Archived: Hiring of Doctors Will Help Medically Underserved Rural Communities


While our state is reeling from a budget crisis of historic proportions and services for our citizens are being cut to the bone, this is not the time to allow short-sighted and self-serving motives to continue to stand in the way of adopting sound policy changes that will improve communities and save lives. Especially when the proposed changes will have no impact on the state budget. To stand in the way of these proposed changes is shameful and exactly what opponents of lifting the “physician hiring ban” (AB 646) are doing.

California’s rural and inner-city communities have long suffered from a shortage of physicians and inadequate access to healthcare. Ineffective incentives and pleading invitations to lure doctors to California’s remote and poor urban communities are unsuccessful due the demographics of these communities. In places like Tulare County where thirty percent of the population is on Medi-Cal and another twenty percent is no-pay/indigent, doctors simply cannot afford to set up practice when they are routinely paid as little as $24 per patient visit when their cost to provide care is closer to $50.

Today we are presented with a sound and simple solution that can go far to fix doctor shortages in poor, medically underserved communities throughout the state. The solution is offered in a bill that will allow California’s Health Care Districts to directly hire and employ physicians, offering them stable employment, a fair salary, benefits and required insurance. This practice is widely accepted and utilized – forty-five other states allow the direct employment of physicians by specified health care facilities and the American Medical Association officially approves of direct physician employment.

However, for decades the public hospitals and clinics operated by California’s Health Care Districts have been prohibited from hiring physicians because of an outdated and unnecessary statute, Section 2400 of the California Business and Professions Code.

While every other public health care agency in the state is exempt from this “physician hiring ban”, California Health Care Districts that operate 46 of California’s 72 public hospitals, 31 of the state’s 66 rural hospitals and dozens of public health clinics, are the only public health care providers that still have their hands tied when it comes to hiring desperately needed doctors.

AB 646 would allow California Health Care Districts to operate under the same rules as every other public health agency in the state, bringing doctors to areas where an unnecessary institutional barrier has choked off the supply of doctors for the poor and people of color, creating a disturbing reality where now nine out of ten communities served by the Districts are designated as “Medically Underserved” or “Health Professional Shortage” areas by the U.S. Department of Health and Human Services.

I have worked my entire life advocating for policies at the state, local and national level that benefit workers, immigrants, families, women and children. I know from my years of experience fighting for social justice that without access to medical care, communities do not improve themselves – they cannot overcome cycles of poverty and low educational and economic achievement.

Our state is already facing a crisis in healthcare. With deeper cuts to Medi-Cal proposed and imminent, the shortage of doctors especially in poor rural and inner-city communities throughout California will quickly worsen. We cannot stand by while our children and elderly go without necessary medical care. Not when a sound and simple solution – an exemption to an outdated statute – is all it will take to help fix the problem at no cost to the state.

I applaud the State Assembly on its recent bi-partisan 57-15 vote in favor of AB 646 and urge our state Senate leadership to pass this bill. Not often are we blessed with such simple solutions to such serious problems – they are a gift in these complicated and troubling times.

Dolores Huerta is a community organizer, a political activist, and co-founder with César Chávez of the United Farm Workers Union. She is the current president of the Dolores Huerta Foundation, which has as its mission to inspire and motivate people to organize sustainable communities to attain social justice.

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