. Uganda declared the end of its locally transmitted outbreak on July 28 after 42 days without a new locally acquired case, although ongoing transmission in the DRC leaves neighboring countries at risk for reintroduction._¹

For physicians in the United States, the immediate risk remains low. No cases associated with this outbreak have been confirmed here. CDC describes the overall risk to the American public and travelers as low and the likelihood of spread to the United States as very low.² Low risk does not eliminate the need for readiness. Early Ebola symptoms, including fever, fatigue, headache, myalgias, vomiting, and diarrhea, overlap with much more common illnesses. Recognition begins with a careful travel and exposure history, particularly during the 21 days before symptom onset.

If a patient has compatible symptoms and a relevant exposure, the first steps are to isolate the patient, implement appropriate infection-prevention precautions, notify the facility’s infection-prevention team, and contact the local or state health department to coordinate assessment and testing.³ That early call protects the patient, clinical staff, laboratory personnel, and the broader community. Local health departments, state agencies, and international partners have different responsibilities, but the value lies in how those responsibilities connect. In the affected areas, conflict, population displacement, limited diagnostic access, shortages of protective equipment, and infections among health workers have made control substantially more difficult. The biology of the virus is only one part of the outbreak; the strength of the surrounding system helps determine what happens next.

New World Screwworm: One Health in Real Time
Closer to home, New World screwworm is no longer only a threat approaching the southern border; it has been confirmed in Texas. The first US animal detection in the current outbreak was confirmed in a calf in Zavala County on June 3. By early August, the Texas Animal Health Commission reported confirmed animal cases on 35 premises in 15 counties.⁴

New World screwworm may sound primarily like an agricultural concern, but it is also a health issue with implications for veterinary medicine, wildlife, human health, and the Texas economy. The larvae of Cochliomyia hominivorax feed on living rather than necrotic tissue. Its reemergence reminds us that protecting health sometimes requires veterinary medicine, agriculture, wildlife management, laboratories, emergency management, and human public health to operate as a system.

There have been no reports of locally acquired human infestation in the United States, and CDC characterizes the current risk to people as very low.⁵ Clinicians should nevertheless recognize the presentation: a rapidly worsening, painful, foul-smelling wound; bloody drainage; visible larvae; or the sensation of movement in a wound or body opening. Treatment requires removal and safe disposal of all visible larvae and eggs, repeat examination of the lesion, wound care, and treatment of secondary infection when present. Suspected human cases should be reported immediately, and intact larvae should be preserved for identification rather than discarded.⁶

The Texas response demonstrates collaboration beyond traditional health departments. USDA, the Texas Animal Health Commission, Texas Parks and Wildlife, CDC, DSHS, local health authorities, veterinarians, producers, and laboratories all have distinct roles. Surveillance, animal-movement controls, wound inspections, public education, and release of sterile male flies are being used together. The sterile insect technique helped eradicate indigenous New World screwworm from the United States in 1966. Its renewed use is a reminder that public health tools can be biological, regulatory, clinical, and operational at the same time.⁴

Cyclospora and Iceberg Lettuce: The Value of Routine Reporting
The 2026 rise in cyclosporiasis illustrates the importance of routine disease surveillance and foodborne outbreak investigation. From May 1 through August 3, CDC reported 10,468 laboratory-confirmed, domestically acquired cases in 47 states, including 517 hospitalizations and, unfortunately, two deaths. CDC was also reviewing tens of thousands of additional illnesses that were not yet laboratory confirmed or required further investigation.⁷

One major subset of these illnesses was linked epidemiologically to iceberg lettuce sourced from central Mexico. Taylor Farms de Mexico recalled affected iceberg lettuce on July 17. Although Texas was not among the 15 outbreak case states listed at that time, recalled products had been distributed through Texas retail and food-service channels.⁸

