19 minute read
The Benefits of Practicing Neurology in a Rural Setting
When you think of practicing medicine in a rural setting, what comes to mind? For neurologists who have lived and trained in densely populated urban areas for most of their lives, the mental image can be full of misconceptions But you may be surprised to learn that salaries for rural neurologists frequently exceed those of their colleagues in the city Another surprise might be the flexibility that rural neurologists often experience, in both the subspecialties they can pursue and the conditions of their work Even the stereotypes about the towns themselves may turn out to be false, with many “country” locations offering amenities that rival those of the big city—albeit in lesser quantities With those stereotypes out of the picture, read on to discover the realities of practicing neurology in a rural setting
Practicing one’s specialty immediately
For Saurabh G Shukla, MD, there was never a question of whether he would practice in a rural or underserved area, since that was a condition for maintaining his visa Even so, he admits the prospect was somewhat daunting for both him and his wife Having completed medical school in India before taking post-graduate roles in Boston, New York City, and Miami, Shukla was used to highly populated cities But once he understood that his first employer would likely be situated in an underserved area, he threw himself into a strategic and methodical job search Shukla’s process took 18 months to complete, partly because of the administrative process with his visa paperwork and partly because he was being extra selective In the end, he accepted an offer from the University of Mississippi Medical Center in Jackson, joining the staff in January 2019 as assistant professor of neurology “One thing that really drove me here was the work factor,” Shukla says of his decision “Here I’m able to practice neuromuscular neurology, which is really difficult for a new doctor in large centers Because in bigger centers, those positions are saturated, and people stay for decades ” Indeed, not only is Shukla able to devote nearly full time to his specialty in neuromuscular neurology, but as it turns out, he’s the only academic neuromuscular specialist in the entire state This provides a unique opportunity for someone so new to the university, as patients come from the states bordering Mississippi in search of
a second opinion on complex diagnoses “I get all the challenging cases, which is amazing,” he notes In addition to seeing patients, Shukla has begun classifying his cases for research purposes, with the support of his chairman and division chief “They all want research to happen here,” he explains “I’m looking forward to collaborations and presenting at conferences ”
Fewer resources but less bureaucracy
For James Dorman, MD, FAAN, FACP, one of the defining features of working in a rural area after his post-doctoral training was the immediate connection he was able to make with everyone from the hospital staff to members of the community Working now as a general neurologist at Stroger Hospital in Chicago—commonly known as Cook County Hospital—Dorman currently practices at one of the nation’s busiest medical facilities But from 2004 to 2006, he was employed as one of two neurologists in a multi-specialty practice serving the town of Dixon, IL, population 20,000, and the nearby towns of Sterling and Rock Falls The overall community of 70,000 supported two hospitals, so Dorman and his partner each served one, but covered at the other To handle call, they each took a week, with the hospitals transferring patients out every third week Dorman remembers that period as a balance between limited resources and lessened bureaucracy For example, he rarely had to wait more than an afternoon to receive a patient’s MRI results from the radiology technician And one of the hospitals didn’t even require the doctors to show ID When Dorman inquired about a badge, he was told, ‘No, it’s okay We put an ad in the paper Everyone knows you’re coming ’ “And it was true,” he says “When I walked in the door on the first day, everyone was saying ‘Hello, Dr Dorman ’ And I had never set foot in there before ”
On the other hand, it could sometimes be nerve-wracking having fewer options for treating patients For example, those needing a tPA medication would require transfer to larger facilities with a neurosurgeon available in case of intracranial hemorrhaging—and the transfer process could involve hours on the phone “There were a lot of gray areas where it wasn’t really clear about whether to keep the patient or transfer them,” Dorman recalls “And with the training wheels just off—and being a little isolated—that in itself could be intimidating ”
Small town amenities
