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1 c o n n e c t i o n s Rural Health Education and Services Vol. 15 No. 1 Summer 2007 What s Inside... Page 3 Quality Health Indicators Page 4 Rural Hospital Replacement Page 6 Mt. Carmel CareVan Page 7 Kansas Recruitment Center - Job listings Page 15 Stories from Greensburg Page 17 Physician s Work-Life Balance Page 18 KanQuit Page 19 Kansas Career Opportunities Teddy Bear Clinic Prescription for hugs and kisses Dozens of pint-sized patients are helped every year at the Clay County Medical Center Teddy Bear Clinic in Clay Center, Kan. Toy toting children from area daycares or preschools arrive at the medical center with their patients, who consist of teddy bears, stuffed animals or dolls. It s a lot of fun, said Tyce Young, director of nursing, Clay County Medical Center. We explain to the kids what happens when you come to the hospital, and then we put the patients through the hospital admission process. During admission, the children offer an ailment for their patients, who then receive a hospital bracelet sporting their names. The group is then sent to an examination room with their patients. Young said the clinic ensures that every child visiting the clinic has a patient. If a youngster shows up without a stuffed toy or doll, the clinic provides a teddy bear for them. This unique event was created to ease the fear many children have of hospitals and physicians, working to familiarize them with the experience. In a way, the children act as the parent and get to observe the process from a different point of view. Most of the patients are diagnosed with tickleitis, said Young. We check them and offer a prescription for lots of hugs and kisses. However, sometimes treatment for the little patient involves breathing treatments or bandages. A visit to the X-ray room is a must during each clinic. While in the X-ray room the kids hitch a ride on the X-ray table, having fake X-ray s taken. Young uses this opportunity as a lesson, showing his visitors authentic X-rays. Some are entertaining, like an X-ray of the Woody doll from Toy Story or a caterpillar. Others show what happens when someone swallows something they shouldn t, such as board game pieces or loose change. After their visit to the Teddy Bear Clinic, the kids are rewarded with cookies and the chance to play on the hospital s restored 1947 ambulance. The Clay County Medical Center Teddy Bear Children visit the Teddy Bear Clinic at Clay County Medical Center, Clay Center, Kan. Continued on page 5

2 From The Director... Lorene R. Valentine Kansas Connections is published four times a year by the University of Kansas Medical Center, Rural Health Education and Services, Kansas City and Wichita. KUMC is an AA/EO/Title IX Institution. (316) DIRECTOR Lorene R. Valentine EdITOR Rebekah Robinson GRAPHIC DESIgNER Amanda Gardner 2 Kansas c o n n e c t i o n s Sen. Roberts named Co- Chairman of Rural Health Caucus On June 20, 2007, United States Senate Republican Leader Mitch McConnell named Senator Pat Roberts as Co-Chairman of the Senate Rural Health Caucus following the death of Senator Craig Thomas, the Caucus previous Co-Chairman. Senator Roberts has been a member of the Caucus since going to the Senate and was a member of the House Rural Health Caucus during his time as a Kansas Big First District Congressman. Roberts is a member of the Senate Committee on Health, Education, Labor and Pensions (HELP), and is a member of the Senate Committee on Finance which has jurisdiction over Medicare and Medicaid. I am honored to follow in the footsteps of Senator Craig Thomas, my dear friend, and will continue working in behalf of our nation s rural communities, Senator Roberts said. Improving access to quality health care is essential to preserving our rural way of life. Kansans Present at NRHA Annual Conference The National Rural Health Association (NRHA) held its 30th Annual Conference in Anchorage, Alaska, May The conference offered attendees the opportunity to network with nearly 1,000 others in the rural health field and attend presentations and panel sessions centered around rural health issues. One group from Kansas was selected to present a session titled America s Heartland: A Statewide Initiative for Rural Quality and Success. The presenters included: Chris Tilden, director, Office of Local & Rural Health, Kansas Department of Health and Environment (KDHE); Shelley Boden, CEO, Russell Regional Hospital in Russell; Shirley Weisz, quality director, Kearny County Hospital in Lakin; and Mark Miller, CEO, Memorial Hospital in Abilene. The group s presentation showcased the quality and performance improvement project that has been implemented in 58 Kansas Critical Shelley Boden, Mark Miller, Chris Tilden, Shirley Weisz Access Hospitals. Rural Health Education and Services staff presented Innovative Approaches to Rural Health Care Recruitment and Retention. Joyce Tibbals, assistant director, RHES, and Marinn Rank, Kansas Recruitment Center office coordinator, RHES, focused on the Kansas Recruitment Center s approach to statewide recruitment. AAFP KU School Of Medicine Recognized for Leading Nation in Educating Family Physicians The University of Kansas School of Medicine was recently presented with the American Academy of Family Physicians (AAFP) Continued on back page

3 Quality Health Indicators QHi program continues to expand successfully In 2003, the Kansas Rural Health Options Project a collaboration among the Kansas Department of Health and Environment (KDHE), the Kansas Hospital Association (KHA), the Kansas Board of Emergency Medical Services (KSBEMS) and the Kansas Medical Society (KMS) developed a Web-based quality benchmarking tool that offers a fundamental measurement for rural hospitals. The Web-based tool, known as Quality Health Indicators (QHi), is used to help Critical Access Hospitals (CAHs) rural hospitals with 25 or fewer beds with their quality improvement efforts. In using this tool, regional hospital networks select from a library of quality indicators and determine which measures meet the hospital s goals for improvement. The goal is to provide hospitals with an economical instrument so they can evaluate their internal processes of care. After evaluation, the CAHs can seek ways to improve practices by comparing specific measures of quality with similar hospitals. The four pillars of measurement used by QHi are clinical quality, financial operations, employee contribution, and patient satisfaction. Participating hospitals are asked to collect and report core measures. According to Sally Perkins, manager of data services, KHA, each pillar has its own advisory committee. This is to ensure each pillar is continuously updated and current. The committees advise and review each pillar and constantly verify the data. She added that although it is a rigid and tough assessment of the pillar, it is critical to have this process in place. Launched as a pilot study in 2005, the QHi program began with 23 CAHs. In the two years since its launch, QHi has expanded successfully. It is now a multi-state project that The program is very beneficial. It is just growing on its own. We didn t anticipate this level of expansion. Sally Perkins, manager of data services, Kansas Hospital Association includes Kansas, Michigan, Montana, Nebraska and South Dakota. The program serves more than 100 hospitals and is positioned with a significant source of information on quality of care and performance. With more comparisons being made, there is more information on similar facilities. The program is turning into a large network for the CAHs, offering good dialogue. This way the hospitals don t have to reinvent the wheel when looking for a new program or a way to improve, said Perkins. They can look at the other hospitals and talk to them anonymously through about what they are doing. The program is very beneficial. It is just growing on its own. We didn t anticipate this level of expansion, Perkins stated. She explained the program has obviously hit a positive nerve with rural hospitals and was something the rural hospitals needed. Perkins said they plan to continually grow QHi. It is something the hospitals need. It really is a vast and important resource for them, she said. For more information on the QHi program or to find out how to become a participant, contact Sally Perkins at (785) , ext

4 Building for the Future Rural Hospital Replacement Recently, two rural Kansas hospitals broke the rural health status quo by investing in the construction of new facilities. Although these rural Kansas hospitals are not the only ones in the state to have done so, they were among 24 other rural hospitals nationwide that participated in a recent study. The 2006 Rural Hospital Replacement Facility Study is a special industry report centered on rural hospital replacement facilities and how a new facility impacts the operations and the bottom line. Building a new hospital in any location is a challenge, especially in rural America where remote communities have limited resources. The purpose of the rural replacement study is to gain a better understanding of replaced facilities and ultimately to aid rural hospitals that may be contemplating building a new hospital. Many of the nation s 2,000-plus rural hospitals are aging, some may be in immediate need of substantial renovation or replacement. However, major construction projects are often unaffordable for small hospitals. Rural hospitals face daily challenges that differ from their urban counterparts. Then Before building a new facility in 1999, Ellsworth County Medical Center (ECMC), Ellsworth, Kan., was an antiquated facility facing several challenges including space limitations and out-of-date equipment. Today, ECMC is an award-winning hospital, receiving the Kansas Excellence Award in Holton Community Hospital, Holton, Kan., needed to develop a new facility because their building was out-dated and did not meet codes. Administrators found it would be more cost effective to build a new facility than renovate the one they had. According to Kathi Noe, CEO, Holton Community Hospital, building the new hospital has had a very positive impact on the community. We are one of the largest employers in Jackson County, she said. Our employees are involved in more than 90 community organizations and we were able to provide $90,000 in charity care last year. The commitment to build a replacement hospital is a difficult one. The costs often represent the biggest investment a rural community has ever made, which leads many rural hospitals to take a slow, conservative approach when Now making a decision. According to Roger Pearson, CEO, ECMC, they decided to develop a new building in 1996 since it would be more cost effective to construct a new building rather than remodel the existing one. The current facility site was land locked, said Pearson. It prohibited future expansion possibilities. Other contributing factors included the need for basic updates, additional space, and new equipment. The study showed a positive change in overall staffing for the participating hospitals, with a five percent increase in the first year and three percent in the second year, after the replacement. In addition, there were positive effects in quality of care, patient safety, and staff and physician satisfaction. Enhanced physician and staff recruitment, and additional primary care, specialist, and nurse availability was also noted. The overall evidence from the study is compelling, demonstrating a new facility can positively impact operations and is illustrated by growth increases experienced beyond the facilities expectations. Continued on next page Ellsworth County Medical Center, Ellsworth, Kan. 4 Kansas c o n n e c t i o n s

