UT Health Science Center Eyes Future Expansion By COSHANDRA DILLARD, Staff Writer   |   Mar 28, 2010

Adding to East Texas as a medical power center, officials at The University of Texas Health Science Center at Tyler are working to expand graduate medical education opportunities and ultimately want to create an environment conducive to bringing a medical school here.

Although plans are indefinite, UTHSCT officials say a medical school is not out of reach.

"What will be a more detailed announcement later, we are beginning to enter into some of the first steps of working with the public health school in Houston; bringing a public health school to East Texas," said UTHSCT president Dr. Kirk Calhoun.

Texas has seven medical schools accredited by the Association of American Medical Colleges. Of those medical schools, four are within the UT System.

"Having a medical school in our area would be beneficial, and we recognize it would take a collaborative effort among both government and private institutions to realize this goal. ETMC looks forward to participating and working together to pursue such a possibility," said Bryon Hale, senior vice president and chief financial officer at ETMC Regional Healthcare System.

The health care industry in Tyler and Smith County accounted for one in five jobs locally in 2009. From 2002 to 2009, employment in the local medical sector increased by 30 percent, according to recent reports released by the Texas Comptroller's Office.

AT THE THRESHOLD

It's an exciting time for UTHSCT: It is expanding its academic center in a more than $67 million project. Meanwhile, it is celebrating the 25th anniversary of its family medicine residency program, which graduates seven or eight residents each year, totaling 132 residents since its inception in 1985.

Now, as UTHSCT launches an internal medicine residency program at Longview's Good Shepherd Medical Center, officials hope to improve the aim of keeping physicians in East Texas.

The program's first class will begin in July 2012.

UTHSCT officials proudly tout 60 percent of its family medicine residency graduates remain in Texas. They say 62 primary care doctors are practicing in East Texas with nearly 40 in Tyler.

Dr. Calhoun said the mission of any academic medical center is to discover new knowledge through biomedical research and disseminate that knowledge by teaching doctors and other health care professionals.

Over the past five years, the center has completed about $70 million worth of biomedical research and Dr. Calhoun said he hopes that number will double in the next five years.

"Our mission is to really focus on education, focus on research, and focus on community and public health. We are going to be driving that message very aggressively as we move forward in the future. You're going to see many new programs coming from the Health Science Center focused on these areas," he said.

He added, "We hope to work with the community in identifying other primary care training programs for physicians and expanding those programs."

FILLING THE GAP

About 1,600 residents relocate to Texas each day, making it one of the fastest-growing states in the nation. More demand will be placed on health care delivery when 32 million uninsured Americans have access to health insurance following last week's signing of the health care reform bill into law. And with Texas ranking second in the nation for uninsured residents -- 25 percent -- the new coverage may present a challenge to the already sparse field of family medicine.

"With the aging population, Texas does not have an adequate physician work force right now and we are going to need 40,000 more (doctors) than we have right now," Dr. Calhoun said. "That's a big driver for the expansion of the physician program. This has become a critical issue for the state of Texas."

TEXAS EDUCATION

UTHSCT is the smallest of six academic medical centers in the UT System, evidenced by its budget. MD Anderson, which joins UTHSCT as the two centers that do not have medical schools, has a budget of more than $2 billion each year.

UTHSCT has $125 million annually.

But, although small, it still is a treasure to East Texas, officials say. Tyler joins San Antonio and Dallas as the only three cities to have both an academic medical center and an academic campus.
In recent years, legislators have urged all the academic centers in Texas to expand. But to do that, Dr. Calhoun said, a sponsoring teaching institution is needed that will be responsible for the education and the administration of the training program.

"Our state has been challenged because we have a lack of these residency training programs. So we make the investment to train the doctors through their medical school education and then we see a significant number of them leave the state of Texas and go elsewhere to do residency training," Dr. Calhoun said.

Dr. Calhoun said California has an opposite strategy: increase the number of residency slots which attracts physicians from other states where there are not enough slots. In turn, most make California their home, since physicians tend to stay where they receive residency training.

Dr. Calhoun said the larger and more capable a hospital, the greater the number of residents who can be trained and the greater variety of subjects physicians can learn.

He also noted any great academic medical center needs a private partner willing to make a significant investment in education and research.

Dr. Calhoun pointed to The University of Texas Southwestern, which recently entered into a partnership with the Seton family, of Austin, to increase the number of physicians trained there.

The program has 180 residents and that number will increase to 350 after a $100 million investment was made in the collaboration. Temple's Scott & White Healthcare is another example of an institution with a private partnership.

ON THE HORIZON

Competition is not here between neighboring hospitals, but with medical communities in other cities, officials say.

"This community would be entirely different if these two giant hospitals weren't here," Dr. Calhoun said, referring to East Texas Medical Center and Trinity Mother Frances Hospital. "We draw from all over Northeast Texas. In a sense, in developing medical services, our competition is less so with the hospitals that are here in town. Our competition in the future is going to be with the major medical centers that are being developed in Dallas, being developing in Houston and being developed in Shreveport."

Mack Griffith, UTHSCT vice president and chief development officer, said bringing together partnerships for medical centers will be the "new normal."

"If we want to keep up with Houston and Dallas and Shreveport ,then that educational link has to be there," Griffith said.

UTHSCT already has played small roles at local medical facilities. Its family medicine residents rotate at ETMC's emergency departments, one of the requirements for the hospital to achieve a Level 1 trauma status. UTHSCT residents also are active in obstetrics and pediatrics at TMFHC.

Dr. Calhoun hopes the two hospitals will collaborate in the future, noting there have been discussions. Officials at the hospitals say they support the efforts of UTHSCT to expand medical education in Northeast Texas and note they are open to the notion of affiliation.

"ETMC Tyler has physician (UTHSCT) residents in our trauma program, and this training opportunity has worked well for both parties," Hale said. "We recognize the population of Texas is growing faster than existing physician training programs have been able to increase and we support the expansion of physician education and training, especially here in East Texas."

When the family medicine residency program began at UTHSCT, Dr. Richard Kronenberg, senior vice president for clinic transformation at TMFHC, was a pulmonologist there. When asked about an affiliation with UTHSCT, Dr. Kronenberg said it is certainly possible.

"There has been some discussion in the past exploring that possibility. I think it is certainly something that can happen in the future," he said.