Rural Health Toolkit

Recruitment and retention are two critical issues to the maintenance of a strong rural hospital clinical workforce that includes physicians, physician assistants, nurse practitioners and nurses. Recruitment is the securing of health professionals, whether it is through community-based programs like the East Texas Area Health Education Center’s (AHEC’s) Health Careers Promotions activities or through searches beyond the community using resources like the National Recruitment and Retention Network (3R Net) database. Retention is the utilization of resources and programs to support the hospital’s health professionals and to promote a positive work environment. The retention topic includes subtopics like Continuing Medical Education (CME) resources, information dissemination resources, and practice management support resources. Also, it includes information on locum tenens programs, which allow existing health professionals to take vacations without leaving the hospital understaffed and preceptorship programs, which allow the health professionals to take on an educational role. Additionally, information on loan repayments and J-1 visa waivers is included.

• Journal of Rural Health - Recruitment/Retention Subject Bibliography
  This bibliography contains Journal of Rural Health articles from 1985-1998 related to rural health workforce recruitment and retention. Articles are not available online, but ordering information is included.
  http://www.nrharural.org/search/subj/Recruitment.ht

Recruitment

• 3R Net

The National Recruitment and Retention Network (3R Net) is made up of 45 state organizations such as State Offices of Rural Health, AHECS, Cooperative Agreement Agencies and State Primary Care Associations. These not-for-profit organizations help health professionals locate practice sites in rural areas throughout the country. Click on a state to browse employment opportunities by state. (Note: Requires registration, but registration is free.)
http://www.3rnet.org/docs/states.html 

http://www.3rnet.org/docs/about.htm
[Explains how to add your organization to their database.] 

• East Texas AHEC – Health Careers Promotion

This site explains the recruitment programs the East Texas AHEC program supports, including a series that helps young people from rural areas become interested in medical professions.
http://www.etxahec.org/hcp/index.htm 

• National Health Services Corps – Automated Information Retrieval

This searchable database produced by the National Health Services Corps, allows users to search for NHSC Scholar Opportunities (HP) and NHSC Loan Repayment Opportunities (LR). It is updated regularly so as to accurately represent which communities are actively recruiting. Does require initial registration, but registration is free. To begin search, click on Search AIR (vacancies, profiles) at the top of the page.
http://158.72.83.221/NHSC.AIR/Main/new_home.htm

• National Rural Health Association – Physician Recruitment and Retention 
  This issue paper produced by the National Rural Health Association (NRHA) is an overview of physician recruitment initiatives and retention problems. It includes a description of government initiatives, private organization and community initiatives, and the economic and social issues facing rural physicians. It includes and extensive bibliography.
  http://www.nrharural.org/dc/issuepapers/ipaper13.html

• New England Journal of Medicine – Recruiting News Online
  This online article from the publishers of the New England Journal of Medicine includes tips for recruiting physicians to a rural area. The necessity of an appealing, yet honest ad is highlighted.
  http://www.nejm.org/classifieds/recruit.htm

• University of Nebraska Medical Center – Recruiting New Rural Practitioners
  The Rural Faculty of the University of Nebraska Medical Center compiled this information. It includes tips to recruit better locally and includes some retention information.
  http://www.unmc.edu/FamilyMed/rural/recruit/introd.htm

Retention

CME

• American Medical Association – CME Locator Home-study Search Criteria
  This site allows users to search for CME courses based on the subject and type (i.e. available through the Internet). It includes the course objectives, cost, AMA credit hours, contact information, and a link for Internet based courses.
  http://www.ama-assn.org/iwcf/iwcfmgr206/SESSION
  

                          http://www.ama-assn.org/cmeselec/courses.htm
                          [Lists the online CME courses available through the AMA.]

• Texas Medical Association – CME
  This site lists CME resources compiled by the Texas Medical Association. It highlights ethics CME programs sponsored by TMA that satisfy the ethics CME requirement for Texas license renewal.
  http://www.texmed.org/cme/default.asp

         http://www.texmed.org/cme/cmeCourses/cmeSearchArea.asp
         [TMA CME search page. Features calendar of CME opportunities in
         Texas and library resources that are available through loan.]

• American Psychiatric Association – CME Credit Online
  This site lists online symposia available from the APA. These courses are delivered through the RealPlayer.
  http://www.apa.onlinecme.org

• American Heart Association – Continuing Medical Education
  This site lists online CME courses created by the AMA. It specifically addresses cardiovascular disease and stroke.
  http://www.americanheart.org/Scientific/CME/

http://www.nichsa.org/   
[National Information Center for Health Services Administration home page.]

• Rural Information Center Health Service (RICHS) – Publications
  Compiled and produced by the Federal Office of Rural Health Policy, this page lists documents that are available on the web or can be ordered through the HRSA Information Center.
  http://www.nal.usda.gov/orhp/pubs.htm  [Documents that are available on the web.

    http://www.nal.usda.gov/orhp/publist.htm  
    [Complete publication list. Includes ordering information]

http://www.rupri.org/  
[RUPRI home page]

Practice Management Support

• Family Practice Management
  Family Practice Management (FPM) is the American Academy of Family Physicians (AAFP)’s free online practice management journal. It is published 10 times per year and includes links to interactive quizzes through which members of the AAFP can earn CME credit.
  http://www.aafp.org/fpm/index.html  [Current Table of Contents link.

