Why Physicians Should Practice Medicine in Texas

Terri Eckert is the only geriatrician in a 2-hour radius from her small town of Athens, Texas; population 12,710.  She told Physicians Practice that while she practices in a rural community, she has ample support - two nearby primary-care physicians and a 100-bed hospital.

Eckert runs a busy solo practice. Her staff includes one nurse practitioner and two nurses.

What do you love about practicing medicine in Texas?

Well the patients. I think everyone is going to say that, everywhere. I don't think that is going to be unique for physicians. We have a lot of rural communities in Texas and there's definitely a need for physicians in those areas. I mean, we have all the same angst as everyone else as far as the Medicare/Medicaid system.

I think the Texas legislature has been pretty pro-medicine and pro-physician. Even in our community, we have politicians come and speak to our local medical societies and ask questions. So, really [they] make an effort to be in contact with us and to listen to our opinions. And the Texas Medical Association (TMA) is the same way. You know, they are really proactive, and you can call them anytime you have a problem or a question. We've had people come from the TMA to our community and talk, speak with us directly.

Is there anything you don't like about practicing in Texas, or would really like to change?

I don't know that it is unique to Texas. It's the same thing, everywhere. We have Medicare/Medicaid issues. Being a geriatrician, Medicare is my bread and butter.  And [reimbursement] is really a problem for us. Honestly, none of the other primary-care physicians in several county areas are even taking new Medicare/Medicaid patients. So I've had to actually close my practice [to new Medicare patients], temporarily, because of that. I just can't take everyone's new Medicare patients. That's probably our biggest problem at this point, reimbursement, and just all the issues with Medicare/Medicaid.

[There are] a lot of intermediaries in the Medicare payment system. We have to go through agencies for our payments, and those people, they've hired people to do reviews and audits. It's actually gotten completely ridiculous, as far as their auditing and holding payments for no particular reason. When you try to get an answer out of them about, "When are you going to release my payment?" they never know.

But, I'm still in practice. I still like what I'm doing. And I haven't stopped yet.

What advice would you have for a young doctor wanting to practice in Texas?

Well, I would say they need to make sure they are practicing for the right reasons. Some people go into medicine for different reasons, but if you don't really love what you do, if it's not basically a "calling," then I think you probably need to rethink that.

We do need physicians in rural communities and they are great places to live and raise a family. We definitely need physicians out in smaller communities. I work with a nurse practitioner, and I would recommend that, too, it makes a huge difference. My patients have loved [her], and she's fabulous, and I would definitely encourage physicians to look at mid-levels.

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