Council Governance

TMA 2010 is a process through which the board is assuring TMA's relevance to its members.  As part of this process, the board is determining the value of every association program in terms of return on investment and value to the membership.  Another part of the process is a review of TMA's governance structure to assure that councils and committees are purposed to meet new challenges.

Council on Practice Management Services

In November 2005, the Board of Trustees focused its evaluation of programs on the association's array of practice management services.  This evaluation included discussion of key elements of operations and challenges and possible solutions.  The board examined key activities, including the Hassle Factor Log, carrier meetings, coding and billing hotline, mini-consultations, publications, seminars, consulting, and health information technology.

The board also reviewed the governance bodies that oversee development and delivery of these practice management services.  They include the Council on Member Services - practice management seminars, practice management publications, and endorsed services, most but not all of which are practice management related; the Council on Socioeconomics - Hassle Factor Log, carrier meetings, which are more advocacy than an actual practice management service, coding hotline, and mini-consultations; the Board of Trustees' Committee on TMA Physician Services - practice management consulting, seminar series for residents, and endorsed services and vendor sponsorships of services related to practice management; and the new Ad Hoc Committee on Health Information Technology - development and delivery of services to increase Texas physicians' understanding, adoption, and appropriate utilization of vital information technologies.

The Council on Socioeconomics covers a broad range of legislative, legal, and regulatory policy topics relating to medical economic issues, including both health care financing and delivery systems.  The council also oversees reimbursement related services and focuses on policy development and advocacy rather than general oversight of practice management services.  The Board of Trustees believes the council's work is critical in supporting the TMA 2010 goal of practice viability - protect, improve, and strengthen the viability of medical practices in Texas - and the board believes the council is purposed appropriately for this work.

The Board of Trustees believes the Ad Hoc Committee on Health Information Technology is appropriately focused on a specific purpose and should remain a separate entity.  The board believes the committee's ad hoc status is appropriate for this work and does not propose a new standing committee.

There is cross-over in the functions of the Council on Member Services and the board's Committee on TMA Physician Services, both of which now provide more oversight than actual development of products and services.  The Board of Trustees believes these components should be repurposed and proposes establishment of a Council on Practice Management Services that would draw from the expertise of both.  The board then would discharge its Committee on TMA Physician Services and recommends discharge of the Council on Member Services.

Recommendation 1:  Establish a Council on Practice Management Services to be composed of nine members charged with overseeing all practice management services provided directly to physicians and their staff.

Recommendation 2:  Discharge the Council on Member Services.

Council on Health Promotion

Beginning in November 2005 and continuing in February 2006, the Board of Trustees examined member publications and association programs related to health promotion, professionalism, and image in terms of their effectiveness in supporting the TMA 2010 goal of trusted leader - strengthen physicians' trusted leadership role within their communities and the health care team.  This examination included a review of a 2003 membership survey finding that TMA should explore how its overall effectiveness could be enhanced by linking its mission more directly to quality patient care.  Findings from member research conducted in 2005 and 2006 also were reviewed: (1) existing TMA "white hat" efforts miss the mark due to a lack of visibility; (2) better efforts are needed to address physician priorities; (3) "white hat" issues should not be separated artificially from traditional core practice issues, since physicians see "white hat" issues interwoven into their day-to-day work; (4) TMA's physician and public "white hat" messaging needs to be better integrated, packaged, and amplified; (5) public service announcements and partnerships are pivotal; and (6) the TMA brand needs to better reflect physicians' emotional identity - caring and compassionate - while not losing its reputation for organizational power and effectiveness.

The board then conducted an analysis of specific activities, including public health, science, and quality policy development and programming; the Physician Oncology Education Program; Be Wise - Immunize ^SM ; medical education and the physician workforce; media and public relations; message training, the Anson Jones, MD, Awards for Media Excellence; Hard Hats for Little Heads; History of Medicine; CME intrastate accreditation program; Do Not Resuscitate forms and bracelets; and physician health and rehabilitation.  Member publications reviewed included Texas Medicine ; Action e-newsletter; membership directory; niche newsletters such as the EVPGram , e-tips , and Student Doctor ; and News of Interest .

