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Published in CenterView on November 19, 2012
Mississippi Gov. Phil Bryant speaks to Mississippi Rural Physicians Scholarship Program participants.
Mississippi Gov. Phil Bryant speaks to Mississippi Rural Physicians Scholarship Program participants.

Office of Mississippi Physician Workforce helps to address state’s primary care shortage

By Gary Pettus

More than 15,000 people live in Tallahatchie County. Three of them are doctors.

In Tutwiler, Dr. Anne Brooks and her staff each year see around 7,600 patients. The next-nearest available doctor is at least 15 miles away.

“We need more doctors; I’ll take all I can get,” said Brooks, a physician and Roman Catholic nun.

More may be on the way – eventually – with the anticipated founding of a family medicine residency training program at Forrest General Hospital in Hattiesburg, which would be only the third such program in the state.

Its creation would herald early success for the Office of Mississippi Physician Workforce (OMPW), established in April to grow a larger crop of primary care physicians in doctor deserts such as Tallahatchie County.

An infusion of money from the OMPW is helping fund the emerging program at Forrest General, making a small but reassuring splash in a deep well of need, said Dr. Diane Beebe, the workforce’s interim director and professor and chair of family medicine.

“We’d like to see family medicine training programs in at least one or two other places in the state over the next five years,” said Beebe, who will remain on the 21-member advisory board after a permanent director is hired.

“Right now, the workforce is getting formed and we’re hoping to make a difference.”

Minus the efforts of the OMPW and initiatives like the Mississippi Rural Physicians Scholarship Program, the health of the nation’s least healthy residents could worsen in a state of nearly 3 million, including about 5,000 licensed physicians.

“It has become painfully evident that there is a critical shortage in the primary care physician workforce, and this is more evident in Mississippi than many other states,” said Dr. John Mitchell of Tupelo, a family physician and the OMPW’s advisory board chair.

For every 10,000 Mississippians, there are 8.3 primary care physicians, which include family physicians, pediatricians, general internists, obstetrician-gynecologists and others. That’s 4.5 fewer than the national average.

In Tutwiler, Brooks is the only private physician covering an area much larger than the town of 3,550 (prisoners skew Tutwiler’s statistics: the 2010 Census includes residents of the 2,800-bed Tallahatchie Correctional Facility, which has its own medical clinic).

“We draw on patients from five counties,” Brooks said. “Seventy-two percent of them can’t pay. We depend on donations to pay for some services, such as ultrasounds. Last year, we spent $48,000 from donations just to assist with medications.

“We see such sick people at the clinic. They have medical problems you don’t see in big cities a lot of times.”

Within the county, there are two other physicians, each about 30 miles from Tutwiler, Brooks said. Clarksdale, a relatively large Delta city, is 15 miles away.

“But 10 percent of my patients come from Clarksdale because there are doctors who won’t accept no-pay patients,” Brooks said.

“The problem is not just, ‘Where is the doctor?’ It’s ‘Where is the doctor who will see the patients?’”

Legislators created the OMPW to bring relief to places like Tallahatchie County. With a maximum $3 million appropriation distributed over three years, the organization will help fund new family medicine residency programs in an effort to add 1,000 physicians to the state’s workforce by 2025.  

Upon signing the legislation, Gov. Phil Bryant said, “Expanding our state’s medical residency programs will directly increase the number of physicians who remain in Mississippi to practice. New doctors generate about $2 million in economic impact in their communities, and more doctors means better health care for our citizens.”

In October, Bryant announced an award of $10 million in federal funds to help the University of Mississippi Medical Center build a new, expanded School of Medicine that will train a greater number of physicians.

“But there’s no way to expand the family medicine residency program at UMMC so that it can take up all the slack,” said Dr. Hugh Gamble II of Greenville, a vascular surgeon and vice chair of the OMPW’s advisory board.

“The logical answer is to spread them across the state,” said Gamble, representing the Mississippi State Medical Association on the board. “The legislature and governor have stepped up and put some money on the line to get the ball rolling.”

Housed at UMMC, the OMPW is more than a funding source for residency programs, Beebe said.
“We help with the process of accreditation,” she said. “We help with everything it takes to put the program together.

“As the only academic health center in the state, we obviously have that expertise here.”

In fact, UMMC helped set up the state’s other family residency training program, in 1995, at North Mississippi Medical Center in Tupelo, where Mitchell serves on the faculty.

By adding a program at Forrest General, the state could produce up to 24 new family medicine doctors by 2016, Mitchell said.
“But that is under ideal circumstances. It takes time to produce significant numbers of new primary care physicians.”

Beebe believes the Forrest General program will be accredited, and already a couple more hospital systems have shown interest in starting their own, she said.

“The workforce is starting small, but my hope is that we will continue to grow and be supported financially so that we will be able to do what we need to.”

That is, put more doctors to work in places like Tutwiler, where Brooks and her staff are also trying to make a difference.

“Adding residency programs is terrific,” Brooks said. “The problem is, physicians who want to get high-paying jobs don’t necessarily want to say they went to Podunk City for their residency.

“But here in the Delta, we’re on the edge. And sometimes people
actually get better. And that’s so cool. If you want to be a doctor, all the fun is here.”