How will health care reform affect TX?

August 7, 2009 8:44:45 AM PDT
There is already a shortage of family practice doctors in Texas, and experts are worrying that health care reform proposed by the Obama administration will make the problem even worse and mean long wait times just to get in for an appointment.To understand how complicated reforming health care will be, consider this: a study by a Houston neurosurgeon says people in cities like Houston, where there are lots of high tech medical procedures performed, aren't as healthy as people where there's less high tech medicine. Why?

"The more primary care doctors you have in a region, the better the quality and the lower the cost of care," Dr. Guy Clifton said.

That's an odd thing for a neurosurgeon to say. But Dr. Clifton, a respected neurosurgeon from UT-Houston Medical School has written a book called "Flatlined: Resuscitating American Medicine."

"What we do very well in the U.S. is deliver high technology procedures, and we do it exceptionally well in Houston," Clifton said.

In the U.S. he says 7 in 10 doctors are specialists, and only 3 in 10 are family physicians, internists or pediatricians. He says it should be a 50:50 ratio. And, he says senior adults in Texas actually have too many doctors.

"The average Medicare patient has seven different doctors," he said. "In Florida, it's 10 different doctors. Nobody can know what's going on."

Clifton, who left Memorial Hermann Hospital Medical Center three years ago for Washington to work on health care reform says Minnesota does it better. He says their Medicare patients only average three doctors, but they're healthier.

He says a family practice doctor spends 40 minutes with a patient. For instance, he or she may be newly diagnosed with diabetes. His nurse practitioner goes through the patient's diet. If the patient's blood sugar spikes on the weekend, he or she calls and gets the doctor or his nurse, who has the patient's records and can tell he or she what they should do. The patient avoids the emergency room.

"A huge number of hospitalizations and cost could have been eliminated by good care in a clinic," Clifron said.

But to do this, Texas will need 30 percent more doctors than it has today. To get an idea of what may happen if health care reform mandates coverage for millions more, take a look at Massachusetts. It mandated universal health coverage three years ago. The state's primary care doctors were overwhelmed and all patients ended up with long waits to see the doctor. Experts say Texas must add primary care physicians immediately to avoid the same thing here.

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Christi Myers is ABC13's Healthcheck reporter.

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