Nicholas Armstrong - Policy Analyst, TPPF Joins Houston's Morning News

Episode Transcript

Speaker 1 (00:01):
Six, twenty three. So time here in Houston's Warning News.
We have a physician shortage in this country. We have
a physician shortage in Texas. Our next guest blames it,
at least in part, on the nineteen ninety seven cap
of Medicare funded residency positions. His name is Nicholas Armstrong.
He's a policy analyst at the Texas Public Policy Foundation.

(00:23):
Is that the major problem or do we just have
a lack of interest in becoming a doctor these days?

Speaker 2 (00:30):
Well, I certainly do think that that that might be
a smaller, a smaller factor into this. But you know,
as you mentioned, you know, the residency caps or the
residency slots were caps back in nineteen ninety seven. There
was a thought in the US at the time that
we would actually have a surplus of doctors, and so

(00:50):
they actually capped this number of spots fund residency slots
funded by Medicare, And you know that has led us
to a shortage right now. Texas has projected to be
short over ten thousand, three hundred doctors, and actually Congress
has just recently lifted that cap and added over one

(01:10):
thousand new residency slots over the next five years. However,
this isn't going to be enough because in Texas alone,
they would have to increase their residency slots in the
state by over one thousand each year for the most
for the next decade. And so, you know, residency slots
adding more, it's going to be a noble policy cause.

(01:33):
But our research has indicated that if you bring more
doctors into the state immediately, that is the best way
to alleviate the doctor shortage that Texas is now facing.

Speaker 1 (01:44):
Okay, so where are these doctors going to come from?
It seems like I don't mean anything negative by it,
but it seems like most doctors who are coming into
Texas now are foreign born. We don't seem to have
as many born in America of students or interested in
getting into medicine or qualifying to get into medical programs.
Why do you think that is?

Speaker 2 (02:06):
Yeah, So, so for the first part, about one in
four doctors in in the US right now have received
their medical training outside of the US, and so this
has kind of led to a phenomenon known as medical tourism,
and so people are going The State Department estimates anywhere

(02:29):
from one hundred and fifty thousand to three hundred thousand
Americans every year actually leave the country to go seek
medical care in other countries. And there's kind of a
wide variety of reasons for this. Oftentimes it can be
cheaper just due to the regulations in the other country.
You know, maybe your insurance doesn't cover that particular procedure,

(02:52):
and so people actually go to other countries. And so,
but what's keeping these doctors in these foreign licenses doctors
from coming and practicing in the US right now is
is residency. So they would have to repeat anywhere from
three to nine years of their medical education that they
have already that they've already completed, and they would have

(03:16):
to come to the US repeat that, take a pay cut,
and then then they would be issued a license through
through that, through that type of pathway.

Speaker 1 (03:27):
I was so that doesn't I was gonna say, I
would guess that part of the problem too. I'm sure
for American students, let's face, a medical school is not
a chief proposition. Should we Should we be offering more
scholarships to write young individuals who are interested in becoming doctors.

Speaker 2 (03:46):
Yeah, so that that certainly could be something that Texas
could could could look at doing. Uh, there certainly could
be a benefit with that, but the our research has
indicated that bringing though bringing doctors in immediately, this alternative

(04:07):
licensing pathway would be able to take take a direct
effect and alleviate the shortage quicker than if we funded
more residency slots, because residency can be anywhere from three
to nine years, and so it is a longer return
on investment. Not saying that, you know, the legislature or

(04:29):
Congress shouldn't address those things or look at those things.
We certainly need residency slots to keep up with the
demand for people who are applying for medical school.

Speaker 1 (04:40):
Maybe under this, maybe it's a little bit of all
the above. I've got a good run. I'm way behind
time here, Nicholas, but I appreciate your insight. Policy analyst
of the Texas Public Policy Foundation, Nicholas Armstrong, it's six
twenty seven.