I have seen the Central Valley’s dangerous physician shortage first-hand | Opinion

I am a high school junior living in Modesto, and I intend to become a physician and practice in the Central Valley. The prospect is daunting, but I’ve grown up watching what happens when medicine is difficult to access.

My family’s roots in this valley run through its urgent cares, hospital corridors and waiting rooms. Four years ago, my grandfather spent six weeks in a hospital waiting for a surgery delayed not by the complexity of his condition, but by a shortage of professional care.

I understood then what scarcity costs; and the valley’s physician shortage is the same problem, scaled.

I see this problem firsthand while working at the front desk of a local urgent care clinic. Recently, I met a farmer who had worked the same land his entire life. Routine work had begun leaving him breathless, so his primary care physician referred him to a pulmonologist for diagnostic testing. But because no nearby specialists were accepting new patients, he had to drive to Fresno for his appointment.

He is not alone. The San Joaquin Valley has 35% fewer physicians per capita than federal recommendations. Nearly every county in the region has been designated a Health Professional Shortage Area.

The San Joaquin Valley has 138 physicians per 100,000 people, well below the California average of 237. When only primary care physicians are considered, that number narrows down to 39 primary care physicians in the Central Valley per 100,000 people. The national recommendation calls for 80 primary care physicians per 100,000. There are 2.87 million San Joaquin Valley residents within a primary care shortage area.

The consequences are not abstract. In a 2024 survey of Central Valley residents, 50% reported waiting longer than they considered reasonable for a medical appointment. That number reflects more than inconvenience, it reflects diagnoses delayed and conditions allowed to progress when they could have been managed.

That farmer’s breathlessness may be benign, or it may be the early sign of something that, caught in February, looks very different than it will in August.

The shortage is worsening. A significant portion of the valley’s current physicians are projected to retire within the next decade, and the incoming pipeline is nowhere near sufficient to replace them. California will need 10,500 additional primary care providers by 2030. The San Joaquin Valley, which already runs a deficit of roughly 4,100 physicians relative to the state average, will absorb a disproportionate share of that shortfall.

Doctors treating valley patients today are aging out. But who replaces them?

Some programs are trying to answer that question. The San Joaquin Valley PRIME+ BS/MD program, a collaborative effort between UC Merced, UC San Francisco and UCSF Fresno, accepts medical students who commit to practicing in the valley after training.

Additionally, loan forgiveness initiatives exist for physicians who serve in designated shortage areas. And community health worker programs are expanding across underserved regions.

These efforts are real and they matter. But they are not enough.

The valley’s shortage did not develop in a decade and will not be solved by a single pipeline program. It requires sustained investment, policy attention and something harder to legislate: physicians from outside the region choosing to come to the San Joaquin Valley, and local physicians choosing to stay. We need physicians who understand that Stanislaus County is not just a stepping stone to somewhere more convenient.

I intend to be a physician, and I intend to practice here in the Central Valley. Not because no better option exists for me, but because this is where the need is and meeting the needs of all patients is the only reason to practice medicine worth holding onto.

That farmer drove two hours to Fresno. He will drive two hours home. Somewhere in Stanislaus County tonight, someone else is deciding whether a symptom is worth the trip.

It should not be a trip at all.

Sparsh Malhotra is a junior at Joseph A. Gregori High School in Modesto, where he performs medical scribe and front desk duties at a local urgent care. He also conducts biomedical engineering research at UC San Diego and intends to practice medicine in the San Joaquin Valley.