Texas Medical Association president shares legislative priorities for 2023 – State of Reform

The Texas Medical Association (TMA) said its main priorities in this legislative session are questions around scope of practice and women’s reproductive health.

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As part of your interim report for the current session, the House Select Committee of Health Care Reform (HSCHCR) recommended increasing funding for medical education and workforce development to expand the state’s supply of physicians, nurses, and mental health professionals.

Speaking to State of Reform on Tuesday, TMA President Gary Floyd, MD, said the effort to expand the delivery of medical services to underqualified and adequately trained individuals is misguided.

“Most of us didn’t learn to care for patients in medical school,” Floyd said. “We learned in graduate school, after we graduated from medical school. We learned this in our residency training, three to nine more years, where we were exposed to not only healthy patients in clinics, but also very, very sick, sick and injured patients in the ICU.

We were monitored and observed by numerous teaching physicians who had significantly more experience and in that teaching, in that learning, [the knowledge] it is invaluable and helps us in any walk of life. To say, ‘Well, I served six months in one or two clinics taking good care of patients’ is nowhere near equivalent. Caring for critically ill and injured patients actually teaches us a lot more about care and a lot more about who is well and who is sick, differentiating between the two.”

He does, however, believe supporting and growing the workforce is a priority and hopes this year’s session will continue to fund programs that encourage students and physicians to pursue medicine in the state. Floyd said that the number of licensed physicians practicing in Texas has kept pace with population growth in recent years, pointing to the record number of physicians, nearly 7,000, licensed last year.

Despite that growth, Floyd admits there are still challenges in serving rural parts of the state.

Lawmakers will be looking at ways to connect access through telehealth in this session. Bills proposed in both House and Senate would pilot a program to provide emergency medical services to rural communities through telemedicine.

The Texas Broadband Development Office recently completed its application process for the Affordable Connectivity Disclosure Grantwhich aims to reduce the digital divide under the infrastructure law at the most critically underserved areas from Texas. In addition to ongoing rural recruitment and training efforts, telemedicine can play an important role in access, according to Floyd.

“If something good came out of COVID, [telemedicine] it might be one of the things why before COVID, less than 5% of our doctors were doing a lot with telemedicine,” Floyd said. “They took phone calls and stuff like that, but as far as video conferencing goes, most of us didn’t know how to do that.

And now over 70% of doctors use it routinely. And I think it certainly helps. Post-surgical care: When people travel to a city 50 to 100 miles or more away, have surgery and then go home, for them to make that return trip for follow-up is sometimes costly. Part of this can be done through a telemedicine call.

… telehealth and telemedicine are definitely part of the future of increased access to medicine.”

Another legislative priority for TMA is women’s reproductive health, especially maternal health. HSCHCR also recommended expansion of postpartum coverage from the current 6 months to 12 months.

Focus on maternal health equity remains after 2022 joint report key data and recommendations Biennial Report on Maternal Health and Safety Initiatives revealed that severe maternal morbidity rates were disproportionately higher for black women than for other racial groups, with 117.3 deaths per 10,000 hospital deliveries, more than double the rate for white women.

“[The report is] disappointing for all of us,” Floyd said. “Since 2020, the numbers have not changed and we can blame COVID and isolation a little, but still, some things have been implemented that [state obstetricians] thought it would help to improve [maternal mortality]. Rethinking these studies, continuing these studies, academic centers are doing several different approaches, to look more at the diversity part. With regard to the diversity of trainees, it is also being addressed at the residency level.”

Floyd shared his insights into the association’s engagement with policymakers during the interim to ensure the needs and concerns of patients and physicians are addressed during the 88th legislature.

“We had countless meetings,” Floyd said. “Our legislative team and our legal team, as well as many positions, met with various committees during this interim period. We hope to have answered the questions that were raised to us. We hope to have given advice that can be used and we feel that this has been accomplished. We’ll see when the bills start coming in, as they already have.

I cannot express the respect I have for all of our representatives, both in the House and Senate. They don’t get paid much to come in for 140 days and do what they do, and listen to all kinds of constituents. We understand, we certainly don’t all agree with our position, but I hope that when it comes to medical and patient care issues, I think that’s where our experience becomes very valuable. And we hope to have relationships built with our legislators so that they will come to us [and] that they will hear us. So that’s what we try to accomplish.”

Texas Medical Association president shares legislative priorities for 2023 – State of Reform

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