UNIVERSITY OF MISSOURI
MISSOURI PHYSICIAN PLACEMENT SERVICE
Completing the Rural Pipeline
Kathy BrownJune 22, 2010
MU AHEC – Office of Rural Health
History Rural track program created in1995
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)
MissionMission
Increase access to health care in Increase access to health care in rural and underserved areasrural and underserved areas
– MPPS is part of the University of MPPS is part of the University of Missouri School of Medicine (MU Missouri School of Medicine (MU AHEC Office)AHEC Office)
– MPPS is a non-profit service – all fees MPPS is a non-profit service – all fees are used to sustain the program are used to sustain the program
Mechanics – How, What, Mechanics – How, What, When, Where, Why?When, Where, Why?
Visited placement programs in Visited placement programs in other statesother states– Similar models (University settings; Similar models (University settings;
AHEC affiliated)AHEC affiliated)– Good reputationsGood reputations
MechanicsMechanics
Developed program frameworkDeveloped program framework
– Fee structure Fee structure Program to become self-sustaining in Program to become self-sustaining in
three yearsthree years
– Service agreementService agreement Approval through University Business Approval through University Business
OfficeOffice
MechanicsMechanics
Visited two area healthcare Visited two area healthcare facilities and “pitched” the facilities and “pitched” the programprogram
– Good dialogueGood dialogue
– Incorporated comments/suggestionsIncorporated comments/suggestions
MechanicsMechanics
Sent letter to all hospitals in MissouriSent letter to all hospitals in Missouri– Explained programExplained program– Invited them to participateInvited them to participate– Announced job fairAnnounced job fair
22 hospitals joined that first year22 hospitals joined that first year– Visited all; toured communities and Visited all; toured communities and
hospitals; met recruitershospitals; met recruiters
MechanicsMechanics
Meanwhile, started establishing Meanwhile, started establishing candidate poolcandidate pool– Sent letters to recent MU med school Sent letters to recent MU med school
graduatesgraduates– Sent flyers and e-mails to MU residentsSent flyers and e-mails to MU residents– Made presentations to MU residentsMade presentations to MU residents– Eventually subscribed to PracticeLink Eventually subscribed to PracticeLink
(national databank of physicians and (national databank of physicians and opportunities)opportunities)
MechanicsMechanics
Purchased recruiting/tracking Purchased recruiting/tracking software program software program – Tracks both candidates and Tracks both candidates and
opportunitiesopportunities
Met with physicians when Met with physicians when possible, but did a lot of contact possible, but did a lot of contact by e-mail and phoneby e-mail and phone
MechanicsMechanics
Organized first job fairOrganized first job fair– Decided on weeknight immediately Decided on weeknight immediately
following the work day (5 – 7:30 p.m.)following the work day (5 – 7:30 p.m.)– Found location on medical school Found location on medical school
campuscampus– Table and two chairs for each participantTable and two chairs for each participant– Specific directions to locationSpecific directions to location– Upscale hors d’oeuvresUpscale hors d’oeuvres– Multiple e-mail reminders to residentsMultiple e-mail reminders to residents
MechanicsMechanics
Job fair very successful (annual event)Job fair very successful (annual event)– ~ 70 physician participants~ 70 physician participants
Meanwhile – first placement in the Meanwhile – first placement in the worksworks– Pediatrics resident placed with FQHC in Pediatrics resident placed with FQHC in
northeast Missourinortheast Missouri
– They weren’t all that easyThey weren’t all that easy
Roxana Ionas, MDRoxana Ionas, MD
Successful pediatrician in
Kirksville, Missouri
Completing her fifth year
MechanicsMechanics
Stayed in touch with both Stayed in touch with both physicians and hospitalsphysicians and hospitals– Offered CV’s to hospitals when Offered CV’s to hospitals when
appropriateappropriate Looked for opportunities to speak Looked for opportunities to speak
to groups of residentsto groups of residents– Developed presentation on rural Developed presentation on rural
practice practice
MechanicsMechanics
Annual evaluationsAnnual evaluations– Physician candidates or potential Physician candidates or potential
candidatescandidates– Hospitals/healthcare facilitiesHospitals/healthcare facilities– Incorporate suggestions when possibleIncorporate suggestions when possible
Sent mailing to facilities to “re-up”Sent mailing to facilities to “re-up”– Number has grown – highest was ~ 40Number has grown – highest was ~ 40– Currently 37Currently 37
Fine TuningFine Tuning
Convinced MU Business Office to Convinced MU Business Office to have “open ended” services have “open ended” services agreementagreement– Don’t have to renew each yearDon’t have to renew each year
Adjusted fee structureAdjusted fee structure– Reduced annual participation feeReduced annual participation fee– Participation fee is subtracted from Participation fee is subtracted from
placement feeplacement fee
Fine TuningFine Tuning
Added information on CV Added information on CV development, interviewing, development, interviewing, contracts to resident presentationcontracts to resident presentation
Expanded presentation to other Expanded presentation to other residency programs in the stateresidency programs in the state
Program MaintenanceProgram Maintenance
Stay in touch with hospitals and Stay in touch with hospitals and physiciansphysicians– Make sure physicians are still active Make sure physicians are still active
candidatescandidates– Make sure open position list is Make sure open position list is
currentcurrent
Visit hospitals periodicallyVisit hospitals periodically
Program MaintenanceProgram Maintenance
Produce periodic e-newsletter for Produce periodic e-newsletter for participating facilitiesparticipating facilities
Continue to look for potential Continue to look for potential physician candidates from a physician candidates from a variety of sourcesvariety of sources– DatabasesDatabases– MU AlumniMU Alumni
FundingFunding
Initial three year grant fundingInitial three year grant funding– ““Banked” all program-generated Banked” all program-generated
income during that periodincome during that period
Projected program self-sufficiency Projected program self-sufficiency at the end of three yearsat the end of three years– Had reserves to last ~ two yearsHad reserves to last ~ two years
FundingFunding
Medical school supportMedical school support– Temporary increased funds for MU Temporary increased funds for MU
AHEC from MU medical schoolAHEC from MU medical school
Stimulus fundsStimulus funds– MU AHEC received share of stimulus MU AHEC received share of stimulus
funds – decision made to apply to funds – decision made to apply to MPPSMPPS
FundingFunding
Unsuccessful overtures to Unsuccessful overtures to Missouri Primary Care Association Missouri Primary Care Association (who receives state funds for (who receives state funds for placing health professionals in placing health professionals in rural/underserved areasrural/underserved areas
Future funding - ????Future funding - ????
