I want to highlight some concerning statistics regarding the current state of California’s economic and health care coverage shortfalls:
• $25 billion budget deficit.
• 12% unemployment.
• 24% uninsured for health care.
These indicators of an economic downturn are more poignant for rural communities, as they tend to have higher percentages of unemployment and being uninsured.
Approximately five million Californians live in rural communities, accounting for 13 percent of the state’s population. In June, the Assembly Committee on Jobs, Economic Development, and the Economy reported that there are 935 rural residents per doctor; there are 460 urban residents per doctor. Rural residents are more likely to rate their health as “poor” compared to urban residents. The report projects the percentage job growth in rural regions to be about half of those in urban regions.
California’s Legislature has a reputation for being dysfunctional, gridlocked, and partisan. We have an opportunity to forge a solution that will connect us as neighbors working in a synergistic fashion.
I believe that a dedicated joint venture between the state and industry to recruit family physicians to rural areas can provide economic and health benefits. The state offers loan repayment to attract physicians to practice in rural areas. However, this incentive alone has not sufficiently addressed the disparities in health between rural and urban regions. The state should bring employers to the table to augment incentives for physicians to practice in rural settings. These incentives can include employers working directly with physicians to construct health care delivery models that remove the current barriers between patients and physicians.
To attract employees, employers seek locations that have a stable and sustainable infrastructure. One key element is accessible health care. A family physician is trained to provide care for adults, expectant mothers, and children. In essence, the family physician is suited to accommodate the growth of a company and of a community.
Family physicians can also generate economic opportunities. The Robert Graham Center, a policy think tank focusing on population health and primary care, estimated that family physicians generated approximately $8.3 billion dollars in revenue for California in 2007. On average, each California family physician had an economic impact of $985,881. This financial benefit includes direct and indirect revenue, such as generation of income for hospitals, nursing homes, and pharmacies. Admittedly, physicians from all disciplines will generate income in their communities of practice. However, specialists are concentrated in urban metropolitan areas.
In times of adversity, true leadership will step forward and rise above the din of naysayers. For over two generations, California had the reputation for being the vanguard of education, technology, agriculture, and diversity, among other domains. We can renew that distinction by investing in our rural communities through the prioritization of primary care.
Dr. Fong is director of the UC Davis Family Medicine Residency Network. His opinions are his own and do not represent UC Davis.
