In 2018, our state needed 6,218 more physicians to meet the demand caused by Texas’ booming population growth—and this shortage is expected to grow to 10,330 physicians by 2032 if we do not find a solution.
In 2014, Missouri became the first state to propose a solution. It created a new role for medical school graduates who are not enrolled in or have not completed a residency program; a licensure type they called “Assistant Physician.”
Nationally, about 8,000 medical students do not match into residency programs every year. The number of residency spots does not equal the number of students graduating medical school. Many of the brightest graduates who make up the top of class percentages in medical school try to match into the most wanted specialties. Despite their academic success and high-level medical training, these students have nowhere to go without a residency spot.
Missouri’s legislation allows for these medical school graduates—now called Assistant Physicians—to undergo a medical training program, specifically in rural and underserved communities in the state, by providing primary care to patients under direct supervision of a licensed, qualified physician.
Bills to create a graduate physician program have been introduced in at least seven states this year, including Texas. Other states are Virginia, Hawaii, Idaho, Maryland, Tennessee, and Nevada.
The Missouri Department of Public Safety recently wrote a letter of support for its Assistant Physician program regarding its success in providing critical care during the COVID-19 pandemic. The Department stated that its Assistant Physicians, “under the guidance of on-site fully licensed medical physicians, have been able to perform as mid-level providers like PAs and NPs with good results.”
A Texas version of the “Assistant Physician” initiative called the “Physician Graduate” program could achieve similar success.
The Physician Graduate concept is a continuous medical training program through which qualified medical school graduates can provide primary care only under complete jurisdiction and supervision of a board-certified physician and only in areas where their expertise is desperately needed. An important distinction is that this program is not mandated. Doctors and facilities in rural Texas are not required to take on a Physician Graduate; this only gives them the ability to opt in and help relieve our physician shortage in the long run.
Not only does this program offer medical graduates a way to continue their career towards becoming a licensed physician, but it also builds their medical experience before transitioning into a residency program.
In addition to this gap in needed doctors, Texan physicians are poorly distributed throughout the state. While many practice in large urban cities, much fewer reach the rural communities. In fact, in 2020, a shocking 32 counties in Texas did not have a single primary care physician. This forces patients to turn to hospitals and emergency rooms for non-emergent reasons—hospitals overcrowd, and beds are taken from emergency patients who really need them. The Physician Graduate program would brng students into rural areas with the hope that they will continue to practice medicine there once they are licensed. Physician Graduates therefore help to fix the lack of primary care providers and keep non-emergent patients out of hospitals.
Texas must open the residency program bottleneck to improve physician shortage for the health and well-being of its people. We have a readily available source of qualified medical providers. Now it boils down to how we can best utilize them to solve a shortage of qualified medical professionals; Graduate Physicians are an answer.