TMA President David C. Fleeger, MD: Installation Address

May 18, 2019

David Fleeger MD190Madam Speaker, Mr. Vice Speaker, medical students and physicians, members of the House of friends. Thank you and good morning. As a profession, as an association and as individuals we have not gotten to where we are on our own.

Indeed, as Isaac Newton told us, "If I have seen further, it is by standing on the shoulders of giants."

My journey has been no different. I would like to take a moment to publicly thank those who have made it possible for me to serve this great association. Thank you to my friends, my practice partners, and my office staff for being here with me today. And thank you for the many years of support you have given me. 

Special thanks to my family---without whom this journey would have little meaning. Thanks to my parents and my sisters. And most importantly my daughter Lauren, son-in-law Jim and my wife and best friend of 34 years ... Jamie.

My parents could not be with us today (they just don't travel much these days) but I thought it important that I tell you a little bit about where I came from so you'll know where I'm coming from. Photography is my hobby and I'll be showing some of my photos today...mainly because I know my fellow surgeons have short attention spans. For obvious reasons, these first few photos were not taken by me.

We have all learned valuable lessons from our parents, and I am no exception. My father was a West Point grad, as was his father before him. I was literally raised on Duty, Honor, Country. Values that are timeless...unchanging. Values that guide the men and women of our military then, now and tomorrow. 

My father also taught me to always leave something better than the way you found wasn't until recently that I found out he was just talking about the lawn...that could have saved me a lot of work. 

My mother spent many years working in the front offices of medical practices until the age of 60, when she went back to school and subsequently became a teacher at a Montessori school working with 3 to 6 year olds, which she did for the next 15 years. It's never too late to change.

Change can be bad or good, disruptive or transformational. What really matters is how we respond to the inevitability of change.

Our profession is facing both external and internal change. Today I would like to focus on that change, what it means to us, and how we can respond.

As professionals we aspire toward a body of core values that are timeless...unchanging. We aspire toward a body of core values that are centered upon an uncompromising and unconflicted regard for the patients benefit and best interest...we aspire toward a body of core values that are centered upon uncompromising and unconflicted regard for the patients benefit and best interest. 

Yet, I have concerns...concerns that our medical profession is becoming a mere trade, a technical skill, a line item on a spread-sheet. There are those who would prefer that it be so, those who prefer that we be called providers...providers who treat clients, customers or covered lives. But we are not. And we don't. We are physicians who treat our patients. 

We rose to the top of the educational system to be privileged enough to undergo one of the most vigorous educational programs in be followed by 3-6 plus years of on the job training. Words matter

We deserve to be called physicians...physicians who treat our patients. We should insist on it.

But, in return, we must also act like professionals. Always.

It is because we are professionals that we do not punch a time clock in the middle of patient care.

It is because we are professionals that we do not charge 3-4 times what our peer across the street does for the same service.

It is because we are professionals that we lead, supervise, educate, and monitor the other members of our health care team. They do not know what we know. They can't do what we do.

And it is through associations (like ours) that we maintain and preserve our profession. Our response to change is and must be grounded in our timeless and unchanging core values: Uncompromising and unconflicted regard for the patients benefit and best interest. Timeless and unchanging. 

But some things should change, inevitably will change...must change.

As the percentage of female physicians increases with time, our association must adapt and provide value to this growing segment of membership. We must do so quickly. We must stay ahead of the curve. 

I am a little embarrassed to say that only 1/3 of the physicians recommended to me for council or committee appointment this year were female. A little over 40% of my appointments will be female. 50% of our leadership college is female. I would ask our county and specialty societies, as well as our women physicians to step up and make Dr. Fite's job a little easier next year.

You could ask me what changes our association should make to adapt to this trend...but personally I would prefer to turn to the physician on my right and the physician on my left and ask her what she thinks we should do.

I call on the House of Delegates to pass the recommendations of the Reference Committee on Financial and Organizational Affairs on Committee on Membership Report 2 and Council on Socioeconomics Report 3. (...I applaud the House of Delegates for passage of Committee On Membership Report 2 and Council on Socioeconomics Report 3....) 

I have high expectations that the Women in Medicine Section will produce results that will "strengthen engagement and representation of female physicians in organized medicine" and bring women physicians to association membership...and even more, to our leadership. 

I am confident that they will be...that they are...dedicated to our core values: Uncompromising and unconflicted regard for the patients benefit and best interest. Our response to change is and must be grounded in these timeless and unchanging core values.

Historically our TMA has been very good serving the needs of the solo and small group private physicians.

Yet more and more physicians have chosen to become large physician groups, hospitals, insurance companies and Wall Street. 

They too aspire to these same timeless and unchanging core values, but their needs are different from the solo and small group physicians. Our TMA must better define the employed physicians' needs and how we as an organization can provide them value for their dues dollar.

I will be appointing an ad hoc Committee On The Employed Physician, whose one year mission will be to study and make recommendations to this House of Delegates on how our association can provide better value to this segment of our membership. I call on county and specialty societies, as well as individuals to submit names of employed physicians of every type for the immediate formation of this committee.

Some change is inevitable. Our Executive Vice President Dr. Louis J. Goodman is beginning his retirement transition. My friend Lou has a long list of accomplishments that have been well voiced over the past few days. I echo the praise for a job well done.

Personally, I think Lou's finest accomplishment is the talent he has gathered and the culture he has created amongst our TMA staff. I have had the privilege to serve in many fine organizations, but none compares to the quality and dedication of our TMA staff- men and women who understand and strive to help us stay dedicated to our timeless and unchanging core values in a time of upheaval and change. 

I want this House, our membership, and our TMA staff to know that your Board of Trustees has undertaken a diligent and purposeful process to find a new EVP who will listen... who will appreciate that culture of service to the patients and physicians of Texas. 

We will not ask the new exec to replace Dr. Goodman (there is no replacing Lou) but rather to stand on the shoulders of our gentle giant and lift our Texas Medical Association to new heights.

Specifically, to our staff...I want you to know that the physicians of Texas have your back-just as we know that you have ours. We will support you through this transition just as you support us in the many changes we face.

It is because we know our core values are timeless and unchanging. Uncompromising and unconflicted regard for the patients benefit and best interest. It is the same time... we know that change is necessary...and that what really matters is how we respond to change. This is why our Texas Medical Association not only stands today as the biggest and the best...but will remain so for years to come.

God bless our Texas Medical Association.

God bless our Texas physicians.

God bless our patients.

Thank you.


Last Updated On

May 18, 2019

Originally Published On

May 16, 2019

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