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A DO Dilemma

TCOM Student Article

By Jared Sloan, OMS-II

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

January to February can be a tough time for many people: The air is cold, holiday street lights are taken down, New Year’s resolutions are abandoned, and osteopathic medical students are deciding whether they want to take double the amount of national licensing exams. While taking the USMLE (United States Medical Licensing Examination) Steps 1 and 2 is not a new expectation of osteopathic students, recent changes, including the formation of a single accreditation system, which fully merged the previously separate osteopathic and allopathic residency accreditation pathways in 2020, as well as the transition of STEP 1 to pass/fail scoring, have left many students scratching their heads and biting their nails at the thought of even more high-stakes exams. Early in their education, students are forced to make a career-defining choice: Should I take both the DO and MD licensure exams if it improves my residency outlook?

Since 1995, osteopathic students have taken the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) as their primary means of gaining licensure. With the large overlap in content between COMLEX and the USMLE (the main difference being the inclusion of osteopathic-specific content), many professional medical societies have stated that the COMLEX is a perfectly acceptable alternative to the USMLE. However, this decision truly lies with individual residencies. Typically, osteopathic students who take STEP do so because it is required for the residencies they are interested in. But for the many year-two students who have not decided on a specific specialty, myself included, this decision is far from simple. Although many of my classmates and I are drawn to specialties that are historically “DO-friendly,” we are also aware that there is still much of medicine we have yet to experience. Many students don’t discover the field of medicine they are passionate about until their clinical rotations, but we must decide to take STEP 1 before we ever step into those roles. Students feel that by choosing not to take STEP they are closing doors to future programs before they even know about them. Many feel it is wiser to “play it safe” by taking the extra licensing exam. At the heart of this dilemma is the tension between what is technically sufficient for licensure and what is perceived as necessary to remain competitive across an increasingly uncertain residency landscape.

Unfortunately, students seeking mentor guidance on this matter often hear conflicting opinions from faculty and experienced osteopathic physicians. With the advancement of the osteopathic profession, many mentors insist that students should not feel pressured to take unnecessary exams. Others concede that, while COMLEX is becoming more accepted, there remains a very real preference for the STEP exams. Students are left with ambiguous answers and are told what they already know, namely, that choosing to take the extra exam depends on what specialty they are interested in.

How does the new pass/fail status of STEP 1 impact this predicament? Now that allopathic schools emphasize STEP 2, should second-year students feel free to skip the stress of STEP 1 and take STEP 2 only if they feel it is necessary? Yes, and some do exactly that. Many, however, are terrified by the idea of taking what feels like the most important test of our lives without taking its predecessor. While the core competencies of COMLEX and USMLE are similar in many ways, it is well known that there are differences in the style of writing and focus areas between the exams. With so much riding on STEP 2, students continue to feel pressured to prepare as best they can, which includes taking STEP 1.

Regardless of which licensure a medical student takes, almost all students would agree that these exams are hard. Fatigue, stress, and financial cost all increase when students choose to take more national boards. I know that I, and many students, worry how this increased burden will impact our performance. Taking an extra exam means risking failure on our core licensing exam or risking failure on an exam that was never necessary in the first place. Ultimately, we as medical students are high achievers, and many of us are willing to put in this extra work if it means more opportunities in the future.

Despite numerous residencies stating that they will review a COMLEX Level 2 score under the single accreditation system, students remain keenly suspicious that STEP 2 functions as a silent requirement. DO students are left wishing that our standard licensing exams were fairly considered but realize there is no way to enforce a fair consideration of COMLEX. Looking ahead, many osteopathic students are hopeful for one of two future outcomes. The first possibility is that the National Board of Osteopathic Medical Examiners (NBOME) could move toward standardization with the USMLE (potentially by accepting a unified licensing exam supplemented by osteopathic-specific assessments). However, given the NBOME’s longstanding commitment to a distinct osteopathic licensure pathway, this outcome appears unlikely. What feels like the more plausible future is that COMLEX scores will become more routinely considered by residency programs as familiarity increases. While this shift may already be underway, it will take time to fully materialize. As a result, although future osteopathic students may ultimately face fewer barriers, for the foreseeable future, many cohorts will continue to navigate a residency application in which the expectation of STEP remains firmly in place. As I look toward my future, I see a wide range of possibilities, possibilities that may quietly close if I choose to ignore this silent requirement.

