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Noxubee General Critical Access Hospital administrator Danny McKay stands in front of the Macon-based facility.

In the race to recruit physicians, small hospitals, many of which are the hearts of their communities, are finding alternate ways to attract them.

For many rural area hospitals across the state trying to keep pace with larger counties in the never-ending crusade to recruit physicians, the ARC J-1 visa waiver program is one answer to the question, "How do we bring doctors to the area?"

Recruitment challenges facing hospitals in small rural communities are different from those based in large cities, explained Danny McKay, administrator for Noxubee General Critical Access Hospital in Macon, which has a population of about 3,100.

Through the J-1 visa program, established in the early 1990s to bring international physicians to the United States, the Appalachian Regional Commission (ARC) is helping underserved communities such as Macon continue to thrive.

Dr. Shan ul Islam traveled to the United States from his home in Pakistan for a three-year internal medicine residency at Resurrection Health Care — Westlake Hospital in Chicago, Ill.

Having received his Mississippi physician's license in late October, he'll be working at Noxubee General and calling the Golden Triangle area home for at least the next three years.

The internal medicinist is joining the staff of Noxubee General on a J-1 visa waiver, allowing him to practice in the United States with the promise of at least three years of service to an area with a significant shortage of healthcare providers.

According to Deann Reed, ARC program specialist, there are 12 such doctors in Mississippi approved by the organization and already under obligation.

Aside from Noxubee County, Clay, Prentiss, Chickasaw, Calhoun, Alcorn, Choctaw, Yalobusha, Webster, Lowndes and Kemper counties host J-1 visa physicians.

"It's a small operation. We have to do what we can," said McKay. "Most of the physicians are acclimated to larger cities and they think there's just not much for them to do here."

Even though there are larger cities within a 30-mile radius of Macon, McKay said he is hard-pressed to convince doctors to give up the fast-paced world of the city for a rural town in Noxubee County.

Since 2004, the number of physicians calling Noxubee County home has only risen from eight to nine. Noxubee's neighboring county, Lowndes, which is 30 miles north of Macon, boasts an increase from 96 physicians in 2004 to 107 this year, according to statistics from the Mississippi Board of Medical Licensure.

Across the state, Lafayette County has 120 physicians, up from 2004's 101; Webster County has seven physicians up from four; Madison County has 153 up from 119.

A smaller hospital is more likely to draw physicians who are from the area or have spouses who are, McKay noted. And then the challenge becomes keeping them.

"You operate on the faith they're going to build a solid practice here; they're going to like it here and want to stay," said McKay.

Even with that commitment solidified, physician recruitment is an ongoing process, he continued.

"Physician and nurse recruiting — really all of the allied health profession — is a never-ending process. You're never through because you have to plan for the future. ... One of our physicians on staff is near retirement, and sometimes it takes years to recruit a physician," he stated, citing Islam as an example. "I spent years recruiting (him)."

Once Islam starts, Noxubee General will have four physicians, not nearly enough to serve the 5,000 emergency room patients the hospital sees each year.

The hospital's ER physicians are contracted through an outside company. On Nov. 1, that same company will be contracting a group of hospitalists who specialize in caring for patients during their hospital stay.

"If doctors have to come in all day to take care of patients in the hospital, it takes away from their private practice," said McKay, who is also making plans to have specialists rotate through the hospital in order to keep patients from making long trips.

"Since the price of fuel is so high and many of our patients can't drive themselves, we have to do what we can to help," commented McKay. "So that's one of our long-term goals."

Noxubee General currently has only one specialist on staff, a rheumatologist.

McKay hopes the rotating physicians will be able to add to the pool of services offered by Noxubee General even if more specialists don't join the hospital's staff.

"Recruitment is very competitive. You just have to work harder," said McKay.

Even while constantly overcoming those challenges, McKay said, the hospital is at the heart of the Noxubee community, serving its citizens at their greatest times of need.

"It's a blessing this hospital is here because sometimes it can mean the difference between life and death," said McKay.


December 2006

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