The training problem
Klasko's objections notwithstanding, perhaps new medical schools can be part of the solution; but even those hospital and health system leaders who are heavily involved in creating new medical schools agree that doing so is only a partial solution—an extremely expensive partial solution.
In central Texas, a rapidly growing part of the state without a medical school nearby, Seton Healthcare Family is partnering with the healthcare district, known as Central Health, to build a new teaching hospital, while the University of Texas at Austin, with the approval of the University of Texas System Board of Regents, will build a new medical school in Austin. Seton, which operates more than 90 clinical locations, including five major medical centers, and is owned by Catholic healthcare giant Ascension Healthcare, says a projected shortage of 700 physicians in central Texas will result simply from the fact that the area will add more than a million in population by 2020.
Seton, for its part, will contribute $250 million to rebuild its aging University Medical Center Brackenridge as a state-of-the-art teaching hospital. UT Southwestern in Dallas will expand its residency program and the UT system will spend $25 million a year for the program—contingent on receiving contributions of an additional $35 million a year from "public sources," including Seton.
Seton already spends $45 million on residency programs each year. If everything goes right, says Jesus Garza, president and interim CEO at Seton, the school will have about 50 students initially, and the first class could begin studies in 2015.
"Austin is an attractive place to recruit physicians," says Garza, "but studies have shown that 80% of residents stay where they're trained."
He anticipates that while the medical school and closer residency programs will be part of the area's physician shortage solution, physician training will also have to undergo major changes so tomorrow's doctors will work in a more team-based atmosphere that brings other disciplines—such as nurses, pharmacists, and other allied healthcare providers—into direct responsibility for certain aspects of patient care that have traditionally fallen to physicians. The idea is to free up physicians to deal with more clinically critical tasks.