Physicians, lawmakers, city leaders, and others came together at the Texas Medical Association’s Border Health Conference in Laredo to find solutions to the most pressing issues affecting physicians and patients on the Texas-Mexico border.
Highlighting such collaboration, the Border Health Caucus honored Sen. Judith Zaffirini (D-Laredo) with its Champion of Medicine award for her decades of contributions to improving health care in the region.
“Together we have identified solutions to health care challenges throughout the border region and throughout our state,” she said in her keynote remarks.
The area presents no shortage of challenges, as Senator Zaffirini and other attendees at TMA’s 19th annual Border Health Conference discussed, including the need to address cross-border infectious diseases and recruit more physicians.
For example, tuberculosis rates in the Texas-Mexico border have been declining since 1993 but are still twice as high as the rest of the state. The area also faces high rates of chronic disease and poverty, and 42% of adults have no health coverage, according to the Texas Department of State Health Services (DSHS).
Border Health Caucus Chair Victor Gonzalez, MD, an ophthalmologist in McAllen, recently saw a patient who died from advanced pneumonia caused by tuberculosis.
“Since we are underserved and underinsured … a lot of the basic education and the early intervention that we should be doing just doesn't happen,” Dr. Gonzalez told conference attendees.
To solve such problems, he and other stakeholders agree partnerships must be fostered between city, county, state, and federal authorities.
“We have to have a strong health care workforce; we need strong resources; and we need proper funding so we can strengthen the overall health system to respond to any health threat,” said TMA President G. Ray Callas, MD.
In discussing the impact of migrant care, Alexander Eastman, MD, chief medical officer of the Department of Homeland Security, says the U.S. Customs and Border Protection has implemented a screening process to assist patients in need of medical resources.
“We created a 13-question screening tool that … helps us narrow the pool of people that need to see physicians,” he said.
But improved communication between health departments and other official bodies doesn’t make up for a continued lack of resources, says Richard Chamberlain, director of the City of Laredo Public Health Department. While Laredo and its sister city Nuevo Laredo in Mexico share data on tuberculosis, he says the follow-up work of contact tracing and isolation often falls through.
“This is not good in terms of public health, and especially for those under- and uninsured populations,” Mr. Chamberlain said.
Dr. Gonzalez also emphasizes the need to attract and retain physicians and other health care professionals, such as through additional medical residency programs. The Texas border has about 56 primary care physicians per 100,000 people compared with about 79 in the rest of the state, according to the latest DSHS data available.
“Statistically speaking, the majority of [physicians] will stay around where they do their residency, so we want to continue to create new quality residencies, so we have a shot at keeping highly trained individuals that we keep losing from our own medical schools,” said Dr. Gonzalez.
It was one such residency program that convinced Tyler King, DO, a family physician and Laredo city council member, to stay in what he calls “one of the most beautiful places in the world to raise a family.”
“I'm a product of the residency programs that have been brought to Laredo in the last six years,” he said. “We’re looking to recruit more and more physicians with Texas ties who are likely to stay here.”
Medicine’s allies are hard at work to support that goal, Senator Zaffirini says. Legislation she helped pass in the 2023 session amounted to millions of dollars invested in regional health care.
“I truly appreciate your naming me your Champion of Medicine, but having collaborated with TMA for almost 40 years and with your border caucus since your founding in 2000, I know you are the champions for your leadership and effectiveness as a caucus,” she said. “Your Border Health Caucus affords you many opportunities to excel within the region, but I also hope you will prioritize more effectively than ever your ability to work with the Texas Legislature that will convene on Jan. 14.”