2005 TMA Annual Report

President's Message:  Why We Join

By Robert T. Gunby Jr., MD
2005-06 TMA President

Do you write a dues check each year without giving a lot of thought to what you're getting for your money? If so, I encourage you to read this Texas Medical Association 2005 Annual Report to see what our association did for us and our patients last year.

As I look back at 2005, I'm struck by the power we were able to exercise throughout the year. And when I say power, I mean it in a good way. Power to defend medicine in the halls of the state Capitol against those who sought changes that were bad for us and worse for our patients. Power to influence lawmakers, policymakers, and regulators to keep medicine the premier profession in Texas. Power to make sure insurance companies treat us fairly and raise a ruckus when they don't. Power to develop a plan to keep our patients safe. Power - and the vision - to enhance our efforts to keep Texas and Texans healthy in the future. And, the power to take a hard look at our association and make sure it remains the successful organization that still deserves the reputation as America's best medical society.

Perhaps the greatest display of our power came in what may well have been our finest hour, when Hurricane Katrina sent hundreds of thousands of devastated people streaming across our borders. The power of our organizational capabilities were instantly on display as we worked with our county medical society partners to mount a relief effort unequaled in Texas history. Thousands of us across this state volunteered to help people we had never seen before and likely would never see again. Why? Because they needed us, and that's what we do. And then we turned around and helped our own, digging into our pockets to help colleagues rebuild their practices after Hurricane Rita paid a nasty visit to the southeast Texas coast.

So, read the report and take pride in what we accomplished last year. After you're finished, show it to your colleagues who are not TMA members. Tell them this is why you write that dues check every year. Encourage them to join us. It's the best deal around.  


For Texas physicians, 2005 was a year of triumph, testing, and tragedy. Triumph early in the year as the Texas Medical Association's army of physicians and alliance members defended patients and the medical profession in a legislative session filled with potential landmines; testing as Hurricane Katrina added 225,000 evacuees to already-overloaded medical systems in Houston, Dallas, San Antonio, and Austin; and tragedy as Hurricane Rita tore apart physicians' homes and practices in Southeast Texas.

TMA's accomplishments in 2005 were many, but five stand out:

  1. TMA protected physicians and patients from an onerous tax on physician practices that would have impeded patients' access to care.
  2. Along with several other state medical societies, TMA generated more than $1 billion in relief for physicians by making some of the nation's largest insurers accountable for their actions in not paying doctors what they were owed.
  3. TMA protected patients by joining a national patient safety campaign and offering solid, evidence-based protocols to improve outcomes.
  4. TMA prevented health care professionals who don't have a medical license from expanding their scope of practice.
  5. TMA mounted an unprecedented humanitarian effort to mobilize physicians across the state to care for the victims of Hurricane Katrina who sought refuge in Texas and raised $225,000 to help Texas physicians rebuild their Rita-ravaged medical practices. 

All of this was done with an eye to the future.  Responding to the priorities set by the TMA Board of Trustees, the association tailored its efforts on behalf of physicians and patients by following the goals of TMA 2010, our roadmap to the future. TMA 2010 is the trustees' strategic plan to allow TMA to remain successful, stick to our core values, and address issues affecting physicians' ability to care for patients. Its goals are Practice Viability, Healthy Environment, Trusted Leader, and One Voice.

With that clear vision of the future, TMA remains America's largest and strongest state medical society, effectively representing member physicians in nearly all venues and providing members with quality education, information, and tools they can find nowhere else. The Lone Star family of medicine - TMA and our 120 component county medical societies - is a 153-year-old institution that no Texas physician or medical student should do without.

Practice Viability

TMA has earned $1.5 billion in retrospective and prospective relief for physicians through its class action federal antiracketeering lawsuits against Aetna, CIGNA, Humana, WellPoint, Prudential, and Health Net. The association and several other medical societies won significant settlements against those health plans. Throughout 2005, TMA's legal and practice management experts monitored the companies' compliance with the settlements and told physicians how to file complaints when the insurers strayed from their agreements.