For clinicians, cyclosporiasis should be considered in patients with prolonged or relapsing watery diarrhea, fatigue, anorexia, weight loss, bloating, and cramping, particularly when symptoms begin about a week after a produce or restaurant exposure. Testing may need to be requested specifically because routine stool examinations and some gastrointestinal panels do not automatically include Cyclospora. Trimethoprim-sulfamethoxazole is the treatment of choice; for immunocompetent adults, CDC lists one double-strength tablet twice daily for seven to 10 days.⁹ Every appropriately ordered test and timely report adds one piece to a much larger puzzle. Epidemiologists, laboratorians, environmental health specialists, regulatory agencies, clinicians, and industry partners then work together to compare exposures, identify clusters, trace products, and prevent additional illness. Clinical medicine and public health are not separate systems; they are complementary parts of the same healthcare continuum.

The World Cup: Preparedness That Stayed in the Background
Perhaps the most overlooked public health success is the event that concludes without a public health emergency. The 2026 FIFA World Cup brought 48 national teams and millions of visitors to 16 host cities across the United States, Canada, and Mexico over 39 days.¹⁰ Despite signs across Tarrant County stating “We Are Dallas,” Arlington actually hosted nine matches and welcomed hundreds of thousands of visitors, and local agencies monitored communicable disease, food safety, heat, air quality, medical surge, and other routine and event-related risks.¹¹

The work began well before the first whistle blew. Locally, healthcare systems, public health, emergency management, EMS, fire, law enforcement, laboratories, airport authorities, and municipal and regional partners established communication pathways and response plans. Nationally, CDC participated in a federal coordination structure; held regular calls with public health officials from all US host sites; deployed epidemiology, laboratory, informatics, and preparedness personnel; and created a shared dashboard for disease trends, heat, and air quality. Twenty port health stations maintained around-the-clock protocols at US ports of entry.¹⁰

At the close of the tournament, available public reporting indicated that no major tournament-associated public health emergency had occurred.10 That does not mean there were no public health concerns to monitor—it means those concerns did not become a defining incident. Risks were anticipated, information was shared, and agencies knew how to reach one another when a signal required attention. An uneventful outcome is often the product of very eventful preparation.

What Public Health Infrastructure Actually Means
Public health infrastructure is not simply a building, a department, or an organizational chart. It is the workforce that answers a report after hours; the laboratory that can identify an uncommon pathogen; the data system that connects cases across counties and states; the epidemiologist who conducts a detailed interview; the infection preventionist who protects a clinical team; the veterinarian who recognizes an unusual wound; the regulatory authority that can remove a contaminated product; and the communication network that provides accurate guidance without unnecessary alarm.

The same sequence appears repeatedly. A clinician or veterinarian recognizes something unusual. A laboratory provides confirmation. Local public health investigates the patient and immediate exposures. State partners identify broader patterns. Federal and international agencies compare signals across jurisdictions. Regulatory, animal health, emergency management, and healthcare partners then act within their respective authorities. No single organization can perform the entire chain, and delays at any handoff can allow a manageable event to become more difficult.

This is not an argument for alarm or for applying the same response to every signal. Good public health is calibrated. It distinguishes common illness from low-probability, high-consequence disease; confirms findings before drawing conclusions; communicates what is known and unknown; and adjusts the response as evidence changes. Strong infrastructure makes that proportional response possible.

The Physician’s Role
For practicing physicians, participation in this system is straightforward but essential:

Ask about travel and exposure when a patient’s syndrome or timing is unusual, particularly for acute febrile illness after travel to an outbreak area.
Order the test that matches the clinical concern, including a specific request for Cyclospora when prolonged or relapsing watery diarrhea warrants it.
Report early. A call to infection prevention or the local health department is not a declaration that a diagnosis is confirmed—it is the beginning of a coordinated risk assessment.

Beyond these examples, vaccination, antimicrobial stewardship, thoughtful diagnostic testing, and routine communicable disease reporting all strengthen the systems our patients depend on. Every clinician contributes to the larger public health enterprise, often without realizing it.

