Northeast Mississippi, nation challenged to train enough doctors

By Michaela Gibson Morris/NEMS Daily Journal

TUPELO – A generation ago, four Tupelo internists decided they needed to bring subspecialists to town even though it could cut into their income.
“They knew it was the right thing to do for their patients,” said Dr. Ken Harvey, president of IMA Foundation, which grew from that initial practice.
The base of primary care doctors supported the growing ranks of subspecialists, allowing Tupelo to grow as a regional referral center and economic engine with incredible impact. A Stennis Institute of Government analysis found that 100 new private hospital jobs create 47 jobs in the larger Lee County economy.
Now that primary care base, particularly internal medicine, needs support.
“It’s going to be a challenge,” Harvey said.
Many of the private practice internists in the region are in their 50s and 60s and, unlike IMA co-founder Dr. Gene Murphey, most do not plan to be practicing medicine at age 90.
Mississippi is already short 52 primary care physicians, based on a Mississippi State University Social Science Research Center report. Well-respected research has found that in both developed and undeveloped countries, where a strong primary care base exists, health care costs less and quality of care is improved.
Developing a physician is not a quick proposition. It takes about 10 years for a college freshman to complete undergraduate studies, medical school and post-graduate training in residencies and fellowships.
“We do clearly need more primary care physicians,” said Bonnie Carew, who oversees the Mississippi Rural Medical Scholars Program for rising high school seniors.
Since 1998, 230 students have gone through the program, which pairs college classes with time shadowing physicians. Most of the participants are still in college, but 24 are currently in medical school. Of the 14 program alumni, 10 are in primary care fields.
“That’s better than the medical school average,” Carew said.
The program is part of the prevailing wisdom that it’s more effective for Mississippi’s rural communities to grow their own doctors.
The North Mississippi Medical Center Family Medicine Residency Center has improved the number of family practice physicians in the region. The center will expand from 18 slots to 24 this summer.
Harvey would like to see an internal medicine residency program established in Tupelo, increasing the training slots and exposing more young doctors to the rewards a private internal medicine practice can offer a doctor.
There have been discussions between local physicians, North Mississippi Health Services and the University of Mississippi Medical School about expanding medical education opportunities in Tupelo.
Without time with private practice internal medicine physicians, medical students and residents miss the most important rewards of the field.
“Long-lasting relationships with patients – that’s part of the joy,” Harvey said.
If they spend more time with internists, perhaps, more would be tempted to stick with internal medicine instead of going on to specialize, Harvey said. However, most other specialties and subspecialties are short-handed, too.
Other than cardiologists, Harvey said, “I don’t know many specialists in Tupelo who don’t need more folks.”
To make up for the shortfall, doctors will likely lean even more heavily on nurse practitioners to handle their patient load.
And although Harvey’s practice takes him to the clinic and the hospital, he sees the day when internal medicine doctors will likely have a hospital-based practice or a clinic-based practice, but not both.
“It’s more efficient to be in one place or the other,” Harvey said. “And efficiency may trump everything else.”
Contact Michaela Gibson Morris at (662) 678-1599 or michaela.morris@journalinc.com.