Mission-driven doctors filling the gap in underserved areas

The country faces a nationwide doctor shortage, which is expected to be exacerbated by the implementation of the Affordable Care Act and an aging population.

Rural and inner-city health facilities have been dealing with this issue for years. One innovative approach has successfully attracted dedicated health professionals to rural Kansas and Iowa, and urban Memphis, and might provide clues for other communities already suffering from this shortage.

The approach, called “mission-focused medicine,” appeals to people who feel called to care for the underserved, both locally and abroad. In many cases, medical staff are given the opportunity to serve the local community and have paid time off to practice abroad.

This tactic worked for the Ashland Health Center, in rural, southwest Kansas, where CEO Benjamin Anderson has recruited one nurse practitioner, one physician assistant, and two doctors to provide care in an agricultural community of about 900 people, located about three hours from Wichita. I first heard about Anderson’s approach on NPR, and contacted him to see if it would work in other medically underserved areas.

“We appealed to the physicians’ sense of mission,” Anderson told me for a piece I wrote for Zócalo Public Square. “If you’re willing to live and serve in a mud hut in the African bush, chances are you don’t need a Nordstrom or a Starbucks or a big airport nearby. You’re there to serve.”

A similar approach has benefitted Mercy Medical Center in New Hampton, Iowa. Six doctors - who were all completing their medicine residency in Wichita, and wanted to work together in a rural setting - asked if the hospital would hire them as a group, and comply with a few requests. For example, the married, female doctors wanted to practice part-time, and all six wanted to do mission work abroad, on a rotating basis, for three months each year, according to a Hospitals and Health Networks article.

Two years later, the unique arrangement has proven advantageous for the medical facility, which, like many rural health centers, traditionally had trouble recruiting individual doctors.

“It’s particularly difficult for communities to attract physicians one at a time, because a new physician coming into a situation may not have much confidence that the circumstances will be workable,” organization president Bruce Roesler told me during a phone interview this week. “When they come in with a partner, or multiple partners in our case, they have more confidence that the workload will be distributed equitably.”

And the doctors’ overseas mission trips are not a barrier to health care in the community, he said.

“I don’t know that patients necessarily prefer that their physician is unavailable for a few months each year,” he said. “But on the other hand, they appreciate that our physicians have this heart for serving other people in other parts of the world. It communicates to our community that they really are caring individuals, and patients have also learned the value of having more than one physician being familiar with them.”

An urban version of this model has worked for Christ Community Health Services, which operates six federally qualified health centers in Memphis. About half of the organization’s 50 doctors live in the poor, high-crime neighborhoods where the clinics are located, with several visiting medical students and residents living in two inner-city guest houses owned by the organization. Those medical students have the opportunity to see patients in the morning and spend the afternoon working on the organization’s urban farm, tutoring refugee families, or assisting with refugee resettlement.

Christ Community medical staff are also given leave and a stipend to practice abroad.

Other community health centers recruit doctors by offering to pay back loans, or they tap into foreign doctors who can practice in the U.S. if they go to an underserved community. But Rick Donlon, co-founder and associate executive director of Christ Community Health Services, said a different approach is needed to retain those doctors.

“The way to engage people is to actually have a mission-driven, passionate reason for existence,” Donlon said. “If you can convince people you got that, they’ll come.” He added: “If it’s just a gig, then it’s not a very good gig. There are other gigs available.”

For Donlon, recruiting doctors to his organization, and other traditionally underserved areas, boils down to one issue: “If you’re coming from a position where you are operating out of a sense of mission and purpose, and you can communicate that, that’s the main thing,” he said.

Image by Missouri Bicycle and Pedestrian Federation via Flickr