MARIN COUNTY -- Prima Medical Group will provide trauma and elective surgeries for Marin General Hospital, marking the first time that all local physicians will deliver such services to the level III trauma center and its patients.

The hospital has always had some trauma providers based in Marin, but it previously contracted with a San Jose-based medical group to provide a significant portion of  the trauma services. That made follow-up care and coordination often difficult or that follow-up care was done by a physician other than the one who had performed a surgery, according to Prima.  Now, all trauma coverage will be provided by surgeons based in Marin.

"There is much more continuity of care for the patients in the new system," said Dr. Crystine Lee, a Prima physician since 2008 who will be one of four new surgeons working with Marin General.

In addition to trauma coverage, Prima and Marin General are working together on a general surgery practice, which will return some elective surgeries to Marin that have been unavailable for up to 20 years, according to Joel Sklar, chief medical officer of Marin General.

"What had happened in Marin for years was, because we had outside care, we didn't have a vibrant local process. If you wanted an elective surgery, you couldn't get it here," Dr. Sklar said. He added that having an outside trauma team is fairly common for a hospital, given that it's difficult to staff because of the late hours involved and that Marin doesn't experience the same sort of trauma as, say, San Francisco or more urban areas.

A patient would typically have to go to San Francisco for elective surgeries such as advanced laparoscopics, Dr. Sklar said.

"We haven't done those at Marin General in 20 years. We just haven't had the expertise  or the local surgeons to do it," he said. "We always had expert trauma care, but we didn't have local surgeons."

The Prima team will consist of Dr. Lee, who completed her service with the Air Force, which awarded her a full scholarship to Stanford School of Medicine; Dr. Edward Alfrey, who was recruited from Southern Illinois School of Medicine and will be the medical director of the Prima Medical Group General Surgery Program;  Dr. Sabrina Kidd, who was recruited to Marin from her Colorectal Surgery Fellowship at University of Southern California; and Dr. Mark Bazalgette, a long-time Marin colorectal surgeon. Both Dr. Kidd and Dr. Bazalgette joined Prima in September.

Prima also relocated its primary care physicians and OB/GYN physicians in Novato, to 11,000 square feet of space at 75 Rowland Way. It was previously located in 5,400 square feet of space in the medical office building directly next to Novato Community Hospital, a Sutter Health operated facility. The move accommodates Prima's recent and planned growth in a highly visible space just off Highway 101 in Novato, spokeswoman Marcy Norenius said.

The new location also houses an outpatient lab subleased by Marin General.

Prima, which has 60 physicians, said it may further grow the surgery team as well as its primary care and specialist teams.

"We will continue to expand as we determine the need for the community," Dr. Alfrey said.

Marin General will benefit financially and patients won't have to travel over the Golden Gate Bridge for certain surgeries, Dr. Sklar said.

"Anything that can bring us additional volume that doesn't get sent elsewhere is good for the hospital and good for the patients," he said. "The real story is the expansion of our general surgery while still doing trauma."

Four local surgeons that have always provided trauma services will continue to do so, working alongside the Prima surgeons. They are: Dr. Ann Vercoutere, Dr. Lawrence Duke, Dr. Jonathan Levin, and Dr. Mohammed Zakhireh.

Last year, Prima and Marin General formed a medical foundation, which was was seen as a pivotal move for physician recruitment.