According to the California Health Care Foundation, a 2011 survey shows there are 128 physicians per 100,000 people in Fresno, and 194 physicians per 100,000 population in the state of California. Of these only 47 and 64, respectively, are primary care physicians. The remaining health care professionals are specialists.

A study conducted by the Robert Graham Center projected that in order to maintain current rates of utilization, California will need an additional 8,243 primary care physicians by 2030 — a 32-percent increase compared to the state’s 25,153 primary care physician workforce in 2010. This only accounts for the needs of a growing and aging population, not the increasing demand for services that has been sparked by the Affordable Care Act (ACA). Even with proposed changes coming, Republican leaders have said the clause that insurance companies can no longer reject people based on pre-existing conditions will remain, thus maintaining much of the recent demand.

“The only thing we know for sure is health care revenue is coming down so we have to have a more efficient and cohesive way of delivering service and taking care of the population,” California Health Sciences University (CHSU) President Florence Dunn said.

CHSU and other educational institutions throughout the Central Valley are implementing and increasing course offerings to prepare students to go into the medical field to help meet the growing demand.

Founded in 2012, CHSU offers doctoral and post-graduate programs to students and health care professionals in an effort to remedy the shortage of health care services offered in the Valley.

The campus currently boasts a College of Pharmacy and is now preparing the launch of its second college, the College of Osteopathic Medicine. A handful of other colleges are planned in the future as CHSU firmly plants the roots for its medical college on a 60-acre campus in Clovis, just steps away from Clovis Community Medical Center.  

“When you talk about meeting the demand in the Central Valley, I think we’re just scratching the surface,” Dunn said. “Right now, there are a lot of pharmacy schools in the state of California, but unfortunately there is mal-distribution and there are a lot of rural cities that do not have enough pharmacists.”

The goal of CHSU, Dunn said, is to recruit and retain. The hope is that pharmacists and medical professionals educated in the Central Valley will choose to stay and work in the area. The campus also gives preference to local students in the hopes of addressing the long lamented “brain drain” that occurs when smart and talented students go off to college somewhere else and don’t come back to the Valley.

Dr. Douglas Wood, who was recently named the founding dean of CHSU’s College of Osteopathic Medicine, said it goes beyond reversing the “brain drain”. Wood has had experience as the founding dean of another College of Osteopathic Medicine in Arizona and said the climate there was similar, with rural areas receiving less care and access. Also akin to the Fresno area, he said many potential students in the rural areas assumed they could never go to medical school. Wood said the goal is to encourage these kids, starting with CTE courses and experiences at the high school level, so they are confident. Plus, he said, they don’t all need to be doctors — they need to know there are other options in the medical field, some of which only require an Associate’s degree.

“One of the things that surprises me again and again is you talk to these kids in rural areas who aren’t well served by physicians or health care providers, and a lot of them will say ‘I can never be a physician because of my background’ and I think in a fair number of those cases that is simply not true,” Wood said.

The beauty of offering these students a pathway to pharmacy school or medical school in their region is, not only does it cost less as the students can live at home, but they are more likely to stay and serve their hometown. And Wood, who strongly believes in the value of community medical centers, said having health care professionals in rural areas is vital.

“No matter what there are groups of people out there who do not have the financial wherewithal to seek health care, and I think it is more prominent in the rural areas,” Wood said. “Sometimes what happens in rural areas is they are so rural that people don’t have enough money to put gas in their car to get to where they would get health care. I feel very strongly that we need to do something to provide health care to those who are in need and not necessarily help them drive 100 miles to meet us here, but to have physicians out and around those areas.”

CHSU isn’t the only university striving to provide medical education. University of California San Francisco’s regional campus in Downtown Fresno in known for its medical education program and plays a substantial role in providing health care to residents of the San Joaquin Valley and training medical professionals in the region.

Annually, UCSF Fresno trains 250 medical residents in eight specialties, 10 oral and maxillofacial surgery dental residents, and 50 medical fellows (physicians completing training beyond residency) in 17 subspecialties. There are approximately 300 medical students in the process of earning medical degrees on a rotating basis.

UCSF Fresno collaborates with UC Davis medical school, UC Merced and UCSF to train medical students who want to practice in the Valley. The program, which started in 2011, is called San Joaquin Valley PRIME. Additionally, UCSF Fresno helps prepare middle, high school and college students for careers in health and medicine through a variety of pipeline programs, including the Doctor’s Academy, a program at Sunnyside High School aimed at educationally disadvantaged students who want to pursue career in health and medicine.

At the city college level, Clovis Community College recently secured Measure C funding to expand its Career Technical Education (CTE) offerings. One program that will be offered starting the fall of 2019 is for a Occupational Therapy Assistant — a position with high demand expected to experience growth of 28.6 percent from  2012 to 2022, according to a chart of occupations with the most job openings in the Fresno metropolitan area provided by Clovis Community College. Another program started this upcoming fall is for Rehabilitation Aide.

Linda Thomas, the dean of instruction, career technical education and athletics at Clovis Community College, said the college currently offers vocational programs in health care interpreter, a Hmong course that just started Jan. 23, and in medical terminology, which started on Jan. 9. Clovis Community also has an agreement with CHSU to reserve seats at the pharmacy school for students that go through a medical program that starts at Clovis Community College.

Clovis Community College also offers several pre-professional pathways that have been developed in partnership with Clovis Unified. The pre-professional programs are offered in pharmacy, physician’s assistant, veterinary, optometry, medical and dental. Through these programs, high school students receive advising and guidance on prerequisites needed for local allied health programs.

“Clovis Community College is really excited about expanding in the health care area and helping people get the education to find jobs here in the Valley and hopefully stay here,” Clovis Community College President Lori Bennett said.

While more medical education programs are being offered in the Central Valley, Dunn said this is just the beginning and the community will need to collaborate more to meet the demand for health care professionals.

“I think there is a lot of synergy going on and a lot of it is due to the ACA and constituents — hospitals, physicians, educators and employers — wanting to work together to build a model that is cost effective but also expands delivery,” Dunn said.