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"disqusTitle": "Help Wanted: Last Pediatrician on Mendocino Coast Retires",
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"content": "\u003cp>Dr. Bill Mahon was a young pediatrician in the early 1970s when he fell in love with the rugged coast and majestic redwoods of Mendocino County. Like other people who have moved to Mendocino from around the country, settling here for him was a personal choice that prioritized lifestyle over money.\u003c/p>\n\u003cp>The prospect of practicing medicine in a small community also called to him. In 1977 he left his well-paying job at Kaiser Sacramento to join a practice with two other pediatricians in Fort Bragg.\u003c/p>\n\u003cp>Still, the move was a risk.\u003c/p>\n\u003caside class=\"pullquote alignright\">“For me it’s rather sad. For all these years there have been resident pediatricians. Now for the first time in 40 years, there is none.”\u003ccite>Dr. Bill Mahon\u003c/cite>\u003c/aside>\n\u003cp>“There were no guarantees coming to the coast. This was a practice that started from scratch, and I just trusted the fact that it would increase and everything would be fine\u003cstrong>,”\u003c/strong> Mahon, now 68, says. “My first month of work here I made $200. That was it.\"\u003c/p>\n\u003cp>Over time, the private practice grew to include any patient regardless of ability to pay, says Mahon. Some patients were not insured. Many had Medi-Cal, the state's health insurance program for lower income residents, which – until Mahon’s office gained rural health clinic status in the 90s – provided reimbursements that were “pretty meager.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Early on we actually did trades at the practice,” says Mahon, with a chuckle. “We would trade a visit for a salmon or pottery or some other commodity, which, in the end, felt good from both sides.”\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/220845410\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>For more than 35 years, Mahon examined patients day in, day out at his small clinic, next to Mendocino Coast District Hospital, the only hospital for miles. He handled everything from regular check ups to broken bones to very sick kids who might need a spinal taps or IV treatment. He got to know families closely. Going anywhere in town almost certainly involved bumping into a former patient.\u003c/p>\n\u003cp>\"It really is the personal aspects of practice here,\" says Mahon. \"The connection with the parents, the connection with the kids and then how that connection spilled over into the larger community.\"\u003c/p>\n\u003cp>Sometimes, he was roused out of bed in the middle of the night to attend to a newborn after a complicated delivery or speak with a distressed parent with an urgent question. Then those kids grew up – and many had kids of their own and brought them to see Mahon.\u003c/p>\n\u003cp>“I frequently tell people that I had a dream practice,” he says. “I took care of at least two generations of children. I wouldn’t trade a minute of it.”\u003c/p>\n\u003cp>Now Mahon is mostly retired. He only works at the hospital on call a few days a month. Families in most of the Mendocino Coast region no longer have access to a pediatrician who lives there permanently. The doctors that Mahon joined in the 70s have long since retired, and other pediatricians have come and gone.\u003c/p>\n\u003cfigure id=\"attachment_68048\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/RS16489_vscocam-photo-1.jpeg\">\u003cimg class=\"wp-image-68048 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-400x320.jpeg\" alt=\"RS16489_vscocam-photo-1\" width=\"400\" height=\"320\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-400x320.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-800x640.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-1440x1152.jpeg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-1180x944.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-960x768.jpeg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Mendocino Coast District Hospital in Fort Bragg has pediatricians on call for emergencies only. Dr. Mahon still works there a few days a month, but no longer sees patients on a day-to-day basis. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Until recently, a nurse practitioner and physician assistant at the clinic handled most cases. But, with no pediatrician in the office, if a patient showed up very sick or with a complicated case, the clinic’s staff sent them to the hospital's emergency department, which has on call access to a pediatrician.\u003c/p>\n\u003cp>“This community deserves better,” says Mahon. “For me it’s rather sad. For all these years there have been resident pediatricians and now for the first time in 40 years, there is none.”\u003c/p>\n\u003cp>Mendocino Coast Clinics, which absorbed Dr. Mahon’s practice a few years ago, contracted an outside agency to bring in a temporary pediatrician for three months. He started last week.\u003c/p>\n\u003cp>“This is a stop gap measure,” says Paula Cohen, executive director at Mendocino Coast Clinics. “We would love to find someone who wants to move to this community and make it their home.”\u003c/p>\n\u003cp>Their search to find someone permanent has a few leads. Cohen says she interviewed an out-of-state doctor last weekend, and her staff is reviewing resumes. However, it’s hard for tiny Fort Bragg –- population 7,300 -- to compete with metropolitan areas when recruiting physicians.\u003c/p>\n\u003cp>Cohen says physicians might prefer the amenities – cultural activities, department stores, even supermarkets -- of bigger cities. A physician who is married might need to look in areas that offer career opportunities for their spouses – who if they work in financial services or tech, say, might not want to move to Fort Bragg.\u003c/p>\n\u003cp>The practice of medicine has also changed since Mahon came to the coast. Today, new physicians might not want to practice by themselves and independently treat the wide range of diseases and behavioral disorders in babies and children that Mahon did.\u003c/p>\n\u003cp>Most new physicians are educated in metropolitan areas, with a large suite of specialists available, says Janet Coffman, associate professor at the Institute for Health Policy Studies at UC San Francisco.\u003c/p>\n\u003cp>“If you are in a rural area and the only pediatrician,\" says Coffman, \"people are expecting you to do a wider scope of practice. New physicians might not be prepared for that kind of medicine.\"\u003c/p>\n\u003cp>Another big challenge is that most new doctors are looking for higher salaries that help them repay their debt from medical school. Graduates of public medical schools owed a median debt of $170,000, while private medical school graduates owed a median debt of $200,000, according to 2014 \u003ca href=\"https://www.aamc.org/download/152968/data/debtfactcard.pdf\" target=\"_blank\">figures\u003c/a> from the Association of American Medical Colleges (AAMC). Rural areas serving a majority of Medi-Cal patients, such as Fort Bragg, might not offer competitive salaries.\u003c/p>\n\u003cp>Coffman said that the state could help rural communities recruit new physicians by expanding programs that help doctors repay their debt if they practice in a medically underserved area. One such program, the \u003ca href=\"http://www.oshpd.ca.gov/hpef/stlrp.html\" target=\"_blank\">Steven M. Thompson Physician Corps Loan Repayment\u003c/a> offers up to $105,000 in financial assistance. Medical schools could also expand programs that train physicians for the daily challenges of practicing in a rural setting.\u003c/p>\n\u003cp>The issue is pressing in Mendocino County and other nearby Northern California counties, where more than half of all doctors practicing are 56 or older and nearing retirement age, according to a 2009 report by the \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/F/PDF%20FewerAndMoreSpecializedMDSupplyInCA.pdf\" target=\"_blank\">California HealthCare Foundation\u003c/a>. Statewide, the physician workforce is one of the oldest in the nation, with only New Mexico having a greater proportion of active physicians over 60, based on AAMC \u003ca href=\"https://www.aamc.org/download/362168/data/2013statephysicianworkforcedatabook.pdf\" target=\"_blank\">data\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, families in Fort Bragg are dealing with the lack of a regular pediatrician they trust.