Need for primary care physicians will continue to increase

According to Our Community Check-up 2007 for Tarrant County, individual health is closely linked to community health – the health of the community and environment in which individuals live, work and play.

More than 50 million people will live in Texas by 2040, one-quarter of them baby boomers older than 65, according to former state demographer and current director of the U.S. Census Bureau Steve Murdock.

As a result, the number of visits to physicians across the state could triple. The demand for health care service will continue to expand as our population grows and ages. Therefore, we must ensure that we have trained health care providers to meet the needs in the future. Specifically, the authors of the study found that to reach 30 million patients by the year 2015, health centers need nearly 16,000 more primary care providers and more than 14,000 additional nurses. To provide a medical home to all 56 million medically disenfranchised Americans nationwide, health care centers would need nearly 66,000 more primary care professionals and almost 45,000 additional nurses, according to the study  ACCESS Transformed: Building a Primary Care Workforce for the 21st Century.

Unfortunately, in Texas we donÂ’t even have enough physicians to treat the patients who need care now. The national average for direct-care physicians per 100,000 people is 220, but Texas averages only 157 physicians per 100,000 people. We are dead last of all the states in the ratio of physicians to the population. In primary care, 114 Texas counties are considered full primary care health professional shortage areas and 47 counties only partly qualify. Twenty-five counties have no physicians.

In Tarrant and Dallas counties, we enjoy more choices because we are an urban area.  We especially enjoy a plethora of specialists. Many medical students are choosing to pursue careers in medical specialties such as dermatology, anesthesiology or podiatry because working hours are more regular, allowing them to balance and schedule family and personal time. However, we still need primary care physicians to care for colds, strains and infections — and to make those referrals to local specialists, if needed.

It takes more than 10 years to educate and train a physician. But the number of U.S. medical school graduates choosing to enter family medicine and general internal medicine residencies has fallen by almost 50 percent since 1997. Graduates leaving medical school carry an average of $100,000 of debt, according to Lewis Foxhall, director of the Statewide Family Medicine Preceptorship Program. The average income for primary care physicians has dropped by more than 10 percent since 1995 when adjusted for inflation, according to a report by the Center for Studying Health System Change. These figures donÂ’t encourage young, eager medical students to pursue a calling to family medicine.

In one of the fastest-growing states in the country with a shortage of family physicians, the future looks worrisome. Where will we find our family physicians when the current group — many of whom are older than 50 now — retires?

In fact, within the next three years, more than half of physicians ages 50 to 65 plan to retire, seek nonclinical jobs or otherwise significantly reduce the number of patients they see, according to a Merritt Hawkins & Associates survey.

ItÂ’s the responsibility of the community to support individuals who choose to accept a medical calling. For the health and future of Tarrant County, we must establish programs that will encourage physicians to practice here, and foster programs that encourage young people in Fort Worth, Saginaw, Euless and Burleson to pursue their medical training, then come back here to care for our residents.

Local businesses and the community can do their part by supporting scholarships for primary care physicians, sponsoring legislation that encourages physicians to practice here in Fort Worth, and ensuring legal and financial considerations are in place to help physicians become licensed here and set up practice with ease.

We must increase the training programs available in all of our hospitals. The Metroplex is the fourth largest metropolitan area in the country. However, we rank 27th in the number of opportunities for training medical students.

By training more physicians, particularly primary care doctors, Fort Worth will be healthier. We can continue to contribute to key advances in clinical research and preserve the fine quality of life that we have come to enjoy here in North Texas. But to get there, we must work together to train the brightest minds in new and proven medical care, then ensure that these newly trained physicians practice here in our neighborhoods, caring for our family and friends.

ItÂ’s not just our dilemma, itÂ’s the health and well-being of our families and our community. LetÂ’s work together to ensure that Fort Worth and the entire North Texas area have the trained health care providers needed to care for our community and our future.

Ransom is president and professor in obstetrics, gynecology, health

management and policy at the University of North Texas Health Science Center at Fort Worth.