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November 16, 2016

Flexible Timeshare Responds To Rural Doctor Shortage

Wisconsin is experiencing an acute shortage of rural primary care health care providers, and the state is not alone in its dearth of doctors and advanced care nurse practitioners who choose to work in its small towns and cities.

Rural Wisconsin Doctors Pursue Interest in International Medicine, too

Wisconsin is experiencing an acute shortage of rural primary care health care providers, and the state is not alone in its dearth of doctors and advanced care nurse practitioners who choose to work in its small towns and cities. According to the Kaiser Family Foundation, while U.S. medical schools produced 18,705 new graduates in 2015 (of that number, 346 were from Wisconsin), it’s the next stage of medical education – residency – where most physicians-in-training choose their specialties, including tracks like family medicine, cardiology, orthopedics, or geriatrics.

Coupled with a significant number of upcoming Baby Boomer physician retirements, Wisconsin faces a projected shortage of 833 to 3,756 doctors by 2035. Wisconsin health care systems are stepping up their game to attract and retain providers for communities of all sizes, especially hard-to-fill rural areas.

According to Stacie Masanz, lead physician recruiter for ThedaCare, the situation requires a full time, full-court press by a team of recruiters, physicians, and system leaders to catch and hold the attention of medical residents. ThedaCare operates seven hospitals; two are in urban centers — Appleton and Neenah — and the rest are in the smaller communities of Berlin, Waupaca, Shawano, New London, and Wild Rose. The system also operates 34 clinics in nine eastern Wisconsin counties.

“At the heart of our organization are the people of rural communities. It’s always been part of our identity. Our job is to communicate to candidates the advantages of being a small-town or small-city doctor with all the benefits of a large fully integrated health care system.”

The ThedaCare recruiting team is on the road across the U.S. consistently throughout the year, attending conferences of the American Academy of Family Physicians (AAFP) and networking on behalf of the Wisconsin Academy of Family Physicians and Wisconsin Association of Osteopathy Physicians & Surgeons. A myriad of career fairs help connect ThedaCare with newly minted medical residents. However, traditional conferences are not enough. “The competition for rural providers is stiff and relentless. We must be creative and flexible, and we are starting to see our efforts pay off,” said Masanz. “But we can’t let up.”

Michael Williams, MD, a member of ThedaCare Physicians in Shawano, population 9,305, joined the health care network 10 years ago because of his personal interest in rural medicine. Rural physicians often run a full scope practice; that is, they care for patients in both clinic and hospital settings, perform many of their own surgical procedures, and most likely deliver babies.

They care for patients from infancy to old age, weaving themselves into the lives of multiple generations of local families.

“Fewer and fewer residency programs these days offer full-scope experiences to young doctors, but some of us actively seek out these opportunities,” Dr. Williams said. “I know they’re out there. We just need to find them and match them to ThedaCare.” Not all rural ThedaCare physicians choose full scope medicine, opting instead for an outpatient-only practice with the choice to do obstetrics or C-sections.

Dr. Williams’s dual interest in international medicine parallels his passion for a full scope medical practice: That’s where he and Masanz put their heads together and uncovered a new avenue to potential candidates for ThedaCare’s rural hospitals and clinics.

“Dr. Williams noted that doctors who want to practice international medicine are expecting to practice full-scope medicine, only in other countries. If ThedaCare could develop a program that allows these doctors to practice here and go abroad for up to three months a year, then that would be very attractive,” Masanz said. “It would help retain these doctors, too, which is good for us as an employer and for our patients, who naturally get frustrated when their doctor leaves.”

This rural/international medicine timeshare model, as it is known, has made inroads into the international medicine residency track, a growing area, even as rural medicine residency programs shrink. Dr. Williams helped design the program and is upbeat about its prospects.

“People with an interest in international medicine are compassionate, service-oriented, and hands-on. It’s a perfect personality for a rural practice. We are attracting some very cool people to Shawano,” noting that two such new physicians are already contracted to join ThedaCare next fall. Dr. Williams himself travels to Haiti twice a year to provide health care for up to two weeks at a time. “The time share model affords physicians a longer-term experience. The practice has to be designed from the beginning to flex to these parameters.”

Masanz predicts the timeshare model will be attractive to doctors with varied interests beyond international medicine. “Millennials in particular come to employers with an increased expectation of work-life balance. Now we have a model that can offer them a way to pursue their interests outside of a traditional work schedule.” This flexibility, which figures in proportional pay structures and peer coverage for those times when physicians are away, will pay off in the longer term when motivated candidates are hired and retained.

For more than 100 years, ThedaCare™ has been committed to finding a better way to deliver serious and complex healthcare to patients throughout Northeast Wisconsin. The organization serves over 200,000 patients annually and employs more than 6,800 healthcare professionals throughout the region. ThedaCare has seven hospitals located in Appleton, Neenah, Berlin, Waupaca, Shawano, New London and Wild Rose as well as 34 clinics in 14 counties. ThedaCare is the first in Wisconsin to be a Mayo Clinic Care Network Member, giving our specialists the ability to consult with Mayo Clinic experts on a patient’s care. ThedaCare is a non-profit healthcare organization with a level II trauma center, comprehensive cancer treatment, stroke and cardiac programs as well as a foundation dedicated to community service.  The ThedaCare Regional Cancer Center in Appleton opened in February.