Proposed bill aims to keep doctors in Central Valley

When Dr. Cristina Valero was growing up in Orosi, there wasn't one doctor in town.

Her farmworker parents would see a doctor in Dinuba who often gave them free care.

This, and her parents' determination to push their daughter to be educated, inspired Valero to become a doctor. When she finished her residency, she returned to Orosi and worked at Family HealthCare Network's clinic there. Now she works at Tulare Regional Medical Center's rural clinics in Lindsay and Hanford and as a hospitalist at Kaweah Delta Medical Center.

While places such as Family HealthCare Network clinics have brought doctors to smaller cities that once had no physicians, Valero said there is still a need for more doctors in Tulare County.

In that thought, she is not alone. To encourage more doctors to work in underserved areas, state Assemblyman Henry Perea, D-Fresno, proposed a bill for the Steven M. Thompson Medical School Scholarship Program to help students pay for medical school. The bill, Assembly Bill 589, has a condition: The students contractually commit to work their first three years after residency in an underserved area.

The bill goes to the Assembly Appropriations Committee in a week, Perea said.

"I think that, from a state perspective, we can use an identified source of funding that could help overcome a major barrier to getting a medical education," Perea said.

That source is the Managed Risk Medical Insurance Program, which is partially funded by fines and penalties on insurance plans. Once those fines amass $1 million, anything above that million would go toward the Steven M. Thompson Medical School Scholarship Program, according to the bill.

While the premise sounds appealing, some supporters doubt its effectiveness.

"We're totally in favor of AB 589, but there's not much money there," said Harry Foster, CEO of Family HealthCare Network.

Even if it started providing scholarships to medical school students, that doesn't mean those students would stay in under-served areas, Valero said.

"They'll come here for their three years, then they'll move to L.A.," she said.

Perea said three years is long enough for a doctor to make roots and stay in an area.

The bill may help in the short term, but pre-med Stanford University student Lena Sweeney said it's not a long-term solution. Sweeney, a Golden West High School graduate who plans to practice in the area once she's a doctor, said the real source of keeping doctors in the Central Valley starts in local high schools.

"I think the barrier is far before medical school," Sweeney said.

While she had support from family and teachers, the college junior said it wasn't easy starting a career path toward becoming a physician. Many of Sweeney's fellow pre-med students have a parent who is a doctor or in some other highly educated field, and they seemed to have had their medical career path laid out when they were in high school, she said.

Sweeney said there should be more mentoring and support at a local level to encourage high school students to become physicians. Valero agreed.

"If you can convince the high school students to go to college and medical school, then they would come back here and stay here," she said.

The upside to the bill, Valero said, is that more local high school students may consider medical school if they knew there was a way to pay for the education.

Perea was asked if he considered that barriers to keeping medical doctors in under-served areas start long before medical school.

"That's a new thought I haven't explored. I'm sure there's something we can do to get folks earlier on in the process. I think that's something smart that we should be looking into," he said.

There is a program in town that is dialing up its efforts to do just that: A.T. Still University, an Arizona-based school of osteopathy that has a satellite school at Family HealthCare Network's administrative facility in Visalia, has an outreach initiative called the Hometown Program. Medical students from the school go into the community and encourage students to take medical career paths, said Dr. Isaac Navarro, who heads the program.

Navarro said the program lets local students observe different facets of health care so they can choose a field. It even allows them to shadow health care workers or volunteer in clinics. Eligible students can be in high school or college. Once they are ready to apply to a medical school, Navarro writes them an endorsement.

"We're here to show them the opportunity exists. We can address the need for health care providers from our own kids," Navarro said.