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Camp Fire burned out their medical practice. Paradise doctors now start their comeback

Dr. Richard Thorp spent two weeks uncertain whether his small medical group in Paradise could recover after the Camp Fire decimated homes and businesses and thick stands of towering oaks and ponderosa pines.

“It was chaos, and we were struggling to figure out how we were going to continue to exist as an organization, how we were going to pay our employees, how we were going to pay our physicians,” recalled Thorp, the president of Paradise Medical Group. “There was no revenue because we weren’t seeing people in the office. We were making phone calls and seeing people in shelters.”

The toll – business and personal – had been high for the 41 people at Paradise Medical Group: They had lost the largest building on their small campus to the fire. The hospital where the group’s 12 physicians regularly saw patients was ravaged by fire and closed.

The homes of roughly 75 percent of the group’s staff and doctors had perished in the blaze, estimated Thorp, including his own. Some still had vivid memories of sitting in gridlocked traffic, wondering whether they would survive, as the fire consumed houses on both sides and the explosions of propane tanks got closer and closer.

Thorp, his partners and their team can’t call their comeback story finished yet. That will take years, he said. But they will pause from 11 a.m. to 1 p.m. Friday to celebrate some big first steps, including their return earlier this month to offering medical care at their 6460 Pentz Road headquarters .

The rebirth of Paradise Medical Group would not have happened, Thorp said, if it hadn’t been for an extraordinary “God thing” that he firmly believes was an answer to prayer: “We wouldn’t be in existence if it hadn’t been for that.”

Dr. Richard Thorp, president of Paradise Medical Group stands on the former location of one of their medical offices on Monday, May 6, 2019 in Paradise. Paul Kitagaki Jr.

Chaotic dash for survival

Thorp wanted to talk about the stunning turn of events that saved his practice. But first, he said, he had to explain what it was like on Nov. 8, the date that the Camp Fire upended life in Paradise, and during the chaotic days immediately after that.

He looked out the glass door at an empty plot of land a few dozen feet from the office where he sees patients. A little more than six months ago, the red dirt covering that patch of land wouldn’t have been visible. There used to be a building there where 20 or so doctors and staff cared for patients, he said.

Walt Taber, the medical group’s information technology manager, was the last medical group employee to leave the campus on Nov. 8 and the last to see that building still standing.

“By 8:15 (a.m.), it started to get very dark here – very, very dark – and then embers were falling...everywhere,” he said. “But there was an office (building) right here, and the little garden near it had wood chips that caught on fire. But patients were still coming.”

People simply didn’t expect the fire to come across the canyon, Taber said, because so many other fires had stopped before reaching Paradise. On his way into work, he said, he had even seen parents dropping their children off at school.

Taber said he decided to leave the Pentz Road after embers grew from the size of snowflakes to the size of dollar bills and the ominous sounds of exploding propane tanks grew more frequent.

He dashed to the server room to gather the latest backups from computer files, he said, and he stuffed them into a storage compartment on his motorcycle. Too late, he realized he didn’t have enough gas to get out of town.

The traffic was bumper to bumper, he said, and for once, the size of his bike was no advantage. Too many cars had been abandoned on the roadside or had gotten wedged between trees as owners tried to cut past the long line of traffic, he said.

After a while, he found a gas station where cars were lined up at the pump. But after pulling in it, he said, he discovered there was no power.

He watched as the Butte County sheriff and his daughter, a Paradise police officer, grabbed stranded people by their collars, stopped passing cars and shoved them inside. He finally managed to buy some fuel from a motorist who happened to have full five-gallon gas can in his vehicle.

Dr. David Russell and other medical personnel evacuate patients as the Feather River Hospital burns while the Camp Fire rages through Paradise, Calif., on Thursday, Nov. 8, 2018. Noah Berger AP

A struggle to provide care

Because of the devastation in Paradise, many of the medical group’s patients relocated to other California communities – Redding, the Bay Area, Chico, Sacramento, Napa Valley, the Central Valley, Los Angeles – but some even moved out of state, Thorp said. In the days immediately after the Camp Fire, he and other members of his medical team focused on ensuring that rural Butte County residents who had sheltered in place and those who were dislocated had access to medical care.

