This SLO County town is losing its only full-time doctor with an office. ‘This is a sad day’
The only full-time physician with an office in Cambria or San Simeon is retiring at the end of 2021, after having served local patients for 35 years.
Dr. Robert Gong will continue to see patients until Friday, Dec. 31.
“Unfortunately, I have been unable to find another physician to take my place,” he wrote in the Oct. 11 letter.
As soon as the resignation letters hit patients’ mailboxes, anxious North Coast residents took to phones, social media and other sources, pleading for help finding a new primary care provider.
“This is a sad day for the Cambria health care delivery system,” Ron Yukelson, chief marketing and strategy officer for Wilshire Health & Community Services, wrote in a series of emails. “I’m hoping the community will work on a creative solution to attract a talented health care provider to the area … and support that person as they have Dr. Gong.”
Many small, remote communities across the country have been facing a shortage of physicians for decades, the Western Journal of Medicine reported in 2000.
“About 20% of the U.S. population … live in rural areas, but only 9% of the nation’s physicians practice in rural communities, which tend to be not only smaller but more remote,” the journal said then.
The situation hasn’t improved over the past decade.
The American Association of Medical Colleges wrote on its website in 2020 that physician shortages have left a growing number of communities “desperate for care.”
“Of the more than 7,200 federally designated health-professional shortage areas, three out of five are in rural regions,” the association said. “And while 20% of the U.S. population lives in rural communities, only 11% of physicians practice in such areas.”
Why has it been so hard to attract a physician to the Cambria area?
“It’s the way health care itself has changed” in recent years, said Cecilia Montalvo, a director on the Cambria Community Healthcare District board. “It’s no longer about the solo doctor.”
Young residents, she said via phone, especially those going into internal medicine and general practice, are affiliated with big medical corporations such as Kaiser Permanente. Or they join a physicians’ network or group of other doctors who share their specialty.
“They don’t want to be business people and medical providers at the same time,” Montalvo said. “Most doctors just want to take care of their patients … and they enjoy collaborating with their peers.”
Some health care providers have said that Cambria’s demographics might discourage doctors from practicing there. Many of the community’s roughly 6,000 residents are retired.
According to Montalvo and Yukelson, mostly geriatric practice in remote areas is less lucrative than general practice or specialty offices in larger communities.
That’s due in part to the high cost of office space and housing and the ever-decreasing rate of Medicare reimbursement to general practitioners.
To make a private practice pay, some doctors feel they must charge their patients more than Medicare’s going rate.
As such, according to Medicare rules, they’re not eligible for Medicare reimbursement. The patient must bill Medicare directly.
“The economics of a solo primary care practice, in today’s world, particularly if the majority payer is Medicare, is very challenging,” Yukelson wrote. “Unfortunately, Dr. Gong’s business model is largely extinct.”
“The evidence is,” he continued, “most solo primary-care doctors in our county have changed to a concierge model as a means of survival,” if they want to practice medicine on their own.
Doctor’s retirement surprises patients, community
While most assumed that Gong would probably retire sometime in the future, his announcement that he’d be closing his office doors on Dec. 31 took most of his patients and the medical community by surprise.
Some community members said they’d estimated the doctor would still be practicing for another year or so at least.
In his letter, Gong did not give a reason for his retirement.
He had a heart attack in June 2010 and resigned from the Coast Unified School District board of directors about a month later, although he later returned to his medical practice. He and his family have declined to give additional details about his health since then.
Gong wrote that, with permission from each patient, he’ll forward their records to the new health care provider of their choice.
He told patients to try contacting Tenet Health Central Coast, which owns Sierra Vista Regional Medical Center in San Luis Obispo and Twin Cities Community Hospital in Templeton, or Dignity Health, which runs Arroyo Grande Community Hospital and French Hospital Medical Center in San Luis Obispo. The Central Coast Medical Association is another option, Gong wrote.
Gong’s office is located at 2150 Main St. in Cambria.
For about a year, First California Physician Partners (FCPP), a nonprofit medical foundation affiliated with Tenet California, had maintained a large, ground-floor office in that building with part-time physician Alison Lewis. It closed in 2020, and the space is still vacant.
The Cambria Community Healthcare District has been in discussions with Tenet, Dignity Health and other providers since FCCP left, hoping to find another physician or medical group willing to move an existing practice to town or start a new one on the North Coast.
So far, that effort hasn’t been successful.
However, David Griffith of Cambria may be able to supply a solution. He is a concierge physician who focuses his local practice primarily on elderly, home-bound patients who cannot go out to a doctor’s office.
Griffith does not have a brick-and-mortar office into which patients come to be treated, or a large office staff. That helps keep his costs down.
He addressed the North Coast looming need for a full-time, in-office physician in a phone interview.
“I’m working on something, and maybe by the time Dr. Gong retires, I can pull it off. Or maybe not.” Griffith said, although he declined to say what that solution might be.
With only two months until Gong’s retirement, the clock is ticking.
According to Gong’s voicemail message, his office is currently open 9 a.m. to noon on Mondays, Tuesdays, Thursdays and Fridays.
Cambria health clinic prepares for move to new office
As news of Gong’s departure spreads, Cambria’s already busy Community Health Clinic of the Central Coast (CHC) is preparing for a possible wave of new patients.
The clinic is moving from its current home at 2515 Main St. to a new, larger office at the Cambria Village Square, 1276 Tamson Drive, in the building that used to be the Heritage Oaks Bank office.
Construction crews have been working on converting the former bank into a medical office.
Nurse practitioner Cesilia “Cece” Lomeli, who works fulltime in the CHC Cambria clinic, has been treating her patients there for more than a dozen years, backed up by various physicians on the CHC roster.
Ben Cooke, a CHC internal medicine physician, treats patients there on Tuesdays.
The new office setup should provide enough space for CHC to expand the number of doctors and specialists it assigns to the Cambria clinic, Lomeli said.
