There's no denying it: Texas is facing a shortage of physicians just as the state's population ages, and an influx of retirees relocate to Texas.
Meanwhile, state lawmakers and the medical community are trying to figure out a solution to the growing problem.
Seniors at the WellMed Senior Community Center in Austin loosen up before their abdominal-core strengthening class.
Marcelina Rivera-Quintania, 87, visits with friends and watches others working out while she waits to see her doctor. She has diabetes, heart disease and rheumatoid arthritis. She’s also in a wheelchair.
"And that's my downfall right now and I wouldn't wish it on my worst enemy," Rivera-Quintania said.
For Rivera-Quintania, it's not a matter of finding a doctor willing to treat her. Rather, it’s having enough doctors close by so she doesn’t have to spend too much time traveling throughout the city and beyond.
Her son, Charles Quintania, left his corporate job to be his mother's primary caregiver.
"I've been doing it for the better part of five years. I help her with her appointments. I help her with her medications. Just day to day, getting up, eating and going to bed," Charles Quintania said.
Quintania said his mom especially needs help getting to and from her appointments. She sees four different doctors in different parts of Austin.
"I set her appointments in the middle of the day. I've lived in Austin since 1976, so I've learned to deal with, ‘If you're going to go here, go before this and get back before then,' " Charles said.
Dr. Steven Hays, a Dallas physician with the Texas Medical Association, said Rivera-Quintina’s story isn’t much different from what other seniors experience when they need a physician.
"Obviously as we grow older, more things start to go wrong. And the more patients you have of older age, the more demand is going to be on those physicians. If those physicians are primarily taking care of those people, then they? might not be taking care of other people," Hays said.
A 2017 study by the Association of American Medical Colleges predicts the U.S. will experience a 40,000 to 100,000 doctor shortage by 2030.
The study ranks Texas 47th out of 50 states for having an adequate number of physicians to care for its patient population.
Hays said Texas has several medical schools, but the problem is too many medical students graduate and then attend postgraduate school or residency programs outside of the state.
"If I do my undergraduate medical education here and I go out of state, then the likelihood of me staying out of state and living in that state is very high," Hays said.
Hays said the Texas Legislature tried to combat this trend by approving the construction of additional medical schools and making sure that there is more than enough open spots at existing medical schools for every undergraduate medical student.
Dr. Carlos Hernandez is president of the WellMed Medical Group, which runs over 250 medical community clinics throughout the state. He said the medical schools in Texas have to take an aggressive approach to convince out-of-state medical students to complete their residency programs in Texas.
"Secondly, we as a medical group have to reach out and engage our medical schools and residency programs and let us help recruit some of their graduates and establishing some partnerships with medical schools and residency programs in Texas," Hernandez said.
But Hays said the problem doesn't just involve medical students leaving Texas to finish their education and practicing elsewhere.
Another reality is many of the doctors in Texas will also eventually become part of the growing population of aged and retired residents.
"In Texas, we have 27 percent of physicians are over the age of 60," Hays said.
The complexities of physician supply and demand and the healthcare needs of Texas' aging population will be something lawmakers will continue to examine now and through the 2019 legislative session.