JULIAN: Town Struggles to Find Replacement for Retiring Doctor

      Although "having a family doctor in town has always been one of the charms, and blessings, of Julian," the town, nestled 4,500 feet up in San Diego's backcounty, has been forced to go without one for the "first time in decades," after the retirement of their 77-year-old physician, Richard Jones. Residents are "desperate" to find a new doctor, but face difficulties not uncommon to other rural areas. Even with aides practicing in town, Julian will still find it difficult to replace Jones. Rural doctors do "not get wealthy," says retired doctor Gene Helsel, who is part of the search committee in Julian. Jones reported making up to $130,000 yearly, but most of his earnings were eaten by expenses, such as care costs not covered by HMOs. "A young doctor who needs a practice to support himself is not going to do it, at least not right away," Helsel said.

Help on the Way?
      The San Diego Union-Tribune reports that many "remote towns are miles from the nearest doctor" because "the current health care system requires doctors to treat a high number of patients in order to turn a healthy profit." Because of that trend, "many general practitioners have joined medical groups instead of opening solitary practices." Sen. Tom Daschle (D-SD), has introduced the Promoting Health in Rural Areas Act of 1999, which "would help rural communities recruit and retain doctors by helping retiring doctors find replacements up to a year before they retire," as well as "establish the National Health Service Corps to place health care professionals in underserved areas. "Additional help comes from the federal government in the form of increased Medicare payments to "physicians who work in rural areas designated as 'underserved.'" Also, the California Rural Health Policy Council formed in 1996 to "increase health care access to four million rural residents across the state." Unfortunately, Julian was taken off the federal list in 1994 and residents have been fighting ever since to get it back on the list (Lieberman, 9/1).