ESCONDIDO — The future of care for pregnant and other gynecological patients remains uncertain at Palomar Health following the termination of four OB/GYN doctors last month.
The OB/GYNs, who work at Palomar Health Medical Group’s North County Women’s Specialists clinic, received 90-day termination notices on Oct. 29.
“There had been no warning, no discussions or negotiations leading up to this surprise announcement,” said Dr. Paul Hinshaw, one of the terminated doctors.
The terminations were “made based on a change in our organization’s direction,” stated Russ Riehl, president of Palomar Health Medical Group and chief administrative officer of Palomar Health, in his email to Hinshaw.
“This is not a reflection of your clinical capabilities or patient care, and I appreciate the contributions you have made to the organization and your service to our patients/community,” Riehl continued.
According to Hinshaw, Palomar Health Medical Group had five OB/GYNs seeing patients before the terminations, along with five nurse practitioners and about 15 staff members.
After the terminations take effect Jan. 31, 2026, only one OB/GYN will remain, operating alone in a separate office from the clinic.
The day after the doctors received their notices, staff asked hospital administrators who would take over their caseload. Hinshaw said administrators did not have an answer.
“There does not seem to be a plan in place to smoothly transition care for all of our patients,” Hinshaw said. “There really isn’t a good reason that this happened, and it will definitely negatively impact patient care for the district.”
The four departing physicians leave behind decades of service in the community.
“We were a well-established private practice, providing care in North County for over 50 years, prior to being taken over by Palomar five years ago,” Hinshaw said. “We have the best reputation in North County for gynecological surgery.”
Hinshaw also expressed concern that the hospital has not informed patients about possible disruptions in care.
Although the hospital will continue delivering babies, the future of prenatal care and numerous scheduled surgeries remains unclear.
“I can’t believe they’re not telling patients or the staff anything,” Hinshaw said. “What are all these people going to do? They should know they’re getting the rug pulled out from under them.”
The termination letters were issued just over a week after the Palomar Health board of directors approved the creation of a joint powers authority with UC San Diego Health, though it remains unclear whether the actions are related.
The Coast News reached out to UC San Diego Health and Palomar Health for clarification. UC San Diego Health redirected questions to Palomar.
“Palomar Health regularly reviews its physician network to ensure we are meeting the needs of our community. As part of that process, we continually evaluate how to best organize and deliver OB-GYN services across North San Diego County,” said Karla Nafarrate, a spokesperson for Palomar Health, via email. “Our focus remains on providing safe, high-quality care and ensuring continued access for all patients. We do not discuss internal operational or personnel matters.”
Laurie Edwards-Tate, a Palomar Health board member, said she did not recall hearing about planned OB/GYN terminations before speaking with The Coast News.
“Patient care and quality is one of my foremost responsibilities and a very big priority for why I ran for office,” she said. “I would hope that whatever options were taken would not jeopardize that in any way.”
The Coast News also contacted Board Chair Jeff Griffith for comment, but did not immediately receive a response.
Hinshaw said he does not believe the terminations stem from the new UCSD agreement.
“We’ve been part of the community for decades,” he said. “I’m sure UCSD wouldn’t try to fire people, they would just try to get us to work for them. It’s all very bizarre.”
Hinshaw said he believes he may have been targeted because of his past reluctance to involve himself in “hospital politics,” though he is unsure why the others were terminated.
Riehl also assured the physicians that they would be paid for their continued work following the notices, which raised additional concerns.
“The medical group has been very difficult to deal with in terms of asking for financial data regarding our pay ever since we joined them,” Hinshaw said. “My partners do not want to take new patients because they don’t think they will be seen for follow up, and quite frankly, we’re not sure we’re going to end up getting paid for what work we do the next few months since it takes a while to collect billing and it is possible they come up with a reason not to pay us.”
Hinshaw added that, nearly every year, the medical group identifies “differences in accounting,” which are described as a shortage.
“They withhold tens of thousands of dollars from us,” he said. “The ‘proof’ or accounting data has been hard to come by.”
Though termination is difficult in any profession, Hinshaw and the others said they are not necessarily looking to stay with Palomar, citing what he described as a decline in management over the past five years. For now, he said his biggest concern is how patients will be treated moving forward.
“So much garbage has happened in the last five years – it’s just another crazy thing, but I can’t believe what they’re setting the patients up for, and I can’t imagine they have a seamless transition in place, because they usually don’t,” he said.
