EL PASO, Texas -

A new report lists El Paso as the second worst large city in the U.S. when it comes to the number of doctors for residents.

With more people having access to insurance more will need access to doctors. Will the Borderland's physicians be overwhelmed?

Dr. Andres Enriquez already sees as many patients as he can handle. At his clinic on the West Side, the doctor retains a staff of more than 20 physician's assistants, nurses and assistants to manage them all.

"They said 'Dr. Enriquez, sometimes you have a wait time of almost an hour,'" Enriquez said. "um, yeah. Sometimes I do."

Enriquez already accepts Medicare and Medicaid -- both programs he admits return a fraction of his cost.
     
He anticipates those patients with new insurance coverage under the Affordable Care Act could spell more of the same.
     
"I'll be honest with you, what concerns me the most is going to be reimbursements," Enriquez said. "If it's not a fair reimbursement, I can't afford to take patients like that."
     
When you step into the doctor's lobby you can see there's plenty of people waiting for their appointments.
     
And with the potential of more patients coming down the pike, the wait could get longer for all doctors.

"When you ask me what I'm going to do next year -- I don't know," Enriquez said. " I've got a lot of viejitos and I love my viejitos, my 80 years olds and they keep asking me, 'Are you going to continue to see us?' and I say, 'well, I will, as long as I can. Because at the same time I've got 23 families to feed. I've got 23 employees."

Medical website vitals.com ranks the city of El Paso as the second worst when it comes to number of doctors per resident in its new study of doctor shortages.
     
With just more than 1,100 primary care doctors in town to serve a population of almost 650,000 residents, El Paso's doctor-to-resident ratio is 1-to-590.
     
Compare that to Boston, where there is a doctor for every 83 residents there.

Enriquez says the Borderland's physician shortage in El Paso has been a problem for a long time and it isn't getting better.
      
Trying to find true physicians of the frontera -- who understand the culture and are willing to make sacrifices is hard to find.

'I've got Mrs. Rodriguez over here, saying 'just see me and I'll pay you with a rosary,'" he said. "'alright, ''ll take your enchiladas this time.' So I mean, what do you do?"