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MEDICAL YEAR
IN REVIEW

Source: US. Census Bureau. 2018 www.census.gov/quickfacts/fact/table/TX/PST045216.
The US federal government identifies sidered a “minority-majority” state whereby care and even create life-threatening situ-
areas experiencing a shortage of physicians a sizable portion of individuals identify ations which are largely avoidable.
and other health professionals as Health themselves as African-American, Hispanic Much success has been made with diver-
Professional Shortage Areas (HPSAs) in or Latino, and Asian, and make up the ma- sifying the entering class of medical schools
primary care, mental health care and dental jority of the population. with respect to gender. In 2018, for the
care. These shortages may be geographic- There’s little question Texas needs more first-time ever, women outpaced men in
based (a shortage of providers for the en- physicians; however, the workforce short- both applying to and enrolling in medical
tire population within a defined geographic age is particularly acute in communities of schools. Well-intentioned efforts aimed at
area), population-based (a shortage of color. The Lone Star state’s biomedical increasing diversity in the medical profes-
providers for a specific population group workforce shortage and maldistribution is- sion are underway at many medical schools,
within a defined geographic area – e.g., low sues are exacerbated by a mismatch in the yet the number of Hispanics and African-
income, migrant farmworkers, etc.), or fa- diversity of the healthcare workforce and Americans entering medical school remains
cility-based (correctional facilities, state the populations they serve. lower than whites, and in some instances,
mental hospitals). HPSAs affect approxi- The physician workforce in the state of has remain unchanged. For African-Amer-
mately 5.5 million Texans, most of whom Texas should ideally mirror its population ican males, the number of applicants to
represent individuals from diverse demographics, and even more so within its medical school is substantially lower than
racial/ethnic backgrounds. According to counties. The North Texas Regional Ex- any other group and has remained stagnant
the Health Resources and Services Admin- tension Center in its 2015 report, docu- for nearly 40 years. The AAMC reports
istration, there are 462 HPSAs throughout mented that the number of Hispanic that in 1978, 1,410 Black men applied to US
Texas. Bexar County has a total of 12 physicians in Texas is about twice that of medical schools, yet in 2014, that number
HPSAs, half are Federally Qualified Health the national physician workforce, 8.7% in was 1,337. In Texas, among the 10 accred-
Centers or community-based health centers Texas compared to 4.6% nationally. Nev- ited allopathic medical schools, the number
that receive direct federal funds to provide ertheless, the number of Hispanic physi- of enrolled Hispanic and African-American
primary care services in underserved areas. cians in Texas is not representative of the is slightly comparable and in some instances
Texas is experiencing significant growth. Hispanic population in the state, nor is the higher than national rates.
Approximately 28.7 million persons reside number of black physicians in Texas rep- One approach that has been identified as
in Texas, which is 14.1% higher than the resentative of the black population. Both effective in addressing these healthcare
25.1 million estimated in 2010. Recent data groups are significantly underrepresented. workforce challenges is the “grow-your-
reveal that more than half of the Texas Asian physicians, by contrast, are overrep- own” strategy. Growing-your-own health-
population, 57.6%, is of a race other than resented relative to the general population care workforce means finding ways to
non-Hispanic white, according to the US of Asians in Texas. About 3,800 Spanish recruit, develop, cultivate and retain indi-
Census Bureau. Texans of color are paving speaking physicians practice in Texas, viduals from the local region to enter
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the way for a true melting pot of back- which is equivalent to approximately 8.1% healthcare careers that would allow them to
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grounds, ideas, and perspectives, yet the of the total physician population. Mis- serve their local community. This approach
number of physicians in the state do not communication and misinterpretation due recognizes the idea that individuals that are
mirror the general population. Texas is con- to language barriers can lead to errors in raised within a local community are more

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