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!”

2025 Gold-Headed Cane Recipient David P. Capper, MD

Feature Article

By Allison Howard Hunter

This article was originally published in the November/December 2025 issue of Tarrant County Physician.

When asked about the best aspect of practicing medicine, Dr. David Capper doesn’t miss a beat. “It’s the people,” he explains. “I think it really just boils down to the opportunity to have in-depth relationships with people.” This makes perfect sense when you look at the trajectory of Dr. Capper’s career—it’s always about the people, whether it’s the unhoused, the underserved, or the dying. From his involvement in street medicine to his longtime work in hospice care, Dr. Capper’s passion for people has led his peers to select him as the 2025 Gold-Headed Cane recipient. For those who know him, it doesn’t come as a surprise.

“David truly embodies the spirit of the Gold-Headed Cane,” says 2024 Gold-Headed Cane recipient Stuart Pickell, MD, a longtime friend of Dr. Capper’s. “I once heard of a patient he treated for skin lesions caused by an arthropod infestation. Not only did David provide medical care, but he also arranged—and personally paid—for the patient’s home to be exterminated. That story captures who he is at his core: physician, colleague, advocate, educator, ethicist, disciple.”

Dr. Capper’s life can be defined by many excellent things, but he defines himself by what is most important to him: his faith in Jesus. As a longtime Christian, Dr. Capper says his motivations ultimately come from his desire to honor God by serving others. He cites Matthew 5:16 as his guiding scripture: “Let your light shine before others, that they may see your good deeds and glorify your Father in heaven.” (NKJV)

He is humbled to receive the Gold-Headed Cane, which he has a unique tie to: his father, Robert Capper, MD, himself received the recognition in 2005.
“It’s not something you strive for,” says Dr. Capper. “What I thought about the Gold-Headed Cane over the years is that it’s a recognition of the peers of a physician whose life was committed to the profession and those professional values. And so, it’s very humbling, and it’s honoring.”

Dr. Capper has long had a passion for service, but he wasn’t always sure that medicine would be his medium. Though his father was a physician and his mother a nurse, he didn’t decide to pursue medicine until he was near the end of his collegiate career.

“I had an extremely high regard for my father and his peers,” he says. “The people that I was introduced to through my parents that were physicians were of the highest integrity, and I thought that’s the way physicians all were. And I didn’t quite see myself in that same category.”

It wasn’t until an emergency appendectomy between his junior and senior years of college that his path became clear. In a way, this was a blow—Dr. Capper was the captain of his football team, and he had recently gotten an All-American honorable mention, yet he would not be able to play the first half of the season. But being forced to slow down gave him the opportunity to spend a lot of time praying about his future. By the end of his stay, Dr. Capper felt a clear calling to become a physician in spite of his reservations. And instead of being intimidated by the excellence of the physicians he knew, he used it as a standard to strive for.

After Dr. Capper completed his undergraduate degree in liberal arts from Austin College and fulfilled his prerequisites, he began his tenure at the University of Texas Medical School at Houston. This was an enriching time that opened Dr. Capper’s eyes to the many possibilities of medicine.

He graduated from medical school in 1982 and was accepted into Good Samaritan Hospital’s internal medicine residency program in Portland, Oregon. It had a multidisciplinary pain program and was home to one of only two hospices in the state, both of which Dr. Capper credits as being formative to his education.

Throughout his medical training, Dr. Capper did extensive mission work, with the goal of eventually working in foreign medical missions. During this time, he met his wife, Dianne, who shared his passion for ministry. When he completed his residency, they planned to pursue mission work together, but a number of life circumstances kept them from taking the leap.

They ended up moving to Tyler, Texas, where Dr. Capper filled in as an emergency room physician. The family eventually came to Fort Worth, where he worked in the Harris Methodist Hospital Emergency Department and then joined E. Richard Holden, MD, a hematologist who needed help in his practice. Ultimately, Dr. Capper pivoted his ministry mindset to a local one—for the most part. Though he never went into foreign mission service full time, he has participated in over 30 short-term mission trips, the majority of which had a medical basis.

In the years since, Dr. Capper has worked in a variety of positions. He would not consider himself a traditional internist—he has a background in emergency medicine, pain management, geriatrics, cardiology, and palliative care that have played extensive roles in his career.

