Just one decade ago, when Round Rock residents required specialized medical services, chances were likely they would need to travel to Austin and sometimes beyond to find care.
In the 10 years since, however, Round Rock's medical community has undergone a complete transformation in capabilities.
"When I came [to Round Rock] I thought it was the boonies, to tell you the truth," said Dr. Oscar Tamez, who founded Tejas Ear, Nose and Throat in Round Rock in 2002. "Twelve years later it is just a totally different place. I think you pretty much have it all."
During the past nine years, the city has seen the opening of two major medical campuses, two rehabilitation hospitals, dozens of clinics and private medical offices, and three higher education campuses with focuses on medical training. Today, Round Rock's medical community is able to accommodate almost any preventive, emergency or surgical service patients may require.
"It has been huge for the community to have access to all of these new systems and physicians and services," said Ernie Bovio, CEO of Baylor Scott & White Health's Round Rock and Hill Country regions. "Probably 95 percent of any health care services patients need, they can get in Round Rock."
As Round Rock's medical community has expanded at an exponential rate, however, so has the health care needs of the city's rising population.
According to census data and demographic studies, Round Rock's population increased by more than 53,000 residents since 2000. Furthermore, the city's population is projected to grow by 12 percent during the next five years and reach nearly 127,000 residents by 2019. The city's major health providers—which include Baylor Scott & White Health, Lone Star Circle of Care, Seton Healthcare and St. David's HealthCare—have invested hundreds of millions of dollars toward facility improvements in the past decade while trying to keep pace.
"The rate of hospital growth across the country is almost starting to flatten out," Bovio said. "But that is not going to be the case in Round Rock for any of us—we are all going to have to expand."
Access to care
Developing and maintaining a health care infrastructure capable of adequately serving a population requires more than simply putting up new buildings, according to industry experts. In growing areas such as Round Rock and Williamson County, there is also the ever-increasing need to find and develop physicians, nurses and support personnel to staff the facilities.
According to statistics compiled by the Texas Department of State Health Services, Williamson County lags behind the state average in its resident-to-physician ratio and well behind the state's major metropolitan areas. In Williamson County, for example, the resident-to-physician ratio is 660-to-1, while in neighboring Travis County the ratio is 372 residents for every one physician.
Dr. Renee Valdez is a general adult psychiatrist at LSCC and a psychiatric consultant to Seton Williamson Medical Center, as well as an associate professor of psychiatry at Texas A&M Health Science Center in Round Rock. At LSCC—a federally subsidized health provider that assists the county's uninsured and underinsured population—finding enough local providers willing to serve patients with government or low-reimbursement insurance plans has become problematic, Valdez said.
"I do think that access [to health care] is a big issue," she said. "There are waiting lists to get in to be seen for certain fields."
LSCC officials say their organization's growth—which includes the expansion from one clinic in Georgetown in 2002 to 30 clinics throughout four Central Texas counties today—is indicative of the health care needs of a growing subsection of the population.
"There is a really significant portion of the Williamson County population that is either uninsured or underserved," LSCC Public Information Officer Rebekah Haynes said. "We would say approximately a third of the population of Williamson County would fall in that boat."
Building a pipeline
As developers of the next generation of medical personnel, Round Rock's three higher education campuses—Austin Community College, Texas State University Round Rock and Texas A&M Health Science Center—all play integral roles in filling the employment needs of local health care providers.
All three schools have clinical agreements with Round Rock hospitals, which allow nursing students to become integrated in the community and receive training locally. Officials say the local hospital and education systems are a natural complement to each other.
"As the [hospital] facilities open, it makes it more convenient or a logical approach to have [educational] programs in that area," said Pat Recek, ACC assistant dean of health sciences. "We couldn't have our programs without the hospitals."
St. David's Round Rock Medical Center hosts clinical rotations for ACC and Texas State nursing students as well as clerkship rotations for medical students at Texas A&M HSC. Debbie Ryle, CEO of St. David's RRMC said the hospital seeks to fill 50 to 70 new or vacated nursing positions each year.
"It is very important for us to have a supply of trained nurses," Ryle said. "Our goal is that the [nursing students], and to some extent the physicians, will be interested in coming back or staying and practicing here."
The schools also have the residual effect of attracting qualified doctors from other regions of the state and nation. According to Greg Hartman, Seton president of external affairs, many of the nation's best physicians seek out medical systems that are aligned with schools.
"Academic medicine and the research that comes along with it help grow new and improved medical activities into a community," Hartman said. "You are able to hire faculty who want to be connected to a well-regarded academic institution."
Texas A&M HSC uses a faculty model that incorporates more than 500 local physicians to teach the school's third- and fourth-year medical students. The students take part in rotations where they are paired with physicians in a variety of fields, including general practice, psychology and emergency care.
"By pairing our educational system with doctors that are in the community ... we have the best opportunity to teach our students the kind of things physicians need to know when they move out into the real world," said Dr. Jim Donovan, Texas A&M HSC associate dean of clinical integration and practice transformation. "For most doctors [teaching] is a labor of love, and they recognize the need to give back."
Continued expansion
Whether through facility improvements, expansion of programs or both, all three of the Round Rock higher education campuses are actively seeking to build on their existing health care programs.
Texas State and Texas A&M are hoping the state Legislature will grant the schools funding in 2015 to expand their Round Rock campuses and ACC officials are considering calling a bond election in 2014 that would include funding for new Round Rock campus construction.
Officials say the projects are a result of the development of Round Rock's medical community as well as the strong interest of students to practice in the area.
"Our students love the Central Texas area, and if there are jobs there, they want to stay," said Ruth Welburn, dean of the Texas State University College of Health Professions. "To have Seton and St. David's and Scott & White and have the research that is going in the area for health care, it is just a very dynamic environment that students gravitate to."
Dr. Lianne Marks, who serves as an internal medicine physician at Scott & White Hospital–Round Rock and an assistant professor with Texas A&M HSC, said the development of the schools and growth of the community will only perpetuate further improvements of the local health care systems.
"The more hospitals there are, the more opportunity there is for medical schools and vice-versa," Marks said. "It accelerates change and accelerates the growth of the health care platform that we have out here.
"We have such a broad spectrum of available options for our patients here in Williamson County—it is really a dream for physicians to be able to work here."
