As the Texas Medical Association digests and analyzes the full impact for Texas of the U.S. Supreme Court decision in Roe vs. Wade, President Gary W. Floyd, MD, issued the following statement today in response to the ruling.
“TMA remains committed to protecting the privacy and sanctity of the patient-physician relationship. TMA is unwavering in its stance against intrusions by government or other third parties that impede the patient-physician relationship, and any criminalization of acceptable and appropriate medical practices that may jeopardize that relationship or patients’ safety.
“Especially in high-risk situations, patients need to know their physicians will be there to care for them, and TMA will continue to work with state lawmakers to ensure a safe practice environment for physicians and their patients.”
As part of their “Conversation With” series, which highlights leaders in the North Texas community, D CEO Healthcare sat down with TMA President Dr. Gary Floyd to discuss a range of topics – from restoring trust in medicine to transgender care and legislative priorities. Here’s an excerpt:
“When the public health emergency is declared over, over a million people will lose coverage in Texas. We’ve been trying to work with our legislators about targeted plans to extend coverage. We would like to continue to cover children from birth through six months and expand it to have 12 months of eligibility; We would like to cover pregnant moms postpartum for 12 months. We are trying to improve payment for delivering Medicaid services that haven’t been changed in over 20 years.”
In a recent advisory calling attention to health care worker burnout, U.S. Surgeon General Vivek Murthy, MD, highlighted the broad response the situation calls for: “We must ensure that every health worker has access to affordable, confidential, and convenient mental health care.”
If finances are keeping you or someone you know from seeking treatment for depression, anxiety, substance use, or other conditions, the Texas Medical Association’s PBF Wellness Fund is here to help overcome that barrier.
Through the fund, physicians with a valid Texas medical license can receive financial support for treatment of conditions that impair their ability to practice medicine safely. In addition, qualifying physicians can receive financial support to cover their family’s living expenses while undergoing treatment.
In the surgeon general’s report, Addressing Health Worker Burnout, Dr. Murthy proposed a variety of approaches to aid the 35% to 54% of physicians and nurses, and 45% to 60% of medical students and residents, reporting symptoms of burnout. He called for individuals, health care organizations, academic institutions, government, and more to help address the problem.
Related to mental health, the advisory calls for such actions as:
Eliminating punitive policies for seeking care for mental health and substance-use disorder;
Normalizing conversations about mental health challenges, including suicide, in health care learning environments to foster a culture of support and awareness; and
Ensuring access to mental health services for health care workers and their families, including the use of telemedicine.
Contact TMA if you or someone you know could benefit from the PBF Wellness Fund. Email Chris Johnson, PBF director, or call her at (512) 370-1602 with questions. Or complete an application. TMA strives to protect the anonymity of fund recipients.
Contributions from physicians and their spouses support the fund. If you want to help, you can contribute via secure, online donation, or send a check to PBF Wellness Fund, Attn: TMA Finance Department, 401 W. 15th St., Austin, TX 78701-1680.
The PBF is a 501(c)(3) organization, so charitable contributions are tax-deductible to the full extent permitted by federal law.
Statement from Texas Medical Association President Gary W. Floyd, MD:
The Uvalde, Texas, school shooting was shocking, and hit me at my very core as a pediatrician, father, and grandfather. I can’t put into words the emotions I felt at the time. But I can tell you the first action I took was to call my Texas Medical Association Board of Trustees colleagues and Michael Darrouzet, executive vice president of TMA, to say, “We have to do something for the Uvalde community. We need to take action to prevent these violent acts from ever happening in Texas again.” Ray Callas, MD, chair of the TMA Board of Trustees, did the same. Together we called for action.
I know you can relate to our reaction, because as physicians, we fix problems – we are trained to diagnose, treat, and heal. And that is exactly the approach TMA took in its response to the Uvalde crisis.
TMA went to work immediately to create the Mental Health Rapid Response Team, a coalition of 20 organizations ranging from state medical specialty societies, statewide leaders from community health centers, and social work and psychology organizations to state government resource leaders, such as the Texas Health and Human Services Commission (HHSC), Texas Child Mental Health Care Consortium (TCMHCC), Texas Division of Emergency Management, and Texas Department of Public Safety, to name a few. See the entire list of participants below. The coalition is co-chaired by Dr. Callas and me.