“I don’t know what I’m going to do when I grow up,” he says, laughing. “I’ve worn so many different hats and continue to do so.”
Throughout his extensive career, Dr. Capper has been heavily involved in medical education for both students and residents, was among the founders of a hospitalist program, worked in private practice, had a leadership role in an independent physician association, was the medical director of a PPO, and served as the medical director of one hospice program and CEO of another. He was among the founding members of a charitable clinic and helped to start JPS’s street medicine program, serving as their de facto medical director in its earliest years. He has worked as a nocturnist and helped to start several medical organizations.

Through the many roles he has held, one he has continually been drawn to is the critical but challenging practice of palliative and hospice care. While there is nothing easy about this field, he values the opportunity to help complex patients manage their conditions and terminal patients pass their last days with the greatest possible dignity and comfort.
Currently, Dr. Capper serves as the CMO of Community Healthcare of Texas, where he also oversees both their hospice and supportive care programs. He is on the faculty of both the TCU Burnett School of Medicine and the Texas College of Osteopathic Medicine (TCOM).

Dr. Capper has been impacted by many people throughout his career, but his greatest support has always come from Dianne, who has worked in ministry alongside him—all while raising their six children and, for a time, their foster daughter.

“I can’t have this conversation without talking about my wife,” Dr. Capper says. “She has supported me and managed our family in my life of craziness; it’s really remarkable.”
He is also grateful for his many siblings and their spouses—he is one of seven—and his parents for the impact they have had on him.
“I have a phenomenal family,” Dr. Capper says. “And you talk about influence on your life. . . . There’s a natural motivation when you have such great people who are encouraging you to do well.”

He views his parents as his ultimate medical heroes and says that their hearts of compassion were critical in the formation of his own worldviews. There are many other mentors and friends he would like to acknowledge for the impact they’ve had on him, and a few are the late John Richardson, MD; Drew Ware, DO; Michael Ross, MD; John Burke, MD; and Bob Keller, MD.

Dr. Capper is grateful for the impact his colleagues have had on his life, and many of those he has worked alongside over the years return the sentiment.
“David is a solid, conscientious physician, and I always felt secure knowing that he was helping my patients when I was away,” says Greg Phillips, MD, a friend and former colleague. “His work in our community helping the underserved and uninsured is without equal.”

Dr. Capper stresses that for patients who are underserved, it is critical to meet them where they are.

“The old saying goes that healthcare is local, right?” he says. “And it’s also true for disenfranchised communities.”

After Dr. Capper began practicing medicine in Texas, he and a group of dentists, physicians, and nurses worked together to start Beautiful Feet’s charitable clinic. It was 1988; JPS only had one central clinic, and the Fort Worth city-run clinics were in the process of being shut down, leaving a gaping hole in the community. The new clinic saw its first patients in 1989, and they have been going strong since. Dr. Capper has served as the group’s volunteer medical director since their doors opened.

“Dr. Capper has been leading [the] . . . clinic through Beautiful Feet Ministries for over 40 years, targeting the homeless and poor living in the Historic Southside of Fort Worth,” says Sarah Myers, Beautiful Feet Ministries co-director. “Through this clinic, countless people have benefited from Dr. Capper’s expertise and compassion.”

Approximately 80 percent of the clinic’s patients are unhoused, which creates unique challenges for continuation of care. His longtime work with this population made Dr. Capper an ideal fit for heading up JPS’s work in street medicine. Later brought on to oversee the palliative care program at JPS, his role grew from working as the volunteer medical director to eventually becoming the staff medical director of their unhoused program.

Though he stepped away from the position in 2022, Dr. Capper is proud of the strides JPS has made in street medicine.

“When we were able to get the 1115 waiver grants—well, I’m not proud of a lot of things, but I am proud of what we were able to structurally do with that,” says Dr. Capper. “And that allowed us to create a program that really addressed the needs of Tarrant County homelessness.”

Though there is a great need for medical care among the unhoused, Dr. Capper has had a broader outreach than that. He helped to form Project Access Tarrant County (PATC), Tarrant County Academy of Medicine’s (TCAM) program that provides specialty charitable care for those who have no resources outside of emergency rooms and primary care charity clinics. He has been on the PATC board since the organization was formed in 2011.

“Dr. Capper was integral to the creation and success of Project Access,” says PATC Director Kathryn Keaton. “His knowledge of charitable care is second to none and is only exceeded by his passion for accessible, comprehensive care for every individual in Tarrant County.”

