Physician search committee: still looking
With just four months until Dr. Janice Miller’s resignation takes effect, the Block Island Health Services (BIHS) Search Committee announced at a meeting on July 7 that it has had no viable candidates to date.
According to Chair Al Casazza, while some interest has been expressed, no one has come forward that is board certified or meets the basic criteria for the post. Citing a recent editorial in The New York Times, he placed the local search within the context of what is happening nationally.
“The doctor market is changing dramatically, with [the editorial indicating a movement] toward integrated care,” Casazza said.
The New York Times noted that facilities were dividing delivery of services into primary care, which might be provided by physicians’ assistants and nurse practitioners, and specialized care requiring physicians in dedicated fields. With the demand for doctors running high across the country, Casazza said, “This adds to the difficulty of finding physicians.”
Committee member Rob Sigman thought it might be time to advertise in The New England Journal of Medicine which, to date, the group had avoided doing because of the high costs involved.
Committee member Nancy Greenaway thought the search needed to be tailored “specifically to Block Island,” and, to that end, suggested [creating] a supplement to The Block Island Times.
“This would be a more effective recruiting device,” Greenaway said.
Committee member Naomi Kerest suggested that the group explore a connection with Brown University, which brings medical residents to the island each summer. Casazza said he’d already begun to do so, having contacted Dr. Jeffrey Borkan, Chair of the Family Medicine program at Brown.
Kerest said, “Since we don’t know how long we are committing to a doctor, perhaps we can think of hiring two fairly new doctors.” They could share a position and salary, she said, and might be willing to take the post “because they’d be learning a lot.”
Greenaway concurred that the medical residents who come each year “love this place, love this experience, and might be willing to make a commitment to this place.”
Noting the exceptional demands placed upon physicians here, Casazza explained that mainland doctors do not generally provide simultaneously for adults, children and geriatrics.
“They don’t work seven days in a row [while] on-call [throughout the night] all of those days,” Casazza said.
Of course, the intense time for the medical staff at the center comes during the summer.
On the other hand, Casazza said that during the rest of the year, the center serves approximately 220 patients a month, averaging 10 patients a day. He compared that to the mainland where he said, “The average primary care, one-physician practice sees 40 patients a day.”
The group seemed to agree that it should “stop thinking of this as a lifetime position,” but rather more of a three-to-five year post.
Needing “to brand ourselves”
Committee member Kristin Baumann said, “It seems that we’re looking to brand ourselves, and it is important to put out there who we are.” She emphasized that much of the outreach needed to be online.
“If you’re a doctor in 2014, you’re checking the web sites,” Baumann said.
She suggested that “an easy way [to create one] would be to go through The Block Island Times, especially if you’re a Biz-site member,” which BIHS is. This approach, Baumann said, would link the site to a web page through the local paper.
After volunteering to help create a web page, Baumann said she thought they could have one up within a week that would at least begin with a good photo and a description of the facility and the services offered. She also agreed to work out the necessary logistics with The Block Island Times.
Kerest thought that part of the description should include an explanation of the role of the local support services, such as the fire and rescue squads.
“We have to sell it that they’re part of an integrated health delivery services system,” Sigman said.
The discussion then turned to the differences between “board certified” and “board eligibility.” Casazza explained that the latter designation usually applies to doctors still in or just out of training. After two or three years, the physicians generally become board certified.
Sigman suggested, “Perhaps we could advertise for both, that is, board certified or board eligible.”
More discussion followed as to what would constitute a competitive salary and how to reach out to spouses. Greenaway stressed the importance of having the town specify its financial commitment to the position.
“If I were a doctor, I would be reluctant to commit if I didn’t know how the position was going to be paid for,” Greenaway said. Town Manager Nancy Dodge said the Town Council was to meet on the issue on July 16.
Executive Director Barbara Baldwin noted that she and Casazza were scheduled to meet with Dr. Michael Fine, Director of the Rhode Island Department of Health on July 15. The physician search is prominent on the agenda.
However, of equal importance at the meeting with Dr. Fine will be the state’s failure to renew the local center’s designation as a Health Professional Shortage Area facility existing in “a medically underserved area.”
She explained, “We have been dropped [from that designation] by the state health department. It [the designation] enables us to get slightly higher reimbursement rates. It can also provide loan forgiveness for those willing to serve in underserved areas.”
Selecting a headhunter
The committee prioritized potential search firms (headhunters) and made the choice to go with TEED Company, voting to recommend that firm to the board.
The group also agreed to expand advertising to online sites, such as PrimaryCareOpenings.com, medicareeconomics.com and the American Academy of Family Physicians (AAFP) Careerlink.
Dodge asked whether the committee had looked into housing for a new physician, and committee members felt that was outside their immediate charge—which is, to find a physician. However, all agreed that housing was an important component of the benefits offered.
Casazza pointed out that benefits to be offered “currently include housing, health insurance and a retirement package.” Dodge brought up that the existing salary is too low, and that she will bring a proposal to the Town Council.
After the meeting, the BIHS Board called a special meeting to be held on Friday, July 11 in the basement of the medical center. The agenda, Baldwin said, was to be very specific: to confirm going with a search firm and to set up a subcommittee to develop a full package to use for recruitment. The package will include temporary housing, long-term housing, a salary range and other benefits.