There are a lot of things that Merced doesn’t have a shortage of: Sunshine, fast food restaurants and subdivisions are just a few.
But there is one thing that the county has a shortage of that hurts everyone -- doctors.
Merced County, like the rest of the San Joaquin Valley, is trying to deal with the fact that for some doctors, Merced just isn’t a place they want to be.
This makes Jill Alley’s job extremely difficult. The physician liaison for Mercy Medical Center Merced spent all day Wednesday showing a pediatrician around town. Alley, and the rest of Mercy’s administration, is hoping that this doctor, who came with his wife from New York, will choose Merced as the place where they want to live.
Alley puts out feelers all over the country, including using headhunters to find doctors who may be interested in living and practicing in Merced. But her job isn’t easy.
“It’s not so difficult to get doctors to come here for a visit. The difficulty is in getting them to sign a contract,” Alley said.
The Valley has the lowest rate of doctors per patients of any region in the state. There are 173 doctors for every 100,000 patients here, while statewide the number is 302 doctors per 100,000 patients. That makes it difficult for everyone, but especially the poor and uninsured, to have access to the doctors they need. Some patients wait from weeks to months to see a specialist, such as an orthopedic surgeon or a kidney specialist.
A lot of different factors affect the county’s ability to recruit doctors to the area, the biggest being the demographics of the area.
Mike Sullivan, chief executive officer of Golden Valley Health Centers, a local clinic that is a safety net for the uninsured and poor patients, said that poverty is a big deterrent to doctors.
“A lot of doctors who went to school in other places just aren’t used to the high Hispanic and Asian populations that are here,” Sullivan said. “They want to practice in the same type of area that they grew up in and went to school in.”
The low reimbursement rate that physicians get from Medi-Cal, and the number of indigent patients in the area, also turn off a lot of doctors, Sullivan said. But both his clinic and the hospital have managed to recruit some doctors, though it’s been difficult.
“We recruited a wonderful family practitioner who came to us because her husband was going to teach at the university,” Sullivan said.
But for the majority of physicians, Merced isn’t a hotbed of opportunity, so Sullivan and Alley must make their businesses attractive. The hospital tries to get specialists to come to the area, while Golden Valley works on getting family practice doctors.
Those specialists are a rare breed in the county. David Dunham, president of Mercy, said that the hospital is currently looking for pediatricians, obstetrics doctors, anesthesiologists, radiologists, orthopedic surgeons, general surgeons, neurologists and pulmonologists.
And the lack of those specialists affects Sullivan’s ability to get the family practice doctors he needs. “They don’t have the backup of the specialists to send their patients to, so they pass us by,” he said.
Both the hospital and Golden Valley give incentives to doctors who choose to move here. Mercy has practice assistance for doctors, which includes guaranteeing a base yearly salary and helping the doctor set up the practice.
While Golden Valley can’t match Mercy’s incentives, they have programs in place that can pay off a physician’s student loans.
But there is another huge factor in getting doctors to commit to a practice in Merced, Sullivan said.
“We aren’t just recruiting a doctor, we are recruiting their spouse too,” he said. Spouses are usually highly trained professionals, and the jobs for them just aren’t in Merced. Yet.
“I think that the medical school that UC Merced is planning will change our ability to recruit here,” Sullivan said. But the school is still just in the planning stages, and the need for physicians is right now. A lot of times the doctors that do come here aren’t from the United States.
“Of the last 18 doctors we recruited, 11 were from other countries,” Sullivan said. But immigration laws are making it more difficult for those doctors to come to the country, and difficult for Golden Valley to meet their physician requirements.
Golden Valley currently has about 60 medical providers that saw almost 70,000 patients last year. Sullivan is worried that the number of patients without insurance is only going to go up. “If we get the cuts in Medi-Cal the state is talking about, we are going to have more patients without insurance, and more burden on clinics like Golden Valley,” he said.
But both Alley and Sullivan are hopeful that the future will be brighter, although things will more than likely get worse before they get better.
“In ten years, we hopefully will have become more sophisticated, and have a medical school here,” Alley said.
Sullivan agreed about the school. “A medical school will train Valley students who want to stay in the Valley,” Sullivan said. “But until then, I think things are going to be tough for everyone.”
Reporter Carol Reiter can be reached at (209) 385-2486 or firstname.lastname@example.org