Dr. Stuart Pickell is beginning his term as Tarrant County Medical Society president after practicing in Fort Worth for over 20 years. He has served on several local and state committees, including roles with Texas Health Physicians Group and Project Access Tarrant County. He also chairs advanced care planning nonprofit Texas Talks and is the ethics team lead and associate professor of internal medicine at Burnett School of Medicine at TCU.
He sat down with D CEO Healthcare to discuss why he got involved in advocacy, how his background in ministry impacts his practice and his hopes for the future of the healthcare industry in Tarrant County.
D CEO: What inspired you to get into physician leadership and advocacy?
“Historically, I’ve always been interdisciplinary in the sense that I don’t like just doing one thing. My job as a physician has never been 100 percent of what I did; it’s probably less of one now in the sense of seeing patients. I am only in the office three and a half days a week. At one point, I was in every day. If you Google me, you’ll find that I’m a physician with Texas Health Physicians Group. But whereas I used to be in much more of a leadership position on the practice side, I’m not in leadership at all at THPG. I’m involved with leadership and other areas and the county medical society as well. I’ve been involved since 2003, but only in the last few years have I stepped that up as my responsibilities and other areas came to an end.”
D CEO: How does your background impact your practice and leadership?
‘When I was five, I apparently made an announcement in the family that I was going to be a minister, doctor, and firefighter. I have been two of the three things, I went to seminary and served churches. As a pastor, I’m still actively engaged in that space. Much of what is important to me has been engaging in the charitable space. I think that as physicians, almost all of whom have benefited to some degree from public financing, have a responsibility to give back. That can take on different forms for different people. I work in a free clinic and am the medical director for Project Access, a Tarrant County Medical Society initiative that provides access to specialists for patients who fall through the cracks in the county health care system, that most of the people who are eligible for the health care system can get connected that way. Medicine is an applied science. Physicians are the ones on the front line applying that science with patients. Ministry is applied theology. When I told people I was going to medical school, I always thought of ministry and medicine as being very similar in that regard because they’re both ministering to people. They’re applying something, whether spiritual or scientific, to help make an individual or community better or more healthy.”
D CEO: Tell me more about Project Access.
“When I worked in clinics before, it was frustrating because people would come in and have some kind of problem that’s easy to fix. But we had no place for them to get it done. You have all these positions, like specialist surgeons who would be willing to volunteer their time, but they don’t want to go to a primary care clinic because they’re not primary care physicians. So they didn’t volunteer in the primary care clinic, and they were stuck. They don’t have a way to give back themselves. So this provides an avenue.”
D CEO: What are some of your advocacy goals?
“One of the things that I’d like to see, and that’s not going to happen this year, and I don’t have any direct control over it at all, but it’s something that we can generally apply pressure to: we don’t have a physician residency at Cook Children’s hospital. The other one is the JPS issue and why in Dallas County, undocumented patients and residents can go to Parkland, but in Tarrant County, they can’t go to JPS community clinics or preventative care. We’re the only county that’s like that. We are the outlier, so I think that needs to change.”
D CEO: It is surprising that a hospital the size of Cook Children’s isn’t involved in educating resident physicians.
“They have never had a pediatric residency program. In the past, it hasn’t been that much of an issue in Fort Worth because Fort Worth was never an academic city. There were a lot of residency programs in Dallas, but there wasn’t anything in Fort Worth except JPS and then Medical City. The D.O. (at UNTHSC) students had to have someplace to go, and so a lot of them ended up getting farmed out either to JPS or THR. As more programs developed, Cook never had one, so it was an outlier because THR and Baylor did. Cook Children’s is somewhere between the 10th and the 18th largest children’s hospital in the country, and Fort Worth is the 13th largest city in the country. And yet, we don’t even have a pediatric residency program, even though we have a large hospital, excellent staff, and excellent resources. We have a residency program for pediatric nurses, but we don’t have a physician residency program.”
D CEO: How can leadership work more effectively with medical societies?
“Disseminating accurate information to the community is hard, but it comes back to education and who you trust. Physicians and physician groups or medical societies are the ones that are in a position to provide that without the bias that you get from the media. But when the government came around to funding COVID-19 vaccines, the county medical societies were left out of that. Medical societies and medical organizations are often overlooked, even though that’s where the leadership in healthcare is. Many look to the leadership, not from the physician organizations, but from business folks at the big hospitals, medical schools, and universities, and I think they’re missing an opportunity. It’s not in the best interest of public health to do that.”
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