Public health is most visible during a crisis, but it is most effective before a crisis fully develops. Ebola, New World screwworm, cyclosporiasis, and the World Cup have very different challenges, yet they share a common lesson: timely information, defined roles, trusted partners, and coordinated action can protect both individual patients and entire communities. The strongest systems are built through relationships among clinicians, hospitals, laboratories, local health departments, state agencies, federal partners, and international organizations long before an emergency occurs. When those elements are in place, nothing happening may be the most meaningful outcome of all.

References:

World Health Organization, “Ebola Disease Caused by Bundibugyo Virus—Democratic Republic of the Congo,” Disease Outbreak News, August 1, 2026, https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON614. W World Health Organization
Centers for Disease Control and Prevention, “Ebola Outbreak: Current Situation,” July 22, 2026, https://www.cdc.gov/ebola/situation-summary/about-current-outbreak.html.
Centers for Disease Control and Prevention, “Screening and Evaluating an Ill Person for Viral Hemorrhagic Fevers,” updated August 3, 2026, https://www.cdc.gov/viral-hemorrhagic-fevers/hcp/diagnosis-testing/index.html. C CDC
Texas Animal Health Commission, “New World Screwworms,” accessed September 2, 2026, https://www.tahc.texas.gov/emergency/nws.html.
Centers for Disease Control and Prevention, “New World Screwworm Outbreak,” updated August 11, 2026, https://www.cdc.gov/new-world-screwworm/situation-summary/index.html.
Centers for Disease Control and Prevention, “Clinical Overview of New World Screwworm,” February 24, 2026, https://www.cdc.gov/new-world-screwworm/hcp/clinical-overview/index.html. C CDC
Centers for Disease Control and Prevention, “Surveillance of Cyclosporiasis,” updated August 11, 2026, https://www.cdc.gov/cyclosporiasis/php/surveillance/index.html. C CDC
US Food and Drug Administration, “Investigation of 15-State Outbreak of Cyclospora Illnesses: Iceberg Lettuce (July 2026),” July 2026, https://www.fda.gov/food/outbreaks-foodborne-illness/investigation-15-state-outbreak-cyclospora-illnesses-iceberg-lettuce-july-2026. ” “OUR WORLD”+1
Centers for Disease Control and Prevention, “Clinical Overview of Cyclosporiasis,” February 29, 2024, https://www.cdc.gov/cyclosporiasis/hcp/clinical-overview/index.html. C CDC
Centers for Disease Control and Prevention, “Statement on CDC Public Health Readiness & Response for the FIFA World Cup 2026™,” July 19, 2026, https://www.cdc.gov/media/releases/2026/statement-on-cdc-public-health-readiness-response-for-the-fifa-world-cup-2026.html. C CDC
City of Arlington, “City of Arlington Prepares for FIFA World Cup 2026™,” February 20, 2026, https://www.arlingtontx.gov/News-Articles/2026/February/City-of-Arlington-Prepares-for-FIFA-World-Cup-2026%E2%84%A2.

Project Access Tarrant County: Spring Highlights

Project Access

By Kathryn Keaton

This article was originally published in the July/August 2026 issue of Tarrant County Physician.

April: Through its Salud en Tus Manos health literacy initiative, Project Access Tarrant County partnered with three other community organizations to present a financial literacy class for uninsured adults. Made possible through BEACON (Building Economic Access, Community, Opportunity & Network) funding from North Texas Community Foundation, the class focused on practical skills such as budgeting, managing debt, building credit, and making informed financial decisions. By strengthening financial literacy, participants are better equipped to reduce financial stress and improve their ability to access and maintain healthcare.

May: Project Access Tarrant County hosted a well-woman event in the Tarrant County Medical Society parking lot in partnership with the Texas Health Community Hope Wellness for Life Mobile Unit. During the event, 15 uninsured women received well-woman and/or mammogram services. Students from TCOM’s Underserved Women’s Health Initiative also provided hands-on instruction on breast self-awareness and distributed educational materials on menopause, helping patients better understand preventive care and recognize changes that should be discussed with a healthcare provider.

