Access to medical care in New Mexico is inadequate. This is a longstanding problem, but now may well be at a tipping point.
The first step in solving a problem is recognizing and accepting its severity. It is quite difficult for many New Mexicans to get and keep a primary care doctor. According to the NM Health Care Workforce Committee 2022 annual report, as of 2021, there are 308 fewer primary care physicians in New Mexico today than in 2013 – and 711 fewer than in 2017. And, compared to 2013, obstetric care – 37 fewer doctors; surgery – 20 fewer general surgeons; and behavioral health – 12 fewer psychiatrists; are also difficult to access.
These decreases are despite a modest population increase coupled with aging, COVID, obesity and increases in medical technology. Twenty-five percent of New Mexicans have a personal health care provider – state rank No. 43. The average age of physicians in New Mexico is 53, so we can predict increasing shortages as retirements occur.
Certain specialties are exceedingly difficult to access: neurology, endocrinology, rheumatology, and several pediatric specialties, to name a few. Shortages are more severe in rural areas. In urban counties, some specialties meet benchmark numbers, but these numbers do not take into account all of the folks who drive into town for care.
Wealthy New Mexicans often go to neighboring states for medical care. Because of physician shortages, we have a two-tier system. New Mexicans who are not wealthy should be able to get what they deserve right here: timely access to quality, affordable care.
While there are doctors who have been practicing in N.M. and have stayed for years, this is only part of the equation. We need health care professionals to want to come to New Mexico, and we need those who are trained here to stay after graduation. Only 40% of New Mexico residency graduates stay in New Mexico. The national average is 47%, and we rank No. 37 as a state in retaining our graduates.
Hospitals and clinics have a hard time recruiting. Online medical magazines rank New Mexico in the bottom five among states for “best states to practice medicine.”
It should be agreed that changes are required. While universal health care is an interesting and promising approach, we should work hard to fix the shortfalls of our present system as, at best, it will take time to establish functional universal care. And universal coverage will not mean universal access if there are not enough health care professionals.
The second step in problem solving is recognizing specific steps and urgency. There are several areas relevant to physician recruiting and retention that require urgent attention: 1) the medical malpractice environment in New Mexico – state funding for the Patient Compensation Fund deficit and accurate classification of health care facilities are important steps; 2) increased funding for Medicaid; 3) eliminating the gross receipts tax on medical care – New Mexico is one of only two states with this tax; 4) delays in physician credentialing; 5) preauthorization requirements; 6) improvement in residency graduate retention; 7) student loan forgiveness; and 8) practice establishment support.
Some of these are being engaged by our governor and Legislature, but all of these areas deserve positive action. The complexity is necessary and important, and the outcomes of these considerations will affect the health of New Mexicans for years to come.