PHYSICIANS ARE PARTICIPATING IN RECRUITMENT

Recruiting doctors to the Cape Girardeau area takes big bucks.

It's estimated that doctors and medical groups, the two local hospitals and the Cape Girardeau County Medical Society combined currently spend more than half a million dollars a year on physician recruitment.

Area doctors say there's a huge need for more primary-care physicians, particularly family physicians.

Last December, a medical society survey showed a need for additional doctors, including six in family practice, five in general internal medicine and three in pediatrics.

Doctors Mark Kasten, David Catron and Ramiro Icaza are among a number of physicians who have been actively involved in the recruitment effort.

Kasten and Catron are family practitioners in Cape Girardeau. Both are in group practices. Kasten is also president of the medical staff at Southeast Missouri Hospital and serves on the medical society's board of directors. Kasten's wife, Lois, is executive director of the medical society. Icaza is a family physician who has a solo practice in Jackson.

Lois Kasten said there are about 150 doctors in the Cape Girardeau area. But of those, only 15 are family physicians. There are six full-time-equivalent pediatricians and seven full-time-equivalent internists, she said.

Family physicians, pediatricians and internists are considered primary-care doctors. In all, only about 19 percent of the physicians in this area are in primary care, she said.

Mark Kasten said that emergency rooms at the two Cape Girardeau hospitals are being over-utilized because of the shortage of primary-care doctors.

Kasten said the average cost of recruiting a physician is in the $25,000 to $40,000 range.

"You really have to go through recruiting firms," he pointed out.

Catron said his group, Family Physicians Group, has been paying a physician recruiting firm $2,000 a month and has yet to see any prospective candidates.

To recruit a doctor, a medical group has to provide a salary guarantee for the first year, Kasten said.

There's also the cost of bringing a physician and his spouse to town to look over the community. Sometimes, more than one visit is made, the three doctors pointed out.

"It's not only the physician, it's the spouse you have to recruit a lot of times," said Lois Kasten.

One doctor, she recalled, was interested in locating in the Cape Girardeau area, but decided against it because his wife didn't want to live here.

Lois Kasten said the society and the two local hospitals recently produced a physician recruitment video at a cost of about $10,000. The 13-minute video has been made available to recruiting firms and local physicians who have been involved in the recruitment effort.

"We made 300 copies. We have already passed out about 75 copies," she said.

"We are not actually out recruiting on our own," she said of the medical society. "We just offer assistance here."

Recruiting doctors is not just a local problem. It's a tough task in communities across the nation, said Mark Kasten.

"It's really difficult to get these people to come into our group." He said that's partly due to the fact that doctors in his group, the Family Practice Specialty Center, handle obstetrics as well as other areas of family medicine.

Only 19 percent of family physicians who have completed their residency training are interested in dealing with obstetrics, he explained.

Kasten said medical schools need to be training more family physicians.

Those in specialty areas of medicine can typically generate a larger income than a family physician.

But for those in family practice, there's a satisfaction in dealing with a variety of medical problems as opposed to specializing in one area, Catron said.

Still, it can be a tough sell. Icaza estimated he's spent about $50,000 in the last two years trying to recruit physicians to his practice.

In addition, he said he "lost" about $16,000 to $18,000 in office expenses associated with adding a physician earlier this year who left after three months.

Icaza said he would like to be in a small group of about three doctors. "You would like to share overhead expenses with someone else," he said.

Icaza, who has practiced in Jackson for about 10 years, said that an organization called Southeast Missouri Medical Center Inc. formed about 18 years ago to recruit physicians to Jackson.

But the group's no longer active in recruiting doctors, he said. Icaza said the group has not assisted him in his recent efforts to recruit doctors to Jackson.

There are currently only three full-time physicians practicing in Jackson, he said.

But Lois Kasten is optimistic that the recruitment efforts of the entire Cape Girardeau area medical community will pay big dividends for the whole region over the next several months.

"Hopefully by next June," she said, "we will have several of those people (new doctors) here."