Letting hospitals hire docs would make it tougher on clinics

March 15, 2010

By David Quackenbush

There is a great need for more physicians throughout California, especially primary care providers. Urban, suburban, and especially rural areas need additional health care providers to care for the ever-growing low-income and uninsured populations. According to the United States Department of Health and Human Services, rural regions such as the Central Valley make up 68 percent of the federally designated shortage areas in California. The lack of doctors is a major reason why 3.6 million Californians go medically unserved each year.

To remedy this dilemma, some are now suggesting that California lifts its ban on the corporate practice of medicine, which stops hospitals from directly hiring physicians. But lifting that ban would have unintended consequences for California’s low-cost health clinics, known as federally qualified health centers. It would make it even harder for us to recruit qualified physicians to work in our clinics. We would have to complete directly against hospitals and their big budgets.

The task of hiring qualified primary care providers already is a difficult task for health centers. Since their inception in the 1960s, federally qualified health centers have gone to great lengths to meet the patient demand for more doctors. We need help to make this job easier, not additional barriers.

Federally qualified health centers provide preventive, quality, comprehensive health care services to people who have the least access to care, regardless of their ability to pay. Our centers are a major source of preventive health care and a piece of the foundation of the proposed federal health care reform. Hospitals are another part of the foundation for both inpatient and urgent care, but hospitals would agree that preventive care should be delivered in outpatient settings, not emergency rooms.

In the current environment, people living in shortage areas have fewer health care providers per capita and must travel longer distances to obtain health care. Additionally, rural residents are more likely to be hospitalized for medical conditions that could have been avoided had they received adequate preventive care, which is evidenced by the increased rates of chronic disease including alarming rates of diabetes and heart disease. In a new nationwide project, federally qualified health centers will take center stage in giving millions of Americans a central point for coordinated, accessible health care.

A more prudent way to approach the doctor shortage would be to offer incentives such as loan repayment options and more scholarship programs for medical students who agree to practice in places where there is a shortage of physicians. We must commit to building new medical schools, expanding residency program slots, and creating residency programs in underserved areas.

Californians deserve access to health care. Let’s promote effective solutions to the physician shortage that will not undermine the vital health care institutions that serve them.
David Quackenbush is CEO of the Central Valley Health Network.

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One Response to Letting hospitals hire docs would make it tougher on clinics

  1. Damianb61

    July 19, 2010 at 10:16 pm

    Mr. Quackenbush offers “effective” solutions to the shortage of physicians in underserved communities. Among these he proposes loan repayment programs and medical student scholarship options to those willing to work in underserved communities. I have only one question for Mr. Quackenbush: If these proposals are truly effective, then why don’t his Federally Qualified Health Centers rely upon them to recruit doctors? At present they do not, because they simply do not work. His facilities are some of the exclusive group of medical providers that are exempt from California’s physician hiring ban. They offer their doctors full time paid employment in order to recruit the docs they need. If the state’s existing “incentive” programs worked, they would be using them to recruit independent practitioners into their facilities and communities – at no cost to the facility. Instead, they are forced to offer full time paying jobs to doctors to attract and keep the physicians they need. Unfortunately, Federally Qualified Health Centers only provide primary care. They don’t offer 24/7 emergency care, and the need to have a network of specialists to refer their patients to for additional necessary care — care that can only be provided by nearby hospitals. Unfortunately, because these hospitals are banned from hiring doctors, they cannot offer this care — which forces rural residents and those on Medi-Cal to travel great distances for the care they need. It is time for Mr. Quackenbush and the facilities he represents to put the interests of the communities they serve ahead of unfounded fears of “competition” from those who are only trying to serve the same communities his clients serve.

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