Every physician knows that there’s more to life than practicing medicine, which makes the community surrounding one’s workplace very important On the one hand, as Dorman notes, “People in a rural area have a reputation for being relaxed and friendly, which is true But it’s easier to be that way if your idea of a traffic jam is three people at a stop light—which it was ” Shukla has also experienced the traffic patterns unique to a rural setting, but from a different perspective Having never needed an American driver’s license, he and his wife are now a two-car family While she needs to bring their daughter to activities, he needs a car to travel between clinic locations
As for socializing—neither Dorman nor Shukla found that difficult, although Dorman missed the variety of restaurants he and his wife had been accustomed to For their part, Shukla and his wife were delighted to find other families originating from the same region of India, providing them with an instant sense of extended family far from home Perhaps the most vaunted amenity of small-town living is the lower cost of living, which can sometimes be much lower compared to urban rates For Dorman, one other amenity that stood out was the smaller community’s attitude toward physicians “I got the impression that they hold doctors in high esteem,” he recalls “It reminded me of the traditional Marcus Welby attitude Where, in the urban area, if you’re a doctor, it’s more like you’re a dime a dozen ”
Future prospects for rural neurologists
With telemedicine and other advances in health care, one could wonder if there’s still a place for small-town doctors, not to mention their specialist colleagues Jason Hermanutz, neurology search consultant for RosmanSearch, Inc , believes the future is rosy for rural neurologists “More and more in the last decade we’ve been seeing programs that maybe 15 years ago wouldn’t have thought of supporting neurologists locally There are more people being treated and that’s creating opportunities for neurologists in rural areas ” Specifically, Hermanutz notes that most of the work in the rural setting is happening in hospitals, with the biggest demand for general neurologists Even so, Hermanutz also sees flexibility offered by rural employers that isn’t being matched in urban centers “One big advantage,” he says, “is that rural programs can create an opportunity or even build a program around a physician, instead of stating, ‘This is the position You have to do this ’ The physician can say, ‘This is who I am; how can we make the position fit what I’m looking for?’” As an example, Hermanutz cites the recent placement of a neurologist who also wanted to use his MBA The new job will start out at 25 percent administration, with the percentage increasing as the doctor gains experience “That’s an incredible package that probably would have been out of reach in an urban program,” Hermanutz notes Not only do the rural employers work hard to accommodate the doctor, but they also extend themselves to help the physician’s family Hermanutz has seen communities provide assistance on everything from house hunting and school searches to finding work for the doctor’s spouse Perhaps the most quantifiable differences between employment offers for rural and urban settings are rooted in the salaries, with Hermanutz consistently seeing rural compensation land in the 75th percentile for neurologists When relatively rich loan repayments and leadership bonuses are included—to the tune of $150,000 or more—the packages offered by small communities frequently eclipse those of larger organizations
Getting started
If you’re interested in exploring opportunities to practice neurology in a rural area, Hermanutz, Shukla, and Dorman all have advice for you Based on his experience, Shukla advises doctors needing a J-1 visa waiver to first identify the specialty or type of neurology they want to practice, and then start early to make connections with the programs “Rural America needs doctors,” he says “When they really need you, they’re very supportive ” Dorman notes that the doctor’s personality will play a role in determining the best opportunities to pursue “So much of it comes down to lifestyle and career goals,” he says “I think the main need is for general neurologists because they can handle 95 percent of what comes through the door ” And Hermanutz says, “The biggest advice I could give someone is to be really open to exploring options that you might consider to be outside your usual comfort zone Going on two or three site visits during your job hunt is not too much There’s a very wide world out there with opportunities you wouldn’t be able to see if you only looked at academic or large settings ” n
Join the most respected neurology practice
in Orange County, California — established over 40 years
The Best Opportunity You Will See in Your Career
Desirable Orange County, California Location with Partner Buy-In Option High Earning Potential
A perfect fit for a productive mid-career neurologist or a new trainee. Develop your own subspecialty area or take pride in being a generalist.
NMSS-designated Comprehensive Multiple Sclerosis Center. Children’s Headache Foundation Certified Center. Active clinical trials program. Infusion suite. Opportunity to teach. Prefer expertise/interest in MS, headache, movement disorders, memory disorders.
