Stanislaus County loses more medical specialists. What’s the solution for patients?
The Stanislaus County health services specialty clinic has lost three medical specialists in the past year and has not replaced them, reducing access to care for some of the county’s poorest residents.
The county’s specialty clinic in the black glass building on McHenry has accepted patients from safety-net clinics who otherwise would be desperate to find care for their health problems.
Mary Ann Lilly, managing director of the county Health Services Agency, said one of the specialists retired and two doctors died unexpectedly last year.
The county has tried to get appointments for patients at other offices in Modesto, which are overwhelmed, and some patients are sent outside the county to Stockton or beyond.
San Joaquin County General Hospital has services for Medi-Cal patients and low-income adults, and children may be sent to Valley Children’s Healthcare in Madera, Lilly said.
The director said the remaining physicians who see patients in the McHenry clinic are stretched thin, exacerbating a shortage of primary care doctors and specialists in the community.
The clinic lost a general surgeon, a neurologist and an orthopedist. Because most patients served at the clinic are Medi-Cal enrollees and are signed up with a managed-care network, the county attempts to work with the health plans to connect them with other providers.
“We have a shortage in our area,” Lilly said. “We need more physicians.”
The county health system continues to shrink, with three primary care health clinics outsourced to other organizations in 2019. At least one former county supervisor has said the county should get out of health care entirely.
The specialty clinic still has six doctors working part time: a general surgeon, a neurologist, an orthopedist, a sports medicine specialist, a diabetologist and a urologist. About 4,500 patient visits are recorded each year.
Lilly said the specialists are community doctors with their own practices who spend some time in the clinic. Filling the gaps in staffing would involve bringing in other community physicians, she said.
The San Joaquin Valley has suffered for decades from a shortage of medical specialists; the ratio is 83 specialists per 100,000 population, compared to 131 per 100,000 statewide, according to the California Health Care Foundation’s Almanac for 2020.
A constant health issue
The shortage of specialists is a constant issue for Golden Valley Health Centers, a nonprofit system that mostly has focused on primary care for low-income residents.
While Golden Valley often has referred its patients to the county specialty clinic, it recently has done more to contract with specialists or add them to its staff. The health centers’ list of specialty services includes podiatry, nephrology, general surgery, cardiology and behavioral health.
Golden Valley is recruiting for several positions. Attrition, retirement and burnout in the health care workforce have contributed to the physician shortage, a spokeswoman said.
“I would say that’s a problem,” said Amy Collier Carroll, GVHC’s vice president and chief communications officer, referring to the shrinking capacity of the county clinic. “For all health care providers, it is hard to attract specialists to this area when there is more money to be made elsewhere.”
Carroll said telehealth appointments increasingly are arranged for patients needing a specialist.
Lilly encouraged patients who need specialty care to talk with their primary care office about finding options.
