Solving Texas' rural health care crisis will require more collaboration - The Dallas Morning News

In rural America, the health care crisis is growing.

Confirmed by a recent Centers for Disease Control and Prevention report, the gap in potentially preventable deaths from cancer, heart disease and chronic lower respiratory disease between urban and rural residents increased significantly from 2010 to 2017.

Potentially preventable deaths, defined as premature deaths that could have been avoided, among rural Americans are a result of not getting the same quality health care as their urban counterparts.

According to the 2018 Rural Health Quarterly published by Texas Tech University Health Sciences Center, Texas ranks last for access to care in rural counties. This grim news is likely no surprise to the roughly 3 million people living in rural Texas, whose long drives to see their doctors reflect one of the leading causes of this inequality.

The Texas Department of Health and Human Services predicts a statewide shortage of 3,375 primary care physicians in Texas by 2030, an increase of 67%.

Meanwhile, only 159 hospitals are left to serve the 3 million rural Texans. Of the remaining hospitals, some are dropping obstetrical services as a cost-saving measure.

What can we do to help stop this growing crisis? I believe it will require purpose, collaboration and innovative thinking by the institutions that are training the next generation of health care providers. On this critical effort, the University of North Texas Health Science Center is taking the lead.

Since 2010, 110 students have participated as Texas College of Osteopathic Medicine Rural Scholars. The Rural Osteopathic Medical Education curriculum is designed to prepare students for life and practice in rural and underserved communities.

Almost three-quarters of program graduates entered primary care and 62% are actively practicing in medically underserved areas. Fifteen graduates practice in locations with fewer than 25,000 people.

As the leading producer of primary care physicians in Texas, UNT Health Science Center is proud of this success. However, to solve a problem of this scale, more innovation and collaboration are needed.

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Telemedicine, which allows providers to evaluate, diagnose and treat patients through technology, can significantly reduce distance barriers separating patients and providers. The rural osteopathic curriculum includes specialized telemedicine training onsite and through rural clinical rotations. The Health Science Center will launch two new virtual care pilot programs in 2020 to improve patients’ access to quality health care.

Population health strategies also show promise. By harnessing big data to measure and improve outcomes, manage chronic diseases and reduce hospital readmissions for specific groups — for example, West Texans — we can make a more meaningful impact. Our university is pursuing development of a population health-focused institute.

Finally, collaboration is key. UNT Health Science Center, our sister campus the University of North Texas in Denton, Midland Memorial Hospital and Midland College have partnered to create an accelerated pathway from community college through medical school.

By rethinking the traditional pre-med track, the partners forged a pipeline that uses each institution’s strengths and provides students with academic and logistical support for their journey, while creating a return pathway to fill the need for rural health care providers.

The health crisis in rural communities should concern us all. We must work together to create innovative partnerships to help all Texans live healthier.

Dr. Michael Williams is president of UNT Health Science Center. He wrote this column for The Dallas Morning News.

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Solving Texas' rural health care crisis will require more collaboration - The Dallas Morning News
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