State regulators green-light two proposed medical schools

How might the Coordinating Board’s actions affect Texas’s decades-long battle with medical scarcity?

Click on the link to read the report or download the attahcment below

Texas Physician shortage lessons

State regulators have endorsed plans to open two new medical schools that together could produce 180 physicians a year once the institutions reach full capacity.

At its quarterly meeting Thursday, the Texas Higher Education Coordinating Board cleared the way for the University of Houston to pursue national accreditation for an M.D. program that seeks to enroll an inaugural class of 30 students in the fall of 2020.

The Coordinating Board also voted to allow the University of North Texas Health Science Center to partner with Texas Christian University in the operation of a Fort Worth-based medical school that’s expected to open next summer with 60 first-year M.D. students.

Although the boost in Texas’s medical workforce will no doubt be welcome, a third-party analysis of historical patterns and population projections suggests it’s unlikely to eliminate the physician shortage that has dogged Texas for more than half a century and turned large portions of the state into medical deserts.

Texas ranks 41st among the 50 states in physicians per capita and even lower — 47th — in the ratio of primary-care physicians to residents. More unsettling, perhaps, is the distribution of physicians in Texas. A 2015 study commissioned by the North Texas Regional Extension Center revealed that despite a concerted effort to increase healthcare accessibility statewide, 185 counties — with a combined population of 3.1 million people — had no psychiatrists, 158 counties (1.9 million people) had no general surgeons, and 147 counties (1.8 million people) had no obstetrician/gynecologists. Thirty-five counties had no physicians of any kind.

An analysis compiled by Harris Search Associates, a global higher-education and academic medicine executive search consultancy, suggests that Texas’s doctor deficit is a chronic condition that can be mitigated, and perhaps even controlled, but never cured — at least not with the tools currently available to state policymakers.

That conundrum loomed over the Coordinating Board’s recent deliberations. Backers of the proposed medical schools made the case that additional training capacity is essential if Texas is to prevent its long-simmering doctor deficit from evolving into a full-blown healthcare crisis. Other policymakers, both inside and outside academia, have maintained that simply opening more medical schools won’t solve the problem. In fact, they say, unless and until Texas can guarantee an entry-level residency slot for every graduate of the state’s existing medical schools, creating additional M.D. programs is counterproductive. Why, they ask, should Texans bear the cost of training doctors to practice elsewhere?

That argument has resonated with some state regulators. Two months ago, the Coordinating Board came within one vote — the final tally was 5-4 — of rejecting Sam Houston State University’s plan to open an osteopathic medical school in Conroe, just outside Houston, in 2020. Raymund Paredes, the state’s commissioner of higher education, opposed SHSU’s proposal, arguing that Texas’s medically underserved areas would be better served by a greater utilization of telemedicine and an expansion of residency programs.

Attached is a just-released analysis of the steps that Texas has taken since the 1960s to keep pace with an ever-growing demand for medical services. The report was produced by Harris Search Associates, a consultancy founded in 1997 to address the senior-leadership needs of U.S. colleges and universities, especially in the fields of medicine, research, and engineering. The report, which draws on a number of resources, both historical and contemporary, is intended to add context to the ongoing debate over Texas’s medical-education boom.

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