"We always need more doctors," said Earl Whiteley, CEO of Jenkins County Medical Center in Millen. "A lot of the primary care doctors that have been holding the fort in these small communities are now at the age of retirement."

A plan by the Medical College of Georgia, part of Augusta University, to send more new doctors to underserved, rural counties has executives of some hospitals in the area interested. MCG intends to shorten medical school by one year and make it tuition-free for up to 50 new physicians each year who fulfill a commitment to complete their post-graduate residencies in Georgia and then serve at least six years in underserved, rural Georgia counties.

Physicians in rural communities have faced "many years of reimbursement cuts and other aspects of having to live up to government regulations," Whiteley said. One federal mandate requires the meaningful use of electronic medical records, and he said that many older physicians have found changing their practices to comply very frustrating.

"So consequently, we have a shortage of doctors and will continue to have a shortage of doctors, and anything that these universities can do to bring more doctors to the rural markets, especially in Georgia and the southeast part of the country, would be a great thing," Whiteley said.

Keel pushing plan

Currently, about 75 percent of the new doctors graduating from the five medical schools in Georgia go to other states for their residencies. Where new physicians complete their residency then becomes the largest factor in deciding where they will practice, so most do not return home, Augusta University President Brooks Keel, Ph.D., said in an interview in Statesboro last week.

He is seeking support from state lawmakers and the public for the Medical College of Georgia's plan to place newly educated physicians in rural communities in Georgia and eliminate much of their student debt load. Even at MCG, which has the lowest tuition for in-state students of any medical school in Georgia, student loan debt averages $150,000 to $200,000 by the time a new physician graduates, Keel said.

Details of MCG's plan, which includes reducing medical school from four years to three years for program participants, were included in a story published in Tuesday's edition and still available online at www.statesboroherald.com.

The program has an estimated one-time, five-year startup cost of $15 million, plus a continuing cost of about $5 million a year in forgiven tuition.

So far, Augusta University has been allotted $500,000 for continued planning in this year's state budget, and Keel said Gov. Brian Kemp has been "tremendously supportive." Philanthropic and corporate support will also be sought, said Keel, who suggested that communities will need "buy-in," such as providing a building for a medical practice or having a car dealership furnish a car for a new doctor.

"That's always a controversial issue, especially with economic development," Whiteley said when asked about this type of local backing. "You know they want to support the hospital, so in many cases if they could lure a doctor to stay, say, six years, 10 years for a full pay-out, I'm sure you'd get some support."

Hospital a survivor

Jenkins County Medical Center, a for-profit, 25-bed critical access hospital in a county with about 8,700 people, has changed ownership twice in a little over two years.

Through the beginning of 2017 it was owned by Optim Health System, which announced it would close the hospital it called Optim Medical Center-Jenkins and consolidate it with Optim Medical Center-Screven in Sylvania. But GA Medical Holdings Corp LLC bought the Millen hospital in mid-2017 and kept it open, then sold it this summer to Sedzer Health LLC.

Jenkins County Medical Center has just finished $1 million worth of construction to open an additional 10 beds as a "senior behavioral health," or geriatric psychiatry, unit, Whiteley noted.

The hospital has three affiliated physicians — two primary-care doctors and a general surgeon — treating patients.

Evans Memorial

Evans Memorial Hospital in Claxton is licensed for 49 beds, but staffs for only 20, with 10 of those being regular in-patient medical beds and the other 10 geriatric behavioral health beds. It is a regular-access, not-for-profit hospital operated under a public authority established for Evans County, which has about 10,700 people.

"We definitely have had issues in the past and continue to have those with recruitment of physicians to such a small area, and there are several reasons, you know," said Evans Memorial Hospital CEO Nikki NeSmith. "They are hesitant, unless they're from this area, about coming here just from the population of the county and just wondering if they're going to be busy enough in order to keep a practice open."

Small, rural hospitals also don't have as much to offer, "even monetarily," as some of the larger hospitals, she noted.

So a plan such as MCG's "would be an incentive for them to come to these rural areas, whether it be student loan reimbursement or however they structure that program," NeSmith said. "I think it would be great. It would definitely help us out."

The medical school's plan proposes to eliminate tuition for MCG-educated doctors who fulfill the in-state residency and six-year rural service commitments. NeSmith related it to the federal Nurse Corps Loan Repayment Program, which is different in that it provides loan forgiveness and communities qualify based on a Health Professional Shortage Area score and not by county population.

Some nurse practitioners have worked in Claxton while in this program. Those with no prior connections to the area tend to leave after their up to three years of qualifying service are done, NeSmith said.

"But it did help out during that period of time," she said. "So if it would be anything like that, we would definitely be interested in participating and learning more about it."

Two primary-care physicians with practices in Claxton are affiliated with Evans Memorial, and the hospital has for years directly employed one general surgeon, Dr. Kyle Parks. Evans Memorial has now hired a second general surgeon, Dr. Rebecca Spahos of Statesboro, who will be joining Parks at EMH Sept. 9, as the hospital seeks to add to its available surgical services, NeSmith said.

Herald reporter Al Hackle may be reached at (912) 489-9458.