Physician recruiting - Eastern Oregon presents unique challenges to physicians

July 16, 2007 11:00 pm

While there is never a scarcity of physicians or nurses when you watch TV — think "ER,'' "Grey's Anatomy,'' "House'' and a long line of soap operas, reality serves us another picture.

Oregon Health & Science University has studied state physician workforce trends since the mid-1970s. Their warnings of severe physician shortages in rural communities became a fact for people in Eastern Oregon several years ago.

The reasons are many: fewer students going into medicine, a lack of educators, high malpractice insurance, a demanding lifestyle, a growing senior population and physician retirement. Barriers specific to rural physician recruitment also include social and professional isolation, frequent on-call shifts, community size — most doctors do not want to work in rural settings with a small population base, a lack of amenities.

Addressing the shortage of physicians

Grande Ronde Hospital is well aware of the situation. Some patients must travel hundreds of miles to Portland or Boise for specialty care. But there is no magic wand or super-hero surgeon from central casting to save the day.

A tremendous amount of time and resources is dedicated to addressing the situation. We work with several national recruiting firms, paying special attention to internal medicine, family practice and general surgery candidates. Applicants have been from Ohio, Illinois, California, Washington, Texas, and New Mexico.

Additionally, four months ago, the state granted Grande Ronde Hospital two J-1 Visa Waiver positions. This enables us to recruit J-1 candidates. These are foreign exchange visitors in the U.S. for graduate medical education or training.

Highly motivated and well educated, these candidates must seek employment at a J-1 visa site in order to stay in the United States.

Because of this new designation we were able to recruit Dr. Inski Yu. Highly recommended, Yu is originally from the Philippines. During his last year of medical training at St. Elizabeth Health Center in Youngstown, Ohio, Yu distinguished himself as chief resident. He joins the Internal Medicine Clinic next summer. But one new physician is not enough. Our community needs more.

An escape from urban chaos

Candidates look at many things when weighing the decision to practice in a new area: housing, taxes, schools, safe communities, career opportunities for other family members, even high speed internet access.

With many attractions for those escaping urban chaos — lack of traffic, access to outdoor recreation, a virtually non-existent crime rate and affordable housing — Eastern Oregon is a prime rural retreat.

However, it takes a unique person to live in the country. Our valley's seclusion, the majestic mountains, the ponderosa pine, has kept my family here for four generations. But one person's rural oasis may be a shopaholic's prison. Without a commercial airport, without a mall, some simply find the area too isolated.

Investment in the future

But there are some bright spots:

• Expansion of the Internal Medicine Clinic should help attract new health providers — research indicates most physicians prefer to be employed and work in a group setting.

• Investment in new information technology systems that provide sophisticated products to help improve care and lessen paperwork. Providing access to electronic medical records is good not only for our patients but is becoming an expectation among health care workers.

• The recently announced partnership between Oregon Health & Science University, Oregon State University and the University of Oregon to expand our state's capability to train medical providers.

Though the barriers to recruiting rural physicians are large, I'd like to believe they are not insurmountable. However, I am extremely concerned that this challenge has approached a crisis situation. Regardless of how much time and money we invest in attracting candidates, our rural community is in the middle of a physician drought, like that of rural areas all across the U.S.

I believe Eastern Oregon is a special place to live and Grande Ronde Hospital is a special place to work. I care deeply about this community. Yet, people go where their passions lead them and geography plays a role.

Those of us who live here and love it can often make good recruiters. I would be very interested in hearing from you if you have ideas for helping our recruitment program, or better yet, a suggested candidate — a physician you know who might consider moving to our paradise, Union County.


Paul Shorb is the senior director of support services at Grande Ronde Hospital. He is responsible for physician recruitment and retention.