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Rural Texas Is Struggling To Keep Doctors. A Proposed Medical School Wants To Change That.

Alex Proimos/Flickr

From Texas Standard:

Texas has almost a dozen medical schools, but it also has a rural healthcare worker shortage. The Texas Higher Education Coordinating Board is set to vote tomorrow on whether to approve another medical school.

Huntsville-based Sam Houston State University thinks it can address Texas’ critical shortage of doctors in rural parts of the state. It’s seeking accreditation this week for its proposed college of osteopathic medicine.
Dr. Stephan McKernan is the associate dean for clinical affairs at the proposed school. He says the goal is to teach students from underserved, rural areas.

“What our model is going to be – if we’re successful – is to recruit students from those areas, so its natural for them to go back there,” Dr. McKernan says. “Not trying to recruit someone from an urban community and then try to convince them to go to, you know, east Texas.”
And he says a college of osteopathic medicine is best suited to do that.

But what exactly is an osteopathic physician, versus someone with an M.D. degree?

To a layperson, they’re just about the same. Both are doctors, both go through the same amount of training. And both have unlimited license to practice medicine in all 50 states. The primary difference is in the philosophy.

“It's very much patient-centered, that’s one of the main tenets. There’s an emphasis on wellness and prevention and nutrition,” says Dr. Boyd Buser, former president of the American Osteopathic Association.

He says D.O’s receive training in something called osteopathic manipulative treatment, a type of manual therapy. That includes a minimum of 200 hours of training in interactions of the musculoskeletal system. Other than that, an osteopathic practitioner can diagnose diseases and prescribe medicine just like an M.D. would.

And while a majority of practicing doctors in the U.S. hold M.D. degrees, the number of D.O.’s is growing. Dr. Buser says one in four students entering medical schools today are going into colleges of osteopathic medicine. And many of those colleges – especially newer ones – are in underserved areas, like deep east Texas.

"They’re almost all being started in areas that have physician shortages, and in particular areas with shortages in primary care because they know that the college of osteopathic medicine will turn out high percentages of primary care doctors," Buser says.

That’s Sam Houston State University’s thinking. The lack of primary care providers in east Texas is due in large part to hospital closures.

"In states where they did not expand Medicaid, hospitals in rural communities are suffering … and they’re closing," McKernan says. "Texas had 14 rural hospital closures since the year 2000."

And losing that infrastructure often means losing physicians. But if Sam Houston State can find and train students within these communities, the hope is that they’ll stick around.

"You’re more likely to get people who come from rural backgrounds, and you’re more likely to get people who train in those smaller communities to go there," McKernan says. "If you never experience rural medicine, you may never know what its like."

So while there’s already 11 medical schools currently operating in Texas, McKernan hopes the Higher Education Coordinating Board approves one more.

"We consider ourselves a community based medical school rather than a research school," he says. "And we have good research schools in the state already, but we need to solve a different problem than what the research schools are solving."

The board is set to vote on the proposed school Thursday.

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