June: Salud en Tus Manos continued to grow with the launch of Food as Medicine, a new four-part series developed in partnership with TCU. Designed for patients living with diabetes or hypertension, each session combined nutrition education with hands-on cooking instruction in TCU’s culinary classroom. Participants learned how everyday food choices can support chronic disease management while preparing healthier versions of familiar meals. The series empowers patients with practical, culturally relevant strategies they can confidently incorporate into their daily lives.

Upcoming: Project Access Tarrant County is preparing for its inaugural golf tournament on September 28, a new fundraising event supporting specialty and surgical care for uninsured adults in Tarrant County. Teams and sponsorship opportunities are still available, and we look forward to launching what we hope will become a long-standing tradition in support of our mission. To sign up, visit the Tarrant County Academy of Medicine website or email Kathryn at kkeaton@tcms.org!

May and June’s events were supported by Texas Health Resources as part of a Texas Health Community Impact grant award. The contents are those of the author and do not necessarily represent the official views of Texas Health.

Women’s Mental Health: The Barriers to Access

The President’s Paragraph

By Cheryl Hurd, MD, TCMS President

This article was originally published in the July/August 2026 issue of Tarrant County Physician.

This May, I had the privilege of presenting at a workshop with psychiatric colleagues regarding women’s mental health at the annual meeting of the American Psychiatric Association. We had strong attendance and a robust discussion. But given all the questions from our audience members, it became evident to me that this is a topic deserving of additional outreach, and not just to fellow psychiatrists. However, I had a dilemma . . . a draft deadline and multiple PowerPoint slides with all the information. After a couple of hours of trying to gather everything into a cohesive article to present to you all here, I decided to seek the assistance of AI. I dumped everything I had into Copilot, gave it about four dozen or more prompts, and it coalesced all my work. I still had to edit extensively; who knew that Copilot was so fond of run-on sentences?! The following has been further edited by the people who help maintain the decorum of our Tarrant County Physician journal.

Women’s mental health is as much an access issue as a diagnostic one. Across clinical settings, it is common to see:

Depression

Anxiety

Trauma-related conditions

Perinatal Mental Health Challenges

Emotional strain associated with:
• Caregiving responsibilities
• Financial hardship
• Discrimination
• Chronic disease

Whether these concerns are recognized, disclosed, and treated is often shaped by social context, such as current physical environment and cultural and/or historical aspects of different communities. Insurance, transportation, childcare, translation services, stigma, community trust, and local behavioral health capacity all affect timely care. Women in underserved communities are at particular risk for late diagnosis and interrupted treatment because social determinants of health and health system barriers often converge. And national mental health workforce shortage areas remain widespread.¹

Underserved care is not found in a single setting but is a condition of limited access that can exist anywhere. A woman may live in a rural county with the closest psychiatrist being a long drive away. Another woman may live in an urban neighborhood with multiple hospitals yet still face long waits, unaffordable copays, language barriers, and fragmented referral pathways. In both settings, available services may not be truly usable. Women may present late, rely on urgent care, or disengage when treatment plans fail to account for barriers such as housing instability, caregiving demands, or work schedules. For physicians, treatment planning must address not only diagnosis and severity but also whether follow-up is realistic.

