Delayed care. Physician burnout.
These are just a few consequences of New Mexico’s health care shortage.
It’s a problem that’s been years in the making — though lawmakers took steps to stem it during the latest legislative session.
A December 2024 report by the state’s Legislative Finance Committee found that all but one of New Mexico’s 33 counties are “health professional shortage areas.” By 2030, New Mexico could be short 2,118 doctors, according to Cicero Institute projections.
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The LFC’s survey of 17,897 physicians found that two out of three considered leaving the state. It makes sense, as 94% of physicians surveyed said the shortage affects their day-to-day work.
Health care shortage consequences
Dr. Robert Underwood, president of the New Mexico Medical Society, told Straight Arrow news that, though the shortage is extensive, “patients need to be seen, and so we do our best to keep trying to see those patients.”
A lot of times, though, “that means patient care is delayed,” Underwood added, and doctors can’t refer out to specialists.
This can lead to worsening circumstances in the long term.
A backlog of patient need already existed due to the COVID-19 pandemic.
“And now, throw on top of that a lack of physicians to be able to see all those patients who need regular screening exams, colonoscopies, cardiac stress tests and the kinds of things that are part of the preventive care that we know is important for good care of patients,” Underwood said. “We’re unable to do all of that, and that puts a lot of pressure on the doctors.”
This pressure leads to burnout, which leads to early retirement, which leads to a shortage of health care workers — “a vicious cycle,” Underwood said.
Not only has state Sen. Linda Trujillo, D-Santa Fe, been hearing from constituents about their difficulties finding care as patients, but she’s experienced it herself.
“My primary care provider retired. And so then I signed up for another one, and before I even got into the appointment to see that person, I got a letter from my health care provider that that person was leaving. At first, I was like, ‘OK, well, I guess that happens sometimes. I just picked an unlucky person.’ But the reality is that it just kept happening,” she told SAN.
The problem is even more exacerbated in rural communities. Underwood said there are what are called “medical islands,” where people can’t get access to care.
Those in younger age groups aren’t wanting to stay in smaller communities as much, Julia Ruetten, senior director of government affairs for the New Mexico Hospital Association, said, and some of these places have had anchor industries and institutions shutter over the last few decades, leaving entire counties without a major employer.
“Our hospitals are not immune from that here in New Mexico,” Ruetten said. “What is interesting is that some of our rural hospitals struggle with low patient volume, and our urban hospitals struggle with high patient volume.”
Legislative solutions
New Mexico’s state budget allocates $546 million to constructing a University of New Mexico School of Medicine; $24 million to support rural residencies and $2 million to increase medical resident and fellows’ salaries.
During their 30-day legislative session, state lawmakers also passed several bills aimed at addressing the shortage that Gov. Michelle Lujan Grisham signed into law.
Student Loan Repayment Fund
One of these is an expansion of the Health Professional Loan Repayment Fund. HB 66 makes it so doctors are eligible for up to $300,000 in student loan repayments if they stay in New Mexico for four years.
State Rep. Christine Chandler, one of the bill’s sponsors, said it’s “probably the most generous physician loan repayment program in the country” in Searchlight New Mexico.
Medical Malpractice
Another bill is HB 99, which tackles medical malpractice — one of the main reasons physicians cited for leaving the state. HB99 makes it so there are tiered caps on punitive damages: $1 million for independent providers, $6 million for locally owned hospitals and $15 million for large systems.
Before, there was no cap for punitive damages.
“When I finished my training, there were states that had a reputation similar to New Mexico’s when it came to medical malpractice and the unfriendly nature towards physicians,” Underwood said. “I never even looked at jobs in those states, and now we’re going to get that look from doctors who are finishing that training who would have otherwise ignored New Mexico completely.”
Ruetten said HB99 is probably the most impactful bill this session, but added that it would take some time to see how much the changes move the needle.
Critics of the bill argue that the changes could create significant hurdles for those looking to get justice for medical negligence.
Chris Supik, an injury lawyer with Keller & Keller, said limiting the amount that may be recovered by medical malpractice victims “is fundamentally wrong.”
“Trivializing the actual harm caused to New Mexicans and making healthcare providers the ‘victim’ is unfair. It ignores the trauma and suffering that families have unnecessarily been forced to endure,” Supik said.
Ruetten, though, said it was important in the New Mexico Hospital Association’s advocacy for the bill that it doesn’t do anything to impede protections for patients.
“We fully feel that any patient that has experienced malpractice should have the full access of the law, and justice to be able to seek remuneration for their injuries,” she said. “And so in House Bill 99 and in all of the items in the bill that we supported and advocated for, we were not adjusting any of the amounts that are compensatory or that are designed to address the patient’s economic classes or their pain and suffering.”
It was the hospital association’s aim to make sure patients still get justice, but also, for there to be some predictability for providers, Ruetten said.
Underwood said the malpractice bill still allows for a level of accountability to providers in a “meaningful but proportional way.”
“We don’t want bad doctors out there either taking care of our patients,” he said.
State-to-state mobility
Trujillo sponsored, and legislators passed, SB 1, which means New Mexico is joining 43 other states in letting physicians participate in licensure compacts.
“People in general, families, are much more mobile, right?” Trujillo asked. “We know that families are more likely to move from region to region, state to state, and so you want those professionals to be able to get licensed as quickly as possible.”
Before, New Mexico had been an outlier in the southwest for not being part of these compacts, Ruetten said.
“Entering that is not going to open the door, and all these providers are just going to run into the state and want to practice,” she said. “But it’s kind of one more thing that puts us in alignment with our neighboring states.”
While the New Mexico legislature did the same for social workers, several other compacts stalled in Senate committees, including for dentists, dental hygienists, physical and occupational therapists, physician assistants, audiologists, speech-language pathologists, emergency medical services personnel, counselors and psychologists.
State Rep. Liz Thomson, D- Bernalillo, who sponsored five interstate compact bills, told Searchlight New Mexico she’s not giving up on them.
“I’ll keep working on them until I get them to a place where they can pass,” she said.
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