In June 2016, Governor Jerry Brown’s administration announced the historic allocation of a three-year, $100 million fund to address the drastic shortage of primary care physicians, and therefore critical health care, for our state’s residents.
Specifically, the money would have backfilled expiring funds for primary care residency programs across the state, as well as increased the total number of programs. Residency is a required, specialized training period for all medical school graduates before they can practice, and it’s absolutely critical for all aspiring physicians.
That’s why I was so disappointed when Governor Brown announced the elimination of the first year’s allotment, $33.4 million, in his 2017-2018 budget proposal.
It seems he forgot the statistics: California ranks 32nd of all the 50 states in patient access. Twenty-three of California’s 58 counties fall below the minimum primary care to patient ratio. Put another way, California needs 8,243 new physicians by 2030 to meet the minimum basic requirements for the adequate provision of primary care.
As a medical student at the primary care-focused UC Riverside School of Medicine, I lobbied for the inclusion of this residency funding. I’ve seen the devastating impact of our weakening primary care system: the diabetic triple-amputee who didn’t have someone managing his blood sugar, the man who presented with late-stage metastatic colon cancer because he never got a colonoscopy, or the woman who went into cardiac arrest because she did not know how to properly take her medications.
It’s easy to point to these patients and say their conditions are their fault. But for many of California’s patients, seeing a primary care doctor means waiting months for an appointment and driving hours away simply because there are not enough providers. Our infrastructure is not nearly robust enough to support the chronic health needs of our population.
It’s important to note that this funding is not merely an addition to already-existing primary care residency funding. Rather, it was also designed to replace more than $60 million dollars of money that expired this past year that was committed to buttressing the primary care workforce. Thus, Governor Brown not only refuses to add more residencies but threatens to eliminate many that already exist.
My peers and I are merely a few days away from applying for residency, and the anxiety is building. Residency determines not just what kind of physicians we will be, but also where we are likely to settle and practice in our career. It seems only logical that the doors to California primary care residencies should be wide open for any students who want to practice primary care in California, given the massive shortage that the state faces. Unfortunately, the spots are so limited that it forces many of us to leave the state.
We owe it to our medical trainees and patients across the state to reinstate this funding. Without it, we may further compromise the health of many Californians. And we risk losing many talented changemakers to residency programs outside of the state, forcing them to leave behind their hometowns, families and communities they want to care for.
My peers and I were raised in California, went to California’s fantastic universities, and then chose to go to a medical school specifically designed to improve the health care of one of California’s most underserved areas.
We have chosen to commit our lives to California’s patients, especially those worst off, and I hope that our Governor and our lawmakers will help us do our job by restoring this primary care funding.