Rural Recruitment Programs

[Tn Family MD]

I just became aware of a program here in Tennessee called the Tennessee Rural Health Recruitment and Retention Center. It's basically a newly formed corporation run by the state's four medical schools that is set up to assess the states health care needs and determine the best way to recruit and retain rural health care providers. Supposedly it is modeled after the highly successful program that was developed in Minnesota.

I guess the point of this thread is to incite discussion concerning these types of programs. First off, is anyone here familiar with the program in Minnesota and how it was set up and how it works, that kind of stuff? Second, I also recently became aware of a program targeted towards residents here in Tennessee where if you opt in to go to a rural community you get an additional 15 grand a year in salary during residency. Is anyone aware of similar financial incentive programs? Also, I have heard of other programs where you can get assistance in starting up a private practice in rural areas, things like help purchasing equipment, discounted leases on office space, etc. Is anyone familiar with these and how they work? Any info or experiences others have to share are greatly appreciated.

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[sophiejane]

Texas has similar programs. One is the Texas State Health Service Corps, similar to the NHSC, but only pays $15,000 toward student loans rather than $30K for the national program. There are also grants to set up practices in underserved areas, offered through the state Office of Rural Community Affairs (they also have other non-medical programs).

Then there are the individual hospitals that will assume all (yes all) of your student loan debt in addition to a competitive salary. Of course you have to sign a contract, perhaps for several years, in order to get the loans repaid in full.

It works out perfectly for me because I wanted to do rural medicine anyway. Now it's just one more perk.

 

[NDMD]

http://www.3rnet.org/docs/states_all.asp

You might be able to find more info here.

 

[countryboy75]

Thanks NDMD,
that site was really quite helpful and I recieved a lot of emails from recruiters afterwards.

The only question I have is that the national health service scholarship is nice but I am not sure if it is enough. I will be well over 200K$ in debt by the time I am out. Now granted as a FP doc I will be making at least 100K a year but still I would like to get rid of those loans as soon as possible.

I mean I am willing to live in a house trailer for a few years but I would eventually like to live in a house that doesn't have wheels

I talked with a recruiter from home (ohio) in passing and he eluded to the idea that his hospital would take over my loan if I set up clinic in one of their outlying towns. Has anyone heard of any such thing actually happening outside fo the TV show northern exposure??

Thanks

 

[deleted77919]

The current award for the National Health Service Corps is $50,000 for 2 years of service. You can apply for an amendment to extend your service and get continued funding after the initial 2 years. There is no guarantee of additional funding, but the possibility does exist to stay in the area longer and get more of your loans repaid.

The National Health Service Corps page is full of good information.

 

[DropkickMurphy]

Then there are the individual hospitals that will assume all (yes all) of your student loan debt in addition to a competitive salary. Of course you have to sign a contract, perhaps for several years, in order to get the loans repaid in full.

You FP's have it good.....I wish rural hospitals would do this for more attractive specialties like EM or anesthesia.

 

[hoboken]

I just became aware of a program here in Tennessee called the Tennessee Rural Health Recruitment and Retention Center. It's basically a newly formed corporation run by the state's four medical schools that is set up to assess the states health care needs and determine the best way to recruit and retain rural health care providers. Supposedly it is modeled after the highly successful program that was developed in Minnesota.

I guess the point of this thread is to incite discussion concerning these types of programs. First off, is anyone here familiar with the program in Minnesota and how it was set up and how it works, that kind of stuff? Second, I also recently became aware of a program targeted towards residents here in Tennessee where if you opt in to go to a rural community you get an additional 15 grand a year in salary during residency. Is anyone aware of similar financial incentive programs? Also, I have heard of other programs where you can get assistance in starting up a private practice in rural areas, things like help purchasing equipment, discounted leases on office space, etc. Is anyone familiar with these and how they work? Any info or experiences others have to share are greatly appreciated.

Rural retention program and primary care office may sound like noble goals but having lost two jobs when two separate primary care offices found a foreign national to serve as a Conrad 30, J-1 visa waver H-1B to take my job, I suggest you look past the name and see how destructive these government bureaucrats could be to your career. My former employers loved having an indentured servant MD that thay could pay 100+K less per year that the market salary rate. When I called the primary care offices to see why my tax dollars were being used to search the third world to find the cheapest physician available to take my job, all I got was lies and excuses. I was told that physicians were critical demand field so it was impossible for me to adversely affected by loosing my job to a foreign visa worker.

Watch your back when dealing with the bureaucrats and the employers they lie for. All too many of these employers need to use these programs because the refuse to pay real salaries or are unable to retain physician since they treat them so poorly. They will lie to you about your salary and promise you a bonus you will never see. As an American you may be used as temporary stand-in until they can get the paper work approved for a much cheaper Conrad 30, J-1 visa waver H-1B to take your job.


