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Texas Health Resources responds to North Texas doctor shortage with new residency programs

 Dr. Ryder says the greatest need for doctors is in internal medicine or primary care.
Dr. Ryder says the greatest need for doctors is in internal medicine or primary care.

Texas Health Resources has responded to the shortage with new residency programs at hospitals in Fort Worth, Denton and Hurst-Euless-Bedford.

Dr. Hilary Ryder, director of the Internal Medicine Program at Texas Health Resources-Fort Worth, told KERA’s Sam Baker the new programs will address a specific need in North Texas.


  • More older physicians are retiring. I think COVID-19 has exacerbated that situation. Some are just not willing to take the risk of contracting COVID.

  • Physician burnout. They’re switching into a non-clinical field, research, or working for a pharmaceutical company or an insurance company. They're just withdrawing their clinical time and not taking care of patients.
  • An increase in demand. We have a growing population with people having children. We also have people migrating from around the country into Texas and those people need physicians.
  • Supply has remained somewhat stagnant. A few new medical schools have opened up, but you need an entire pipeline. We have smart Texas medical students who want to stay in Texas for the rest of their training and they can't. There aren't enough spots for them. And so they're being forced to leave our state to go to other states for training.
    • In rural Texas, 33 out of 254 Texas counties do not have a single physician.

  • More than a quarter of Texas residents, mostly rural, live where there's less than one physician per 200,000 residents.
  • A 2018 survey of Texas physicians showed there were only 54 primary care doctors for 100,000 people. The national average is 76 per 100,000 people.
  • What we really need is internal medicine doctors, primary care. That's the greatest shortage. Psychiatry is another area where there are large shortages. Without an increase in the number of positions, medical students, residents, we're won’t be able to meet demand. In fact, we are already failing to meet demand.

    There are a few things that I'm doing.

    We’re really trying to enrich primary care opportunities so that residents really have the opportunity to develop expertise and excellence in primary care in the hopes they might go on to become primary care doctors.

    We're trying to make wellness and physician wellbeing a real hallmark of our program. We're really trying to train physicians who can take care of themselves as well as take care of their patients.

    You know how medicine used to be practiced, where doctors really lived in the hospital and worked these 30-hour shifts.

    Our shifts are going to be 12 to 14 hours — no longer than that. We're going to be a shift-based system, not a call-based system.

    An opportunity to work with amazing sub-specialists in our community, so they can really get kind of the breadth and scope of how medicine is practiced here.

    Making sure they have enough vacation time, enough two-day weekends. Some people take that for granted, but in medicine, they're all too rare.

    How hard has it been to find a primary care doctor? Do you have one you can rely on? Do you get shunted to their Physician Assistant a lot, or do you have to wait a week or two before you can see them? Do you end up going to free-standing urgent care or an emergency room because you can't get in to see the doctor that you have, or do you live rurally?

    If you've answered yes to any of those questions, more doctors in this area, especially primary care doctors, means more access for all North Texans.

    We are hoping also to expose our residents to rural practice through collaboration with other Texas health hospitals. If even one resident decided to go into rural primary care and ended up in one of these counties in north Texas that has no doctors, we could increase the access dramatically in just a few years.


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    Shortage of Primary Care Doctors Is Costing American Lives

    Interview highlights were lightly edited for clarity.

    Got a tip? Email Sam Baker at sbaker@kera.org. You can follow Sam on Twitter @srbkera.

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    Copyright 2021 KERA. To see more, visit KERA.

    Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.