A former president of the California Medical Association, Thorp connected regularly with the doctor group’s chief executive officer, Dustin Corcoran, to provide updates on access to care and to seek counsel on potential solutions to problems. Adventist Health had long run a rural health clinic in Paradise, Thorp said, and Paradise Medical Group had employed the doctors who worked there. Thorp was anxious to see it reopened, he said, because the region’s residents needed nearby access to medical care.

Paradise and other rural areas around it have long had a shortage of primary care providers even before the Camp Fire shut down the Feather River hospital and left the future of Thorp’s group uncertain. The U.S. Bureau of Health Workforce considers a geographic region as having a shortage if the ratio of patients to primary care providers equals or exceeds 3,500 patients to one provider.

The Paradise, Magalia and Stirling City area comes in close to the line with a ratio of 3,763 to 1, but the Oroville area has a ratio of 5,063 to 1 and the Butte Meadows and Forest Ranch area, bordering Lassen National Forest, a ratio of 4,877 to 1.

“I was concerned about the clinic, how that was going to be restructured,” Thorp said. “I’m only telling you this to say that the conversations were not so much about Paradise Medical Group, as they were about how we find another way to solve this problem for a number of medically indigent folks.”

But as he and Corcoran talked, Thorp said, it became apparent that he and his partners weren’t certain they had the payroll to keep doctors and other medical personnel in the region.

A welcome call

One day, Corcoran called up Thorp and asked: “Hey, do you have a few minutes to talk to Paul Markovich?” Corcoran had to remind him: “He’s the CEO of Blue Shield.”

A few weeks before the fire hit Paradise, Thorp said, he had welcomed a Blue Shield team to the medical group’s offices on Pentz Road. Blue Shield, which covers about 1,000 of the medical group’s patients, had committed $30 million to a pilot project with the CMA, developing what the primary care office of the future would look like, Thorp said, and his team in Paradise was one of the medical groups that had been chosen for the evolution.

Thorp said he wasn’t sure what to expect from Markovich’s call since the future of Paradise Medical Group was very much in doubt.

Markovich told The Bee, during a telephone interview, that the thought uppermost in his mind was that Paradise residents “could lose access to physician services completely, not just for a few weeks or a for month but potentially for years.” That, he said, was difficult to digest.

“They didn’t have a building,” he said. “They don’t have access to all their records. They don’t know how they’re going to make payroll.”

Markovich said he connected with Thorp the Monday before Thanksgiving and told him: ‘The plan is gone. What do you need?”

Thorp expressed concern about meeting payroll and equipping a facility in Paradise where the doctors could see patients in the region, Markovich said. The medical group had worked with Enloe Medical Center in Chico to get a space to see patients, Thorp said, because so many had relocated near or in that city. All the equipment they had left in Paradise had been moved down to that facility.

Markovich asked him how much money it would take to shore up payroll and get equipment. The figure was roughly $2 million.

After hearing the number, Markovich said he told Thorp: “‘I don’t want you to worry about this. I don’t want your physicians to worry about this. You’re going to get that money before Thanksgiving.’ That covered about three months of payroll.”

Thorp said at first he was thrown by the offer, “But it became pretty clear that there were no strings attached, and it wasn’t a loan, so within a couple of days, we had money in the bank that gave us the security to be able to move ahead and not feel like we were going to have to declare bankruptcy or worry about one week to the next.”

Adventist Health also pledged to provide 90 days of payroll support to the medical group right after the fire, Thorp said, but Blue Shield’s gift allowed them to think beyond immediate concerns.

In some ways, Markovich and Thorp said, the fire has helped Paradise Medical Group, giving it technology to start transforming into the primary care office of the future. It has also added challenges, such as a new billing process.

Still, Thorp said, his practice is in a much better position than it was in November.

The Blue Shield capital infusion “gave us the stability to be able to plan a little further down the road and not just look at what’s going to happen this week or next week,” Thorp said. “Our medical group was able to say, ‘OK, we are going to be here for another year, it looks like, at least, so let’s start looking at what that means. How do we make that optimal? How do we make sure we have the best presence possible in Chico? How do we have the best presence possible in Paradise?”

He added: “We got to start looking at those types of questions rather than: ‘Can we make payroll next week?’”

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Cathie Anderson covers health care for The Bee. Growing up, her blue-collar parents paid out of pocket for care. She joined The Bee in 2002, with roles including business columnist and features editor. She previously worked at papers including the Dallas Morning News, Detroit News and Austin American-Statesman.