Creative Recruiting Helps Rural Hospitals Overcome Doctor Shortages | Texas Public Radio

Creative Recruiting Helps Rural Hospitals Overcome Doctor Shortages

Aug 15, 2019
Originally published on August 16, 2019 10:13 am

In the central Idaho community of Arco, where Lost Rivers Medical Center is located, the elk and bear outnumber the human population of a thousand. The view from the hospital is flat grassland surrounded by mountain ranges that make for formidable driving in wintertime.

"We're actually considered a frontier area, which I didn't even know was a census designation until I moved there," says Brad Huerta, CEO of the hospital. "I didn't think there's anything more rural than rural."

There are no stoplights in the area. Nor is there a Costco, a Starbucks or — more critically — a surgeon. With 63 full-time employees, the hospital is the county's largest employer, serving an area larger than Rhode Island.

Six years ago, the hospital declared bankruptcy and was on the cusp of closing. Like many other rural hospitals, it was beset by challenges, including chronic difficulties recruiting medical staff willing to live and work in remote, sparsely populated communities. A hot job market made that even harder.

But against the odds, Huerta has turned Lost Rivers around. He trimmed budgets, but also invested in new technologies and services. And he focused on recruitment.

Kearny County Hospital CEO Benjamin Anderson, left, and Bradley Huerta, CEO of Lost Rivers Medical Center.
Courtesy of Becky Chappel and Bradley Huerta

He targeted older physicians — semiretired empty nesters willing to work part time. He also lured recruits using the area's best asset: the great outdoors.

"You like mountain climbing, we're gonna go mountain climbing," says Huerta, who also uses his local connections to take recruits and their families on ATV tours or flights on small planes, if they're interested. "The big joke in health care is you don't recruit the person you recruit their spouse."

Huerta's approach has paid off; Lost Rivers is now fully staffed.

Recruitment is a life or death issue, not just for patients in those areas, but for the hospitals themselves, says Alan Morgan, CEO of the National Rural Health Association. Over the last decade, more than 100 rural hospitals have closed, he says, and over the next decade, another 700 more are at risk.

"Keeping access to health care in rural America is simply a challenge no matter how you look at it, but this shortage of rural health care professionals just is an unfortunate driving issue towards more closures," Morgan says.

And that's affecting the health of rural communities. "Most certainly the workforce shortages in rural America are contributing towards the decreased life expectancy that we're seeing in rural America," he says.

For some rural hospitals, that dire need is the basis of their recruiting pitch: Come here. Make a difference.

That is the crux of Benjamin Anderson's approach at Kearny County Hospital in the southwestern Kansas town of Lakin.

With a population of about 2,000, last year The Washington Post ranked Lakin one of the country's most "middle of nowhere" places.

Anderson says he's found success targeting people motivated by mission over money: "A person that is driven toward the relief of human suffering and the pursuit of justice and equity."

It's not that the hospital ignores practical concerns. Hospital staff often house-hunt for recruits, or manage home renovations for incoming workers. Anderson, who isn't a doctor, also personally babysits the children of his staff, because Lakin lacks nanny services.

"I mean as a CEO I do a lot of different things, but that's among the most important, because it communicates we love you," Anderson says. "We're gonna live in a remote area but we're gonna live here and support each other."

But the cornerstone of the hospital's recruitment pitch is 10 weeks of paid sabbatical a year, which allows time for doctors to serve on medical missions overseas.

Anderson says he came to appreciate the draw of that after a mentor told him, "Go with them and see what motivates them; see why they would want to go there." Anderson did. It not only changed his life, he says, "I realized that in rural Kansas we have more in common with rural Zimbabwe than we do with Boston, Mass."

It's a compelling enough draw that every couple of weeks, Anderson gets a call from physicians saying they want to work in Lakin, despite its remoteness.

One of those callers was Dr. Daniel Linville. He'd read about Kearny County Hospital and its sabbaticals in a magazine article during medical school. Last fall, Linville joined the hospital, having done mission work since childhood in Ecuador, Kenya and Belize.

He says he and his physician wife were also drawn to the surprisingly diverse population Kearny County Hospital serves, including immigrants from Somalia, Vietnam, Laos and Guatemala. In that sense, says Linville, every day feels like an international medical mission, requiring everything from delivering babies to treating dementia.

But life in Lakin also been an adjustment.

"Now that we've been out here practicing for a little bit, we realize exactly how rural we are," Linville says. It's not just that same-day shipping takes four days; transferring a patient to the next biggest hospital in Wichita means the ambulance and staff are gone for an 8-hour round-trip ride.

And, in an incredibly tight-knit community where he is a newcomer, he's often reminded that patients see him as another doctor just passing through.

"We're seen a little bit as outsiders," Linville says. "We get asked frequently: 'How long are you here for?' "

I don't know, he tells them. But for now, I'm happy.

Copyright 2019 NPR. To see more, visit https://www.npr.org.