\u003c/p>\n\u003cp>Cassandra and Milo Young now drive their three children 60 winding miles inland to a pediatric practice in Ukiah. The road is so twisty that the kids sometimes get sick on the way. The trips usually take an entire day and represent additional costs in gas and time off work.\u003c/p>\n\u003cp>“It’s definitely a downfall to the area,\" says Cassandra Young. She moved to the coast after working as a creative director at a large advertising firm in New York City.\u003c/p>\n\u003cp>\"We made certain concessions to give this lifestyle to our children. We gave up the big career and department stores. But giving up good quality pediatric care doesn’t feel like something we should have to give up,\" Young says.\u003c/p>\n\u003cp>She says she likes the pediatric practice in Ukiah well enough, but misses Dr. Mahon.\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>He’s just wonderful, the kind of doctor we all wish our kids could have,” Young says. “It would be amazing to get another Dr. Mahon to move out here, and be our country doctor.”\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story is part of our series \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/vital-signs/\" target=\"_blank\">Vital Signs\u003c/a>. Send story ideas to fjhabvala@kqed.org.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Early on we actually did trades at the practice,” says Mahon, with a chuckle. “We would trade a visit for a salmon or pottery or some other commodity, which, in the end, felt good from both sides.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/220845410&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/220845410'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>For more than 35 years, Mahon examined patients day in, day out at his small clinic, next to Mendocino Coast District Hospital, the only hospital for miles. He handled everything from regular check ups to broken bones to very sick kids who might need a spinal taps or IV treatment. He got to know families closely. Going anywhere in town almost certainly involved bumping into a former patient.\u003c/p>\n\u003cp>\"It really is the personal aspects of practice here,\" says Mahon. \"The connection with the parents, the connection with the kids and then how that connection spilled over into the larger community.\"\u003c/p>\n\u003cp>Sometimes, he was roused out of bed in the middle of the night to attend to a newborn after a complicated delivery or speak with a distressed parent with an urgent question. Then those kids grew up – and many had kids of their own and brought them to see Mahon.\u003c/p>\n\u003cp>“I frequently tell people that I had a dream practice,” he says. “I took care of at least two generations of children. I wouldn’t trade a minute of it.”\u003c/p>\n\u003cp>Now Mahon is mostly retired. He only works at the hospital on call a few days a month. Families in most of the Mendocino Coast region no longer have access to a pediatrician who lives there permanently. The doctors that Mahon joined in the 70s have long since retired, and other pediatricians have come and gone.\u003c/p>\n\u003cfigure id=\"attachment_68048\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/RS16489_vscocam-photo-1.jpeg\">\u003cimg class=\"wp-image-68048 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-400x320.jpeg\" alt=\"RS16489_vscocam-photo-1\" width=\"400\" height=\"320\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-400x320.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-800x640.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-1440x1152.jpeg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-1180x944.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-960x768.jpeg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Mendocino Coast District Hospital in Fort Bragg has pediatricians on call for emergencies only. Dr. Mahon still works there a few days a month, but no longer sees patients on a day-to-day basis. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Until recently, a nurse practitioner and physician assistant at the clinic handled most cases. But, with no pediatrician in the office, if a patient showed up very sick or with a complicated case, the clinic’s staff sent them to the hospital's emergency department, which has on call access to a pediatrician.\u003c/p>\n\u003cp>“This community deserves better,” says Mahon. “For me it’s rather sad. For all these years there have been resident pediatricians and now for the first time in 40 years, there is none.”\u003c/p>\n\u003cp>Mendocino Coast Clinics, which absorbed Dr. Mahon’s practice a few years ago, contracted an outside agency to bring in a temporary pediatrician for three months. He started last week.\u003c/p>\n\u003cp>“This is a stop gap measure,” says Paula Cohen, executive director at Mendocino Coast Clinics. “We would love to find someone who wants to move to this community and make it their home.”\u003c/p>\n\u003cp>Their search to find someone permanent has a few leads. Cohen says she interviewed an out-of-state doctor last weekend, and her staff is reviewing resumes. However, it’s hard for tiny Fort Bragg –- population 7,300 -- to compete with metropolitan areas when recruiting physicians.\u003c/p>\n\u003cp>Cohen says physicians might prefer the amenities – cultural activities, department stores, even supermarkets -- of bigger cities. A physician who is married might need to look in areas that offer career opportunities for their spouses – who if they work in financial services or tech, say, might not want to move to Fort Bragg.\u003c/p>\n\u003cp>The practice of medicine has also changed since Mahon came to the coast. Today, new physicians might not want to practice by themselves and independently treat the wide range of diseases and behavioral disorders in babies and children that Mahon did.\u003c/p>\n\u003cp>Most new physicians are educated in metropolitan areas, with a large suite of specialists available, says Janet Coffman, associate professor at the Institute for Health Policy Studies at UC San Francisco.\u003c/p>\n\u003cp>“If you are in a rural area and the only pediatrician,\" says Coffman, \"people are expecting you to do a wider scope of practice. New physicians might not be prepared for that kind of medicine.\"\u003c/p>\n\u003cp>Another big challenge is that most new doctors are looking for higher salaries that help them repay their debt from medical school. Graduates of public medical schools owed a median debt of $170,000, while private medical school graduates owed a median debt of $200,000, according to 2014 \u003ca href=\"https://www.aamc.org/download/152968/data/debtfactcard.pdf\" target=\"_blank\">figures\u003c/a> from the Association of American Medical Colleges (AAMC). Rural areas serving a majority of Medi-Cal patients, such as Fort Bragg, might not offer competitive salaries.\u003c/p>\n\u003cp>Coffman said that the state could help rural communities recruit new physicians by expanding programs that help doctors repay their debt if they practice in a medically underserved area. One such program, the \u003ca href=\"http://www.oshpd.ca.gov/hpef/stlrp.html\" target=\"_blank\">Steven M. Thompson Physician Corps Loan Repayment\u003c/a> offers up to $105,000 in financial assistance. Medical schools could also expand programs that train physicians for the daily challenges of practicing in a rural setting.\u003c/p>\n\u003cp>The issue is pressing in Mendocino County and other nearby Northern California counties, where more than half of all doctors practicing are 56 or older and nearing retirement age, according to a 2009 report by the \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/F/PDF%20FewerAndMoreSpecializedMDSupplyInCA.pdf\" target=\"_blank\">California HealthCare Foundation\u003c/a>. Statewide, the physician workforce is one of the oldest in the nation, with only New Mexico having a greater proportion of active physicians over 60, based on AAMC \u003ca href=\"https://www.aamc.org/download/362168/data/2013statephysicianworkforcedatabook.pdf\" target=\"_blank\">data\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, families in Fort Bragg are dealing with the lack of a regular pediatrician they trust.