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Range of programs addressing state's doctor shortage

Mississippi has a shortage of doctors so critical that the state ranks 49th in the number of doctors per person. Visit Jackson, the Gulf Coast, Hattiesburg or DeSoto County (Southaven), though, and there`ll be no signs of such a crisis.

That`s because the problem is in Mississippi`s many rural counties.

“There`s not really a shortage of doctors in the state,” according to Alvin Harrison, physician recruiter and administrator working out of the Mississippi State Department of Health. `the problem is the distribution of doctors. If you could redistribute doctors now in urban areas, there would be no shortage.”

But more than half the state`s population lives in rural counties and some 56% of the doctors are in four urban areas. (The federal government defines a rural area as one with fewer than 50,000 people.)

Mississippi State University (MSU) and the state`s 15 community and junior colleges are cooperating in a program to help provide rural Mississippi with enough healthcare providers in coming years by identifying future doctors while they’re still in high school.

The Rural Medical Scholars program is an intense five-week stay each summer on the MSU campus. This summer`s program runs from July 5 to August 6. Up to 30 students – two each selected by the community and junior colleges – who have completed their junior year in high school and have an ACT composite score of 25 take zoology and algebra and observe doctors at work.

“The program tries to steer future doctors into the practice of family medicine in underserved areas,” according to Bunny Carew, rural health policy coordinator and director of the Rural Medical Scholars program at MSU. “This is a special program for accelerated, talented students who have already been accepted to Mississippi State.”

And the zoology and algebra they study are actual college courses, Carew emphasized, the same courses they’d be taking in premed.

There are other programs helping to alleviate rural areas’ need for doctors.

In what`s called the J1 Visa program, funded by the Robert Wood Johnson Foundation, foreign doctors are recruited to work in rural areas in exchange for a waiver of the home residency requirements.

“We’re now recruiting 10 to 15 foreign doctors a year to help these critical needs area,” Harrison said. Though he works out of the office of the health department, he`s actually employed by the Mississippi Primary Health Association (MPHA), whose programs are also funded by the Robert Wood Johnson Foundation.

A federal program provides for scholarships and loans for medical students who agree to practice in underserved areas for a minimum of one to two years, according to Harrison. These federal programs are attractive because they include tax incentives.

The state also has scholarship and loan programs for medical school students who agree to work in rural areas but these aren`t as attractive because they don`t include any tax incentives.

The MPHA and other groups have been trying to convince the Legislature to add these tax incentives to the state program, Harrison said, but so far they’ve been unsuccessful. He cited the Legislature`s preoccupation the past couple of years with such matters as malpractice insurance, Medicaid and a hiring freeze.

As for the near future, Harrison said that everyone in Mississippi is pretty tight about funds. And the same is true on the federal level. So it`s a matter now of maintaining the services that exist.

“One of the biggest problems in recruiting doctors for rural areas is in matching a doctor to the proper location,” Harrison said. “If a rural area has no doctors, it wouldn`t help much if it got, say, a neurosurgeon.”

“There`s also the perception of lower salaries, but that`s not true. Salaries are actually about the same as in urban areas.”

Another perception is that because there are no other doctors in the rural area to which a doctor might go, a doctor who located there would have to work too hard, “wouldn`t have enough down time, enough quality time with his family.”

“There`s also the fact that many doctors are married to other doctors, or to dentists, nurses, PAs,” Harrison added. “And there`s no work in the rural area for the spouse.”

In the Rural Medical Scholars program, the students shadow a doctor at work, one on one.

“This way, they can learn what it`s really like, instead of just watching ‘ER’,” Carew said. “Forty doctors in the area have agreed to be shadowed.”

The participants also go to the University of Mississippi Medical School in Jackson, where someone from the faculty talks to them and tries to channel them into family medicine.

“If there is a shortage of doctors in an area, the greatest need is not for a specialist but for a generalist,” Carew said.

The program, which was started in 1998, is funded by a grant from the United States Department of Agriculture (USDA). This past fall was the first year that students from the program entered medical school. Three started last year and there will be four this coming fall. The majority of the rest are in health-related fields such as medical research and nursing.

In the past, the USDA also provided funds for the Rural Health Explorers Program, which was sponsored by the community and junior colleges and in which students with a more generalized interest in health care careers, such as nursing, took part in a five-week program.

But USDA funding has been cut and this summer`s program had to be canceled.

Contact MBJ contributing writer at George McNeill at mbj@msbusiness.com.

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