I have lived in Texas ever since I was transported down here by my long gone ex less than three years after we married. Even though he left, I chose for a variety of reasons to stay. I tolerate the summers in order to enjoy the quality of the rest of my life down here.
It disturbs me when I so often see Texas in the bottom rankings on anything. It seems quite frequent. The latest state ranking was published yesterday. (FW Star-Telegram Monday, March 29, 2010) Texas ranks 46th in the supply of physicians. Now to be fair, Texas is such a big state that any other state this large would have the same problem. When you group everyone together, there are only 175 physicians for every 100,000 residents. It’s difficult for small towns to attract physicians, especially doctors who desire to achieve an upper class economic status as so many specialists seem to do.
I am happy to see that Fort Worth’s own Texas College of Osteopathic Medicine is increasing class size to help accommodate the need for primary care physicians. There was a time in the not too distant past that allopaths (M.D.s) voraciously guarded their turf from osteopaths (D.O.s) That difference has started to subside since everyone has to take the same state boards.
While M.D.s are steering themselves into more and more specialties, ($$$), more D.O.s are tending to veer towards the career of primary care. The future is bright for such schools. With the passage of the health care bill (until it gets overturned or finally accepted), more people now will have access to medical care. It is one of the fears of those who were opposed to health care reform. They were comfortable with the access they had to their own physicians and were jealously guarding that position. Their fears may soon become reality.
I don’t particularly relish not having as much access to my own PCP, but I’m willing to tolerate it if it is because someone else’s medical conditions were caught at a much earlier treatable stage. Right now I am spoiled when it comes to my opinion of my access to medical care. I have been fortunate.
More than 22% of practicing physicians in Texas are over 60. My own PCP is in that category. When he is ready to retire I hope there is someone as good as he is willing to take over his practice. He swears he is not thinking retirement, but he’s already worn out one hip replacement and is recovering from receiving his second artificial hip. Some days I think I should be proactive and be lining up a new PCP and other times I like this guy so much I think I should just wait.
If 1/4 of all PCP’s retire at the same time, everybody in Texas will feel the change if there aren’t new PCPs ready to replace them. The problem is not just the number who prefer to specialize, it is also the fact that those who graduate from medical schools have to compete very actively for not enough internships and residency slots available. That is definitely a concern that needs to be addressed.
I encountered that very situation a week ago. I was shadowed in my patient advocate volunteer job by a young woman volunteer. It turned out she was a medical student who has completed her training and is waiting for an internship slot to open up. She desires to be a PCP. She has to wait a year until they announce the next admits to the limited programs next March. In the meantime, she is volunteering her time on weekends to stay as close to hospital activity and to patients as possible. She is in a time warp now. There is nothing she can do but wait.
America could progress quite far in solving the problem of the shortage in doctors to care for an increasing patient load if somehow the following things could be accomplished: (1) Open up new medical schools and internship and residency programs, (2) Convince more future doctors to practice primary care rather than crave the lucrative benefits of specializing and (3) Convince more practicing PCPs to seek smaller home towns in more rural areas to practice.
Yah, like that will be easy to do. Namaste. Attic Annie