When Texas Tech’s Health Sciences Center in El Paso was established as an independent university a little over two years ago, one hope was that it would produce doctors who would stay in El Paso.
That El Paso suffers from a doctor shortage is no secret. El Paso has half as many doctors per resident compared to other Texas cities like San Antonio.
What might surprise some is that 25 percent of the 967 medical residents who completed residency programs at Texas Tech El Paso have stayed in El Paso. That’s nearly 250 doctors.
“It’s moving the needle, but not far enough,” Richard Lange said in a wide-ranging interview last week.
Lange, who was named founding president of Texas Tech El Paso a year ago, also weighed in on the financial troubles plaguing El Paso Children’s Hospital, which owes Texas Tech millions of dollars. El Paso Children’s filed for bankruptcy protection in May, three years after opening.
Lange talked about his vision for the budding university, plans for a fourth building and Texas Tech’s role in the development of a new teaching hospital in Northwest El Paso. Called The Hospitals of Providence Transmountain Campus, it is being built by for-profit Tenet Healthcare.
Texas Tech’s university in El Paso is the system’s fourth. It operates a medical school and nursing school in El Paso. Enrollment at the Paul L. Foster School of Medicine has reached 385 students and enrollment at the Gayle Greve Hunt School of Nursing is 122 students.
Texas Tech also operates clinics and research labs in El Paso and has launched a graduate school.
Researchers at Texas Tech El Paso are working on vaccines to combat viruses like West Nile Virus and a vaccine for tuberculosis. They have created a large gene bank and are mining it for genetic markers that might predict who is at risk for certain behavioral health problems.
Lange, 59, was born in Anchorage, Alaska. His father was in the Air Force, so the family moved a lot.
Lange’s training, job experience, articles, projects, honors, book chapters and appointments fill a 57-page curriculum vita.
He has a bachelor’s degree in biochemistry from North Texas State University and MBA from Johns Hopkins University. He earned his medical degree from the University of Texas Southwestern Medical School.
From 2004 to 2008, Lange served as chief of clinical cardiology and a tenured professor at Johns Hopkins Medicine in Baltimore.
Most recently, he was vice chair of medicine and director of educational programs at the University of Texas Health Sciences Center at San Antonio.
Lange also co-hosts a popular podcast called PodMed.
Besides his job as president of Texas Tech El Paso, Lange is also dean of the medical school and a professor of internal medicine. A cardiologist, he also sees patients.
Lange and his wife, Joy Bobette, have three children.
In his office at Texas Tech, he talked with El Paso Inc. about the school’s unique curriculum, how money troubles at Children’s Hospital affects recruiting, and programs he’d like to add.
Q: What have you learned since becoming founding president of Texas Tech El Paso a year ago?
I’ve really come to appreciate the fact that the education here is among the best in the nation. I’m not just saying that subjectively, but the American Association of Medical Colleges put out a list of the top 10 curriculums across the United States, and ours was ranked No. 2.
Harvard just announced it is going to revamp its curriculum. It looks like it is going to be a lot like ours. Here in El Paso, they had the opportunity to build the curriculum from the ground up, and they started it right.
With regard to the patient care, what I have come to appreciate is just how underserved the area is. I knew it by numbers, but witnessing it is another thing. Some of our clinics are just full.
We recently hired a chair of psychiatry, and within a couple of months, he has hired seven individuals – just to help him meet the needs. And that’s just scratching the surface.
One of the goals here is to educate local students and get them to stay. This year, of the little over 100 medical students enrolled, 24 are from El Paso.
We are going to increase our graduate medical education by partnering with The Hospitals of Providence Transmountain Campus under construction in Northwest El Paso. Our partnership allows us to bring in 45 to 50 physicians to El Paso.
We are also going to look at what additional schools we need to build. We are doing a needs assessment, and we will be looking at what needs the community has that aren’t currently being provided.
Q: What are some possibilities for new schools?
One of the things we are thinking about is a dental school. Is this the right time to start one? Physician assistants and nurse practitioners – there is a huge need there. Allied health is another area. That includes things like physical therapy, occupational therapy, speech therapy and dental hygiene.
I’ve asked to get a list of every training program in the Texas-New Mexico region, including the number of students that are enrolling and the acceptance rate. From there, we’ll begin to plot what we need to be doing over the next three to five years.
We are going to time that with our new building. The Texas Legislature approved funding for a brand new building that will increase our research capacity. It will double it.
It will also allow us to build additional classrooms for the new schools we’re looking at starting. It will add some space for administration as well, because as we break off from being a regional campus to our own campus, we need to add all those services.
Q: With double the research space, what areas of research might you all expand into?
The four areas we emphasize now are neuroscience, infectious disease, cancer and also diabetes and nutrition.
Q: If I were the head of one of those centers, I’d be asking for some of that new space.
(Laughs) Absolutely. All of them are by the way. I think the area we are going to invest most heavily in is cancer research. That is a huge need in the area.
Q: What is the timeline for the new building?
We would like to begin construction next year.
Q: Given the financial problems of El Paso Children’s Hospital, is Texas Tech nervous about its partnership with Tenet, building the new teaching hospital?
