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Disruptive Remedies for the Physician Shortage

Philip Betbeze, for HealthLeaders Media, October 25, 2012

The training problem

Klasko's objections notwithstanding, perhaps new medical schools can be part of the solution; but even those hospital and health system leaders who are heavily involved in creating new medical schools agree that doing so is only a partial solution—an extremely expensive partial solution.

In central Texas, a rapidly growing part of the state without a medical school nearby, Seton Healthcare Family is partnering with the healthcare district, known as Central Health, to build a new teaching hospital, while the University of Texas at Austin, with the approval of the University of Texas System Board of Regents, will build a new medical school in Austin. Seton, which operates more than 90 clinical locations, including five major medical centers, and is owned by Catholic healthcare giant Ascension Healthcare, says a projected shortage of 700 physicians in central Texas will result simply from the fact that the area will add more than a million in population by 2020.

Seton, for its part, will contribute $250 million to rebuild its aging University Medical Center Brackenridge as a state-of-the-art teaching hospital. UT Southwestern in Dallas will expand its residency program and the UT system will spend $25 million a year for the program—contingent on receiving contributions of an additional $35 million a year from "public sources," including Seton.

Seton already spends $45 million on residency programs each year. If everything goes right, says Jesus Garza, president and interim CEO at Seton, the school will have about 50 students initially, and the first class could begin studies in 2015.

"Austin is an attractive place to recruit physicians," says Garza, "but studies have shown that 80% of residents stay where they're trained."

He anticipates that while the medical school and closer residency programs will be part of the area's physician shortage solution, physician training will also have to undergo major changes so tomorrow's doctors will work in a more team-based atmosphere that brings other disciplines—such as nurses, pharmacists, and other allied healthcare providers—into direct responsibility for certain aspects of patient care that have traditionally fallen to physicians. The idea is to free up physicians to deal with more clinically critical tasks.

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1 comments on "Disruptive Remedies for the Physician Shortage"


david rollins (10/26/2012 at 1:24 PM)
There are four ways to fill physician positions in medically underserved areas. ? Expand medical school enrollments and establish more primary care residency programs. ? Raise the financial payments for primary care physicians. ? Open our doors to English speaking foreign physicians. ? Train local people, volunteers, to recruit physicians from the more popular U.S. locations where physicians tend to congregate to the less well known areas where there are few to none. The first two ways are ongoing but time and logistics are required to educate new physicians. The third would antagonize many groups of people and cause an exodus of physicians from our country's friends and neighbors. The fourth, the approach by Citizen-Volunteers Limited, is one that can be implemented immediately. Our vision is for each HPSA having too few primary care providers, high infant mortality, high poverty and/or high elderly population to have access to the physicians that they need. OUR MISSION IS TO ORGANIZE AND TRAIN LOCAL CITIZENS IN THESE HPSAS TO RECRUIT THEIR OWN PHYSICIANS. We are currently raising funds for our Beta Training program. David Rollins, Ex. Director/Founder