As one of the fastest growing regions of California, the San Joaquin Valley’s persistent shortage of health care providers is creating a public health crisis with no easy solutions in sight. Fully addressing the situation will require a multi-pronged strategy, including expanding medical school opportunities in the Valley and providing debt relief for graduates who agree to stay and practice medicine here.
On that first point, we have good news to share.
Last week, Gov. Jerry Brown signed a new bill into law creating the UCSF San Joaquin Valley Regional Medical Education Endowment Fund. The fund is solely dedicating to supporting annual operating costs and development of a branch campus of UCSF’s School of Medicine in the San Joaquin Valley. The goal is to support 50 students per class for 10 years which would go a long way toward reducing the shortage of physicians in our area.
Last year, Legacy Health Endowment worked with Livingston Community Health and CSU Stanislaus to create a new Master’s in Family Medicine, which will graduate 23 nurse practitioners in December 2019. Under the supervision of a physician, nurse practitioners can improve access to care for patients and help alleviate our region’s shortage of providers.
These advancements are critically important because the scarcity of physicians in the Valley is growing worse by the day. The Robert Graham Foundation released a report in 2017 showing that California’s primary care physician shortage will exceed 8,000 doctors by 2030.
The Valley already has just 71 primary care physicians per 100,000 residents compared to 86 per 100,000 in the rest of the state. That gap will only get worse over the next 7 to 10 years.
Graduating physicians and nurse practitioners locally is critical, but is insufficient by itself. We also must address the debt these practitioners face upon graduation. LHE already has taken action by offering NP graduates the opportunity live and work in Stanislaus and Merced counties debt free once they graduate. In fact, 15 of the initial 23 students have agreed to do just that.
Next, we want to create a similar program for medical school graduates. Upon completion of their residency programs, young doctors often find themselves heavily in debt, from $150,000 to $300,000 or more. Many look to work in communities, and for health systems, providing a debt-relief program. Such programs are lacking in the Central Valley. Many employers who offer them, do not focus on the poor, immigrants, or undocumented workers – nor on middle-class individuals who can only afford high-deductible health insurance plans.
By creating a physician debt relief program and coupling it with a new UCSF School of Medicine branch campus, we can make a significant dent in reducing the shortage of primary care physicians and specialists and significantly improve access to care.
Last month, New York University Medical School announced that all current and future students would receive full-tuition scholarships. Of 151 medical schools in the United States, NYU is the first to offer free tuition to medical students.
Imagine the impact a similar program would have here in the San Joaquin Valley through the UCSF Medical School, targeting students who agree to live and work in our medically underserved communities. By educating our own doctors, nurses and nurse practitioners in the Valley, and providing debt relief for those who choose to live and work here upon graduation, we can go a long way toward improving our own healthcare infrastructure and quality of life.
These challenges are not new; the debate has gone on for years with little or no change. It’s time to take specific action that leads to real results. We cannot ignore Medi-Cal patients, and we cannot forget about the middle class.