rapidly growing population. The sheer size of the state’s population is the biggest driver of physician demand. The state’s broad expanse and variance in geography and demographics, plus the great attraction for others to move to Texas, result in an ever-increasing demand for physicians and other health care professionals. Over the past two decades, Texas has led the country in population growth.
The convergence of a larger, increasingly aging, and increasingly obese population of Texans represents “a recipe for disaster.” In the United States, approximately 80 percent of all persons 65 or older have at least one chronic condition, and half have at least two. These patients take longer to treat and grow more and more complex in the amount of services and care they require. Diabetes, which causes excess morbidity and increased health care costs, affects more than 1.7 million Texans 65 or older. As U.S. adults live longer, the prevalence of Alzheimer’s disease, which doubles every five years after age 65, also is expected to increase.11
Texas is a state with significant shortages of physicians and other health care professionals. Several powerful trends are pushing those shortages to levels that will threaten the ability of Texans, regardless of where they live or whether they have insurance, to access health care. Those trends include:
• More than 5.7 million Texas baby boomers will become eligible for Medicare,12
the age group with the highest demand for physician services;
• Our high birth rate, which further increases demand for physician services;
• The possible addition of more than 2 million people eligible for Medicaid in 2014, due to the PPACA;
• The possible addition of more than 2.2 million currently uninsured Texans who will qualify for subsidized coverage through the PPACA’s insurance exchanges; and
• The growing prevalence of chronic diseases that frequently require more health care services, such as diabetes and hypertension.
July 2012 TEXAS MEDICINE 57
More and more Texans will experience health- related disparities because of poor health status and/or a lack of preventive health options or access to timely medical care. Health disparities include differences in the occurrence or prevalence of a disease or a poor health condition. For example, the Texas Diabetes Council estimates that the number of adult Texans with diabetes will quadruple from the current 1.7 million to almost 8 million in 2040. This surge is strongly associated with population growths in African-Americans and Latinos, who have higher rates of diabetes.13
People with diabetes and other chronic health
A PHYSICIAN’S STORY
Nancy Dickey, MD Bryan/College Station
Need to Keep Young Doctors in Texas
“We need to give the state of Texas high marks for what they’ve done to help increase the number of medical school graduates per year that we have. But if those graduates have nowhere to get their graduate medical education — their residency training to become board-certified — they will leave the state and that state investment will be lost.”
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