• Improving the Health of All Texans

    • Advancing Care, Treatment for Patients With Mental Illness

      In 1861, the Texas State Lunatic Asylum admitted its first patients. With funding granted in 1856 and construction starting in 1857, the institution featured state-of-the-art design and construction. Physicians and state leaders recognized the need to humanely treat those with mental illness. I'm proud to say the institution and the original building now stand as the Austin State Hospital. I was the clinical director there from 1995 to 2005.
  • Standing up for Public Health

    • Bill Could Protect Mental Health Patients, Others
      Senate Bill 359 applies only to a small group of patients: individuals who have sought services at a hospital or freestanding emergency medical center voluntarily then want to leave, but the physician at the hospital believes these patients are a danger to self or others. It does not apply to any patient who is brought in on an emergency detention initiated by a peace officer or is under an order of protective custody issued by a court.
    • TMA Supports Five Bills to Limit Minors’ E-cig Access
      The nicotine present in these devices has measurable levels of toxicity. Nicotine has known psychoactive effects and quickly becomes addictive — requiring additional levels of nicotine as the body becomes more tolerant. We encourage you to take steps to prohibit the use of tobacco products in schools and other public places as some of these bills propose. We also join other national and state organizations in urging caution in recognizing e-cigarettes as a tobacco-cessation or harm-reduction strategy for current tobacco users because of the lack of scientific evidence on the safety of these products. E-cigarettes have not been approved as either a cessation or a replacement product for cigarettes by FDA.
    • Support Better Reporting of Disease Outbreaks, Vaccine Exemptions
      While we have a good process for school district reporting on vaccination exemptions and DSHS tracking, this information is only at a district level, which is of limited benefit to families evaluating their schooling options.  Parents must be able to make informed decisions so they know what they may have to do to protect their children in the event of a school-based infectious disease outbreak. These reports will serve as tools for becoming best informed, and also will enable the public health community and physicians to respond in the event of an outbreak.
    • Don’t Toss 18 Year-Olds’ Valuable Shot Records
      The confidential, electronic registry maintains my patients’ immunization record, which can be accessed by their doctor(s), child care center, or school nurse. Having a dependable vaccination record ensures patients are appropriately immunized, especially because the recommended immunization schedule is complex and our patients may move among different physicians and different cities in our state.
    • TMA: Let Human Trafficking Prevention Task Force Continue
      As physicians, our interest is to help identify and treat potential human trafficking victims and ensure victims obtain the extended care and support they need. We encourage you to amend the makeup of the current task force to include representatives of TMA and relevant subspecialty groups to assist in this regard. We have physician members with expertise in caring for victims of human trafficking, and we believe these health professionals can best help guide the development of screening tools and expanding access to educational programming for providers on health issues associated with trafficking.
    • Support Physicals, Not Mandated Heart Tests for Student Athletes
      While electrocardiograms (ECGs) could enhance screening for cardiac disorders, there is a lack of scientific evidence demonstrating whether or how this should be implemented on a broad scale in the United States. The medical evidence does not support mass screening with ECGs, as required by HB 767.
    • Shore Up State's Core Public Health System
      SB: 202 - Inventory: We endorse the activities specified in SB 202 to complete an inventory of the roles, responsibilities, and capacity of our state, regional, and local services and programs. Action Plan: We support the collaboration with the Public Health Funding and Policy Committee also created by Senator Nelson; however, we ask that you recognize that the composition of this body is currently limited. We would like to see this inventory process also include other stakeholders at both the community and the statewide levels. This would ensure a more public and transparent process. Physician Leadership: Over the last decade, we have seen a significant decline in the number of physicians working in public health at DSHS. This is also occurring in many local health departments. It concerns us particularly because disease transmission and disease preparedness are increasingly global concerns, as we saw with the Ebola scenario in Dallas.
    • Keep Perinatal Advisory Council to Improve Birth Outcomes
      Over the last several legislative sessions, Texas has invested significant new resources towards improving maternal health and birth outcomes, including improving early entry into prenatal care, educating parents about the importance of optimal birth spacing, and establishing an expert review panel of maternal illness and death. But Texas still has work to do. The state’s preterm delivery rate (12.3 percent) is still well above the Healthy People 2020 goal (9.6 percent), and significant racial and ethnic disparities still exist in Texas’ birth outcomes, as does sky-high maternal mortality.
  • Addressing Pollution from Legacy Coal Power Plants in Texas

    This June 2013 report examines retrofitting Big Brown, Martin Lake, and Monticello coal-fired facilities with modern emission controls or retiring the plants and replacing them with cleaner alternative energy sources. Prepared by Daniel Cohan, PhD, assistant professor of environmental engineering at Rice University, Addressing Pollution targets these three 1970s-era legacy coal-fired power plants because they are "the leading emitters of air pollutants and greenhouse gases in Texas." And they heavily contribute to the formation of ground-level ozone and particulate matter, a mixture of substances including carbon-based particles, dust, and acid aerosols formed in the atmosphere by volatile organic compounds, sulfur dioxide, and nitrogen oxides.

    The report explores four options that "could foster the ability of electricity providers to offset any loss of generating capacity from the legacy coal-fired power plants, while enhancing air quality and minimizing costs to ratepayers."

  • Texas Public Health Stats

    • Immunizations

      There is a greater risk of outbreaks of vaccine-preventable diseases in communities with low immunization rates. Vaccine preventable diseases will increase if Texas cuts immunization funding.
    • Obesity

      "F as in 'Fat'" Ranks Texas the 13th most-obese state in the country. Healthy eating starts in childhood.
    • Smoking

      Tobacco use is the leading cause of preventable death in the state. More than 24,000 Texans die each year from tobacco-related illnesses. Join with TMA to make Texas smoke-free.
    • Mental Health Funding

      More than 4.3 million Texans, including 1.2 million children, live with some form of mental health disorder. Of these, 1.5 million cannot function at work, school, or in the community due to their illness.