5 Replacements continued from page 4 The Holton hospital doubled in size in the three years since opening its new facility, Noe said. Meaning an increase in jobs, that turned into money spent in the community. Noe stated that their new hospital has had an impact on their recruitment efforts as well, Absolutely, she said. It was more difficult to recruit at the old facility than it is now with the new hospital. There are suggestions that a new facility investment generates positive payback, placing the organization on a lower cost trajectory. Since staffing represents more than half of a hospital s operating expenses, it proves an important driving factor behind increased efficiency. Twentytwo of the 24 participating replacement hospitals showed reduced volume increases for staff standby capacity or downtime. The Holton hospital reported a positive economic impact in the community and in the hospital as a result of the new facility. We are able to provide more services locally, which keeps the patient from driving out of town, said Noe. With new equipment, the facility is more efficient and the increased space has helped provide better patient care. Facility development is considered an opportunity to re-think processes leading to better outcomes. Pearson offered a few suggestions to those who are considering a replacement for their Critical Access Hospital (CAH), Involve the community in the project early on and consistently. Build for future needs, not just to replace and meet current needs. Holton Community Hospital, Holton, Kan. Noe reiterated that it is imperative that an organization fully understand what their community needs. Simply building a new facility does not translate into making more money or better business. A new facility needs to be thoroughly planned out, she said. Since we are physically located within 30 minutes of Topeka, a great medical community, we have to ensure we are giving our community what it needs. Teddy Bear continued from Front page Clinic was started when a Clay Center Sunday School teacher asked a hospital employee if there was a Teddy Bear clinic at Clay County. Although the medical center did not have one at the time, it was quickly decided it could and should be done. After researching other Teddy Bear Clinics in different states, Clay County combined what they saw and added some ideas of their own. The Teddy Bear Clinic has been open for two years, and is held about three times a year. Young explained that the clinic is a hospital team effort, with all the staff working to create a pleasant experience for the kids. The goal of the clinic is to get the kids comfortable with a hospital and Young and his team work hard to achieve that goal. The Teddy Bear Clinic is successful and popular. According to Young, all the groups that come in for the clinic hear about it through word of mouth. It is a great resource for the community, and the kids learn that going to the hospital isn t a negative experience, said Young. It is simple and fun for us to do and good for the kids. If you are interested in starting a Teddy Bear Clinic, contact Mary Jensen or Tyce Young at (785)

6 Mt. Carmel CareVan Providing patient transportation Trains, planes, and automobiles, to those living in urban areas, easy access to dependable public transportation is typically not a concern, but a choice. However, rural communities do not always have access to public transportation and, if they do, it is often limited. Pittsburg, Kan. offers one example of a rural community that does not have a public transportation system, yet its local hospital found a way around the town s limited transportation. Thanks to Pittsburg s Mt. Carmel Regional Medical Center, local residents and those in surrounding areas have the help they need, to get to and from medical visits. The CareVan transportation program was created in 1992 to meet the transportation needs of the economically disadvantaged and medically underserved with non-emergency medical appointments. Its mission is to provide courtesy transportation to medical appointments at the hospital and physician offices. Our service was founded to remove the transportation barrier and assist ill, underprivileged and elderly people to their medical appointments, said Dawn McNay, director of planning. When the first wheelchair accessible van and full-time driver were added in 1993, ride requests skyrocketed. McNay said they began hearing stories from CareVan patients that had literally been trapped inside of their homes for years due to disabilities; and subsequently they had not been receiving the health 6 Kansas c o n n e c t i o n s Mt. Carmel Regional Medical Center, Pittsburg, Kan., provides patients a ride to their appointments on the CareVan. care services they needed. Fourteen years and millions of passenger-miles later, CareVan is the primary provider of medical transportation for the ill and handicapped in southeast Kansas. The service now operates with six full- or part-time drivers, and a fleet of seven radio dispatched vans, four of which have wheelchair lifts. Many of our passenger s financial situations are perilous. They can t afford a car, or the gas to put in it, stated McNay. It s safe to say the CareVan is a lifeline for many, and if not for the program they may not get the medical attention they need, McNay said. Certainly, transportation represents a huge commitment on the part of Mt. Carmel to meet community needs, said McNay. She added, At times, people in the community who use the van s services or see the van around town may assume the hospital has unlimited resources for the program. She clarifies that the hospital does not make money from providing the service as CareVan does not charge anything for medical transportation. However, they do take donations from riders. There is little doubt that the service has made a positive impact in the region. Many community residents have chosen to remain in their homes longer, confident that if they need medical transportation, it will be available through the CareVan services Rural Kansas Photography Contest The 2007 Rural Kansas Photography Contest is presented by the University of Kansas, Rural Health Education and Services. Photos submitted should depict Kansas as a great place to live, work and play. Winning photos will be published and prizes will be awarded. Photographs are due by Sept.30, Download an entry form today! ruralhealth.kumc.edu

7 K A N S A S R E C R U I T M E N T C E N T E R July 2007 The mission of the Kansas Recruitment Center (KRC) is to assist Kansas rural communities in recruiting and retaining physicians and other health care providers. KRC works with hospitals, private physician practices, community health centers, and other organizations recruiting physicians, nurses, physician assistants or other health care professionals. KRC is also a health care career service for physicians, physician assistants, nurses, nurse practitioners and other allied health professionals. KRC assists candidates in finding a community and practice or career opportunity that meets their requirements. Services are provided to candidates at no charge. Candidates should refer to a position by number when they are calling about a specific opening. For more information, contact the University of Kansas Medical Center, Rural Health Education and Services, or , or visit the Web site at NORTH CENTRAL KRC Hematologist/Oncologist new cancer center approved by the Commission on Cancer, American College of Surgeons; current staff: 3 physicians and 1 midlevel; patient population is adult through geriatric; facility amenities include chemotherapy room w/window wall, counseling room, wig room KRC Pulmonary Medicine/ Critical Care 26-physician multi-specialty clinic; currently 10 specialties; additional services include full-service lab, nuclear medicine, echo and vascular testing, ultrasound, and full x-ray unit; full-service acute facility and surgery hospital nearby KRC Invasive and Interventional Cardiologist 26-physician multi-specialty clinic; currently 10 specialties; additional services include a full service lab, nuclear medicine, echo and vascular testing, ultrasound, and full x-ray unit; full-service acute facility and surgery hospital nearby KRC Internist 26-physician multi-specialty clinic; currently 10 specialties; additional services include a full service lab, nuclear medicine, echo and vascular testing, ultrasound, and full x-ray unit; full-service acute facility and surgery hospital nearby KRC Nephrologist 26-physician multi-specialty clinic; currently 10 specialties; additional services include a full service lab, nuclear medicine, echo and vascular testing, ultrasound, and full x-ray unit; full-service acute facility and surgery hospital nearby KRC Family Physician group practice, 25-bed CAH, acute medical, skilled nursing unit, 24-hour emergency, IP & OP surgery, OB, very active rehab department KRC General Surgeon group practice affiliated with a regional medical center that serves a population of 60K; the medical center s state-of-the-art technologies include a full laparoscopic system, family birthing rooms, well-equipped intensive care unit, ER, Level II nursery, fixed site MRI and CT; salary: $200,000-$250,000; great benefits; H1-B Visa opportunity KRC Orthopedist group practice affiliated with a regional medical center that serves a population of 60K; the medical center s state-of-the-art technologies include a full laparoscopic system, family birthing rooms, well-equipped intensive care unit, ER, Level II nursery, fixed site MRI and CT; competitive salary; great benefits; H1-B Visa opportunity KRC General Surgeon hospital-employed, 25-bed CAH with new surgical addition in progress; current staff: 3 family practitioners, 1 surgeon, 1 mid-level; additional hospital facilities include a 30-bed long-term care unit and an outreach clinic that is staffed 3.5 days per week; hospital services include OB, a full lab, diagnostic imaging, physical therapy; KRC Family Physician for 25- bed CAH w/ 2 satellite clinics; OB required, prefer ability to do c-section; currently 3 family physicians, 1 surgeon, 1 radiologist, 2 PAs, and 1 NP on staff; call is 1:5; hospital services include general surgery, cardiac rehab, cardio pulmonary, radiology, OB, OT, PT, CT scans, MRI, x-ray; salary is negotiable; full benefits KRC Family Physician 25-bed CAH; hospital services include: on-site CT, mobile MRI and ultrasound, lab, x-ray, swing beds, urology clinic, cardiac clinic; salary: $145,000-$155,000, potential for production bonus; full benefits; KRC Family Physician with OB for a 25-bed CAH and rural health clinic; the hospital does OB and the family practitioners may perform c-sections; general surgeon, 2 family practitioners, and 2 nurse practitioners on staff; currently, call is 1:4 and they locum tenens ER coverage 1 weekend/month; hospital services include OB, ER, lab, radiology, specialty care, and long term care; salary is $140,000-$160,000; full benefits KRC C Family Physician w/o OB or surgery, 12-bed CAH; rural health clinic attached to hospital; 83 staff members at hospital, including PA; call time is 1:2 and non-call time is completely off for practitioner; hospital services include acute care, swing bed, ER, PT, cardiac rehab, ADA certified, and outpatient clinics for cardiac and orthopedics; salary is $135,000-$160,000; full benefits Continued 7

