UTEP School of Nursing

Professionals to Prevent A Health Care Crisis

AUSTIN -- Texans are getting older, fatter, sicker and poorer, and the state must invest in training more doctors, nurses and other health professionals to prevent a health care crisis as the population continues to grow, officials told lawmakers Monday.

"We have come a long way in the last decade," but there is still work to be done, said Dr. Ben Raimer, senior vice president for health policy and legislative affairs for the University of Texas Medical Branch.

Lawmakers from three different House committees met to hear from Texas health care experts about the need for more health care professionals and what the legislature can do to address it.

Even though lawmakers have in recent years put more funding into doctor and nurse training programs, including the medical school in El Paso, officials from several health care agencies and associations said more is needed and soon. The need is even greater on the border, they said.

"We have shortages in every profession," Raimer said.

Karl Eschbach, state demographer, said the Texas population is expected to grow from about 23.5 million in the 2000 census to up to 52 million by the year 2040.

And in the next several years, especially beginning in 2012, thousands of so-called baby boomers will begin reaching retirement age, increasing the need for health-care professionals statewide.

"Really, you haven't seen anything yet in terms of the increase in the older population," Eschbach said.

And, he and other officials said, Texas continues to rank at the bottom nationally when it comes to rates of uninsured while at the same time obesity and chronic disease continue to rise.

Those problems are exacerbated on the border, where the largely Hispanic population faces even high rates of underinsurance, obesity and diabetes.

"Border health issues are abundant, almost too many to enumerate," Raimer said.

Although the statewide ratio of doctors and nurses to the population is well below the national average, there are even fewer in border regions.

Data Raimer provided to lawmakers showed that non-border Texas areas averaged about 70 physicians per 100,000 people in 2007. On the border, the ratio was about 50 per 100,000.

Dr. Robert Anders, dean of the University of Texas at El Paso School of Nursing, said in a phone interview that in 2003 border counties had about 380 nurses per 1,000 people. The statewide ratio was 611 nurses per 1,000.

Texas is on track to increase its medical school enrollment, but capacity should be further increased and more must be done to keep graduates in the Lone Star state, said Dr. Nancy Dickey, chairwoman of the Texas Health Care Policy Council.

Lawmakers must decide whether to invest in new medical schools or in expanding the class size at existing schools, the officials told legislators.

Texas lawmakers also need to fund more residency programs, Dickey said. About 80 percent of doctors who complete their residencies in Texas stay here.

Dr. Jose Gonzalez, associate dean for graduate medical education at the Paul L. Foster School of Medicine in El Paso, said there are nine residency programs in El Paso with 182 positions for doctors.

The medical school must pay for some of those positions that he said the state should fund. And several more residency programs are needed in areas like anesthesiology and ophthalmology.

"We want to be able not only to graduate medical students, but also we want to graduate residents," he said "That way, we have better chances of keeping them in the community."

Anders said UTEP graduated 209 nurses last year, up from 159 the year before, and is working to enroll more students. The school admits about 230 students per year, he said.

"But that's just a drop in bucket if you look at how many more we need," he said.

Lawmakers, he said, could help by providing more funding to hire nursing faculty, which are in high demand nationwide, and by giving nursing students incentives like reduced tuition and rewarding schools that graduate more nurses.

Brandi Grissom can be reached at bgrissom@elpasotimes.com; 512-479-6606.