As doctors leave, Medi-Cal options vanish

After 29 years of running a local family practice, Dr. Jerry Connell is retiring and closing the doors to his Santa Rosa medical office on Sept. 26.

It appears those doors will never open again because no doctor is willing to take his place.

In a letter to his patients, he said he's been unable to "entice another physician to take over our practice."

One option, he tells them, is to go to one of four local doctors accepting new patients (though two of are not taking Medicare).

But for those with a health care card that says Medi-Cal, instead of a private health insurance carrier, the options are few and not encouraging.

The letter states: "For those of you with Medi-Cal, contact the Southwest Community Clinic at 547-2222 as soon as you can because you MUST call this number to be put on a waiting list to be an established patient or they will not see you if you have an emergency cold or such."

Connell said his retirement will especially hurt 50 longtime Medi-Cal patients, about 5 percent of his practice, because many doctors no longer will accept them.

He worries that the consequences of low payments to physicians from Medi-Cal and Medicare will soon become widespread, as older doctors retire and younger ones join Kaiser, which pays an annual salary, or move to locations where the cost of running a practice makes sense.

Thirty-five years ago, doctors could "survive" on Medi-Cal reimbursements, Connell said. Now, Connell's Medi-Cal reimbursement per patient visit is about $24, less than half of his $50 overhead cost for that visit.

"In approximately five years," Connell said, "there will be a number of other practices that will disappear in Sonoma County, and there will be essentially no one that somebody can call, 'My doctor.' "

Brad Drexler, an obstetrics and gynecology specialist in Healdsburg, said he stopped taking new Medi-Cal patients at his practice several years ago because the numbers simply didn't add up.

Drexler, the current president of the Sonoma County Medical Association, said that while Medi-Cal patients made up only 10 percent of his practice, "my billers were spending 90 percent of their time on these patients."

Dr. David Charp, an internal medicine physician in Santa Rosa, said he gets a Medi-Cal reimbursement of $20 to $21 per office visit.

He hasn't taken new Medi-Cal patients for well over five years. The few he does see -- about 10 percent of his load -- have been with him for years, or are referred from Santa Rosa Memorial Hospital when no one else will take them.

"It costs me about $30 in office overhead for a 15 to 20-minute visit," said Charp. "I'm seeing about 10 people a week in that situation . . . That's when Medi-Cal even pays."