8 KRC C Family Physician 25-bed CAH and rural health clinic; current staffing includes 1 physician and 1 PA; call is 1:3; hospital services include acute care, swing bed, ER services, therapy department, full service lab and x-ray, contracted sonogram and mammogram, and mobile CT scan unit; salary: $135,000-$150,000; full benefits KRC Physician Assistant KRC Nurse Practitioner position to work with 2 Gastroenterologists in a 26-physician multi-specialty clinic; currently 10 specialties; Gastroenterology experience preferred, but willing to train the right person; clinic services include a full service lab, nuclear medicine, echo and vascular testing, ultrasound, and full x-ray unit; full service acute care facility and surgery hospital nearby; salary is competitive and negotiable depending on experience; opportunity for incentive bonus; all clinic benefits available KRC Gastroenterologist a 26-physician multi-specialty group with 3 Gastroenterologists seeks BC/BE Gastroenterologist to join a well established, busy practice; early partnership, surgical hospital ownership, excellent benefits and a large referral area make this an excellent opportunity KRC Family Physician for wellestablished group practice; OB preferred, but not required; 4 ½ days per week schedule; call is 1:5; currently 4 family physicians and 1 midlevel on staff; salary is $130,000; full benefits; H-1B opportunity KRC Physician Assistant KRC Nurse Practitioner for well-established group practice covering a full range of family practice services; 4 ½ days per week schedule; call is 1:5; currently 4 family physicians and 1 mid-level on staff; salary is $60,000-$70,000 plus bonus; benefits include liability insurance, 20 vacation days, CME allowance, and relocation KRC General Surgeon for multi-specialty clinic that is owned and operated by 25 physicians representing 11 medical specialties; 3 general surgeons on staff; call is 1:4; full service acute care facility nearby as well as a surgery hospital; salary and benefits are negotiable KRC Family Physician without OB for 25-bed CAH; currently 3 FPs, 1 8 Kansas c o n n e c t i o n s surgeon, and 1 mid-level on staff; additional hospital facilities include a 25-bed long term care unit and outreach clinic that is staffed 2 ½ days per week; rotating local on-call backup; hospital services include lab, diagnostic imaging, rehab services, surgical services, ER, OR, and respiratory therapy; salary is $145,000- $165,000; full benefits KRC Physical Therapist Assistant for 25-bed CAH with brand new PT Department; also a 30-bed long term care unit and an outreach clinic staffed 3 ½ days per week; currently 3 PTs, 1 CPTA, 1 Exercise Physiologist, 1 Massage Therapist and an assistant on staff; the dept. treats an average of 40 patients/day including inpatient, outpatient, and long term care; caseload includes cardiac rehab, ortho, and neuro; experienced therapists and new graduates encouraged to apply; must have KS licensure or be eligible; hospital services include OB, lab, diagnostic imaging, and PT; salary is $38,000-$50,000; benefits KRC Emergency Medicine for 25-bed CAH; currently 3 FPs, 1 surgeon, and 1 mid-level on staff; additional hospital facilities include a 25-bed long term care unit and outreach clinic that is staffed 2 ½ days per week; rotating call schedule; hospital services include lab, diagnostic imaging, rehab services, surgical services, ER, OR, and respiratory therapy; salary is $145,000-$165,000; full benefits KRC Family Physician for ER in a 25-bed CAH; currently 3 FPs, 1 surgeon, and 1 mid-level on staff; additional hospital facilities include a 25-bed long term care unit and outreach clinic that is staffed 2 ½ days per week; rotating call schedule; hospital services include lab, diagnostic imaging, rehab services, surgical services, ER, OR, and respiratory therapy; salary is $145,000-$165,000; full benefits KRC Laboratory Supervisor for 25-bed CAH that supports a health clinic; currently 3 med techs and 1 phlebotomist on staff; average of 30 patients/day; hospital services include cardiac rehab, PT, CT, mobile MRI and ultrasound, lab, x-ray, scopes, swing beds, urology clinic and cardiac clinic; CLIA required; experience preferred, but new graduates encouraged to apply; salary is negotiable KRC Family Physician for a 25-bed CAH; they are expanding their medical staff to treat patients at the Rural Health Clinic and hospital; must have experience in a rural ER; hospital services include acute care, preventive medicine, PT, hospice, EMS, OB, surgery, and swing bed; call is 1:4 or 1:5; salary is $180,000 with a bonus package; full benefits; KRC Family Physician with OB for hospital-owned group practice; two-campus, 99-bed hospital with secondary campus 20 miles southwest; hospital services include a full laparoscopic system, family birthing rooms, ICU, ER, Level II nursery, MRI and CT, PT, OT, speech rehab, cardio-respiratory, lab, respite care, mammography, oncology, orthopedics, pulmonology, cardiology, nephrology outpatient clinics available; salary is $130,000 + production incentive + sign-on bonus; call is 1:5 but will be 1:6; full benefits KRC Physiatrist/Pain Management for group practice; two-campus, 99-bed hospital with secondary campus 20 miles southwest; hospital services include a full laparoscopic system, family birthing rooms, ICU, ER, Level II nursery, MRI and CT, PT, OT, speech rehab, cardio-respiratory, lab, respite care, mammography, oncology, orthopedics, pulmonology, cardiology, nephrology outpatient clinics available; salary is competitive and negotiable; sign-on bonus available; full benefits; KRC Nurse Practitioner KRC Physician Assistant for 14-bed modern, progressive CAH with large rural health clinic and ER coverage; caseload includes inpatient and outpatient; call is 1:4; salary is competitive and negotiable; full benefits KRC Orthopedic Surgeon with interest in fracture care, joint replacement, and sports medicine for well-established group practice; currently 2 orthopedic surgeons and 3 PA s on staff; call is 1:3; full ancillary services available; new Q-Rad Radiographic System on premises; excellent compensation; benefits package KRC Family Physician w/ or w/o OB (OB preferred) for well-established group practice; currently 4 physicians and 1 ARNP on staff; weekend call is 1:5; lab, mammography, and x-ray services on premises; full service acute hospital and surgical hospital nearby; salary is competitive; full benefits KRC Obstetrician/Gynecologist for single specialty clinic with OB/GYN Continued

9 practice; must be board certified or eligible; 385-bed hospital; 125 physicians currently on staff; hospital services include behavioral health, cancer, cardiology, emergency services, lifeline, radiology, rehab, sleep disorders center, and a wound care clinic; salary is competitive; full benefits; H-1B opportunity KRC Orthopedist for successful single specialty clinic w/ thriving Ortho practice; must be board certified or eligible; 385- bed hospital; 125 physicians currently on staff; hospital services include behavioral health, cancer, cardiology, emergency services, lifeline, radiology, rehab, sleep disorders center, and a wound care clinic; salary is competitive; full benefits; H-1B opportunity KRC Pediatrician for private practice opportunity with privileges at the 385- bed hospital; services include behavioral health, cancer, cardiology, emergency services, lifeline, radiology, rehab, sleep disorders center, and a wound care clinic; must be board certified or eligible; salary is competitive with loan forgiveness; full benefits; H-1B opportunity KRC Child Psychiatrist for progressive Behavioral Health Department; practice expenses are paid by the health center; call is 1:4; the 385-bed hospital s services include behavioral health, cancer, cardiology, emergency services, lifeline, radiology, rehab, sleep disorders center, and a wound care clinic; salary is competitive and negotiable; full benefits; H- 1B opportunity KRC Radiation Oncologist for growing staff at state-of-the-art Cancer Care Center; the 385-bed hospital s services include behavioral health, cancer, cardiology, emergency services, lifeline, radiology, rehab, sleep disorders center, and a wound care clinic; 125 physicians currently on staff; salary is competitive and negotiable; full benefits; H-1B opportunity KRC Radiologist for wellestablished private practice group; must be board certified or board eligible; the 385-bed hospital s services include behavioral health, cancer, cardiology, emergency services, lifeline, radiology, rehab, sleep disorders center, and a wound care clinic; 125 physicians on staff; salary is competitive and negotiable; full benefits; H-1B opportunity KRC Physician Assistant KRC Nurse Practitioner for Rural Health Clinic attached to 25-bed CAH; hospital services include CT on site, mobile MRI and ultrasound twice/week, lab, x-ray, cardiac rehab, urology clinic, cardiac clinic, and eye surgeon; no call; salary is competitive and negotiable; benefits; H-1B opportunity NORTHEAST KRC Medical Technologist 24- bed CAH; experienced and new graduates encouraged to apply; hospital services include inpatient, outpatient, swing bed, OB; salary: $37,000-$52,000 depending on experience; full benefits KRC C Internist private practice in building attached to hospital; this internist would join 3 other internists, all of which are in private practices, in seeing a quickly growing patient population and to share call; clinic office space, practice management services, and a start-up loan to cover initial business expenses are available; call is 1:4; family practice physicians perform ER coverage; net income guarantee of $160,000 (negotiable depending on training and experience); benefits KRC Family Physician group practice located next to a 28-bed CAH; prefer OB, but not required; currently 3 physicians and 1 mid-level on staff; call is 25%; salary and benefits are not predetermined as this is considered an independent practice KRC General Surgeon for group practice; currently 1 general surgeon on staff; limited call coverage; hospital is a 28-bed CAH and supports a satellite clinic; salary is structured on a fee-for-service basis; benefits are negotiable; H-1B opportunity KRC Family Physician with OB for 24-bed CAH with 2 satellite clinics; currently 2 family physicians and 2 NP s on staff; call is 1:5; hospital services include inpatient, outpatient, sub acute, surgery, OB, PT and OT, lab, radiology, and outreach clinics; salary is $125,000-$175,000; full benefits KRC Obstetrician/Gynecologist for hospital-employed group practice; the community and hospital are growing hospital service area is 45,000 and they expect 30,000 new residents within the next 6 years; hospital is undergoing a $40 million expansion over the next two years; salary is competitive and negotiable; full benefits KRC Cardiologist for 120-bed, hospital-based regional health center with a variety of services; call is no more than 10 days/month; salary is competitive and negotiable; strong vacation and benefits package; H-1B and J-1 opportunity KRC Hematologist/Oncologist for 120-bed, hospital-based regional health center; serves an 8-county population of approx. 186,000 people; physician needed to diagnose and treat tumors, and blood and blood-forming tissue disorders; call is no more than 10 days/ month; salary is competitive and negotiable; strong vacation and benefits package; H-1B and J-1 opportunity KRC Pulmonologist/Critical Care for multi-specialty group with internal medicine, cardiology, gastroenterology, oncology, and pulmonary/critical care specialties; call is no more than 10 days/month; salary is competitive and negotiable; strong vacation and benefits package; KRC Pharmacist with Kansas licensure for 150-bed hospital-based regional health center; pharmacist prepares and dispenses drugs, monitors patient drug therapies, and provides drug information; hospital uses electronic MAR and bed-side verification; currently 4 pharmacists on staff; salary is competitive and negotiable; full benefits KRC Physician Assistant to support interventional cardiologist developing heart program within 150-bed, hospital-based regional health center; experienced and new grads are encouraged to apply; salary is competitive and negotiable; full benefits KRC Oral and Maxillofacial Surgeon for group practice, with opportunity for partnership; call is no more than 10 days/month; salary is competitive and negotiable; strong vacation and benefits package available; KRC Family Physician for 40-bed CAH; hospital services include ER, swing bed, Oncology Nursing, outpatient IV therapies, specialty clinics, PT, OT, and speech therapy; physician can be employed by hospital or join a group; salary is competitive and negotiable; full benefits; KRC Pharmacist registered Continued 9

