William W. Hinchey, MD Installation Address

Friday, April 27, 2007
Hyatt Regency Dallas
William W. Hinchey, MD

Thank you Ladon. And congratulations Mia, I look forward to the next year working side by side with you. 

A good friend in San Antonio, Dr. Jesse DeLee was recently quoted as follows: "No one does anything by themselves, you do things because opportunities arise and because other people help you." 

Jesse could have been talking about me because I have had so many opportunities come my way and so many people to help me.  Some are here today. 

First, the lady I love more than yesterday but less than tomorrow, my wife Joann.  The lights of our lives, our children John William, George Edward, and Carolyn Marie.  My mother, Kathryn Hinchey. 

My mother and father-in-law, Connie and George Casseb.

My sister Mary Kay Whaley and her husband Lawrence, and their son Dr. Andrew Whaley.  Two other sisters, Ida Scott and her husband Clarence and Margaret Mitchell and her husband Bill had to stay in San Antonio.

Also with me today is my sister-in -aw Margaret Casseb and my brothers-in-law, George Casseb, John Casseb, Frank Casseb, and Edward Casseb. 

Father Kevin Shanahan, who so graciously agreed to give our invocation. 

Special friends Lisa Uhl from San Antonio and Karen Roberts from Dallas. 

Members and staff of the Bexar County Medical Society led by our President, Dr. Del Chumly and CEO, Mr. Steve Fitzer. 

Mr. Mark Clayton, chief development officer for the Baptist Health System in San Antonio.  Representing Ameripath are Mr. Don Steen, the chairman, Mr. Dave Redmond, president and chief financial officer, Mr. Joe Zimmerman, president of the West Region, Dr. Steve Aldred, managing director of Ameripath North Texas, Mr. Phil Spencer, president for Anatomic Pathology Services, and Ms. Kay Cox, vice-president of Government Relations.

Honoring me by their presence from my medical school are Dr. Francisco Cigarroa, president of the UTHSCSA, and Dr. William Henrich, dean of the medical school at the UTHSCSA, and the man who personally made sure the house staff in San Antonio retained their membership in TMA.

Finally, four colleagues from Severance and Associates, Ameripath South Texas are with me as well.  Dr. James Humphreys, who serves as the vice-chairman of the BCMS Delegation, Dr. Rene Rone and her husband Fred Lesuir, Dr. Oscar Abbott and his wife Pat,

And the man who got me started in TMA, the last person from Bexar County before me to serve as chairman of the board of trustees, my organized medicine father, Dr. Merle Delmer and his wife Mary Ann.

In 1910, Dr. William Russ, the last person from Bexar County named William to serve as president of the TMA, opened his annual address as follows:  "The high office of president of this association is not only a position of honor, of which any man might well be proud, but it is primarily a position of trust." 

I am honored to be the 142nd President of the Texas Medical Association, and I am humbled by the trust you have placed in me. 

In his address, Dr. Russ, discussed the efforts and successes of what was then known as the State Medical Association of Texas to pass six critical pieces of legislation. They were:

  • The Medical Practice Act
  • The Anatomical Law
  • The Board of Health Law
  • The Tuberculosis Sanatorium Law
  • The Leprasorium Bill
  • The Pure Food and Drug Act

Several of these far-reaching laws remain in effect today and continue to define the practice of medicine in Texas. Their titles reflect the health care issues of the early 20th century and define an association whose mission was not preserving the self interest of any individual or group, but rather improving the health of Texans. 

Simply put, medicine's agenda and activities, the focus of our associations, the TMA and the TMAA, was all about the patient.

Now fast forward to the early 21st century.  Despite several meaningful legislative and regulatory successes, many challenges remain before us as we struggle to continue that same critical mission, to improve the health of all Texans. 

The problems are numerous but well known.  We care for the uninsured with little or no expectation of recovering our costs.  We continue to serve the most needy and senior citizens well below the costs of basic services.  We contract with health plans despite the increasing burdens and unrealistic expectations of these plans.  And we engage in uphill struggles to promote and encourage healthy lifestyles, wellness programs, and preventive care. 

An outside observer might well ask, "Why?" What makes a group of sane, intelligent men and women act in ways that are so obviously contrary to our own self-interest. 

And we all know the answers.  Because of why we entered this noble profession, because we took an oath, an oath we hold sacred, to serve, because we truly believe we have an ethical duty to serve, because it is all about the patient, because as the recently departed Dr. James Graham of Austin, a former member of the TMA Board of Trustees, said "The hope of every physician is that he will carry out good and faithful service to humanity throughout his life," because physicians manage patient care. 

However, we are in a crisis.  If you believe the media, the crisis is all about the uninsured, but the real crisis is access to care for all of our patients.  Access by those on Medicaid to both primary care physicians and specialists is wanting.  Heaven help the Medicare recipient searching for a doctor. The uninsured or under insured seek their primary care in the ERs. Those with health insurance are forced to navigate a maze of convoluted paths to learn if their physician is in network.

The data is clear.  Physicians are at the breaking point, and I fear only a total meltdown of the system will cause true reform.  The burden of providing care below the cost of providing the service (the cost of the office staff, the rent, the utilities, the supplies) has become a cross too heavy to bear. 

We work to improve practice reimbursements in the Medicaid, Medicare, and SCHIP programs, and to reform the policies and processes of the health insurance plans for the same reasons our predecessors passed those laws of the early 20th Century: to benefit the patient. Because physicians manage patient care. 

All of us are the spokespeople for medicine.  Our patients depend on us to advance the cause for more affordable and accessible health care.  Our patients demand that we advocate on their behalf to reform the practices of the health plans.  Thankfully, our patients still trust us to help solve our health care crisis.  They are our willing allies.

Our job is daunting, but the objectives are clear and simple:

  • First, to hold all health plans, public and private, accountable to the promises they make to the citizens they insure. 
  • Second, to promote and put forth meaningful solutions to reduce the uninsured or underinsured population. 
  • Third, to promote wellness and preventive medicine. 
  • Our job, in four words, to preserve patient care .

As we work to preserve patient care, it is paramount that we always remember the lessons of our predecessors.  My father, in accepting the Distinguished Service Award in 1988 reminded us that physicians must continue to practice medicine with love, understanding, and compassion for their fellow human beings and their families, and empathy for their problems.  The patient is the center of all we do.  The interest of the patient is the cornerstone of any decision we make in our individual practices.  We are obligated to practice in an ethical manner even to the detriment of our self-being.

As Father Kevin reminded me in a sermon one Sunday, we, doctors, no matter our specialty, must see the whole person and not the narrow interest of our specialty (see Father, I do listen).  That's what sets us apart, our profession is all about the patient.

While I will be proud to be the spokesperson for Texas medicine over the next year, I will even be more proud that we all will be spokespeople for the citizens of Texas.  For when the TMA speaks it is really for all Texans, to improve the health of all Texans. 

I will take great pride in my sojourn as your president, but I ask you to work with as much pride for the collective benefit of health care in Texas.  I will promise to perform my duties with passion, and I ask you to be equally passionate about the many issues we must confront in our daily lives. 

We  will improve the health of all Texans.

We will preserve patient care.

We are the advocates and the voice for health care in Texas.

We are TMA.    


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