Texas Medical Association

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Texas Medical Association
TMA logo.png
Basic facts
Location:Austin, Texas
Type:501(c)(6)
Top official:A. Tomas Garcia III, M.D.
Year founded:1853
Website:Official website
Budget
2014:$24,085,506


The Texas Medical Association (TMA) is the country's largest 501(c)(6) nonprofit medical society. According to TMA, the group's legislative team aims to lobby on behalf of physicians at the state and federal levels in order to promote physician autonomy and minimize regulatory intervention in the practice of medicine. The association also offers outreach services to members such as professional insurance and continuing medical education.[1][2]

Mission[edit]

According to the organization's website, the Texas Medical Association has the following mission statement:

TMA stands up for Texas physicians by providing distinctive solutions to the challenges they encounter in the care of patients.[3][4]

History[edit]

The Texas Medical Association was founded in 1853 by a group of 35 physicians. The goal of the organization was to "advance the status and standards of medical practice in Texas." TMA membership grew from 10 percent of Texas physicians in 1880 to 98 percent in 1954. Today, TMA is the nation's largest state medical society. Members include over 48,000 physicians and medical students from 112 county-level medical societies.[1][5]

TMA has supported state and federal legislation in order to implement what the group considers to be public health improvements and medical advancements in Texas. Over the years, the organization has advocated for its positions on healthcare issues such as AIDS awareness, rural access to care and transportation safety standards. During the 2015 session of the Texas Legislature, TMA worked to help increase graduate medical education funding, enact changes to the Medicaid fraud investigation process, regulate the sale and use of e-cigarettes and repeal the annual $200 physician occupation tax, which had been temporarily implemented in 1993.[5][6]

Work[edit]

Texas Medicine magazine

As a 501(c)(6) nonprofit organization, the Texas Medical Association functions as a business league to bring together Texas physicians and support the group's positions on the practice of medicine. TMA provides its members with professional services and engages in lobbying and campaign activities related to the medical community.

Professional services[edit]

TMA offers a number of professional services to its members including continuing education opportunities, practice insurance and business management workshops. TMA also produces several publications including Texas Medicine, a monthly news magazine, and Action, a monthly member newsletter.[5][7]

Lobbying[edit]

TMA's legislative team monitors state and federal legislation that impacts public health, the practice of medicine and physician autonomy. According to a 2015 report from the Texas Ethics Commission, 26 lobbyists were registered to advocate on behalf of TMA in Texas.[2][8]

TMA's primary advocacy areas include:[5]

  • The Affordable Care Act
    TMA provides member physicians with resources to help navigate the changes to policies and procedures implemented under the Affordable Care Act (ACA). The organization also aims to develop recommendations and solutions to administrative complications under the ACA.[9]
  • Medicare
    TMA seeks to advocate on behalf of Texas physicians at the federal level in order to implement the organization's legislative solutions to Medicare challenges such as payment formulas and reporting requirements. The group also offers administrative resources to physicians who accept Medicare patients.[10]
  • Medicaid and the Children's Health Insurance Program (CHIP)
    TMA aims to secure Medicaid and CHIP funding at the state and federal levels and develop proposals for administrative solutions. The organization offers administrative resources to member physicians who accept Medicaid and CHIP patients.[11]
TMA members in the Texas capitol
  • Workforce
    According to TMA, the group seeks to expand the medical workforce in Texas in order to improve care for the state's growing population. TMA aims to advocate at the state and federal levels for increased academic funding and incentive programs to bring physicians to the state.[12]
  • Scope of practice
    TMA endeavors to support "physician-led teams" and opposes efforts to broaden the functions and responsibilities of non-physician health practitioners, such as nurses.[13]
  • Health insurance
    TMA provides administrative assistance to member physicians in order to help doctors navigate the complexities of traditional insurance, the Affordable Care Act, Medicare, Medicaid, CHIP and workers' compensation.[14]
  • Liability
    According to TMA, the group seeks to advocate for legislative solutions to contain the cost of physicians' liability insurance.[15]
  • End-of-life care
    TMA provides guidance to physicians regarding the legal aspects of end-of-life care, such as advanced directives and medical power of attorney. The group also aims to work with the Texas Legislature to enact its proposals for end-of-life legal solutions.[16]
  • Public health
    According to TMA, the group endeavors to improve public health in Texas and support efforts to address infectious diseases, obesity, mental health and tobacco use in communities across the state.[17]
  • Other issues
    TMA monitors developments surrounding issues that impact the practice of medicine, such as health information technology systems and the use of telemedicine in rural communities. Among other issues, the group focuses on women's healthcare, access to care along the Texas-Mexico border and workers' compensation.[18]

Opposition[edit]

The Texas Medical Association has faced opposition from medical professionals and legal groups. The main sources of outside criticism focus on TMA's support of scope-of-practice limitations for non-physician health professionals and tort reform legislation.

Scope-of-practice[edit]

The Texas Medical Association has encountered opposition regarding scope-of-practice issues for non-physician health practitioners. According to a 2013 article in Texas Medicine, doctors and nurses have disagreed for years over medical scope-of-practice, such as limits on prescriptive authority for nurses and requirements for physician-led medical teams. TMA maintains that physicians are the only medical professionals with the training and authority to diagnose and oversee treatment for patients. Nurses have struggled to gain increased autonomy under the level of physician oversight required by Texas law and supported by TMA. In a 2013 interview with Bloomberg Business regarding scope-of-practice legislation, Sandy McCoy, former president of Texas Nurse Practitioners (TNP), explained that nurses "really would have liked independent practice, but we realized we work in a state that has one of the most powerful medical groups in the country...they have deep pockets and are able to provide more financial contributions than we can and that does have influence to some extent in the legislature.”[19][20]