10 pharmacist for 91-bed hospital; currently 1 pharmacist, 2 RNs, 1 pharm tech, and 3 support staff; experienced as well as new grads encouraged to apply; salary is $62,940-$93,163 depending upon experience; full benefits NORTHWEST KRC Orthopedist 2 positions available for group practice; 190+ bed stateof-the-art medical center with an in-clinic MRI and wellness facility; 90 physicians on active medical staff; salary negotiable; benefits; H1-B and J-1 opportunity KRC Plastic Surgeon 190+ bed state-of-the-art medical center with new wellness facility; currently 90 physicians on active medical staff; salary negotiable; benefits KRC Cardiologist 190+ bed state-of-the-art medical center with new wellness facility; currently 90 physicians on active medical staff; salary is negotiable; benefits; H1- B and J-1 opportunity KRC Gastroenterologist 190+ bed state-of-the-art medical center with new wellness facility; currently 90 physicians on active medical staff; salary negotiable; full benefits; KRC Nephrologist 190+ bed state-of-the-art medical center with new wellness facility; currently 90 physicians on active medical staff; salary negotiable; full benefits; KRC Family Physician with OB, prefer c-section certified; 25-bed CAH; currently 3 physicians and 1 mid-level; call is 1:4 as secondary to ARNP (primary ER call); full service hospital including med/surg acute care, OB/nursery, ER, outpatient, surgery/ recovery, diagnostic imaging, lab, PT, RT, inpatient pharmacy, ambulance, specialty clinic, primary care clinic; salary includes base + productivity incentive, approximately $150,000+ depending on OB and procedures; full benefits; H-1B opportunity KRC Respiratory Therapist 25-bed CAH that includes a 2 physician hospital-based clinic and a 68-bed long term care facility; hospital services include acute care, swing bed, OB, diagnostic, lab, respiratory, specialty clinic, ER, and ICU; staff includes 2 full time therapists and 3 prn therapists; daily 10 Kansas c o n n e c t i o n s average of 15 patients; rotating call; open to experienced therapists and new graduates and CRTT or RRT KRC General Surgeon 190+ bed, state of the art medical center and wellness facility; currently 90 physicians on staff; call time is 1:3; salary is negotiable; benefits; KRC Hematologist/Oncologist for cancer center that is an affiliation of a 190+ bed, state-of the-art medical center and wellness facility due to growth; currently 90 physicians on staff; salary is negotiable; full benefits; KRC Internist 190+ bed, state of the art medical center and wellness facility; currently 90 physicians on staff; call is 1:5; salary is negotiable; benefits; an outstanding hospital in a positive and progressive environment; KRC Family Physician without OB for 190+ bed, state of the art medical center and wellness facility; currently 90 physicians on staff; call is 1:6; salary is negotiable; benefits; an outstanding hospital in a positive and progressive environment KRC C Family Physician for 25-bed CAH and family health care center to provide care at new clinic attached to the hospital; this clinic serves the whole county; satellite clinic 19 miles east; acute care and swing beds; currently 3 physicians and 1 mid-level on staff; call is 1:4 weekends and 1 night/week w/ backup on midlevel; hospital services include on-site CT, mobile MRI, nuclear medicine, lab surgery, and rehab; physician will be taking over an existing patient base; salary is $140,000 with additional income for ER coverage can be higher based on productivity; full benefits KRC C Internist for 25-bed CAH and family health care center to provide care at new clinic attached to the hospital; this clinic serves the whole county; satellite clinic 19 miles east; acute care and swing beds, 37-bed long term care unit and 6-bed assisted living unit; currently 3 physicians and 1 mid-level on staff; call is 1:4 weekends and 1 night/week w/ backup on midlevel; hospital services include on-site CT, mobile MRI, nuclear medicine, lab surgery, and rehab; physician will take over existing patient base; salary is $140,000 with additional income for ER coverage can be higher based on productivity; full benefits KRC C Family Physician for 25- bed CAH; OB preferred; rural health clinic onsite (4-day schedule); currently 3 family physicians, 1 general surgeon, 1 mid-level on staff; call is 1:5 ER and 1:3 OB; hospital services include acute care, intermediate care, ER, lab, x-ray, PT, RT, specialty clinics, cardiac rehab, skilled nursing, and chemotherapy administration; salary is $140,000-$150,000 + incentives; full benefits; J-1 and H-1B opportunity KRC Family Physician for hospital-based group practice; position is combo of outpatient services in a new rural health clinic and inpatient services in the 25- bed CAH; currently 2 physicians in the group practice; call is 1:4; hospital will provide coverage every 5th weekend of the month; hospital services include acute care, swing bed, x-ray, CT, mobile sonography, lab, ER, home health, hospice outpatient clinics, surgery, PT, RT, and cardiac rehab; salary is $150,000-$175,000 with incentives; full benefits; J-1 and H-1B opportunity KRC Physician Assistant KRC Nurse Practitioner for hospital-based group practice; position is a combo of outpatient services in a new rural health clinic and inpatient services in 25-bed CAH; 2 physicians will be part of group practice; call is 1:4; hospital will provide coverage every 5th weekend of the month; hospital services include acute care, swing bed, x-ray, CT, mobile sonography, lab, ER, home health, hospice outpatient clinics, surgery, PT, RT, and cardiac rehab; salary is competitive; full benefits KRC C Family Physician for 25-bed CAH with a 33-bed long term care unit attached; 2 clinics - one in town, and one 15 miles away; out of town clinic has a physician half day/week and FT NP; new physician will work in the clinic 4.5 days and will perform rounds on long term care patients, as well as with their patients in the hospital; OB preferred, but not required; no high-risk OB; currently 1 physician (does OB), 1 NP, and 2 PAs on staff; call is 1:4 with second call backup for the PAs; hospital services include acute care, ER, minor surgery, OB, EECP, PT, OT, and speech; salary is $150,000-$165,000 + additional pay for ER coverage and production bonus; full benefits; KRC Physical Therapist for 25- Continued