Contact jflorin@fullertoneuro.net
Visit fullertonneurocenter.com and jackflorin.com
OUTPATIENT-ONLY GENERAL NEUROLOGY
• Guaranteed base compensation for two years + RVU bonus potential • Monday - Friday schedule with no call • Upfront Bonus • $6,000 CME annually • 6 Weeks PTO • Join a hospital-employed group of five board-certified Neurologists and one
APRN • Student loan repayment and residency stipends available • Funded liability insurance/ malpractice/tail coverage, multiple retirement plans, full health/ medical benefits & more • Fully-integrated EMR (Epic) •
Certified Stroke Center “Gold Seal” by The Joint Commission
Brittni Duginski, Physician Recruiter Brittni.duginski@specialtycare.net 615.345.5381
Neurological Institute Sleep Disorders Center
The Cleveland Clinic Neurological Institute’s Sleep Disorders Center is recruiting Neurologists with fellowship training in Sleep Medicine. We invite highly qualified candidates who are committed to excellence in patient care, education and research. Candidates should be BC/BE in Sleep Medicine, able to obtain an Ohio medical license and meet hospital credentialing requirements. The Sleep Disorders Center at Cleveland Clinic is accredited by the American Academy of Sleep Medicine and was among the first in the nation dedicated to the diagnosis and treatment of sleep disorders in people of all ages. The Center is staffed by 13 sleep physicians, including 2 pediatricians, as well as 3 psychologists and 8 advanced practice providers. Our team conducts nearly 16,000 sleep tests annually supported by 7 sleep laboratories, a home sleep apnea testing mail out program and actigraphy. This dynamic position commands a competitive salary enhanced by an attractive benefits package including medical malpractice coverage and a collegial work environment. A faculty appointment at a rank commensurate with experience is available with the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.
Interested candidates should apply online at: https://jobs.clevelandclinic.org/ Please include a CV and cover letter with your application addressed to: Nancy Foldvary-Schaefer, DO, MS│Director, Sleep Disorders Center
Cleveland Clinic values a culture where caregivers integrate diversity and inclusion throughout the enterprise. We respect and appreciate our similarities and differences, they enable us to better serve our patients, one another, and our global communities. Cleveland Clinic is pleased to be an equal employment/affirmative action employer: Women/Minorities/Veterans/Individuals with Disabilities. Smoke/drug free environment.
Neurology Career Opportunities
NORTON NEUROSCIENCE INSTITUTE is recruiting multiple board-certified or board-eligible physicians in Louisville, Kentucky. Our program offers multidisciplinary research pathways and expanding facilities, including a comprehensive neuroscience space that opened in June 2021. The ideal candidates will have an opportunity to join a collaborative team of more than 110 subspecialty neuroscience providers with Norton Neuroscience Institute and Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine. Career opportunities are available in the following programs: y Behavioral/memory y Epilepsy y General neurology y Headache y Movement disorders y Neurocritical care y Neuromuscular disorders y Neuro-oncology y Stroke Each opportunity includes a competitive compensation package, including sign-on bonus and relocation assistance.
To discuss this opportunity, contact Angela Elliott, senior recruiter, providers, Norton Medical Group, at (859) 613-1984 or angela.elliott@nortonhealthcare.org. ABOUT NORTON NEUROSCIENCE INSTITUTE
LEADER
in using innovative and cutting-edge technology and robotics
Participating
in more than
130
RESEARCH STUDIES
over the past decade
Named one of 100 GREAT
neurosurgery and spine programs by BECKER’S HOSPITAL REVIEW
Location, Location, Location
Concord :30 Boston
world - renowned affiliations | 30 minutes from boston | quality of life
Emerson Hospital located in historic Concord Massachusetts has an opportunity for Board Certified/Board Eligible Neurologists to join a growing Neurology Service.
This opportunity is an employed position with Emerson Practice Associates
• Competitive salary and benefit package • Night and weekend call covered by Teleneurology Service • Sleep Center, Concussion Center, Parkinson’s Center, Telestroke • Excellent support from a dedicated team of neurologist, administration and staff • Full service diagnostics are available at hospital, which was certified by the state of Massachusetts as a Primary Stroke Center in 2004 • Practice in one of the most desirable practice locations in Massachusetts
Just 25 miles Northwest of Boston, the area offers four seasons of recreational activities, including driving distance to the ocean, hiking, biking trails and several ski areas. Excellent place to raise a family with some of the best school systems in the state.