\u003c/p>\n\u003cp>Cassandra and Milo Young now drive their three children 60 winding miles inland to a pediatric practice in Ukiah. The road is so twisty that the kids sometimes get sick on the way. The trips usually take an entire day and represent additional costs in gas and time off work.\u003c/p>\n\u003cp>“It’s definitely a downfall to the area,\" says Cassandra Young. She moved to the coast after working as a creative director at a large advertising firm in New York City.\u003c/p>\n\u003cp>\"We made certain concessions to give this lifestyle to our children. We gave up the big career and department stores. But giving up good quality pediatric care doesn’t feel like something we should have to give up,\" Young says.\u003c/p>\n\u003cp>She says she likes the pediatric practice in Ukiah well enough, but misses Dr. Mahon.\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>He’s just wonderful, the kind of doctor we all wish our kids could have,” Young says. “It would be amazing to get another Dr. Mahon to move out here, and be our country doctor.”\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of our series \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/vital-signs/\" target=\"_blank\">Vital Signs\u003c/a>. Send story ideas to fjhabvala@kqed.org.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Immigrant Doctors Help Ease California's Primary Care Doctor Shortage",
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"content": "\u003cp>By \u003ca href=\"http://www.kaiserhealthnews.org/Reporters/GoldJ.aspx\">Jenny Gold\u003c/a>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/April/04/california-doctors-primary-care-latin-america.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cdiv>\n\u003cfigure id=\"attachment_12010\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/08/immigrant-doctors-help-ease-californias-primary-care-doctor-shortage/immigrant-doc-300_jennygold_khn/\" rel=\"attachment wp-att-12010\">\u003cimg class=\"size-full wp-image-12010\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/immigrant-doc-300_JennyGold_KHN.jpg\" alt=\"Dr. Jose Chavez Gonzalez examines Graciela Jauregui at Riverside County Regional Medical Center (Jenny Gold/Kaiser Health News).\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Jose Chavez Gonzalez examines Graciela Jauregui at Riverside County Regional Medical Center (Jenny Gold/Kaiser Health News).\u003c/figcaption>\u003c/figure>\n\u003cp>It's a familiar story in California.\u003c/p>\n\u003cp>When Jose Chavez Gonzalez moved to the United States from El Salvador, he took any job he could get -- stocking warehouses, construction, cleaning houses and working in a meat processing plant.\u003c/p>\n\u003cp>But unlike most of the other immigrants he worked alongside, Chavez, 38, was a doctor with eight years of medical training. He came to the U.S. in the mid-1990’s to be with his family, but like all doctors from other countries, he still had to pass the U.S. medical boards and go through at least three years of residency in order to practice here. The process can be both expensive and time consuming, so during the day he worked various menial jobs. At night he studied for the boards.\u003c/p>\n\u003caside class=\"pullquote alignright\">Hundreds, maybe thousands, of immigrant doctors from Latin America could be practicing, but are instead working other –- often menial –- jobs. That’s a wasted resource.\u003c/aside>\n\u003cp>“I had to do it. And I wouldn’t complain,” says Chavez. “It was OK to me. I mean, of course medicine is my passion, but since I didn’t have a license here, I couldn’t practice it.”\u003c/p>\n\u003cp>A quarter of U.S. doctors are foreign-born, mostly from countries like India that focus on training medical students to work in the U.S. Many other immigrant physicians never become American doctors, particularly those who come from Latin American countries like Chavez.\u003c/p>\n\u003cp>But a program at the University of California is seeking to change that, while at the same time helping to address \u003ca href=\"http://www.npr.org/2012/08/07/158370069/the-prognosis-for-the-shortage-in-primary-care\" target=\"_blank\">the shortage of primary care doctors\u003c/a> in the state. The UCLA \u003ca href=\"http://fm.mednet.ucla.edu/IMG/img_program.asp\" target=\"_blank\">International Medical Graduate Program\u003c/a> offers Latino doctors a stipend along with board preparation classes, mentorship and references to help them find a good residency slot in primary care. In return, the doctors pledge to work in an underserved area of California for two or three years.\u003c!--more-->\u003c/p>\n\u003cp>The program at UCLA was founded by Dr. Patrick Dowling and Dr. Michelle Bholat to help address the shortage of primary care doctors in the state, and a particular shortage of doctors of Latin American heritage. Though more than one-third of California’s population is Hispanic, only 5 percent of its doctors are.\u003c/p>\n\u003cp>In addition, nearly half of the estimated \u003ca href=\"http://www.healthexchange.ca.gov/BoardMeetings/Documents/November%2014_2012/IX_HBEX_CoveredCaBoardLevel2-Blueprint11-14-2012_Final.pdf\">5 million Californians\u003c/a> expected to be newly eligible for health insurance under the Affordable Care Act are Latino, and Dowling says it’s key that patients see a doctor who understands their language and culture.\u003c/p>\n\u003cp>“You can either do total body cat scans on everybody or you can sit down and try to understand what the patient is saying and why and what’s going on in their life,” says Dowling.\u003c/p>\n\u003cp>The program is small. But slowly, it’s making a dent. Chavez was able to pass his medical exams in two years. Today, he’s hard at work as a first-year resident at the Riverside County Regional Medical Center. Most of his patients are Hispanic, and many are immigrants like him.\u003c/p>\n\u003cp>Graciela Jauregui came to the clinic with severe pain in her knee. She was born in Mexico but has lived in the U.S. for 17 years, working as a housekeeper. She’s 62 and doesn’t speak English. She says she always prefers to see a doctor who can actually understand her.\u003c/p>\n\u003cp>Speaking through an interpreter, Jauregui says, “All doctors are good people, but when they speak Spanish it’s better.”\u003c/p>\n\u003cp>Chavez’s fluency in Spanish is prized by his boss, Riverside’s chief of family medicine Dr. Geoffrey Leung. Leung says the clinic employs translators, but they are often in short supply. And even \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2009/April/21/Medical-Interpreters.aspx\" target=\"_blank\">with a translator\u003c/a>, important details can be lost.\u003c/p>\n\u003cp>“No matter how good of a translator you have, your concern is that you may lose some part of the integrity of the message,” Leung says.\u003c/p>\n\u003cp>So far, the UCLA program has placed 54 Hispanic doctors into family medicine training programs –- Dowling says that’s almost as many as came from all 10 California medical schools put together.\u003c/p>\n\u003cp>Dowling says hundreds and maybe thousands of immigrant doctors from Latin America could be practicing, but are instead working other –- often menial –- jobs. And that’s a wasted resource.\u003c/p>\n\u003cp>“I was just reviewing an applicant this morning who’s currently working in McDonalds,” Dowling says. “And I thought of the irony: She’s serving people Big Macs right now and what she could be doing is explaining to people that isn’t what you want you want to be eating.”\u003c/p>\n\u003cp>Chavez, for his part, is happy to be treating patients again: “[It] gave me the opportunity to stop working and focus full-time on studying. Without the program, I would still be working on construction.”\u003c/p>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "When Jose Chavez Gonzalez moved to the United States from El Salvador, he took any job he could get -- stocking warehouses, construction, cleaning houses and working in a meat processing plant.\r\n\r\nBut unlike most of the other immigrants he worked alongside, Chavez, 38, was a doctor with eight years of medical training. He came to the U.S. in the mid-1990’s to be with his family, but like all doctors from other countries, he still had to pass the U.S. medical boards and go through at least three years of residency in order to practice here. The process can be both expensive and time consuming, so during the day he worked various menial jobs and at night he studied for the boards.