11 bed CAH; building new hospital; currently 1 PT and 1 PTA on staff; responsibilities include evaluation, planning and administering therapy treatment to an avg. of 20 patients/day; hospital services include: lab, OB, PT, stress testing, cardiac rehab, diagnostic imaging, CT, MRI, EKG, nuclear medicine, ER, ultrasound, and general surgery; 4 satellite clinics; experienced and new graduates encouraged to apply; must have Kan. licensure or be eligible; salary is negotiable; full benefits KRC Anesthesiologist to join group of 4 anesthesiologists; group has exclusive agreement with hospital to provide services; currently 4 physicians and 6 CRNA s; 193-bed hospital provides cardiothoracic surgery, general surgery, orthopedics, peds, OB, internal medicine, pulmonology, neurology, and family medicine; salary is $250,000; full benefits; KRC C Family Physician w/o OB for a health center that operates a 24-bed CAH, 2 rural health clinics, 8 specialty clinics, and a retirement community; the family physician sees patients in a rural health clinic setting and long-term care facility, and participates in the admission and delivery of inpatient care; call is no more than 1:3 ½ ; currently 3 full-time providers on staff; salary is $150,000- $170,000 + productivity bonus starting 2nd year + $10,000 sign-on bonus; excellent benefits; H-1B opportunity KRC C Internist for a health center that operates a 24-bed CAH, 2 rural health clinics, 8 specialty clinics, and a retirement community; the internist sees patients in a rural health clinic setting and long-term care facility, and participates in the admission and delivery of inpatient care; call is no more than 1:3 ½ ; currently 3 full-time providers on staff; salary is $150,000-$170,000 + productivity bonus starting 2nd year + $10,000 sign-on bonus; excellent benefits; H-1B opportunity KRC Family Physician w/o OB for 18-bed CAH; patient population is pediatric through geriatric in variety of settings; hospital services include lab, x-ray, rehab, mobile CT & MRI, interactive TV, and EMR equipment; excellent opportunity with an up-and-coming rural healthcare facility; currently 1 physician and 1 mid-level on staff; call is 1:3 with ER; flexible schedule; salary is $120,000+ with sign-on and production bonuses; full benefits; KRC Internist for 18-bed CAH; patient population is pediatric through geriatric in variety of settings; hospital services include lab, x-ray, rehab, mobile CT & MRI, interactive TV, and EMR equipment; excellent opportunity with an up-and-coming rural healthcare facility; 1 physician and 1 mid-level on staff; call is 1:3 with ER; flexible schedule; salary is $120,000+ with sign-on and production bonuses; full benefits; H-1B and J-1 opportunity KRC Pediatrician for 18-bed CAH; patient population is pediatric thru geriatric in variety of settings; hospital services include lab, x-ray, rehab, mobile CT & MRI, interactive TV, and EMR equipment; excellent opportunity to learn and grow with an up-andcoming rural healthcare facility; currently 1 physician and 1 mid-level on staff; call is 1:3 with ER; flexible schedule; salary is $120,000+ with sign-on and production bonuses; full benefits; KRC Medicine-Pediatrics for 18-bed CAH; patient pop. is pediatric through geriatric in variety of settings; hospital services: lab, x-ray, rehab, mobile CT & MRI, interactive TV, and EMR equipment; excellent opportunity; 1 physician and 1 mid-level on staff; call is 1:3 with ER; flexible schedule; salary is $120,000+ with sign-on and production bonuses; full benefits; KRC Family Physician w/o OB, outpatient and inpatient caseload; 24-bed CAH with a rural clinic on-site; hospital services: outpatient surgery, med surg, CT, lab, and radiology; 2 internists on staff; call is 1:3 and includes ER; salary is competitive and negotiable; full benefits; KRC Pulmonologist/Critical Care Physician for 2 physician team, practice attached to hospital; the 190+ bed stateof-the-art medical center s services include pulmonary/critical care, sleep lab, cardiology, cardiac surgery, orthopedics, OB/GYN, general surgery, internal medicine, neurology, infectious disease, urology, pediatrics, and oncology; currently 90 physicians on staff; call is 1:3; salary is competitive and negotiable; full benefits; KRC Physician Assistant KRC Nurse Practitioner for 24-bed CAH, rural health clinic on-site; outpatient and inpatient caseload; hospital services: outpatient surgery, med surg, CT, lab, and radiology; 2 internists on staff; this position responsible for participating in call coverage; competitive salary is negotiable; full benefits KRC Radiologist for well-established, hospital-based, state-of-the-art medical center and wellness facility; currently 90 physicians on staff; call is 1:4; salary is negotiable; full benefits; positive and progressive environment; KRC Radiologic Technologist for 25-bed CAH serving a tri-state area; diagnostic imaging dept. features x-ray, CT, mammography, ultrasound, dexa-scan, and mobile MRI & nuclear medicine; 4 full-time and 2 part-time radiographers on staff; experienced and new graduate encouraged to apply; must have AART (CT) certification; additional certification in other modalities preferred; call includes 1 day/week and every 5th weekend; salary is $34,320-$45,660; full benefits KRC Registered Nurse for 16-bed hospital that takes pride in service and values employees; newly remodeled hospital; experienced and new graduates encouraged to apply; for a new grad, hospital offers wellrounded experience, available mentoring; ADN or BSN prepared candidates welcome; many educational opportunities including NALS, PALS, ACLS, TNCC, and Advanced Burn; current administrator is a nurse; salary is competitive; strong benefits package KRC Radiologic Technologist for 24-bed CAH with 36-bed long term care unit; hospital services: med-surg, OB, OR, OP, and specialty clinics; radiology dept. has CT, RT, mammography, and mobile services for MRI, nuclear medicine, and sonogram; 3 family physicians, 1 NP, and 1 rad tech on staff; call is every 3rd weekend; experienced and new grads encouraged to apply; candidate should have experience in CT and x-ray; salary is competitive and negotiable; benefits SOUTH CENTRAL KRC Family Physician w/o OB; 2 physicians and 1 NP on staff, 24-bed CAH with on-site clinic; hospital services: CT, travel MRI, Dexxa, full-service surgery; salary: $130,000-$140,000 (2 yr. contract); relocation and CME allowance; possible loan repayment KRC Pediatrician group practice in a peds-only clinic connected to 82-bed hospital with Level 2 nursery (gestation not Continued 11

12 < 32 wks); complete EMR/HER; 3 pediatricians, 1 ARNP; call 1:4 weekdays, 1:4 weekends; salary: $116,000; full benefits, production after one year; part-time considered KRC C Family Physician w/o OB for 25-bed CAH; hospital services: acute care, swing bed, lab, x-ray, PT, OT, 24-hour ER, mobile CT scan, ultrasound, mammogram, and bone density screening; call is 1 evening/ week and 1:5 weekends; salary: $150,000- $160,000 with up to a 2 year contract; full benefits; KRC Registered Nurse hospital based rural health clinic connected to a 25-bed CAH; prefer acute care or surgery experience in hospital setting; will consider new graduates; day shift (7:00am-3:00pm); 2.2 FPs and 1 PA on staff; hospital services: x-ray, CT, ultrasound, lab, surgery, specialty clinics, mobile MRI, and telerad; salary: $33,800-$44,000; benefits KRC Family Physician w/o OB for patient-centered, family-focused, hospitalbased rural health clinic connected to a 25-bed CAH; 1 offsite rural clinic; 2.2 FPs and 2 PA s on staff; backup call only; hospital services: x- ray, CT, ultrasound, lab, surgery, specialty clinics, mobile MRI, and telerad; salary: $145,000- $160,000; full benefits KRC Family Physician for energetic group practice; 2 physicians in practice; the hospital has an LDRP in the same building as the group practice; the nearby 69-bed hospital s services include radiology, lab, OB, ER, mobile MRI, CT, PT, swing bed, acute care, and general surgery; salary is negotiable KRC Family Physician new position with or w/o OB; based in a new rural health clinic across the street from the hospital; the 25-bed CAH s services include ER, OR, lab, x-ray, MRI, CT scan, ultrasound, RT, PT, OT, speech therapy, EKG, EEG, and sleep studies; no call on weekends, during the week, call is 1:3; salary: $140,000-$160,000; full benefits; KRC C Otolaryngologist for new group practice; strong physician support for ENTs; the 105-bed hospital s services include pediatrics, OB, general surgery, medical, ICU, inpatient rehab, gero-psychiatry unit, and ER; call would not exceed 10 days/mo; salary is competitive and negotiable; full benefits; H-1B opportunity 12 Kansas c o n n e c t i o n s KRC C Family Physician w/o OB for 25-bed CAH with attached clinic; 1 physician, 1 general surgeon, and 2 mid-levels on staff; call is 1:4; to be responsible for patient care at clinic, hospital rounds, and ER call; hospital services: general acute, skilled, intermediate care, CT, and PT; salary is $170,000- $200,000; full benefits; H-1B opportunity KRC C Director of Physical Therapy for 25-bed CAH with 3 rural health clinics and a home health dept; responsibilities: overseeing PT dept, providing PT to inpatient, outpatient, and home health patients, and paperwork to bill for services rendered; currently a contract therapist and PTA on staff; avg. of 10 patients/day; experienced therapists preferred, new grads considered; hospital services: acute care, swing bed, long-term care, home care, and outpatient; salary is $47,000- $73,000 depending on experience; benefits KRC C Urologist for progressive multi-specialty group practice; salary is $350,000 (guaranteed first year), with possible production bonus; excellent benefits KRC C Orthopedist for progressive multi-specialty clinic; salary is $350,000 (guaranteed first year), with possible production bonus; excellent benefits KRC Internist for patient-centered, family-focused, hospital-based rural health clinic; clinic is connected to a 25-bed CAH; 2.2 family physicians and 2 PAs on staff; unless the physician has an interest in primary call coverage, the call responsibility is based on backup coverage; hospital services: x-ray, CT, ultrasound, lab, surgery, specialty clinics, mobile MRI, and telerad; salary is competitive and negotiable; full benefits KRC Physician Assistant w/o OB for 25-bed CAH with attached clinic; 1 physician, 1 general surgeon, and 1 mid-level on staff; call is 1:4; the PA is responsible for providing patient care at the clinic, performing hospital rounds, and ER call; hospital services: general acute, skilled, intermediate care, ancillaries including in-house CT, and on-staff PTs; salary is $65,000-$75,000; benefits KRC Registered Nurse for family-focused, hospital-based rural health clinic connected to 25-bed CAH; 2.2 family physicians and 2 PAs on staff; hospital services: x-ray, CT, ultrasound, lab, surgery, specialty clinics, mobile MRI, and telerad; shift supervisor position available as well as full- and parttime opportunities for RNs; will consider new grads; salary is competitive; full benefits KRC C Internist for progressive multi-specialty group practice; call will vary w/ 4 other internists; established patient base; 11 specialties, 23 physicians, and 5 mid-levels on staff; salary is $120,000 (guarantee 1st yr) + production bonus; excellent benefits SOUTHEAST KRC Family Physician with OB; 25-bed CAH; call rotates with groups of 5; hospital services: OB, ICU Level I, general surgery, orthopedics, ENT, urology, CT, lab; salary is negotiable; benefits KRC Orthopedist group practice, 2 orthopedic surgeons looking for 3rd partner; 1 mid-level, office manager, 2 rad techs, 1 orthopedic nurse on staff; office located in a 100+ bed hospital, recently announced $20 million expansion; salary $350,000; benefits KRC Anesthesiologist with Pain Management office located in hospital; 3 orthopods on staff want to open a pain management clinic; option to work as a solo physician or be hospital-employed; 100+ bed hospital, recently announced $20 million expansion; 37 physicians representing over 15 medical specialties; salary is negotiable; benefits KRC Non-Invasive Cardiologist 100+ bed hospital, recently announced $20 million expansion; 37 physicians representing over 15 medical specialties; option to work as an independent practitioner or be hospitalemployed; salary is negotiable; benefits KRC Physiatrist 100+ bed hospital, recently announced $20 million expansion; 37 physicians representing over 15 medical specialties, 3 orthopedic surgeons; option to work as an independent practitioner or be hospital-employed; salary is $250,000 min. w/ yearly performance incentive bonus; benefits KRC Internist multi-specialty group with 4 satellite clinics; staff includes: 6 family physicians, 1 pediatrician, 2 internists, 2 general surgeons, 1 urologist; the clinic offers a full spectrum of care such as family medicine including OB, physical exams and sports physicals, lab and x-ray, EKG testing and bone density studies, minor surgery, wellness exams Continued

