​On Saturday, April 9, five-time Grammy Award winner Michael McDonald is performing a benefit concert for two organizations: Family Medicine Education for Mendocino County and a scholarship program for nursing students attending Mendocino Community College.

Joining McDonald will be world-renowned guitarist Alex de Grassi, multi-instrumentalist Gene Parsons, former member of The Byrds and the Flying Burrito Brothers; David Hayes, acclaimed bassist with Van Morrison; multi Grammy Award winner Paul McCandless and other special guests.

The sold-out show is the first fundraiser for the FMEMC, a nonprofit organization which was formed last year and received official status in September of 2015. The organization is working with Ukiah Valley Medical Center in a community capacity to create a family medicine residency program at Ukiah Valley Medical Center.

The fundraiser will help meet a $100,000 challenge grant match offered by the Adventist Hospital Corporation. Proceeds from the fundraiser will be split with the FMEMC and a scholarship program for nursing students wishing to continue on to advanced nursing practice.

Dr. Noemi “Mimi” Doohan, MD, PhD has a medical practice in Ukiah. She is a hospitalist, the director of the FMEMC and it was her personal connection to Michael McDonald that helped coalesce the energy needed to put the star-studded concert together.

Though the event will be a fun-filled evening, the focus of the FMEMC is serious: the decreasing number of family physicians in Mendocino County.

“The FMEMC is acting as the community arm of the effort to create a family medicine residency program at Ukiah Valley Medical Center,” explains Mary Anne Landis. Landis is an FMEMC board member and the chairwoman of the concert fundraising committee.

“We are creating a teaching hospital at UVMC – one which will train professionals who will become our county’s future family physicians,” says Doohan.

The formation of the FMEMC started as grass-roots teas hosted by long-time Ukiahan Darca Nicholson. “People attended the teas and realized that this is a critical need we have in our community,” Landis continues.

Mendocino County’s primary care doctors are aging and retiring, and replacements are not filling their ranks. Newly trained doctors and nurses are often weighed down by educational debt, resulting in choices to specialize and locate in urban communities.

In addition, the number of residents now insured through the Affordable Care Act has resulted in increased patient workloads. “In rural areas like ours, the health of our residents largely depends on long-term relationships between patients and primary care doctors,” Landis continues.

“The concept of FMEMC is that if you grow your own, they stay here,” says Dr. Doohan. “Eighty-seven percent of our nursing graduates stay in Mendocino and Lake County. There are similar stats for doctors who affiliate with teaching hospitals. Family physicians tend to stay where they train. We have a critical need to retain doctors who come here. It’s not just about recruiting them. It’s about doctors falling in love with their community,” she continues.

Physicians who come to this area are recruited through the Adventist Health system, according to Doohan. “They do a very good job of recruiting those doctors. When you bring in a doctor that is brand new in their training, they put down roots here, which gives them a tendency to stay.”

It is this motivation that has resulted in a dynamic partnership between the Ukiah Valley Medical Center, the FMEMC and UC Davis Medical School. UVMC will provide the location and sponsorship of the residency program. UC Davis is acting as the academic sponsor. “It was a big win for us to receive the affiliation with UC Davis,” Landis notes.

The FMEMC will provide event planning, education, fundraising and act as a community conduit between residents and the teaching program.

“The FMEMC board will take information from the community, give it to the hospital for the purposes of program development and then feed back information from the hospital to the community,” Landis explains.

The all-volunteer board members are: Daphne McNeil, president; Mary Anne Landis, vice-president; Colleen Gorman, secretary; Donna Ruoff, treasurer; Darca Nicholson, Linda Burris and Jonathan Middlebrook.

The focus of the residency program is recruitment of primary care physicians. “American primary care doctors, as a percentage of all doctors, have dropped from about 80 percent in 1930 to around 30 percent in 2011,” says Landis.