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By \u003ca href=\"http://www.kaiserhealthnews.org/Reporters/GoldJ.aspx\">Jenny Gold\u003c/a>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/April/04/california-doctors-primary-care-latin-america.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cdiv>\n\u003cfigure id=\"attachment_12010\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/08/immigrant-doctors-help-ease-californias-primary-care-doctor-shortage/immigrant-doc-300_jennygold_khn/\" rel=\"attachment wp-att-12010\">\u003cimg class=\"size-full wp-image-12010\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/immigrant-doc-300_JennyGold_KHN.jpg\" alt=\"Dr. Jose Chavez Gonzalez examines Graciela Jauregui at Riverside County Regional Medical Center (Jenny Gold/Kaiser Health News).\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Jose Chavez Gonzalez examines Graciela Jauregui at Riverside County Regional Medical Center (Jenny Gold/Kaiser Health News).\u003c/figcaption>\u003c/figure>\n\u003cp>It's a familiar story in California.\u003c/p>\n\u003cp>When Jose Chavez Gonzalez moved to the United States from El Salvador, he took any job he could get -- stocking warehouses, construction, cleaning houses and working in a meat processing plant.\u003c/p>\n\u003cp>But unlike most of the other immigrants he worked alongside, Chavez, 38, was a doctor with eight years of medical training. He came to the U.S. in the mid-1990’s to be with his family, but like all doctors from other countries, he still had to pass the U.S. medical boards and go through at least three years of residency in order to practice here. The process can be both expensive and time consuming, so during the day he worked various menial jobs. At night he studied for the boards.\u003c/p>\n\u003caside class=\"pullquote alignright\">Hundreds, maybe thousands, of immigrant doctors from Latin America could be practicing, but are instead working other –- often menial –- jobs. That’s a wasted resource.\u003c/aside>\n\u003cp>“I had to do it. And I wouldn’t complain,” says Chavez. “It was OK to me. I mean, of course medicine is my passion, but since I didn’t have a license here, I couldn’t practice it.”\u003c/p>\n\u003cp>A quarter of U.S. doctors are foreign-born, mostly from countries like India that focus on training medical students to work in the U.S. Many other immigrant physicians never become American doctors, particularly those who come from Latin American countries like Chavez.\u003c/p>\n\u003cp>But a program at the University of California is seeking to change that, while at the same time helping to address \u003ca href=\"http://www.npr.org/2012/08/07/158370069/the-prognosis-for-the-shortage-in-primary-care\" target=\"_blank\">the shortage of primary care doctors\u003c/a> in the state. The UCLA \u003ca href=\"http://fm.mednet.ucla.edu/IMG/img_program.asp\" target=\"_blank\">International Medical Graduate Program\u003c/a> offers Latino doctors a stipend along with board preparation classes, mentorship and references to help them find a good residency slot in primary care. In return, the doctors pledge to work in an underserved area of California for two or three years.\u003c!--more-->\u003c/p>\n\u003cp>The program at UCLA was founded by Dr. Patrick Dowling and Dr. Michelle Bholat to help address the shortage of primary care doctors in the state, and a particular shortage of doctors of Latin American heritage. Though more than one-third of California’s population is Hispanic, only 5 percent of its doctors are.\u003c/p>\n\u003cp>In addition, nearly half of the estimated \u003ca href=\"http://www.healthexchange.ca.gov/BoardMeetings/Documents/November%2014_2012/IX_HBEX_CoveredCaBoardLevel2-Blueprint11-14-2012_Final.pdf\">5 million Californians\u003c/a> expected to be newly eligible for health insurance under the Affordable Care Act are Latino, and Dowling says it’s key that patients see a doctor who understands their language and culture.\u003c/p>\n\u003cp>“You can either do total body cat scans on everybody or you can sit down and try to understand what the patient is saying and why and what’s going on in their life,” says Dowling.\u003c/p>\n\u003cp>The program is small. But slowly, it’s making a dent. Chavez was able to pass his medical exams in two years. Today, he’s hard at work as a first-year resident at the Riverside County Regional Medical Center. Most of his patients are Hispanic, and many are immigrants like him.\u003c/p>\n\u003cp>Graciela Jauregui came to the clinic with severe pain in her knee. She was born in Mexico but has lived in the U.S. for 17 years, working as a housekeeper. She’s 62 and doesn’t speak English. She says she always prefers to see a doctor who can actually understand her.\u003c/p>\n\u003cp>Speaking through an interpreter, Jauregui says, “All doctors are good people, but when they speak Spanish it’s better.”\u003c/p>\n\u003cp>Chavez’s fluency in Spanish is prized by his boss, Riverside’s chief of family medicine Dr. Geoffrey Leung. Leung says the clinic employs translators, but they are often in short supply. And even \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2009/April/21/Medical-Interpreters.aspx\" target=\"_blank\">with a translator\u003c/a>, important details can be lost.\u003c/p>\n\u003cp>“No matter how good of a translator you have, your concern is that you may lose some part of the integrity of the message,” Leung says.\u003c/p>\n\u003cp>So far, the UCLA program has placed 54 Hispanic doctors into family medicine training programs –- Dowling says that’s almost as many as came from all 10 California medical schools put together.\u003c/p>\n\u003cp>Dowling says hundreds and maybe thousands of immigrant doctors from Latin America could be practicing, but are instead working other –- often menial –- jobs. And that’s a wasted resource.\u003c/p>\n\u003cp>“I was just reviewing an applicant this morning who’s currently working in McDonalds,” Dowling says. “And I thought of the irony: She’s serving people Big Macs right now and what she could be doing is explaining to people that isn’t what you want you want to be eating.”\u003c/p>\n\u003cp>Chavez, for his part, is happy to be treating patients again: “[It] gave me the opportunity to stop working and focus full-time on studying. Without the program, I would still be working on construction.”\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Mentors Inspire Young Woman To Become Doctor For Low-Income Communities",
"title": "Mentors Inspire Young Woman To Become Doctor For Low-Income Communities",
"headTitle": "Vital Signs | State of Health | KQED News",
"content": "\u003cp>\u003cem>Editor's note: There was little in her background to suggest Vanessa Armendariz could become a doctor. But as she was growing up, mentors from similar circumstances made her dream seem possible. As part of our occasional series, \"\u003ca href=\"http://www.californiareport.org/specialcoverage/whatsyourstory/index.jsp\" target=\"_blank\">What's Your Story?\u003c/a>\" \u003cem>Armendariz explains why she wants to be a primary care physician for people in low-income communities like her own\u003c/em>.\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_10990\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/04/mentors-inspire-young-woman-to-become-doctor-for-low-income-communities/screen-shot-2013-03-04-at-11-08-22-am/\" rel=\"attachment wp-att-10990\">\u003cimg class=\"size-medium wp-image-10990\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Screen-Shot-2013-03-04-at-11.08.22-AM-300x291.png\" alt=\"Vanessa Armendariz says her goal is to go to medical school and become a primary care physician so she can help serve her community. (Photo Courtesy of Vanessa Armendariz)\" width=\"300\" height=\"291\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Vanessa Armendariz says her goal is to go to medical school and become a primary care physician so she can help serve her community. (Photo Courtesy of Vanessa Armendariz)\u003c/figcaption>\u003c/figure>\n\u003cp>Like any child, I was terrified of going to the doctor. But as a child of a low-income family in Stockton, my reasons were different.\u003c/p>\n\u003cp>I wasn't afraid of a shot. Instead, I dreaded the hours-long waits and seeing my parents struggle to afford the visits. I couldn't stand my family feeling unheard or helpless.