Physician technology to assist with ultrasound procedures.
Physician technology to assist with ultrasound procedures.

CV prep

Community profile: Sacramento Valley, California

Table of Contents

The broad valley north of Sacramento between the Pacific coast of California and the Sierra Nevada, known as the Sacramento Valley, contains a group of communities which differ from the general image of California. In some ways, the area does typify California: a warm, sunny climate, abundant agriculture, an outdoor lifestyle. But in many other ways, it is unique.

The unique qualities of Sacramento Valley

The high cost of living, heavy traffic, and many of the crime problems which many Southern California coastal residents endure are not serious here. The costs of living in Redding, Chico, and Yuba City are quite reasonable by California standards, particularly when it comes to home prices. In these relatively small cities, the commute times average about 17 minutes. In addition, levels of many crimes are substantially lower in these communities than in the larger urban areas of Los Angeles, San Francisco, or even Sacramento.

This is gold rush territory. The terrain, marked by mountains, lakes, and flat valleys, is sprinkled with towns founded by and for prospectors and miners. Beginning in the late 1840s, thousands of miners flooded this area in search of gold. Various points along the Sacramento Valley were sites of mines, camps, and towns where the coveted ore was extracted from the land. Along with the miners came farmers. Some were livestock ranchers, others grew grapes and other fruit and vegetables. The miners left long ago, taking much of their wealth with them, but the farmers’ legacy lives on the fertile fields of the valley.

The inland climate has more distinct seasonal changes in temperature than the coastal regions of the state. Summers can be hot, exceeding 100 degrees F on many days. Winters are cool and wet. Snow and other frozen precipitation are almost never seen, since the temperature rarely dips below freezing.

These communities are growing, and while they are preserving their histories, they are also working to keep pace with developments in health care. Most of the communities are still in some stage of transition to managed care. Redding and Chico are the two largest cities in the region, serving as medical, cultural, and economic centers for large sections of the northern state. Yuba City and Marysville, twin cities closer to Sacramento, reflect the suburban nature of their location. They are more culturally diverse, if somewhat less developed medically. Each community has its own character, culture, and medical climate.

Yuba City and Marysville: Historically diverse

The histories of these twin cities are tied to the gold rush and 19th century California settlement.  Yuba City was founded in 1849 as a distribution center for selling supplies to gold seekers. Marysville, just east across the Feather River, grew faster however since it was easier for the riverboats to stop there. Marysville was named for Mary Murphy, a survivor of the infamous Donner Party and the wife of a city founder. Incorporated in 1851, it was the eighth city to incorporate after

California became a state.

The cities are now often considered the same community. A trolley run between the two downtown areas across the Feather River.

Sutter Buttes, the world’s smallest mountain range at 2,117 feet high and covering 75 square miles, lies just north of Yuba City. The buttes, remnants of an ancient volcano, once served as a refuge from flooding for Native Americans and local wildlife.

Yuba City and Marysville are more racially diverse than Chico or Redding. The population, consisting of nearly 9 percent Asian and more than 16 percent Hispanic residents, celebrates its diversity in a number of festivals and activities in both cities.

In Marysville, the Bok Kai Temple was established to honor the Chinese god of water in the 1850s by immigrants who came here to work in the gold mines. The Chinese new year is celebrated with a parade and festival honoring the god. Even though the Bok Kai festival takes place in February, at the height of the rainy season, it has supposedly never rained on the parade in its 118-year history. Perhaps the water god is watching. The festival is a colorful and noisy affair featuring a dragon, 50,000 firecrackers, gongs, and drums, as well as art exhibits, a run, and kite flying.

A large number of Punjabi Americans also live in the area. They celebrate their heritage at their own festival of music, dance, and food.

In May, participants in the Twin Cities City Slickers Cattle Drive spend five days on the trails, herding cattle from Timbuctoo into Marysville and Yuba City. The event is followed by the Marysville Stampede Rodeo each Memorial Day weekend.

Beckwourth Frontier Days pays tribute to the African-American frontiersman James Pierson Beckwourth. He discovered an easier and safer pass through the Sierra Nevada and led the first wagon train into Marysville in 1851. The October festival includes Native American cultural events, gold panning, music, poetry, and other activities in Marysville.

Northern California’s growing economy

Agriculture and the Air Force are important economic factors in Yuba and Sutter counties. Beale Air Force Base, which employs 4,800 people in Yuba County, is 12 miles east of Marysville. Plums, rice, beans, tomatoes, melons, and almonds are among the most important crops here. Agriculture represents nearly 18 percent of employment in the counties.

Another significant festival in September celebrates the area’s vital prune crop, which also includes music, food and multicultural entertainment. Most of the plums grown here are converted into prunes by Sunsweet.

