Texas needs doctors. The shortage is severe.
The state currently ranks near the bottom -- 43rd -- in its ratio of primary care physicians per 100,000 people. And where you live in Texas makes a big difference: 80 counties have five or fewer practicing doctors; 35 have none at all, according to one of the nation's top health care recruiting firms.
With sick and aging populations concentrated in rural areas, the need will only become greater.
An irony in all this is that Texas is churning out more brand-new doctors than ever. We're a magnet for the elite corps of students earning medical degrees, due in no small measure to affordability. Because of a longstanding state law that caps medical school tuition at public universities -- a cap that's matched by some private universities, such as Baylor -- costly medical education here is a comparative good deal.
A recent ranking published by USA Today citing the top 20 most affordable reputable medical schools in the country listed seven in Texas, including University of Texas Southwestern Medical Center in Dallas and University of North Texas Health Science Center in Fort Worth. And Texas universities are on a med-school building boom, with new medical education centers scheduled to come online within the next few years.
"It's a bargain," says Stacey Silverman, deputy assistant commissioner at the Texas Higher Education Coordinating Board, which helps set higher-education policy and priorities for the state. "Going to medical school in Texas is a way to ensure you don't get into a lot of debt."
That's the good news. The downside? Texas loses too many of those new graduates to other states.
The reason is that the next step in a physician's education is on-the-job training: a residency at a teaching hospital, where young doctors are supervised by experienced veterans. Without enough residency slots in Texas to accommodate all those new graduates, they must look elsewhere, and the statistical reality is that doctors who complete their residencies out of state are less like to return to Texas to pursue their careers.
In recent years, state legislators have devoted increased funding to create new residency programs in Texas. As a result, Silverman said, the state is closing in on meeting the Legislature's established goal of 1.1 first-year residency program openings for every graduate.
But that careful balance will be altered as universities build new medical schools.
"In 2021, our new medical schools graduate their first round of entrants," Silverman said. "We need to be finding new resources to open up new residencies."
The solution, Silverman said, is a three-way effort including universities, hospitals and lawmakers to ensure there are job opportunities waiting for all those new graduates. In particular, the state needs creative incentives to persuade young doctors to establish practices in underserved rural areas.
For the good of all Texans, these efforts need to be a continuing priority.
It's prestigious for Texas universities to be educating so many new doctors. But we're only served well if we can keep them.