Who We Are
As you just heard, I earned my MD degree on the Island, at the University of Texas Medical Branch at Galveston. I’m curious, how many of you are UTMB graduates? Would you all please stand up.
And how many of you received an MD or DO from one of the other Texas medical schools? Would you please stand as well.
And how many of you graduated from a medical school in another state or another country? Would you please stand.
So now, look around you. With the exception of the medical students – who will be joining us soon enough – every one of you is standing. Every single one of you put in the time and enormous effort it took to earn a very distinguished degree.
Give yourselves a round of applause … and then please take your seats.
Yes, each of us worked hard not just to be able to put those letters after our names … but for the rights and privileges that come with those letters. The right to prescribe potent medications and therapies. The right to put someone to sleep and then use a knife to cut into someone’s body. Doing something like that outside the bounds of our profession would set you up for charges of assault and battery.
As physicians, we have the privilege of helping a mother bring new life into the world and being there when her child takes that very first breath. And we have the privilege of sitting beside an elderly gentleman who has made many marks in his life, holding his hand as he takes his very last breath.
And we get to do all of that because of the amazing nature of the patient-physician relationship. From a well child exam to the most complex surgery. From administering a flu shot to listening … intently and personally … when an otherwise healthy, middle-aged man shares with us his symptoms of depression.
For our patients, that relationship means trust … trust that we will listen faithfully and do what’s right to help them heal and mend … or make the best of their final days with as little pain and suffering as possible.
For physicians, for us, that relationship means responsibility. Because with those rights and privileges that accompany our status, with those rights and privileges come serious duties and responsibilities. We have the right to ask our patients the most personal of questions … and the duty to honor their confidence … to protect their privacy. That’s a duty that predates our HIPAA laws by centuries.
We have the unequivocal responsibility to put our patients’ best interests first … above our own … above any insurance company’s or hospital’s or government agency’s. It is our duty to fight for our patients’ best interests.
And we do all of it...quite willingly … because of the incredible energy we draw from doing our jobs … from the patient-physician relationship. That energy is what enables us to respond to an emergency call at 3 am. That energy is what enables us to deliver very bad news to patients, and/or their loved ones. It’s the same energy that enables us to make the very most of 15-minute appointment slots that really should be two or three times as long. That energy … combined with our education, skills, and training … is what gives us the confidence to be able to drill a hole in someone’s skull, thread a catheter into someone’s heart, make the tissue diagnosis of cancer, or transplant an organ.
Taken together, those rights and privileges … those duties and responsibilities … that energy that comes from the patient-physician relationship … taken together, they define us. IT IS WHO WE ARE. Healers, educators, and caregivers. All of us who make up the House of Medicine.
It is WHO WE ARE. It sets us apart. Many others – nurse practitioners, pharmacists, chiropractors, insurance executives, and hospital administrators – many others want to be who we are. Many others want the rights and privileges WE have earned … without the work and sacrifice it took for us to get to where we are … and without the duties and responsibilities that fall to us as well.
This is WHO WE ARE … not just individually, but collectively as well.
As a great organization of physicians … it is WHO WE ARE as the Texas Medical Association. I think at TMA we recognize that probably better than most organizations....because we are a “bottoms up” organization. We are from the grassroots. WHO are the grassroots? WE are the grassroots. Every member of our association is WHO WE ARE.
And WHO WE ARE is our patients’ defenders … our patients’ voice. Think about it. Every time we approach a legislator … or a judge … or some faraway insurance company official … every time we make an argument about health care in this great state … we put it in terms of our patients.
Unfounded scope-of-practice expansions … are assaults on patient quality of care.
Defending tort reform and fixing the Medicaid mess … that’s how we embrace our duty to expand patient access to care.
Stepping up for immunizations or against tobacco … are opportunities for us to keep our patients healthy and safe.
But remember this. The Texas Medical Association is a living, breathing nimble organization that exists in every corner of this state. We are 50,000 Strong. Many members may not have the time to come to Austin or Washington to participate in what we do but are out there doing it every day and making this a better place for all of us to live in. It is WHO WE ARE.
