Children’s Mercy hiring specialists ‘right now’ to work in Queen City

Dr. Robert W. Steele: The priority in physician hires is to provide care to children now.

John Myers: Mercy Springfield Communities has the bricks and mortar needed to support more pediatric services.

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In cooperation with Mercy Springfield Communities, Children’s Mercy Kansas City is now hiring pediatric physician specialists to live and work in Springfield.

“We can and are doing that immediately,” said Dr. Robert W. Steele, executive vice president and chief strategy and innovation officer at CMKC. “We are recruiting physicians right now – we have interested physicians ready to go right now.”

CMKC is a separate entity from Mercy Springfield Communities, and the two organizations in March announced a collaboration to expand access to pediatric medical care in southwest Missouri. That announcement ended plans unveiled just four months earlier for a collaboration between Mercy Springfield Communities and CoxHealth, Springfield’s two largest employers, to join forces in building a pediatric hospital.

At a July 10 information session titled Discover Children’s Mercy, representatives of CMKC introduced themselves to Springfield stakeholders.

In an interview during the event, Steele said the most important consideration is caring for children.

“What’s important is to get pediatric specialists in town seeing patients,” he said. “To elevate the access to care, you’ve got to have two things – you’ve got to have inpatient and you’ve got to have outpatient. To do that, you just need a space – and that can be done immediately, which is what we’re doing – we’re hiring physicians.”

Steele himself previously operated a pediatric physician practice locally and served as president of Mercy Hospital Springfield in 2013-14. He said Mercy Springfield Communities is making it possible for CMKC to recruit and hire physicians for both inpatient and outpatient work because it is willing to give them space.

“What we’re talking about is identifying and recruiting physicians for gaps in care that are here,” Steele said. “Pediatric surgery is an immediate one. Endocrinology is another. Our list is actually fairly long.”

Pediatric challenges
Steele explained that delivery of pediatric care is expensive, and there are not many specialists. For those who are coming out of training now, he said, the challenge is to recruit them to be the only one in their specialty in town.

“What they want is a group, because they want to have a life, too, right? They don’t want to be on call 24/7,” he said. “What we can offer is the ability to bring in enough specialists so that we have a presence here in Springfield but are supplemented in care in one way or another with the specialists we already have, whether that’s bringing physicians down here to help cover them or through telehealth.”

The ultimate goal is to have all of the physicians in Springfield, he said.

“What we can do is give them bandwidth. They can be here and they can still get a vacation,” he said. “It’s sort of the best of both worlds. That’s what we’re going to do immediately.”

Steele noted there are multiple options for a more permanent solution, and they range from the pediatric hospital idea to a hospital-in-hospital solution that would place CMKC inside of Mercy Hospital Springfield. Hiring doctors and getting them to work immediately bypasses some of the regulatory challenges of a longer-term solution, he said.

“It’s prioritizing speed,” he said. “Every solution has its own pluses and minuses when it comes to operational challenges, and there are financial challenges, too, that all go into a gemish. What makes the most sense to be able to deliver care to all children of southwest Missouri? We’re just feeling that out.”

It may seem that Springfield and southwest Missouri, with two large hospital systems, would not have the gap that has been identified, Steele said, acknowledging that the city’s biggest industry is health care.

“The challenge is that nationally, only 15% of the health care dollar goes to pediatrics. Because of that, it’s hard to invest in pediatrics,” he said. “It’s very hard for large, what I call adult-based health systems to invest in pediatrics because the economics just don’t work out.”

Some hospitals are getting out of pediatric care entirely, he said.

“There are many, many systems that are actually divesting of pediatrics completely,” he said. “That’s why we’re beginning to expand out into a larger region because we’re seeing hospitals just go, you know what? We can’t do pediatrics anymore.”

Steele said a CMKC study shows that 36% of children in southwest Missouri leave the region to obtain inpatient care.

Prioritizing local needs
John Myers, president of Mercy Springfield Communities, said the CMKC approach to health care prioritizes local needs by listening to what local people have to say.

“They really assess the needs of the community and what services they need to bring here,” Myers said. “They really look at the community and build around us.”

Myers said subspecialty coverage is lacking in some areas.

“That’s why this Children’s Mercy collaboration is so important, because they can help build up the provider capacity to match what we can already offer,” he said.

He added that CMKC has been expending a lot of effort for months, and they are excited to be here.

“We will have physicians coming to Springfield shortly with different kinds of specialists and different kinds of hospital providers, and it’s building up our capacity and offering specialty coverage that either, one, doesn’t exist or, two, we just need more of,” he said.

Myers added that Mercy Springfield Communities has the physical capacity to handle the influx of physicians.

“The bricks and mortar are here,” he said, noting Mercy has a pediatric medical/surgical unit, intensive care unit, neonatal intensive care and ambulatory clinics. “They’re going to bring the physicians to make sure we take advantage of that capacity.”

Cardiology practice acquired
One example of CMKC’s quick approach to physician hires is in its acquisition of professionals from a practice, Pediatrix Cardiology of Springfield, that was already operating in town but that learned its national ownership would be closing all of its outpatient clinics.

“What do those cardiologists do? They either have to get acquired by somebody or they have to then invest in their own practice,” Steele said. “They were essentially looking at shutting down, so that’s when they reached out. We just said we can’t lose pediatric cardiology in town. That would be horrible. That just means more kids leaving southwest Missouri.”

Dr. Frederick Emge of Pediatrix noted the ink is barely dry on his agreement with CMKC. He said when he learned in a meeting that Pediatrix would be closing the practice within 90 days, he got on the phone with the head of cardiology at CMKC.

“They were down in two days to meet with us, and we had a serious discussion,” he said. “It quickly evolved that there was a distinct value in our practice – we’ve been here for 35 years now.”

Emge said the practice serves 53 counties, extending into Oklahoma and Kansas.

“It’s just a huge geography, and we’re the primary pediatric cardiology provider,” he said. “This is preventing us from closing our doors because we’re the only rural pediatric cardiology practice that pediatrics have.”

Had the practice disappeared, Emge said, the area would have lost two echo techs with 50 years of combined experience. As a result of the agreement with CMKC, cardiology services can continue to grow.

Emge said one problem that exists in Springfield with its two large hospital systems is what he calls the balkanization of medical services.

“Some of the specialists at one hospital don’t even know specialists at the other place, which is, you know, odd,” he said.

Because of this, local specialists have missed out on an opportunity to provide cross-coverage for one another, creating the need for physicians to be on constant call, Emge said.

“Business decisions got in the way of good patient care,” he said. “I mean, we’re not unique – that happens every place.”

Emge said he is hopeful that the hospital collaboration will help to solve some of the problems that exist with pediatric care locally.

Eliminating stress
Katie Towns, director of the Springfield-Greene County Health Department, was on hand as an observer at the Discover Children’s Mercy event.

“In our community, one of the things that we are very cognizant of in terms of public health is just the need for attention and resources for the pediatric population here,” she said. “Any sort of additional capacity in our community to serve kids and their families is a good thing.”

Towns said anecdotally, there is evidence of the need for additional pediatric resources, with many families having to drive three or four hours for care.

“Eliminating that just helps people be able to create less stress in their lives and to focus on the needs of the child, and that alleviates a lot of the stress in situations like that,” she said.