• Health Care Financing Administration – HCFA Forms
  This site includes many of the HCFA forms in PDF format, which may be printed out. This site includes Patient's Request for Medicare Payment and Health Insurance Claim form.
  http://www.hcfa.gov/forms/

• University of South Carolina - Health Economics Tutorials
  This site offers several interactive tutorials related to economics and health administration. The faculty at the Department of Health Administration from the University of South Carolina created all of the tutorials.
  http://hadm.sph.sc.edu/COURSES/ECON/Tutorials.html

• American Medical Association – Legal Issues for Physicians
  This site offers tips for the physician regarding legal issues, including a link to a page, which offers tips for evaluating professional liability insurance.
  http://www.ama-assn.org/physlegl/legal/busmgmt.htm

Locum Tenens

• New England Journal of Medicine – Locum Tenens
  This online article from the publishers of the New England Journal of Medicine explains why a facility might choose to recruit a physician in a locum tenens position. It includes what to look for in a locum tenens recruitment firm and the characteristics of physicians who succeed in this type of position.
  http://www.nejm.org/classifieds/locum.htm

• American Academy of Family Physicians – A Physicians Guide to Locum Tenens
  This article from the American Academy of Family Physicians describes the reality of being a locum tenens physician and offers tips on how to make it a positive experience.
  http://www.aafp.org/fpm/990200fm/41.html

• American College of Physicians – American Society of Internal Medicine – Locum Tenens
  From the Career Counseling section of the American College of Physicians – American Society of Internal Medicine website, this page offers information regarding the benefits and difficulties of being a locum tenens physician, including a link to more information on malpractice insurance.
  http://www.acponline.org/counseling/locumtenens.htm

• Center for Rural Health Initiatives Interim Study
  This page provides notice that the Center for Rural Health Initiatives has been charged with coordinating and completing a study of physician relief services. Locum tenens will be included in this study. Site includes contact information to participate in the study or for more information.
  http://www.crhi.state.tx.us/pdf/rh1_reporter/sept_76.html

Preceptorships

• American Academy of Family Physicians - Rural Physicians as Educators: Why Take On Another Job?
  This full text online article from the American Family Physician offers reasons for a rural physician to become a preceptor. Explains that although there may be an increased to the physician in time and billing, the rewards of enhanced recruitment and retention of partners as well as professional satisfaction are great. Includes a bibliography.
  http://www.aafp.org/afp/100196/med_soc.html

• Society of Teachers of Family Medicine – Office-based Teacher
  This site has the full text of the column "For the Office-Based Teacher of Family Medicine" from the journal, Family Medicine. These columns address specific issues related to preceptorships.
  http://www.stfm.org/teacher/hub.html

• University of North Carolina School of Medicine - Expert Preceptor Interactive Curriculum
  This site is an online faculty development system for preceptors of health-professions students. It is arranged by module and may be used for reference or it may be completed for CME credit. If used as a reference, user must register, but registration is free. If used for CME credit, user must register and registration is $30.00 per module. If user registers for all 10 modules, registration is $270.00.
  http://www.med.unc.edu/epic/

• West Virginia School of Osteopathic Medicine - Journal Articles for Rural Preceptors/Community Hospital Attendings
  Helen H. Baker, Ph.D., Director of Educational Development at West Virginia School of Osteopathic Medicine compiled this bibliography of articles related to rural preceptorship. Many of these articles are available full text online.
  http://www.wvsom.edu/ClinicalSciences/FacDev/articles.htm

• National Health Services Corps – Loan Repayment
  This site explains loan repayment and other benefits that the National Health Services Corps (NHSC) offers to eligible health professionals who serve at qualifying sites. This service is not restricted to physicians.
  http://www.bphc.hrsa.dhhs.gov/nhsc/Pages/
  about_nhsc/3B5_loan.htm

• National Health Services Corps – State Loan Repayment
  This site explains a state loan repayment program that the NHSC offers to health professionals through funds provided to states. This service is not restricted to physicians.
  http://www.bphc.hrsa.dhhs.gov/nhsc/Pages/
  about_nhsc/3B6_stloan.htm

• Association of American Medical Colleges - State and Other Loan Repayment/Forgiveness and Scholarship Programs
  This site offers a state-by-state compilation of U.S. programs that offer loan repayments.
  http://www.aamc.org/about/gsa/stloan/start.htm

• American Academy of Family Physicians – Funding Resources for Practicing in Underserved Areas
  This site described financial aid programs, scholarships, fellowships, grants, awards and other incentives to attract and retain health care personnel in scarcity areas on a state-by-state basis. The American Academy of Family Physicians (AAFP) compiled these resources.
  http://www.aafp.org/special/resource/index.html

J-1 Visa Waivers

• Texas Department of Health, Community Oriented Public Health – J1 Visa Waiver
  This site offers comprehensive information on obtaining a J-1 visa waiver for foreign medical graduates. It includes a link to Health Professional Shortage Areas (HPSA’s) and Medically Underserved Areas (MUA’s) that are available for J-1 visa waivers as well as a link to the necessary forms.
  http://www.tdh.state.tx.us/coph/chprj1.htm

• 3R Net – J-1 Visa Waivers
  Compiled by the National Recruitment and Retention Network (3R Net), this site offers a USDA note regarding J-1 visa waivers, links to U.S. government contacts, and a list of shortage areas with contact information.
  http://www.3rnet.org/docs/j1_detail.htm

•  US State Department – Services – Visas
  This site offers important information regarding J Visa waivers, including which address to use and status inquiries.
  http://travel.state.gov/jvw.html