Former Texas Governor Rick Perry signs 2003 tort reform legislation

Chiropractors in Texas have also taken issue with TMA, claiming that "Texas chiropractic has been under full frontal attack by the Texas Medical Association (TMA)...with regard to diagnosis and chiropractic scope-of-practice." The Texas Chiropractic Association (TCA) has sparred with TMA in the courts and the legislature regarding scope-of-practice issues, such as the diagnostic authority of chiropractors and their capacity to perform acupuncture and related procedures.[21][22]

Tort reform[edit]

In addition to struggles with non-physician health professionals, TMA has faced opposition from Texas trial lawyers. TMA and the Texas Trial Lawyers Association (TTLA) have disagreed over issues of medical malpractice and physician liability since the 1980s. A 2003 article in Texas Monthly described TTLA as an "old enemy" of TMA. The disagreement between the two groups came to a head in 2003, when the Texas Legislature passed tort reform legislation. Physicians claimed that the reforms allowed them to practice medicine without the threat of "frivolous lawsuits," but trial lawyers argued that the reforms limited the legal options of medical malpractice victims.[23][24]

Leadership[edit]

The 150th president of the Texas Medical Association is A. Tomas Garcia III, M.D. TMA is governed by the House of Delegates, a group of 472 members that make policy decisions for the organization. The Board of Trustees implements TMA policies and manages the association's financial and business affairs.

Board of trustees[edit]

  • Douglas Curran, M.D., Chair
  • David N. Henkes, M.D., Vice Chair
  • Richard W. Snyder, M.D., Secretary
  • Keith Bourgeois, M.D.
  • Diana L. Fite, M.D.
  • David C. Fleeger, M.D.
  • Gary W. Floyd, M.D.
  • Dan McCoy, M.D.
  • E. Linda Villareal, M.D.[25]

Finances[edit]

According to tax documents, the Texas Medical Association generates revenue through contributions and grants, investment income, membership dues and program services. As a 501(c)(6) nonprofit organization, membership dues must account for a significant portion of the organization's revenue.[26]

Annual revenue and expenses for TMA, 2010-2014[26]
Tax Year Total Revenue Total Expenses
2014 $24,085,506 $23,671,758
2013 $23,876,036 $24,164,338
2012 $23,571,673 $22,404,591
2011 $22,442,572 $22,011,274
2010 $22,366,854 $21,398,624

Related programs[edit]

The Texas Medical Association Alliance (TMA Alliance) is an affiliated 501(c)(6) nonprofit organization of roughly 4,000 volunteers dedicated to realizing the group's vision of a healthier Texas and achieving TMA goals through community service and political action.[27]

The Texas Medical Association Political Action Committee (TEXPAC) is a bipartisan political action committee that assists state and federal candidates who work to advance TMA's healthcare policy positions.[28]

The Texas Medical Association Foundation is a 501(c)(3) nonprofit organization that aims to support TMA's priorities by providing financial support to public health programs in Texas.[28]

Media[edit]

TMA Texas legislative summary, June 2015
TMA Texas legislative budget update, May 2015

Recent news[edit]

The link below is to the most recent stories in a Google news search for the terms 'Texas Medical Association'. These results are automatically generated from Google. Ballotpedia does not curate or endorse these articles.

See also[edit]

External links[edit]

Footnotes[edit]

  1. 1.0 1.1 Texas Medical Association, "Who is TMA?" accessed September 11, 2015
  2. 2.0 2.1 Texas Medical Association, "Division of Advocacy," accessed February 10, 2016
  3. Texas Medical Association, "Vision, mission and goals," accessed September 11, 2015
  4. Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source.
  5. 5.0 5.1 5.2 5.3 Texas State Historical Association, "Texas Medical Association," accessed September 14, 2015
  6. Texas Medical Association, "Texas medicine scores for patients, physicians in legislature," August 3, 2015
  7. Texas Medical Association, "TMA publications," accessed September 14, 2015
  8. Texas Ethics Commission, "2015 list of registered lobbyists with employers/clients (EMP/C) sorted by concern name," accessed February 10, 2016
  9. Texas Medical Association, "Affordable Care Act Resource Center," accessed January 5, 2016
  10. Texas Medical Association, "Medicare," accessed January 5, 2016
  11. Texas Medical Association, "Medicaid and CHIP," accessed January 5, 2016
  12. Texas Medical Association, "Workforce," accessed January 5, 2016
  13. Texas Medical Association, "Scope of practice," accessed January 5, 2016
  14. Texas Medical Association, "Health insurance," accessed January 5, 2015
  15. Texas Medical Association, "Professional liability insurance reform," accessed January 5, 2016
  16. Texas Medical Association, "End-of-life care," accessed January 5, 2016
  17. Texas Medical Association, "Public health," accessed January 5, 2016
  18. Texas Medical Association, "Other issues," accessed January 5, 2016
  19. Bloomberg Business, "Nurses Spar With Doctors as 30 Million Insured Seek Care," March 3, 2013
  20. Texas Medicine, "Buried in Paperwork," accessed March 1, 2016
  21. Dynamic Chiropractic, "Texas Medical Association Denied," August 1, 2013
  22. Texas Medicine, "A Needling Controversy," accessed March 1, 2016
  23. Austin-American Statesman, "Tort reform foes team up to force insurance companies to pay promptly," January 27, 2013
  24. Texas Monthly, "The Enforcer," accessed March 1, 2016
  25. Texas Medical Association, "Board of trustees," accessed September 11, 2015
  26. 26.0 26.1 Guidestar, "TMA forms 990," accessed September 14, 2015
  27. Texas Medical Association, "TMA Alliance," accessed September 14, 2015
  28. 28.0 28.1 Texas Medical Association, "It takes a village: TMA works arm in arm with other organizations," accessed September 14, 2015

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