BusinessTN

For Dr. Amanda Stoltz, practicing medicine in a rural area is about making a difference.

"That's important to me," says Stoltz, a 29-year-old East Tennessee State University residency graduate who recently began working as a family practitioner at the Rural Health Services Consortium in Rogersville, Tenn.

Her aspirations are important to the state, too, because Tennessee, like other states, is desperate for more like her. In 2006, Tennessee's 91 non-metropolitan counties had more than 739 openings for physicians, specialists, physician assistants and advanced nurse practitioners. And one year earlier in its annual update of the Health Access Plan, the Tennessee Department of Health designated 30 Tennessee counties as health resource shortage areas.

But The Rural Partnership—a nonprofit group formed by ETSU, UT-Knoxville, Meharry Medical College and Vanderbilt University—is trying to change that. Established in 2006, the organization matches residents like Stoltz with job openings in rural, under-served areas across the state. "We serve as a recruitment, placement and retention service for graduates of the residency programs at ETSU, UT, Meharry and Vanderbilt," says Jackie Cavnar, COO of The Rural Partnership. "Basically, we are the career placement office for positions in underserved areas."

While the group will assist anyone in finding a position in Tennessee (regardless of whether he or she attended one of the four medical schools), it can award 20 stipends each year ($25,000 a year for up to four years) to individuals from the four university residency programs who agree to work in rural communities. Since September 2007, Cavnar says they have placed nine doctors and awarded five stipends.

That's progress, says Mary Ann Watson, assistant dean for graduate medical education at UT-Health Sciences Center in Memphis. Watson is a rural partnership board member and has been involved with efforts to place doctors in rural areas for about 10 years. As she explains, in the 1990s, TennCare began receiving federal money from the Centers for Medicare and Medicaid Services (CMS) for a Graduate Medical Education Physician Resident Stipend program. TennCare distributed the money to ETSU, UT-K, Meharry and Vanderbilt, which awarded stipends to residents who chose to work in the state's rural and under-served urban counties. Between 1996 and 2002, the four universities awarded only 11 of a possible 143 stipends.

"We knew something was wrong, and we began to look at ways to better utilize the dollars," Watson says. "Other states had models similar to what the Tennessee Rural Partnership is today, so we asked CMS for permission to utilize the dollars to create a not-for-profit that took inventory and then matched the doctors of our residency programs with sites that need physicians."

As its first order of business, The Rural Partnership conducted the 2006 demand assessment that identified 739 physician vacancies in Tennessee's non-metropolitan counties. It then created a database detailing practice locations and openings. Today, communities pay a $500 participation fee to post job openings in the database. Residents who, like Stoltz, are interested in working in a rural area, fill out an interview form, and the Partnership uses personal and professional information to match them with compatible opportunities.

"They took all the work out of it—they sent me a stack of practices that fit the description of what I was looking for," says Stoltz, whose job is in Hawkins County, which is ranked second worst among Tennessee counties designated as health shortage areas.

In addition to information about the clinics or hospitals that have openings, residents receive information about each community, including details about housing and schools. Watson says the new system is much more efficient.

"If a resident came to me and said, 'Where can I go,' the only thing I could show them was a map and say, 'These blue counties are shortage areas.' They would say, 'Who do I contact?' and I had no idea."

For Stoltz, who also received a stipend, the money will be a huge help as well—especially because this year, The Rural Partnership's Stipend Revision Committee, which Watson chairs, increased the amount primary physicians can receive from $15,000 to $25,000 a year. "The stipend is a bonus," Stoltz says. "It's going to help compensate for the fact that the place that I'm going doesn't have money to pay off student loans, and my salary is less than what a hospital system would have paid in the city."

With the stipend as an incentive and the database in place, the partnership hopes that chipping away at the state's shortage numbers will help in the effort to ensure that all Tennesseans have access to adequate health care.