Being a family doctor in Texas isn't easy. Treating the state's poorest residents can be even harder. A 2010 survey shows that fewer physicians are taking new Medicaid patients because of low reimbursement rates. At the same time, the state must face the prospect of adding millions more Texans to Medicaid by 2014, when the Affordable Care Act mandates that nearly all residents sign up for insurance. That means access to primary care will be critical.

But there is a trend developing statewide that isn't likely to be addressed or fixed anytime soon: Over the last 10 years, Texas’ population has grown rapidly, but the state isn't producing enough doctors to treat Texans' health problems. (See the Tribune's reporting on legislative cuts to graduate medical education programs.)

Tom Banning, CEO of the Texas Academy of Family Physicians, said it's important for Texans to pay attention to access issues because "care delayed is essentially care denied. People who put off going to see the doctor end up in much more severe or acute problems if they're not addressed early on. Which not only costs the system more money, but it impacts significantly the well-being of that patient."

This interactive tracks the number of primary care doctors available to treat the population, per 100,000 individuals. You can search the trends by county. Note the population density in urban areas as opposed to rural areas.

Banning says the charts below (and this companion interactive tracking Medicaid expenditures) provide a snapshot of the areas that will face access problems for Medicaid patients in 2014 unless more doctors are trained and willing to participate in Medicaid.