Primary Care Physicians
Texas has 196 non metropolitan and 58 metropolitan counties according to The Center for Rural Health Initiatives. As can be expected, rural counties often do not have adequate medical services or physician services. However, even large metropolitan areas can be considered to be medically underserved.Medically underserved areas (MUAs) were defined and recognized by the federal government as those areas having inadequate health services. The determining factors in these areas are the percentage of the population aged 65 and over, the poverty rate, the infant mortality rate, and the ratio of number of primary care physicians to the areašs population. The MUAs can include all of a county, part of a county or a census division. The identification of these areas help determine which areas need additional health care services such as clinics or health professionals.
Areas of health professional shortages were defined by the United States Department of Health and Human Services (DHHS). The DHHS defined primary care physicians as those in the following specialties: family practice, general practice, internal medicine, pediatrics, and obstetrics and gynecology.
Primary care physician shortages were identified by using a ratio of 3,500 people to one primary physician as the cutoff point. The assumption is that one physician cannot efficiently manage 3,500 patients; thus there is decreased access to health care. Distance is also an important factor in determining access to services; thirty minutes is considered a reasonable time to travel. Even metropolitan areas can be considered as having physician shortages due to physician location, accessibility to transportation, income level, and natural and physical barriers. For example, Harris County, a large metropolitan area, is designated as partially a medically underserved area and as having primary physician shortages. Texas in particular has a primary care physician statewide ratio of 1,520:1; urban areas average 1,432:1; and rural areas average 2,227:1.
The primary care physician is a key resource in the continuing war on cancer. As the front line in early detection, diagnosis, and continuing care and treatment, the primary care physician is a vital component of the strategy toward eliminating cancer as a public health problem in Texas.
Data from the Texas State Board of Medical Examiners were analyzed by the Texas Cancer Data Center as to the number of nonmilitary physicians who reported the specialties defined by the DHHS and were engaged in full-time practice. As can be seen from the following map, the number of primary care physicians is inadequate for a state as large as Texas. The data agree with those noted by the federal government for the medically underserved areas and for the primary care physician shortage areas.
