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How the Dakotas Keep Their Doctors: Sanford Merit Says: 'We Grow Our Own'

Cheryl Clark, for HealthLeaders Media, May 12, 2010

You've heard the cliché: How you gonna keep ‘em down on the farm after they've seen Paree?

For rural healthcare providers, that expression might translate to something like "How do you get your medical school residents to set up practice in the buffalo lands of Fargo or Sioux Falls after they've been to New York City or L.A.?"

Great expanses of this six state region fall into the federal definition of "Frontier," areas with fewer than six residents on average per square mile.

It is well-documented that rural areas throughout the U.S. are provider-poor, and with the coming shortage of doctors estimated at 150,000 over the next 15 years, these areas may be especially challenged to find qualified practitioners.

But apparently, Sanford Merit Care, the primary healthcare network serving this six-state region, has overcome the physician recruitment challenge.

Many of the 800 physicians who practice in the Sanford Merit system, which includes North Dakota, South Dakota and parts of Iowa, Minnesota, Nebraska and Oklahoma, received training at the North Dakota School of Medicine and South Dakota Sanford School of Medicine. Those schools rank high in the number of primary care providers they bring to practice, for which they have both received awards from the American Academy of Family Physicians.

I asked Cindy Morrison, Sanford's vice president of public policy, just how do they keep their doctors, an essential part of their network of 30 hospitals, 25 of which are classified as critical access.

She answered quickly: "We grow our own."

Morrison says that recruitment and retention efforts start with 17,400 employees of the facilities in the system. They're asked to reach out to their own family members to find their future doctors.

"Recruitment is a long process" that focuses on local residents, people who understand the culture because they were born and raised in the area, she says. "We are starting before they even enter school."

There are programs that give youngsters who think they might like to grow up to be a doctor an opportunity to follow physicians around for a few days. That way, they might get a taste of the experience, and see how much providing care would mean to their family, friends and community.

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