Physicians are the beacon of health in our communities. We stand up for the health of our community, not just what we do at the bedside, but what I like to call the bigger, the greater bedside which is our community – where we live. Our job is to create a healthier community, a healthier environment for our children and our grandchildren to grow up in so that we can stamp out suffering and disease.
If each of us has the duty and responsibility to stand up for our individual patients … we have that same duty and responsibility to stand up for all of our patients … to put the health and best interests of our communities first … to stand up for clean water and good hospitals … to take part in immunization clinics and to provide physical exams for student athletes … to educate, push, and cajole our community leaders to make the right decisions.
Those are the stories that need to be told … in every community … because no community can exist without a strong healthy environment and a leader to stand up and cry “foul” when necessary. It is up to us, the physician-leaders, to chart the course for the health of our communities and when called upon to be the voice for the voiceless. It is Who We Are.
And, you know, it’s not always an easy thing to do. We live in a world where politics trumps policy. We live in a world where … despite our degrees and our professional standing … we are quite often the Davids standing out in the field with the slingshot. That means sometimes we have to take some risks to stand up for what’s right for our patients and our profession.
But … no pain, no gain. With risk can come great reward.
When the physicians of South Texas decided to march to our courthouse to demand an end to the epidemic of medical liability suits … to put a stop to the lawsuit lottery … we were warned. No. Don’t do it. Too risky. You might fail.
But when you’re getting shot at all the time, when 70 percent or more of your colleagues are named in a lawsuit and you can no longer recruit, retain, or attract people to your community to do what needs to be done for the health of your community, something has to change. That was the something that drove us to stand up and say, “No more.” I can’t think of a prouder moment in my professional life than when we marched on the courthouse with all of our colleagues and had a day of awareness where we shut our practices down, but wouldn’t allow a single person to fall through the cracks in our emergency rooms. We stood shoulder to shoulder with our colleagues, our patients, and our staff to demand redress from our government.
And a statewide movement grew out of that march … a statewide movement that led to the passage of some of the country’s best medical tort reform laws … laws that stopped the lawsuit lottery … laws that brought down our insurance rates … laws that helped us bring the specialists we needed to South Texas....East Texas.... and Rural Texas.
Risky? No Question!!!
Worth it? Absolutely!!!
Or … years before that … when a group of young physicians in South Texas decided to pool our resources, take out a loan, and open our own surgery center. It made sense. It was a hedge against the future. We saw the changes that were coming and knew we had to do something for our patients. We couldn’t sit by, for example, and watch charge nurses going away, more and more patients being assigned to fewer nurses to care for them, and our patients’ health suffering for it.
How else would we be able to control what was going to happen in our future if we didn’t have an opportunity to work on both sides of the equation, not just as a physician, but also as a person who administered the hospital or surgery center. It made just perfect sense that the physicians should own their own day surgery centers … we should own our own hospitals. We can run them better than the people who are in the hospital administration business because we are the ones who do the patient care. That’s WHO WE ARE.
We are the ones who should make the decisions about which equipment to buy and how to staff a unit. So, if what we really wanted to do was grab the mantle and take charge of health care quality and control, it was only natural that physicians should own their own hospitals and clinics.
I invite each of you to come to Edinburg, Texas, to see the hospital we have built … to see the quality controls we physicians have put in place … to see the kind of care we can provide without someone else telling us how to do it. Because it’s WHO WE ARE.
Risky? No Question!!!!!
Worth it? Absolutely!!!!!
Today, tomorrow, for the next year … and for the years to come … we will all be asked to take risks … worthwhile risks … for our patients.
It revolves around a Nexus.... the care of our patients and what happens in the exam room. The policies we craft and the direction we chart all evolve from the bedside. If we do that right and we stand up for the right reasons … for our patients, the rest of it will take care of itself because that’s a bond that we have. All those bureaucrats can do whatever they want to do … they can never have what we have or do what we do.
It still comes down to taking care of one patient at a time. That’s what it comes down to. That’s the wellspring for our energy and our hope and our ambition.
Because that, my friends, is WHO WE ARE.
(All together) WE ARE THE TEXAS MEDICAL ASSOCIATION (or TMA)
Thank you.