No. They have been a terrific partner. It is an adult hospital, and what is happening at Children’s really doesn’t affect it at all. It’s an opportunity for us to increase our educational capacity, and that is really our goal.
Q: What services does Texas Tech provide El Paso Children’s?
It provides not only general pediatric care but also much of the subspecialty care – things like cardiology, gastroenterology, infectious disease, diabetes, endocrinology and pediatric surgery.
Q: How much does Children’s owe Texas Tech, and how much is it paying now?
It is in arrears $9.8 million. What they’ve had to do as part of the bankruptcy proceeding is pay us and University Medical Center ongoing.
Q: What are your thoughts on a proposal to bring El Paso Children’s under University Medical Center, an idea that has not been very popular with Children’s?
What we have been able to do in all this controversy is continue to provide care to children while the hospitals work out their situation. There are a lot of nuances I am not privy to. A lot takes place behind closed doors, and the truth of the matter is we don’t own a hospital and we don’t run a hospital.
We provide education, patient care and do research. So what we’ve tried to do is make sure that the care to the children is maintained while these two entities work out their situation.
Q: Do you share any of Children’s concerns about University Medical Center?
The concern that I share is anything that doesn’t allow us to provide the right care to the children. If we get decisions where we can’t provide that, then that’s going to be an issue.
Q: Do you see any other way out for Children’s?
If I had some great insight or a crystal ball, they wouldn’t all be sitting in Austin negotiating this stuff right now.
Q: What hope is there for a good resolution to the situation?
Call me an eternal optimist; I actually think it will be resolved favorably. There is a will in this community to provide great care to children.
Q: What are you hearing from doctors? Has the situation at Children’s impacted Texas Tech’s recruitment efforts?
Anything that happens in El Paso that is adverse that makes it onto a website affects us. It affects our ability to attract medical students, it affects our ability to attract residents and we’ve had faculty we have been trying to recruit who have said they are not going to come until things become more stable.
We’d like a time of peace in the area where things are going well, because the area speaks for itself. It is a terrific place to live.
Q: Physicians you are recruiting have specifically mentioned the situation at Children’s as a reason for holding off from coming?
Yes, at all levels – students, residents and faculty. We have to address these things right up front.
Q: What areas of medicine are students graduating from the medical school here going into most often?
Because of the children’s hospital, I think we had 22 of our students last year go into pediatrics. That is a huge amount. About 50 percent of our residents go into primary care, which is phenomenal. That’s family practice, internal medicine, OB/GYN or pediatrics.
Q: The number of doctors in El Paso grew from 1,093 in 2010 to 1,332 in 2015, a 21-percent increase over five years, according to data collected by the Texas Medical Board…
That’s pretty good.
Q: Much of the increase was in pediatrics, which makes sense given the opening of El Paso Children’s. But are those gains now at risk given Children’s financial woes?
If the hospital were to close, then the training program would close. If the training program closes, then we lose many of those physicians. They came here with two missions: one is to train students and residents and the other is to provide specialty care to children. Inevitably, if that weren’t available, then they would leave.
Q: I made an appointment for my son with a pediatric neurologist a month ago, and the earliest they could see him was in three months. It will be Thanksgiving by the time he sees the doctor.
And take that a step back to when there were no pediatric neurologists in El Paso. Then people had to travel hundreds of miles.
Q: One area that actually saw a decline in the number of doctors over the past five years was dermatology – from 14 to 11 doctors.
We don’t have a dermatology training program right now. So if I am looking at what we need in the community, that may be one possibility.
Q: The new hospital under construction in Northwest El Paso – what difference does it make that it will be a teaching hospital?
It’s a huge difference to the patients. We are able to provide a level of expertise – professors who are there to not only care for patients but also to train residents on how to do that. There is an emphasis on quality, efficiency and performance.
It helps provide the funds we need to add to residency programs. It will allow us to train 75 to 90 new physicians. We are already maxed out in the number of residency slots at UMC and El Paso Children’s Hospital.
Having a new hospital also allows us to draw down federal funds to develop residency programs that we can’t at UMC.
Q: How so?
In 1997, as a result of the Balanced Budget Act, Congress capped the number of residency slots the federal government would pay for. For example, 50 percent of the residents trained at UMC are actually paid for by UMC.
If you have a brand new hospital that has never had residents before, the federal government will allow you to add residency slots and will pay for them. So this is going to bring additional revenue to the city that would otherwise not be available.
Q: You mentioned the curriculum here is unique. How so?
We are the only curriculum in the United States in which students are required to learn Spanish.
Q: Do they really learn it?
Yes. Would they be able to go negotiate the price of a house in Spain? I doubt it. But can they interview and examine a patient in Spanish? Absolutely.
We also have a very advanced simulation center so that students learn techniques and procedures not by practicing on patients but on a simulation.
Students start seeing patients very early on, by the second week of medical school, and the curriculum is not centered on memorizing books and chapters but on symptoms. Everything is integrated and makes sense.
When I trained, you spent the first two years memorizing stuff. You crammed, and there was no context.