The quality of life in Yuba City and Marysville is enhanced by their proximity to other areas and the short drive to Sacramento. “We’re about two hours away from everything—two hours from the mountains, San Francisco, the coast. It’s just a real central location,” says Deborah Coulter, the director of community relations of Fremont-Rideout Health System. “And we’re only 45 minutes
from Sacramento, which has an airport that can get you just about anyplace you want to go.”

Other amenities of Sacramento are available as well, such as the NBA and soccer teams, concerts, and the University of California-Davis.

For cultural events closer to home, the Regional Arts Council serves Yuba and Sutter counties with music, and The Acting Company provides award-winning community theater productions.

The Fremont-Rideout Health System serves the medical needs of the community through two hospitals, one each in Yuba City and Marysville. Currently, says Coulter, patients must go to Sacramento for open-heart surgery and other services not offered locally. Fremont-Rideout is planning to expand its services by the year 2000, however, by adding an open-heart surgery and invasive cardiology program.

Chico: “A great little college town”

Chico is about 50 miles north of Yuba City. While agriculture is still important here, there are other industries that support the economy as well. Chico has its own university and a rather different culture from Yuba City and Marysville.

Physicians in Chico are feeling the ground shake in the medical community, and it’s not from earthquakes. The city’s two hospitals have recently merged, creating some anxiety about the direction of healthcare in Chico. In addition, some physicians feel there may be too many doctors here.

David Clark, MD, a cardiologist in solo practice, is concerned with the number of physicians in Chico, particularly the specialists. “When I came here it was great for specialists, it was specialty oriented. The primary-care people who were here had really much more than they needed to do and they really needed specialists to help them out. In 1980 there was one internist calling himself a cardiologist. Since then it’s gone up to about 11 cardiologists, all of whom want to do everything. We don’t have one section of non-invasive and another section of interventional. Everybody wants a piece of the pie.”

Jerry Weiner, DO came to Chico a little over a year ago to join a family practice clinic. Now, he says, there seems to be overcrowding among primary-care physicians. “There was a real physician shortage two years ago. Three large medical groups were vying for territory and each of them brought in physicians all at once and now the area has quite a few physicians and maybe even has too many.”

Weiner sees more opportunity for specialists in the community than for primary- care physicians, naming several specialties in which he believes there is need for more physicians, particularly endocrinology and dermatology. Cardiology was not one of them.

Clark says that the focus on primary care is largely due to the influence of managed care. Weiner says that although the growth of managed care has outpaced the systems’ ability to manage it properly, things are improving. “Everyone’s been scrambling so quickly to set up things that they’ve tried to do things without sufficient staff and without sufficient training but it’s getting a little bit better.”

The merger of the two hospitals has both Clark and Weiner concerned. As of July 1, Enloe Health System purchased Chico Community Hospital from Paracelsus Corporation as part of a strategic plan to create an integrated delivery system that would be more attractive to managed-care contractors. According to Elizabeth Mitchell, the director of public relations at Enloe Hospital, the services of the two hospitals have been largely complementary. Enloe Health System offers heart and cancer care, orthopedic services, and designated level II trauma services. The community hospital offers extended care, acute psychiatric services, acute rehabilitation services, and skilled nursing care. Since these were areas which Enloe had determined were lacking in its services, it seemed a natural move to purchase the community hospital.

Weiner, who has been affiliated with both hospitals, is unsure about the consequences of the merger. “That’s an unknown right now. We have some real fears about whether they are going to have a sufficient number of beds. Their (Enloe’s) emergency room is real, busy.” Patients have told him they have sometimes waited up to two hours to be seen for non-emergent situations.

Although the details have not been decided, it has been suggested that Enloe may use the former community hospital for outpatient surgery, psychiatric, rehabilitation, and extended care services, while providing inpatient surgery and emergency room services at the original Enloe campus.

Mitchell says that no reduction in the amount of services is planned. “The recommendation is to centralize the provision of emergency care. If that goes forward, the staff of the emergency department of whatever facility doesn’t stay open would be transferred over to the hospital that will operate the emergency department because there will be a higher volume of patients,” says Mitchell.

Community growth

If the community keeps growing, the use of medical services should rise. The population of Chico has grown more than 60 percent since 1985.

That’s more than Clark would like. He laments the rapid growth of the city since his arrival 12 years ago. “It certainly has grown a lot more than I wish it had. Northern California is doing exactly what Southern California did in the ’70s. Chico is part of that. It’s growing by leaps and bounds. Some people love that, but I happen to be single. This place attracts mostly family people and retired people.”

The growth means more traffic and more congestion for Clark, although it still doesn’t come close to levels in larger urban areas. “We had one doctor who went before the city council pleading for no more stop lights and no more stop signs in this darned town,” says Clark. “People here were almost used to horse and buggy days. You could go on streets for miles without any problem, but now with such huge numbers of people going here and there and everywhere, that’s the only way they’ve been able to control traffic is to stop us about every quarter of a mile,” he says.

