Morgan Murray is too young to have any idea who Doogie Howser is, but the 16-year-old from Shawnee is cut from a cloth similar to the prodigy doctor in the '90s TV show.
Even while finishing high school and getting a jump on college, Murray finds time to be flown across the country several times a year to help teach doctors twice her age how to perform challenging tracheal intubations, a procedure to get oxygen to patients with blocked airways.
"It's a very high-stress, very time-oriented procedure," said Murray. "I am helping teach the doctors how to intubate using high-fidelity simulators. I act as their nurse, getting them anything they need. Then I help debrief and tell them what they can do better."
Murray came into the teaching opportunity while sitting in on classes, which were taught by her mother. Two years ago, the instructor in the nurse role was out sick, and Murray seized the opportunity to fill in.
Now Murray is seizing another opportunity to get a jump on her career at the Kansas Academy of Mathematics and Science.
The two-year program is a sort of fast-track boarding school at Fort Hays State University. Each year, up to 40 high school juniors from across the state move into a campus dorm and complete their last two years of high school coursework while also taking college math and science courses.
Murray said that the academy — often called KAMS by students — provides an environment where staff and other students drive each other to set goals high.
"I've been wanting to pursue medicine since I was in third grade," Murray said. "KAMS has pushed me to do even more than I thought I could. I've done more in this semester than I thought was even possible."
Plugging the brain drain
Murray is one of 68 students currently enrolled in the academy. Another 53 students have graduated from KAMS since the first class in 2009.
The Kansas Legislature founded KAMS in 2006, in part to give students like Murray a learning opportunity in Kansas that would challenge the state's most talented students, said director Ron Keller.
"The academy was formed to keep the students here in the state — to keep intellectual capital from leaving Kansas, to keep from losing our best and brightest kids," Keller said.
Practicing medicine on the frontier in Kansas doesn't have a whole lot in common with big city medicine — so why would small town hospitals use big city physician recruiters?
Kiley Floyd said it's clear to her now that they shouldn't, but the chief executive of Osborne County Memorial Hospital learned the hard way.
"Small rural hospitals are not the same as large tertiary hospitals. Requirements of docs are different, the relationship with staff is different, the patients are different. When you're using a large recruiting firm, I learned the hard way that they don't get that. They're in it to make money," Floyd said. "We needed a good match."
The last time she used a national recruiting firm, it took two years to fill a family practice physician vacancy — and that's all the longer the doctor stayed at her north-central Kansas critical access hospital.
"The doc was not a match at all. He looked good on paper, he was a great interview, but he was not a match. He lasted a couple years," Floyd said. "He was a city guy. He'd never lived in a rural community. He thought he wanted to, but when it came down to it, he did not."
Overall her experience recruiting has been time-consuming and expensive.
"We've hired recruiters, we've done contingency firms, we tried it on our own. We've kind of run the gamut," she said. "My experience was terrible previous to Sunflower."
Things are different now.
To fill the last two openings at her hospital, Floyd has enlisted the physician recruiter from the Sunflower Health Network.
The network — one of a dozen in Kansas — consists of 15 critical access hospitals that share services, pool resources and refer patients to a common hub, Salina Regional Health Center. Salina Regional first began contracting out its internal recruiter to network members in 2009.
Floyd decided to give the new recruiting service a shot, and said that in about three months she had filled the position at a third of the cost of the previous, failed effort.
"And it was a good match," Floyd said of the recruit, Dr. Dorothy Breault.
In February, the recruiter began working full time for the Sunflower network. In the last three years, eight openings at member hospitals have been filled and three more are in contract negotiations to start in 2013, said the network's executive director, Heather Fuller.
"This is a service our members wanted," Fuller said. "It's just so expensive for hospitals, especially critical access hospitals, to do on their own. It made sense to look at it from a group standpoint. It's something they all need at one point or another."
The financial toll of untreated mental illness in Kansas is $1.17 billion annually, according to new research released today by the Health Care Foundation of Greater Kansas City.
In the KC metro area, the cost is $624 million per year — about $287 million of which is also included in the statewide Kansas tally.
