Recruitment of
Physician Specialists to
Rural Communities
Presented By:
Patricia McCullough
Michael Hagen
Thomas Reek
June 2010
Our Market Area(s)
The Market Area
 In the primary market areas combined, RHCC and
CRMC control approximately 75 to 80 percent of the
primary care market, which is approximately 28,000
persons
 Both organizations draw from outside of the primary
market areas – Riverwood to the East and South
and Cuyuna to the North and West
Our System
Riverwood Health Care Center
 Integrated health care provider with three rural
health clinics and a 25-bed Critical Access Hospital.
Clinics located in Aitkin, McGregor, and Garrison.
 New 24-bed hospital was built in 2003.
Our System
Cuyuna Regional Medical Center
 25-bed Critical Access Hospital, which has been
essentially completely renovated over the past five
years.
 Primary care clinic in Longville.
Our System
Central Lakes Medical Clinic
 Multi-specialty clinic located on the campus of and
attached to Cuyuna Regional Medical Center
 Specialists serve both facilities
 Integration discussions underway with CRMC
Provider and Health Care Resources
Combined medical communities of Riverwood Healthcare
Center, Cuyuna Regional Medical Center and Central
Lakes Medical Clinic include:
 24 family practice physicians
 5 nurse practitioners/physician assistants
 3 internal medicine specialists
 2 non-invasive cardiologists (in a partnership with
Minneapolis Heart Institute)
 4 general surgeons
 2 orthopedic surgeons and one orthopedic PA
Provider and Health Care Resources
 2 obstetrician/gynecologists and one OB/GYN NP
 3 ophthalmologists
 1 psychiatrist
 1 neurologist
 1 anesthesiologist
 Full-time radiology coverage at both hospital locations (in
partnership with Regional Diagnostic Radiology of St.
Cloud, a group of 15 radiologists providing on-site
interventional radiologic procedures and reads)
Provider and Health Care Resources
 In-house MRI and CT scanning capabilities at both
Hospital locations
 State of the art operating suites
 24/7 Emergency Services
 Full service laboratories.
 Pulmonology / Sleep Medicine, Dermatology,
Rheumatology, Oncology, Urology and ENT/Plastics.
How Specialty Collaboration Began
and Significantly Expanded
 Combined use of surgeons was the first area of
collaboration; in order to have more than one surgeon
CLMC needed to offer services at both RHCC and CLMC
 Shared in recruitment costs
 Significant event occurred with a joint community survey
 The message:
 We are fighting border wars with one another while a very
large share of our combined market is going to Twin Cities
facilities
 The key to growth in our future is developing capability to
provide more specialty care on something other than an
“outreach” model
How Specialty Collaboration Began
and Significantly Expanded
Key components of decisions related to
recruitment of specialists:
 Medical Staff Development Plan
 Analyzing data related to potential business
related to the specialty and how much may be
leaving the local communities
How Specialty Collaboration Began
and Significantly Expanded
 Work with local medical staff to discuss adequacy
of coverage, their needs, their satisfaction with
services now received, and their consensus to
move forward with exploring options
 Careful
thinking about probability of being
successful in expanding time of existing specialists
and/or successful in getting them to change their
patterns – e.g., doing minimal work at site and
taking the rest “back home”
How Specialty Collaboration Began
and Significantly Expanded
 When everyone is “on board”, begin process of
recruitment
• Presentation of “us” – a sales presentation
• Request for information from the potential respondents
• Invitation to a site visit
• Inform existing specialists of process and include them
• After site visits and review of RFIs, determine next steps with
one or several of the respondents
• Complete detailed RFP with expectations, etc. and distribute
to selected firms
How Specialty Collaboration Began
and Significantly Expanded
 Selection process
• Physician participation is key
• Establish criteria for review of proposals using the
RFP
• Conduct an objective review of each response
• Respond respectfully to ones not chosen
• If you are changing your existing specialists, meet
with them in person to talk about the decision and the
reasons for the decision; they won’t be happy and the
meeting will be difficult but necessary; include a
physician if possible in the meeting
What Has Specialty Expansion
Meant to Our Communities
 Recent examples of our collaborative effort

Adult and Pediatric Urology

Increased coverage between the two communities

Significantly more outpatient procedures being
done in the local hospitals

Will expand coverage more as need increases

Recruiting a urology PA which will allow for some
overnight procedures

Physician satisfaction very high – APU made it
point to ask all of the physicians if they were
satisfied and if they were meeting their needs
What Has Specialty Expansion
Meant to Our Communities
 Recent examples of our collaborative effort

Partnership with Virginia Piper Cancer Institute

Bringing VPCI brand to our local community

Jointly recruited a nearly full time oncologist
through MN Oncology, VPCI partner

VPCI will bring “value added” services that we
cannot do in our community

Seamless process for patients between VPCI and
local providers

On track to develop an accredited Community
Cancer Center
What Has Specialty Expansion
Meant to Our Communities
Our stories of growth:

Riverwood Healthcare Center

Cuyuna Regional Medical Center
What Has Specialty Expansion
Meant to Our Communities
Advice to consider  Great luck in working with specialty groups or
groups that have more than one or two
specialists to provide coverage
 Make sure they understand that you are not an
“outreach” site, e.g., don’t present yourself as
“needy” and willing to do anything
 Work
with your medical staff to have
opportunities
for
communication
and
interaction when the specialists are at the site
Questions