03/23/07 — Hospital makes effort to attract more doctors to Wayne County

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Hospital makes effort to attract more doctors to Wayne County

By Phyllis Moore
Published in News on March 23, 2007 1:51 PM

Recruiting enough physicians for Wayne County is a challenge, but one the medical community is working to address.

In recent years, the community has felt the loss of its only endocrinologist, Dr. Michael Brennan, and such specialists as neurosurgeon Dr. Robert Lacin and Dr. Michael Hill, a plastic surgeon. Vascular surgeon Dr. Jose Guijarro's death last month resulting from a car crash left still another void.

General physicians are always needed, as are doctors to care for patients during a hospital stay. The latter has prompted Wayne Memorial Hospital to institute the hospitalist program, designed to free up primary care physicians who were previously forced to juggle office time with hospital visits.

Dr. Ernie Marshall, president of the medical staff this year, says there is a push to draw physicians to the area. One big obstacle is that the pool of physicians from which to recruit in specialty areas, such as medicine, oncology or surgery, is limited, he said.

"The major challenge we face is matching the doctor and his, or her, family to this community. The physician has to be happy with the medical community, but then the family must be happy with what life is like in Goldsboro," he said.

The pervading theme out there is quality of life, Marshall said.

"Physicians need to know that they'd make a good living to support their families, but they want adequate time off to go to soccer games and vacations with their families," he said.

"When I went into medicine, doctors knew their life didn't come first, but I'm a dinosaur. Part of providing the quality of life thing for young physicians is helping them out with the amount of time they have to put in at the hospital."

The hospitalist program has come into prominence in recent years, with doctors hired to work exclusively in the hospital taking care of patients.

Calling it the "wave of the future," Marshall said Wayne Memorial must have hospitalists to better compete. The program was introduced at the hospital about a month ago, with plans to have six doctors in rotation, working around the clock in shifts.

But hospitalists do not replace the role of the family doctor or specialist, which is why having a sufficient amount of each remains critical.

The two areas of emphasis, Marshall said, are recruitment and retention.

A recruiting subcommittee has been established at the hospital, made up of members of the medical staff and hospital administration. A recruiting firm has also been hired to "help us cast a wide net," Marshall said.

"The recruiting firms have a database that's bigger than what we have," he explained. "If they know what we're looking for, they'll come, take a look at what Goldsboro's like, what we need, and try to match the applicant with what we need."

For now, the local wish list includes finding a thoracic surgeon, vascular surgeon, general surgeon, endocrinologist, plastic surgeon, neurosurgeon and more psychiatrists.

"It's important to have more than one person in a given specialty, to share the workload and also you need a safety net," Marshall said. "It's also important for patients. They should not have to travel far to get health care."

Unfortunately, he said, the process takes time.

"We looked for probably two years for a person who's joining us in September. ... It can be a multi-year search," he said. "We're not the best place right now for people fresh out of training, but might be good for people in another city who may be looking to relocate."

While it is a difficult task, Marshall said he remains positive.

"We're always optimistic, or we wouldn't be here," he said.

There are advantages to a smaller community, he noted, so emphasis will be placed on promoting those to potential candidates. One he mentioned is the fact that there is only one hospital the doctor would have to cover.

"For some coming from a larger metropolitan area where they have to make rounds at several hospitals, this could be appealing," he said.

Wayne County has a good medical community, Marshall said, enhanced by the fact that they know each other well and work collaboratively.

"We all have the sense that we're in this thing together. We take care of each other," he said. "There's a lot of camaraderie here and of course, we don't have the traffic problems or the crime problems or the high cost of living. To me, Raleigh is just a suburb of Goldsboro."

Competition for good doctors is fierce, and Wayne Memorial is in the same boat as 5,000 other hospitals across the country, says Amy Cain, its public relations officer.

To stack up against others vying for candidates, some incentives are necessary.

"That's the way the market is today," said Tom Bradshaw, vice president of operations at Wayne Memorial. "Physicians used to just come and hang their shingles up and start from scratch.

"Those coming here today want some assurances that they're going to be financially stable. It's the set-up phase of his practice."

Goldsboro is competing with larger markets, Bradshaw said, whether it be Raleigh or anywhere across the United States, for potential candidates.

"To come to this community, you have to make it attractive to them, just like you would make it attractive for a business to come here," he said.

In the past, the hospital has offered such options as assistance with moving expenses, help with educational loan repayments, overhead expenses to launch their own practice. The biggest incentive, he said, is a form of primary income guarantee.

"The hospital will make up the difference in what they're able to generate and collect on their own versus the amount they receive," he explained. "Typically, the physician will make that in a matter of months."

Such cases of financial assistance are usually limited to a period of time and involve a commitment also benefitting the medical community.

"They have to pay the hospital back in the form of staying in the community for a certain number of years, usually about four, and we forgive a little bit along the way," he said.

A similar arrangement has been in place for nurses for years, he said. A percentage of their loans are defrayed in exchange for working at the hospital. If they default, they must pay it back.

The hospital's role is to provide the best use of resources needed for medical care, Bradshaw said. But such services are crippled without a solid base of physicians, he added.

"The goal is to provide what the people in Wayne County need with regard to health care so they don't have to go elsewhere," Marshall said. "We have a strong physician base. We're just trying to fill openings."

"The idea that there's such a limited number of specialists, especially psychiatrists -- there are not enough psychiatrists coming out of school to address the needs -- that's not something we can control. It will always be a challenge," Ms. Cain said.

Marshall agreed.

"There's no surplus of doctors. That's why it's challenging to fill our ranks," he said.

"We can change the things we need within the medical community to make this more attractive and then the city has to speak for itself."