Dr. Capper is heavily involved in charity care, but he still makes time to focus on a sister cause: medical ethics. He has been on a number of ethics committees, including TCAM’s ethics consortium, and he currently chairs the ethics committee at Medical City Fort Worth.

Because of his work in palliative and hospice care, this has continued to be a significant focus throughout his career.

“You have a lot of potential ethical conflicts in this world,” he says, “so I started going to conferences 20 years ago and then eventually entered a master’s program in biomedical ethics.”

He graduated with his master’s from Trinity International University this past December, and he plans to keep teaching medical ethics not only to physicians but to the public at large.

“So many of these conflicts that we deal with in clinical ethics, they come back to just people living their lives,” Dr. Capper says. “How many of these ethical conflicts could be avoided if people only took a knowledgeable approach to their own advance care planning?”

Like many things, Dr. Capper believes it comes back to education—one of his greatest passions.

Dr. Capper knew he liked to teach early in his career. When he had an extended year in his residency as the chief resident, it was a heavily teaching-focused position. He loved sharing with and learning from other doctors to make the group better as a whole.

When he moved to Fort Worth, teaching at TCOM—which his father had also done—was a natural transition. He works in their geriatric medicine department, and he also joined TCU’s faculty when the medical school was started in 2018; he serves as the chair of clinical sciences. He had also been involved in teaching residents at JPS and Medical City Fort Worth.

He has three charges for those who are just starting out on their careers: physicians must consciously subjugate their own desires for the good of the patient; they have to recognize the unique role of the profession and the responsibilities it entails; and they should always practice with humility.
“We must realize we are no better than our fellow human beings and treat them with respect, no matter what the circumstances of a fellow human being are.”

Dr. Capper does not limit his teaching to the classroom; he marries his love of education with caring for the underserved most Saturdays when he oversees the student-run clinic at Beautiful Feet. As he works with students, he encourages them to make sure they have the right perspective when caring for their patients.

“My warning to the future of medicine is that we need to come back to more of a standard that is time immemorial,” he says. “We shouldn’t bend to the culture; we still need to hold true to ultimate or eternal values.”

Ultimate and eternal values drive Dr. Capper in all that he does. When he isn’t working, he has often spent time ministering to others alongside his family; years ago, when his children were growing up, they did family mission trips together every summer instead of family vacations.

He is incredibly proud of the people they have become, and whenever he and Dianne have the chance, they love spending time with their children, their children’s spouses, and their ten grandchildren, as well as close friends they have worked and served alongside over the years.

Looking back over his career, Dr. Capper is grateful for the path his life has taken.

“You have a relationship with people that exceeds that of any other relationships between people and a profession,” he says. “It’s not just contractual but covenantal; it’s about making a difference.”

Student Article: Carrying the Torch

By Olivia Mayer, OMS-II, TCOM

In one way or another, I have always been tied to medicine by an invisible string. One of my fondest memories of my childhood was around the age of five, when I would help my mom put together goodie-baskets for the oncology patients she would be visiting the upcoming week. This was a Sunday ritual for my mother and me, one we did while simultaneously baking chocolate chip cookies in the oven. No, my mom is not a medical provider; she is a pharmaceutical sales rep who spent any extra time she had on the weekends creating those baskets to show the patients that were taking part in clinical trials for the lymphoma drug she sold that she cared about them. This was an act out of pure benevolence and servitude for those who needed it more than the average person.

In a similar light, my grandmother spent most of her nursing career as a breast cancer nurse in Buffalo, New York. Growing up, I remember Grandma always sharing her favorite memories as a nurse. She was glowing with pride when I told her that I had a similar interest in oncology. Fast forward to today—now Grandma and I share conversations and exchange information about new developments in the breast cancer world. It is truly a full-circle moment with a touch of nostalgia from my younger days. Now as a medical student, I have the immense privilege to carry the torch of my mother and grandmother into my own medical journey. Besides being introduced to this field at a very early age, oncology has piqued my interest by its very nature. The endless opportunities to become a pioneer in cancer research or navigate complex treatment options that can potentially impact countless lives is truly the epitome of medicine, and continues to be the center of my “why.”