“Family practice physicians are what we call pluri-potent. They are able to perform a number of functions, such as pediatrics, which is why they’re so valuable in rural communities. We have an aging population of physicians. More patients are seeking care. The doctors that will come here will have their own case-load. Family medicine residents are right out of medical school, so this will be their first residential practice. Very strong relationships develop between doctors and their patients, which will encourage them to stay,” Doohan continues.

“There is data to support the idea that more primary care equates to healthier communities, because of access to preventive services and the focus on health screenings and other routine services. Family doctors have long-term relationships with their patients and their families. Because they’re generalists, they treat a variety of problems before they become crises,” notes Doohan.

“We’re launching in 2018, creating 18 new training slots for our doctors,” says Landis. “It will be a three-year training program with six doctors graduating each year.”

The residents will spend a month at UC Davis receiving pediatric training. The teaching clinic will be located at 1050 N. State Street. “Doctors Lynne Cohen, Ida Harris and Andrew Coren are already housed at this location. Much of the teaching will take place at UVMC, and our residents will also have opportunities to work on the coast and other areas in Mendocino and Lake County,” says Doohan.

Mendocino College is interested in more than just helping with the fundraiser, notes Viki Chaudrue, director of nursing for Mendocino College.

“We approached the Mendocino College Foundation with the idea of a partnership. We realized that the growing of doctors and nurses go hand in hand in improving our community. The foundation agreed,” said Doohan.

“The college is already doing what we would like to do. Partnership with the college is essential. This in an inclusive program that is grounded in the community,” says Landis.

“Some of the funding is earmarked to go to advanced education for our nursing graduates,” says Chaudrue. “There’s a nursing shortage and additionally a shortage of what we call mid-level providers –Family Nurse Practitioners and Physician’s Assistants –which require master’s degrees and higher level education. We’re facing the same attrition situation with middle-aged and retiring nurses. The fundraiser will provide scholarships for nurses who graduated from our rural program, giving them opportunities to continue their education at Sonoma State, where they offer advanced nursing programs,” she explains.

“We really need to recruit and train this group of individuals – advanced practice clinicians,” says Doohan. “At the fundraiser, we’re announcing practitioner awards. Part of the reason we’re giving awards is to recognize all levels of practitioners. We intentionally awarded a nurse, a nurse practitioner, a physician and an advocate,” she continues. This year’s awards go to Lillian Basner, FNP, Mark Apfel, MD, Amy Buckingham, RN and Buz Graham, MD.

Landis and Doohan hope the new program will also draw other doctors to the region.

“Family medicine physicians are generalists who need to be taught by psychiatrists, internists and pediatricians. This isn’t just recruiting family physicians. There are physicians who love to teach and would love to be involved with an innovative, new teaching program,” Doohan continues.

“All our doctors are retiring. This program has the potential to have a very positive impact on our community’s health through greater access to doctors. I also see potential for economic development. With 18 new doctors coming in, auxiliary services will also be needed. It will be a boon to our economy,” Landis notes.

There is another, much-needed component to the program. “Our most vulnerable citizens are receiving care at the ER. UVMC just received a $394,000 Partnership Health grant to develop a street medicine program, which will be a core part of the two-year curriculum,” says Doohan.

Resident physicians and nurses will likely be training in this adjunct program. “The goal is to provide better access to care for our homeless population,” says Landis.

“The rule of thumb says it costs $2 million over two years to create a family medicine residency program. We’re taking three years and budgeting $1.5 million. We’re being frugal and taking our time to run an excellent program,” says Doohan.

The Adventist Health corporation is matching up to $100,000 in community donations. “This concert is our kickoff, and with the generous sponsors we’ve accrued, I think we’re already at the $50,000 mark before ticket sales. Fowler Auto Center is our very generous lead sponsor. There are many, many others listed on our website. Our community sees that this is a program we really need,” says Landis.

