Alternative Forms of Revenue
NMHS is addressing the physician shortage by growing our own pipeline of internal medicine doctors, many of whom remain in our region to care for patients.
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North Mississippi Health Services recently graduated our first class of internal medicine residents. Watching those 12 residents grow from fresh medical school graduates into fully competent physicians during this three-year program has been rewarding, and we know we are growing our own talent to better serve our patients in the future.
- Access to care
- Growth needs
- Alternative revenue source
- Evolving how the work gets done (growing our own talent)
How the Internal Medicine Residency Program Started
Our mission is to continuously improve the health of the people in our region, and you can’t do that without physicians. We already had a family medicine residency program, which provides a really important component of care. This very successful program provided a great foundation to build upon.
In light of the physician shortage nationwide, we knew we had to evolve so we could improve access and provide the best care for our community.
If they don’t choose to go on to a fellowship, internal medicine providers often become hospitalists. Hospitalists comprise the largest physician group at NMHS, and they take care of over 80% of our patients who are admitted to the hospital. If the hospitalist consults a specialist, they likely are also trained in internal medicine. After discharge, patients are likely to follow up with either an internal medicine doctor or a specialist who had internal medicine training.
As you can see, in many areas of our health care system, patients are being cared for by an internal medicine doctor.
Our graduates will have the option to stay with us and practice hospital medicine or internal medicine or go on to complete fellowships. The best part is that typically about 75% of trainees will stay close to where they trained.
That vision, to start creating our own pipeline of doctors, was the impetus for starting the program. We started small deliberately to make sure we had a great program that could deliver a valuable educational experience. We started with 12 residents in our first three classes, and that first class recently graduated. This year, we took 24 residents, and every year after this we will take 24. In the next three years, the size of our program will double to 72.
Financial Incentives for the Residency Program
In order to have a health care system that can care for patients, it has to be financially viable. In order to pay salaries, get access to equipment, educate staff, provide electronic medical records and more, finances are important.
There is an expense to the organization to create a residency program. However, it has also made it possible to bring in new sources of funding to our organization. CMS recognized how important it is to train residents, so they provide direct and indirect funds that help cover the salary of the residents and other costs associated with the program. There are also opportunities for grants that help cover costs, so it ends up being a positive financially for our organization.
What Makes NMHS Special
I’ve had experience in several different sizes of health care systems. NMHS is an amazing place to train because we have all the resources and specialists of a large hospital, but the culture and support of a smaller community hospital. Because Mississippians face so many health challenges, trainees can come here and see anything in rural Mississippi — not only complex diseases but also cutting-edge treatments we offer here.
Future of the Program
We have a duty to the public to ensure that we are training competent doctors. We have developed a foundation here of really rigorous academic standards. Each year, residents do a national test, and we are in the top 25% in the country on that exam. There’s also a national survey that goes out to all trainees, and the data shows that our residents are really happy with the training they get.
Having that data each year really ensures that we listen to our residents and evolve and grow. We know now that we have the infrastructure, teams and operational processes, as well as great standards for how we educate residents. As we grow, it’s really important to me that we don’t lose that community hospital feel and supportive culture.
We are addressing the problem of a physician shortage in the right way — by training people in our system, on a large scale, who will be able to care for our patients in the future. It will be really fun to come back in about 10 years and have a conversation about the impact this residency program has had.
There will be a large percentage of these residents who stay here and become leaders both on our medical staff and in our community, and that is woven into the fabric of their training here.
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