Tucked away in the Sierra foothills some 35 miles north of Marysville, Brownsville residents enjoy beautiful scenery, clean air, and a small town atmosphere where people know each other by their first name. They’re also subject to harsh winters and long drives down winding mountain roads to get to the nearest major city.
           
Despite its remote location, Brownsville boasts a modern health center complete with laboratory, X-ray, EKG, and mammogram equipment. Family physicians William Hoffman, MD, and John Rose, MD, started the clinic 30 years ago with the help of the community and funding from the Federal government’s rural health program.
 
Before the clinic opened in 1974, the nearest doctor was in Marysville or Yuba City. Stories abound of residents cross country skiing to get to a doctor when the snow got too deep to drive or injured loggers floated down the lumber flume to the hospital. Many people simply went without health care. Some waited until it was too late to get the treatment they needed for cancer and other serious health problems.
           
Meeting community needs
In Brownsville, two log cabins that once served as a staging site for fighting forest fires have been transformed into a 7,000 square foot medical building. The clinic serves an estimated 10,000 people spread throughout the foothills and are the only full-time providers of care for miles around.
 
Drs. Hoffman and Rose continue to practice at the Brownsville Clinic and have since been joined by a fulltime nurse practitioner.  Treating newborns to seniors, they give new meaning to the term family doctor.
 
“I’ve known many of my patients for 20 or 30 years and treated their children and grandchildren,” says Dr. Hoffman. “I love the people and challenges of practicing in a small rural area where I can take care of patients of all ages, no matter their ability to pay. I may earn less than I would in a big city, but the satisfaction I get from my job is priceless.”
 
Allie Rodenburg, age 90, is one of many residents to praise the clinic and the doctors. She and her husband moved to Brownsville 40 years ago before there was a health center.
 
 “I don’t know what I would do without the clinic, especially Dr. Hoffman. I was one of his first patients. He’s always been incredibly caring and helpful,” says Rodenburg. “My husband had terrible heart problems. If it wasn’t for Dr. Hoffman, he wouldn’t have lived as long as he did.”
 
Financial challenges
Nearly 70 percent of the clinics’ patients are on Medi-Cal or Medicare. Over the years, Medicare and Medi-Cal payments haven’t kept up with rising health care costs making it difficult for the clinics to cover their costs. Relief came in 1993 when the clinics joined Sutter North Medical Foundation and in 2002, when they received Rural Health Initiative (RHI) status from the Federal government. Clinics in underserved areas meeting RHI criteria receive higher Medicare and Medi-Cal payments to help cover the cost of caring for these patients.
 
“Given our high percentage of low income and uninsured patients, we wouldn’t be able to continue without the RHI funding and support from Sutter North. Being part of a larger medical group has made it easier for us to meet the administrative demands necessary to run a small practice and given us access to technologies we couldn’t afford on our own,” explains Dr. Hoffman. “Our patients also get access to specialists, hospital care, home health and other services available through Sutter North and Sutter Health. Just because you live in the country, doesn’t mean you shouldn’t have access to the same services as people in a big city.”
 
In March 1998, Sutter North opened a second small rural clinic in Wheatland to serve the community south of Marysville. Staffed by a full-time physician assistant, the clinic received RHI designation in 2003. Warren Campbell, MD, a semi-retired Sutter North physician, visits the Wheatland Clinic once a week to care for the more difficult cases.
 
Real town docs
After 30 years, Drs. Hoffman and Rose don’t show any signs of slowing down. Both continue to see over150 patients a week and log thousands of miles on their cars making house calls and following up on patients in the hospital and nursing homes. They also take the term “community” doctor to heart. They were instrumental in establishing the town’s first and only bank and helped create a local community center and park with two baseball fields.
 
“Brownsville and the surrounding area really hasn’t changed all that much. The people are still very community oriented and supportive of their neighbors. These people are more than my patients. They’re my friends and family too,” says Dr. Hoffman. “It’s been a great ride, and I’m looking forward to many more years to come.”

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