Physician practices in rural Texas contribute to the local economy in three critical ways.
• They employ administrative and clinical staff to help care for patients. On average, a solo primary care physician in a rural area will employ three staff: a registered nurse, a medical technician or licensed vocational nurse, and a receptionist/billing clerk.
• They contribute revenue to and generate additional employment at local hospitals through inpatient admissions and outpatient services.
• They generate essential tax revenues for their communities.
If rural physician practices and rural economies are to thrive, physicians need incentives to practice in those areas. Medical school programs with rural-focused curricula increase the supply of primary care doctors in underserved areas as do loan forgiveness programs like the National Health Service Corps and the State Physician Education Loan Repayment Program (SPELRP).
No inappropriate scope of practice expansions
The state’s 11 health-related institutions have
experienced firsthand the growing demand for health care services. They have expanded clinical services and added slots in their schools of medicine, dentistry, nursing, physician assistants, and a broad array of other health professions. Although the Texas Medical Board (TMB) has set a string of new records in medical license applications and newly licensed physicians since the passage of solid tort reform provisions in 2003, most other major health professions have grown at an even faster rate.
• Physician assistants and advanced practice nurs- es (APNs) grew at the highest rate, 132 percent and 1,114 percent, respectively. (Physicians grew by 32 percent.) In absolute numbers, registered nurses (RNs) had the largest gain, 56,000; physi- cians followed, up by about 10,000.24
• While Texas added 56,000 RNs over the past de- cade, shortages persist in many parts of the state.
• Of the 10 largest health professions, podiatry had the slowest growth rate.
This increase in specially trained health care professionals is good for Texans. TMA believes that a physician-led team approach to care, with each member of the health care team providing care based on his or her education and training, is key to ensuring that patients receive high-quality care. Maintaining the integrity of the health care team,
Texas Workforce Comparison (from 2001 to 2011)
Texas Health Professionals Physicians
Physician Assistants
Advanced Practice Nurses Dentists
Physical Therapists Registered Nurses Pharmacists Chiropractors Optometrists Podiatrists
2001
32,281 2,319 5,145 7,561 7,526
128,514 15,559 3,676 2,262 746
2011
42,716 5,372
10,995 11,751 11,127
184,467 21,306 5,020
3,077* 882
* Comparison for optometrists is from 2001 to 2010. 2011 data are not yet available. July 2012 TEXAS MEDICINE 61
Net Difference +10,435 +3,053 +5,850 +4,190 +3,601
+55,953 +5,747 +1,344 +815 +136
Rate of Change +32% +132% +114% +55% +48% +44% +37% +37% +36% +18%
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