Is It Easy to Open Clinic as a Rural Doctor

Serving the community

Rural citizens love their rural doctors — if they stick around.

Too often, however, new doctors end up in places like Fall River Mills because the position provides an easy way to dissolve student debt. This is because generous federal loan forgiveness programs pay off hundreds of thousands of dollars in young doctors' student debt in exchange for practicing in medical shortage areas for a few years.

"In the 12 years I've lived here, I've probably had six different doctors," said retiree Bob Jehn, a former mayor of Cloverdale in Sonoma County and an active member of the Rotary Club of Burney-Fall River. "The prospect of having a single physician, especially at my age, for the rest of my life is not only appealing, but is a dream come true. For rural communities, including this one, that's been very difficult to make happen."

The two major health care organizations in the area — Mayers Memorial and Mountain Valleys Health Centers — face extreme challenges persuading doctors, physician assistants, nurses, physical therapists and other workers to move to the region.

"The person who wants to come here, live here and engage in the lifestyle — it's not for everyone," said Louis "Louie" Ward, chief executive officer of Mayers Memorial Hospital District, the 230-employee, economic engine of Northeastern Shasta County.

Although he can't compete with the hospitals in coastal cities that lure young doctors, Ward seeks to recruit people who want a variety of responsibilities, prefer slow-lane community life, and appreciate the old adage: It's a great place to raise a family.

"Most people enjoy the lifestyle once they give it a shot," said Ward, a Bay Area transplant who married into a family from Fall River Mills, where he and his wife are raising four children.

Leaders of Mountain Valleys and Mayers Memorial set their sights on Saborido a few years ago and have allowed him to work shifts in their inpatient and outpatient settings, side-by-side with Dahle, even though Saborido's UC Davis residency training program does not have a formal relationship with either organization.

It was a savvy get-to-know-you move for everyone because Dahle, a Vietnam War medic and local fixture for more than three decades, refused to retire until a young doctor arrived and committed to stay.

Louis Ward, left, CEO of Mayers Memorial Hospital District, and Saborido look over the construction of the hospital's new outpatient clinic for primary care medicine. (Edwin Garcia/UC Davis)

UC Davis meeting its mission

University of California medical schools have a young but rich history preparing a workforce to better meet the state's evolving health needs.

Between 2004 and 2008, each school began implementing programs to increase the number of physicians from underrepresented groups and placing them in communities where they are most needed, in order to achieve health equity.

Among the initiatives at UC Davis is Rural-PRIME, which offers medical students rotations in rural communities, often in places at or near where they grew up. Most of these opportunities are in the Central Valley but also north of Sacramento and in rural sections of the Central Coast.

In addition, UC Davis has launched a $1.8 million grant-funded initiative by the American Medical Association to expand access to quality care in pockets between Sacramento and Portland. It is known as COMPADRE, which stands for California Oregon Medical Partnership to Address Disparities in Rural Education and Health. The partnership with Oregon Health & Science University seeks to place hundreds of medical students and residents across a network of hospitals and federally qualified health centers.

Rural-PRIME and COMPADRE are taking major steps toward fulfilling the School of Medicine's mission of transforming the health of the communities where students and residents will one day serve as physicians.

"What UC Davis does is, we offer that richness, and that exposure, and that immersion into the breadth of clinical care needed to be a well-rounded doctor now, to take forward once you're in practice," said Godzich, an associate residency program director for UC Davis Health. Although Saborido wasn't in the rural track as a medical student, he shares the top characteristics that rural doctors possess, according to Godzich and Dahle.

Those traits include: a personal connection to the rural area, the ability to create and cultivate relationships, a commitment to primary care medicine, flexibility and wanting to be involved in the community. Being comfortable with uncertainty and with performing procedures that might be referred to specialists in a larger hospital also help.

Tommy Saborido is now a physician with the Mayers Memorial Hospital District in Shasta County.

Photo: Edwin Garcia/UC Davis

What's next for Saborido?

Saborido spent months contemplating whether to work for Mountain Valleys, Mayers Memorial, or both, like Dahle, as he approached the June 30 conclusion of his residency.

He chose Mayers Memorial in part because the hospital will soon open an outpatient clinic for primary care medicine. It's a similar role to what he's done in Sacramento, shuttling between the family medicine clinic and the emergency department.

"UC Davis has absolutely prepared me very well to welcome this opportunity that I have right now," he said.

Saborido and his wife recently purchased a house in Fall River Mills. Sloat, a graduate of the Rural-PRIME track at the School of Medicine, will give birth to their third daughter this fall and plans to return to clinical work in the near future. Saborido has been talking about getting involved in the Rotary Club, an elementary school and the 4-H Club.

He also plans to offer himself as a mentor for UC Davis students and residents.

"I would like to be able to do what Dr. Dahle did for me in a sense — show individuals who are interested or don't know if they are interested but end up finding out that they love it — find out what it's like to be a rural family doctor."

Saborido said he is grateful for the many professors who helped him pursue his dreams, adding he's confident that what he's learned will improve the health of Fall River Mills and surrounding communities.

"I'm the oldest of five kids of a single mom, we grew up on government assistant programs, and to be in a position now where I've gone through college, through a fine medical school such as UC Davis, and then residency, I have an incredible, incredible opportunity to give back," Saborido said.

"And it's not just in a way where I'm listening to hearts and lungs with my stethoscope, but really being there as an ear to my patients. That is what's really satisfying to me."

Saborido's first day at Mayers Memorial was July 5.

That happened to be the one-year anniversary of the remarkable day that deepened his desire to be a country doctor — when he correctly diagnosed a patient's stroke and arranged for a helicopter to fly her to UC Davis Medical Center, which ultimately saved her life.

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Source: https://magazine.ucdavis.edu/the-rural-doctor/

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