TMA Testifies: Rural Health Hospital Employment Bills

Testimony: SB 310 by Kel Seliger (R-Amarillo) Dallam-Hartly Counties Hospital District  and  SB 311 by Kel Seliger (R-Amarillo) Ochiltree County Hospital District

By: Sara Austin,  MD
March 8, 2011

Senate Intergovernmental Relations Committee 

 Mister Chairman, members of the Committee, I am Dr. Sara Austin. I am a neurologist here in Austin and a member of the Texas Medical Association’s Council on Legislation. I am speaking on behalf of the TMA and our more than 45,000 physician, resident and medical student members. 

 Both SB 310 and 311 would allow for the employment of physicians by two rural hospital districts with a general prohibition on interference in the practice of medicine. They are the first of several local bills that will be offered by a number of sponsors.  And they are in addition to a broader bill, SB 894 by Senator Duncan, that also has been introduced. 

 We believe that without some structure and form to the protections for a physician’s clinical autonomy that we cannot support these bills as they are currently written.  

 Fundamentally, these protections we seek are not for physicians as much as they are for the protection of the patient-physician relationship. 

 TMA has shared with Senator Duncan and Senator Seliger our thoughts on both the principles and structure of such a series of protections.  Our suggestions are not meant to be onerous or bureaucratic. But rather principles related to: 

  • Assuring that the clinical aspects of medical practice - the medical staff bylaws,  the credentialing  process, peer review, governance of the medical staff – would apply to all physicians, employed or independent. 
  • That the rules regarding the physicians’ practice apply to all as well as the responsibilities. An employed physician may be neither favored nor disfavored in call schedules, for example, or serving on the various committees of the hospital meant to assure quality of services. 
  • Since all physicians ultimately are licensed to practice by the Texas Medical Board, we believe that the Board should play a role in certifying that a hospital’s governance documents are drawn to assure that physicians control the clinical practice of medicine and that there are protections for individuals and a process to adjudicate complaints. 

 Senator West, members of the committee, and Senator Seliger – we appreciate the opportunity to work with you on local bills and broadly drawn bills to help address the needs of small communities and the rural parts of our state.  

 For example, we pray that we can maintain some funding for the loan repayment program that has great promise to helping recruit physicians for medically underserved areas.  

 These are daunting challenges for rural areas – both medically and economically – and with a number of important issues to address. The direct employment of physicians by a rural hospital may be a part of a solution, but it is not the entire solution.  But we believe that employment should be balanced  with solid protection of the patient physician relationship. 

82nd Texas Legislature Testimonies 

Last Updated On

May 21, 2016