When Texans voted to pass Proposition 12 a few years ago, they sent an invitation to doctors and medical students across the country: Please come here and care for our fellow Texans. And come they have. In answer to the voters’s invitation, Texas has seen an enormous increase in the number of applications to practice medicine, with each year setting a new record. In 2006, applications filed with the Texas Medical Board exceeded more than 4,000. But fixing one problem has created another. Currently, there are more applicants asking to be admitted to the practice of medicine in this state than the Texas Medical Board has the capacity to timely handle. Prior to the passage of Prop 12, a routine application took approximately 30 days to be approved. Now, because of the crush of applications, a wait of six to nine months for each applicant is typical. Take the case of Dr. Kimberly Bingaman. Bingaman is a pediatric neurosurgeon who chose to move to San Antonio, one of the areas in the state that is in great need of neurosurgeons. Bingaman promptly filed her application in February 2006 and moved her family to San Antonio in May, expecting the quick approval of her license.

She was not approved until mid-October. While awaiting the approval of her license, Bingaman traveled from San Antonio during the week to one of the 10 other states in which she was licensed to practice medicine and returned home on the weekend. Ironically, her house was only 10 minutes away from a Level I trauma center desperately in need of her services.

During this time, patients in Bexar County and South Texas did without the needed medical services of Bingaman solely because the Texas Medical Board lacked the personnel to process her application. Texas has experienced a remarkable increase in the number of physicians since the passage of the 2003 reforms. Texas has added 163 obstetricians, 154 orthopedic surgeons and 23 neurosurgeons since then. The Rio Grande Valley physician population increased by 128, and the physician growth rate in San Antonio has been a whooping 52 percent. Even the number of doctors in Houston is 45 percent greater than pre-reform. The growth in the number of physicians is exactly what Texans requested. After experiencing the majority of Texas counties being without either a pediatrician or obstetrician, the change is exhilarating.

The growth of medical clinics in rural areas is unprecedented. Here in Houston, Baylor College of Medicine is planning to build and staff a new hospital. Texas Children’s Hospital has announced a huge expansion. And the University of Houston is hoping to partner with Cornell University to start a new medical school. What a turnaround! But clinics and hospitals serve no purpose unless staffed with licensed doctors.

After working so hard to protect doctors from frivolous lawsuits and to encourage doctors to practice medicine in Texas and stay in practice, it is more than troublesome if Texas does not process physician applications promptly. Dr. Donald Patrick, head of the Texas Medical Board, says that six more positions and only $400,000 are needed for the board to timely process the applications. This is a small cost compared to the huge benefit Texans will receive in increased health care. Texas has moved from the 45th worst state in the number of physicians per population to 42nd in just three years. If just the applications on file now are promptly processed, Texas can move into the mid-30s and will be well on its way toward having enough physicians to provide quality health care to the citizens of this growing, vibrant state.

The promise the Legislature made to Texans of increased access to health care cannot be fully realized until the Texas Medical Board is appropriately funded and staffed. If the delay persists, doctors like Bingaman will move on to other states. An unncessarily long delay was not the invitation Texans extended to doctors when Prop 12 was passed.