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HOME > ABOUT > PRESS > DOCTOR'S RESIDENCY PROGRAM STILL VITAL
Article published - June 4, 2007
Credit: PRESS DEMOCRAT
Doctors' residency program still vital
This interview was conducted via e-mail by Staff Writer Carol Benfell.
PRESS DEMOCRAT: What is a residency program?
HAMMER: All physicians must complete residency training after medical school to become board-certified in a specialty. In family medicine this is a three-year program to follow four years of medical school. During residency, physicians are taking care of patients; managing clinics and hospital care; and fine-tuning all the knowledge from medical school with supervision from faculty. The Sonoma County program has a total of 36 residents, 12 in each of the three years of training.
PRESS DEMOCRAT: How did Sonoma County's Family Practice Residency Program get its start?
HAMMER: The Family Medicine residency in Santa Rosa started in 1938 as a training program for general practice doctors at the Sonoma County Hospital, which later became Community Hospital and then Sutter Medical Center. Before World War II most physicians were general practitioners, and after the war, the era of specialty care started. Family medicine became a specialty, and the residency was one of the first to become accredited in 1972 to train specialists in family medicine.
PRESS DEMOCRAT: Has this program received recognition outside Sonoma County?
HAMMER: What is phenomenal is the national stature of this program. It is truly one of the top programs in the country for training in family medicine. Also unique is the academic sponsorship by UC San Francisco, which gives medical students from there an opportunity to come to Santa Rosa for training in family medicine.
PRESS DEMOCRAT: Why is the program important to Sonoma County?
HAMMER: The primary importance of this program to the county is as a source of physicians. Over half of the primary care physicians now practicing in Sonoma County trained in this program. Here at Kaiser Permanente, 25 of my colleagues are from this residency.
Equally important is the medical care offered by the residents in clinics and to hospitalized patients. They are innovative and concerned and are active in many community health projects. To me and other faculty members, the importance of a teaching climate is that it keeps all of us on our toes with those questions from residents, and it makes us all learners.
PRESS DEMOCRAT: Sutter Medical Center has been operating the program for the past 10 years, but plans to close its doors in 2008. What is happening to the residency program?
HAMMER: A work group of concerned health care leaders was formed by Sutter last year to evaluate the residency. The product of this committee, consisting of Sutter, Southwest Clinics, the county, Kaiser Permanente and UCSF, was to develop a community-based consortium to administer the residency. The board of directors of the consortium will have representation from all these groups and Memorial Hospital and will be responsible for supporting the finances and administrative duties of the residency program.
PRESS DEMOCRAT: What part is Kaiser playing?
HAMMER: Leaders at Kaiser Permanente recognize the value to the community and service of the residency and have become a major contributor. Historically, we have sponsored and supported residency programs throughout California for over 60 years. The organization is foremost in the country in training residents in an integrated care model.
Until last year, Kaiser Santa Rosa had limited interaction with the residents. Now, Kaiser Permanente physicians such as Drs. Walter Mills and Cherie Green are spending many hours a week teaching and mentoring the residents. More than 30 physicians at Kaiser Permanente are mentors to residents. Many more members of the staff are teaching both at Kaiser and at other clinics.
PRESS DEMOCRAT: How will the program change when the consortium takes control?
HAMMER: The fact that all major health care groups are now involved will make this program even more extraordinary.
It allows the faculty, under the direction of the new program director, Dr. Colin Kopes-Kerr, and associate program director, Dr. Walter Mills, to plan a three-year curriculum using the best teaching sites in the county.
PRESS DEMOCRAT: What changes will residents notice?
HAMMER: The residents' training will be expanded to many new areas and they will be going to more sites.
As an example, the residents will be introduced to a comprehensive electronic medical record and concepts of population management at Kaiser Permanente or, with the more recent addition of Memorial Hospital, they could rotate through the Trauma Center.
They may be learning in a Sports Medicine clinic at Kaiser in a morning, then spend the afternoon at their clinic on Chanate. Then they might be at Memorial for rounds on hospitalized patients.
The biggest change for the faculty is the closure of Sutter as the teaching hospital. For those who did most of their hospital work at Sutter this shifts to Memorial.
PRESS DEMOCRAT: It costs about $8 million a year to run the program. Where will the money come from when Sutter closes?
HAMMER: This is the biggest challenge now facing the consortium. In this country, the primary source of funding for medical training has been Medicare. Medicare reimbursement for training is currently going to Sutter, and by bizarre and unusual Medicare rulings, we are having difficulty transferring that funding to Memorial. We do have support from Kaiser, and the Southwest Clinic has come forward with very generous support, but like every other program in the country involved in physician training, funding will be a chronic problem.
Through this yearlong process we at least know a few things: the residency program is a treasure and the health care community is doing their best to support it. This may be a truly uniting service in this county.
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