In the last few days, horrific wildfires have taken at least 17 lives and destroyed thousands of homes and businesses across California. I did my medical training with the Santa Rosa Family Medicine Residency Program, in one of the spots hit hardest by the fires, so I’ve closely followed media reports and updates from the local health care community.
While what is happening to this beautiful city is unimaginable, I can’t help but be inspired by the actions of the doctors in training and the community health center staff at the clinic where I learned medicine.
On Sunday, the first night of the wildfire, flames quickly surrounded the Sutter Santa Rosa Regional Hospital, and it was clear that the need for evacuation was urgent. The resident doctors spent all night stabilizing patients and preparing for transport while the fire advanced. The doctors rode transport to Sonoma West Medical Center in Sebastopol, Santa Rosa Memorial Hospital, and Sutter Novato Community Hospital and continued care in those facilities. Residency Director Tara Scott, MD, later sent an update to all residency program alumni: “Our town has been hit hard, and we don’t even know the extent of the devastation at this point, but you may not be surprised to hear that the residents and faculty were amazing. . . . They rode through the city in the middle of the night, through the fire zone with patients in their care, and they helped continue the care wherever they were taken. The doctors at those hospitals have all reached out to tell me how great our young doctors in training were!”
Across Sonoma and Napa counties, health care providers stepped up as the disaster spread, as is shown in this dramatic video footage of Monday’s evacuation of patients from Kaiser Permanente Santa Rosa Medical Center:
The Vista Family Health Center (the residency program training site, and part of a network of clinics for low-income residents called Santa Rosa Community Health), badly damaged by fire, is now unusable. On Monday morning, faculty, alumni, and residents set up a base at Sonoma West (formerly Palm Drive Hospital) to plan for a response to the disaster. From there, they worked out the logistics and communications needs to serve Santa Rosa residents displaced to shelters, and the more than 45,000 patients counting on the Santa Rosa Community Health Centers for care.
Residents, health center clinicians, and staff immediately became an emergency response team, working with residents at local shelters to make sure people received medical services. Asthma was a common complaint because of the worsening air quality. Staff worked around the clock at the call center, ensuring patients could refill medications lost in the fire. The CEO of Santa Rosa Community Health, Naomi Fuchs, commented on social media: “So incredibly proud of all the Santa Rosa Community Health staff and Santa Rosa Family Medicine faculty and residents. They are working all day and night at the Elsie and Cook Shelters helping those in need. Providers and staff and IT rallied at Lombardi to triage calls and see patients. Love you all.”
The Vista clinic is badly damaged and will not be functional for patient care for many months, displacing low-income patients as well as the doctors in training. Sutter Santa Rosa Hospital remains closed because of smoke damage — but only temporarily — so the residency program still appears to have a sponsoring hospital. Scott assured the alumni that her team will remain in place, and thanked everyone in the medical community for all the support from afar.
This could not come at a worse time for the region’s safety net. In Washington, the debate about repeal of the Affordable Care Act meant missed deadlines for community health center funding, causing significant financial challenges for the safety-net system. Now, the costs of rebuilding (and lost income) will be enormous for Santa Rosa Community Health, the center of care for low-income Santa Rosa residents.
Several of the physician residents have confirmed that their homes were destroyed. And yet the patient needs don’t end, the fire continues to progress, and they continue to work to make sure patients do not fall through the cracks.
Kelly Pfeifer is director of CHCF’s High-Value Care team, which supports policies and care models that align with patient preferences, are proven effective, and are affordable. She leads CHCF’s efforts in maternity care, end-of-life care, and the care of populations with complex behavioral health and medical conditions. Kelly was named the 2017 recipient of the Beverlee A. Myers Award by the California Department of Public Health for her work addressing the opioid epidemic. It is the agency’s highest annual award given to an individual exhibiting outstanding leadership in public health.
Prior to joining CHCF, Kelly served as chief medical officer for the San Francisco Health Plan — a managed Medicaid health plan — and medical director and family physician at Petaluma Health Center. She also served as the medical director for access for Redwood Community Health Coalition, a network of community clinics in four North Bay counties. She continues to practice family medicine. Kelly received a bachelor’s degree in English literature from Oberlin College and a medical doctorate from the Medical College of Pennsylvania. She trained in family medicine at the University of California, San Francisco, program at Sutter Santa Rosa.