Let Doctors Be Doctors: Jay Shah, MD, Readies For a Holistic Approach to Serving as TMA President
By Phil West Texas Medicine March 2025

From there, he flew halfway around the world to New York City – where thanks to a J-1 visa, he was able to pursue his medical degree at Columbia University. 

The San Antonio internist first considered medicine at the urging of his father, an electrical engineer in a family full of engineers. When his grandmother became ill – while Dr. Shah was growing up alongside three siblings – his father was concerned that no one in the family could confer with him on medical matters. By the time Dr. Shah entered high school, he knew he’d follow his dad’s wish for a doctor in the family. 

Upon finishing his medical school program in 1996, his story took a surprising twist – to a Texas town far smaller than anywhere he’d lived before – Uvalde.  

Thanks to a rural service requirement tied to his visa and after mulling the opportunity to practice in several states, he gravitated to Texas in 1997 because its climate was similar to where he grew up, and “felt a good Texas welcome” upon arriving. 

“I was seeing so many patients,” he said of his first few years as a physician. “I had an internal medicine practice, there was no wound care doctor in that area for 200 to 300 miles, and there was a huge need. And being a young doctor in the community, they looked at me to see if I can help them to develop their wound care program, and I took that opportunity.”  

In addition to working in one specialty and learning another, Dr. Shah experienced his first foray into hospital administration, becoming medical director of the Wound Care and Hyperbaric Center at Uvalde Memorial Hospital. 

That initial leadership post, born out of necessity, shaped his career as profoundly as his adopting an additional specialty. In a long, successful career after answering that initial call to lead, he’s preparing to embark on his biggest leadership challenge yet – overseeing one of the nation’s largest physician state medical societies, 59,000 members strong, advocating for medicine on a state and federal level.

As Dr. Shah readies to become the TMA’s 160th president at the upcoming TexMed conference in May, and the association’s first Indian-American president, he’s put forth a simple four-word motto encapsulating his focus: “Let doctors be doctors.” 

“My focus this year is making sure that doctors are respected as doctors. My goal is to elevate the profession,” he said, concerned that decreases in Medicare payment for physicians, insurer obstacles to patient care, and a system that regards physicians as mere “providers” despite their extensive education and experience, all contribute to an overall “devaluing” of physicians. 

He even goes as far as labeling this devaluation as a “moral injury” contributing to physician burnout – motivating him to take on multiple leadership roles. (See “Bio Box: Jay Shah, MD,” page 12.) 

Dr. Shah, who has a daughter in medical school, says he is prepared to fight for – and empathizes with – some of the top concerns he hears from physicians, like bolstering graduate medical education, guarding against scope of practice infringement, and addressing longtime practice struggles that get in the way of doctors being doctors, like the hassles and harms of prior authorization.  

For his own wound care patients, for instance, he knows a delay in prior authorization can mean a delay in a patient’s healing and decidedly worsened outcomes.  

In a 2021 article for San Antonio Medicine, he cited the dangers of such delays for a diabetic patient, for whom, once he or she undergoes an amputation, the risk of mortality is 68% within five years. He wrote that this was “more than the mortality of breast cancer, prostate cancer, and lymphoma combined.”  

“The physician who is seeing the patient knows what’s best for the patient, more than someone who is just reviewing the chart,” he told Texas Medicine. “Sometimes, the person who is reviewing the chart may not be a doctor. Sometimes, AI [artificial intelligence] will, just based on an auto-formula, deny or delay care, and when you have that, it can cause bad outcomes.” 

He also cited protecting medicine from corporate influence as another primary focus and “making sure physicians get to do what they are trained for.”  

Regardless of whether doctors work for hospitals or in private practice, he says he seeks to bring all physicians in Texas together under the TMA banner. 

“We all are physicians, and we are united for our patients, because that’s what brings us together,” he said. “We want to do what’s best for the patients. Whatever I would advocate while I’m TMA president will be keeping patients first.” 

He notes that his entire motivation for engaging in advocacy started with his patients, and his concern for them will drive his agenda in his year as president.  

“When I went into advocacy, it was not about anything else but wanting to help my patients right away,” he said. “That is the underlying reason why, when someone asks why for anything that we do, we must dive down to our patients. Even our advocacy, whatever patients’ or physicians’ issues we have, at the end of the day, it’s patients that we are representing. And like we did with liability reform win in 2003, if we can develop partnership with our patients on issues like prior authorization and scope of practice, we will have a much better chance to win some of these difficult battles.”

In 1999, Dr. Shah moved 85 miles east from Uvalde to San Antonio, where he and his family have been anchored for more than 25 years now.  

Zeke Silva, MD, chair of TMA’s Council on Legislation, enjoys a long history with Dr. Shah dating back to their time together in the early 2000s working at Southwest General Hospital in their shared hometown.  

“He knows how complex our issues are, but he understands also that the most fundamental, foundational relationship in all of this is between the physician and patient,” the San Antonio radiologist said.  

They’ve had extensive conversations about topics like workforce and prior authorization over the years, and Dr. Silva’s impressed with how vocal Dr. Shah has been to support physicians stymied by administrative burdens.   

“He’s going to be quite an advocate for physicians, on both the state and the national level. I’m excited to see what he can accomplish,” Dr. Silva added, echoing similar comments from associates. 

Leah Jacobson, MD, a San Antonio pediatrician who preceded Dr. Shah as Bexar County Medical Society president and currently serves on TMA’s Board of Councilors, praises him for working well with people of all backgrounds, for his aptitude as a mentor, and for how he’s managed his own practice.  