And, TMA secured a $1 million grant from the Physicians' Foundation for Health Systems Excellence - one of two foundations created by the settlement - to help Texas physicians learn about, adopt, and maximize use of health information technology.

You cannot maintain a viable medical practice unless you are treated fairly by insurance companies and other payers. Thanks to advocacy initiatives by the TMA Council on Socioeconomics with the Texas Department of Insurance in 2005, UnitedHealthcare was fined $4 million in early 2006 for violating the state's prompt payment law.

In addition, TMA in 2005:

  • Helped 20,000 physician practices resolve payment disputes with health plans and recover lost reimbursement through the TMA Hassle Factor Log™.
  • Provided 6,324 physicians and office staff the tools to make their practices better through comprehensive seminars, conferences, and home studies on topics such as Medicare, workers' compensation, health information technology, practice management, medical records, consumer-directed care, coding, cost analysis, patient-physician communications, and risk management.
  • Provided cutting-edge, personalized consulting services at a members-only price to more than 200 physicians in 60 practices with a focus on operational challenges, reimbursement, optimal coding and documentation skills, and setting up new medical practices.
  • Answered 4,000 practice management and 3,000 legal questions that members and their staffs sent to the TMA Knowledge Center via telephone calls and e-mails.

Healthy Environment

TMA's theme for the 2005 Texas Legislature was "In Defense of Medicine." The session was unlike most sessions before it. Instead of focusing primarily on trying to get legislation passed, TMA defended physicians against hundreds of proposed bills that were bad for doctors and patients.

By the end of the session, thanks to TMA's strong legislative presence:

  • Physicians did not have to pay a new tax on their practices. TMA let lawmakers know that physician practices are not traditional businesses and should not be subject to a business activity tax and that taxing patient care is neither good public policy nor in the best interests of Texas.
  • The landmark 2003 tort reforms remained intact, and liability carriers across Texas followed the lead of the Texas Medical Liability Trust and reduced their rates. In the first nine months of 2005 alone, all five of Texas' largest physician insurers announced rate cuts.
  • Lawmakers passed legislation establishing a new workers' compensation system that ensures injured workers' access to quality health care and guarantees physicians prompt payment and the right to negotiate fees.
  • None of eight proposed bills to prohibit out-of-network physicians from balance billing patients when their HMO or PPO fails to pay the physicians' full fee or to place a cap on out-of-network physician fees were passed.
  • An attempt to pass a state moratorium on physicians referring patients to physician-owned specialty hospitals and other facilities in which they hold financial interests and stop new construction of physician-owned facilities was blocked. TMA is still pursuing this issue at the federal level.
  • The state improved funding for Medicaid and the Children's Health Insurance Program and put on hold the STAR+PLUS Medicaid HMOs rollout.
  • The Texas Legislature created the first state formula for funding graduate medical education and restored $51 million in funding.

As the legislative session began in January 2005, TMA released Healthy Vision 2010 . TMA published a second, stronger edition of the Healthy Vision document in November, timed to generate maximum impact on the 2006 elections and the 2007 legislature. Healthy Vision articulates the voice of medicine and allows TMA to assume the lead in preparing Texas for the health care challenges of the future.

Healthy Vision 2010 offers a five-point prescription for change:

  1. Health care must be accessible and affordable for all Texans.
  2. Prevention and personal accountability must be increased.
  3. Health information technology should be used effectively and wisely.
  4. Patient safety must be protected.
  5. End-of-life care must be humane and cost-effective.

The entire report is on the TMA Web site ( www.texmed.org/healthyvision ).

Meanwhile, in Washington, TMA worked with the American Medical Association and other state and specialty societies to stop what would have been a disastrous 4.4-percent cut in physicians' Medicare reimbursements. The lobby campaign extended up to - and beyond - Congress' 2005 Christmas holiday, as the Medicare cuts actually took effect on Jan. 1, 2006. Medicine's hard work throughout 2005, however, paved the way for Congress to reverse the reduction shortly after convening in the new year.