Spencer Brewer, Mac Magruder, Susan Spencer and Doug Browe have created the awards for this year’s practitioner awards. “Spencer – what a great man. We’re blessed with his promotion skills and leadership. He’s really guided us through this process. Alex de Grassi and Paula Samonte have been instrumental in helping get the concert off the ground. Shannon Riley created an awesome Rural Health Rocks window at Shoefly and Socks. She’s been so helpful, as has Julia Dakin, who is providing support for our reception. Katie Fairbairn, director of the Mendocino College Foundation, and Jonathan Dooley have also been exceptional partners,” says Landis.

“Michael McDonald is a great humanitarian. He is from Ferguson, Missouri. He gives a lot in terms of doing fundraisers. This is a testament to his love of rural America,” Doohan concludes.

Though there are no more concert tickets available, T-shirts are for sale through the concert website. “We will have a concert next year at a bigger venue so we can have more people at the event. Congratulations, Ukiah. We’re getting a teaching hospital!” Landis concludes.

For more information on Rural Health Rocks, please visit http://ruralhealthrocks.com

​This article appeared in the Ukiah Daily Journal on April 6, 2016

By Richard Selzer
POSTED: 03/03/16

I don’t know if you’ve heard, but there’s a non-profit group working to start a family medicine residency (doctor training) program in Ukiah. While this may not appear to be closely tied to real estate, I’d argue it is, because anything that substantially improves the quality of life in our town also improves real estate prices. And a residency program would definitely send positive ripples throughout our community.

Health care has been in the news a lot during the past few years, with concern about the rising cost of health care for everyone—insured or not—and the shortage of doctors. In Ukiah, we do not have enough primary care doctors to care for everyone. Primary care is the term used to describe whole person health care, not specialized care focused on a certain body system or disease. Within primary care, there are different specialties, including family medicine, internal medicine and pediatrics. Primary care doctors are the doctors you go to first when you’re sick, if you’re lucky enough to have one.

Family medicine is unique in that it is the only specialty that does not narrow its practice by organ/system, age or gender, according to one of the nationally (and internationally) known leaders in family medicine who is interested in little ‘ole Ukiah, professor Richard Roberts, MD, JD. A pediatrician, for example, focuses on children. An internist focuses exclusively on adults. An obstetrician/gynecologist may provide some primary care, but only treats women.

At a talk he gave in Ukiah recently, Dr. Roberts said, “[Family practitioners] think about people, not the disease.” He appreciates working with specialists when they are needed, but estimates that family practitioners can usually take care of “90-95 percent of what walks through the door.”
In Ukiah, we have far fewer primary care doctors than we need, and many of them are getting close to retirement. Chief of Staff Dr. Charlie Evans, a family physician who works in the Ukiah Valley Medical Center Emergency Department, shared startling news when he said, “We need 42 primary care doctors, and we have 28— nine of whom are over 65.” This equates to approximately 40,000 local people who don’t have a primary care doctor, and who therefore put off care until they either need emergency care or until their disease progresses to the point where treatment is no longer effective or available. Clearly, we need to do something.

This is where the residency program comes in. After doctors finish medical school, they are trained in a specialty, like family medicine. Statistics show that a huge percentage of residents (50 to 80 percent) stay close to wherever they finish their residency. These new doctors get comfortable with the area, build relationships, and their children get established in local schools. Recognizing the value of such a program, Dr. Mimi Doohan—who recently returned to Ukiah after growing up here—spoke with Dr. Evans and suggested the possibility of starting a residency program. They spoke to UVMC President Gwen Matthews, who loved the idea.

Since then, the hospital and its parent company, Adventist Health, have agreed to house the program, and offered a $100,000 matching grant to go toward the $1.5 million start-up costs. A group of community-minded locals called Family Medicine Education for Mendocino County have been busy publicizing and fundraising. Once the residency program is up and going, it will be self-sustaining because it will qualify for federal funding after its first year—four years from now.
I sure like the idea of having enough doctors for local people, and since we are in a nationwide competition for them, let’s tip the scale in our favor. Let’s get this residency program up and running.

This article appeared in the Ukiah Daily Journal on March 3, 2016.