13 and preventative medicine, osteopathic manipulations, PT, diabetic education, cancer center; salary is negotiable; full benefits KRC C Obstetrician/Gynecologist can be an independent practitioner or employed by 109-bed hospital; 37 physicians representing over 15 medical specialties; OB unit undergoing renovations central monitoring and electronic medical records to be added; approx 300 deliveries/year; level I nursery; 1 OB/GYN and 2 family physicians (perform OB) on staff; salary: $250,000 + sign-on bonus; benefits and vacation if employed by the hospital KRC Physician Assistant KRC Nurse Practitioner for group practice; 3 physicians, 3 NP s and 1 PA on staff; salary is $58,500; vacation includes 12 days/year, 10 paid holidays, and 12 days sick leave; full benefits KRC C Internist can be independent practitioner in group practice or employed by hospital; position provides outpatient services only; 109-bed acute, intensive and skilled care hospital; 37 physicians representing 15+ medical specialties; salary is $160,000- $170,000 + sign-on and incentive bonuses; benefits and paid vacation if employed by hospital KRC C Hospitalist can be independent practitioner or employed by hospital; patient load will max at 25; 109-bed acute, intensive and skilled care hospital; 37 physicians representing 15+ medical specialties; salary: $170,000-$180,000 with a yearly performance incentive bonus + sign-on bonus; benefits and paid vacation if employed by hospital KRC C Emergency Medicine for family physician, internist, or emergency medicine physician; 109-bed acute, intensive and skilled care hospital; 37 physicians representing 15+ medical specialties; ER sees an avg. of 900 visits/mo.; 3-bed multi-care area, cardiac room, trauma room, and orthopedic room; applying for Level 3 trauma designation; 3 ER physicians forming an LLC; ideally, 4 full-time physicians will provide coverage 24/7 with 12 hour shifts (4 days on, 4 days off); salary is $118/hr for non-er certified and $125 for ER board certified; sign-on bonus available KRC C General Surgeon can be independent practitioner or employed by hospital; 109-bed acute, intensive and skilled care hospital; 37 physicians representing 15+ medical specialties;or undergoing extensive renovations, resulting in 4 OR suites and 2 procedure rooms; approx. 400 surgeries/mo.; salary is $250,000-$350,000 + sign-on bonus; benefits and paid vacation if employed by hospital KRC C Pulmonologist for 148-bed licensed, 105-bed operating medical center; hospital services: acute care, skilled nursing, OB/GYN, ICU, ER, behavioral health, surgery, all clinical ancillary services, and cancer treatment center; not a hospital employee, but will be provided a salary guarantee; benefits KRC C Otolaryngologist for 148-bed licensed, 105-bed operating medical center; hospital services: acute care, skilled nursing, OB/GYN, ICU, ER, behavioral health, surgery, all clinical ancillary services, and cancer treatment center; not a hospital employee, but will be provided a salary guarantee; benefits KRC C Family Physician for busy rural health clinic; 1 family physician, 1 NP, 1 practice administrator, and 1 office coordinator on staff; admitting 25-bed licensed inpatient acute care CAH directly across street; salary is competitive and negotiable; great benefits KRC Family Physician KRC Internist medical director for federal clinic; 70 staff members including 3 physicians, 3 NPs, and 1 PA; call is included; salary is $130,000-$136,000; great benefits SOUTHWEST KRC Family Physician federally qualified community health center, 3 satellites; current staff: 1 physician and 8 mid-levels; no call coverage, no weekends, salary negotiable, benefits; KRC Urologist for multi-specialty group with 27 physicians and 11 specialties; large service area with many referrals; 3 satellite facilities; 100-bed hospital s services: ER, lab, x-ray, CT, MRI, OB, peds, new cardio and ICU services; salary is competitive and negotiable; full benefits; KRC Registered Nurse 25-bed acute care setting including swing bed unit and ER; experienced nurses and new graduates encouraged to apply; ASN or BSN acceptable; 12-hour evening shift 3 days a week; salary depends on experience; benefits KRC Registered Nurse nursing home unit; experienced nurses and new graduates encouraged to apply; ASN or BSN acceptable; 12-hour evening shift 3 days a week; salary is negotiable; benefits KRC Extended Care Facility Manager 48-bed nursing home unit; responsible for supervising staff of approx. 30 employees; must be RN with long-term care experience, long-term care management experience preferred but not required; ASN or BSN acceptable; salary is negotiable; benefits KRC Lab Tech 25-bed acute care setting with swing bed unit and ER; first shift; will cross-train into radiology with training provided if needed; salary is negotiable; benefits KRC C General Surgeon 45-bed county owned, not-for-profit, rural hospital; 2 physicians and 1 PA on staff; call negotiable; hospital services: radiology, lab, OB, ER, mobile MRI, CT, swing bed, acute care, general surgery, pediatric care, RT, ICU, home health, and PT; salary is $250,000-$300,000; full benefits KRC Family Physician 25-bed hospital; patient care provided at clinic and extended care facility; hospital services: general medical-surgical, skilled nursing, ER, OB, geriatrics, inpatient, outpatient, and long term care; 1 family practitioner, 1 part-time general surgeon, and 1 NP on staff; call 1 week every 3-4 weeks; salary is $150,000-$170,000; benefits KRC Physician Assistant KRC Nurse Practitioner for 25-bed hospital; patient care provided at the clinic and extended care facility; patient caseload includes women s health, child health, diabetic care, and ER; currently 1 family practitioner, 1 part-time general surgeon, and 1 NP; salary range: $70,000-$95,000; benefits KRC Nurse Practitioner KRC Physician Assistant community health center with 3 satellite facilities; 1 physician, 6 NPs, 2 PAs, and 1 volunteer physician on staff; no call coverage or weekends; salary range is $58,000, negotiable; full benefits KRC C Family Physician w/o OB for multi-specialty group practice; strictly outpatient, clinic-based; 2 family physicians, 5 internists, and 3 pediatricians on staff; call is shared with family physicians and internists; family physicians are responsible for answer- Continued 13

