TMA Membership Development

TMA Membership
As of Dec. 31, 2006, TMA physician and medical student membership totaled 41,810, compared to 41,089 the same time last year. The year-over-year membership increase was up 1.75 percent, or 721 members.

In addition, compared to this same time last year, the membership categories of active and students experienced increases. The increase in the active category was 2.29 percent or 599 members, and students 3.79 percent or 170 members.

AMA Membership
Texas physician and medical student membership in the American Medical Association, including those who joined the AMA directly, experienced a decrease of 399 members as of Nov. 30, 2006. AMA membership totaled 17,433 compared to 17,832 at the same time last year.

The AMA proposed several changes to the 2007 Partnership for Growth agreement that defines the marketing relationship and responsibilities of TMA and AMA. The changes were significant and after extensive feedback from the states, including Texas, the AMA decided not to make any changes in the PFG. Instead, several all state meetings were held and a staff work group was formed that will look at improving the AMA membership model. TMA staff will represent Texas along with 14 other states and one county medical society.

The first meeting of the work group was held on February 12. The group identified several key components to a new model. They include clarity of the value proposition, increased relevance of AMA by identifying and communicating tangible benefits, a segmented integrated marketing plan, and testable, measurable ideas.

Working with County Medical  Societies
The director of membership development and staff committed to implementing scheduled local activities with physicians via county medical society and other local-market activities. Per the feedback and discussions generated, several key improvements will be made to the newly licensed recruitment plan, the renewal campaign site, and the Texas Execs online community of practice that will further recruitment and retention efforts. Additionally, key markets and specific strategies were identified for 2007.

Field Representatives
Following board approval, TMA and Dallas County Medical Society hired the first membership development field representative based in Dallas earlier this year. Cara Clemson, Dallas CMS Director of Membership Development, started in March and is responsible for all TMA and DCMS membership recruitment activities and programs in Dallas. Cara has worked closely with TMA staff during her orientation period. Mutual goals were set, with recruitment targets based on a percentage above historical intake of new members.

A key priority has been to implement a consistent grassroots presence and work with county medical societies to establish and implement local non-member events and recruitment strategies. A field representative in Dallas has allowed local analysis of member and nonmember data, member segmentation, outreach activities, direct mail, membership messaging, and programs to strengthen association visibility among members and non-members.  Likewise this presence affords TMA the opportunity to further develop a network of relationships with physicians, physician groups, specialty societies, and medical schools to strengthen awareness of association/society efforts and membership.

Harris County Medical Society hired a field representative starting in January 2007. The number of recruitable non-member physicians in Harris CMS, (approximately 3,700) make this well worth the time and effort. It is expected that recruitment efforts will fully offset the cost of a full-time membership field representative whose main goal would be to increase HCMS/TMA membership. Again, TMA and HCMS will work closely together to set mutual targets and goals.

Ambassador Program
TMA has implemented a plan to provide an enhanced TMA presence in the field; including being responsive to county societies, hospital medical staffs, large groups, and specialty societies. The project will have several payoffs, but the ultimate goals are to increase membership and enhance the success of advocacy efforts. The ambassador program is designed to support efforts already in place, while implementing a more organized, pushed-out, and consistent presence via scheduled local activities with physician members and prospective members via county medical society and other local efforts. Momentum is building and the interest level of staff and the county medical societies is encouraging.

New To Texas- Newly Licensed Physicians Plan
Recruitment of newly licensed physicians remains a high priority as the growth of this population has spiked in the past 12 to18 months. In 2001, TMA began receiving data on newly licensed physicians from the Texas Medical Board approximately six times a year. This data is imported into the TMA iMIS database to be used to recruit newly licensed physicians for membership. The data show that, on average, 70 percent join within five years of licensure and it takes an average of eleven months to convert a newly licensed physician into a member. The year of their license and the year after their license are the two most successful years for recruitment of newly licensed physicians. 

The Texas Medical Board received applications for 4,026 physicians during its 2006 fiscal year (September 2005-August 2006) compared to 2,992 during that same time last year. However, the TMB is months behind in its processing of applications and approximately 2,389 applications were still in various stages of process at the close of the 2006 fiscal year.

TMA and CMS staff have followed a long standing step-by-step process for multiple follow-up activities. The percentage of newly licensed recruited has remained fairly steady, increasing only slightly over the past five years, in spite of this focus. TMA is working with county medical societies to revise the current newly licensed recruitment plan. The new plan will include more personal interactions with new licensees and more tangible information and benefits for this key group.

