Community Engagement Dept.: RHES
Program: Kansas Recruitment and Retention Center
When Roy Sprunger and his wife, Lynn, relocated from the Kansas City area to Ashland, Kan. more than a decade ago, they had to drive 60 miles to take their 1-year-old daughter to a doctor. They didn't like traveling so far for health care, but they had no other options. Over the years, they saw that lack of local care was a pervasive rural plight that made Sprunger uncomfortable and unsatisfied.
"We came to understand that in a small, rural community, it's very difficult to find quality, long-term health care professionals," says Sprunger, who serves as pastor of Ashland's First Church of God. "People just didn't take their kids to the doctor because there wasn't convenient medical care. As a result, it took a crisis or something major before they would even seek care, missing things like routine screenings and general maintenance."
Unfortunately, many Kansas families know what it's like to live in communities without doctors, dentists or pharmacists. Like the Sprungers, these Kansans face long commutes for health care or assume the health risks that come from going without.
Leaders in these communities work to recruit health providers to town not only to improve the health of their residents, but also to improve the community's economic outlook. According to the American Academy of Family Physicians, one family physician provides more than $875,000 in economic benefit for a Kansas community.
A Perfect Match
But not just any doctor will do, explains Joyce Grayson, director of the Office of Rural Health Education and Services at the University of Kansas Medical Center.
"It's important to find the right health provider for the community and organization. Finding the right fit means looking at all the elements that will position both the provider and family to thrive," says Grayson.
Grayson and her team have matched more than 160 health care providers with employers in 55 medically underserved Kansas counties since 2003 through the Kansas Recruitment and Retention Center (KRRC), part of KU Medical Center's Office of Rural Health Education and Services. The matching service is free to the more than 1,000 health care providers looking for employment and for a nominal fee to 85 currently recruiting health care organizations in Kansas.
Seven of the 146 placed providers have been matched with the Community Health Center of Southeast Kansas in Pittsburg and Coffeyville. Each of those providers still practice at the center, a success rate that CEO Krista Postai says is rare.
"Something like 70 percent of physicians change jobs in the first three years of their career. Which means they start at some place, and it was not a good match," says Postai. "I know the odds are against me, but I want to find the square peg for the square hole."
To find the right fit, Postai needs more than credentials.
"I look for people with a sense of mission, but not necessarily missionaries. So they go into the job understanding that health care is about the whole person. I look for people who want to approach the patient from the holistic approach and who just want to take care of people," says Postai.
KRRC helped her find those mission-minded providers who would be a good fit in the Pittsburg and Coffeyville communities.
"A recruitment is like a marriage. The KRRC wants the marriage to last, which is how they differ from a conventional recruiter. The conventional recruiter wants to make the match and make the commission," says Postai.
Long-term retention is a central focus for KRRC, which conducts a screening to understand the candidate's professional interests and community-based preferences. KRRC also screens the interests of the candidate's family, if applicable, because research has shown that providers are more likely to stay in an area based on lifestyle factors and spousal satisfaction than for any other reason.
That's a recruiting and retention principle that Postai and Benjamin Anderson, CEO of Ashland Health Center, know well.
A Mission-Focused Model Creates a Health Care Hub in Ashland
Today, the Sprunger family's long drives for health care are a thing of the past because of a mission-focused medicine model that Anderson brought to Ashland Health Center in January 2009.
When Anderson started at Ashland, the 24-bed critical access hospital had been through 11 providers and seven administrators in 18 years. The hospital had been without a doctor for eight months and was operating with one physician assistant, Jon Bigler, who was recruited in 2006 through KRRC. Bigler worked around the clock to cover the clinic, nursing home and emergency room with a myriad of temporary providers on the weekends.
"We were in an urgent situation," says Anderson.
The hospital's dire situation encouraged Anderson to pursue a mission-focused medicine model instead of standard recruiting.
"You show them the houses that are falling down, or the park that needs to be restored, or the 55-year-old health care facilities that haven't been renovated. You tell them about the Hispanic population that drives two-and-a-half hours to the nearest Spanish-speaking obstetrician," Anderson says. "We want the person who sees these challenges and wants to come anyway. Actually, we want the person who wants to come because of these challenges."
It worked. Today, Ashland Health Center is fully staffed with two physicians and three mid-level practitioners.
To ensure those mission-minded providers would stay, Anderson offered limited emergency room and on-call hours, provided a national-average salary and offered eight weeks off for mission work. Anderson wanted the whole hospital team to be part of the mission-minded vision so he gave nursing, administration, lab personnel, maintenance and other positions the benefits of eight weeks off, too.
Now, the hospital's vision is changing the way the Ashland community sees its local health care system and in turn, the vision of the community as a whole.
In July, Anderson and five others made the trek to Zimbabwe where they served in the community of Doma. Donations from the Ashland community funded the $25,000 trip cost.
"All building and travel expenses were paid for. That doesn't happen if the community doesn't truly support these efforts. These efforts and the culture we're developing have helped us restore some of the trust that had been lost," says Anderson.
Chance Wilkinson, a maintenance worker for Ashland Health Center, was a member of the latest group to go to Zimbabwe.
"This is my second time to serve overseas," says Wilkinson, who first went to Zimbabwe in November 2010. "We spent our time there this year constructing dining room table and bench sets for orphan cottages. On our last night in Doma, we had dinner with some orphans on their new table. The trip was especially meaningful because we were able to see the immediate impact of our work."
Those who have gone on the mission trips bring the experience back and use that passion to serve their own community.
"There are plenty of problems in our own backyard, but the reality is that we see them day in and day out, and we ignore them or they just don't really register with us because we've seen them for so long," says Anderson. "When we go and serve people on the other side of the world, we begin to see parallels to things here and our eyes are opened.
Benjamin Anderson, CEO of Ashland Health Center, on a medical mission to Zimbabwe