\u003c/p>\n\u003cp>I wanted to change that for families like mine, so I decided to become a doctor.\u003c/p>\n\u003cp>But in high school, I was told that as a low-income Latina, my chances of getting pregnant were higher than going to college. My mother was pregnant at 16, and no one in my family had attended college, so it was hard to argue those statistics.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"In high school I was told that as a low-income Latina, my chances of getting pregnant were higher than going to college.\"\u003c/aside>\n\u003cp>Then, my parents were caught selling drugs to support our family. My mother continued to support my dream, but it seemed impossible. That changed when I found a program that introduced disadvantaged students to medicine through mentoring and visits to our regional health centers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>I interacted with physicians I could relate to. They came from low-income, minority backgrounds and were passionate about giving back. I realized that if they could do it, so could I. I excelled academically \u003c!--more-->and graduated high school as valedictorian. I was even accepted to my dream school, Johns Hopkins University, on a scholarship. There, I met world-renowned physicians, traveled to Honduras and mentored Latino youth. My students, many of whom were undocumented, gang-affiliated, or from low-income households, reminded me of myself.\u003c/p>\n\u003cp>I met students like my brothers, who were capable but never attended college because they felt compelled to provide for their families. Many children of low-income families have this mindset. The only way to change it is to help them believe they can pursue their goals and to show them how. That’s what mentors from difficult backgrounds who have achieved their dreams can do. When we inspire and challenge our young people of color, they achieve much more than they’ve imagined.\u003c/p>\n\u003cp>Today, I work at the \u003ca href=\"http://www.sjcms.org/\" target=\"_blank\">San Joaquin Medical Society in Stockton\u003c/a>, a job that includes facilitating the very program that got me started. I will apply to medical school this summer.\u003c/p>\n\u003cp>I hope to return to the San Joaquin Valley to practice medicine and to help more families trust their doctors, rather than fear them; to deliver quality care -- regardless of income, or language, or the struggles they’ve faced. If more young people of color get the kind of help I did, the future of health care in all communities will be brighter.\u003c/p>\n\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201303040850b.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201303040850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Editor's note: There was little in her background to suggest Vanessa Armendariz could become a doctor. But as she was growing up, mentors from similar circumstances made her dream seem possible. As part of our occasional series, \"\u003ca href=\"http://www.californiareport.org/specialcoverage/whatsyourstory/index.jsp\" target=\"_blank\">What's Your Story?\u003c/a>\" \u003cem>Armendariz explains why she wants to be a primary care physician for people in low-income communities like her own\u003c/em>.\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_10990\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/04/mentors-inspire-young-woman-to-become-doctor-for-low-income-communities/screen-shot-2013-03-04-at-11-08-22-am/\" rel=\"attachment wp-att-10990\">\u003cimg class=\"size-medium wp-image-10990\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Screen-Shot-2013-03-04-at-11.08.22-AM-300x291.png\" alt=\"Vanessa Armendariz says her goal is to go to medical school and become a primary care physician so she can help serve her community. (Photo Courtesy of Vanessa Armendariz)\" width=\"300\" height=\"291\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Vanessa Armendariz says her goal is to go to medical school and become a primary care physician so she can help serve her community. (Photo Courtesy of Vanessa Armendariz)\u003c/figcaption>\u003c/figure>\n\u003cp>Like any child, I was terrified of going to the doctor. But as a child of a low-income family in Stockton, my reasons were different.\u003c/p>\n\u003cp>I wasn't afraid of a shot. Instead, I dreaded the hours-long waits and seeing my parents struggle to afford the visits. I couldn't stand my family feeling unheard or helpless.\u003c/p>\n\u003cp>I wanted to change that for families like mine, so I decided to become a doctor.\u003c/p>\n\u003cp>But in high school, I was told that as a low-income Latina, my chances of getting pregnant were higher than going to college. My mother was pregnant at 16, and no one in my family had attended college, so it was hard to argue those statistics.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"In high school I was told that as a low-income Latina, my chances of getting pregnant were higher than going to college.\"\u003c/aside>\n\u003cp>Then, my parents were caught selling drugs to support our family. My mother continued to support my dream, but it seemed impossible. That changed when I found a program that introduced disadvantaged students to medicine through mentoring and visits to our regional health centers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>I interacted with physicians I could relate to. They came from low-income, minority backgrounds and were passionate about giving back. I realized that if they could do it, so could I. I excelled academically \u003c!--more-->and graduated high school as valedictorian. I was even accepted to my dream school, Johns Hopkins University, on a scholarship. There, I met world-renowned physicians, traveled to Honduras and mentored Latino youth. My students, many of whom were undocumented, gang-affiliated, or from low-income households, reminded me of myself.\u003c/p>\n\u003cp>I met students like my brothers, who were capable but never attended college because they felt compelled to provide for their families. Many children of low-income families have this mindset. The only way to change it is to help them believe they can pursue their goals and to show them how. That’s what mentors from difficult backgrounds who have achieved their dreams can do. When we inspire and challenge our young people of color, they achieve much more than they’ve imagined.\u003c/p>\n\u003cp>Today, I work at the \u003ca href=\"http://www.sjcms.org/\" target=\"_blank\">San Joaquin Medical Society in Stockton\u003c/a>, a job that includes facilitating the very program that got me started. I will apply to medical school this summer.\u003c/p>\n\u003cp>I hope to return to the San Joaquin Valley to practice medicine and to help more families trust their doctors, rather than fear them; to deliver quality care -- regardless of income, or language, or the struggles they’ve faced. If more young people of color get the kind of help I did, the future of health care in all communities will be brighter.\u003c/p>\n\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201303040850b.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201303040850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Approach to Medical Residency May Ease Doctor Shortage in Central Valley",
"title": "New Approach to Medical Residency May Ease Doctor Shortage in Central Valley",
