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Why Does it Take So Long to Get a Health Care Appointment?

A recent article in the Fort Worth Star Telegram highlights a big problem plaguing Texas: Texas has a growing and aging population, but this population growth continues to outpace that rate at which Texas adds physicians to the workforce.

Here are the facts:

  • Texas ranks 41 out of the 50 states with 219.4 physicians per 100,000 residents. The national median is 257.6, making it one of the worst shortages in the country.

  • Only 45 percent of physicians accepted and treated patients with Medicaid.

  • The state also leads the nation in closures of critical access hospitals, with 16 closing since 2010.

  • 25 counties in Texas don’t have a single physician.

In an effort to expand much-needed access to care to every corner of the state, legislators are exploring different solutions to address the provider shortage. One such solution is to allow other health care providers, like Advanced Practice Registered Nurses, to practice to the full extent of their training and education -- fully utilizing the state’s resources.

Current laws requires APRNs to enter into contracts with a physician, or what’s called a “Prescriptive Authority Agreement,” in order to practice. This creates an added layer of bureaucracy and unnecessary expense, with these contracts requiring an average fee of $6,000 annually, and in some cases many times that cost. Without this burden, APRNs would have a greater ability to open up clinics and expand access to care in underserved areas.

“A real problem in Texas is that we don’t allow APRNs to go out and taking care of patients in independent practice,” Waldman said. “The excuse is for the safety of the patients. I reviewed 128 [journal articles and studies] and found no evidence of [putting patients at risk].”

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