UNIVERSITY OF MISSOURI MISSOURI PHYSICIAN PLACEMENT SERVICE Completing the Rural Pipeline

1. UNIVERSITY OF MISSOURIMISSOURI PHYSICIAN PLACEMENT SERVICECompleting the Rural Pipeline Kathy Brown June 22, 2010 MU AHEC – Office of Rural Health

3. 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

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

5. 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)

6. Mission • 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

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

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

9. Mechanics • Visited two area healthcare facilities and “pitched” the program • Good dialogue • Incorporated comments/suggestions

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

11. Mechanics • 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 PracticeLink (national databank of physicians and opportunities)

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

13. Mechanics • 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

35. Challenges • Not achieving financial sustainability • Duplication and other issues with state’s placement service • Issues with statewide group of in-house physician recruiters

36. MPPS Successes

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

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