It has always been extremely important to me that I seek out any opportunity to create an impact in this field, just as my mother and grandmother did. As the current vice president for my school’s Oncology Student Interest Group (OSIG), I have had the amazing opportunity to assist in cultivating a tight-knit community of passionate students united by a shared commitment to being a source of support and positive change for patients during their most vulnerable moments.

One of the most significant moments I have had serving as a leader of this organization was in honoring the memory of my childhood friend, Zach, who passed away from astrocytoma in the fall of 2018. I felt a personal calling to head an OSIG fundraiser in honor of Zach and in support of his charity, the Big Z Foundation. The Big Z Foundation is led by Zach’s mother and father and financially supports terminally ill children and their families around the DFW area. Just in time for North Texas Giving Day on September 19th of this year, OSIG was able to raise hundreds of dollars for the Big Z Foundation. This support will help local families by assisting with the cost of their hospital bills, treatments, and housing costs. I can only describe the feeling I experienced as true enrichment when I surprised Zach’s parents on behalf of OSIG with our collective donations for the charity. The profound gratitude they expressed is something I will forever hold near and dear.

In moments like this, sharing acts of servitude and benevolence with fellow classmates is an experience so rewarding that it is impossible to fully express in words. This journey has brought me a feeling of gratification in service that is similar to the one I reminisce about when remembering making oncology patient baskets in my childhood. As I continue on my path in medicine, it is my personal mission to continue these acts of benevolence and shed light on those around me so that the flame of my mother’s and grandmother’s torch continues to be passed forward and illuminate a new generation’s impact on the field of oncology.

Project Access Tarrant County: Growth in 2025

by Kathryn Keaton

Another year has come and gone, and Project Access Tarrant County is beginning its fourteenth full year of serving Tarrant County.

While a full 2024 annual report will be included in the next edition of Tarrant County Physician, we did experience growth and are excited that new relationships in our community are bringing new things for this year. Here’s what you can expect to see from us in the next twelve months.

Staffing

In February 2024, PATC hired a new full-time bilingual case manager, Karla Aguilar. Karla was not new to PATC—she originally came to us in 2021 to complete her internship for her undergraduate degree in public health. Over the past ten months, Karla has refreshed our enrollment and application process, increasing overall efficiency.

PATC also has an additional new employee starting this month. Joanna Lopez, our part-time bilingual program specialist, will be the first point of contact for all new referrals and will assist with processing referrals, prescreening patients, reviewing paperwork, and keeping up with patient communication.

Interns and Volunteers

In the fall of 2024, PATC invited freshman medical students from both the Burnett School of Medicine at TCU and UNT Health Science Center to volunteer with us. These students have been instrumental in keeping us on top of new referrals and other data entry. We will continue to have medical student volunteers and appreciate the time they give, however limited. Two incoming TCU students have chosen PATC for their four-year Scholarly Pursuit and Thesis (SPT) project—we’ll have more information on those projects in the following paragraphs.

In an exciting development, PATC recently finalized an agreement with the UTA School of Public Health that makes us a sanctioned site for undergraduate and graduate students’ internships, which are required for graduation. In January, three of these undergraduate interns will work in the Project Access office part-time. In addition to assisting with daily PATC activities, they will also each complete a special project related to improving or expanding Project Access services.

The TCMS Alliance also lent support over this year. We appreciate our Alliance volunteers that assist with data entry, appointment follow-ups, and patient communication.

Patient Education

In the May/June 2024 issue of Tarrant County Physician, the PATC article focused on ways PATC navigates social determinants of health. Since that article, Karla and a first-year medical student at TCU have written a curriculum geared toward PATC patients to address common barriers to medical care as part of this medical student’s SPT project. We plan to host the first class in March of 2025. It will address medication compliance and teach not only about the importance of taking medication for chronic diseases but also how to understand medication instructions, warnings, and other labels patients may see on their bottles. Future class topics may include basic financial literacy, applying for state benefits, and teaching patients how to ask their medical team questions in order to understand their conditions and care plans. We are coming up with incentives to encourage patient attendance, and we have every reason to believe this will be a great success.

Technology

PATC has used CareScope, a database that holds patient and volunteer information, since 2011. CareScope continues to provide what we need from a demographic and reporting standpoint; however, it is limited in its communication abilities. Fortunately, a new innovative program called CareMessage offered a grant to Project Access to use its software for two years. CareMessage will allow PATC staff to communicate with patients through text messages regarding appointments, enrollment deadlines, and post-appointment questions. In addition, we will be able to select sub-groups of our patients for reminders about preventive care, invite patients to our classes mentioned above, and distribute pre- and post-surveys needed for funding purposes. Another TCU medical student has chosen to work on CareMessage as his SPT project. He will assist with setting up the technology, integrating it into CareScope, and creating processes and content that we will be able to build on for years to come.

