Yuma Regional Medical Center's chief medical officer will ask the state Senate Appropriations Committee Wednesday to funnel a significant chunk of funding proposed for training new doctors to Yuma and other rural counties facing a physician shortage.
Dr. Bharat Magu said the bill he will testify about, SB1354, has already been unanimously approved by the House, and is expected to allocate $30 million to
$50 million to Graduate Medical Education (GME, also known as residency) programs statewide.
"But how much of that comes to the rural programs is where the rubber meets the road. And frankly, if you train doctors in Maricopa (County) and Tucson, it doesn't help us very much here.
"What we want to stress is it's extremely critical in the funds allocation for rural GME programs specifically dedicated, which is carved out of the bigger fund. Generally, all those funds have traditionally gone to U of A or the bigger systems, and we become part of the bigger rural community which is asking for these funds," he said.
Magu said Yuma County currently has one doctor for every 2,700 of its residents, or 1,000 more than the statewide average of 1,700, which "isn't great." He wants to expand the hospital's current residency program for family medicine practitioners, as well as add new ones for sorely needed specialties.
YRMC sends about 700 patients needing critical and acute behavioral health treatment by ambulance to hospitals in Phoenix or Tucson each year, he said, and it's unknown how many are referred out of the community by other sources.
"That's really a big disservice, we really need to make sure we have a training program where we can train physicians to provide psych, emergency, general surgery, sports medicine, palliative care, these are very very critical needs of the community," he said.
There is one full-time psychiatrist in town, while emergency room visits for behavioral health problems quadrupled from 2017 to 2018, to more than 17,000.
Some of that increase is due to painkillers becoming less accessible to patients due to the fight against opioid addiction, with some of them coming in with a psychiatric diagnosis instead, Magu said.
"But still, that doesn't even come close to explaining the whole horizon of this, it's almost at a crisis level at this point. So we definitely want to make sure we address it not only by putting resources into our psych (emergency room) department but also start up a (residency) program in the future."
All of these specialties are facing critical shortages now in Yuma County or are expected to within five to 10 years, as 25 percent of all of its current physicians reach retirement age.
There is currently only one doctor at YRMC specializing in palliative care to reduce suffering for end-of-life patients, he said. Orthopedic patients, particularly children and those with small-bone injuries, are forced to go outside the community for care at the second-highest rate, after psychiatric patients.
YRMC launched its Family and Community Medicine Residency Program in 2013 and has graduated 17 doctors so far, said program director Dr. Kristina Diaz. Another six are on track to graduate this year.
"One of the things that's important is when a provider leaves residency, especially in family medicine, they will touch approximately 250,000 lives in the course of their career. So if you think about it, every year we graduate a bandwidth of touching 1.5 million people in their lifetime. It's amazing," she said.
Magu said about 70 percent of YRMC's former medical residents have chosen to stay in the community. "We would have been a lot worse if we did not create this program," he said.
He said his cause has already gotten support from many local legislators, including Sens. Sine Kerr, R-Buckeye, and Lisa Otondo, D-Yuma. But he encourages constituents to continue to press those at the Capitol for additional funding for rural medical education.
"We don't want to create the image that it's YRMC supporting the law. We want to create that funding for the medical education program for the rural community in Arizona ... We want to support that in every way possible," he said.