Healthcare Cuts Complicate Efforts to Address Rural Doctor Shortages
Healthcare funding cuts are hindering efforts to resolve the persistent shortage of physicians in rural Northern California. The University of California-Davis School of Medicine has been actively involved in initiatives to train and retain local doctors, but recent reductions in state and federal healthcare spending threaten these plans.
Olivia Owlett is a resident in a newly established family medicine program led by the nonprofit organization Healthy Rural California. Owlett chose to complete her residency in Chico, a town facing healthcare challenges similar to those of her upbringing in Wellsboro, Pennsylvania. Having witnessed the difficulties her family faced in accessing healthcare, she understands the importance of local solutions to medical shortages. Owlett expressed optimism about the program’s potential to attract and retain more doctors in the region, stating, “With the growing family medicine residency program here, it’s a great opportunity to bring more doctors into the area, and I’d love to be a part of that.”
Local leaders are eager to expand the medical workforce, especially in a region where the physician shortage is critical. Debra Lupeika, associate dean for rural and community-based education at UC-Davis, emphasized the urgent need for healthcare professionals. “We need help up here, and cutting funding is not going to help us,” Lupeika stated. The challenges are compounded by an aging physician workforce and the allure of more urban areas for new medical graduates.
The geographical landscape of this part of California is vast and sparsely populated, stretching from just north of Sacramento to the Oregon border. The healthcare crisis is so pressing that support for a proposed $200 million healthcare training campus has gained bipartisan traction. Doug LaMalfa, a Republican Assembly leader from the region, underscored the need for prioritizing healthcare funding, stating, “It’s about what are the priorities, right? And healthcare certainly is a priority — should be a priority.”
The healthcare landscape is further complicated by recent legislative actions. In July, Republican lawmakers in Congress voted to cut nearly $1 trillion from Medicaid, with local representatives like LaMalfa arguing that the bill ensures those eligible for benefits continue to receive them. Simultaneously, California’s Democrat-controlled Legislature has reduced healthcare coverage for undocumented immigrants, further straining the system.
Patients in rural areas often experience severe delays in obtaining care. For instance, Lupeika’s daughter had to wait nearly a month for an MRI, while others, like Ginger Alonso, travel long distances for basic care, driving 70 miles to Redding for OB-GYN services. Many patients arrive at emergency rooms with advanced medical issues due to the lack of timely care. “We see sicker patients, bottom line,” said Tanya Layne, a primary care physician in Chico, who recently transitioned from her private practice to work at an urgent care clinic.
The scarcity of specialists is acute, with many northern counties lacking access to neurologists, endocrinologists, and oncologists. Doug Matthews, a colorectal surgeon and regional medical director of Partnership HealthPlan, noted that patients often forgo care due to long wait times or unavailable specialists.
The healthcare crisis intensified following the devastating 2018 Camp Fire, which destroyed the town of Paradise and its hospital, displacing numerous healthcare professionals. In response, local leaders established Healthy Rural California, which has since launched residency programs in psychiatry and family medicine. The organization also works to inspire high school students to consider careers in healthcare and is pursuing plans for the proposed healthcare campus.
Despite the challenges posed by budget constraints, leaders like James Schlund, a radiologist and board member of Healthy Rural California, are advocating for funding from the state Legislature. “We are building the coalition,” he said, emphasizing the need for financial support during these difficult times.
Efforts to establish a medical school in the region, potentially in partnership with UC-Davis, are also underway. Such an initiative could help retain graduates and address the physician shortfall. Paul Dhanuka, a gastroenterologist and member of the Redding City Council, highlighted the importance of creating roots for medical professionals in the area.
Despite the small population of rural areas posing challenges for residency training, there are opportunities for specialties beyond family medicine. Dhanuka noted that multiple hospitals and clinics in the northern region are eager for more residency participation.
Funding for residency programs largely comes from federal sources through Medicare, but state funding is also crucial. Much of California’s graduate medical education funding relies on revenue from a tax on Medi-Cal plans. Changes in budget law could significantly reduce this revenue, jeopardizing the future of training programs. Mark Servis, vice dean for medical education at UC-Davis, warned, “We could lose that Prop. 35 funding.”
Recent announcements, such as Glenn Medical Center’s decision to close its emergency room and hospital services due to loss of federal designation, illustrate the immediate impact of funding cuts. A $50 billion rural healthcare fund proposed in the budget law may provide some relief, but uncertainty remains regarding its distribution and impact.
Community leaders emphasize the need for a united front in advocating for a robust healthcare system. “Healthcare is such a human need, because we all hurt the same, regardless of race, color,” Dhanuka remarked. The challenge ahead is to convey that enhancing healthcare access benefits everyone, irrespective of political affiliation.
