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Doing Our Part to Plug the Primary Care Physician Gap

By Monte Bostwick, CEO and Market President, St. Luke’s Health–East Texas

March 23, 2023 Posted in: Leadership

Health care experiences the straightforward problem of supply and demand—and the solutions are anything but simple. The need for primary care is growing, but over the next decade, the U.S. faces a shortfall of tens of thousands of primary care physicians. The dearth of primary care is especially acute in rural America. In East Texas, St. Luke’s Health is doing its part to help solve this problem.


In July 2022, we welcomed the first group of three physician trainees to the new St. Luke’s Health Family Medicine Residency Program. A partnership between St. Luke’s Health and Baylor College of Medicine, this three-year program exposes participants to family medicine in urban and rural settings, emphasizing the latter. Second- and third-year residents will train at St. Luke’s Health-Memorial in Lufkin and nearby clinics. We hope this program pays lasting dividends for residents of our region while giving these new medical professionals a meaningful career experience.


Attracting and retaining physicians in rural markets such as East Texas can be challenging, but the Family Medicine Residency Program could provide an advantage. Data tell us family medicine physicians tend to work within 100 miles of where they completed their residency. Our Family Medicine Residency Program affords us a better chance of attracting graduates to live and work in the communities we serve. 


Recognizing Possibilities and Finding an Ideal Partner

I joined St. Luke’s Health-Memorial in 2016 from a hospital in rural eastern Washington state. My former hospital had a family medicine residency program. Observing it up close helped me understand how a similar program could benefit St. Luke’s Health-Memorial and help satisfy the need for primary care services in East Texas. We began the process of determining what it would take to get a family medicine residency program off the ground here. At first, many stakeholders had one question: “Can we really do this?” My experience in Washington state told me we could.


What we needed most was the right academic partner. Fortunately, our health system already partnered with Baylor College of Medicine, one of the country’s foremost medical training institutions. Our existing relationship with the college and its impeccable record of training residents made our choice of partner easy. 


Best of Both Worlds

The Family Medicine Residency Program will feature nine residents at full capacity. Residents will spend the first year of the program in the Houston area completing rotations at Baylor St. Luke’s Medical Center in the Texas Medical Center, Texas Children’s Hospital Pavilion for Women, and Texas Children’s Hospital The Woodlands. These first-year rotations at tertiary and quaternary medical centers will allow the residents to build experiences in different aspects of care, such as inpatient pediatrics, which are rare or nonexistent at St. Luke’s Health-Memorial.


The preponderance of residents’ training will take place in a rural setting, which differentiates our program from many other family medicine residency programs. Starting with the second year, the program’s focus shifts to rural medicine, with St. Luke’s Health-Memorial hosting the trainees in their final two years. Patients in rural areas have different needs than those in urban and suburban settings. Our program offers residents the best of all three by giving them a well-rounded experience. They get to spend a year training in a big city, followed by two years of immersion in a rural area with attending physicians who provide rural medicine every day.


Built-In Flexibility

One of the great things about our Family Medicine Residency Program is that it’s still evolving, giving the first groups of trainees the chance to be trailblazers. They’ll get to shape the program’s future, and that future is predicated on the flexibility to help residents pursue their passions in rural medicine.


All second- and third-year residents will complete certain standard clinical rotations at St. Luke’s Health-Memorial, such as inpatient medicine, emergency medicine, orthopedic surgery, and general surgery. Our program, however, is nimble, allowing trainees the flexibility to mold their knowledge to fit their interests. Some residents, for example, may wish to experience rural medicine beyond our hospital in Lufkin. That might mean caring for patients at our critical access hospital in San Augustine. If that’s the type of experience residents want, we can help them turn their vision into a reality.


Exciting Future

Family medicine residents and the patients they care for aren’t the only ones who stand to benefit from the Family Medicine Residency Program. As members of our medical staff at St. Luke’s Health-Memorial take on the role of teachers in the program, they’ll be well-versed in the latest literature and evidence-based practices, ensuring they’re providing the most up-to-date care.


We recently began welcoming medical students into our hospital for educational purposes. The impending arrival of the initial group of second-year residents in the summer of 2023 will extend a continuum of education at St. Luke’s Health-Memorial that elevates the game of everyone in our medical community. That’s exciting. What also excites me is where I see our Family Medicine Residency Program headed. 


In East Texas, second- and third-year residents will find a community that’s eager to welcome and support them. We’re committed to providing these residents with training that shapes them into high-quality physicians. We’ll prepare them to move into the next phase of their careers ready to care for patients confidently and competently.


Most of all, I’m excited for the people of East Texas. As the Family Medicine Residency Program grows and achieves success, it has the potential to have a generational impact on the communities we serve. I hope that’s exciting for everyone in the region.




Learn more about how St. Luke’s Health promotes diversity, equity, and inclusion.

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