gqlshare posted: "According to the Soil Test Report, commissioned by Adventist Health last December, to determine the viability of the community to recruit and sustain primary care doctors: "…Ukiah is home to 91,000 residents… known for its beautiful views, great climate, " The Willits News
According to the Soil Test Report, commissioned by Adventist Health last December, to determine the viability of the community to recruit and sustain primary care doctors: "…Ukiah is home to 91,000 residents… known for its beautiful views, great climate, recreational activities, and wineries. Despite these attributes, AHUV struggles with provider recruitment and retention…not unique…a national report revealed that nearly one in five health care workers have left their jobs during the COVID-19 pandemic, citing environmental strains related to the pandemic, poor pay, and burnout as primary reasons."
Judson Howe, President of Adventist Health's North Coast Network. "We need to initiate a community-led approach to health care with community resources augmenting the physician. That's what we're doing with the Incubate Program."(Contributed)
Judson Howe, President of Adventist Health's North Coast Network that includes six facilities in Mendocino, Napa and Lake begins, "We've been experiencing some challenging times in hospital administration—burnout and loss of purpose causing us to question why we make the sacrifices we make every day; and it's especially challenging under these circumstances to find and recruit physicians."
With the needs being greater than what physicians can provide, creating human suffering that cannot be solved or cured, he is seeking solutions for breaking out of this cycle, a situation not unique to Mendocino County but of national import.
According to an article from the Press Democrat dated March 6th, 2021, Lake County had the highest rate of fatal overdoses statewide in 2019 with more than 60 deaths per 100,000 people, more than triple the statewide average rate of 19.6. Mendocino County came second on the list with an overdose death rate of just over 40 fatalities per 100,000, followed by San Francisco County.
Howe adds to these statistics: the county is burdened with severe impairments in the social determinants of health; adverse childhood experiences four times the national norm; alcohol use two times the national norm; and severe mental illness that is worsening.
He estimates there are 50 primary care providers in the county with a need for 25 more and he is looking for a way for the hospital and community to come together to break out of this impasse and develop a viable method of recruiting and retaining physicians, to support, appreciate and acknowledge what they do and to build capacity for them to preserve themselves for tomorrow.
The Soil Test Report identifies that some of the biggest challenges are stability of physician workforce, call/practice coverage, mental health, spousal satisfaction and specialist availability.
Corporate medicine is identified as a problem.
"We're seeing a loss of empathy and kindness in the medical space; at AHUV we often fail to put a human face to our business," he says.
The report points out the importance of doctors having access to specialists, allowing them to practice full spectrum medicine—the way doctors practiced in an earlier era, with a broader spectrum of practice as opposed to hyper-specialization.
"The idea that health care is a relationship between the patient and the provider and to build that continuity within the same visit are what full spectrum residencies are going for. We're a full spectrum program, cradle to the grave."
But that is not their present reality.
"It can take weeks or months to see a doctor and there are not enough. Our current health inequities are massive to the point where senior citizens cannot get in to see a provider."
Howe is currently working with Benjamin Anderson, formerly the CEO of Kearney County Hospital in rural, western Kansas, who developed a successful model for medical provider recruitment. Anderson says they developed a culture that allowed them to recruit medical staff – everything from a sustainable on-call structure to building a sense of trust between medical providers and administration. He says by way of providing support, he and his wife babysat a physician's two-year-old daughter; and that most important is communicating that they care about their team members and their families.
Howe says, "Everyone needs to stop competing and create access for health care together—not just Adventist Health but Mendocino Community Health Clinic and other stakeholders and providers, as well. We need to be willing to be accessible and humble, to create a safe vulnerable space so we can have a conversation about the collective health needs of the community.
"Recruiting on wine, Redwoods and the coast is not sufficient; we have to recruit differently to missional providers, those who realize there's a problem and want to be a part of the solution; we need to initiate a community-led approach to health care with community resources augmenting the physician. That's what we're doing with the Incubate Program."
The Incubate Program is a county wide, collaborative task force sponsored by Mendocino County Health Clinic; Adventist Health; Ukiah Valley Residency Program; North Coast Opportunities; and the Mendocino County Public Health Department to cultivate a supportive training environment for full-scope family medicine in Ukiah, connecting provider and community well-being.
Its volunteer members meet twice a quarter with the intention of uniting diverse stakeholders and constructing a supportive environment for physician residents and their families. Their goals include summarizing the current state of workforce challenges, implementing collaborative solutions and developing multi-year strategies.
"We need to have housing—viable, sticky neighborhoods where physicians can stay, help connect them to our community, appreciate them and… we need to support local medicine. Every time a patient leaves the community, it takes away a local job.
"I want to gather people who want to be part of the conversation, who want to be part of the solution."
For further information contact Daphne Macneil at daphnemacneil@yahoo.com or Jeremy Malin at malinjr@ah.org.
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