The decision is the outcome of an ongoing rift between Community and Valley Children’s Hospital over control of pediatric services in the central San Joaquin Valley and could result in the Fresno-area having two competing residency programs, one based at Community Regional Medical Center and the other at Valley Children’s.
In a memo released to employees and the public, Tim Joslin, Community’s president and CEO, said the hospital system and the university have signed a letter of intent to expand pediatric care and education. “The immediate goal — by this summer — is to increase the availability of pediatric medical specialists at Community Regional,” Joslin said. “We’re working on long-term goals, too, and I’ll share details when they’re sufficiently concrete.”
Community and the University of California at San Francisco-Fresno Medical Education Program have had a decades-long relationship. Community trains about 300 medical residents and fellows through the UCSF-Fresno program at Community Regional Medical Center in downtown Fresno.
The new collaboration allows UCSF-Fresno to “better integrate our women’s and children’s services in the region and support UCSF’s mission to provide care to patients in areas that are underserved,” said Dr. Stephen Wilson, associate chief medical officer for UCSF Benioff Children’s Hospital San Francisco.
It’s not yet known how many pediatric residents will be in the new program or what specialties will be included. The specialties could include, for example, pediatric gastroenterology, cardiology or neurology.
Dr. Michael Peterson, interim associate dean for UCSF-Fresno, said “we have a lot of work to do between now and over the next six months to answer those kind of questions.”
In the interim, one possibility is for UCSF pediatric sub-specialists in the Bay Area to travel to Fresno to see children or provide examinations via telemedicine, he said. The goal is to make sure “pediatric patients have access to the sub-specialty services that in the past was something Valley Children’s provided and that they’re not currently providing,” Peterson said.
There was little doubt what prompted Community’s decision to expand its partnership with UCSF-Fresno. Joslin said the actions were taken in reaction to recent decisions by Valley Children’s Hospital to cancel an agreement with Santé Independent Physicians Association and to create its own pediatric residency program.
In October, Valley Children’s notified Santé that it was severing ties with the doctors’ group that is aligned with Community Medical Centers. The officials said Community was building its own pediatric network to support a 40- to 80-bed pediatric tower. Community denied such plans but said once Valley Children’s cut ties with Santé, the largest doctor’s group in Fresno, it had no choice but to build up pediatric services.
Now, Community Regional Medical Center will need to add pediatric beds, said Craig Wagoner, chief executive officer. The downtown hospital, the largest in Fresno with more than 600 beds, currently has eight beds designated for children and operates an 84-bed Level 3 neonatal intensive care unit. Community’s neonatal unit is only slightly smaller than an 88-bed Level 4 unit at Valley Children’s, which can handle babies with the highest medical needs. Wagoner on Monday would not say how many new pediatric beds are planned or whether they will be part of a women’s and children’s tower that hospital officials have said will be built.
Valley Children’s officials announced on Jan. 8 they had plans to create a standalone residency program, effectively ending a 40-year partnership with UCSF-Fresno. The hospital said the decision was not connected to its dispute with Community, but the announcement caught UCSF-Fresno administrators by surprise. UCSF-Fresno currently trains 12 pediatric residents at both Community Regional and Valley Children’s Hospital. Community Regional receives federal funding for five of the residents and Valley Children’s Hospital gets federal money for seven.
Peterson said the hope is that UCSF-Fresno can work out a smooth transition for its current pediatric residents to complete the program with Valley Children’s over the next two to three years. He would like to work with hospital officials for training opportunities to continue “even if they have their own residency program,” he said.
Valley Children’s had said it was willing to take over the responsibility for the UCSF-Fresno pediatric residency, both its finances and programs, until the Valley Children’s residency program is established, which could be another year or two.
On Monday, Dr. David Christensen, senior vice president and chief medical officer at Valley Children’s, said he was “disappointed to learn late last week about UCSF-Fresno’s decision to reject our offer to assume academic and financial responsibility of its pediatric residency program. With the cooperation of UCSF-Fresno, we would have been able to provide the most seamless transition for residents currently in the program and ensure continued collaboration on graduate medical education.”
Valley Children’s will proceed with its own pediatric residency and fellowship training program at the hospital in Madera County, Christensen said.