"When my colleagues get a letter from a constituent who has been displaced by temporary foreign guest workers, they should write back to them and say, 'It is the policy of this government to displace you, to move you into a lower economic income category, because we believe in cheap labor and we believe the politics of open borders helps our party." -- Rep. Tom Tancredo (R-CO), U.S. Congressman


"It does [H-1B] allow employers to evade the basic rules of the capitalist market Typically, if you have a hard time finding workers, you have to offer better wages and working conditions to attract them. Employers in the H-1B program don't do that." -- Mary Bauer, legal director of the Virginia Justice Center


"Unlike the permanent and temporary labor certification programs, Congress did not include a requirement for a labor market test, or a no-layoff provision, under the H-1B program. Therefore, the Department does not have any information concerning employers' efforts to recruit U.S. workers for the position, nor are employers required to provide such information." -- Dale Ziegler, Division Chief of Foreign Labor Certifications, U.S. Citizenship and Immigration Services

 

[sophiejane]

Rural retention program and primary care office may sound like noble goals but having lost two jobs when two separate primary care offices found a foreign national to serve as a Conrad 30, J-1 visa waver H-1B to take my job, I suggest you look past the name and see how destructive these government bureaucrats could be to your career. My former employers loved having an indentured servant MD that thay could pay 100+K less per year that the market salary rate. When I called the primary care offices to see why my tax dollars were being used to search the third world to find the cheapest physician available to take my job, all I got was lies and excuses. I was told that physicians were critical demand field so it was impossible for me to adversely affected by loosing my job to a foreign visa worker.

Watch your back when dealing with the bureaucrats and the employers they lie for. All too many of these employers need to use these programs because the refuse to pay real salaries or are unable to retain physician since they treat them so poorly. They will lie to you about your salary and promise you a bonus you will never see. As an American you may be used as temporary stand-in until they can get the paper work approved for a much cheaper Conrad 30, J-1 visa waver H-1B to take your job.

I'm sorry to hear that, hoboken. Do you mind telling us what state you are in? I've never heard of a doc being fired to be replaced with another unless there were other issues going on. What reasons were you given when you were terminated from your jobs, and how did you come to find out you were replaced with foreign docs?

I think a lot of us would benefit from learning more about your experience. Thanks for sharing it.

 

[hoboken.]

yes

 

[huron]

Rural retention program and primary care office may sound like noble goals but having lost two jobs when two separate primary care offices found a foreign national to serve as a Conrad 30, J-1 visa waver H-1B to take my job, I suggest you look past the name and see how destructive these government bureaucrats could be to your career. My former employers loved having an indentured servant MD that thay could pay 100+K less per year that the market salary rate. When I called the primary care offices to see why my tax dollars were being used to search the third world to find the cheapest physician available to take my job, all I got was lies and excuses. I was told that physicians were critical demand field so it was impossible for me to adversely affected by loosing my job to a foreign visa worker.

Watch your back when dealing with the bureaucrats and the employers they lie for. All too many of these employers need to use these programs because the refuse to pay real salaries or are unable to retain physician since they treat them so poorly. They will lie to you about your salary and promise you a bonus you will never see. As an American you may be used as temporary stand-in until they can get the paper work approved for a much cheaper Conrad 30, J-1 visa waver H-1B to take your job.


"When my colleagues get a letter from a constituent who has been displaced by temporary foreign guest workers, they should write back to them and say, 'It is the policy of this government to displace you, to move you into a lower economic income category, because we believe in cheap labor and we believe the politics of open borders helps our party." -- Rep. Tom Tancredo (R-CO), U.S. Congressman


"It does [H-1B] allow employers to evade the basic rules of the capitalist market Typically, if you have a hard time finding workers, you have to offer better wages and working conditions to attract them. Employers in the H-1B program don't do that." -- Mary Bauer, legal director of the Virginia Justice Center


"Unlike the permanent and temporary labor certification programs, Congress did not include a requirement for a labor market test, or a no-layoff provision, under the H-1B program. Therefore, the Department does not have any information concerning employers' efforts to recruit U.S. workers for the position, nor are employers required to provide such information." -- Dale Ziegler, Division Chief of Foreign Labor Certifications, U.S. Citizenship and Immigration Services

Lawyers in a how-to video: as in how to avoid hiring an American

from;

http://www.networkworld.com/community/?q=node/16421

also on you-tube

programmers guild;

http://www.youtube.com/watch?v=TCbFEgFajGU


Lou Dobbs story;

http://youtube.com/watch?v=Bsp2V3ifZjM

Lawyers in a how-to video: as in how to avoid hiring an American

"Watch this video and keep it in mind the next time you hear a high-tech industry titan such as Bill Gates complain that he simply cannot find qualified American employees and therefore the country needs more H-1B visas: You'll see a panel discussion that looks like a sit-down with "the families" on The Sopranos, only instead of talking about organized crime these lawyers are discussing the ins and outs of helping employers side-step immigration law.

http://www.youtube.com/watch?v=TCbFEgFajGU

The objective, says Lawrence Lebowitz, vice president of marketing at Cohen & Grigsby, couldn't be more straightforward.

