Copyright Los Angeles Times
As a family physician, I am all too familiar with difficult conversations. I know what it is like to tell someone that their breast cancer has come back, their child passed away, or they are HIV-positive. But right now, I am in the process of telling all my patients that after more than a decade, I can no longer be their doctor. Every time, it is the most difficult conversation of my career. I am not retiring or moving practices. Instead, I am losing my job because the Trump administration’s “defunding” of Planned Parenthood has forced Melody Health, my primary care and behavioral health practice, to permanently close. Because Melody Health is a part of Planned Parenthood, we cannot be reimbursed by Medi-Cal, and therefore cannot afford to stay open. Planned Parenthood of Orange and San Bernardino Counties started Melody Health in 2013 because patients who came in for things like birth control and STI testing were often unable to find quality, affordable primary care. I was recruited straight out of a family medicine residency to be the first doctor at Melody Health. Word spread quickly that people could get primary care at Planned Parenthood, and even get appointments with a family physician that same week. We went from two clinics to four to seven in a few short years, with Melody Health locations at Planned Parenthood health centers in Anaheim, Costa Mesa, Mission Viejo, Santa Ana, Westminster, San Bernardino and Upland. We built out our ability to manage chronic diseases like diabetes and hypertension, and offer preventive healthcare like cancer screenings. We hired new doctors, added staff and equipment, and did everything we could to meet the needs of our community. Last year, Melody Health served 13,000 patients across Orange and San Bernardino counties. When the COVID pandemic hit, we opened one of the first community-based vaccine clinics in Southern California, and offered free vaccines to anyone who needed them — not just our own patients. When we learned that our patients were having difficulty finding affordable mental health counseling, we started our own behavioral health program, and brought on eight therapists to serve our low-income patients. When we learned that many of our patients had difficulty navigating the complex health care system, we hired a patient navigator for every health center to assist patients with care coordination. But now, my patients have nowhere else to go. I don’t know what will happen to them, or if they will keep taking their medications, or if their next doctor will have someone on staff who can help them schedule specialist appointments because they don’t speak English. What will happen to the patient that needs weekly psychotherapy to manage their depression? Who will be there to guide that patient in the tenuous early stages of recovery from addiction? I also think about our staff. Seventy-seven people at Melody Health, myself included, will lose their jobs. These are kind, dedicated, patient-centered, mission-driven people who chose to work in a difficult field because it is the right thing to do. They created a culture in our health centers of compassion and deep responsibility to the needs of our community. There is a great irony in the Trump administration’s actions. While they claim to target Planned Parenthood to eliminate abortion care, the reality is that they are instead devastating vital primary care and behavioral health services for low-income individuals. This week, I have looked each Melody Health patient in the eye and told them that I am sorry that I can’t be there for them anymore. My heart breaks as I acknowledge the uncertainty they are now facing. I will do my best to shore up any treatment plans and make sure they have medication refills, but make no mistake, this will have lasting impacts that will ripple through our community for years to come.
