Texas legislators have invested millions into expanding medical education programs in the state, but medical and educational leaders say it may not be enough to combat the impending physician shortage.
The United States is facing a national physician shortage. The Association of American Medical Colleges estimates the country will be short 90,000 physicians within the next decade. Texas is already feeling the pinch. There are 165 physicians per 100,000 people in the Lone Star state; the national average is 220. There are also 126 counties within Texas that have fewer than one primary care physician for every 3,000 people. Lawmakers have not been sitting idly by. They have devoted millions of tax dollars to solve the shortage problem. So far they have approved plans to open two new medical schools in Austin and the Rio Grande Valley, subsidize the state’s medical students’ tuition, and finance 6,500 medical residency positions in 2014-2015. However, their efforts may not be enough. Beginning in 2014, there will be students graduating from Texas institutions who will not be able to find a residency position in the state. This has some lawmakers worried that other states will reap the benefits of the Texas taxpayers’ investment. Lawmakers have created a grant program to try and lessen the financial burden healthcare organizations must carry when operating a residency program. The state’s first-year grant will provide up to $65,000 to cover the first year salary for each medical resident. The trouble is residency programs typically last three to eight years and cost healthcare organizations more than $100,000 per year. Most of the state’s residency programs are in urban institutions, where large organizations can afford to take on medical residents. Smaller rural facilities, which operate in areas where the shortage is most severe, can’t. Even if rural hospitals can afford to start a program, most lack the patient volume to earn accreditation. Some providers have explored the idea of creating a network of rural hospitals that would provide enough volume to gain accreditation, but none have been successful as of yet. The trouble in Texas is just another example of how healthcare organizations, particularly in rural areas, are struggling to meet the needs of their patient population. Without the ability to produce new doctors in the state who are willing to work in underserved areas, rural providers will continue to rely on locum tenens physicians and nurse practitioners to keep their facilities staffed. As Dr. Edwin Leap said in a recent blog post, locum tenens providers are some rural patients’ only hope.