TMA already had its first meeting with the Mental Health Rapid Response Team to learn what resources are being deployed in Uvalde, what is needed, and how we can collectively help with the response without overwhelming the community or interfering with ongoing efforts by the state. We also started establishing short- and long-term goals for the coalition, focusing on the needs of the Uvalde community, first responders, communities all over Texas that also are dealing with this tragedy, and new legislation we can put before our legislators in January 2023. Being proactive is TMA’s primary goal, in the hope our efforts will prevent such situations from occurring again.
What we know: Uvalde currently is overwhelmed with offers to help with counseling. TMA’s goal will be to look longer-term, finding in-person counseling for Uvalde during the next year or two. HHSC has asked TMA to create a list of people who are willing to provide long-term counseling services in Uvalde. Eventually, we will need telemedicine services as well. TMA will soon publish information about how to get involved. Please keep an eye out for this.
TMA learned one valuable lesson from the COVID-19 pandemic: When we work together and learn from each other, we can be much more effective. We are taking that same approach now. This is not a problem we can fix quickly but one that will take time to properly diagnose, treat, and heal.
Please join TMA as we help the Uvalde community and our state to detect, prevent, and start fixing the many problems affecting our children and families in Texas.
Gary W. Floyd, MD President Texas Medical Association
Mental Health Rapid Response Team
Child Psychiatry Access Network (CPAN is part of TCMHCC) – Laurel Williams, DO, CPAN medical director; Nhung “Noon” Tran, MD, Texas Pediatric Society liaison to CPAN and CPAN pediatric consultant; and Luanne Southern, TCMHCC executive director
Federation of Texas Psychiatry – Phillip Balfanz, MD; Eric Woomer, lobbyist and government affairs consultant; and Courtney Williamson
National Alliance for Mental Illness Texas – Greg Hansch, executive director
National Association of Social Workers Texas – Will Francis, executive director
Texas Academy of Family Physicians – Tom Banning, CEO/executive director
Texas Association of Community Health Centers – Jana Eubank, executive director
Texas Chapter of the American College of Physicians – Nicole Abbott, executive director
Texas Counseling Association – Jan Friese, executive director
Texas Hospital Association – John Hawkins, president/CEO; Steve Wohleb, general counsel; and Sara Gonzales, vice president, advocacy and public policy
Texas Medical Association – Gary Floyd, MD, president, and Ray Callas, MD, chair, board of trustees
Texas Nurses Association – Julia Menegay, interim CEO, and Dawn Webb, director of nursing practice and professional development
Texas Pediatric Society – Stacey Mather, executive director, and Clayton Travis, director of advocacy and health policy
Texas Psychological Association – Angie Guy, interim executive director
Office of the Governor – Heather Fleming, advisor
Texas Child Mental Health Care Consortium – David Lakey, MD, chair
Texas Department of Public Safety – Steven McCraw, executive director/colonel, and Lt. Charles Havard
Texas Department of State Health Services – John Hellerstedt, MD, executive commissioner, and David Gruber, associate commissioner, regional and local health operations
Texas Division of Emergency Management – Nim Kidd, Chief
Texas Health and Human Services Commission – Cecile Young, executive commissioner, and Sonja Gaines, deputy executive commissioner for intellectual and developmental disability and behavioral health services
The federal government is trying to standardize data sharing so electronic health records (EHRs) across the country can all speak the same language. The Texas Medical Association is telling the government to keep working on it.
TMA submitted comments on the draft of version 3 of the United States Core Data for Interoperability (USCDI), which aims to establish data-sharing standards “for nationwide, interoperable health information exchange.” USCDI updates come from the Office of the National Coordinator for Health Information Technology (ONC), which released the version 3 draft in January. The first version of USCDI became part of certain EHR certification criteria.
