Texas County Memorial Hospital has retained a nationally known recruiting firm, Delta Physician Placement of Dallas, Texas, to assist it in recruiting two primary care physicians for the TCMH Medical Complex, board members heard last week at their monthly meeting.
“Over the past year we have lost some physicians,” said Wes Murray, chief executive officer at TCMH. “There are many challenges to recruiting physicians in a rural area.”
In 2007 internal medicine physicians, Lubna Wani, M.D. and Tasaduq Fazili, M.D., a married couple, left TCMH for Wani to pursue a fellowship opportunity in Oklahoma. TCMH moved Mohd Boda, M.D., also an internal medicine physician, from his Cabool clinic to Houston, consolidated the two clinics in Cabool and continued to seek an additional internal medicine physician.
Boda gave notice to TCMH in April this year that he was leaving, and TCMH modified its physician recruiting efforts from one physician to two and broadened the search to include family practice physicians with an interest in adult medicine and geriatric care.
Internal medicine and family practice physicians, commonly referred to as “primary care” physicians, are the most sought after physicians throughout the U.S. and have been for several years.
Fewer physicians are choosing primary care as a specialty, and the numbers of physicians retiring are outpacing the numbers of physicians entering the workforce to replace them. Additionally, the need for physicians is growing as the population continues to age.
“We want you to know that we’re doing everything we can to recruit physicians to our area,” Murray told board members.
Joleen Senter Durham directs physician recruiting efforts at the county hospital in addition to her public relations and marketing duties. Durham works with about 10 different contingency recruiting firms to assist her in identifying and recruiting potential physician candidates, but in the past year, the numbers of leads have dropped off.
Durham explained to board members that in addition to utilizing outside recruiting firms, she networks with other physician recruiters, has attended physician functions to recruit physicians, utilizes an online physician recruiting source that provides daily leads and cold calls and follows up on any physician leads that are given to her.
“I have not been able to find a physician that will be a good fit for our recruiting needs,” Durham explained.
After lengthy discussion and much research regarding retained physician recruiting companies, the hospital hired Delta Physician Placement. It was recommended to TCMH by another small hospital in southern Missouri.
More than half of Delta’s physician placements in 2007 were in locations with populations of 50,000 or less and 42 percent of its searches in the past year have been for primary care physicians.
“Now is an excellent time to throw everything we’ve got into recruiting efforts because the residents in their final year are looking at practice opportunities available after they graduate in 2009,” Durham said.
The TCMH compensation package for primary care physicians is higher than the national average and above the range recommended by Delta.
“We are offering a very competitive wage and total compensation package for our primary care physicians,” Murray explained. “I don’t want anyone to think that the reason physicians leave or the reason recruiting is a challenge here is because we don’t pay enough.”
Murray noted that geographic location is a drawback to many physicians and their families.
“We have to identify physicians that are willing to practice in rural areas,” he said.
Durham is in contact with family practice programs that have rural residency rotations such as the Cox Family Practice Residency Program in Springfield. TCMH also hosted a University of Missouri medical school student this summer as another way to expose a future physician to what Texas County has to offer.
“If we can identify physicians that are interested in working in rural locations, I’m certain that our compensation package and what our hospital has to offer will convince a physician to join us,” Durham said.
Durham added that she’s “very confident” regarding the addition of a retained physician recruiting firm.
“I believe they will greatly assist TCMH in identifying and recruiting in the next few months,” she said.
Debra Buckle, family nurse practitioner, continues to see patients at the TCMH Medical Complex. Dr. Michael Moore, a retired family practice physician from West Plains, is also seeing patients two days a week there until a full-time physician is recruited.
The hospital is searching for a family nurse practitioner to collaborate with Dr. Eugene Honeywell at the TCMH Family Clinic in Licking. With the addition of a mid-level provider like a nurse practitioner, the clinic could receive “rural health clinic” designation, which provides a higher Medicare and Medicaid reimbursement level for the hospital.
Murray also reported that Medivan trip rates will increase beginning Aug. 1. The hospital operates two Medivans as low-cost, non-emergency transportation for Texas County and the surrounding areas.
“Three years ago we received a grant from the Missouri Foundation for Health to assist us with the costs of running the Medivan program, and that is about to run out,” Murray stated.
He noted that with the increased cost of fuel, the $5 one-way rides were up for evaluation.
“We have created a multi-tier approach to better address the current cost of fuel for the vans,” Murray explained.
One-way trips of five miles or less in length will remain $5; trips up to 15 miles will be $10; trips up to 25 miles are $12.50; and it will be an additional $1 per mile for trips outside of the TCMH service area.
The Medivans have transported more than 3,800 passengers over 110,000 miles in less than three years since the program began. More than 40 percent of the passengers needed transportation with wheelchair accessibility, available through the Medivan. The Medivans have many repeat customers, and Houston, Cabool, Mountain Grove, Licking and Summersville are the major pick up and drop off locations.
“We don’t want to cut off accessibility to the Medivan, but we need to help cover more costs,” Murray said.
The hospital’s proposed expansion project is moving forward as planned. Blueprints for the project are close to finalization, and JE Dunn Construction Co. is sending the blueprints out for bids.
“Local and regional sub-contractors have expressed an amazing amount of interest in the hospital’s project due to the downturn in overall construction projects,” Murray said.
More exact construction cost numbers will be presented at the August board meeting after the subcontractors have made their bids.
Linda Pamperien, chief financial officer at TCMH, presented the financials for June. Inpatient and outpatient revenues were down, and the hospital ended the month with a negative bottom line of $80,627 and a year-to-date balance of $210,234.68. The average daily census was 12.
Present at the meeting were Murray; Durham; Pamperien; Doretta Todd-Willis, chief nursing officer; Dr. Charles Mueller, chief of staff; Jeff Ijames, dietary director; Hope Best, human resources and clinic coordinator; Terri Driesel, physical therapy director; Christie Koch, physical therapy student; and board members Omanez Fockler, Jane Kirkwood, Janet Wiseman and Larry Southern.
Board member Mark Forbes was not present.
The next meeting of the TCMH board of trustees is noon Tuesday, Aug. 26, in the downstairs meeting room of the hospital.