Trusted Leader

When Hurricane Katrina devastated our neighbors to the east, TMA acted immediately. It drew on the compassion of our members and their local county medical societies to enlist physicians across the state to provide medical care for the victims who sought refuge in Texas. TMA compiled a database of more than 1,500 Texas and out-of-state physicians willing to volunteer to care for hurricane victims in some 2,000 shelters and coordinated volunteer activities in concert with county societies and state health and emergency response officials.

The most sacred element of the patient-physician relationship is patients' trust in their doctor to keep them safe. Acting on Robert T. Gunby Jr., MD's, call to make patient safety the cornerstone of his year as president, TMA launched the Select Committee on Patient Safety in July to develop programming, services, and strategies to help keep patients safe.

TMA backed up that effort by joining the Institute for Healthcare Improvement's 100,000 Lives Campaign to save 100,000 patient lives across the country over 18 months by implementing six interventions. TMA also adopted three of those goals to help improve Texas patient outcomes:

  1. Prevent surgical site infection and related deaths by not using razors to shave surgical patients ("Clip, Don't Nick").
  2. Deliver evidence-based care for patients with acute myocardial infarction by prescribing aspirin when they arrive at the hospital and beta blockers when they leave ("Keep a Healthy Heart").
  3. Prevent adverse drug events through medication reconciliation ("What Are You On?").

In addition, a Patient Safety Resource Center was established on the TMA Web site. It will be updated continuously with news, research findings, and links to tools physicians can use in their practice. To reach the resource center, browse to www.texmed.org/patientsafety .

During the legislative session earlier in the year, TMA created the PatientsFIRST coalition to protect patient safety and blocked legislation that would have expanded the scope of practice of optometrists, podiatrists, and other allied health professionals.

Thanks to association members, TMA's commitment to enhancing physicians' roles as trusted leaders in public health was evident in 2005:

  • Texas' new disaster response and pandemic influenza plan includes communication strategies and the role of private physicians in responding to events.
  • The National Newborn Screening and Genetic Resource Center comprehensive report on screening in the state included physicians' recommendations for areas needing attention or improvement.
  • At the Obesity Summit at TexMed 2005, 303 physicians increased their awareness of Texas' obesity epidemic.

One Voice

The power of TMA's voice to serve physicians and patients grew louder in 2005 as TMA membership reached a record 41,000. Recruiting newly licensed physicians added 775 names to the association's membership rolls.

Not only did TMA add new members in 2005, but the value you get for your dues dollars increased as TMA secured new benefits and services for physicians.

The TMA Web site was redesigned to provide information that's easier to find. The site's navigation structure was redone. The search feature was enhanced to make it Google-like, and key words for every major topic on the site were created. More color and graphics were added to the site.

Communication with members also was enhanced with new e-mail newsletters to target audiences - medical students, academic physicians, and international medical graduates - as well as a newsletter on continuing medical education. They complement existing newsletters for young physicians, TMA Action , and TMA Practice e-Tips .

TMA also improved its communications with members by launching the TMA Folio, a new communication e-tool that delivers, stores, and organizes TMA's best information on your desktop in an easy-to-use electronic portfolio (log on to www.texmed.org and click on TMA Folio on the left side of the home page).

2005 by the Numbers

TMA members at end of 2005
Physician practices helped in resolving payment disputes with health plans and recovering lost reimbursement
Texas primary care physicians, nurses, and other allied health care professionals who attended 18 Physician Oncology Education Program cancer prevention, screening, and early detection programs
Physicians who attended CME programs offering 695 credits in 206 courses
Physicians and alliance members who signed up to receive a daily e-mail newsletter updating them on the 2005 legislative session.
Do-not-resuscitate bracelets and advance directive forms distributed to physicians and patients
Physicians educated in forums on health literacy, pay for performance, children's environmental health, children's mental, and the TMA Obesity Summit

2005 Income and Expenses

TMA ended 2005 with revenue of $18,977,920 and expenses of $19,224,920. The loss resulted from expenses associated with representing the interests of physicians and patients in two special sessions of the Texas Legislature. The association's primary source of income was membership dues. TMA members received $2 worth of service for every $1 of dues money.

AR pie charts

May 2006 Texas Medicine Contents
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