responsible for regulating APNs who would be practicing medicine.


The Texas Legislature, wisely, rejected those bills. Granting independent practice to APNs will not increase the health care workforce, nor has other states’ experience shown APNs are likely to locate in medically underserved and rural areas. Further, APN independent practice will not lower costs. Research found utilization rates for medical


services, referrals to specialists, and hospitalizations for patients were higher for APNs versus physicians or resident physicians.


On the other hand, some scope expansions are consistent with team care, based on objective educational standards, and would improve patient care services. These should be carefully weighed and ultimately involve some supervision and regulatory oversight by TMB.


A PHYSICIAN’S STORY


Adrian Billings, MD Alpine


Physician Loan Repayment Program Helped Me Return Home to Alpine, Texas


“I went to medical school to become Dr. Garcia, the family physician who delivered me, who took care of me. I knew early on that God put me on this earth to become a family physician on the Texas-Mexico border. I found the National Health Service Corps, a federal program … that pays for training and medical school so you graduate debt- free. Your repayment to the federal government, to the taxpayers, is to go a medically-underserved area. That was home, that was where I wanted to go ... to be a primary care physician. It has allowed me to go back to Alpine and see everybody regardless of their ability to pay because I don’t have loans to repay. My time to repay is four years of practice. Currently in my third year, I have no plans to leave.”


July 2012 TEXAS MEDICINE 63


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