In response to a published invitation sent by ten Austin doctors, thirty-five physicians from eighteen counties assembled in Austin on January 17, 1853, to organize the Texas Medical Association. The group wanted to advance the status and standards of medical practice in Texas. When forty-five members met again on November 14, 1853, they changed the society's name to the Medical Association of Texas. The Fifth Texas Legislature chartered the group on November 28, 1853. The Medical Association of Texas was inactive for the next sixteen years, but physicians in Texas organized several municipal and county societies (see MEDICAL SOCIETIES). In the spring of 1869, the Washington County Medical Association urged the revival of the state society. In June 1869 the Harris County Medical Association hosted a reorganizational meeting of the renamed Texas State Medical Association. In 1901 the group renamed itself the State Medical Association of Texas; in 1951 the original name, Texas Medical Association, was reclaimed. The constitution of 1853 allowed "every gentleman of the Medical Profession" to become a member, but irregularly trained doctors were specifically excluded. An amendment of 1893 permitted membership to female physicians, but not to black doctors. In 1955 the racial ban was lifted, and osteopathic physicians were admitted in 1972.
Throughout the early 1900s, the wives of Texas doctors gathered for social events and receptions alongside the TMA meetings. These women were originally known as the “visiting ladies” but organized into the Women’s Auxiliary of the Texas Medical Association during the national mobilization efforts of World War I. The first meeting was held on May 15, 1918, in San Antonio, and over a century the group morphed into the TMA Alliance, which consists of more than 4,000 men and women. TMA Alliance is a powerful political, community, and service organization that undertakes political advocacy on behalf of TMA campaigns, as well as locally driven service projects. In 2003 the TMA Alliance helped create First Tuesdays at the Capitol lobbying days on behalf of health care liability reform.
Since its founding, the TMA has encouraged postgraduate education through the scientific programs of its annual meetings and through special symposia. In 1904 Dr. Frank Paschal encouraged members of the TMA house of delegates to collect materials and established the Committee on Collection and Preservation of Records. Established in 1922, the TMA Archives and Collections now contain more than 8,000 books, papers, photographs, files, and medical artifacts available to researchers. The Lekisch Collection includes medically-related stamps, coins, medals, postcards, and letters donated by Dr. Kurt Lekisch. The TMA established the History of Medicine Committee in 1953, and the University of Texas Press published a centennial history of the TMA authored by Dr. Pat Ireland Nixon. The TMA History of Medicine Gallery at the headquarters in Austin showcases annual exhibits featuring materials from the archives, and several traveling banner displays promote history of medicine topics at libraries and museums across the state. The exhibits provide information on the history of the TMA, Texas hospitals and medical schools, women in medicine, international medical graduates, botanical medicine, and preventing disease through immunization.
The TMA published annual Transactions between 1869 and 1904. In 1905 it began publishing a monthly scientific journal originally named Texas State Journal of Medicine and renamed Texas Medicine in 1966. The journal became primarily a medical news magazine in 1991. The TMA also publishes a semi-monthly electronic newsletter, Action, and provides other services to physicians including practice management workshops, a physician placement service, group insurance, and a special trust for professional liability insurance (see MEDICAL JOURNALS IN EARLY TEXAS). The TMA Insurance Trust was created in 1955 to meet the personal insurance needs of physicians and their families. Members of the TMA created the Texas Medical Liability Trust in 1979 as a source of affordable and stable malpractice insurance that provided affordable, reliable coverage against medical liability claims for its members. The trust currently includes more than 20,000 policyholders making it the largest medical liability insurance provider in Texas.
The TMA has always been a strong advocate for professional autonomy and for the integrity of the medical profession. Throughout its history, the organization has campaigned for effective medical practice legislation and the suppression of medical charlatanism. The TMA has supported important public health laws, including the Pure Food and Drug Act of 1907, the State Board of Health Bill in 1909, the Vital Statistics bills of 1916 and 1927, and the Indigent Health Care Bill of 1985. In 1999 the TMA partnered with the Texas Hospital Association and thirty-six other medical groups across the state to create the Coalition for a Healthy Texas.
The Physicians Benevolent Fund was established by the TMA in 1961 to assist Texas physicians and their families with rent, utilities, insurance, medical bills, clothing, and food. Since the initial donation of $2,500 by Dr. May Owen, the fund has provided more than $3.9 million in assistance payments to more than 750 recipients struggling with poverty, sickness, disability, an accident, or other circumstances. TMA recently created the Wellness Fund to provide financial assistance to licensed Texas physicians who cannot afford treatment for depression, substance abuse disorders, and other impairing conditions. The association also offers low interest loans to qualified medical students and resident physicians.
