Will loss of doctors add to local health care crisis?

In response to the Sept. 18, front-page story of doctor shortages, I want to let your readers know that, by my count, at least 14 specialist physicians have also left Santa Rosa in the last 18 months.

I bet every reader out there knows of at least one doctor who left. My list probably underestimates the actual number. These specialists include obstetricians, cardiologists, neurosurgeons, anesthesiologists, orthopedic surgeons and general surgeons. These doctors left for Kaiser, other cities in California, Nevada and places such as Bellingham, Wash., and Richmond, Va. While these communities are now richer with our talent, we in Sonoma County suffer.

In our quarterly staff meetings, the number of doctor resignations outnumbers new medical staff. The morale among Memorial Hospital's medical staff is at an all-time low. The patented reply of Santa Rosa Memorial Hospital is that these doctors left due to circumstances beyond its control such as low Medicare reimbursement rates, high cost of doing business in California and high cost of living. But one factor that I never see reported is the hospital itself. The problems health care professionals encounter in day-to-day care at this hospital could fill pages. The focus is more on cost-cutting than on patient care. Physician and hospital administration communication is one-sided.

Memorial's response to this crisis is that doctors and nurses are chronic whiners, and they can be replaced by new hires.

I recently received a survey from Memorial asking me what direction should be taken in hiring future doctors. I answered by asking Memorial to do something to keep the doctors it already has rather than looking for new doctors. Hiring is not being proactive, it is a reactionary response.

I estimate it costs the hospital fives times more to hire new doctors than to retain physicians it already has.

Memorial offers little incentive for doctors to stay. The hospital does not recognize there is talent among its physician roster. As Joni Mitchell once sang, "You don't know what you've got 'til it's gone."

Memorial has to work harder at physician retention. As with all businesses here, Memorial is betting that it is so ideal to live in Sonoma County, no one would consider leaving. A colleague told me that if this was not such a desirable place, many more doctors and nurses would have already jumped ship.

What should Memorial do? It could start by listening and responding to physician and nursing concerns, better organize its system of care delivery and health information, focus on the patient not on budget cuts and not bow to pressure from its headquarters in Orange County. The delivery of health care is unique to this community. We are underserved, and the problem is growing.

The people of Santa Rosa should tell the Memorial Hospital board of directors there is a crisis, and something should be done. The public has to participate in the discussion of how local hospitals are run. You may not think this is your concern, but it will be when your doctor leaves.

Dr. Robert E. Khoo, based in Santa Rosa, specializes in colon and rectal surgery.