“He has worked tirelessly for physicians of Bexar County and Texas, and I know he will continue to do so during his tenure as TMA president,” she said, crediting his county medical society leadership as an important steppingstone.  

Dr. Shah characterizes the county he led as being unique in Texas, being part of the association’s Border Health Caucus even though it’s not physically on the border. While San Antonio sits about 170 miles from Laredo and 250 miles from the Rio Grande Valley, it serves as the biggest hub for health care in South Texas and draws patients from across the state’s southern region.  

“Whatever happens in the border area, it affects our physicians,” he said. “We do have a huge population of uninsured people; they don’t have enough resources to take care of themselves. They don’t have enough money to pay their co-payments. They don’t have transportation. They have food insecurity. They have all the issues that we see happening in border towns.” 

He asserts that when “practices are not able to keep their lights on” and a local hospital like Texas Vista Medical Center (formerly Southwest General Hospital) has to close its doors, as it did in 2023 after nearly 40 years in operation serving low-income patients, that can be especially impactful on meeting a community’s health care needs.

Much of his investment in that committee stems from being the father of an aspiring doctor. Now his daughter, Prachi, is in her fourth year at the University of the Incarnate Word School of Osteopathic Medicine, preparing to become a family physician and planning to stay in the Lone Star State.

“When you see that every day at home, you know that our medical students work very hard to become physicians, and they deserve the respect that they earn,” he reflected. “We should fight every inch to protect our profession, and because I have a daughter who’s going to be a doctor, I think that gives me the inspiration, that gives me the strength, to make sure that we do everything in our power to protect the scope of practice and protect the title of doctor.” 

It’s not just his daughter who helps him focus on the future. 

“I also have medical students that rotate with me, and I teach medical students, so that really helps me to relate what they go through and to make sure that our deserving medical students, who work so hard, and have so much in loans while they finish their school, shouldn’t be treated like mere ‘providers.’ They should be getting the respect that they deserve.” 

While he’s buoyed by the engagement of young physicians and medical students in TMA, Dr. Shah also is looking to encourage more participation in the association’s councils and committees while he’s president. 

“There are so many potential young leaders who want to learn about leadership,” he said. “The most successful leader creates the pipeline … if you don’t have a pipeline to replace you, then you are not a good leader.” 

In addition to “let doctors be doctors,” Dr. Shah’s blog offers another four-word slogan he anticipates emphasizing during his tenure as TMA president: “Reclaim joy in medicine.” 

He believes that in order for doctors to be able to do that, they have to take care of themselves in both body and mind.  

“You have to put a mask on yourself before you can a put mask on someone else,” he said, using a metaphor for self-care owing to a flight attendant’s pre-takeoff safety instructions. 

“Physicians have to take care of themselves first, so they can take care of the patients,” said Dr. Shah, who also stressed the importance of physician wellness during his time leading the Bexar County Medical Society. “At TMA, it’s our role to make sure that we provide wellness initiatives, make sure we take care of our physicians, make sure they are able to reach out to us when they are burned out.”

“I want to help physicians talk about their burnout, and also help other physicians share how they got out of it,” he said. “I want to do a podcast and talk about all this throughout the state, to say this is what they did, they had burnout, this is how they got out of it, and this is what’s available to them. There are ways that you could practice medicine and not feel burned out. And we need to be able to provide those resources.” 

Dr. Shah also emphasizes the importance of hobbies, and lists bicycling, cricket, racquetball, and travel with his wife, Neha, who works as a lymphedema and cancer rehab physical therapist, as some of his primary hobbies. 

Also, he’s a big believer in yoga. 

“I practice yoga every day,” he said. “That has changed my life and has helped me with burnout.”  

He is a trained yoga instructor himself and is well-versed in the practice, teaching patients how to utilize it in their own lives. He’s even willing to lead a session for physicians at an upcoming TMA conference should there be interest. 

“There’s nothing like meeting members face-to-face,” he said. “TMA is going where the members are with our regional events, so we will travel everywhere, wherever members are, to make sure they feel connected with TMA, to feel like they know what TMA brings to the table, and we’ll continue that journey.” 

To that end, Dr. Shah wants to make it out to even the smallest counties in the state, noting that even one rural physician reaching out to one rural representative or senator can make an immense difference.  

Even in an off-session year when he’s president, he emphasizes doctors need to be proactive in their advocacy for medicine by getting to know their elected officials. 

“A lot of our legislators come from smaller counties, and physicians have the best connection with them,” he observed. “When they talk to them, they can make a huge policy difference. Strengthening that arm is very important. Going to a rural area, even if they have just 10 or 15 physicians, will strengthen our message and strengthen TMA.”  

He values the work rural physicians do in their practices, pointing out that as they don’t have as many readily available specialists to work with as their suburban and urban counterparts, they strive to be well-rounded physicians, gaining confidence in working outside of their familiar specialties “because they have no choice.”  

That perspective on rural medicine, which he developed as a young physician in Uvalde, will inform his presidency – as will the memories of what first drew him to join TMA.  

“When I started my practice 28 years ago, I joined TMA because I was feeling alone in that small community,” he recalled. “Joining TMA, I was able to vent about our issues and be part of a bigger community to find out solutions. That’s the important thing that TMA provides, it provides a platform, provides a community that holds your hand during the tough times.”