Additionally, at the request of the Texas Medical Board, TMA is preparing a seminar on the licensure process to help better educate students and residents about when they are eligible, what is involved in the licensure process, and how to properly complete an application. TMA also has offered assistance in securing a Web site that would allow licensure applicants to log on and track the status of their application. Donald Patrick, MD, is putting together a task force of TMB employees to facilitate this process.

The Committee on Membership suggested TMA establish a Web page and materials dedicated to information beneficial to newly licensed physicians. It would include Texas physician statistics and shortages information, requirements for licensure in Texas and application instructions, answers to frequently asked questions, and key resources like the Physician Services practice checklist. Additionally, the committee suggested segmenting the information provided to newly licensed physicians based on whether they had already practiced elsewhere (outside of Texas), had not practiced before, or are international medical graduates. TMA membership development staff are working at defining the complete list of items that might be included.

Trusted Leader Activities
At the November TMA-CMS Membership Marketing meeting, participants discussed how to better promote the positive volunteer efforts and community projects taken on by member physicians. Instead of allowing media publicity to be driven by reports about "bad doctors" discussion centered on how TMA and county medical societies could help generate positive stories about physicians.

One idea was to nominate physicians for prominent community awards and volunteer opportunities. These might include opportunities for providing health advice via local radio or news programs. County medical societies were encouraged to consider opportunities in their local communities and work with their leadership on recognition of these efforts.

TMA staff recently worked with Travis CMS to nominate members for two upcoming awards. Dawn C. Buckingham, MD, was nominated for the Austin Under40 award. TMA nominated Daniel J. Leeman, MD, chair, Committee on Membership, who won in the Healthcare category last year.

Karen Teel, MD, a pediatrician and lifetime member of Travis CMS, was nominated for the Girl Scouts Women of Distinction Award. Dr. Teel was recently retired and has been a long-time Austin activist. She was instrumental in working to establish the Austin Children's Hospital.

TMA Focus Groups
Segmentation of TMA membership for recruitment and retention was a key focus of membership efforts. By better targeting and identifying specific needs of key audiences the message should encourage TMA membership. TMA plans to conduct focus groups for key segments including residents, newly licensed, and young physicians. Key objectives include gaining knowledge and feedback from targeted groups to learn what they value most about potential benefits and services, determine what influences or does not influence them to be members of TMA and involved in organized medicine, and assess awareness of TMA activities, programs, benefits, and services. 

Resident Recruitment
Resident recruitment remains a high priority as TMA continues to look at the challenges of recruiting and retaining young physicians. Several large residency programs have discontinued paying for membership or discontinued using TMAIT as the provider of insurance. TMAIT has paid for TMA resident memberships for all residents insured by the programs. When programs discontinue paying for resident membership or using TMAIT, several hundred resident memberships are immediately lost. Though there is no imminent threat that the number of residents will decline, the urgency to look at ways to enhance and increase resident membership and service offerings for this key group is critical.

TMA membership development is exploring various options with other departments. TMA's physician services department would like to assist on a publication of interest to residents, such as negotiating an employment or recruitment contract. A San Antonio attorney with experience writing a similar publication has offered to meet with the director of TMA Physician Services and the director of Membership Development.

Additionally, staff would like to compile a resident kit as a recruitment incentive during summer resident orientations. Residents who join would receive the kit with their completed membership application.  The Committee on Membership is exploring a multi-year membership fee (one price for a certain number of years or the length of residency). The kit might include the contract negotiation publication, a reference guide to billing and coding, and information on navigating the licensure process.

Leadership Development
During TMA's board, council, and committee appointment process, more members apply than positions available. Approximately 30 to 40 members are not chosen to serve and there is no standard process for notifying them. A staff committee will look at how we could do a better job of providing leadership training, identifying and tracking potential leaders, and establishing pathways to leadership. It will provide a plan to notify members not selected for official appointments, provide a list of other opportunities, and track and assist member involvement efforts. It also will include better coordinate efforts and share information with county medical societies.

Summary 
Through diligent efforts and closer collaboration with county societies, fresh ideas and approaches to membership development and operations has resulted in a solid foundation for 2007. The committee believes that with continued collaboration with county societies, the addition of the HCMS field representative, increased field presence, and further market segmentation, TMA membership will continue to grow.

TMA House of Delegates: TexMed 2007