Opening more medical schools in Texas won’t cure the need for more doctors.

Opening more medical schools around Texas won’t cure this serious problem.

Texas has a doctor shortage. The latest report by the Texas Medical Board, which licenses the state’s physicians, lists at least one doctor in 227 of Texas’ 254 counties, but 24 counties have just one physician. Seventeen others only have two, and 15 counties have three doctors.

The Association of American Medical Colleges ranked Texas 47th out of the 50 states in having enough physicians to serve its population. More doctors are especially needed in medically deprived rural areas. Unfortunately, Texas seems to be taking the same approach to its doctor shortage as it did by building more roads to address its snarled traffic: It’s building more medical schools. That alone won’t solve the problem.

The University of Houston and Sam Houston State University will by 2020 open medical schools. Already recently opened are the new Dell Medical School at the University of Texas at Austin, the University of Texas Rio Grande School of Medicine in Edinburg and the University of the Incarnate School of Osteopathic Medicine in San Antonio. That’s not all: Texas Christian University and the University of North Texas Health Science Center in Fort Worth have partnered to start teaching medicine in 2019.

All that activity will bring up-to-date medical care to more Texans. But graduating more medical students is only part of the prescription for Texas’ physician shortage. Doctors can’t practice until they complete a residency, and Texas hospitals don’t have enough slots for all the residency requests they receive. “If you don’t have a Graduate Medical Education position for residents, they will go someplace else for training and that’s where they will stay,” said Dr. George Santos, president of the Harris County Medical Society.

This isn’t just a Texas problem. There is a shortage of residencies across the United States. Cost is the main culprit, followed by Congress’ inability to walk and chew gum at the same time when it comes to repairing America’s health care system.

Most of the cost to pay about 115,000 residents at the nation’s 1,000 teaching hospitals is provided by the Department of Health and Human Services through an annual Medicare allocation of $9.5 billion and an additional $2 billion from Medicaid.

Those amounts have remained relatively unchanged since a cap was put on federal funding for medical residencies in 1997 as a budget-balancing measure. The budget still isn’t balanced, but a lot has changed in 21 years. Medicare is adding almost 10,000 new Baby Boomer enrollees every day, and the Affordable Care Act has meant medical insurance for more than 30 million additional potential patients.

Student Doctor Network, a nonprofit that supports medical education, points out that a surplus of 70,000 physicians was being predicted when the 1997 cap was placed on funding residencies. The Association of American Medical Colleges now estimates the country will be 121,000 physicians short by 2030. The Texas Department of State Health Services predicts that by 2030 the Lone Star State will have 3,375 fewer primary physicians than it needs. A bill that has languished in a House subcommittee since 2017, the Resident Physician Shortage Reduction Act, would increase the number of Graduate Medical Education slots nationally by 3,000 each fiscal year from 2019 to 2023. About half the slots would be for residents practicing in “high-demand” areas such as primary care, which is also a recommendation of the Congressional Research Office.

Other recommendations made by the CRO make a lot of sense, too, and should be part of any reform that is reintroduced in the new Congress. For example, the CRO pointed out that GME allocations to hospitals do not reflect the income generated by residents specializing in a particular field. Hospitals shouldn’t be allowed to use the GME program to boost profits. The report also noted that Medicare and Medicaid are not collecting data to assess whether their GME allocations are well spent. It’s that type of poor stewardship of taxpayer money that has blemished those programs’ reputations. Here’s a chance to address one aspect of it by requiring them to collect that information.

The Texas Legislature and the state’s hospitals also should find ways to fund more residencies. In North Texas, the UNT Health Science Center, Medical Center Healthcare and HCA Healthcare announced in June that they would create 500 new residencies over the next five to seven years. Similar partnerships already exist, but Texas needs more. Without additional resident slots, the state stands to lose many of the graduates from its new medical schools. They will leave the state for post-graduate training and never return. Preventive steps should be taken now to avoid an avoidable outcome.

This isn’t just a Texas problem. There is a shortage of residencies across the United States