In California and Texas, hospitals cannot hire physicians directly under state law. The law was originally intended to protect patient choice, but it is swiftly turning into a factor in underemployment of physicians at rural hospitals in these states. Without the ability to hire, hospitals don’t actively recruit. Without the active recruitment, rural areas suffer since the benefits of living in such an area can’t be advertised.

Rural communities, regardless of the state they are in, typically lose doctors to metropolitan areas for many reasons. More money, more culture, and a perceived higher standard of living usually draw younger doctors just out of med school. In California and Texas, add the lack of recruitment and the ability to offer employer incentives to the mix and the result may be disastrous to the future in reducing patient access to care.
California hematologist and oncologist John Rochat, MD, is employed by Mendocino Coast District Hospital. He was hired through a 2003 pilot project and he argues in this article that being employed by the hospital does not interfere with his rights as a physician. He also argues that he cannot stock necessary chemotherapy drugs without the support of the hospital.

While it is all very well and good to suggest new legislation that allows employment of doctors by hospitals in these states, the question remains of how these hospitals can recruit until then. Recruitment can be done effectively and inexpensively online through job matching services tailored to physicians, such as eMatch Physicians. Even if they are not employing them directly as hires, such inexpensive means can be used to at least advertise that they do, indeed, need physicians to staff their hospitals. Rural locations in both California and Texas may appeal to the older physician with a family that wants to be home more, and these points can be sold on such a service.

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