Home for doctors-in-training

Southwest Community Health Center took over a key piece of a training program for new doctors Wednesday, resolving a major sticking point associated with Sutter Health's plans to cease providing hospital services in Sonoma County.

Under a new arrangement, medical interns will do their outpatient work at Southwest Community Health Center's two clinics instead of at Sutter's clinic, which has been shut.

Sutter will continue in-patient instruction for interns at its Santa Rosa hospital. When it closes the hospital, that part of the program will occur at Memorial Hospital and Kaiser Permanente Medical Center, clinic officials said.

"The big unknown is when Sutter is closing," said Dr. Colin Kopes-Kerr, residency program director. "It is delayed, but we will be prepared."

Currently, Sutter's plans to halt hospital services in Sonoma County are mired in negotiations over its county contract to provide medical service.

Sutter and Memorial are working out details of an agreement to transfer most of the required services to Memorial. Sonoma County officials, however, say Sutter must ensure all services will continue before it can withdraw from its contract with the county.

A nonprofit consortium of executives from Sutter, Kaiser, Memorial, the Southwest Community Health Center and UC San Francisco have been scrambling to salvage the Family Practice Residency Program since January, when Sutter announced that it wanted out of its contract for medical services with Sonoma County.

The consortium received a major boost when Kaiser awarded $3 million to the family practice program to pay the salaries of family medicine residents. And Sutter provided a $1.25 million loan to cover operating expenses to demonstrate its commitment to keeping the program alive, said Sutter CEO Mike Cohill.

"Sutter's cutting back is what triggered this move, and it threw everyone into a tailspin," said Geza Kadar, a Santa Rosa attorney who serves on the Southwest clinic board. "If someone hadn't stepped into the void, there would be no family practice program."

Naomi Fuchs, Southwest's executive director, said the clinic took over vacant space at the residency program's Chanate Road office in late 2004 with an eye toward integration with the medical interns. Sutter's impending departure sped up the process, she said.

"It will strengthen access to primary care for patients, particularly in the Latino community and for people with Medi-Cal," Fuchs said.

Sutter's move to bow out of managing the residency program began about two years ago. But efforts to keep it alive reached a critical point last spring when doctors warned that medical students would shun any residency program that couldn't guarantee them three years' worth of training.

Over several decades, the residency program has become a primary source of physicians in the county. Currently, almost half of all those in active practice here are program graduates. With 36 doctors-in-training at any one time, the program graduates 12 annually and has created an influential constituency in the local medical community at area hospitals and clinics.

Efren Carrillo, the Southwest Community Health Center's board president, said the clinic is a logical place for new doctors to practice.

"There is still a crisis in health care for the uninsured and underserved patients," said Carrillo, who recalled visiting the clinic as a child with his parents. "But at least this shows we are preparing now for demographic changes that require more bilingual and bicultural medical service providers."

The clinic has about 8,000 individual patients, which clinic officials would like to expand to about 10,000. Because the clinic can operate as a federally qualified health center, Southwest is eligible for higher Medi-Cal reimbursement rates than the family practice clinic run by Sutter.

You can reach Staff Writer

Bleys W. Rose at 521-5431 or bleys.rose@pressdemocrat.com.