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Written by Donald A. Promnitz
In the San Joaquin Valley, there has been a severe shortage of workers that has made access to health care increasingly difficult — especially in the poorer parts of the region.
Added onto this problem is the fact that the physicians in the Valley are getting older. The Robert Graham Center, which studies family medicine and primary care policies, found that California will need more than 8,200 primary care physicians by 2030 to cover the doctors going into retirement. The issue is being felt even more so in the San Joaquin Valley.
According to a 2015 research report by the Healthcare Center at UCSF, 29 percent of physicians in Fresno County are older than 60, while the number in Madera County is 24 percent. In Tulare and Kings County, the percentages of physicians in this age bracket are 38 and 39 respectively. This is compared to an average of only 17 percent of doctors older than 60 statewide. USCF Fresno Dean Dr. Michael Peterson said that this has led to a race against the clock to get new, younger doctors into the regional workforce.
“So about 30 percent of the physicians practicing right now in the Central Valley… are likely to retire somewhere in the next 10 to 15 years,” Peterson said. “So unless we work aggressively at bringing up the younger physicians to fill those gaps, it’s going to be even worse.”
One of the biggest reasons for the severe lack of physicians (especially younger ones) has been a lack of places to educate doctors. To meet this need, California Health Sciences University (CHSU) broke ground in May on a new osteopathic medical school in Clovis. Dr. John Graneto, the dean for proposed College of Osteopathic Medicine at California Health Sciences University, said that if they succeed with their accreditation, they will have the first full, four-year medical school in the Valley.
Graneto and Peterson both stated that a student is far more likely to work in the area where they are from and where they were educated. Doctors are also more likely to stay in the area where they completed their residencies. The main problem, then, has been a lack of places to study and a shortage of residencies.
“We hope to combine all three of those factors as we look at expanding the opportunities to provide residencies in our region to give local medical students the best incentive to remain here and practice,” Graneto said.
Administrators at CHSU hope to matriculate their first 150-student class in 2020. The dean further stated that osteopathic medicine has a tradition of training primary care physicians, a practice severely lacking as more and more young doctors go on to become specialists.
Meanwhile UCSF Fresno has been designated as a “branch campus” by the San Francisco-based medical school. Starting in the fall of 2019, it is hoped that 12 students at the UCSF branch will be doing their studies in Fresno, including two-and-a-half years of clinical work. Over time, it’s hoped that this number will reach 50.
According to Peterson somewhere between 45 and 55 percent of residents and fellows that graduate each year out of their current program stay in the region. Bringing in students from the area, he said, could potentially give them a 70 percent retention rate.
Many of these students will be able to get this work experience through UCSF Fresno’s partnerships with Community Regional Medical Center and the Veteran’s Administration hospital. Alongside these partnerships, more flexible electives are now available. There are talks planned, Peterson said, with other hospitals and rural clinics.
As for partnership, both deans have expressed a willingness to collaborate to face the shrinking number of Valley physicians. Peterson speculated that CHSU students would have the ability to practice with UCSF Fresno in their fourth year. Meanwhile, Graneto said that they hope to have their students collaborating across multiple professions.
With a wave of retirements on the way, Peterson said there is likely to be a dip in the number of doctors available. However, they hope that in time, a growing number of newer, younger physicians will step in to fill that void, many of them being local.
“They’re comfortable with it,” he said. “Their families are in the Valley, they know all the positive advantages of living in the Valley and working in the Valley.”
BY THE NUMBERS
The percentage of doctors over age 60 in the Central Valley
29 percent in Fresno County
24 percent in Madera County
38 percent in Tulare County
39 percent in Kings County
Source: 2015 research report by the Healthcare Center at UCSF