14 ing questions over the phone (1:3) and the internists provide all call coverage to hospital (inpatient); the 132-bed admitting hospital s services: acute care, OB, emergency medicine, surgery, oncology, rehab, wound care, cardiology, orthopedics, and neurology; salary is $150,000; full benefits KRC Otolaryngologist options for practice: hospital employed, an independent practitioner that contracts the admin. functions to hospital, or a solely independent practice; the admitting 132-bed hospital provides acute care, OB, emergency medicine, surgery, oncology, rehab, wound care, cardiology, orthopedics, and neurology; 1 hospital-employed ENT on staff; salary is $200,000 + sign-on bonus; full benefits; H-1B opportunity KRC Orthopedic Surgeon looking for 2nd Orthopedic Surgeon to join hospital-based practice; caseload is full service general orthopedics including sports medicine; the admitting 132-bed hospital provides acute care, OB, ER, surgery, oncology, rehab, wound care, cardiology, orthopedics, and neurology; 2 orthopedists in community; salary is $400,000 and negotiable; full benefits; H-1B opportunity KRC Emergency Medicine join emergency medicine physician group; 2 fulltime physicians and 1 part-time physician; Level II ER with 13,500 visits/yr.; the admitting 132- bed hospital provides acute care, OB, ER, surgery, oncology, rehab, wound care, cardiology, orthopedics, and neurology; salary is $133/hour + sign-on bonus; benefits; H-1B opportunity KRC Interventional Cardiologist for group practice to join 8 Cardiologists in outreach clinic; admitting hospital is 132-beds and provides acute care, OB,ER, surgery, oncology, rehab, wound care, cardiology, orthopedics, and neurology; salary is $450,000 negotiable KRC C Obstetric Nurse for 45-bed, county owned, not-for-profit, rural hospital; should have at least 2 years experience and eligible for KS licensure; required certifications ACLS, NRP, BCLS, PALS; 3 FT nurses and 2 prn nurses; hospital services: radiology, lab, OB, ER, MRI (mobile), CT, acute care, swing bed, general surgery, pediatric care, RT, ICU, home health, and PT; salary is $37,000- $48,000; full benefits KRC Physical Therapist for a new 20-bed CAH and 43 bed long-term care unit; under direction of an experienced PT, this PT will provide services for post-op orthopedic patients, athletic injuries and geriatrics; experienced therapists and new grads encouraged to apply; Director, PTA, and an aide currently on staff; hospital services include orthopedic surgery, swing bed, CT scan, ultrasound, home health and long-term care; salary is $62,000- $83,000; full benefits KRC Dermatologist for multispecialty group with 27 physicians and 11 specialties; large service area with many referrals; group also supports 3 satellite facilities including an urgent care clinic; the local 100-bed hospital s services include ER, lab, x-ray, CT, MRI, OB, peds, new cardio and ICU services; salary is competitive and negotiable; full benefits; H- 1B and J-1 opportunity KRC Family Physician with or without OB to treat patients in an inpatient or outpatient setting; currently 2 PA s and 2 parttime physicians on staff; call is 1:3; outpatient clinics have a podiatrist, cardiologist, and chiropractor on staff; hospital consists of 12 beds, 35-bed long-term care unit, and a rural health clinic; hospital services: PT, lab, x-ray, ER, acute care, home health; salary is negotiable and competitive; full benefits KRC C Pharmacist solo position available in a 45-bed county owned, not-forprofit, rural hospital; experience preferred but new grads encouraged to apply; PharmD required and must be Kan. licensed or eligible; hospital is currently contracting with a local pharmacist; hospital services include radiology, lab, OB, ER, MRI, CT, acute care, general surgery, pediatric care, RT, ICU, home health and PT; salary is $75,000-$110,000; full benefits KRC C Family Physician for growing multi-specialty group practice; excellent opportunity for physician interested in learning more general surgery and OB/GYN; group specialties: family medicine, general surgery, OB/GYN; position is w/o OB, but if there is a strong interest, there may be flexibility; currently 3 physicians and 1 mid-level on staff; call is 1:3 (no ER); caseload primarily outpatient; 100-bed hospital is 1 block away and is a full service acute care center; salary is $135,000+; full benefits; KRC C Medicine-Pediatrics position at growing multi-specialty group practice; group specialties: family medicine, general surgery, OB/GYN; currently 3 physicians and 1 mid-level on staff; call is 1:3 (no ER); caseload primarily outpatient; 100-bed hospital is 1 block away and is a full service acute care center; salary is $135,000+; full benefits; H-1B and J-1 opportunity KRC Endocrinologist for multispecialty group housing 25 physicians with 11 specialties; serves the endocrine needs of 24 counties; 2 satellite facilities; proud of their highly complex lab and radiology/nuclear medicine depts; call is 1:6; 100-bed hospital is 3 blocks away and includes ER, lab, x-ray, CT, MRI, OB, peds, new cardio and ICU services; salary is $180,000 depending on experience; full benefits; KRC Rheumatologist for multispecialty group housing 25 physicians with 11 specialties; large service area w/ many referrals; 2 satellite facilities; proud of their highly complex lab and radiology/nuclear medicine depts; call is 1:6; 100-bed hospital is 3 blocks away and includes ER, lab, x-ray, CT, MRI, OB, peds, new cardio and ICU services; salary is $180,000 depending on experience; full benefits; KRC Pulmonologist for multispecialty group housing 25 physicians with 11 specialties; large service area w/ many referrals; 2 satellite facilities; proud of their highly complex lab and radiology/nuclear medicine depts; call is 1:6; 100-bed hospital is 3 blocks away and includes ER, lab, x-ray, CT, MRI, OB, peds, new cardio and ICU services; salary is $180,000 depending on experience; full benefits; KRC Gastroenterologist for multi-specialty group housing 25 physicians with 11 specialties; large service area w/ many referrals; 2 satellite facilities; proud of their highly complex lab and radiology/nuclear medicine depts; call is 1:6; 100-bed hospital is 3 blocks away and includes ER, lab, x-ray, CT, MRI, OB, peds, new cardio and ICU services; salary is $180,000 depending on experience; full benefits; KRC Medicine-Pediatrics to treat patients in inpatient and outpatient setting; currently 2PA s and 2 part-time physicians on staff at hospital; call is 1:5; outpatient clinics have a Podiatrist, Cardiologist, and Chiropractor on staff; hospital services include PT, lab, x-ray, ER, acute care, swing bed, home health and independent living apts; salary is negotiable and competitive; full benefits Candidates looking for job opportunities in Kansas can access those listed by the KRC by visiting ruralhealth.kumc.edu on the Web.

15 Stories from Greensburg: Health care perspectives after the storm Over the next year, Kansas Connections will run a series of articles focusing on the recovery and rebuilding efforts of the Greensburg medical community. The first article features three health care providers, and their first-hand accounts from the night of the tornado and the days following. Prior to the devastating hit of an F5 tornado on May 5, Greensburg, Kan. was a self-sufficient rural town, owning and operating its own power plant and hospital. With safe streets, this town was quiet and peaceful. At the time of the tornado Greensburg s population was approximately 1,400. The National Weather Service estimates it took less than 10 minutes for the tornado to pass through the length of the town. All but one of the town s 11 local churches was destroyed. The single-screen movie theater and soda shop are gone. The police and fire department and the hospital are wiped out. The school was ripped apart and the town s sole stoplight was no longer standing. Bassam Maalouf, MD, and Nizar Kibar, MD, are on the staff at Kiowa County Hospital in Greensburg, Kan. On the night the tornado hit, Maalouf, a graduate of the internal medicine program at the University of Kansas School of Medicine-Wichita, was taking shelter in his friend s basement with his wife. His personal account follows: Our home does not have a basement, so my wife and I went to Nizar s place to take shelter. Nizar was in Wichita that night, so we joined his parents who were staying at his house. Nizar s dad refused to stay in the basement and we couldn t convince him otherwise, so he was up in the bedroom during the storm. When we lost electricity and phone service, we knew it was getting worse outside. I remember 15 to 20 minutes of hail. Then we heard terrible winds. Four minutes later we heard a crash and we started getting debris down in the basement, this continued for about 10 to 15 minutes. Water was leaking all over the basement. I felt our lives were in danger. It finally started to get calm and the tornado had passed. It took us awhile to create a small clearing so we could get out of the basement. We were fine, my wife, Nizar s mom, and me. I was worried about Nizar s dad upstairs. As we made our way out of the basement we realized the house was pretty much gone, and so was everything around it. We couldn t find Nizar s dad, I started looking for him. Finally, I heard his voice. The house had fallen in on him, and he had multiple wounds, some reaching the muscle. He was unable to walk, so I tried to carry him. When that wasn t working, I went to find a car. My car which had been parked in the garage, was no longer there (we found it the next day, two blocks away on a tree). I found a man with a car who was willing to help. We put Nizar s father in the car and took him to the hospital. The hospital was hardly accessible and was severely damaged and the clinic was in poor condition. There were some walls standing, but not much to recover. The hospital s patients and staff were safe in the basement. One of the ambulances was damaged. We were able to find some gauze and wraps and I did first aid on Nizar s father s wounds. We were able to stop the bleeding but I knew he might have fractures, and he needed care at a functioning hospital. While at the hospital we made a plan with EMS to start moving injured people to the Dillon s grocery store area near the highway and start triage. I took Nizar s dad to Dillon s and he was eventually transferred to Wichita. Ambulances from all surrounding counties came to help. While still at the Dillon s parking lot, two people were pronounced dead and there were two who were severely injured. One of them I had to intubate and transfer quickly. We saw a lot of minor injuries and transferred some of those with the minor injuries to surrounding hospitals. Later we were able to evacuate the hospital patients and started taking people to shelters. My wife stayed at the hospital shelter. I toured with firemen and EMS checking for people who were hurt and trapped in rubble. Continued on page 16 15