"Our goal is clearly not to find a qualified U.S. worker ... our objective is to get this person a green card," Lebowitz tells his audience.

And how does an employer go about doing that in light of the legal obligation to first search for a qualified American? It's all about where you search, he says.

"Clearly we are not going to find a place where the applicants are most numerous, we're going to find a place where - again we're complying with the law - and hoping and likely not to find qualified worker applicants," Lebowitz says.

And if despite looking in all the wrong places a gem of an American candidate pops up anyway?

"If someone looks like they are very qualified, if necessary schedule an interview; go through the whole process to find a legal basis to disqualify them," he says.

That's just a taste; there are lots more.

Lebowitz prefaced that first remark - the one about the objective being "not to find a qualified U.S. worker" - by saying, "this may sound funny."

Don't know about anyone else, but I didn't even crack a smile. It doesn't sound funny. It sounds like it ought to be illegal. At the very least, it sounds like Congress should be tightening the screws on current law before increasing the number of H-1Bs.

 

[safron]

My university had a program in which the state, a rural work site and the university chipped in funding of up to $90k towards school loans over 4 years. It had to be an underserved community of 10,000 souls or less.
My rural hospital was in a town of 1,245. I spent my time between 2 clinics 9 miles apart. And ran to the ER if an emergency occurred. Both towns together might have had 2500 folks. Very appreciative mostly elderly farmers. It was a wonderful, rewarding experience. The townfolks would take care of all my needs. Flat tire-the local tire repair guy would come to the hospital and fix the tire. Snow on my driveway- my 85 year old neighbor and patient would bring his grader up while I was at work. One time it was 20 below zero and snowing and I went of the road with my 2 dogs in the car at night on the way to the ER. The next truck that came by gave me and the dogs a ride to the hospital and the hospital maintenance guy pulled my car out of the ditch.
I left after 4 years because I got to know all the townsfolk, and it bothered me not to be able to escape practicing medicine. I'd run into my patients at a large Walmart an hour away. And the ER was too small to have manned except by clinic docs. So FP clinic by day and ER at night. It became painful to treat people I saw in town everyday, and were not anonymous patients.
Now I'm doing ER in a city of 80K. When I go home, I'm not a doctor among my friends and I can be anonymous out of the ER.

 

[3dtp]

Before med school, I worked in a city of 275,000. When I announced my intention to leave the hospital for medical school, I identified several well qualified US nationals with experience to replace me. The hospital took out an ad in the local newspaper on two consecutive Sundays. I had tendered the resumes of people I knew who could do the job very well to the hospital management. All of these folks were ready and willing to move to the community and work in the hospital and knew the environment. The specialty is such that it was extremely unlikely that anyone in town would have the necessary qualifications and the usual approach to recruiting for these kinds of positions is to advertise in a national journal.

When (surprise) no Americans applied, the hospital then recruited a freshly minted grad student who was underqualified on a J-1 visa, paying half of what a US grad similarly situated would have been paid. The usual course since then has been to wait until the J-1 waiver period is up, the now qualified person gets the waiver and moves to the 'burbs and gets a real wage and the hospital repeats the cycle.

When I was faculty, one of my recent grad students called me from his J-1 visa waiver opportunity. An Indian firm (Chicago based, but run by an Indian, a former H1b visa holder), had hired him fresh out of grad school and told him they'd pay him a "training" stipend until he was eligible to take the board exams. (medically related specialty at the MSc. level), or about 2 years, placed him unsupervised in a rural hospital. A short time after he took this position, he had an offer from another hospital in a nearby community that he wanted to take and called me to ask about the contract he had signed. He wanted out, but his boss told him if he didn't honor the contract, he'd have to report him to the INS and he'd be deported because his visa would be revoked since he didn't have a contract and the J-1 would be expired and he'd be in the country illegally if he didn't stay put and continue working for the "training wage." If he were deported for being in the US illegally, then he'd never be able to visit the US again, he was told.

The training "wage:" $600/month. The competing offer, also in a J-1 waiver area, $6000/month. I live in a border town and called a buddy who's a senior INS inspector and asked the question hypothetically. He was pissed. After he promised amnesty for my former student, I gave him copies of contracts, check stubs and he went after the guy. Turns out the schmuck had about a dozen recent grads in similar situation and he was billing the hospitals well over $120k/person per year for the on-site labor in addition to a "supervisory" fee of $80k/hospital. Guy had made millions through terror and intimidation, and the promise of the green card down the road. He, himself was a green card holder, and suddenly found himself an undesireable alien and was most unceremoniously deported following the trial. Only problem is, he got to keep most of the ill-gotten cash. If I were the judge, I would have made him do the laundry in the local hoosegow for a few years before deporting him.

 

[Faebinder]

I agree, rural recruitment program might look noble on the outside but it's pretty much their way of avoiding hiring a US citizen... Think about it. The J-1 visa is training many people every year... over 6000. People will do anything to avoid going back to their country and stay in the US (and I don't blame them for wanting this, but I do blame the system for prefering them over the tax payers).