In addition, PATC launched a new website in September 2024, which you can visit at http://www.tcam.org. This website hosts all Tarrant County Academy of Medicine programs but focuses on PATC. We still have two developmental phases to go through before we have our fully operational website, but here, donors and supporters will be able to support us and find general information much more easily than before.

Fundraising and Capacity Building

As a recipient of the 2024 Community’s Foundation ToolBox Grant, our project was to create and implement a 12-month operational plan—think like a mini-strategic plan. We worked with a consultant, analyzed processes, met with focus groups, and wrote a month-by-month strategy for 2025 to recruit and retain volunteers and expand funding opportunities. Grant writing will continue, and individual giving will be given increased focus.

Patient Services

In addition to the above, our main day-to-day activities will remain the same. Our goal is to serve 250 patients in 2025, including performing 100 surgical procedures. We aim to fully utilize the 48 surgical cases Park Hill Surgery Center has committed to, with the other 52 cases being performed among our other hospital partners. We have strategies in place to make strides to reduce and perhaps even eliminate the general surgery and gynecology waiting lists.

Conclusion

We are excited about what this year will hold, and we look forward to sharing it with our supporters. In addition to the PATC column in the magazine, please be sure you are subscribed to our monthly e-newsletter and follow us on social media as we share our 2025 successes.

TMA Poster Session: Shaping Research and Health Policy

Student Article

by Naimah Sarwar, MS-IV

When medical students don their freshly starched white coats for their first days of medical school, they cross the bridge from being a patient to also becoming a clinician. This evolution, from one side of the doctor-patient relationship to the other, provides medical students a unique perspective. It is at this phase of our training that we arguably have the greatest ability to have clear insight into the nuances of the healthcare system. Armed with the textbook knowledge of how to recognize, diagnose, and treat our patients’ ailments, we have a front row seat to the struggles our patients have in accessing the care they need. We also become privy to the ever-growing challenges that physicians face in providing quality care to their patients while also caring for themselves. With fresh eyes, we witness the successes and failures of the healthcare system. This lens brings into focus much of the scholarly activity medical students engage in. Our curiosity and motivation to advocate for our patients drives us to ask questions, design research projects, and share our findings with others.

The poster session at the 2024 TexMed conference that took place in Dallas this year provided medical students the perfect venue to share such scholarly work with fellow attendees. Participants were required to submit an abstract outlining their projects that were then reviewed in a selection process. Once selected, presenters designed and submitted their posters for display in the gallery. Posters were judged by attendees of the conference for recognition with the “People’s Choice Award.” The gallery provided local students with an opportunity to present their work and featured several posters from the Anne Burnett Marion School of Medicine and Texas College of Osteopathic Medicine.

The works submitted covered a variety of topics, from advocacy and medical education to public health and the presentation of clinical cases. A team of students from the Burnett School of Medicine, including Carter Clatterbuck, MS-IV, and Peter Park, MS-IV, presented on the effects of the new Texas abortion legislation on medical school admission rates. They found that after the overturning of Roe v. Wade, there was a significant drop in female applicants to Texas medical schools. Many physicians stopped at the poster, surprised at how quickly health policy seems to have influenced the decisions of future students and reflected on the effects of certain health policies on their own specialties.

As a first-time presenter at the conference this year, my poster outlined my project investigating patients who connected with specialty care through Project Access. Project Access connects underserved patients who do not have access to insurance to charity care, particularly specialists and surgical services. I wanted to investigate the utilization of these services in order to better understand gaps in access to care locally. The project was inspired by an interaction on my very first day of outpatient clinic, where an unfunded patient was struggling to connect with a specialist they needed. Through my work, I hope to identify where vulnerable patients that fall through the cracks end up seeking care and the burden that inaccessibility to care places on our health system.