16 Greensburg continued from page 15 Later, I called Nazir and told him about his dad. He had a foot fracture and multiple wounds but no major injury. Isn t that a miracle? Currently, Maalouf works from an outreach clinic in Haviland, about 30 miles outside of Greensburg, and at Kiowa County Hospital in Greensburg. Since the storm, The Kiowa County Hospital is set up like a military hospital, made up of tents, now located on highway 54. Even though they have an emergency room, patients are not being admitted. Maalouf said they do have an X-ray area. Conditions are totally different and it is harder in the tent hospital. When there are storms it makes things more difficult, said Maalouf. But things are gradually getting better; we have four trailers by the hospital as well. According to Maalouf, the current plan is to start rebuilding Kiowa County Hospital as soon as possible, though it may be a year or two before it is operating. I want to share that every survivor from Greensburg has a story to tell, he said. The people in Greensburg are going to stick together and rebuild their town. He added that Greensburg residents appreciate all the help and concern they have received. On the same night of the tornado, Brenda Watson, RN, BSN, CCM and CNE coordinator with the KU Area 16 Kansas c o n n e c t i o n s Health Education Center (AHEC) Southwest, was on her way home from a meeting in Wichita when she was stopped in Haviland by police keeping drivers from going any further because of the tornado. After 45 minutes had passed, Watson went to talk to a police The Kiowa County Hospital, Greensburg, Kan., is set up like a military hospital, made up of tents. The people in Greensburg are going to stick together and rebuild their town. Bassam Maalouf, MD Kiowa County Hospital, Greensburg, Kan. officer and identified herself as a nurse. After receiving the okay from the officer, Watson headed into Greensburg to help. About an hour after the tornado hit, Watson was in the Dillon s parking lot that Maalouf had helped designate as the triage area. At that point, Watson was the only medical responder at the Dillon s site since Maalouf was looking for survivors with rescue teams. She mostly cared for cuts and scrapes. After the first few hours a physician from Jetmore arrived to help, and Greensburg residents were being cared for quickly. I learned so much about the people of Greensburg. They are not selfish, they were more concerned about others in the town, said Watson. When I offered them help they would say, I m fine, go check on this or that person. Watson went on to share how the people of the town were so in shock that they weren t worried about their own health. After working throughout the night, Watson was able to head back to Garden City around 6 a.m. She mentioned that, in the end, it is all about the people of Greensburg, not what she did to help. Back in Garden City, Glenda Owens, manager for KU AHEC Southwest and national disaster first responder with the American Red Cross, was waiting to go into Greensburg with the Red Cross the next day. Owens assisted at the Mullinville, Kan. shelter, located approximately 30 miles outside of Greensburg, where she assessed the mental health needs of the displaced Greensburg residents staying at the shelter. Since her first response, Owens has been back to Greensburg several times to help some of her family members who live there. By May 11, the streets were cleared out so residents could get in, find their homes and go through their things, she said. The people there aren t looking for handouts; they are more concerned with their friends, neighbors and families. She went on to add that although some residents are still in shock, they are strong and have a sense of survival, not devastation. She plans to continue to help in the town where she can, believing the people of Greensburg are prepared and will rebuild their town. The rural towns surrounding Greensburg are at full capacity, rental property and hotels are being used by displaced residents. People are waiting, as buildings are going up and framing has begun on several buildings.

17 Rural Physician s Work-Life Balance Finding a work-life balance in today s frenetically-paced world is no simple task. Add to that the pressures and challenges that come along with being a rural health care provider and it can be complicated. For some, spending more time at work than home could mean missing out on a rewarding personal life. Ryan Williams, MD, family physician, Great Bend, Kan., has a demanding medical practice and he and his wife have four children. As a busy rural physician Williams manages to strike a healthy work-life balance and shares how he has developed his strategy. I think it has something to do with where you practice. I m not in a solo practice so I have other doctors around, plus I try to keep my priorities straight, he said. That is the biggest part. My wife is very helpful in keeping me up to date with family issues and letting me know if I need to be home for something. Williams points out that physicians just starting out usually stay in the business climate where they originally began for quite some time which is why it s important to choose carefully. Make life balance a priority, Williams suggests. Evaluate work and personal life expectations before choosing where to establish a career. Be up front with what you want and understand what the employer expects, set out what kind of time restraints you are willing to live with. Williams reiterated the importance of knowing what you want when choosing an employer, insuring their priorities match your own. Larry Long, Ph.D., senior director, psychologist, student counseling and education support services, University of Kansas Medical Center, notes that rural physicians have a greater challenge since it is more difficult to manage their private life. They get tagged for medical consults outside of work, for example at the local grocery store, said Long. Physicians adopt a lifestyle in medical school that carries into their practice, Ryan Williams, MD, is a family physician and a family man in Great Bend, Kan. where work rules and owns their time. He adds that physicians have to tweak their personal life, like relationships or spirituality, to fit into the balance. Williams can identify his priorities that define his balance, Faith, family, career. He stresses that he is not in his practice alone, which allows freedom for his priorities. Between him and his partner Marta Edmonds, MD, they are able to cover for one another, allowing for time off. I have the freedom to take vacation or to be available for a family event without feeling guilty for it, Williams shared on his ability to do what is important to him. At the same time I am able to fill in at work when my partner needs it. Since Long understands the challenges facing physicians, he offers suggestions on creating a healthy work-life balance. One thing he suggests is to find a brief time during the day to meditate or relax. Don t try to be perfect or feel like you have to do everything, and create a list of priorities, Long added. Try to develop a wide variety of resources for enjoyment, whether it is family, friends, hobbies, interests or vacations. Long emphasizes the importance of being assertive, learning to express needs and differences and making requests. It is important to learn to say no constructively. Another key strategy in finding a good work-life balance is to avoid people who are negaholics, those with a negative outlook, while looking for emotional support through peers, a spouse, friends and family. Long said that finding humor is a great coping strategy as well, try to find something funny in a difficult situation. As a physician with a good handle on a healthy work-life balance, Williams suggests regularly re-evaluating priorities, Sit down and make a list of things that are important in your life. He adds if you love working out and need to do that every day to feel good, make sure wherever you work, you can accommodate your life priorities. He also proposes making a set list and sticking to it, since work can slowly take over and it just sort of happens to you, he said. Be proactive in thinking about those decisions. 17

18 Edward Ellerbeck, MD 18 Kansas c o n n e c t i o n s KanQuit, Research on Rural Smoking Cessation Research covering smoking cessation is necessary for learning more about how to treat the problem. Nearly one-in-four U.S. adults are currently smokers, and of those, adults in rural counties are more apt to smoke than their urban counterparts. Two factors possibly contribute to a higher incidence of smoking among rural residents. Typically the factors include a lack of smoking restrictions and fewer anti-smoking campaigns in rural areas. In addition, there is less access to services, and less available cessation resources, and often those in rural areas face economic burdens that do not allow them to pay for special services. One University of Kansas Medical Center, School of Medicine physician, Edward Ellerbeck, MD, MPH, interim chair of the Department of Preventive Medicine and Public Health and associate professor of internal medicine, initiated KanQuit in the summer of A five-year grant-funded project, Kan- Quit is a cessation project that looks at nicotine addiction as a chronic illness requiring comprehensive disease management. While many studies have sought to determine which smoking interventions are most effective in medical office settings, Ellerbeck s research aims to help a smoker access smoking cessation programs in addition to receiving help from their primary care physician. The primary outcome of the study is abstinence from cigarettes after two years of enrolling in the program, Ellerbeck said. If this type of smoking cessation intervention is successful, it gives us a model that could improve long-term disease management for rural Kansans. Laura Mussulman, project director, preventative medicine at the University of Kansas Medical Center, School of Medicine, explains the importance and strategy of the research which is in its fourth year. This research is the first of its kind, Mussulman stated. We are looking at treating smoking like other chronic diseases that take continuous care over a period of time. Smokers often relapse. Ellerbeck s research focuses on treating smokers over a two-year period with continual support. According to Mussulman, this research is trying to provide unique specialty care from afar everything is done over the phone or through mail. The KanQuit program is a two-year effort on the part of the research participants. Rural smokers who participate in KanQuit are placed in one of the three test groups. Each group receives a different level of personal involvement in their smoking cessation. The KanQuit participants programs vary from one to six phone counseling sessions over a six month period, free medication and educational materials which are sent by mail. Every six months the cycle starts over and the program continues on for two years. It is tough because rural smokers have less access and less care for smoking cessation, said Mussulman. Our research aims to help rural smokers with specialty smoking cessation, something they wouldn t otherwise have access to. There are 50 rural

19 Your Future Awaits Resident physicians and medical, nursing, and allied health students Mark your calendars to attend Kansas Career Opportunities Visit with representatives from over 20 rural communities Explore rural practice opportunities Learn about rural living Win prizes Free lunch Spouses welcome to attend KU Medical Center, Kansas City Oct. 18, 2007 KU School of Medicine - Wichita Oct. 25, 2007 Registration Kansas City call (913) Wichita call (316) or online health care clinics that are participating in the research, along with 80 physicians, nurse practitioners and physician assistants, and 750 rural Kansans who smoke. In the meantime, while the research continues, there are some actions a rural family physician can do to help patients with their battle to quit smoking. The Kansas Tobacco Quit Line, hosted by the Kansas Department of Health and Environment (KDHE) is available for every Kansan. The smoker s family physician can send a fax referral for their patient to the KDHE, and the KDHE will then contact the patient and help them directly. According to Mussulman, 70 percent of smokers want to quit and are interested in a smoking cessation program. Through the research so far, they found that rural patients see their primary care physician often, giving a rural physician many opportunities to intervene. During the study we have been hearing that patients believe their family physicians can help them quit smoking, stated Mussulman. A physician can start by asking if the patient is interested in quitting, and remind them to set a quit date. Physician Reminder: 5 A s of Smoking Cessation 1. Ask, Do you smoke? 2. Advise every smoker to stop. 3. Assess the patient s readiness to quit. 4. Assist patients, whether they re ready to quit or not. 5. Arrange a follow-up, and discuss the subject of smoking at every subsequent visit. 19