SANTA ROSA -- Kaiser Permanente’s recent announcement that it will launch a family residency program for Sonoma County reflects both local and national health care issues, as providers seek to attract and retain physicians in lieu of a heightened emphasis on expanding primary care capabilities to best serve the community.
The effort, announced last week, is twofold. For one, it hopes to recruit and retain physicians for the region. Secondly, the focus on primary care has been established as a key measure in coordinating better and more cost-effective care, not just in Sonoma County but across the health care landscape, officials said.
But it’s also unique to the county and the North Bay: While Kaiser runs numerous residency programs, the latest effort in Sonoma County is the first family medicine residency program in Northern California for the Oakland-based HMO, according to Dr. Walt Mills, who will be the program’s director.
With an estimated 22 percent of the county’s primary care physicians expected to retire and another percent 6 to 8 percent planning on leaving the area, the issue has become critical if Sonoma County is to maintain a comparatively robust physician community, said Dr. Mills.
“Primary care in the future is going to be family medicine. Everybody recognizes that,” Dr. Mills said. “We need to have a strong primary care foundation.”
Kaiser’s new three-year residency program will train six physicians a year. Currently, Sutter Medical Center of Santa Rosa’s three-year family medicine residency program, an affiliate of UCSF, trains 36 physicians per year, with 12 graduating each year. Sutter’s program also works in conjunction with the Santa Rosa Community Health Centers, where residents typically focus on outpatient care.
By 2017, the two programs combined will graduate 18 physicians each year. The first group of residents is expected to enter Kaiser’s program in July 2014. It will cost about $250,000 per resident per year to train, Dr. Mills said.
The latest effort by Kaiser to secure physicians mirrors other efforts that have taken shape throughout the county, as providers adapt to the primary care physician shortage spurred in part by health care reform.
Last year, Santa Rosa Community Health Centers became one of eight health centers in the country to launch a nurse practitioner residency program, with similar stated goals of being able to provide primary care to as many residents as possible.
The Affordable Care Act has shifted the incentives in much of the medical community to focus on primary care, Dr. Mills said, a development he said is likely to continue.
“It aligns the incentives with what we need to do,” he said. “Whether the mandate is upheld, we’re very clear on what needs to be done -- patient-centered medical homes from a quality and economic standing. There are going to be (accountable care organizations) and those patient-centered homes will be integrated with ACOs. So without an adequate primary care workforce, that is going to be very difficult.”
Having the additional residency program will help health care providers confront the shortage -- faced by communities across the country, particularly rural counties -- and nearly all providers have a vested interest in the matter, Dr. Mills said, noting that resident physicians often stay in the community where they train. That in turn helps in workforce development.
And despite the often competitive nature between Sutter and Kaiser, Dr. Mills said there is broad consensus that cooperation is key when it comes to having a viable physician workforce for the region, something not all communities have.