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2023 TEXAS LEGISLATIVE
SESSION WRAP-UP

Meeting The Bexar County Health Needs

Through Graduate Medical Education

By Scott Jones, MD
T he healthcare community of Bexar County is responsible for begin to sponsor some core residency programs with HCA. San An-

identifying and collaborating with other entities, including
tonio has over 100 GME programs with more than 1,000 physicians.
patients, to improve the health of all our communities. As a
the future to meet our regional and county needs.
fundamental role of physicians, it is paramount that our next generation Multiple entities have recognized the value of investing in training for
of physicians are appropriately introduced to these needs, educated, and GME supports underserved communities, with the University
engaged in our community interventions. So, what are those needs, and Health Robert B. Green Campus downtown serving as the largest am-
how is Graduate Medical Education (GME) currently engaged? bulatory site for the LSOM GME programs. The TIGMER Family
I decided to ask the open-access artificial intelligence platform, Chat- Medicine (FM) residents train at the Communicare West clinic, an
GPT, about the most significant healthcare needs for Bexar County. FQHC serving the inner westside. University Hospital (UH) is the
ChatGPT provided seven categories of greatest needs with brief de- safety net hospital for San Antonio and the primary inpatient location
scriptions. While this list is not exhaustive, it was a reasonable starting for LSOM GME and, more recently, TIGMER Internal Medicine
point. I then sent this list to some GME program leaders in the county, (IM) Residents. The LSOM IM residency has an Ambulatory Track, a
asking for examples of engagement. This article will highlight GME ef- program that encourages internal medicine residents to enter Primary
forts in Access to Healthcare, Health Insurance Coverage, Chronic Care. Many graduates work in clinics throughout San Antonio. Un-
Disease Management, Behavioral Health Services, Maternal Child fortunately, the underprivileged often primarily access care through
Health, Health Disparities, and Aging Population and Geriatric Care. emergency rooms. The LSOM started an Emergency Medicine (EM)
ChatGPT responses are bolded throughout. residency program in 2013, and these residents are often the first to see
these patients, along with the many GME consulting services. The Gen-
Bexar County, Texas, which includes the city of eral Surgery residents and faculty are the first on hand in the trauma
San Antonio, has several notable healthcare needs. bay for the only one of two Level 1 trauma centers serving this region.
Here are some of the greatest healthcare needs The LSOM Psychiatry residents provide telepsychiatry services to the
in Bexar County:
underserved communities of Del Rio, Hondo and Uvalde. The pro-
1. Access to Healthcare: Ensuring equitable access to healthcare
grams and services listed are but a small representative sample of how
services is a significant need in Bexar County. While there are
the 100+ GME programs are improving access.
healthcare facilities in the area, disparities in access exist, particu-

larly for underserved populations, low-income individuals and those
2. Health Insurance Coverage: The uninsured rate in Bexar County
without health insurance. Improving access to primary care, spe-
remains a concern. Many residents lack health insurance, limiting
cialty care, mental health services and preventive care is essential.
their access to necessary healthcare services and increasing the burden
Given the projections of growing physician shortages in our region,
on safety-net providers. Expanding access to affordable health insur-
1
GME is critical to closing these gaps. The University of Texas Health
ance options and Medicaid eligibility could help address this need.
Science Center San Antonio Long School of Medicine (LSOM) has
This generation of new physicians is very engaged in advocacy, in-
trained physicians in Bexar County for over 50 years in every major
cluding advocacy for patients gaining access to healthcare. LSOM has
healthcare system. Other enterprises currently training in the county
several residents in different programs engaged with the Texas Medical
include Christus Santa Rosa, Baylor College of Medicine and, more
Association’s First Tuesdays up in Austin. Others advocate through
recently, Texas Graduate Medical Education Research (TIGMER), the
their national or State specialty associations, such as the LSOM FM
GME branch of the University of Incarnate Word. The Texas Higher
residents. They attend the Family Medicine Advocacy Summit, where
Education Coordinating Board GME Expansion Grants have played
they are given training on advocating with lawmakers and their staff.
a significant role in financially supporting Baylor's programs at Chil-
Expanding Medicaid coverage is recognized as a significant healthcare
dren's Hospital of San Antonio and TIGMER, and to a lesser extent,
issue in Texas and even more so in our region.
LSOM GME Programs. Soon, Methodist Healthcare System will also
The residents and fellows in all our County GME Programs see

30 SAN ANTONIO MEDICINE • August 2023