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Mississippi homes in on strategies to increase number of physicians the state

By BECKY GILLETTE

The shortage of physicians is an issue across the United States., but it is particularly acute in Mississippi, which ranks 50th in the country in access to active physicians per capita. But a number of different efforts are underway to increase the number of physicians in the state.

One simple action is that the state got rid of some of the unnecessary burdens to getting a license to practice medicine in the state, making it easier to recruit physicians from out of state, said Dr. Claude Brunson, who is retiring as a professor at the University of Mississippi Medical Center (UMMC) School of Medicine and taking over as executive director of the Mississippi State Medical Association.

Brunson said the biggest positive step to increasing the number of physicians in Mississippi has been the construction of new medical school facilities in Jackson that allowed the School of Medicine to increase the number of students in a class from 150 per year up to 165 students.

“We built a new medical school that is one of the best in the country now,” Brunson said. “We will exceed producing 1,000 physicians by 2025. One other thing we have done working with the governor and the legislature is start another medical school that trains Doctors of Osteopathic Medicine that has increased fairly significantly the output of medical students across the state. The William Carey University of School of Osteopathic Medicine graduated their first class two years ago. The graduation of their third class is coming up.”

William Carey is graduating about 100 medical school students per year.

While great process has been made, Brunson said since the state is so far behind, it will take awhile to catch up. It takes eight to 15 years to get a physician trained and out in practice.

“We are on the right path,” Brunson said. “There is a delay because of the time it takes to get through medical school into practice.”

Brunson said the support of Gov. Phil Bryant and the Mississippi Legislature has been critical. He also said they have had a lot of help from the Mississippi State Medical Association working with UMMC to develop and find funding for the rural physician scholarship program. Participants get four years of medical school paid for in return for agreeing to spend four years practicing in the state, generally outside the largest cities in the state.

The scholarships are for primary medicine, pediatrics, internal medicine and OB-GYN. This year the legislature has added an additional scholarship for psychiatry.

Some states have relied heavily on foreign trained physicians to meet gaps in coverage. Foreign physicians are required to do residency training in the U.S. Brunson said as the number of medical students in Mississippi has increased, the number of residency slots for foreign doctors has decreased. But with the amount of resources the state puts into training doctors, Brunson said it is important to being committed to providing residencies that give them the rest of the training they need to go out and practice.

“We do have commitment to students to find them residencies,” he said.

When advocating for more resources for physician training, Brunson points to the importance of health care as an economic driver.

“We know that for each physician we put out in the state, there is $1.8 million economic impact in that community including new jobs,” Brunson said. “That doesn’t include ancillary positions outside. Annually health care has a $8.2 billion impact per year in Mississippi. We get about $313 million in state and local taxes for health-care services. Increasing the number of physicians is a great investment for the state, and makes us an inviting state for folks to come to.”

Increasing the number of residencies available so medical school graduates can complete their training in state is a critical factor in alleviating the physician shortages, said Dr. John R. Mitchell, director of the Office of Mississippi Physician Workforce, who is also an associate professor of family medicine at UMMC. Mitchell said hospitals in Hattiesburg, Meridian, Columbus, Tupelo and Corinth are now providing residencies to medical students. Efforts are underway to develop residencies in Oxford, Greenville and Gulfport.

“Unless we can develop training positions, they will likely go elsewhere to practice,” Mitchell said. “Statistically speaking, about 60 percent of residents will stay to practice within a 100-mile radius of where they trained. Most who are trained will practice even closer than that. We’ve approached it from the standpoint of training and retaining, which is pretty much the way other states are approaching it. We want to do it better than others states so we will get more physicians to stay in our area.”

It is important to look not just at how many physicians there are per capita, but how they are distributed. Like other states, Mississippi has a maldistribution of physicians with more choosing to locate in urban areas.

“We know the Mississippi Delta, in particular, has a great need,” Mitchell said. “It is also important to look at the age of the existing physician workforce. Some areas have a lot of physicians nearing retirement age. There are areas very sufficiently covered today that might not be covered in five years or less. We are working with Mississippi State Board of Medical Licensure to determine how many are nearing retirement age and how many are planning to retire soon. If doctors are 65, you don’t know if they are going to retire or not unless you ask. We are trying to build a more robust data base to get a better prognosis.”

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About Becky Gillette