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Is A New Medical School The Answer To The Valley's Doctor Shortage?

Jul 12, 2016

Have you ever called your doctor or hospital seeking an appointment and been told the wait will be weeks or maybe months? You have been affected by the Central Valley’s doctor shortage.

Now more than one group is pushing a potential solution, locally sourced doctors from a new medical school.

Being in a waiting room at the doctor’s office isn’t the most pleasant place to be.

But waiting to get into that waiting room can be even worse.

That is what health care experts call a ‘doctor shortage’ and in the valley it’s bad.

The Central Valley has about half the doctors per 100,000 people compared to places like the Bay Area. But even compared to the state average, the San Joaquin Valley has about 50% fewer doctors. And when you dig into high demand specialists the picture can be even bleaker.

The answer, according to people in both the private and public sector, is a medical school dedicated to the Central Valley.

“Most of the medical literature I have ever read always suggest medical school and residency is how you can retain, keep physicians locally,” Arambula says.

"I don't care how this cat gets skinned. I care that it gets done," Joaquin Arambula

Newly minted Assemblymember Joaquin Arambula, a physician who represents the 31st district, has made bringing medical school to the Valley a main promise.

Arambula says establishing a medical school would keep students in the valley throughout their education making it more likely they stay long term.

“Now the question is how. And how soon. And what does it look like? And there are a lot of question that we don’t have answers to. At the end of the day, to be as forthcoming as I can, I don’t care how this cat gets skinned. I care that it gets done,” Arambula says.

Arambula thinks an ideal situation would be establishing the school at UC Merced. However, he says he has had meetings with two private groups, including the Assemi family, about building a private medical school.

The Assemis founded the California Health Sciences University, which is a private pharmacy school in Clovis. The family is also a donor to Valley Public Radio.

Source: https://www.fresnostate.edu/chhs/ccchhs/documents/hps-report.pdf

   

 Provost Wendy Duncan says the vision is to slowly add additional programs over the next 15 years until the school can offer a full range of education up to a physician’s residency.

“Oh my goodness yes, there is huge demand. Whenever we talk about the need for particular kinds of health care providers people’s eyes light up because they know there is a huge need. The wait times for primary care are getting to be ridiculously long,” Duncan says.

No matter if it is private or public, medical schools are expensive costing $100-million or more.

But the evidence of people staying in an area where they do their residency is conflicting. Industry research says in California, which is a popular destination for students and doctors, upwards of 75% of students stay here after they do their residency.

However, for the residency program at UCSF Fresno only about 30% of those students stay and work in the Central Valley. So why not cut out the middleman and just bring in established doctors?

“It’s pretty difficult actually to convince physicians to come to Fresno,”

Jolie Limon is Chief of Pediatrics with Valley Children’s Hospital.

She says their focus is on recruiting outside doctors to the valley but that has its own challenges since doctors can go just about anywhere in the country.

“It’s Central California. It is not right at the beach. It is not right in the mountains. We do have a large underserved population and maybe that is not attractive to people. And I think it’s just generally, outside people out of the state have a perception of California and this is not what it is,”

Limon is skeptical that establishing a new medical school would result in a material increase in the number of doctors working here, saying it's more about finding doctors who want to live a valley lifestyle.

Not to mention building a new medical school, training the doctors, and convincing them to stay will take years. The valley has a doctor shortage right now. Especially when the population is growing and many newly insured people seeking out all kinds of care.

While strongly supporting the idea of a medical school, John Capitman with the Central Valley Health Policy Institute says it can’t be the only step taken to improve access to health care, pointing to other options like Licensed Practical Nurses, allowing pharmacists to have limited prescribing ability, and establishing Patient Centered Medical Homes.

“So that is another example of a frame work, the intent of which is to broaden the health care work force so it is not just doctors and nurses,” Capitman said.

Freeing up pharmacists’ to do more is an idea that is getting kicked around Sacramento, and one that is supported by the local private pharmacy school.

Whether it is building a new school, recruiting existing docs to the Valley, or broadening who can provide what health care, the problems with access are unlikely to vanish anytime soon.