Addressing the Threat to Primary Care in Texas: The Texas Medical Association advocates the following to help alleviate the shortage of primary care physicians in Texas:
TMA should continue to monitor the impact of physician education loan repayment in the state, including repayment amounts that correspond to current debt levels. Input from graduating medical students, residents, and practicing physicians should be considered in defining repayment levels.
Annual loan repayment amounts should be increased for each year a physician practices in an underserved community, within a defined cap, such as five years.
Strong consideration should be given to expanding the state loan repayment program to include medical specialties experiencing shortages in addition to primary care.
Consideration should be given to offering higher repayment amounts for physicians who practice in areas of greatest need, including areas with longstanding physician shortages.
Encouragement of Texas medical schools with rural missions to periodically evaluate their student admission criteria to ensure that the most appropriate criteria are utilized for identifying students most likely to select careers in rural medicine. This would help prepare more physicians to meet the needs of rural, medically underserved areas.
Reaffirmation of TMA Policy 185.001(1) that asks TMA to "continue to focus efforts on resolving the maldistribution of physicians by encouraging physicians to locate in underserved areas of the state."
In addition to loan repayment, state incentive and benefit programs for recruiting and retaining primary care physicians for medically underserved communities should be: (1) adequately funded and (2) sufficiently promoted among potential physician candidates to prevent available grants and stipends from going unspent.
Efforts should be made to consolidate physician benefit and incentive programs for medically underserved communities at a single agency. The programs should be evaluated on a periodic basis to assess their effectiveness and net benefit to the state.
TMA should take an active role in promoting awareness of the Physician Education Loan Repayment Program, in partnership with the Texas Higher Education Coordinating Board and Texas Medical Board.
TMA also should promote greater awareness of other existing benefit and incentive programs for medically underserved communities through postings on the TMA Web site and promotion among TMA's Medical Student and Resident and Fellow Sections (CME Rep. 3-A-08; amended CM-PDHCA Rep. 2-A-17).