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

• brownmak@health.missouri.edu