TMA founded the Texas Medical Education and Research Foundation in 1966, which originally served as a repository for bequests from the association and membership. In 1988 the TMA Board of Trustees Subcommittee on Development began the process of transforming the foundation into the philanthropic arm of the association. In 1989 the Legacy of Caring endowment campaign established the Legacy fund that currently consists of more than $1 million to support various programs. In 1993 the TMA board of trustees elected to form a separate board of trustees for the TMA Foundation to expand partnerships and fundraising opportunities. The TMA Foundation is the only philanthropy in Texas dedicated to the charitable concerns of all physicians. An annual TMA Foundation Gala supports health improvement, science, quality of care programs, and family of medicine community health initiatives. Foundation projects often involve collaboration among medicine, business, and community partners to focus on the public health and science priorities of the association.
Since the 1980s, the TMA has monitored government health care proposals, especially those involving health care insurance, and new health care delivery systems, such as health maintenance organizations. Its political activities are supported by TEXPAC, the largest bipartisan political action committee in Texas and the fifth largest committee of its kind in the nation with more than 5,000 members. During 1991 and 1992 the TMA supported the 1990–91 AIDS bill that appropriated more funds for AIDS education in Texas, the Omnibus Health Care Rescue Act that addressed problems of rural health care in the state, and legislation that required motorcyclists to wear helmets and automobile drivers and passengers to wear seat belts. In 2003 TEXPAC supported medical tort reforms in response to lawsuit abuse against medical professionals. The committee focuses on issues that matter to physicians and patients, including reforming Medicaid, opposing efforts to expand scope of practice, limiting taxes on health care as a business activity, removing bureaucratic red tape, supporting a fair system of health insurance, and the expansion of telemedicine. The TMA Grassroots Action Center and Knowledge Center help members track legislation and engage in advocacy.
Texas Physicians are required to complete forty-eight hours of continuing medical education (CME) every twenty-four months to maintain a valid Texas medical license. The TMA offers a variety of formal and informal CME opportunities, including meetings, webinars, and publications. The TMA Education Center offers hundreds of free CME hours to members and their staff. The Committee on Physician Health and Wellness (PHW) provides educational resources to encourage health and well-being for physicians, residents, and medical students. The PHW Education Team connects with more than 3,000 participants each year and holds the Annual Physicians Health and Wellness Exchange.
The TMA has grown steadily throughout its existence. In 1880 the 269 members comprised only 10 percent of Texas physicians. After the reorganizational policies of the American Medical Association were instituted in 1903, membership grew dramatically, reaching 2,415 within a year. By 1954, 6,974 doctors—98 percent of all Texas physicians—were members. This number tripled by 1984, when the TMA became the third largest medical association in the United States. The TMA vision is to improve the health of all Texans, and its mission is to stand up for Texas physicians by providing distinctive solutions to the challenges they encounter in the care of patients. By the end of 1992 there were 31,973 members, and membership reached 52,634 in 2018. The basic unit of organization is the local medical society, which enrolls members from one or more counties. In 2018 there were 112 of these societies, each separately chartered by the TMA. Therefore, membership in the TMA requires membership in a county medical society.
TMA is governed by a board of trustees, an executive board, and a house of delegates elected by local societies. The house had nearly 600 delegates in 2018. The house of delegates met once a year until 1971, when it began meeting at semiannual conferences because of the growing volume of business. The delegates also gather at the TexMed annual meeting each spring to elect TMA leaders, decide policy, and present awards. The various functions of the TMA are handled by twenty-eight councils and committees, many of which meet during TexMed. The Interspecialty Society Committee is composed of delegates from twenty-six specialty societies across Texas who present legislative, economic, social, and professional concerns to the TMA leadership. A salaried executive vice president and a full-time staff of 192 employees work in Austin at the TMA headquarters, which was constructed and formally dedicated in 1991. During a building dedication ceremony on March 5, 2019, the headquarters was named in honor of retired CEO Louis J. Goodman. In 2018 the TMA operating costs reached $26, 226, 306; expenses totaled $26,406,576, and the association held $35 million in cash reserves. The TMA leadership included President David C. Fleeger, CEO and Executive Vice President Michael Darrouzet, and Board of Trustees Chair E. Linda Villarreal.