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"content": "\u003cp>By Rebecca Plevin, \u003ca href=\"http://kvpr.org/post/are-teaching-health-centers-cure-valleys-doctor-shortage#.USea0lGUDxU.twitter\" target=\"_blank\">Valley Public Radio\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_10770\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/25/new-approach-to-medical-residency-may-ease-doctor-shortage-in-central-valley/plevinphoto/\" rel=\"attachment wp-att-10770\">\u003cimg class=\"size-medium wp-image-10770\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/PlevinPhoto-300x225.jpg\" alt=\"Dr. Peter Broderick examines a patient's x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Peter Broderick examines a patient's x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)\u003c/figcaption>\u003c/figure>\n\u003cp>The Central Valley suffers from an \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/17/in-fresno-the-road-to-health-reform-is-bumpy/\" target=\"_blank\">acute shortage of doctors\u003c/a> -- especially primary care doctors -- but a new type of residency program aims to bring relief. These new \"teaching health centers\" are funded by the Affordable Care Act.\u003c/p>\n\u003cp>This new approach contrasts with traditional medical residency programs, which are often based at university medical centers in large cities and encourage specialty training.\u003c/p>\n\u003cp>With the recognition that medical residents often stay where they are trained, the idea behind this new approach is to place these young doctors not in large hospitals but in community health centers where they will focus on primary care.\u003c/p>\n\u003cp>“The hope is that more of the graduates from these programs will stay in these underserved settings, will work in these community health clinics, and hopefully address some of the shortages that we have with that population,” said Dr. Peter Broderick, the CEO of Modesto's Valley Consortium of Medical Education.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In 2010 Broderick's group opened the state's first \"teaching health center\" -- the Valley Family Medical Residency Program. It has trained 12 doctors a year since then.\u003c!--more-->\u003c/p>\n\u003cp>The teaching health center model is gaining traction. This summer, the Sierra Vista Family Medicine Residency Program will welcome its first four residents to Fresno. California's third teaching health center will be located in Redding.\u003c/p>\n\u003cp>Still, traditional programs play a huge role in training the Central Valley's future doctors. UCSF-Fresno remains the largest provider of graduate medical education in the Valley, including 12 family medicine residents each year.\u003c/p>\n\u003cp>Gene Kallsen, the assistant dean of UCSF-Fresno, says the university and the teaching health centers share the goal of increasing the number of primary care doctors in the Valley.\u003c/p>\n\u003cp>But, Kallsen explains, UCSF-Fresno is blocked from growing its residency programs to meet the region’s needs for primary care doctors. A major one, he says, is a convoluted system that ties -- and caps -- the number of medical residents to the number of Medicare patients at a hospital. Once that cap is set, it can’t be changed.\u003c/p>\n\u003cp>“One of the barriers is that programs like ours can’t grow unless we identify new sites,” Kallen said. \"We can only get federal funding for so many residents, and we live up against that cap.”\u003c/p>\n\u003cp>That’s where new programs, like the teaching health centers, come in.\u003c/p>\n\u003cp>“We’re not trying to compete with UCSF at all, and we don’t want to have that perception,” said Norma Forbes, the executive director of Fresno Healthy Community Access Partners. Her organization partnered with Clinica Sierra Vista to launch its Medicine Residency Program.\u003c/p>\n\u003cp>“This is a different model that we hope will grow the number of family medicine doctors,\" she says. \"There is room for both types of training residents here in the Valley and across the country.\"\u003c/p>\n\u003cp>Forbes said the program follows a curriculum similar to more traditional family medicine residency programs. But residents at the teaching health center will gain experience with a variety of patients and procedures, instead of specializing in one specific type of medicine. She drew a distinction between the care offered at a large university hospital's outpatient -- or ambulatory care -- clinics and that of community health center's primary care clinics.\u003c/p>\n\u003cp>“Those primary clinics are free-standing and they are really focused on prevention and wellness -- and working with patients from birth to death,\" Forbes says.\"And when you get into ambulatory clinics associated with more urban environment hospitals, you run into the specialization.”\u003c/p>\n\u003cp>She is confident that the teaching health center model will help train more doctors who are dedicated to serving Valley communities and slowly remedy the region’s primary care doctor shortage. She hopes all of the program’s residents will practice in clinics in rural areas of the Valley after they finish their residencies.\u003c/p>\n\u003cp>“Our goal is to get 100 percent of them, all four of them (each year), staying right here, so we can truly increase the number of doctors through this residency program,” Forbes said.\u003c/p>\n\u003cp>The program currently has a three-year grant from the federal government.\u003c/p>\n\u003cp>Back at the teaching health center in Modesto, Dr. Broderick congratulated medical student Dr. Gewel de los Santos for helping a patient reach a healthy weight. She responded with outright enthusiasm.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Valley residents can only hope that more family medicine residents are as excited about practicing in the region.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Rebecca Plevin, \u003ca href=\"http://kvpr.org/post/are-teaching-health-centers-cure-valleys-doctor-shortage#.USea0lGUDxU.twitter\" target=\"_blank\">Valley Public Radio\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_10770\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/25/new-approach-to-medical-residency-may-ease-doctor-shortage-in-central-valley/plevinphoto/\" rel=\"attachment wp-att-10770\">\u003cimg class=\"size-medium wp-image-10770\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/PlevinPhoto-300x225.jpg\" alt=\"Dr. Peter Broderick examines a patient's x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Peter Broderick examines a patient's x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)\u003c/figcaption>\u003c/figure>\n\u003cp>The Central Valley suffers from an \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/17/in-fresno-the-road-to-health-reform-is-bumpy/\" target=\"_blank\">acute shortage of doctors\u003c/a> -- especially primary care doctors -- but a new type of residency program aims to bring relief. These new \"teaching health centers\" are funded by the Affordable Care Act.\u003c/p>\n\u003cp>This new approach contrasts with traditional medical residency programs, which are often based at university medical centers in large cities and encourage specialty training.\u003c/p>\n\u003cp>With the recognition that medical residents often stay where they are trained, the idea behind this new approach is to place these young doctors not in large hospitals but in community health centers where they will focus on primary care.\u003c/p>\n\u003cp>“The hope is that more of the graduates from these programs will stay in these underserved settings, will work in these community health clinics, and hopefully address some of the shortages that we have with that population,” said Dr. Peter Broderick, the CEO of Modesto's Valley Consortium of Medical Education.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In 2010 Broderick's group opened the state's first \"teaching health center\" -- the Valley Family Medical Residency Program. It has trained 12 doctors a year since then.\u003c!--more-->\u003c/p>\n\u003cp>The teaching health center model is gaining traction. This summer, the Sierra Vista Family Medicine Residency Program will welcome its first four residents to Fresno. California's third teaching health center will be located in Redding.\u003c/p>\n\u003cp>Still, traditional programs play a huge role in training the Central Valley's future doctors. UCSF-Fresno remains the largest provider of graduate medical education in the Valley, including 12 family medicine residents each year.\u003c/p>\n\u003cp>Gene Kallsen, the assistant dean of UCSF-Fresno, says the university and the teaching health centers share the goal of increasing the number of primary care doctors in the Valley.\u003c/p>\n\u003cp>But, Kallsen explains, UCSF-Fresno is blocked from growing its residency programs to meet the region’s needs for primary care doctors. A major one, he says, is a convoluted system that ties -- and caps -- the number of medical residents to the number of Medicare patients at a hospital. Once that cap is set, it can’t be changed.\u003c/p>\n\u003cp>“One of the barriers is that programs like ours can’t grow unless we identify new sites,” Kallen said. \"We can only get federal funding for so many residents, and we live up against that cap.”