In an April 27 letter to ONC, TMA offered several suggestions on how to improve the proposed new version, including:
Assign “applicable vocabulary standards” to any data elements added to the USCDI so there’s an established way to refer to those data across EHRs. “Adding nonstandard elements will result in an enormous amount of vendor and end-user work that will simply create nonstandard data that are difficult to transfer. It also will create an excessive amount of rework in the future once applicable vocabulary standards are set for these data elements,” TMA said in the letter.
Test EHR vendors and users to ensure a smooth transfer of data from previous USCDI versions 1 and 2. TMA told ONC it is hearing from physicians already frustrated “because of the manual manipulation of data received [from EHRs] that places additional burden on practice staff who are already stretched thin.” Information that a physician receives from a hospital, TMA said, “is not always in a human-readable format or is so limited as to be not useful or actionable.”
In fact, then-TMA President E. Linda Villarreal, MD, and Ogechika Alozie, MD, chair of TMA’s Committee on Health Information Technology, urged ONC to delay finalizing and requiring the new USCDI version “until EHR vendors prove their users are able to functionally use USCDI versions 1 and 2 and that all data elements” are streamlined.
This article was originally published in the May/June 2022 issue of the Tarrant County Physician.
On April 30, 2022, longtime TCMS member and past president Dr. Gary Floyd was installed as TMA’s 2022/2023 president. A pediatrician who has practiced in Tarrant County for over 40 years, Dr. Floyd sat down with the Tarrant County Physician to talk about everything the led him to this point, and what he anticipates for this next year as he takes the helm of one of the largest medical associations in the country.
Q So Dr. Floyd, what would you say, in your opinion, is the best thing about being a doctor?
A You know, I think the best part or the most amazing part to me is that people, and in my case families, trust you enough to take care of their children. And for adult docs, those patients trust them enough to take care of them. I have always just stood in awe of that. The second part for me has been the collegiality, and that has come both in the workplace and through organized medicine. I have over the years made many acquaintances, many friends, and that’s just not replaceable.
Q Speaking of the physicians you’ve worked with, how do you think organized medicine – TMA specifically or any of the multiple organizations you’ve worked with over the years – impacts both physicians and patients?
A I think organized medicine gives us a collective voice for the issues that plague all of us. We can usually come to common consensus, and it gives us a large body of people, a large number of physicians, who will speak out for our issues. And instead of just one person crying in the wilderness alone, you go representing fifty-six thousand members of TMA. People start listening in.
Q That makes a lot of sense. So, on advocacy: what do you think are some of the most important ways that advocacy has impacted the practice of medicine? I know there’s a pretty long laundry list.
A There’s a long list, yes. I think for Texas physicians one of our biggest achievements or wins was our liability reform that occurred back in 2003, almost 20 years ago. Thanks to work with the public and literally grassroots in the office in talking to patients, this went before the public in a proposition for a constitutional amendment and passed. So hats off, not only to the physicians who worked so hard on that but to the public who understood the need to bring in more physicians to Texas.
I think you’d also have to hallmark [that TMA] sued CMS and won in the district court in Tyler and now we’re waiting for their appeal. This had to do with the No Surprise Billing act. Congress got it right in their wording and had a very fair independent dispute resolution process. But in writing, CMS’s rules initially came out very much in favor of insurance companies and detrimental to physicians. So that’s why Texas sued and won. It’ll be interesting to see how this will pan out, and whether the federal government will appeal to a higher court. But we’re ready for that battle. It’s an expensive battle, but it’s well worth fighting for physicians and for patients.
Q You’ve talked about some issues that are clearly important to you. Focusing on your leadership roles: a lot of physicians are involved in organized medicine but only so many choose to actually get involved on the leadership level, which allows you to really participate in creating change. What inspired you to do so?
A I think every leadership position I’ve ever run for or been elected to, it’s been because others have asked me to do it, so I think it’s been because of the relationships that have been built with colleagues as we went through our normal course of work. Showing up to those meetings and participating in committees. And with respect to TMA, not only committees but councils; apparently people agreed with some of the things that were important to me and with the way that I could express that, and those were the folks that asked me to serve in various positions with TMA. And my wife says it’s because I can’t put my hand down and haven’t learned how to say “no!”
