OPINION: In the land of deserts, health care shouldn't be one 

As the federal government launches a $50 billion Rural Health Transformation Program aimed at reversing decades of decline in rural care, states like New Mexico are faced with defining decisions, including: How can we move forward to keep our residents healthy?

Chief among these concerns should be residents’ access to oral health care. Thirty percent of New Mexicans skip critical dental care due to cost, and less than two-thirds of state dentists accept Medicaid, despite roughly 800,000 residents enrolled. New Mexico spends millions each year on preventable emergency and emergency room treatment — dollars that could instead strengthen the pipeline of providers New Mexico’s communities desperately need.

With only 46.8 dentists per 100,000 residents, a number that has continually decreased since 2017, and 32 of the 33 counties designated as dental Health Professional Shortage Areas, the crisis is measurable and growing. The median number of dentists to population is 1 to 3,297 residents — nearly three times the federal recommended ratio of 1 to 1,050. This means for rural families, accessing dental care often means driving hours to a provider.

To build a sustainable workforce, we must train locally. That responsibility falls squarely on the state’s higher education institutions and policymakers to create programs specifically designed to train providers who will stay and serve their own local communities, ensuring the deserts that exist don’t include health care. Retention of in-state residency training has shown that 58.6% of graduates practice within the state of their training.

Rural communities have long struggled to attract medical professionals. Local residents interested in medicine, be it dentistry, nursing or behavioral health, leave and go out of state to pursue their training and rarely return. Meanwhile, the patchwork of providers caring for these communities grows more disjointed and desperate for additional capacity and resources.

Breaking this cycle requires a new approach to education. Universities must design programs with explicit goals of rural workforce development; this means recruiting rural students, embedding rural clinical experiences in training, creating financial incentives for rural practice and building partnerships with underserved communities.

One model for this approach is Touro College of Dental Medicine in Albuquerque, which opened last year. Touro invested in the state, which previously had no dental school, by creating a clinical facility to attract New Mexico residents and others who hopefully will continue to practice where they have been educated. The facility provides access to care for uninsured, underinsured and Medicaid patients, and brings students to a state where they can see and make a meaningful impact. In addition to seeing patients in Albuquerque, through affiliations, Touro students travel into the community to some of the health care deserts.

But one dental school alone cannot solve a statewide crisis — the entire education system must adopt this mindset. Every nursing program in the state should include required rural rotations. Physician assistant programs should offer scholarships tied to rural service commitments. Behavioral health training programs — desperately needed as mental health and addiction crises deepen in rural areas — should be launched with rural practice as the explicit goal.

And it doesn’t stop with higher education; New Mexico can incentivize rural practice through loan forgiveness programs, tax incentives and infrastructure support that will prevent health care deserts.

Only when we launch a coordinated, sustained commitment across higher education, state and local government, and health care institutions will we see the impact we can have to meet the needs of New Mexicans.

Our model proves that we can address decades of provider shortages with a collaborative approach that prioritizes the development of a pipeline. It will require sustained investment and recognition that workforce development is also economic development — particularly for rural communities where a single provider can determine whether families stay or leave.

The rural health crisis won't be solved overnight. But by keeping and attracting providers to New Mexico and ensuring they're prepared to serve the most vulnerable populations, we're building the foundation for a healthier future.

Dr. Ronnie Myers, is the dean of the Touro College of Dental Medicine.