Physician recruiting and retention continue to be a focus at Texas County Memorial Hospital, board members heard at their monthly meeting on Tuesday.
Since the July board meeting, two family medicine physicians have participated in site visits at the facility, Wes Murray, TCMH chief executive officer, reported.
“We have made contract offers to both candidates that came on site for visits in the past month,” Murray said, “And both candidates have other opportunities they are looking at.”
Joleen Senter Durham, physician recruiting director at TCMH, explained that she tries to have everything in place prior to a candidate’s arrival so that TCMH can make a contract offer if the candidate seems to be a good fit with the community and the medical staff.
“We check references and gather as much information as possible prior to the physician’s arrival,” Durham said.
A physician site visit is a full day event with tours of the hospital, clinics and communities where the clinics are located, lunch with the department managers and culminating in a dinner with the medical staff.
“Candidates give very positive feedback about their site visit experience and the work done prior to the site visit to prepare them for the visit,” Durham said. A site visit may include meeting with a local realtor, providing childcare for the visiting physician’s family and taking the physician’s family to the tour the local school system.
According to Durham, studies show that less than 10 percent of physicians are willing to consider living and working in a community of less than 50,000 people.
“We are always very fortunate when a physician chooses to work in our community,” Durham said.
Jim Perry, chairperson of the TCMH board of trustees, asked Jonathan Beers, DO, internal medicine physician and chief of staff at TCMH, what makes TCMH stand out in the recruiting process.
“For me, it was the opportunity to broaden the scope of what I was able to do as a physician at TCMH,” Beers said. In addition to inpatient and outpatient internal medicine, Beers also does stress tests and endoscopy as part of his practice.
Beers explained that the community size can be hard for an outsider to grasp as well as understanding where TCMH is located and its proximity to larger towns.
“I have had the placement firms I work with tell me that our package is the best one they have seen,” Durham said. “Our guaranteed salary and bonus can be very lucrative.”
Durham noted that in addition to the salary, bonus and benefits, student loan repayment, a moving allowance, a sign-on bonus, a residency stipend and visa sponsorship are also available to potential recruits.
Beers agreed that the recruiting package at TCMH was competitive with the major challenge being the size of the communities in the TCMH coverage area.
Beers was looking for a full-scope primary care package and a smaller community to practice medicine in.
“Recruiting and retention are a challenge for healthcare facilities across the nation, but the needs are more acute in the small communities where there are fewer doctors and mid-level providers,” Durham said.
In 2015 TCMH has recruited five mid-level providers. Holly Atterberry, FNP and Ray Bruno, FNP are working full-time at the TCMH Medical Complex in Houston. Sara Openshaw has completed family nurse practitioner training and will begin working full-time at the TCMH Mountain Grove Clinic in October. Kim Kemnitzer, FNP is returning to work part-time in the Walk-In Clinic at the TCMH Medical Complex in Houston in September. Sheena Painter is currently in a family nurse practitioner training program, and she plans to work part-time for TCMH when she completes her program in 2016.
TCMH recruited Cory Offutt, MD, a family medicine and obstetrics physician, to work at the TCMH Medical Complex and at the TCMH Mountain Grove Clinic in 2016 when he completes his residency program.
“We have had great success in recruiting this year,” Murray said, “But we still need additional physicians.”
Durham noted that she continues to be in contact with physicians that are interested in the positions at TCMH.
“I am hopeful that we will have success with at least one of the physicians that have done a site visit at TCMH, and I’ll continue to reach out to all other potential candidates,” Durham said.
Murray has also met with two third year residents at the Cox Family Medicine Residency in Springfield, MO that are interested in providing additional weekend and inpatient call coverage.
TCMH is bringing in an additional physician to provide 48-hours of call coverage one weekend a month to help ease some of the on-call burden to the physicians currently taking call at the hospital.
“These physicians will be available from Friday evening until Sunday evening admitting patients from the emergency department and handling inpatient needs,” Murray said, explaining that obstetrics’ patients still will be handled by the OB physician on call.
Murray noted that weekend call is the busiest time for physicians, and until additional physicians join the call group, TCMH will provide this benefit for the current call group.
Murray also reported that the Missouri Department of Health and Senior Services (DHSS) has accepted and approved the hospital’s application for designation as a Level IV STEMI (ST segment elevated myocardial infarction) facility. The STEMI designation will allow emergency medical services personnel to bring any patient with symptoms of a heart attack to TCMH where the hospital team will proceed with protocols to begin medical treatment to prevent cardiac muscle damage.
After the initial medical treatment, the patient would be transferred to a healthcare facility where interventional cardiology was available, if needed.
The state deadline for the first round of STEMI applications was June 22. TCMH anticipates an onsite visit by DHSS officials regarding the STEMI application in the spring of 2016.
TCMH received their designation as a Level III Stroke Center from DHSS in March of this year.
Although inpatient and outpatient revenues were below budgeted expectations for the month of July, expenses we also down for the month, Linda Pamperien, TCMH chief financial officer, reported.
TCMH ended the month of July with a negative bottom line of $106,728.36 and a negative year to date balance of $1,165,164.60.
The state of Missouri has notified TCMH that they will receive cost report settlements for the hospital’s rural health clinics from 2010 and 2011. Pamperien expects approximately a million dollars for those fiscal years. There is no time frame on when the funds will be disbursed to the hospital.
Present at the meeting were Murray; Pamperien; Durham; Beers; Amanda Turpin, quality assurance nurse manager; Ron Prenger, and board members, Perry; Mark Hampton and Omanez Fockler.
Board members, Russell Gaither and Janet Wiseman, were not present at the meeting.
The next meeting of the TCMH board of trustees is Tue., Sept. 22 at 12 p.m. in the hospital board room.