\u003c/p>\n\u003cp>That’s where new programs, like the teaching health centers, come in.\u003c/p>\n\u003cp>“We’re not trying to compete with UCSF at all, and we don’t want to have that perception,” said Norma Forbes, the executive director of Fresno Healthy Community Access Partners. Her organization partnered with Clinica Sierra Vista to launch its Medicine Residency Program.\u003c/p>\n\u003cp>“This is a different model that we hope will grow the number of family medicine doctors,\" she says. \"There is room for both types of training residents here in the Valley and across the country.\"\u003c/p>\n\u003cp>Forbes said the program follows a curriculum similar to more traditional family medicine residency programs. But residents at the teaching health center will gain experience with a variety of patients and procedures, instead of specializing in one specific type of medicine. She drew a distinction between the care offered at a large university hospital's outpatient -- or ambulatory care -- clinics and that of community health center's primary care clinics.\u003c/p>\n\u003cp>“Those primary clinics are free-standing and they are really focused on prevention and wellness -- and working with patients from birth to death,\" Forbes says.\"And when you get into ambulatory clinics associated with more urban environment hospitals, you run into the specialization.”\u003c/p>\n\u003cp>She is confident that the teaching health center model will help train more doctors who are dedicated to serving Valley communities and slowly remedy the region’s primary care doctor shortage. She hopes all of the program’s residents will practice in clinics in rural areas of the Valley after they finish their residencies.\u003c/p>\n\u003cp>“Our goal is to get 100 percent of them, all four of them (each year), staying right here, so we can truly increase the number of doctors through this residency program,” Forbes said.\u003c/p>\n\u003cp>The program currently has a three-year grant from the federal government.\u003c/p>\n\u003cp>Back at the teaching health center in Modesto, Dr. Broderick congratulated medical student Dr. Gewel de los Santos for helping a patient reach a healthy weight. She responded with outright enthusiasm.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Valley residents can only hope that more family medicine residents are as excited about practicing in the region.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_10232\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/29/are-there-enough-medi-cal-doctors-in-kern-county-how-about-statewide-who-knows/clinica/\" rel=\"attachment wp-att-10232\">\u003cimg class=\"size-medium wp-image-10232\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/clinica_3-300x231.jpg\" alt=\"People wait in line at Clinica Sierra Vista at the East Bakersfield Community Health Center. Some were waiting before they opened at 7:30am. (Casey Christie / The Californian)\" width=\"300\" height=\"231\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">People wait in line at Clinica Sierra Vista at the East Bakersfield Community Health Center. Some were waiting before they opened at 7:30am. (Casey Christie / The Californian)\u003c/figcaption>\u003c/figure>\n\u003cp>Once Obamacare is fully implemented in January, hundreds of thousands of Californians will move from the ranks of the uninsured to the insured. That's the good news. The downside: many California counties already face \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/11/29/california-faces-shortage-of-primary-care-doctors/\" target=\"_blank\">a shortage of primary care doctors\u003c/a> -- a shortage that is especially\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/17/in-fresno-the-road-to-health-reform-is-bumpy/\" target=\"_blank\"> acute in the Central Valley\u003c/a>.\u003c/p>\n\u003cp>How those newly insured -- especially those who will be enrolled under Medi-Cal -- will access care is an especially pressing question in Kern County, as the CHCF Center for Health Reporting has been exploring under a series,\u003ca href=\"http://centerforhealthreporting.org/project/desperate-doctors-will-obamacare-deliver-access-physicians-poor-kern-residents\" target=\"_blank\"> Desperate for Doctors\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">“It would be really helpful for policymakers to have an agreed upon set of facts.”\u003c/aside>\n\u003cp>A chief problem is not only the shortage of primary care doctors, but also the question of whether physicians accept Medi-Cal patients. If individuals and families hold Medi-Cal insurance, but can't find a doctor who will accept it, their new coverage isn't much help.\u003c!--more-->\u003c/p>\n\u003cp>A straightforward starting point would be to quantify how many doctors there are and how many accept Medi-Cal. But, in a \u003ca href=\"http://centerforhealthreporting.org/article/are-there-enough-medi-cal-doctors-kern-county-who-knows1050\" target=\"_blank\">great piece of reporting\u003c/a>, Emily Bazar found that there's little agreement on these two critical pieces of information -- within statewide agencies.\u003c/p>\n\u003cp>The state's Department of Health Care Services (DHCS) report there are 2,023 Kern County doctors who see Medi-Cal patients, Bazar writes. Starting point, yes? But this number was a surprise to people on the ground in Kern County. From Bazar's report:\u003c/p>\n\u003cblockquote>\u003cp>Here’s what Sandi Palumbo, executive director of the \u003ca href=\"http://www.kms.org/\" target=\"_blank\">Kern County Medical Society\u003c/a>, says:\u003c/p>\n\u003cp>“Whaaaattt!? I didn’t even know there were that many licensed physicians in Kern County.\"...\u003c/p>\n\u003cp>There aren’t.\u003c/p>\n\u003cp>The state \u003ca href=\"http://www.mbc.ca.gov/\" target=\"_blank\">Medical\u003c/a> and \u003ca href=\"http://www.ombc.ca.gov/\" target=\"_blank\">Osteopathic Medical\u003c/a> Boards, in charge of licensing doctors who practice in California, show about 1,200 physicians in Kern County, more than 800 fewer than the state’s statistic.\u003c/p>\u003c/blockquote>\n\u003cp>A DHCS spokeswoman told Bazar that the discrepancy could be accounted for by doctors who are licensed in other counties, but practice in Kern. Palumbo didn't buy it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Bazar reports that DHCS says there are 104,239 doctors statewide who are enrolled as Medi-Cal providers. But the California Medical Association doesn't buy that number, either. From Bazar's report:\u003c/p>\n\u003cblockquote>\u003cp>Lisa Folberg, vice president of medical and regulatory policy for the California Medical Association ... says the state’s number is “ridiculously overinflated.” ...\u003c/p>\n\u003cp>She points to the number of doctors licensed by the state with addresses in the state: About 107,000.\u003c/p>\n\u003cp>Folberg said there’s no way that almost every doctor in the state accepts Medi-Cal. “Every study across the nation shows that not all physicians participate in Medicaid,” she said.\u003c/p>\u003c/blockquote>\n\u003cp>State officials again had an explanation for these conflicting numbers: there is currently no expiration date on a doctor's enrollment in Medi-Cal. But starting this month, the Affordable Care Act requires that state's confirm a doctor's participation in the program every five years.\u003c/p>\n\u003cp>Perhaps that 104,000 number of doctors who accept Medi-Cal will decline.\u003c/p>\n\u003cp>“It would be really helpful for policymakers to have an agreed upon set of facts,” Andrew Bindman, director of the University of California-based California Medicaid Research Institute, told Bazar.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Staff writer Rachel Cook of \u003ca href=\"http://www.bakersfield.com/\" target=\"_blank\">The Bakersfield Californian\u003c/a> contributed to Emily Bazar's report.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Once Obamacare is fully implemented in January, hundreds of thousands of Californians will move from the ranks of the uninsured to the insured. But as we've reported, many California counties already face a shortage of primary care doctors -- a shortage that is especially acute in the Central Valley.\r\n\r\nHow those newly insured -- especially those who will be enrolled under Medi-Cal -- will access care is an especially pressing question in Kern County, as the CHCF Center for Health Reporting has been exploring under a series, Desperate for Doctors.",
