Senator Eliot Shapleigh - El Paso, Texas

By 2015, Texas would need more than 4,500 additional primary care doctors and other medical professionals to serve all of its residents who have limited access to health care, according to a report being released today by the National Association of Community Health Centers.

The report recommends that Texas hire 1,993 primary care providers within seven years and seek the rest later. The report defines primary care providers as primary care doctors, nurse practitioners, physician assistants and certified nurse midwives.

In Travis County, five areas defined as underserved by primary care — South Austin, Dove Springs, Del Valle, Manor and East Austin — are short 35 primary care providers, said José Camacho, executive director of the Texas Association of Community Health Centers. He defined underserved in those areas as having fewer than one primary care provider for every 3,500 people.

"The bottom line is Texas is not producing a sufficient number of primary care providers, and we're going to have to do something to change that or to attract primary care providers into areas that don't have enough," Camacho said Sunday. "What that's going to take in Texas is some type of loan repayment program coupled with some incentives for graduate medical education coupled with some changes in medical school curricula."

The shortage is a national problem that is worsening as fewer medical students choose primary care. Dr. James Rohack, a senior cardiologist at Scott & White Clinic in Temple and president-elect of the American Medical Association, said recently that the field has become less financially attractive.

The report recommends solving the problem in stages. It says that the nation's 6,600 community health center sites now serving 18 million uninsured or underinsured people with 11,887 providers around the country are 1,843 providers short. Those health centers, which receive federal aid, will need an additional 15,585 to 19,428 primary care providers to reach 30 million patients by 2015. And to reach a total of 69 million patients — the actual number of patients that the report anticipates needing service by 2015 — 51,299 to 60,138 more providers will be needed, the report says.

Millions who are uninsured have no regular doctor, but clinics can't serve them all overnight, Camacho said.

Right now, the 14 Travis clinics have a total of 11 primary care provider vacancies out of 57 slots, said David Vliet, president and CEO of the Austin Community Care Services Department.

"Recruiting is so competitive right now. The new graduates can pick and choose where they want to go," and community clinic salaries are lower than private practice ones, he said. The salaries vary based on experience but are in the range of $120,000, Vliet said.

The report says Texas will need 4,584 more primary care providers to reach its entire underserved population, which it calculated at 5.3 million people by 2015. The state should move in steps and set a goal of hiring 1,993 providers by 2015, which would allow it to serve 1.9 million uninsured or underinsured people, Camacho said.