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Rural hospitals adopt ‘grow your own’ strategies to attract staff

It certainly is not news that there is a nursing shortage in Mississippi and elsewhere in the country. But particularly when it comes to hospitals in rural areas, it can be especially difficult to attract and retain nurses, and also physicians, nurse aides and many other types of medical professionals.

“I think staffing is the hardest challenge,” said Fred B. Hood, administrator of the North Mississippi Medical Center-Pontotoc, which is a division of North Mississippi Health Services based in nearby Tupelo. “Maintaining an adequate staff is always a challenge. There is so much other industry in the area. We compete with the non-healthcare industry for people who are certified nursing assistants.”

The North Mississippi Medical Center-Pontotoc is a small hospital with both inpatient and outpatient facilities and a 44-bed nursing home. Hood said the regulatory requirements for staffing are more stringent for nursing homes than hospitals.

“A nurse aide at a nursing home has a hard job,” Hood said. “It is probably the hardest job in the facility. It is physically and emotionally stressful, in many instances. That same individual with the same skill set can drive across town to work at a furniture factory making the same rate, or a dollar or two more per hour. They do their job and go home and don’t have the stress they have with a healthcare job. They have holidays and weekends off. The fact we are 24-7 and have peculiar stressful demands on people can sometimes make it difficult to find the right person who wants to work in that atmosphere. But it can be very rewarding work for people who have a genuine desire to care for others. It really takes a special person to be successful in that job, and to stay with it.”

Pontotoc, like many rural areas of the state, has been hard pressed to retain enough physicians to adequately serve the population. A year ago, seven physicians were practicing in Pontotoc. Today, there are four. One physician died unexpectedly. Another is on military leave in Iraq. A third left to practice in another area.

“So we have the same patient load as a year ago, but we have half as many physicians here to deal with it,” Hood said. “That obviously puts some additional stress on them.”

Rather than recruiting more physicians from the outside, the community is growing their own. One current physician has a younger brother who is now in a residency program and plans to join the Pontotoc clinic after completing his residency. The physician on military leave is expected to return between February and May next year.

“We are just trying to weather it until we get our home-grown physicians,” Hood said. “We studied the situation, and the physicians feel they can make it until the physician comes back from Iraq and the local physician’s younger brother is ready to practice. We are stretched thin, but we opted to make do rather than look for someone who is a complete unknown to the community.”

Some rural areas of the country have taken advantage of the J-1 VISA program that allows foreign doctors to practice in medically underserved areas in return for receiving residency in the U.S. Hood said his hospital hasn’t used the J-1 program.

Debra Griffin, administrator of the Humphreys County Memorial Hospital in Belzoni, said they weren’t impressed with the work of the initial J-1 physicians recruited to Belzoni.

“Earlier we didn’t have good results with J-1,” Griffin said. “They were just interested in getting their VISA and getting out of here. My thing is even if that is my interest, I made this agreement as a contract and should abide by it. I thought they would do the best they could, be productive and work hard. But they just weren’t interested.”

They have had better luck with a current J-1 physician, whom Griffin said is doing a good job. But overall Humphreys County Memorial has adopted a “grow your own” strategy. With the low-income levels in the Delta, it is very difficult for small hospitals to recruit physicians from outside of the area.

“It is almost impossible to encourage doctors to come and work in an environment such as ours,” Griffin said. “We currently have only three physicians. One is a physician born and raised here. One has been here for 25 years. The other is a J-1 physician recruited here. We started a program where we pay tuition for anyone from the county who will go to medical school and then come back and practice here. We do the same thing for nurses. Someone from this area has a greater understanding and appreciation for the area.”

Money is also an issue. Dr. Joan Exline, associate professor of health policy and administration at the University of Southern Mississippi, said all hospitals are trying to cope with the nursing shortage.

“But sometimes it is even harder for the smaller hospitals because they are in a rural setting that may not attract people,” Exline said. “It is hard to compete with the higher wages offered in metropolitan areas.”

Exline said each hospital is trying different things to attract and retain nurses. Some are recruiting students at the high school level to get training and come back to practice nursing in the community. Others are touting their family atmosphere and a close-knit relationship with other staff members.

Mendal Kemp, director of the Center for Rural Health of the Mississippi Hospital Association, said it is important for rural areas to improve all facets of the community in order to attract physicians, nurses and other health professionals. It is difficult to get medical professionals to move to an area unless there is a good hospital and other quality of life amenities.

Contact MBJ contributing writer Becky Gillette at bgillette@bellsouth.net.


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