On Leadership
By Heidi Dickerson
 
Developing a Program to bring in New Family Docs
 
            Many local physicians, particularly those who are family practitioners who do everything from taking care of broken bones to treating the flu, delivering babies to aiding the elderly, are aging out of the profession.
            Also known as family or primary care physicians, they are in short supply not only in our community in Mendocino County but across the nation. The US Health Resources and Services Administration (HRSA) predicts a shortage of 24,000 primary care docs by 2020.
            Two Leadership Mendocino graduates Darça Nicholson (Class I) and Mary Anne Landis (Class XII) along with Dr. Mimi Doohan, a hospitalist at the Ukiah Valley Medical Center (UVMC), Dr. Charlie Evans, a family physician and the CEO at the Pacific Redwood Medial Group, Dr. Lynne Cohen, a family doctor, and Dr. Andy Coren, another family physician are leading the way to establish a Family Medicine Training Residency at UVMC with outreach to Willits and the coast.
            All of these leaders have long histories with Mendocino County and have drafted an easy to comprehend plan that explains the need, defines the criteria, and creates a timeline with a deadline to launch a local residency for new family practitioners by July 2018.
            Doohan explains how the program works. When someone graduates from medical school, the next step is to take a three year residency in order to gain real life experience in a hospital or other medical institution. In 2014 the National Residency Match program filled 25,687 positions of which only 3,777 or 14.7 percent were in family medicine, internal medicine and pediatrics. The shortage of family docs is true around the country, with rural areas hit the hardest.
            “This program will benefit the entire community,” says Dr. Doohan, who knows from experience. She helped set up a family medicine residency in Palm Springs and knows the hoops to go through to bring in community involvement and financial support. “The benefits are big. Patients love knowing their doctor can deal with most of their maladies. The residents who are chosen come from the top of their class and score extremely high in the screening process. They are very high end.”
            “Mimi knows the requirements for attracting and training prospective residents, says Nicholson, a practicing heat shock therapist. “She can lead the way an avoid pitfalls during the startup of the Family Medicine Residency Training in our county.” 
            “We have the perfect mix of medical training that residents are required to complete in residency,” continues Doohan. A few examples include sports medicine and orthopedics at Howard Hospital, global outreach by UVMC in Haiti, County Public Health department programs, working in the emergency rooms, family practice modeling at Baechtel Creek Medical Clinic, interacting with Juvenile Hall detainees, interning in ways to keep the homeless healthier, and working with the aging population of baby boomers.  
            Prospective graduate residents put in their applications and are screened by a noteworthy panel of medical professionals associated with the University of California at Davis. They visit sites and communities and are interviewed and courted to determine and recruit the residents that are most likely to not only stay for the three year residency but continue practicing in Mendocino County.
             “The potential of this program really drew me in,” says Landis. “Learning about the integrity of the program and seeing the energy and professionalism that comes with Mimi, Dr. Lynne Cohen and Charlie, got me excited to be part of something that can make a difference not only in our communities’ medical care, but with the multiplier effects new doctors bring when they settle here.”
            Goals of the three year timeline include reaching out to the community and businesses in order to garner strong local support for this residency program with Adventist Health as the institutional sponsor and UC Davis as the academic affiliate. It would be based at UVMC and its affiliated clinics including the Rural Health Clinic and the Mendocino Community Clinic in Ukiah. Given the successful completion of the accreditation by the American College of Graduate Medical Education, the first class of new residents is expected to be on board by the summer of 2018.
            Community support is vital, say the organizers. Everyone is invited to a meeting to learn more on Monday, June 8 from 5:00-7:30 pm at Mendocino College hosted by the Mendocino College Foundation. An enthralling guest speaker Dr. Richard Roberts, a rural doc, professor at the University of Wisconsin and President of the American Academy of Family Physicians will share his experiences and support for the family residency program in Mendocino County.
           
 
Heidi Dickerson is the director of Leadership Mendocino, a ten month program which creates opportunities to educate and inspire local people who believe in the future of Mendocino County and who are ready to make a difference. Applications for Class XXIII are now available by emailing lm@pacific.net.