Q Looking back at some of your leadership roles between TCMS, TMA, AMA, and the different organizations you’ve been with, what have been some of the highlights along the way?
A I’ve had the incredible privilege to serve as president of Tarrant County Medical Society, now president-elect for the TMA. I’ve been very honored to serve as president for Texas Pediatric Society and president of the Texas chapter of the American Academy of Pediatrics. One of my most fun jobs was when I got to chair the TMA Council on Legislation. That was really a fun time – there was a lot of interaction at the capital, and I’m looking forward to that as president next year since it’ll be a legislative year starting in January.
But perhaps one of the most challenging positions was serving as chair of our TMA Board of Trustees during the pandemic when we had to become an emergency disaster board. Thanks to the great teamwork by all members of our Board, we got through it and managed to take care of the TMA business that needed handling.
Q Going back to the legislative session, what are some of your overarching goals for that? And what are some of the things you hope to accomplish during your presidency?
A My agenda is mainly just serving my fellow physicians in the best way I can. You know, I think we’ve really taken it on the chin with COVID. For two years there have been challenges from appropriate equipment shortages to a lot of garbage on the internet that has been very misleading. So my main goal for this year is for us as physicians to reclaim trust, to try to unify better, to try to communicate better, and try to find the common issues that we need to stress and push that really impact our patients. Also, to protect the autonomy of the patient-physician relationship however we can so physicians can address issues comfortably without either [patients or physicians] fearing interference from any of those other entities, be it government, be it insurance, be it hospital – whatever.
Q That concern is definitely a top issue. So what would you tell someone who is right at the beginning of their career, or the beginning of their involvement with organized medicine?
A For any physician just starting it’s really important for them to know who they are, so they have to have a support base. And for me that starts with faith, with my faith in the Lord. For them it may be something else, I don’t know, but I think that has really helped ground me. The other part of that is my family; they keep you grounded, and they keep it real. And then joining in with colleagues. Being not just a participant or a member but being and getting involved in organized medicine.
There’s a lot to be done. We have a lot of committees and councils that are doing excellent work and it’s finding what’s important to you and making the time. You literally have to make the time to get involved. You sacrifice some family time and time working in your practice. So you have to be aware of that; you have to plan. But I just can’t encourage people enough, to know how rewarding and how worthwhile it is to make that time to join with your other colleagues and be involved in organized medicine and join the leadership team.
Q So looking at this next year, it’s a very exciting time for you. You’ve had a great career; you got to help a lot of people in both practice and in organized medicine, but now you’re starting something new. Do you have anything you’d like the physicians of Tarrant County to keep in mind this next year?
A One thing I would say, not only to the Tarrant County physicians but those throughout the state, is to stick to issues. State opinions about issues, but insulting public officials is never going to get us anywhere, not even into compromised territory. Call me, call [TCMS CEO] Brian Swift, get it off your chest. But don’t put it out on social media; it rarely achieves anything.
For the folks in Tarrant County, I know practice and family and faith life are demanding, but I am an example that you can do organized medicine with all of that. I would encourage you to show up. Just come. The biggest part of getting involved is showing up. We are always looking for people to serve on committees and councils. I didn’t do anything special; I don’t have any special knowledge. The experiences I’ve gained are because I’ve shown up. It’s important to be involved now, because the practice of medicine is being challenged in many ways, and it is your chance to make a difference for your practice and your patients. So show up; you’ll be glad you did.
In our next issue, you will again hear from Dr. Floyd as he reports on his experience as TMA president and highlights TMA’s top priorities.
When Trey Moore, MD, started his career as a urologist in Fort Worth 26 years ago, he worked in a busy emergency department and his own private practice. In both settings, many of his patients weren’t covered by insurance and could only access stopgap care. At the same time, he was surprised by the dearth of opportunities for physicians like him to give back to their community by offering their services pro bono.
So, in 2011 he jumped at the chance to join Project Access Tarrant County, a then-nascent initiative of the Tarrant County Medical Society (CMS) that connects low-income, uninsured residents to specialty and surgical services provided by a network of volunteer physicians and facilities. Since its start, Project Access has served more than 1,700 patients and provided more than $14.5 million in donated health care.