Despite these concerns, however, Clark says that life in Chico is very good. “I would say overall lifestyle is a real plus in northern California. You can’t take anything away from that. It’s really environmentally conscious even with all the construction. So for families I think they love it.”

“If you’re looking at everything from camping and hiking and hunting and fishing, this is northern California. We are an hour and a half from Mt. Lassen, two hours from Mt. Shasta, and we’re still only maybe three hours plus to San Francisco,” says Clark.

Weiner is also happy with the community. “It’s very friendly. It really seems like a midwestern city. Except for the mountains, you’d think that you’re in Illinois or Indiana or Iowa,” he says.

Arts and sports

Education, government, and health services are some of Chico’s major employers. As in many parts of the Sacramento Valley, agriculture is important here. That activity tends to aggravate allergies.

“It’s not a good place to be if you have allergies with all the farming and the spraying and the pollens,” says Weiner.

One big plus for Chico is the presence of California State University, Chico. The university offers instruction in liberal arts and science as well as engineering, computer science, technology, communications, business, nursing, agriculture, and education. Jobs are competitive in some fields thanks to the labor pool provided by the university.

In addition, Western University of Health Sciences has a branch at Chico, training physician assistants and nurse practitioners.

According to Regina Levison, the president of Levison Search Associates, a search firm in Sonoma County, the university lends Chico an intellectual atmosphere. “Chico is a great little college town. It has a very intellectual feel about it with the college there. It’s also on a river, and it’s very pretty. It just feels safe.”

University arts programs enrich the community with their performances in music, ballet, and theater as well as sponsorship of touring artists and community productions. University students ensure patronage of the numerous nightclubs and coffee houses.

Weiner has found plenty of cultural events in Chico. “There is usually a lot of theater. They have Shakespeare in the park during the summer, lectures at the university, a lot of movies,” he says.

The Chico Symphony Orchestra performs at CSU and the Chico City Light Opera stages productions. In addition, there is the Chico Creek Theater Festival, a young group which produces a variety of unusual as well as more common productions.

The downtown area is vital, according to Weiner. “They’ve been preserving the downtown pretty nicely. They have a farmers’ market on Thursday and Saturday and they have concerts in the park on Fridays during the summer.”

Chico even has its own professional baseball team. The Chico Heat, a member of the Western Baseball League, entertains crowds at CSU’s Bohler Field.

Chico is a physically active town, as well. Bicycling magazine named Chico America’s number one bicycling town in its August 1997 issue. Part of the reason for this distinction was that the city’s large urban park, Bidwell Park, offers places for mountain and road biking right in the city. A trail to Mount Lassen, 60 miles away, starts right in downtown Chico. The city also favors bike lanes and bike parking areas.

Bidwell Park, 3,600 acres of preserved space within the city, was established by the city’s founders, General John and Annie Bidwell. The second largest municipal park in the nation, it contains a  children’s park, nature center, dirt and paved trails for walking, skating, biking, and riding. It is here that Shakespeare productions are held in summer.

Redding hospitals and lifestyle

Residents of Redding, at the northernmost tip of the Sacramento Valley, take the activity one level further. Redding lies between the Cascade and Trinity Alps mountains and is surrounded by national forests. Mount Shasta and Shasta Lake are just north of the city. These features promote the outdoor lifestyle and tourism that characterize the area.

In fact, Fred Grabiel, MD was visiting from Monterey County, looking for a vacation home, when he found a position and ultimately made a permanent move to Redding. “Actually I wasn’t looking for a job, I just went by the ER and checked it out and I was very impressed at how advanced the medical community was,” says Grabiel. “The medical community here, in my judgment, practices better medicine than they do in Monterey County—even in Carmel. I was very impressed.”

The two hospitals in Redding, Mercy Medical Center and Redding Medical Center, provide services in cancer care, cardiac surgery, trauma, infertility, and emergency care.

Grabiel, an emergency physician, says that the quality of medicine in Redding is enhanced because the attractive area draws the best physicians. “The area has attracted physicians who look for quality of life in their practice and in their surroundings. It is a very beautiful area,” he says. “I can’t help but make a strong correlation between the people who really enjoy their life and who are refreshed and renewed with that outdoor recreation and their quality of medicine. They are able to break away from the hectic and I think they are better physicians as a result.”

Grabiel says most members of the medical staff are involved in outdoor activities on an intensive level. “There isn’t a couch potato in the group. We have rock climbers, we have marathoners, we have triathletes right in our ER group,” he says, and adds that other members of the medical community are equally active.

