Marin General explores response to doctor shortage

MARIN COUNTY – The number of physicians connected with Marin General Hospital is expected to significantly decline in the next few years as many near retirement, in some cases all in one specialty area, and the health care district is accelerating a region-wide effort to address recruitment, including the possibility of developing a joint outpatient or medical center.

According to a report presented to the Marin Healthcare District, the hospital is in critical need of enlisting new providers in 11 specialty areas. The public organization readying to take over administration of the hospital from Sutter Health next summer is collaborating with other local groups on strategies for attracting new professionals to the area, including collaboration with the Marin Individual Practice Association and Prima Medical Group, the largest in the county.

“Under the district’s leadership as a freestanding hospital the opportunity for local collaboration will be multiple, with Kaiser, with the physician population, with the county. We have had preliminary talks with all of them, and all have expressed interest in working together,” said district Chief Executive Officer Lee Domanico.

The report commissioned by the district and prepared by The Camden Group found that all of the county’s specialists in nephrology, podiatry and ophthalmology are older than 60, and at least 80 percent to 96 percent of doctors in gastroenterology, psychiatry and head, neck and throat care are in the same age bracket. Recruitment will also soon be needed in family medicine, cardiology, cardiovascular surgery, OB/GYN and orthopedic care.

Researchers conducted an online survey as part of the report and physicians overwhelmingly agreed that the best way the hospital can support their practices would be with recruitment, specifically by creating some kind of joint medical office building or urgent care center. The survey also found an increasing trend of patients migrating out of the county for care, in large part due to referrals from local providers who either didn’t have the time or the expertise.

The need for services at the hospital is also expected to increase as the Marin County population 65 and older is growing the fastest, an estimated 8.1 percent between now and 2012. The hospital’s total number of patient days is also rising, and its market share of about 42 percent has been consistent.

Mr. Domanico said the district is currently gauging the interest among local physicians in a joint venture, and officials will soon write a development plan. He said the center would mostly likely be on the hospital property or in close vicinity.

Hospitals in the North Bay that have either established or are working toward developing some kind of association with a medical group include Healdsburg District Hospital, Palm Drive Hospital in Sebastopol and St. Joseph Health System in Sonoma County. Sutter operates the largest of these groups, the Sutter Medical Foundation–North Bay, and Petaluma, Sonoma Valley and others are in the process of developing their own version.

The groups have so far proven a successful model for attracting physicians as the cost of running an office escalates. The health care organization covers the administrative part of the business, making it easier for doctors to set up shop.

At the same time, the hospitals also benefit from referrals from the facilities typically with a majority of insured patients, particularly if the outpatient center is on hospital property.