Dr. Moore especially likes the program’s focus on surgical care, which is unique in the world of health care safety-net programs. Given his specialty, many of his neediest patients – such as those suffering from large kidney stones that cause recurring, and sometimes disabling, infections – require surgery to recover fully.
“Every [pro bono service] makes a difference, whatever we do, but [Project Access is] particularly helpful because so many of these patients – until they have a surgical resolution – are stuck in a vicious cycle of not being able to go back to work and cycling in and out of emergency rooms,” he said. “It’s a big stress on the patients and their families, and it’s a big stress on the system.”
But relieving that stress would not be possible without ongoing financial support.
Project Access is one of several long-standing recipients of the Texas Medical Association Foundation’s Medical Community Grant program, which accepts applications from county medical societies and alliance chapters for up to $7,500 in matching funds to support unique community health improvement initiatives. The separate Medical Student Community Leadership Grants program accepts applications from TMA medical student chapters for up to $3,000 thanks to a fund established by Houston pathologist Roberto J. Bayardo, MD.
For more than two decades, TMAF’s grant programs have helped the Family of Medicine tackle the state’s most pressing health care concerns at the local level. Many grantees, including Project Access, have received funding over successive years, which allows for continuous programming. Physicians like Dr. Moore say this is especially important in Texas, which has the highest rate of uninsured residents in the nation.
Not only do the grant programs connect patients to life-changing care but also they honor TMA’s mission to stand up for Texas physicians by providing them with resources to create solutions to local health challenges and by reinforcing physicians’ trusted leadership in the community, says TMA Foundation Executive Director Lisa Stark Walsh.
“Our goal is to remove the obstacle of resources for members to do what they feel is necessary in their communities,” she said. “Medical Community Grants give physicians an opportunity to chip away at long-standing, intractable problems over the long term and to demonstrate their advocacy for the health of all Texans.”
Originally founded in 1966 as the Texas Medical Education and Research Foundation, TMAF is a separate, nonprofit entity that serves as the philanthropic arm of TMA. Since 1998, the Medical Community Grant and Medical Student Community Leadership Grants programs have disbursed $891,931 across more than 200 such grants to support myriad community health improvement programs all over Texas, ranging from vaccine clinics and border health services to breast cancer screenings and kids’ bicycle helmet giveaway events.
Houston neonatologist and TMAF Board President Michael E. Speer, MD, is passionate about growing the foundation’s endowment so it can offer even more grants that support Texas physicians and their patients. “If you look at the most successful colleges and charities, the best ones spend very little on themselves and most of their endowment on supporting the organization,” he said.
This growth mindset has paid off. In recent years, TMAF has fielded increased demand for the grant programs from county medical societies, alliance chapters, and medical student chapters. As a result, the upcoming application cycle will include a new focus area of physician health and wellness. This expansion stems from the success of a recent TMAF initiative, Caring for Physician Healers: Mental Health and Wellness Resources During COVID-19 Fund, which helped seven county medical societies launch or extend physician health and wellness initiatives during the ongoing pandemic. (See “Self-Investment: Physician Wellness Programs Bolster a Beleaguered Workforce,” November 2021 Texas Medicine, pages 22-25, http://www.texmed.org/Self-Investment.)
By harnessing the expertise of medicine to help address a community health problem, the TMAF grant programs complement the work of the association and represent the best of organized medicine, says TMA President-Elect and TMAF board member Gary Floyd, MD.
“Anyone in practice will find things that need to be changed,” he said. “When you’re alone or in a small group, you’re just a small voice yelling into the wind with very little result. When you join into organized medicine, particularly with TMA, you have [more than] 55,000 voices, and people tend to start listening.”
Physician-driven results Tarrant County Medical Society received its eighth TMAF Medical Community Grant in support of Project Access in 2021. The program’s organizers say it is a prime example of what physicians can accomplish working together to solve an entrenched community health problem. Tarrant CMS was inspired by the Dallas County Medical Society’s now defunct Project Access initiative, which focused on primary care. Given Tarrant County’s robust network of free and income-based primary care clinics, Tarrant CMS decided to gear its own Project Access initiative toward specialty and surgical care since that’s where the need was most acute.