Although the area may lack a full array of department stores and shopping centers, Grabiel says that is more than made up for in the natural scenery and quality medicine. “You’ve got absolutely  gorgeous surroundings and advanced, cutting-edge medicine.”

The city has seen its market enter into the managed care era, although not to the degree of   Sacramento, according to Grabiel. While some of the doctors had difficulty accepting it, the community has adjusted to the change. “We had probably two or three years of a delay in managed care hitting us as compared with Sacramento which is heavily penetrated,” says Grabiel. “We saw them go through a terrible transition before it became a reality for us.”

Redding does not seem to suffer from the perceived overcrowding of physicians that Chico does, according to Grabiel. “You know, it’s amazing. The medical community keeps growing and every new doctor that comes to town gets his practice filled overnight. You can go down to Monterey and it takes two years to get your practice going. You come up here and in three months you’ll be booked. There is a demand here,” says Grabiel.

That may be due to the large area served by Redding’s health-care community. The emergency medical systems region which includes Redding encompasses 11 counties, representing 22 percent of California’s land mass and two percent of its population, says Grabiel. Residents of this region receive advanced or critical care in either Redding or Chico. That means that the level of service available in Redding is much higher than would normally be found in a town of this size.

Redding is also the cultural center for far northern California. The Redding Symphony, Shasta Symphony Orchestra, and Community Concert Association present musical programs. The Redding Museum and Art Center, Carter House Science Museum, and Shasta Natural Science Association see to the enrichment of the community.

Residents have developed an appreciation of the historic buildings and attractiveness of downtown, says Grabiel. “We didn’t pay that much attention as a community for a long time. It has become a focus. We’ve spent some money rebuilding downtown, keeping the old theater and things with history and with character.”

In addition to preserving historic architectural treasures in the downtown area, the city is making efforts to make the downtown area accessible and attractive, says Grabiel. For example, the city developed the Sacramento River Trail System, eight miles of trails along the Sacramento River, which runs through the city.

Crime is less of a problem in Redding than in the more urbanized parts of the state according to  Grabiel, and residents are working to keep it that way. “Our gang violence is very minimal. It’s nothing compared to other towns,” says Grabiel. “But as long as there’s even a fraction of a component, it’s something that we address.” The city is building and enhancing facilities for recreation and developing the services needed to keep kids out of trouble.

That low level of troubled youth is perhaps reflective of the quality of schools and the level of parental involvement. Grabiel is supportive of the public schools in Redding. “This won’t say very much because California has taken a dive, but they’re at the top of California school systems. California is struggling with the quality of their education now so it’s not saying as much as it would have,” he says.

As another alternative, a significant number of parents in Redding have chosen to educate their children at home, says Grabiel. “We’ve traditionally had a fair amount of homeschooling and the home schools have become organized. They have become grassroots schools that have integrated into the public schools and have become charter schools.” These charter schools offer unique and varied curricula such as an emphasis on computer sciences or natural sciences.

Redding’s scenic setting

Natural sciences are experienced first hand in the mountains which surround Redding. Lassen  Volcanic National Park, about 40 miles east of Redding, features Lassen Peak, a volcano which erupted in 1914. It was made a national park in 1916 as an active volcanic landscape. The park includes geothermal features, cinder cones, and several lakes.

The majestic Mount Shasta is a focal point for the region. The largest stratovolcano in the Cascade Range, the peak, which last erupted in 1786, stands at 14,160 feet elevation and hosts five glaciers. Its slopes are used for skiing and hiking.

Just north of Redding and within sight of Mount Shasta is Shasta Lake, California’s largest lake. Houseboating is one of the more popular water sports on Shasta Lake. Whiskeytown- Shasta-Trinity National Recreation Areas also include several other large reservoirs for water sports and forests for mountain climbing, hiking, hunting, and horseback riding.

Castle Crags State Park and Lake Shasta Caverns display remarkable stone features above and below ground.

It is access to these resources that Grabiel says make Redding special. “It doesn’t have access to Macy’s, but it has access to the outdoors and rock climbing, lots of bicycling, tons of water sports, hunting, fishing, camping—all the outdoor stuff is available here. There is a lot of public land, there is the national park, the national forest—people really do have access up here,” he says. �

Bett Coffman is the associate editor of UO.


Bett Coffman

Easy to Register >> Control your visibility >> 100% free

Take control of your Job Search

Recommended PracticeLink Magazine Articles

Physician technology to assist with ultrasound procedures. Physician technology to assist with ultrasound procedures.
Community profile: Eagle La...
PracticeLink MagazineMarch 1, 2013
By Marcia TravelsteadBy Marcia Travelstead
Family-friendly cities for physicians Family-friendly cities for physicians
Live and Practice: Family f...
PracticeLink MagazineDecember 4, 2013
Eileen LockwoodEileen Lockwood