Recruiting family docs a 'challenge' in NW Ohio


“Difficult” and “challenging” are two adjectives used by officials at several local medical facilities to describe efforts to recruit physicians to rural northwest Ohio.

Family-practice physicians, who provide primary care to a patient, are in even shorter supply. A projected shortage of about 139,000 family practice physicians in the United States by the year 2020 has officials in the medical field looking for answers to the problem.

At the Henry County Hospital in Napoleon, hospital CEO Kim Bordenkircher described the difficulties in recruiting family-practice physicians.

“It is difficult,” she said. “I try to be open and honest about the attractions of practicing family medicine in a small community. I try to point out the positive features of raising a family in a small community and, also, the not-so-positive features of living here.”

She said she wanted a physician considering a move to understand completely the area into which he/she was moving.

“To have a physician come here and then become dissatisfied and leave after several years is difficult for him and for the hospital,” she explained. “So, I talk to the doctors about what they can expect to find in the community — such as shopping, access to theater, and so on.”

She said one time she was set to interview a physician about coming to Napoleon and the physician’s wife walked into the room in a pair of expensive designer slacks. She said she knew the couple probably would not be happy in a small town.

At the Defiance Clinic, CEO Chad Peter said, “We have succession plans to recruit to replace physicians who retire or move and also to expand our existing departments as patient volumes dictate. Each of these plans is tailored to some degree to the specialty, but they all have many basic components in common. In addition to using the services of professional recruiters, we also ask our physicians to contact their medical schools and residency programs directly.”

Peter added, “Primary care physicians, both family practice and internal medicine, are becoming increasingly difficult to recruit because of the shortages, the tendency for physicians to enter subspecialties and the attraction that larger metropolitan areas have for young physicians and their families.

“A recent report showed the large majority of internal medicine residents are going into a subspecialty such as cardiology or pulmonology rather than into the practice of general internal medicine,” Peter said. “We need the physicians who like the broad range of general primary care. As that physician pool shrinks, finding the right candidates is becoming more difficult, but they are out there and we do eventually connect with the right physicians.”

Timothy Jakacki, president of Defiance Regional Medical Center (DRMC), said, “With the shortage of physicians nationwide, recruitment of both family medicine physicians as well as specialists can be difficult. The rural location of Defiance adds one more challenge to the recruitment process.”

He said ProMedica Physician Group (PPG) is the employed physician arm for DRMC. PPG has a physician recruitment team in place to match physicians with their practice interests throughout the ProMedica Health System. He said DRMC recruitment plans are based on community and population needs.

“ProMedica also sponsors two residency training programs in family medicine through its Health, Education and Research Corporation,” he said. “There are 18 residents in each of the residency programs and efforts are constantly made to ensure that the residents in the three-year training programs are exposed to ProMedica hospitals, including DRMC.”

Bordenkircher added, “I try to point out the positive aspects of raising a family in a small community like Napoleon,” she said. “It is a safe place to raise children. I am a single mom raising a 15-year-old and I know there are other sets of eyes on my child all of the time.”

Jakacki said, “Many family-practice physicians enjoy coming to communities the size of Defiance because they can have a much broader practice, including obstetrics.” He said this was the case with DRMC’s most recent family medicine recruit, Chong Yi, MD.

“It is often more difficult to recruit specialists to Defiance because you must have the population and referral base (family practice physicians) to support specialists,” he said.

Other subjects Bordenkircher discusses with physicians are those of community leadership and more personal contact with their patients.

“In small towns, physicians are held in high regard by the community,” she said. “They are considered community leaders. This is not so common in large cities.

“In small towns, there is more opportunity for personal management of their patients,” she said. “A physician can treat a patient and his family throughout their lives. That is hard to do in cities because so many people stay a while and then leave.

“In family practice in cities, a doctor will see a patient and then often refer her to a specialist,” she continued. “Here, that does not happen as much. Referrals to specialists are made if needed, but physicians here have more of a one-on-one relationship with their patients. Here doctors have more control over their medical practice. There is not as much managed care as there is in the cities.”

Jakacki agreed with the advantages of living in a small community. He said some of the benefits of practicing in a small community that are pointed out to recruits are the safe neighborhoods and a great school district.

“Yet, Defiance is located close to multiple metropolitan areas,” he said. He said the city has many convenient “city-like” features such as outstanding health care, thriving retail and higher education. DRMC also offers opportunities for physicians including the trauma designation, heart catheterization lab, chest pain accreditation and e-ICU ProMedica®.

At the Defiance Clinic, Peter said, “In most cases, we are recruiting not just the physician but the physician and his or her spouse and children. We are looking for candidates and families who want the high-quality, small-town life Defiance offers.

“Young physicians want balance in their lives, time with their families and opportunities for personal growth, and we are able to offer that,” Peter said. “We can provide flexibility in scheduling so that a physician can balance professional life with personal life, and our multi-specialty group practice provides numerous advantages that help a physician maintain a large practice efficiently. We have ancillary services such as laboratory and x-ray in our building, which makes for speedy reporting of test results, and Mercy Hospital of Defiance is located right behind us for quick and easy access.

“The support of veteran physicians is especially important to young recruits who can rely on experienced clinic colleagues for hallway consults.”

With a shortage of physicians predicted by 2020, ideas to solve the problem are in short supply.

Jakacki said, “Neither this problem nor any other issue in health care is easily fixed. All issues facing health care are multifacted, meaning there is not just one solution.” He added that the shortage of doctors will take time to fix and that scholarships and sponsorships to help with the cost of education may encourage more students to pursue a medical career.

Peter said, “Medicine in general will have to retool its delivery system to handle the shortage of primary care physicians. We expect to see more physician extenders — nurse practitioners and physician assistants, who are well equipped to provide many healthcare services. They allow the physicians to concentrate on the more complex patient needs. Defiance Clinic has for some years had two nurse practitioners and two physician assistants, who do an excellent job and are popular with patients. We expect that the role of these professionals will grow in coming years.”
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