If you would like more information please contact:
Diane Forte Willis dfortewillis@emersonhosp.org phone: 978-287-3002 fax: 978-287-3600
About Concord, MA and Emerson Hospital
Located in Concord, Massachusetts Emerson is a 179-bed community hospital with satellite facilities in Westford, Groton and Sudbury. The hospital provides advanced medical services to over 300,000 individuals in over 25 towns.
Emerson has strategic alliances with Massachusetts General Hospital, Brigham and Women’s and Tufts Medical Center.
Concord area is rich in history, recreation, education and the arts and is located 20 miles west of downtown Boston.
Join a Well Established Neurology Group in Omaha, Nebraska
As part of Methodist Physicians Clinic the group has a built in referral source and access to multiple specialists. The group supports the Methodist Health System with both inpatient and outpatient services. This group is expanding and would like to add to their team with the a vision of creating a regional presence for neurology service in the Midwest.
About Methodist Physicians Clinic
An affiliate of Methodist Health System, Methodist Physicians Clinic is the largest private, multi-specialty group practice serving Nebraska and western Iowa. Founded in 1952, Methodist Physicians Clinic now consists of more than 30 owned and operated clinics throughout western Iowa and Nebraska. With over 300 providers, Methodist Physicians Clinic offers patients access to more than 30 specialties. Providing patients with high-quality health care from the most respected medical professionals in the area has helped Methodist Physicians Clinic establish itself as the region’s leading group medical practice. Methodist Physicians Clinic has been a member of Methodist Health System since July 1990.
Enjoy the following benefits as part of Methodist Physicians Clinic
• Health, Dental & Vision Insurance • Paid Liability Insurance • CME Allowance • Retirement Package
For more information contact Keri Charron keri.charron@nmhs.org or visit www.methodisthealthsystem.org
Marshall Neurology in Huntington, West Virginia, is currently seeking qualified candidates for neurologist positions within the following subspecialties due to a rapidly increasing volume of patients with neurologic disorders: • Movement disorders • Pediatrics • Epilepsy • Behavioral neurology We offer an attractive, university employee-based benefits package that provides very competitive compensation. These positions also offer the opportunity to be involved in resident and medical student educational activities and neurology research endeavors. Marshall Neurology is an academic-based physician group affiliated with the Marshall University Joan C. Edwards School of Medicine. We have a network of clinical affiliations and provide patient care within the state. Our physicians are trained in the full spectrum of neurology subspecialties. Additionally, we have an established neurology residency and train four residents per year.
Contact David O’Dell at odell@marshall.edu or 304-691-1157. jcesom.marshall.edu | marshallhealth.org
Lancaster Medical Center
GENERAL NEUROLOGIST OPPORTUNITY
Penn State Health Lancaster Medical Center is seeking a General Neurologist for our brand-new state-of-the-art Lancaster Medical Center. The new facility located in Lancaster, PA and set to open summer 2022.
Neurologists with clinical expertise in general neurology are invited to apply for an open position at Penn State Health Lancaster Medical Center. You will fl ourish in a supportive work/life balance environment. Leadership opportunities are available to those with relevant experience.
What we’re seeking:
• We are seeking someone trained in general neurology • MD, DO, or foreign equivalent
Opportunity highlights:
• Competitive salary and benefi ts • Sign-on bonus and relocation assistance • CME time and fund • Ability to acquire a license to practice in the state of Pennsylvania • Completion of an accredited residency program
• LTD and life insurance • Penn State University tuition discount for employees and dependents
Area highlights:
• Lancaster Medical Center will enhance an already vibrant network of primary and specialty care providers across Lancaster County, including practice sites of the former
Physicians’ Alliance Ltd. that joined Penn State Health in 2017 and the Lime Spring
Outpatient Center that opened in East Hempfi eld Township in January 2019. • The Lancaster Medical Center will create new clinical and research opportunities for learners and investigators at Penn State College of Medicine, both during construction and after the hospital opens. • The new hospital will feature all private inpatient beds, an emergency department, physician offi ces, various specialty inpatient services, an imaging lab, and complete medical and surgical capabilities.
