Opinion Columns & Blogs

Congress must save program that trains doctors in Modesto

Two years ago, Nicole McLawrence was in her second year of residency in family medicine when she joined critical care technician Kenneth Perkins to view a patient’s data. Now she is in practice in Modesto.
Two years ago, Nicole McLawrence was in her second year of residency in family medicine when she joined critical care technician Kenneth Perkins to view a patient’s data. Now she is in practice in Modesto. jwestberg@modbee.com

A federal program helping Stanislaus County address its serious shortage of primary care physicians is set to expire Sept. 30 unless our members of Congress take immediate action.

The Valley Consortium for Medical Education, a teaching health center, is training 32 physicians who deliver much-need and irreplaceable care to several thousand patients each year.

Teaching Health Centers like the Valley Consortium train medical school graduates as primary care physicians in community-based residency programs, usually clinics. This differs from training in traditional residencies, which are mostly in hospitals. These teaching centers prepare future physicians to serve in rural and other underserved areas by training them in just such communities.

Physicians who train in rural settings are three times more likely to practice in rural settings after completing their residencies.

This is especially important in Stanislaus County, where clinics in Patterson and Turlock were forced to close in 2015 when they couldn’t find enough primary care physicians to see patients. Other area clinics also are struggling to get enough doctors. As a result, patients often face long waits for appointments, have to travel long distances to see a doctor and sometimes have trouble finding a physician to see them at all.

Primary care physicians are a critical part of our healthcare system because they provide preventive screenings and expert management of chronic conditions.

We need more of them, which is why the “Teaching Health Centers Graduate Medical Education Extension Act of 2017” has bipartisan support in Congress with 67 co-sponsors. Californian representatives Jeff Denham, John Garamendi and David Valadao are among 11 co-sponsors from California. We urge their colleagues to support continued THC funding.

This care is much-needed in Stanislaus County, which ranked second highest in the state for deaths caused by colorectal cancer and coronary heart disease and third highest in the state for deaths from breast cancer, according to a 2016 report by the California Department of Public Health. The same study showed that death rates for colorectal cancer, breast cancer, lung cancer, prostate cancer, Alzheimer’s Disease, stroke, influenza/pneumonia and AIDS all rose over the previous two-year reporting period.

Since its inception in 2010, the Valley Family Medicine Residency of Modesto – based in the socioeconomically disadvantaged neighborhood of West Modesto – has graduated 75 residents, with well more than a third staying to work in the Central Valley. Many are serving in safety-net settings, helping the most disadvantaged patients.

We are entering our seventh year, which is most critical from a funding standpoint. From the outset, a large portion of our funding came from the Teaching Health Center grant; but it will expire on Sept. 30. When it does, our sponsoring institution will face an extreme fiscal barrier to sustaining all the doctors who are participating in the program.

Originally, our program was accredited as a 10-10-10 program, meaning there were 10 residents doctors in each of three cohorts within the three-year program. But we were able to show robust volume and high-caliber residents and we were allowed to increase the programs to 12-12-12 in July, 2015.

But this increase came just as there were changes in the political climate at the federal level, placing the longevity of our teaching center in jeopardy.

In the face of uncertainty, our sponsoring institution made the difficult decision to allow only nine incoming residents for our class of 2020. Without supplemental funding, we risk having to contract our program even further, with the next two cohorts also at nine doctors – a trend that flies in the face of the critical shortage of physicians in this region. Considering that every physician-in-training provides thousands of patient-care hours each year, this will mean a real reduction in medical care to thousands of people in our community.

Several parts of Stanislaus County are designated as Primary Care Health Professional Shortage Areas by the Office of Statewide Health Planning and Development. These areas, often rural and poor, are particularly underserved.

Allowing more doctors to serve their residencies here will reduce the primary care physician shortage and improve patient care. That will improve healthcare outcomes and decrease costs. We urge Congress to reauthorize and fully fund THCs.

Dr. Kate Kearns is director of the Family Medicine Residency program at Valley Consortium for Medical Education, and a practicing family physician in Modesto. Dr. Michelle Quiogue, FAAFP, is president of the California Academy of Family Physicians and a practicing family physician in Bakersfield.