Services for Medical Services for Medical StudentsStudents
Help students look at residency Help students look at residency optionsoptions
Encourage medical students to Encourage medical students to remain in Missouri for residencyremain in Missouri for residency
Services for Services for PhysiciansPhysicians
Provide information about Provide information about communities looking for communities looking for physiciansphysicians– Web site linksWeb site links– Info from Chamber of CommerceInfo from Chamber of Commerce– Knowledge from personal on-site Knowledge from personal on-site
visitsvisits
Services for Services for PhysiciansPhysicians
Sponsor an annual job fair where Sponsor an annual job fair where residents meet with representatives from residents meet with representatives from healthcare facilities looking for physicianshealthcare facilities looking for physicians
Facilitate spouse/partner job searches Facilitate spouse/partner job searches (e.g. put in contact with appropriate (e.g. put in contact with appropriate people)people)
Assist with CV development and/or reviewAssist with CV development and/or review
Services for Services for PhysiciansPhysicians
Enable physicians to look at a variety of Enable physicians to look at a variety of opportunities coordinated through a single opportunities coordinated through a single sourcesource
Provide information on practice types, Provide information on practice types, compensation models, salary surveys, etc.compensation models, salary surveys, etc.
Assist international medical graduates with Assist international medical graduates with positions that meet their visa requirementspositions that meet their visa requirements
Services for Services for Hospitals/ Hospitals/ CommunitiesCommunities
Visit communities and prepare practice Visit communities and prepare practice profilesprofiles
Help communities identify assets and Help communities identify assets and liabilities related to recruiting/retaining liabilities related to recruiting/retaining physiciansphysicians
Identify physicians that match Identify physicians that match community/ hospital needscommunity/ hospital needs
Services for Services for Hospitals/ Hospitals/ CommunitiesCommunities
Promote Practice OpportunitiesPromote Practice Opportunities– Advertise on national websitesAdvertise on national websites– Exhibit at national and regional Exhibit at national and regional
conferencesconferences
Promote practice opportunities to MU Promote practice opportunities to MU and other residents – as well as and other residents – as well as practicing physicianspracticing physicians– MU grads and othersMU grads and others
Services for Services for Hospitals/ Hospitals/ CommunitiesCommunities
Advise on process and techniques of Advise on process and techniques of recruitmentrecruitment
Assist with development or review of Assist with development or review of promotional materialspromotional materials
Benefits of MPPSBenefits of MPPS
Helps connect physicians and Helps connect physicians and communities/healthcare facilities that may communities/healthcare facilities that may never have learned about each othernever have learned about each other
Provides assistance/expertise with Provides assistance/expertise with recruitment that is not available in many recruitment that is not available in many hospitals or other healthcare facilities in hospitals or other healthcare facilities in Missouri (particularly in smaller, more Missouri (particularly in smaller, more rural communities)rural communities)
BenefitsBenefits
Anticipated increased retentionAnticipated increased retention
Increases the number of Increases the number of physicians in rural and physicians in rural and underserved areas of Missouriunderserved areas of Missouri
Helps renew the rural pipelineHelps renew the rural pipeline
ChallengesChallenges
Services agreementServices agreement
Identifying physician candidates Identifying physician candidates seriously interested in practicing in seriously interested in practicing in rural Missourirural Missouri
Recruiting for many facilities Recruiting for many facilities simultaneouslysimultaneously
ChallengesChallenges
Not achieving financial Not achieving financial sustainabilitysustainability
Duplication and other issues with Duplication and other issues with state’s placement servicestate’s placement service
Issues with statewide group of in-Issues with statewide group of in-house physician recruitershouse physician recruiters
MPPS SuccessesMPPS 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