News from Sierra Nevada Memorial Hospital and Hospital Foundation


When you live in a rural community, it can be challenging to get connected to the medical services you need. A significant obstacle is access to a primary care physician. The number of primary care physicians in the U.S. is declining significantly. According to the Association of American Medical Colleges, the shortfall will range from 21,400 to 55,200 by 2033.

While recruiting primary care physicians is a high priority for communities across the U.S., impact is immediately felt by people when their physician leaves or retires. When that happens, they are frequently left on their own to find a new doctor. While this can be incredibly frustrating, Nevada County is not unique as communities across the country grapple with filling these shortages.

Something that many people don’t know is that in California, nonprofit hospitals such as Dignity Health Sierra Nevada Memorial Hospital, cannot legally employ physicians. One exception is hospitals in extremely remote and isolated areas. While we consider our area rural, we do not qualify for the exemption. Another is for profit hospitals set-up under a physician group model.

There is genuine collaboration between physicians and the hospital in many areas of medical practice. However, federal and significantly influence how hospitals can structure their relationships with physicians. People often think the physicians they see at SNMH are employees, but they are actually employees of physician groups, which contract with one or more hospital. Examples of this include hospitalists, emergency department physicians, radiologists, and others.

The same is true within the community. A physician may be a sole provider, part of a physician group, and may even have privileges at SNMH, but they are not employees of the hospital. While the names are similar, Dignity Health Medical Group (DHMG) is an independent nonprofit physician office and not part of SNMH which has been confusing for many.

For those challenged with finding a primary care physician, an option that more and more people are considering is a Physician Assistant (PA). Many physician offices have PAs. They are medical professionals who diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient’s principal healthcare provider.

PAs broad medical training enables them to provide a wide spectrum of patient care and treat the whole person. According to the National Commission on Certification of Physician Assistants, from 2013 to 2018 the rate of certified PAs per 100,000 population increased from 31 to 40. A 2014 Harris poll found 92% of Americans who engaged with PAs said it was easier to schedule a medical appointment. The Harris poll also showed extremely high satisfaction among those that have seen a PA and found 91% believed PAs improved the quality of their care.

As many things in life, healthcare continues to evolve. Some may remember a time when doctors made house calls. The medical community will continue to work hard to bring new physicians to the area, but it continues to be a challenge.

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