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"description": "Once Obamacare is fully implemented in January, hundreds of thousands of Californians will move from the ranks of the uninsured to the insured. But as we've reported, many California counties already face a shortage of primary care doctors -- a shortage that is especially acute in the Central Valley.\r\n\r\nHow those newly insured -- especially those who will be enrolled under Medi-Cal -- will access care is an especially pressing question in Kern County, as the CHCF Center for Health Reporting has been exploring under a series, Desperate for Doctors.",
"title": "Are There Enough Medi-Cal Doctors in Kern County? How About Statewide? Who Knows? | KQED",
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"headline": "Are There Enough Medi-Cal Doctors in Kern County? How About Statewide? Who Knows?",
"datePublished": "2013-01-29T11:19:24-08:00",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_10232\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/29/are-there-enough-medi-cal-doctors-in-kern-county-how-about-statewide-who-knows/clinica/\" rel=\"attachment wp-att-10232\">\u003cimg class=\"size-medium wp-image-10232\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/clinica_3-300x231.jpg\" alt=\"People wait in line at Clinica Sierra Vista at the East Bakersfield Community Health Center. Some were waiting before they opened at 7:30am. (Casey Christie / The Californian)\" width=\"300\" height=\"231\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">People wait in line at Clinica Sierra Vista at the East Bakersfield Community Health Center. Some were waiting before they opened at 7:30am. (Casey Christie / The Californian)\u003c/figcaption>\u003c/figure>\n\u003cp>Once Obamacare is fully implemented in January, hundreds of thousands of Californians will move from the ranks of the uninsured to the insured. That's the good news. The downside: many California counties already face \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/11/29/california-faces-shortage-of-primary-care-doctors/\" target=\"_blank\">a shortage of primary care doctors\u003c/a> -- a shortage that is especially\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/17/in-fresno-the-road-to-health-reform-is-bumpy/\" target=\"_blank\"> acute in the Central Valley\u003c/a>.\u003c/p>\n\u003cp>How those newly insured -- especially those who will be enrolled under Medi-Cal -- will access care is an especially pressing question in Kern County, as the CHCF Center for Health Reporting has been exploring under a series,\u003ca href=\"http://centerforhealthreporting.org/project/desperate-doctors-will-obamacare-deliver-access-physicians-poor-kern-residents\" target=\"_blank\"> Desperate for Doctors\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">“It would be really helpful for policymakers to have an agreed upon set of facts.”\u003c/aside>\n\u003cp>A chief problem is not only the shortage of primary care doctors, but also the question of whether physicians accept Medi-Cal patients. If individuals and families hold Medi-Cal insurance, but can't find a doctor who will accept it, their new coverage isn't much help.\u003c!--more-->\u003c/p>\n\u003cp>A straightforward starting point would be to quantify how many doctors there are and how many accept Medi-Cal. But, in a \u003ca href=\"http://centerforhealthreporting.org/article/are-there-enough-medi-cal-doctors-kern-county-who-knows1050\" target=\"_blank\">great piece of reporting\u003c/a>, Emily Bazar found that there's little agreement on these two critical pieces of information -- within statewide agencies.\u003c/p>\n\u003cp>The state's Department of Health Care Services (DHCS) report there are 2,023 Kern County doctors who see Medi-Cal patients, Bazar writes. Starting point, yes? But this number was a surprise to people on the ground in Kern County. From Bazar's report:\u003c/p>\n\u003cblockquote>\u003cp>Here’s what Sandi Palumbo, executive director of the \u003ca href=\"http://www.kms.org/\" target=\"_blank\">Kern County Medical Society\u003c/a>, says:\u003c/p>\n\u003cp>“Whaaaattt!? I didn’t even know there were that many licensed physicians in Kern County.\"...\u003c/p>\n\u003cp>There aren’t.\u003c/p>\n\u003cp>The state \u003ca href=\"http://www.mbc.ca.gov/\" target=\"_blank\">Medical\u003c/a> and \u003ca href=\"http://www.ombc.ca.gov/\" target=\"_blank\">Osteopathic Medical\u003c/a> Boards, in charge of licensing doctors who practice in California, show about 1,200 physicians in Kern County, more than 800 fewer than the state’s statistic.\u003c/p>\u003c/blockquote>\n\u003cp>A DHCS spokeswoman told Bazar that the discrepancy could be accounted for by doctors who are licensed in other counties, but practice in Kern. Palumbo didn't buy it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Bazar reports that DHCS says there are 104,239 doctors statewide who are enrolled as Medi-Cal providers. But the California Medical Association doesn't buy that number, either. From Bazar's report:\u003c/p>\n\u003cblockquote>\u003cp>Lisa Folberg, vice president of medical and regulatory policy for the California Medical Association ... says the state’s number is “ridiculously overinflated.” ...\u003c/p>\n\u003cp>She points to the number of doctors licensed by the state with addresses in the state: About 107,000.\u003c/p>\n\u003cp>Folberg said there’s no way that almost every doctor in the state accepts Medi-Cal. “Every study across the nation shows that not all physicians participate in Medicaid,” she said.\u003c/p>\u003c/blockquote>\n\u003cp>State officials again had an explanation for these conflicting numbers: there is currently no expiration date on a doctor's enrollment in Medi-Cal. But starting this month, the Affordable Care Act requires that state's confirm a doctor's participation in the program every five years.\u003c/p>\n\u003cp>Perhaps that 104,000 number of doctors who accept Medi-Cal will decline.\u003c/p>\n\u003cp>“It would be really helpful for policymakers to have an agreed upon set of facts,” Andrew Bindman, director of the University of California-based California Medicaid Research Institute, told Bazar.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Staff writer Rachel Cook of \u003ca href=\"http://www.bakersfield.com/\" target=\"_blank\">The Bakersfield Californian\u003c/a> contributed to Emily Bazar's report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"marketplace": {
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"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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},
"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
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"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
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"onourwatch": {
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"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"order": 11
},
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"on-the-media": {
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"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"link": "/radio/program/on-the-media",
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"pbs-newshour": {
"id": "pbs-newshour",
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"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
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},
"perspectives": {
"id": "perspectives",
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"order": 14
},
"link": "/perspectives",
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"planet-money": {
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"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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"link": "/radio/program/planet-money",
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"order": 5
},
"link": "/podcasts/politicalbreakdown",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5Nzk2MzI2MTEx",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
"meta": {
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"source": "Possible"
},
"link": "/radio/program/possible",
"subscribe": {
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
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