More Rural Docs By Impacting at Multiple Points

Over the years the shortage of primary care practitioners in rural areas of Nebraska has continued to be a problem. Rural communities now face even more changes with reimbursement changes and the reorganization of health service delivery.

Academic health science centers face similar challenges, but they do have the benefit of expertise in research, health policy, and practitioner training. Partnerships between rural communities and academic centers can be mutually beneficial. This is not meant to be a comprehensive guide, but it is a listing of helpful resources at UNMC and the state.

The Facts A rural physician is worth $380,000 in local economic impact and 18 jobs. Each physician brings in about $500,000 a year in hospital revenue. At least 4 practitioners (FP, PA, NP) must be able to share call to stabilize the primary care workforce, promote retention, and allow the system to deal with internal and external changes. Failure to address adequate workforce will likely result in limitation or cessation of local health services with loss of jobs in multiple community areas.

Resources available

• The annual recruitment fair at UNMC gathers much of the future primary care capacity of the state in one room for recruitment purposes. It also is a venue to exchange the latest information on recruitment techniques. Recent fairs have prioritized family practice residents, physician assistant students, and nurse practitioner students, giving communities a chance to meet with them over an entire morning and noon hour at seminars and during booth visitation. Students have a chance to visit booths later in the day. The fair continues to grow and those who attend give it high marks. Next year the fair will be held April 17th at UNMC. Contact 402-559-8873 for more information.
• Evening, noon, or weekend recruitment dinners/picnics/retreats for the residents, their spouses, and their families. These can be arranged through UNMC or through the resident’s association. Contact Dr. Bowman or Tom Rauner for details.
• Send your practitioner to teach at Omaha, Doniphan, North Platte, Scottsbluff, or Ravenna. Your family physician can supervise residents during their clinics. This gives them a chance to meet likely future colleagues. The branching out of the family medicine residency training gives increased opportunities for teaching and recruiting.

See the Recruitment Guide for further information. Other opportunities include participating together with several other communities through the recruitment efforts of the Nebraska Academy of Family Physicians. The NAFP attends several events and generates a list of names of current and future practitioners who have expressed an interest in Nebraska. Contact NAFP at (402) 572-3530.

Communities need the best information in order to make decisions regarding local health care needs. The last few years have brought several efforts from the state and UNMC to address these needs. Your point of first contact is the Nebraska Office of Rural Health. This office can address a broad scope of needs, from shortage area designations to information on rural health clinics to referrals on consultants and more. The state and many other organizations are sponsoring a Nebraska-wide effort to improve the information available regarding health needs and resources.

• The Community Health Partners of Nebraska can be of help to you. This group was formed by the Nebraska Department of Health, the Nebraska Medical Association, the Nebraska Association of Hospitals and Health Systems, the Local Health Departments of Nebraska, and the Community Action Agencies of Nebraska. They have extensive contacts and materials to help communities identify local health needs and resources. Contact Mike Heyl at the Nebraska Department of Health, P.O. Box 95007, Lincoln, NE 68509 or call (402) 471-4419.

Minnesota resource - http://www.ruralresource.org/index.shtml

• If you are in need of persons to help collect information in your community, you could become a Community Connections site. Community Connections is a program funded by the National Health Service Corps and the Nebraska Department of Health. The UNMC Department of Family Medicine directs the program. Contact Bob Bowman at this meeting, or call (402) 559-8873 if you would like a student to help you collect interviews, prepare a questionnaire, or assist with a community project.

• The Rural Managed Care Project of the Nebraska Center for Rural Health Research may help you with information about managed care and forming various types of provider organizations. In order to preserve and improve health services, it is clear that practitioners, providers, and the community must work together. The center is helping communities, practices, and networks at 4 sites. Please contact the Center at (402) 559-4473 if you would like information that could help you preserve your local voice as health systems change. Remember that physicians groups, hospital networks, or other organizations that have the most covered lives will be in the best position to negotiate for those that they represent. Medicare managed care is just around the corner and has the potential to impact 20-30% of a rural physician’s practice. The good news is that there is actually potential for increased reimbursement from Medicare managed care patients when compared with the current Parts A & B.

• The Nebraska Institute of Agriculture and Natural Resources (IANR) can also assist you with information about rural health. Contact them at (402) 472-1772 for a copy of their report on the Current Economic Impact of Nebraska’s Rural Hospitals or other information.

• The Office of Rural Health is also a key resource for recruitment, retention, networking, and more. Contact Tom Rauner at 402-471-2337 for further information.

There are many other programs that are available in Nebraska. Give us a call if we can help at (402) 559-8873 or Rbowman@unmc.edu