October 21, 2009


Incentives help to recruit doctors to the area

Cortland Regional Medical Center sets up practices for new physicians to fill health care needs

MayoBob Ellis/staff photographer
Obstetrician-gynecologist David Mayo was recruited by Cortland Regional Medical Center through its Regional Medical Practice, which brings in doctors to work inside the hospital and sets up practices for new physicians in other parts of the community by providing office space, marketing and other support services. Mayo will work from this office at the corner of Groton and Townley avenues.

Staff Reporter

Dr. David Mayo, an obstetrician-gynecologist, will open an office at 141 Groton Ave. by the end of November, a project funded entirely by Cortland Regional Medical Center through a program to fill local health care needs.
He will do consultations in the office, much like a private physician, but he will be an employee of Regional Medical Practice, an affiliate of CRMC.
Mayo is one of nine physicians that CRMC has recruited to Cortland County through Regional Medical Practice, a company the hospital set up about three years ago to improve its recruiting ability.
Regional Medical Practice recruits doctors to work inside the hospital and sets up practices for new physicians in other parts of the community by providing office space, marketing and other support services.
“It’s to make sure the community has a stable number of physicians in the necessary specialties,” said Chris Kisacky, who oversees Regional Medical Practice.
Mayo will fill the community’s need for more obstetrician-gynecologists, Kisacky said.
Regional Medical Practice is paying for the costs of buying the Groton Avenue property, renovating the building and buying all instruments that will be used there, Mayo said. The building, formerly Otter Creek Medical Office, remains on the tax rolls.
The hospital estimates that the renovation of the building, which includes an interior demolition, will cost $400,000, said Tom Quinn, the hospital’s marketing director. The building was purchased for $300,000, and supplies will cost at least $100,000, said Kisacky.
Cortland County is a Health Professional Shortage Area, a status the federal government gives to certain areas that enables local physicians to receive higher reimbursement rates, said Catherine Feuerherm, director of the county Health Department. The county has a shortage of primary-health providers, dentists and mental health providers, Feuerherm said.
The state also offers loan forgiveness programs for doctors who have recently finished medical school and work in shortage areas, including federal programs and the state’s Awards for Doctors Across New York Program.
Rural areas, such as Cortland County, have more difficulty recruiting doctors than metropolitan areas, because rural areas have fewer resources, less money and lower reimbursement rates, and many physicians come from metropolitan areas, Feuerherm said.
“We don’t always sell ourselves well ... If we really market the positives of our area, I believe there’s a certain group out there that we can attract,” Feuerherm said.
When recruiting physicians, Regional Medical Practice officials take them on tours of the hospital and the community, often stopping at local schools and landmarks, Kisacky said.
Mayo said that when he visited Cortland for the first time in June 2008, the recruiters took him to see Homer and Skaneateles. He said he immediately fell in love with the area, partly because he feels it is very family oriented.
Mayo was born in Buenos Aires, Argentina, and earned his medical degree from the University of Buenos Aires. He recently completed a four-year residency in obstetrics and gynecology at Saint Peter’s University Hospital in New Brunswick, N.J. Hospitals in New Jersey and Texas also offered to set up a practice for Mayo, but he chose Cortland, he said.
“My plan is to stay in this town, forever hopefully,” he said.
Setting up practices through an affiliate company, rather than through the hospital, allows for more flexibility in the design and construction of the physicians’ offices. Buildings set up by the hospital itself would have to follow all the building codes and regulations that the hospital must follow, Kisacky said.
Mayo began seeing patients in a temporary office in the hospital over a month ago. After his office opens, Mayo will still be required to work in the emergency room at certain times.
Regional Medical Practice is funded through loans the hospital takes out, Kisacky said. It takes a few years for the hospital to make a profit by setting up outside practices for physicians, but the hospital benefits in other ways, she said.
“There’s coverage for the community, so people aren’t leaving, and the ER’s covered, so we have services that are necessary,” Kisacky said.
Doctors who have their own practices sign two-year contracts. After two years, they can choose to become private providers by paying the hospitals for all costs of setting up the practice, or they can leave, in which case the hospital would look to place a new physician in the practice, Kisacky said.
Since its creation, Regional Medical Practice has recruited four orthopedic surgeons, three surgeons, a cardiologist, an obsterician-gynecologist and two nurse practitioners, Kisacky said.
Mayo is the second doctor that has set up an outside practice through Regional Medical Practice. The company previously set up an office for Dr. Linda Martin, an orthopedist, at 1095 Commons Avenue in the city. Regional Medical Practice later recruited three partners to work with Martin.
Reports released by the Center for Health Policy Studies show that Cortland County should have four orthopedic surgeons and three obstetrician-gynecologists, which influenced Regional Medical Practice’s decision to recruit doctors in these areas, Kisacky said. The reports use statistics such as the size of an area, population and the ages of residents to show how many doctors of each type geographical areas should have.
Dr. Douglas Rahner, medical director for the Family Health Network of Central New York, which has offices in Cortland, Marathon and Moravia, said recruiting primary-care physicians is becoming more challenging than it once was.
“At one point I sent letters to every family medicine practice in the Northeast with little results,” he said.
CRMC forwards information about doctors looking for jobs to the Family Health Network and other local health care providers, Rahner said. Making sure other health centers have enough doctors helps the CRMC, because it provides patients whose conditions require hospitalization and prevents residents from using the emergency room for primary care.
“It’s part of their business plan, but it’s also part of the general corporate citizenship in making sure the community is cared for,” Rahner said.
Cortland County’s largest needs right now are primary-care physicians and general surgeons, Rahner said. If a few primary-care physicians were to retire, there would be a significant shortage, he said.
Only 13 percent of doctors who graduated medical school last year became primary-care physicians, he said, as more physicians are going into specialized fields. But seeing a primary -care doctor for multiple problems is more cost-effective for patients than seeing multiple doctors, he said.
“Potentially you end up seeing three doctors for issues that could have all been addressed by a primary-care doctor,” Rahner said.


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