Tarrant CMS Executive Vice President and CEO Brian Swift says Project Access runs on a shoestring budget that belies its impact. Patients are largely members of the working poor, and many are undocumented immigrants. They don’t qualify for Medicaid but typically don’t earn enough to afford private insurance, leaving them without coverage and beholden to emergency departments for symptom management. Without care that addresses the root cause of their medical problems, however, they are often robbed of their livelihoods – and sometimes their lives.
By providing specialty and surgical care to eligible Tarrant County residents, the initiative not only helps patients resume healthy lives but also saves area hospitals tens of thousands of dollars in emergency department costs. “These patients don’t have access anywhere else,” said Stuart Pickell, MD, Project Access’ medical director and an internist-pediatrician in Fort Worth.
Although physician volunteers provide specialty and surgical care, Project Access still requires funding to fulfill its mission. “Free isn’t free,” Mr. Swift said.
As with previous awards, the county medical society used the TMAF funds to offset the costs of its annual patient database subscription. “Data management does not come cheaply, so we really depend on that [funding] to be able to manage our Project Access database,” Mr. Swift said.
The grant-funded database – which Dr. Pickell describes as “essential” – allows staff to determine patients’ eligibility, which helps ensure Project Access is distributing its limited resources as judiciously as possible, and to track their care, including the donated value of medical services and administrative costs. In this way, the grant helps Project Access obtain more funding by quantifying its positive impact and cost savings.
Armed with the database, staff can focus on serving patients – and the broader community. Typical cases include a woman with cervical cancer who would have died without surgery, leaving her young children orphans; a construction worker with a hernia that kept him out of work; and a patient with osteoarthritis that had nearly disabled her until surgery allowed her to resume a productive life.
The Project Access model not only unburdens its patients and their loved ones from medical crises but also often allows them to return to work. This can be transformative, Dr. Pickell says, because a job offers the possibility of long-term health care access through employer health insurance.
After a decade of success, staff are now working on growing the program. With more than 500 volunteer physicians across numerous specialties, including ancillary care, their attention is focused on the limiting factor of operating room space and other facility needs. By renting such space, rather than relying on the whims of donors, Project Access can increase its patient volume.
Physicians would welcome such a change. “It’s such a gracious group of people,” Dr. Moore said. “They’re so grateful to get help. In a selfish way, it’s a great group to treat.”
Project Access also is keen to expand, both to meet the community need and to highlight the work physicians do every day to serve their patients. It’s supported in this endeavor by TMAF’s Medical Community Grant program, which allows physicians to spearhead solutions to the problems they’re facing on the ground.
“That’s why it’s so important for the foundation to continue doing what it does,” Mr. Swift said.
An engine for innovation Another repeat recipient, in this case of the TMAF Medical Student Community Leadership Grants program, the annual HOPE Health Fair in Galveston tackles a community health challenge while also providing medical students with the opportunity to fine-tune solutions over the long term.
The University of Texas Medical Branch (UTMB) TMA Medical Student Section chapter hosted its fifth annual event in November thanks, in part, to its fourth annual TMAF grant award. The fair connects approximately 250 uninsured Galveston residents – around a quarter of whom are homeless – to vaccinations, health care screenings, meals, and educational resources through the St. Vincent’s Student Clinic at UTMB. It also serves as a critical outreach opportunity in Galveston County, where 17.4 percent of residents under age 65 lack health insurance, according to the U.S. Census Bureau.
“We’re just catching ships in the night, people who frequently never have access to health care,” said John W. Davis, one of the event’s organizers and a third-year medical student at UTMB who also is pursuing a PhD.
The HOPE Health Fair received a $3,000 Medical Student Community Leadership Grant from TMAF in 2021, which covered about 40 percent of the overall cost. Without it, organizers would not have been able to host the event. “It’s very helpful for us to get this grant each year,” said Jenna Reisler, a third-year medical student at UTMB and an event organizer.
In addition to providing critical funding, the grant also has spurred innovation. Because the organizers are repeat recipients of the grant program, they take pains to improve the event each year. In 2021 they used the award to offer rapid COVID-19 testing and screenings for sexually transmitted infections, including HIV and hepatitis C.
