Fleeing Valley's unhealthy air
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Seeing a specialist often means waiting weeks or leaving the area. Hospitals and medical groups are forced to create new incentives to lure doctors and nurses.
Air quality "is a black eye" for the Valley, said Matthew Craven, manager of recruitment at Saint Agnes Medical Center in Fresno.
At recruiting conferences, Craven said people tell him they would never move to the Valley because of what they've heard about the air.
It is the No. 1 reason specialists refuse offers to join lucrative Valley medical practices, said Fresno cardiologist John Telles, who interviews potential doctors for a large cardiology office.
Doctors interested in practicing medicine in California are attracted to the Valley by the low cost of housing and the Sierra. Medical groups also offer doctors a lot of money to move here, Telles said.
But air quality becomes a sticking point. Doctors and nurses know the risks, such as heart and lung illnesses, that come with polluted air.
Highly trained specialists are in short supply nationwide. They can pick anywhere in the country to practice medicine, said Dr. Jim Davis, chief of trauma at Community Regional Medical Center in downtown Fresno.
"If the money is relatively equivalent, then you get to lifestyle issues -- health, family," said Davis, who helps recruit surgeons for the teaching staff at the UC San Francisco-Fresno Medical Education program.
Davis has seen a change over the years in the priority doctors place on air quality. Surgeons he interviewed in the 1990s asked a lot of questions about crime in Fresno. They now ask about air quality first.
One doctor who fled the Valley's poor air quality said the slow pace of change drives people out.
Dr. Fred Williams said he might have considered remaining in Fresno at his neurosurgery office. But he didn't have confidence that those charged with cleaning the air would be able to reduce the smog and soot that affected wife Nessie Williams' lungs.
"My wife was just becoming more and more unhealthy," Williams said. "Whenever we would travel away from Fresno, her breathing would improve and when we came back, her breathing would deteriorate."
The couple left Fresno three years ago for cleaner air in Hillsboro, Ore., a city west of Portland, where there are only a handful of bad-air days each year. Since the move, Nessie's asthma symptoms have eased.
Said Williams, 53, of the decision to leave Fresno: "I had to make a move -- I didn't have a choice."
The departure of one doctor might not sound like much, but his decision to leave Fresno compounded a problem.
More brain surgeons have closed offices and moved or retired in the past few years than have come to the Valley, said Dr. John Bonner, a neurosurgeon who closed his practice in 2003 after a 31-year career in Fresno.
Replacing a professional in a highly competitive field such as neurosurgery is neither easy nor cheap.
Recruiting, interviewing and hiring a new employee -- not to mention paying substitutes to fill in until a person is hired -- can cost up to three times a replaced professional's salary, said John Sullivan, a professor of management at San Francisco State University.
"When you lose health-care professionals in any city, it's millions of dollars," he said.
And one decision to leave has a ripple effect, said Sullivan. Colleagues also begin thinking about a move. "If a top person leaves, five to 10 people follow them."
Air quality officials say they recognize there are economic consequences from air pollution chasing professionals away. They cite the problem when asking for federal and state money to help clean the air.
"Now the health consequences and the economic consequences of air pollution have been given equal consideration" when considering clean-air regulations, said Seyed Sadredin, executive director of the San Joaquin Valley Air Pollution Control District.
But those who flee the Valley for cleaner air say that concession may be too little and too late.
Fresno dentist Bob Claypool, 52, sold his dental practice in 2005 and moved to San Diego for healthier air.
Claypool said he spent a decade relying on two asthma medications, antihistamines and steroids to try and keep his lungs open. For the past year in San Diego, he hasn't needed them.
He gets sick when he returns to the Valley for any length of time.
Claypool had expected to keep filling cavities at his Fresno office for another decade or longer. "I loved my patients," he said. But he hated being ill.
"I was getting sicker and sicker," Claypool said. "I knew if I didn't make a change, I was probably going to end up in the hospital -- or dead."
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