The board also reviewed the governance bodies that oversee these activities and publications. They include the Council on Communication, Council on Medical Education, Council on Public Health, Council on Scientific Affairs, Joint Committee on Health Improvement Initiatives, Texas Medicine Editorial Board, and Select Committee on Patient Safety.

The Council on Medical Education coordinates the association's medical education activities.  TMA is in a unique position to represent the state's medical education interests collectively and to ensure a high quality medical education system by convening all medical schools and advocating for adequate resources.  The Board of Trustees believes the council is purposed appropriately for this work.

The Council on Public Health is a major contributor to association policy and TMA's legislative platform.  It is positioned to access a wide array of physician experts and specialists and respond to current public health issues in Texas.  The Board of Trustees believes the council is purposed appropriately for this work.

The Council on Scientific Affairs responds to a myriad of science questions from the Texas Legislature and the media, advances a public policy priority agenda, and provides direct support to physicians.  The Board of Trustees believes the council is purposed appropriately for this work.

The Texas Medicine Editorial Board is a committee of the Board of Trustees that fulfills the TMA Bylaws requirement for the board to superintend publication of Texas Medicine .  As long as the magazine continues to publish peer-reviewed articles, the editorial board will serve a useful and necessary purpose.  In addition, by virtue of their service on the editorial board, many members feel an obligation to participate in the magazine's monthly story planning meetings.  This provides valuable physician insight that shapes how staff develops stories for Texas Medicine each month.

The Select Committee on Patient Safety is a one-year committee appointed by TMA President Robert T. Gunby Jr., MD, to focus patient safety issues for advocacy in 2007, participate in the Institute for Health Care Improvement 1,000 Lives Campaign, and coordinate with TMF Health Quality Institute's efforts for a successful 8th Scope of Work.  After one year, ongoing programs will be transferred to other association components.

The Council on Communication is charged with conducting such programs and engaging in such activities as necessary to inform the membership and the public of problems, policies, positions, and programs of the association.  The Joint Committee on Health Improvement Initiatives is a joint committee of TMA, TMA Alliance, and TMA Foundation charged with developing, two or more years in advance, an annual statewide joint community service project.  The Board of Trustees believes these components can be restructured and repurposed to leverage more effectively the leadership, organizational resources, and talent of TMA, TMAA, and TMAF.  This change would enable it to focus in a more coordinated and systematic way on programming, marketing, and image building.

To this end, the board proposes establishment of a Council on Health Promotion charged with planning and overseeing programs and activities that enable TMA, TMAA, and TMAF to work effectively and collectively in support of the association's vision - improve the health of all Texans.  The council would conduct ongoing, cross-organizational strategic planning for health promotion and physician image building; coordinate and implement a unified look and message behind TMA image-building programs; supervise the Anson Jones, MD, Awards for Media Excellence; supervise implementation of health promotion programming such as Be Wise - Immunize ^SM and Hard Hats for Little Heads; review and approve all TMA requests for funding from TMA Foundation; and assure more targeted networking with county medical societies, medical specialty societies, and alliance chapters to strengthen physicians' trusted leadership role and advance image building opportunities.  Key to this organizational strategy, which would bring unity to entities within the family of medicine, would be appointment of TMA Alliance members and TMA Foundation representatives as full members of the council.

Recommendation 3 : Establish a Council on Health Promotion, charged with planning and overseeing programs and activities that enable TMA, TMA Alliance, and TMA Foundation to improve the health of all Texans, and composed of nine TMA member physicians, three TMA Alliance members, and three TMA Foundation representatives including one public member of the TMAF Board of Trustees, all with full rights of participation including the right to vote.

Recommendation 4 : Discharge the Council on Communication and the Joint Committee on Health Improvement Initiatives.

TMA House of Delegates: TexMed 2006