Senior population feels effects of primary care shortage in New Braunfels

Local officials say the 65-and-older age group faces difficulty finding Medicare-friendly options.

Local officials say the 65-and-older age group faces difficulty finding Medicare-friendly options.

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Breakdown of senior living facilities
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Thriving in the golden years
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Ask the experts
New Braunfels’ senior population  is growing. Numbers from the U.S. Census Bureau show New Braunfels saw a population increase of 5,385 residents between 2014-16, and 1,317—or 24.5 percent—were 60 or older.

Tripp Lyles, director of strategy for Resolute Health Hospital, said as the senior population grows, the health care industry struggles to keep up.

“I would say there is probably inadequate coverage today,” he said.

In particular, Lyles cited a shortage of primary care physicians in New Braunfels.

“If you look at demand, our hospital service area is short by 68 primary care physicians,” Lyles said.

Dr. Emily Briggs, chief of staff for Christus Santa Rosa Hospital-New Braunfels, said the push for more family physicians—which are largely responsible for taking care of the geriatric population—is a nationwide effort, particularly in New Braunfels where she says seniors are thriving.

“If you’re an 80-year-old in New Braunfels, you are vibrant; you are doing your own gardening,” she said.

The Medicare factor


As more baby boomers are tapping into Medicare benefits, Lyles and Briggs said it is not uncommon for them to face challenges when searching for a primary care physician.

“Medicare patients tend to take a lot more time; they have a lot more chronic issues, which limits the number of patients a physician office can see in a day,” Lyles said.

Cost is another factor, Briggs said, because Medicare only covers the cost of care, which makes it more difficult to make a profit.

After he turned 65, longtime New Braunfels resident Steve Chapman said he felt the reluctance of local physicians to see him.

“I was looking for a new doctor, and I did find that at least initially I tried two or three different doctors and they weren’t accepting new Medicare patients, so I had to lean on a friend.”

Chapman said his friend was an influential person in town who helped connect him with a doctor who took him on as a patient.

Briggs accepts Medicare at her practice, Briggs Family Medicine, but she said she has witnessed the struggle local seniors face when it comes to finding—or keeping—a primary care home.

“There are primary care physicians who, if they don’t’ take Medicare, they have to drop patients once they turn 65,” she said.

Although local primary care options are scarce, Chapman said he has seen the specialty care landscape expand significantly since moving to New Braunfels in 1975, and since he was able to establish care with a primary doctor, his experience on Medicare “has been fantastic.”

“We’ve got great specialists,” he said. “In fact, one of the surgeries I had to undergo the past year required robotic assistance, and we’ve got a hospital now with that ability. I’ve had friends in my age group who have had to have quadruple bypass, and they had it right here in New Braunfels.”

Can technology fill the gap?


John Kublank is the director of Connected Home Living’s southwest region, and he said the telehealth company is helping to fulfill the area’s need for additional health care options.

“I think New Braunfels has a lot of really great physicians, but as New Braunfels is growing and as our senior population grows, I can imagine today we are starting to feel more of a squeeze.”

Connected Home Living works with home health agencies to provide remote monitoring services to patients post-hospital discharge. Connected Home is able to monitor blood pressure, glucose and other medical indicators from a remote location.

Kublank said he believes health care is moving toward using more of this type of technology as Texas Medicaid and Medicare continue to add to the list of telehealth services it covers.

“Our ideal client is somebody who is dealing with some sort of diagnosis that is limiting, and they just need that extra support to make sure those indicators are in a normal range and that we’re proactive so that they don’t ever have to go back to the hospital.”

Such services can replace the need to make a doctor’s appointment at a local practice, and Kublank says data shows telehealth provides more of a savings than an investment.

“The average cost of hospitalization is anywhere from $10,000-14,000, so if your patient readmits, you’re going to eat that entire cost as the hospital and be penalized at the end of the year for total Medicare reimbursement.”

Planning for the future


Because the senior population is  projected to keep growing, local efforts are being made to help ensure adequate primary care access.

Briggs said training opportunities can play a part when it comes to retaining regional medical talent.

“In the surrounding area, we’ve looked at bringing more residence programs to the area to train these doctors,” Briggs said. “We know if we train them in a local area, they are likely to go back to that area [to practice].”

At Resolute, Lyles said the hospital recently opened a primary care location—the MedFirst Primary Care Villas—that has one physician and one mid-level provider. The hospital plans to open another primary care clinic in February with the ultimate goal of adding four to five providers.

In addition, Dr. David Pak plans to open a private practice in September geared toward senior health care. He said the initial clinic in New Braunfels will be the first of many.

“My passion is in senior care,” he said. “We’re going to extend to corridors that have high densities of Medicare patients, senior care populations and retirement communities.”

According to Pak, who has been practicing medicine for more than 20 years, managing care in senior populations is much different than other age groups. He sees primary care acting as the “quarterback” on the senior’s health care team.

One of Pak’s goals is to help patients simplify medications and educate them on important issues such as fall prevention. He also hopes to partner with local organizations to provide senior-focused seminars.

Although the senior health care demand is becoming more challenging to fulfill, Pak said the endeavor is worthwhile because the senior age group has  a lot to offer.

“I think they’re the most amazing people in the world,” he said. “I think we need to tap into their knowledge and experience.”
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