Family-Practice Program Attracts and Holds Good Doctors

For John Prichard and 120 other local physicians, the lure of Ventura County was not its balmy weather or low crime rate, but a program at the county’s public hospital where talented young doctors are trained as latter-day Marcus Welbys.

In the world of family-practice medicine, experts say that Ventura County Medical Center’s UCLA residency program is among the best in the nation.

As a result, not only do the county’s poor and uninsured receive their care from a stable of 39 good young doctors, but the larger community has retained a rare cluster of talented general physicians.

“The thing that’s amazing is that this program really is respected around the country, yet it’s something that few people in this county are aware of,” said Prichard, who directs the Department of Internal Medicine at the county hospital.

Prichard, 47, is among the 80 local graduates of the program who first came to Ventura for training, then remained for the quality of life and the level of medicine practiced here.

Though recruited away to help build a family-medicine program at Baylor University in Houston in 1986, Prichard said he came back in 1988 partly because the students and doctors at Ventura County public hospital were very good.

Prichard is among 21 graduates of the residency program who now teach in it and who base their practices at the county hospital. And he is one of four hospital department heads trained in the program.

That has produced a professional respect and small-town collegiality unusual in hospitals and very important in how departments work together, Prichard said.

The county hospital’s UCLA residency is exceptionally good partly because it has been around for so long, said program director Lanyard K. Dial, who is himself a graduate.

A general practice residency was set up here in 1928, and Ventura County’s public hospital was one of the first 14 in the nation to begin offering family medicine as a recognized specialty in 1969, Dial said.

“When you look at the quality of care at a hospital, there are a variety of things you consider--nursing, equipment, office competence,” Dial said. “But the key component is the physician.

“Here we have 39 extra physicians, and the whole program is run through a group of 40 teaching physicians who tend to be on the leading edge of what is going on in the medical world,” Dial said.

While no one precisely ranks the nation’s 400 family medicine residencies, a program’s quality can be determined by how many top medical graduates apply, Dial said.

The Ventura program has 13 openings a year and should expect 50 applications if it is moderately good, he said. Instead it receives 400 applications.

With that pool of talent, the young doctors accepted are inevitably among the top students in their medical schools, Dial said. Three of the current 39 residents were first in their graduating classes at large eastern medical schools, he said.

Jodie Escobedo, 25, is among the top medical-school students at Washington University in St. Louis. By this time next year she said she hopes to be practicing at Ventura’s county hospital.

“Everybody I talked with said great things about this program,” she said Monday while in Ventura for a class at the hospital. “I talked with people at other programs in California, and everywhere I was I’d say, ‘How would you compare to Ventura?’ They all said this is a very strong program.”

A large plus for the Ventura County program, she said, is that the hospital needs its family doctors to be responsible for all aspects of a patient’s care.

“A lot of big university hospitals have more doctors than they do patients,” Escobedo said. “And there are so many other specialties (residency programs) that the primary care doctor is at the bottom of the heap. So you have to fight to do anything.”

Robert K. Rakel, author of three textbooks on family medicine, said he always recommends that students apply for residencies in Ventura.

“That is one of the best training programs for family physicians in the United States,” said Rakel, who is head of the Department of Family Medicine at Baylor College of Medicine in Houston.

In fact, Rakel said, Ventura County is fortunate because by hosting the residency program, this community is improving the quality of its health care.

“You’re seeding that area with the best physicians in the country,” he said.

Local doctors tend to agree.

“Up in Ojai most of our family physicians come from that program,” said veteran obstetrician Robert Skankey. “I would trust my life with them. They’re very well-schooled.”