Bisbee, Ariz., is a former mining town of about 6,700 people, some 12 miles north of the Mexican border and nearly two hours southeast of Tucson.
Improve rural access to care
Physician shortages constitute a special problem in rural areas of the state. The continued urbanization of Texas exacerbates this longstanding problem. Approximately 12 percent of Texans live in rural counties, yet only 10 percent of primary care physicians practice there. In 2011, Texas had 52 primary care physicians per 100,000 population in rural areas versus 72 per 100,000 in urban areas. Physician shortages in rural areas not only hinder access to primary and other specialty care but also lead to potential losses in the local economy, difficulties attracting new businesses, and diminished quality of life for residents. A number of factors hurt physicians’ ability to open and sustain rural practices, including heavy concentration of Medicare, Medicaid, and uninsured patients; professional isolation; and high debt after medical school.
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).