1. UNIVERSITY OF MISSOURI MISSOURI PHYSICIAN PLACEMENT SERVICE Completing 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 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 Visited placement programs in other states –Similar models (University settings; AHEC affiliated) –Good reputations

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

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

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

11. Mechanics Meanwhile, started establishing candidate pool 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 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 Met with physicians when possible, but did a lot of contact by e-mail and phone

13. Mechanics Organized first job fair 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) Job fair very successful (annual event) –~ 70 physician participants Meanwhile – first placement in the works 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 Stayed in touch with both physicians and hospitals –Offered CV’s to hospitals when appropriate Looked for opportunities to speak to groups of residents Looked for opportunities to speak to groups of residents –Developed presentation on rural practice

17. Mechanics Annual evaluations Annual evaluations –Physician candidates or potential candidates –Hospitals/healthcare facilities –Incorporate suggestions when possible Sent mailing to facilities to “re-up” 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 Convinced MU Business Office to have “open ended” services agreement –Don’t have to renew each year Adjusted fee structure 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 Added information on CV development, interviewing, contracts to resident presentation Expanded presentation to other residency programs in the state Expanded presentation to other residency programs in the state

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

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

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

23. Funding Medical school support Medical school support –Temporary increased funds for MU AHEC from MU medical school Stimulus funds 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 Unsuccessful overtures to Missouri Primary Care Association (who receives state funds for placing health professionals in rural/underserved areas Future funding - ???? Future funding - ????

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

26. Services for Physicians Provide information about communities looking 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 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) Facilitate spouse/partner job searches (e.g. put in contact with appropriate people) Assist with CV development and/or review 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 Enable physicians to look at a variety of opportunities coordinated through a single source Provide information on practice types, compensation models, salary surveys, etc. Provide information on practice types, compensation models, salary surveys, etc. Assist international medical graduates with positions that meet their visa requirements Assist international medical graduates with positions that meet their visa requirements

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

30. Services for Hospitals/ Communities Promote Practice Opportunities 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 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 Advise on process and techniques of recruitment Assist with development or review of promotional materials 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 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) 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 Anticipated increased retention Increases the number of physicians in rural and underserved areas of Missouri Increases the number of physicians in rural and underserved areas of Missouri Helps renew the rural pipeline Helps renew the rural pipeline

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

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