Modesto Bee Article
By Ken Carlson, Modesto Bee Staff Writer
last updated: March 22, 2009
At left, Emma Padilla and mom Catalina Mascota, 93, discuss Mascota’s care with Todd Bouchier,
a resident in the Stanislaus Family Medicine Residency program, as attending physician Juan-Lopez Solorza listens. (Debbie Noda / The Modesto Bee)
Program resident Abilene Enriquez, left, prepares to examine Cadie Winkle, 6 months, as her mom Kristin Winkle holds her hand. (Debbie Noda / The Modesto Bee)
Multimillion dollar deficits and budget cuts in recent years haven't stopped the Stanislaus County health system from providing care for more than 70,000 low-income residents.
The loss of federal funding has been unsettling for the doctors-in-training at Doctors Medical Center and the Stanislaus County Health Services Agency clinics.
Jerry Chastain, one of two chief residents in the Stanislaus Family Medicine Residency Program, said it likely has hurt the program's ability to attract good residents. Medical school graduates want the assurance they can complete the training and move forward with their careers.
"I like the program; I want to stay; I want to be supported here, also," he said. "I am curious to see how the county reacts to the funding issue."
After completing medical school, young doctors receive practical training in health care settings before starting their practices. The applicants rank desired residency programs, and the programs rank the applicants, then a national system is used to match residents with programs.
If the Stanislaus program has to close for a year to qualify a new program for federal reimbursements, it will fall to the bottom of people's lists, Chastain said.
"If it were me starting over again, I wouldn't even consider it," he said.
The 27 residents in the Stanislaus program will be able to complete the three-year training if county supervisors commit the funding Tuesday.
Chastain and fellow chief resident Todd Bouchier talked about the 65 to 80 hours per week they spend in the program.
They routinely see patients come through the hospital emergency room who don't have private insurance or a regular doctor. The residents treat them in the hospital and then become their primary care doctors in the county health clinics.
During his first year of training, Chastain delivered more than 100 babies under the supervision of faculty members. About a third of the mothers have histories of drug use or problems such as gestational diabetes, he said.
Bouchier said they are getting more clinic visits from children whose parents have lost insurance.
"I think we will see more of that in the future," he said, alluding to the recession. "I would like to know how (the loss of federal funding) is consistent with the goals of serving the uninsured and underinsured. You have a program that has been shown to be a cost-effective way to serve this population. Why would you pull the money from that?"
Ex-refugee has wider view
The Stanislaus program is recognized for preparing doctors to work with underserved populations.
Dr. Sa Vang rose from humble beginnings in Stockton to attend the University of California at Davis Medical School and completed the residency last year. Born in a refugee camp in Thailand, she was among the thousands of Southeast Asian refugees who migrated to the Northern San Joaquin Valley in the 1970s and '80s.
It gave her the sensitivity to work with women of different ethnic backgrounds in the Ceres health clinic. The residency gave her the practical training to help them with their pregnancies.
"I grew up poor," Vang said. "I understand the things I grew up with: the language barriers, the cultural misunderstandings, the distrust of American medicine. I hope that with my background, the patients trust me and follow through with the care I recommend."
