State physician membership association
One uniform surface for comparison; detailed evidence is below.
The score summarizes assessed evidence; evidence coverage is reported separately.
TMA reported percentages to one decimal place in its 2025 annual report. Dollar amounts in the chart are approximate calculations from those rounded percentages and the reported $24,258,534 total; the figures are subject to audit.
| Accounting category | Amount | Share |
|---|---|---|
| Membership recruitment and retention | $16.35M | 67.40% |
| Royalty income | $2.09M | 8.60% |
| Rental income | $1.36M | 5.60% |
| Organizational support activities | $897,566 | 3.70% |
| Other income | $824,790 | 3.40% |
| Investment income | $776,273 | 3.20% |
| Educational programs | $630,722 | 2.60% |
| Communications | $557,946 | 2.30% |
| TexMed and conferences | $388,137 | 1.60% |
| Member experience and education | $388,137 | 1.60% |
| Total | $24.26M | 100.00% |
Primary constituency: Texas physicians, residents, fellows, and medical students through county societies, delegates, trustees, and elected officers.
Physician alignment: Generally supportive for Texas physicians; ultimate payer identity remains incomplete.
Funding model: Membership-related revenue dominates; ultimate payer of group arrangements is unknown.
Primary influence: See the detailed authority and influence analysis.
TMA is a large Texas physician membership association with a formal House of Delegates, elected physician officers, a governing board, and professional staff. Its newest organization-published report identifies membership recruitment and retention as the dominant operating-income category, while the filed FY2024 Form 990 confirms that program-service and royalty revenue are much larger than charitable support. The evidence supports describing TMA as primarily sustained by its physician-member ecosystem rather than direct hospital grants. It does not support claiming that all membership-related revenue was personally paid by individual physicians, because practices, residency programs, academic institutions, and health-system-affiliated groups may participate in group arrangements. The B grade reflects strong physician governance, current advocacy, and usable financial reporting, with important limits in payer identity, concentration, and segment-level outcome disclosure.
One sentence: TMA appears primarily supported by its physician-member ecosystem and generally aligned with physician advocacy, but public records do not reveal who ultimately pays most group memberships or commercial revenue.
Every organization uses the same twelve evidence sections and order.
Organization type: State physician membership association
Primary constituency: Texas physicians, residents, fellows, and medical students through county societies, delegates, trustees, and elected officers.
Mission: Improve the health of all Texans by serving the people of Texas in matters of medical care, prevention, and cure of disease, and improvement of public health.
Scale: More than 60,000 physician and medical-student members are reported by TMA.
| Leader | Current role | Authority context |
|---|---|---|
| Bradford W. Holland, MD | President | Elected physician leader |
| Kimberly E. Monday, MD | President-elect | Elected physician leader |
| John T. Carlo, MD | Board chair | Board governance |
| Michael J. Darrouzet | Executive vice president and CEO | Operational leadership |
Period: Calendar year 2025, cross-checked to filed FY2024 Form 990
Status: 2025 annual-report figures subject to audit; FY2024 Form 990 filed
TMA reported percentages to one decimal place in its 2025 annual report. Dollar amounts in the chart are approximate calculations from those rounded percentages and the reported $24,258,534 total; the figures are subject to audit.
| Accounting category | Amount | Share |
|---|---|---|
| Membership recruitment and retention | $16.35M | 67.4% |
| Royalty income | $2.09M | 8.6% |
| Rental income | $1.36M | 5.6% |
| Organizational support activities | $897,566 | 3.7% |
| Other income | $824,790 | 3.4% |
| Investment income | $776,273 | 3.2% |
| Educational programs | $630,722 | 2.6% |
| Communications | $557,946 | 2.3% |
| TexMed and conferences | $388,137 | 1.6% |
| Member experience and education | $388,137 | 1.6% |
| Entity or relationship | Relationship type | Why it matters |
|---|---|---|
| TMA Foundation | Separate 501(c)(3) | Charitable donations and grants must not be combined with TMA operating revenue. |
| TEXPAC | Separate political committee | Political receipts and expenditures are distinct from association finances. |
| TMA Insurance Trust and Texas Medical Liability Trust | Endorsed related organizations | TMA identifies royalty relationships; counterparties and exact allocation should remain explicit. |
Related entities, foundations, PACs, trusts, networks, and LLCs remain financially and legally separate unless a documented transfer is included in the reviewed organization’s accounts.