INTERESTED APPLICANTS, SEND CV AND COVER LETTER TO Anderson Smith, Physician Recruiter at asmith50@pennstatehealth.psu.edu
Penn State Health is fundamentally committed to the diversity of our faculty and staff. We believe diversity is unapologetically expressing itself through every person’s perspectives and lived experiences. We are an equal opportunity and affi rmative action employer. All qualifi ed applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affi liation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information.
Practice Opportunity Profile: Neurology
Practice Description: The Elkhart Clinic is a physician-owned multi-specialty group practice with 36 physicians in 16 different specialties and sub-specialties; 40% primary care (general internal medicine and family medicine) and 60% surgical and non-surgical specialists. Comprehensive laboratory, imaging services including MRI and CT-PET, onsite infusion, EEG, AEEG, EMG-NCV. One week per month neuro-hospitalist opportunity optional. eCW EMR.
Area Description: Elkhart, Indiana, just 2 miles south of the Michigan border, is called the “City with a Heart.” Elkhart is a family-friendly community with a wide range of recreational activities for every season from water skiing in the summers to snow skiing in the winters. Chicago, Indianapolis, Indiana Dunes National Park, and Lake Michigan are just a short drive away, with the University of Notre Dame’s beautiful campus within minutes. Elkhart County’s population is 205,000 and offers 7 public school systems, and over 50 private schools. Elkhart, known as the “RV Capital of the World” and the “Band Instrument Capital of the World,” provides a strong manufacturing economy with a concentration in recreational vehicles and manufactured housing. Indiana is a malpractice friendly state for physicians.
Qualifications and Training: Board certified or board eligible considered if residency completed in last 5 years. Subspecialty interest preferred. EEG strongly preferred. EMG recommended. Excellent communication skills required.
Clinic Hours: Monday through Thursday, Friday until noon.
Serving Michiana Since 1954
Contact Ann Mattei 574-296-3357
amattei@elkhartclinic.com
Practice Environment: Private physician office with exam and procedure rooms as needed. Front office, back-office and support staff as needed. Full time research center with phase 2-4 research protocols (national research network).
Hospital Environment: Modern, financially sound, full-service 270-bed single community hospital; 23-bed ICU, 30-bed PCU; located within one mile from the Clinic. Good working relationship with hospital administration and medical staff. Opportunity to participate in neuro-hospitalist rotation one week per month.
Office Call Rotation: 1 in 3, by phone, we generally take one week at a time. Full time hospitalist program affiliated with the hospital provide 24/7 in-service coverage.
Compensation: Annual guarantee $300,000 guarantee for two years with worked RVU incentive, signing bonus, relocation assistance and annual CME allowance.
Membership/Partnership: Expectation of ownership in Elkhart Clinic LLC and Elkhart Clinic Building LLC, which provides significant additional compensation opportunity.
Reimbursement Environment: Clinic participates in traditional fee-for-service contracts with most Medicare, commercial and preferred provider plans; a few of these plans offer bonus incentives for quality performance. Clinic also participates in certain value-based preferred provider contracts that requiring the documentation and submission of cost and quality data.
Number of existing physicians in
specialty: Two for practice and Elkhart County.
Boulder Community Health Boulder, Colorado
Full-Time Neurologist with General Neurology Focus
Fellowship Expertise Welcomed in All Fields but Particularly Movement Disorders
• Physician will join a health system owned practice currently comprised of 2 Physicians and 2 APPs
• Call coverage is only for outpatient/clinic and shared among the provider
• There is not hospital call or coverage. This is covered by a contracted neurohospitalist group who also cover all acute stroke call via telehealth system
Contact Amber Kelly with interest or for more information at ackelly@bch.org
Boulder Community Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, sexual orientation, national origin, ancestry, age, marital status, gender variance, genetic information, military or protected veteran status and will not be discriminated against on the basis of disability.
