UNIVERSITY OF MISSOURI PHYSICIAN PLACEMENT SERVICE Completing the

UNIVERSITY OF MISSOURI PHYSICIAN PLACEMENT SERVICE Completing the Rural Pipeline Kathy Brown June 22, 2010 MU AHEC – Office of Rural Health

History § Rural track program created in 1995 § Evolved into pipeline program – Summer community program – Third year clerkship program – Bryant Scholars pre-admissions program – Fourth year electives

History § Successful program/significant results § Pipeline had tendency to leak towards the end § MPPS created to stop leaks § Connect physicians with communities

History § Applied for grant to Missouri Foundation for Health – awarded in 2004 § Expand third year clinical training sites § Expand Bryant Scholars pre-admission program § Provide faculty development activities for community-based preceptors § Create “bridging program” (which became Missouri Physician Placement Service)

Mission n Increase access to health care in rural and underserved areas – MPPS is part of the University of Missouri School of Medicine (MU AHEC Office) – MPPS is a non-profit service – all fees are used to sustain the program

Mechanics – How, What, When, Where, Why? n Visited placement programs in other states – Similar models (University settings; AHEC affiliated) – Good reputations

Mechanics n Developed program framework – Fee structure n Program years to become self-sustaining in three – Service agreement n Approval through University Business Office

Mechanics n Visited two area healthcare facilities and “pitched” the program – Good dialogue – Incorporated comments/suggestions

Mechanics n Sent letter to all hospitals in Missouri – Explained program – Invited them to participate – Announced job fair n 22 hospitals joined that first year – Visited all; toured communities and hospitals; met recruiters

Mechanics n Meanwhile, started establishing candidate pool – Sent letters to recent MU med school graduates – Sent flyers and e-mails to MU residents – Made presentations to MU residents – Eventually subscribed to Practice. Link (national databank of physicians and opportunities)

Mechanics n Purchased recruiting/tracking software program – Tracks both candidates and opportunities n Met with physicians when possible, but did a lot of contact by e-mail and phone

Mechanics n Organized first job fair – Decided on weeknight immediately following the work day (5 – 7: 30 p. m. ) – Found location on medical school campus – Table and two chairs for each participant – Specific directions to location – Upscale hors d’oeuvres – Multiple e-mail reminders to residents

Mechanics n Job fair very successful (annual event) – ~ 70 physician participants n Meanwhile – first placement in the works – Pediatrics resident placed with FQHC in northeast Missouri – They weren’t all that easy

Roxana Ionas, MD Successful pediatrician in Kirksville, Missouri Completing her fifth year

Mechanics n Stayed in touch with both physicians and hospitals – Offered CV’s to hospitals when appropriate n Looked for opportunities to speak to groups of residents – Developed presentation on rural practice

Mechanics n Annual evaluations – Physician candidates or potential candidates – Hospitals/healthcare facilities – Incorporate suggestions when possible n Sent mailing to facilities to “re-up” – Number has grown – highest was ~ 40 – Currently 37

Fine Tuning n Convinced MU Business Office to have “open ended” services agreement – Don’t have to renew each year n Adjusted fee structure – Reduced annual participation fee – Participation fee is subtracted from placement fee

Fine Tuning n Added information on CV development, interviewing, contracts to resident presentation n Expanded presentation to other residency programs in the state

Program Maintenance n Stay in touch with hospitals and physicians – Make sure physicians are still active candidates – Make sure open position list is current n Visit hospitals periodically

Program Maintenance n Produce periodic e-newsletter for participating facilities n Continue to look for potential physician candidates from a variety of sources – Databases – MU Alumni

Funding n Initial three year grant funding – “Banked” all program-generated income during that period n Projected program self-sufficiency at the end of three years – Had reserves to last ~ two years

Funding n Medical school support – Temporary increased funds for MU AHEC from MU medical school n Stimulus funds – MU AHEC received share of stimulus funds – decision made to apply to MPPS

Funding n Unsuccessful overtures to Missouri Primary Care Association (who receives state funds for placing health professionals in rural/underserved areas n Future funding - ? ?

Services for Medical Students n Help students look at residency options n Encourage medical students to remain in Missouri for residency

Services for Physicians n Provide information about communities looking for physicians – Web site links – Info from Chamber of Commerce – Knowledge from personal on-site visits

Services for Physicians n Sponsor an annual job fair where residents meet with representatives from healthcare facilities looking for physicians n Facilitate spouse/partner job searches (e. g. put in contact with appropriate people) n Assist with CV development and/or review

Services for Physicians n Enable physicians to look at a variety of opportunities coordinated through a single source n Provide information on practice types, compensation models, salary surveys, etc. n Assist international medical graduates with positions that meet their visa requirements

Services for Hospitals/ Communities n Visit communities and prepare practice profiles n Help communities identify assets and liabilities related to recruiting/retaining physicians n Identify physicians that match community/ hospital needs

Services for Hospitals/ Communities n Promote Practice Opportunities – Advertise on national websites – Exhibit at national and regional conferences n Promote practice opportunities to MU and other residents – as well as practicing physicians – MU grads and others

Services for Hospitals/ Communities n Advise on process and techniques of recruitment n Assist with development or review of promotional materials

Benefits of MPPS n Helps connect physicians and communities/healthcare facilities that may never have learned about each other n Provides assistance/expertise with recruitment that is not available in many hospitals or other healthcare facilities in Missouri (particularly in smaller, more rural communities)

Benefits n Anticipated increased retention n Increases the number of physicians in rural and underserved areas of Missouri n Helps renew the rural pipeline

Challenges n Services agreement n Identifying physician candidates seriously interested in practicing in rural Missouri n Recruiting for many facilities simultaneously

Challenges n Not achieving financial sustainability n Duplication and other issues with state’s placement service n Issues with statewide group of inhouse physician recruiters

MPPS Successes

The “Bird’s Eye View” 37 current participating facilities/communities More than 200 open positions Fifteen successful placements 92% retention rate

Contact Information • Kathy Brown, Missouri Physician Placement Service • (573) 882 -3910 • brownmak@health. missouri. edu