During the poster session, I had conversations with physicians that broadened my understanding of the challenges different communities face. One physician from the Rio Grande Valley shared how his community had a shortage of specialists. Many of his patients were thus forced to present to the emergency department with complex diseases without the specialty care they needed. In another conversation, I spoke with a retired local rheumatologist about how many of his patients would lose their jobs due to complications of their conditions. When they lost their jobs, they lost their health insurance and, by extension, access to their immunotherapies. These stories raised so many questions about further areas for study, and I realized that there is no-one-size-fits all solution to the challenges we face in our different communities.

Our clinical experiences and patient narratives have the potential to become major drivers for shaping research and health policy. The TexMed poster session fostered dialogue and facilitated the exchange of ideas between students, physicians, researchers, and clinicians from across Texas with a shared passion for policy and advocacy work. The opportunity to share research findings and to use that research as a springboard for discussions on what our work means to our patients and our practice was immensely valuable.

TexMed 2024: Education Outside of the Classroom

Student Article

by Ashley Taylor, OMS-I

When I received an email from the Texas Medical Association inviting me and other medical students to the annual TexMed conference, my initial thought was that it might be fun to do something other than go to class and study that weekend. I had no idea what TexMed was all about or why I was invited as a first-year medical student, but the thought of a change of scenery was very appealing to me, so I decided to sign up. To my surprise, I was unable to convince any of my friends to attend with me. As more of an introverted individual, the idea of going alone was daunting, but I am beyond happy that I did.

The first night I arrived at TexMed, I attended the Medical Student Section Networking Event where I met dozens of students from around the state, including several from my own school with whom I had not previously had the opportunity to become acquainted. I also began to meet physicians from various parts of the state; each of them was surprisingly friendly, engaging, and eager to get to know me and answer my questions. I am not sure why I was under the impression that the title “networking event” implied that we would all be sitting at a formal table while I tried my best to remember all of my manners while struggling to make conversation with some highly accomplished physician who did not wish to speak to me, but my expectations could not have been more off the mark. I had not been there five minutes before Melissa Garretson, MD, from Cook Children’s Medical Center was offering me her phone number and agreeing to come speak at the next UNTHSC Pediatrics Club meeting that I was organizing. I was blown away by her willingness to help me, a student she had just met, and this feeling continued the rest of the evening as I met more and more physicians who were equally kind and eager to help me succeed. I quickly grew comfortable in this new setting and could not wait to return the next day.

Friday morning came around, and I took my seat with thousands of others in the expo hall for the Opening General Session. Harvey Castro, MD, gave us a presentation on the future of medicine involving AI and what this means for us as students and physicians. His talk was both fascinating and terrifying, but what I really gathered from that morning was the realization that medicine is constantly changing and that it is crucial for all of us to stay up to date on innovations and advancements in the field in order to provide the highest quality care to patients. Another key point that I took away from his lecture was that every person there has a purpose. I found it truly inspiring to look around the room at so many different faces, knowing that we all shared the same objective of learning how we can be the best physicians possible so that we can then provide our best to others.

When the morning’s opening events were complete and we were free to attend our meetings of choice, I headed to what I found to be the most entertaining part of the weekend: the reference committee meetings. Wanting to learn more about healthcare policy, I took a seat in the Science and Public Health committee meeting, per the suggestion of a physician I had just met at lunch, completely oblivious as to how it would work. A few minutes in, I began to understand why he had made this suggestion. I was completely enthralled by the debates unfolding before me, and, naively, I had not expected such current, controversial topics to be discussed. I did my best to absorb all of the information and opinions being presented while frantically googling terms I had never heard and taking notes on the key points that I wanted to use later as subjects for my own research. This meeting was easily the highlight of the conference for me as well as an invaluable learning experience. When I started medical school last summer, I thought the only thing I would ever need to care about again was learning science and doing research, but I now know that there is much, much more to practicing medicine.

My weekend at TexMed ended up being one of the most transformative educational experiences of my life. From meeting physicians of all ages and from all different fields to learning how TMA adopts policies and what they stand for as an organization, I gained more from the conference than I could have ever imagined. I understand now that practicing medicine involves more than scientific knowledge and empathy toward patients. In order to truly put patients’ best interests first, we, as current and future physicians, must be involved on a much larger scale outside of the hospital. It is our responsibility to stay up to date on ever-changing technological advancements, to form and maintain relationships with other physicians and healthcare workers so that we may work as a successful team, and to identify areas of healthcare that need improvement. We need to then introduce and adopt policies that will benefit our patients while also allowing us to effectively practice medicine. Who knew I could learn so much outside of the classroom?