AILSA CHANG, HOST:

Finding a cardiologist or a gynecologist in a rural area can be really tough. That's because finding medical staff willing to live and work in remote, sparsely populated communities is a big challenge. And the hot job market has made that even harder. But some rural hospitals are overcoming those obstacles, as NPR's Yuki Noguchi reports.

YUKI NOGUCHI, BYLINE: In Brad Huerta's community of Arco, Idaho, elk and bear outnumber the human population of a thousand.

BRAD HUERTA: We're actually considered a frontier area, which I didn't even know was a census designation until I moved there. I didn't think there was anything more rural than rural.

NOGUCHI: Huerta is CEO of Lost Rivers Medical Center in central Idaho. The view from his office is of grasslands surrounded by mountains that make for formidable driving in winter time. With sixty 63 full-time employees, the hospital is the county's largest employer, serving an area larger than Rhode Island.

HUERTA: Our hospital where I'm at is the only elevator in the entire county. We have zero stoplights in Arco. And again that's the county seat. So I'm not really aware that there's a stoplight in the entire area.

NOGUCHI: Nor is there a Costco or a Starbucks or more critically a surgeon. Six years ago, the hospital declared bankruptcy and was set to close. In came Huerta, who invested in new technologies and services. He also focused on recruitment. Huerta targeted older physicians, semi-retired empty nesters willing to work part time.

HUERTA: Cobbling together a medical staff of folks that are - will come out on Monday, Wednesday, Fridays. Some might come out every other Tuesday.

NOGUCHI: He also lured recruits using the area's best asset - the great outdoors.

HUERTA: You like mountain climbing - we're going to go mountain climbing. We took a recruit who wanted to get into flying. A friend of ours, a local guy, he owns a plane, and we were like, we're going to take you up in the plane.

NOGUCHI: Huerta leans on his staff and organizers of the local church potluck for what he calls an all-hands-on-deck approach to recruitment.

HUERTA: So we start looking at attracting and recruiting their entire family. You know, the big joke in health care is you don't recruit the person. You recruit their spouse.

NOGUCHI: That approach pays off. Lost Rivers is now fully staffed. Alan Morgan is CEO of the National Rural Health Association. He says recruitment is a life-or-death issue, not just for patients in those areas but for the hospitals themselves.

ALAN MORGAN: Keeping access to health care in rural America is simply a challenge no matter how you look at it. But this shortage of rural health care professionals just is an unfortunate driving issue towards more closures.

NOGUCHI: Morgan says, over the last decade, more than 100 rural hospitals have closed. Over the next decade, another 700 more are at risk and so are the populations they serve.

MORGAN: Most certainly, the workforce shortages in rural America are contributing towards the decreased life expectancy that we're seeing in rural America, too.

NOGUCHI: For some hospitals, that dire need is the basis of their recruiting pitch. Come here, make a difference. Benjamin Anderson is CEO of Kearny County Hospital in the southwestern Kansas town of Lakin. With a population of about 2,000, last year The Washington Post ranked it one of the country's most middle of nowhere places. Anderson says he's found success targeting people motivated by mission over money.

BENJAMIN ANDERSON: A person that is driven toward the relief of human suffering and the pursuit of justice and equity.

NOGUCHI: The hospital takes care of a host of practical concerns. Staff often house hunt for recruits. They sometimes manage home renovations for incoming workers. Anderson also personally babysits the children of his staff because Lakin lacks nanny services.

ANDERSON: I mean, as a CEO, I do a lot of different things. But that's among the most important because it communicates we love you. We're going to live in a remote area, but we're going to live here and support each other.

NOGUCHI: But the cornerstone of the hospital's recruitment pitch is 10 weeks of paid sabbatical a year. That allows time for doctors to serve on medical missions overseas. Anderson is not a doctor but a mentor once gave him advice.

ANDERSON: Go with them and see what motivates them. See why they would want to go there. And I did, and it was life-changing. And I realized that in rural Kansas, we have more in common with rural Zimbabwe than we do with Boston, Mass.

NOGUCHI: Family physician Daniel Linville read about Kearny County Hospital and its sabbaticals in a magazine article during medical school. Last fall, he joined the staff hoping to continue some of his own mission work in Ecuador, Kenya and Belize. He says he and his physician wife were also drawn to the surprisingly diverse population the hospital serves.

DANIEL LINVILLE: Somalia and Vietnam, Laos and then from our Central American countries...

NOGUCHI: In that sense, every day feels like an international medical mission, requiring everything from delivering babies to treating dementia. But Linville says it's also been an adjustment.

LINVILLE: Now that we've been out here practicing for a little bit, then we realize exactly how rural we are.

NOGUCHI: It's not just that same-day shipping takes four days. Transferring a patient to the next biggest hospital in Wichita means the ambulance and staff are gone for an eight-hour roundtrip ride. He's often reminded that patients see him as another doctor just passing through.

LINVILLE: We're seen a little bit as outsiders, but also there's been physician turnover in the past. And so we get asked frequently, how long are you here for?

NOGUCHI: I don't know, he tells them, but for now, I'm happy.

Yuki Noguchi, NPR News. Transcript provided by NPR, Copyright NPR.