Rural and urban settings pose different challenges. In rural practice, barriers often include distance, limited specialist supply, service closures, privacy concerns, and broadband gaps that weaken telehealth. In urban settings, the problem is often system complexity: long wait times, fragmented care, uneven service distribution, insurance limitations, and cultural or linguistic mismatch between a patient and their physician. These differences require different responses. Rural physicians may depend more on collaborative care, telepsychiatry, and cross-system referral relationships, whereas urban physicians may focus on reducing handoff failures, improving navigation, and integrating behavioral health into primary care or women’s health clinics. Rural counties fare worse than non-rural counties on measures of clinical care and social determinants of health,² and shortage designations affect both rural and urban areas.¹

Perinatal mental health is critically important, but risks change across the lifespan. Anxiety, depression, trauma exposure, eating disorders, self-harm risk, intimate partner violence, caregiving stress, chronic illness, loneliness, grief, and cognitive concerns may present differently at each stage of life. In underserved communities, unstable housing, food insecurity, discrimination, limited preventive care, and delayed treatment can intensify symptoms and complicate care. A useful clinical framework goes beyond symptom checklists to assess safety, functioning, social stressors, and barriers to follow-up.
Routine screening is one of the strongest opportunities to improve women’s mental health care, but only when paired with a workflow that supports action. In women’s health, primary care, and perinatal settings, screening can identify depression, anxiety, trauma-related symptoms, and safety concerns before they escalate. A positive screen should trigger a risk assessment, a discussion of treatment options, a referral or warm handoff when indicated, and a plan for monitoring response and adherence. Routine screening for depression and anxiety is recommended in well-woman, pre-pregnancy, prenatal, and postpartum care. Standardized instruments and systems for timely assessment, treatment, and follow-up are also recommended.³

Care models should reflect practice realities rather than assume one solution fits all. In rural settings, telehealth can reduce travel burdens and extend specialty access, especially when supported by audio-only options and coordination with local primary care. In urban settings, access may improve more through shorter referral loops, stronger safety-net capacity, co-located behavioral health services, and language-concordant care. Telehealth is most effective when patients have the privacy, reliable connectivity, digital skills, and device access needed to use it. Underserved communities may also benefit from multiple telehealth formats, including phone-based care.⁴ At the same time, rural telehealth continues to face setting-specific implementation barriers.⁵

As you can see, addressing women’s mental health requires a layered, setting-specific approach. Trauma-informed, culturally responsive care is essential. In rural settings, physicians may need to offset workforce shortages and distance through collaborative care and telehealth-enabled consultation. In urban settings, the priority is often reducing fragmentation and improving access within systems that may appear resource-rich but remain difficult to navigate.
Ultimately, the central question is not simply whether a patient lives in a rural or urban area, but whether she can obtain timely, acceptable, and practical care. That requires early identification, realistic care planning, and systems that coordinate between screening, referral, and treatment. For physicians, the implication is straightforward: overcoming social barriers is part of the care plan, not peripheral to it.

“Healing takes time, and asking for help is a courageous step.” —Mariska Hargitay

References:

Health Resources and Services Administration, “Health Workforce Shortage Areas,” accessed June 30, 2026, https://data.hrsa.gov/topics/health-workforce/shortage-areas/dashboard.
W. B. Weeks et al., “Rural-Urban Disparities in Health Outcomes, Clinical Care, Health Behaviors, and Social Determinants of Health and an Action-Oriented, Dynamic Tool for Visualizing Them,” PLOS Global Public Health 3, no. 10 (2023): e0002420, https://doi.org/10.1371/journal.pgph.0002420.
American College of Obstetricians and Gynecologists, “Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum,” Clinical Practice Guideline, June 2023, https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/06/screening-and-diagnosis-of-mental-health-conditions-during-pregnancy-and-postpartum.
U.S. Department of Health and Human Services, “Telehealth for Underserved Communities,” August 20, 2024, https://telehealth.hhs.gov/documents/Telehealth_for_Underserved_Communities_08-20-24.pdf.
Rural Health Information Hub, “Rural Telehealth Toolkit,” last modified June 8, 2023, https://www.ruralhealthinfo.org/toolkits/telehealth.
Centers for Disease Control and Prevention, “Social Determinants of Health,” last modified May 16, 2024, https://www.cdc.gov/public-health-gateway/php/about/social-determinants-of-health.html.

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.

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.

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;.

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

Feature Article

By Allison Howard Hunter

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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