Kristina Rodriguez grew up in Healdsburg caring for her ailing grandfather, an immigrant from central Mexico who raised his family while working on railroads in Northern California. The experience tending to a loved one through a progression of problems — from intense stomach pains to diabetes and liver failure — gave Rodriguez a glimpse into the complicated world of health care.
What really struck her, however, was something simple: Her grandfather’s deep relationship with his primary care doctor.
“He struggled so much in his life, so seeing the doctors really care about him and his health meant so much to me,” she said. “They developed such a strong relationship that his doctor even came to his funeral when he passed away.”
Now Rodriguez, 23, wants to join the ranks of local family doctors. This summer, she was one of six people selected for a fast-track joint medical program offered by the UC Davis School of Medicine in partnership with Kaiser Permanente.
The three-year program, shortened from the standard four-year medical education, is the first of its kind in California. It aims to fill what health care officials and medical experts call a perilous shortage of primary care physicians nationwide.
The dwindling supply of family practitioners, who handle patient needs including childbirth, preventive care, obstetrics and gynecology, is a not a new problem; but it is growing more pronounced as graduating physicians — faced with hefty six-digit student loan debt — instead choose fields where they can make more money or have more flexible schedules.
Among doctors and medical students, the rigors and sacrifices of primary care medicine are well known.
“Primary care is one of the most complex and demanding fields,” said Mary Maddux-Gonzalez, chief medical officer for the Redwood Community Health Coalition, a network of 17 community health centers in Sonoma, Marin, Napa and Yolo counties. “There’s the medical school debt and low Medi-Cal reimbursement rates, and then you’re asked to provide a full scope of practice to patient populations that vary widely.”
In Sonoma County, patients and providers are feeling the pinch. With about 70,000 people who became newly eligible for coverage on Jan. 1 after the rollout of President Barack Obama’s Affordable Care Act, county health officials say the demand for doctors far outweighs the supply.
Nearly four times as many primary care physicians are needed than are practicing in the county today, according to a recent study by the county’s Department of Health Services and the Sonoma County Medical Association.
Sonoma County has 488 primary care physicians, and health officials say the county needs 2,331 to meet the needs of its 495,000 residents.
The problem is mirrored throughout the state and across the nation. In California, all 58 counties are experiencing a primary care doctor shortage to some degree, with rural areas suffering the biggest shortfalls.
The problem is getting worse as millions of Americans become newly eligible for health coverage and seek care. The country is projected to be short 45,000 primary care doctors from what it will need in 2020, according to the American Association of Medical Colleges.
“Producing enough future primary care physicians is absolutely a challenge,” said Andrew Bindman, a physician and professor at UC San Francisco who has studied doctor shortages. “Part of my concern is the number of new people coming into the field to replace those who are retiring.”
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