| Influencer | Evidence classification | Evidence-supported relevance |
|---|---|---|
| House of Delegates and county medical societies | Directly documented | Set policy through organized physician governance. |
| Board of Trustees and executive staff | Directly documented | Control business, finances, and operational execution. |
| Physician members and group membership programs | Directly documented | Provide the dominant membership-related economic base. |
| Endorsed insurance organizations | Directly documented financial relationship | Generate royalty income; influence does not equal control. |
Interpretation: A documented relationship may create influence or incentives; it does not by itself establish control, misconduct, or improper capture.
| Mission or public commitment | Alignment assessment | Documented action or tension |
|---|---|---|
| Physician payment and practice viability | Aligned | Current priorities address Medicare payment, consolidation, and administrative burden. |
| Physician autonomy | Aligned | Advocacy emphasizes physician judgment and physician-led care. |
| Broad physician representation | Generally aligned | Formal delegate and county-society pathways exist, but segment-level participation is not quantified. |
| Financial transparency | Partially aligned | Revenue categories are disclosed; ultimate payer classes are not. |
| Physician or member segment | Evidence-supported assessment |
|---|---|
| Texas physicians | Formal membership and delegate constituency |
| Residents, fellows, and students | Formal lower-cost or complimentary pathways |
| Independent physicians | Strong policy relevance |
| Employed physicians | Represented; employer payment and influence are unclear |
| Rural and community physicians | Policy attention present; measurable outcomes not segmented |
No material final adverse regulatory or criminal finding against TMA was identified in the reviewed sources. TMA is active in litigation and advocacy, often as a challenger or amicus; participation in litigation is not itself an adverse finding.
TMA documents advocacy, education, legal activity, and member services, but does not publish a single causal outcome framework showing benefit by physician segment.
Normalized score: 84/100 (B). Raw evaluated points: 84/100. Evidence completeness: 92%.
| Dimension | Score | Grade | Interpretation |
|---|---|---|---|
| Financial Transparency and Source Identification | 12/15 | B | 80% of dimension maximum |
| Funding Independence and Concentration Risk | 11/15 | C | 73% of dimension maximum |
| Mission-to-Action Alignment | 18/20 | A | 90% of dimension maximum |
| Physician or Member Governance and Representation | 13/15 | B | 87% of dimension maximum |
| Breadth of Support Across Physician Segments | 9/10 | A | 90% of dimension maximum |
| Leadership, Conflict Management, and Accountability | 8/10 | B | 80% of dimension maximum |
| Legal, Regulatory, and Ethical Record | 9/10 | A | 90% of dimension maximum |
| Outcomes and Public Accountability | 4/5 | B | 80% of dimension maximum |
Information most likely to change this assessment: current audited financials, mutually exclusive payer-class schedules, top-funder concentration, current bylaws and conflict records, segment-level participation, and independently validated outcomes.
Publication status: Public review. A last-link check and final editorial approval are required before each release.
Editorial independence: The reviewed organization did not approve, edit, or veto the findings or score. Factual corrections may be submitted through the published corrections process.
Scope: Verification is limited to publicly accessible records. Private contracts, nonpublic minutes, sealed proceedings, and undisclosed conflicts are outside the available evidence.
Source rule: Primary and official records were preferred. Accounting categories were not converted into payer identities. Related entities were kept separate. Allegations were not treated as findings.
Verification: current leaders and major financial arithmetic were checked for this publication batch. Material corrections and future updates follow the published verification process.
