I Never Knew TMA: Did So Much Legislative Work
By Phil West Texas Medicine December 2024

Kimberly Monday, MD, remembers what it was like to testify on the Texas Medical Association’s behalf at a Texas Senate hearing in 2017.

“Doctors love to learn, and it was a learning experience,” the Houston neurologist said of the process. “It’s a tad intimidating, and it’s a tad disorganized, and so you have to be flexible to be able to jump in and speak quickly and make your points.”

Dr. Monday advocated for a bill that ultimately became law to address the Texas Medical Board’s maintenance of certification requirements.

“It was a great use of my time, because I was passionate about the issues,” the TMA Board of Trustees member added. “I wasn’t sure that just having lawmakers read something that I have written would have had the same impact as being there in person and speaking to the issue.”

The advocacy work TMA does during each legislative session boils down to “keeping patients safe, keeping Texans healthy, and keeping practices strong,” said Michelle Romero, TMA associate vice president of public affairs.

That’s of particular importance to Josiah Ward, DO, who, in attending TMA’s 2024 Listening Tour, expressed a need for and learned of the association’s advocacy work in strengthening telemedicine to address rural health needs. Some of his patients travel up to three hours to get to his San Angelo pediatrics clinic; he now does about 15% of his appointments via telemedicine to better serve his patients.

“Being able to have payment for [telemedicine] is very important to allow us to continue to provide that as an option for people,” he said.

Through its Council on Legislation, TMA tirelessly tracks and advocates on issues like scope-of-practice creep, bolstering the physician workforce, and payment problems impacting access to care and practice viability – all pressing concerns Texas physicians have shared with TMA, and all shaping up to be priorities for the 2025 legislative session that begins Jan. 14.

During the 2023 session, legislators filed nearly 12,000 bills, more than 2,000 of which impacted medicine. TMA followed all of those, weighing in with its team of lobbyists and army of physician testifiers like Dr. Monday.

Throughout TMA’s Listening Tour, doctors across the spectrum listed loss of “physician leadership of the health care team” as one of the most worrisome issues affecting medicine.

Younger physicians, for example, “want reassurance that as employed physicians, they are not going to be responsible for nurse practitioners without their consent and their involvement and without compensation,” Dr. Monday said she heard during several tour stops she attended. “Especially in our emergency rooms, we heard a lot of doctors saying they’re concerned about the level of nurse practitioners handling things that may be outside their scope.”

TMA also fielded concerns regarding physician workforce shortages, for which Ms. Romero said the association has been successful in securing additional funding over the past few sessions.

“I remember a time when it could take some physicians up to a year to get a license to practice medicine in Texas,” Ms. Romero said. “Now I think we’re down to 51 days. And it took a concerted effort from TMA to advocate for adequate funding.”

Such advocacy is only successful with physician involvement, which is why TMA has created engagement opportunities like First Tuesdays at the Capitol. The event rallies TMA physicians, alliance members, and medical students in Austin to take concerns directly to their state senators and representatives during the legislative session. In 2025, TMA’s First Tuesdays at the Capitol events will be on Feb. 4, March 4, April 1, and May 6.

For physicians who can’t make it to Austin, TMA alliance chapters host local events in lawmakers’ districts. Plus, watch for TMA-sponsored “action alerts,” prepared messages from TMA that physicians can send to legislators, asking them to stop or pass a bill. Members can type in their ZIP code on the Action Alerts webpage and instantly get a list of state and/or federal officials to contact.