By offering screenings, the organizers not only help attendees detect any debilitating illnesses they might have contracted but also prompt them to return to the student clinic to get their results and receive treatment. Once attendees have made the jump from the health fair to the student clinic, they can receive treatment for underlying health problems, such as diabetes and hypertension, and start to build patient-physician relationships.
In this way, the health fair functions as a kind of benevolent Trojan horse, linking Galveston’s most vulnerable residents to health care for years to come. “It’s a way to show people that we care about them,” Mr. Davis said.
Global reach Located in a top U.S. county for refugee resettlement, the Baylor College of Medicine (BCM) TMA Medical Student Section chapter and the Houston nonprofit Alliance for Multicultural Community Services have used the TMAF Medical Student Community Leadership Grants program to host the BCM-Alliance Refugee Health Fair. The annual event helps refugees navigate the local health care system – and provides medical students a glimpse at global health in action.
Like the HOPE Health Fair, the BCM-Alliance Refugee Health Fair aims to serve as a conduit for attendees to long-term health care access. At an upcoming event scheduled for this spring, student volunteers will distribute hygiene kits – including soap, hand sanitizer, masks, and health care resources in multiple languages – via a COVID-19-safe drive-thru. Attendees also will receive basic preventive health screenings and flu vaccines from local free and income-based clinics.
Although refugees can access Medicaid for up to eight months upon their arrival in the U.S., they are expected to secure private insurance afterward. This is a complicated process that can quickly fall to the bottom of a refugee’s to-do list, overtaken by tasks such as learning a foreign language, securing a job, and familiarizing oneself with the local public transit system. But the BCM-Alliance Refugee Health Fair aims to smooth attendees’ search for health care by introducing them to the Alliance and area clinics.
“Ultimately, even if these patients don’t stay on with these clinics, they at least have a starting-off point to return to if they develop a medical issue in the future,” said Avery Haugen, a fourth-year medical student at Baylor and one of the event’s organizers. “It really alleviates a lot of the stress of those first steps.”
The Baylor TMA student chapter will use its latest TMAF grant – its fifth – to print promotional flyers, purchase hygiene kit supplies, and furnish volunteers with personal protective equipment. The grant, which accounts for nearly all of the event’s budget, is critical to its success.
“This event is really not possible without the help from the TMA Foundation,” said Chris Wong, a fourth-year medical student at BCM and another event organizer.
In addition to educating refugee attendees about the local health care system, the event also serves as a critical learning experience for the medical students involved. Both Ms. Haugen and Mr. Wong are interested in global health, which is partly what prompted them to get involved with the fair.
“The event was really my first exposure to the idea of refugee health [and] the very specific health disparities that immigrants face, especially in our very complicated health system,” Mr. Wong said.
Similarly, Ms. Haugen sees the event as a unique opportunity to learn more about global health while studying medicine in Houston – and largely prohibited from international travel by the ongoing pandemic.
“For us, the refugee health fair is a really unique example of a way to promote global health on a local scale,” she said.
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 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.
If you’re looking for the next invaluable member of your health care team, the Texas Medical Association offers opportunities for health care organizations to recruit physician and medical staff talent at its Virtual Career Fairs. The next Virtual Career Fair is on April 28, and spots are open for employers to exhibit.
Here’s why you should exhibit at the next Virtual Career Fair:
Reach physicians and medical care professionals – TMA members and their teams are a ready-made pool of qualified professionals in a variety of specialties, locations, and career stages. TMA’s Virtual Career Fair offers employers exclusive access to this select group.
Chat one on one with candidates in a virtual setting – Getting in front of busy physicians and other members of the health care team can be challenging. At the Virtual Career Fair, employers can meet directly with jobseekers at a specified time in a virtual setting.
Have a database of candidates to follow up with – All job-seeking participants create a profile and upload a resume to register for the fair. This means exhibitors can review potential candidates and follow up with specific individuals after the event. (Available for Gold sponsors only.)
TMA 100% member practices receive 25% off exhibitor packages.
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.”