About one in 10 adults in Kansas and Kansas City has at least one of the serious mental illnesses considered in the research: major depression, anxiety disorder, schizophrenia and bipolar disorder, said Jessica Hembree, the foundation's policy officer. About 40 percent of those go untreated, she said.
The financial consequences of untreated mental illness is spread across the economy, according to the research, but the lion's share was shouldered by individuals and employers.
Hurting the bottom line
"We were surprised by how many of those costs are borne by individuals and by private employers," Hembree said. "I think it's a wake up call to the business community that the lack of funding for mental health is affecting the bottom line of businesses just as much as the pocketbooks of taxpayers. The costs are showing up in the places we don't want them to show up, which is job development and business creation."
The study reinforced what advocates have been telling the Legislature for a number of years, said Rick Cagan, executive director with Kansas Chapter of the National Alliance on Mental Illness.
"You can cut funding for mental health centers — and (legislators) have substantially over the last four or five years — but you can't make these people go away," Cagan said. "These are life-long chronic illnesses and they need treatment. They're going to show up as a cost on somebody's ledger."
Kansas spending for mental health services dropped by more than $14 million — or 16.4 percent — between fiscal years 2009 and 2012, according to a recent report by the national NAMI organization. Only six states made steeper cuts during that same period.
→ Continue reading and download full report at khi.org.
State hospitals for the mentally ill and the developmentally disabled have not replaced many employees who’ve quit or accepted Gov. Sam Brownback’s invitation to take early retirement.
At the same time, the number of patients at the hospitals has remained flat or increased.
That means fewer workers caring for more patients.
The governor’s budget proposal for the coming fiscal year would allow for 2,298 full-time positions at the five state hospitals, or 311 fewer slots than there were in fiscal 2011 and about 100 fewer than the current fiscal year.
Democratic members of the House Appropriations Committee said this week that the reduced hospital workforce was causing problems.
“At Osawatomie State Hospital we have 55 fewer FTE’s (full-time equivalent employees) than we had in the fiscal 2011 budget and we’re running over (patient) capacity,” said Rep. Bill Feuerborn of Garnett, the committee’s ranking Democrat.
Feuerborn said 13 employees at Osawatomie took the administration’s offer of early retirement. Only three of those positions were refilled. The additional vacancies occurred from people quitting or otherwise leaving the hospital’s roster.
Feuerborn’s district includes Osawatomie State Hospital, the largest of the state’s three hospitals for the mentally ill.
The committee, dominated by Republicans, debated four of the five state hospitals’ budgets on Monday, approving all four in line with the governor’s spending recommendations.
“I’m hearing from several employees who are concerned about safety issues and mandatory overtime,” Feuerborn said. “They work eight hours and then they’re told they mandatorily have to work another eight hours. But they’re not paid overtime. They’re given comp time that they have to be given permission to use.”
Feuerborn told KHI News Service he thought the arrangement might be a violation of labor laws.
“These are people who are working under a lot of stress,” he said.
Officials at the Kansas Department of Social and Rehabilitation Services said it was legal to require employees to work double shifts.
Feuerborn also said the other state hospitals were not replacing employees who had been fired or quit.
“We have 58 fewer employees at Parsons State Hospital than we did two years ago,” Feuerborn said.
The hospitals are under the broad supervision of SRS, but the individual hospital superintendents manage each somewhat differently.
Parsons State Hospital, for example, has reported that its overtime costs increased 139 percent in the current fiscal year, which began July 1, 2011.
Budget documents provided to legislators also showed Kansas Neurological Institute in Topeka losing 16 full-time positions in the proposed budget for fiscal 2013.
KNI and Parsons State Hospital care for people with severe developmental disabilities.
“Across the board, about a hundred positions at the state hospitals have been lost” in the past year, said Rep. Jerry Henry, a Cummings Democrat.
Henry, echoing concerns he said he heard from hospital workers, said the facilities were “OK when nobody’s sick or on vacation, or there’s a holiday. But when somebody is sick or on vacation or there’s a holiday, we’re in trouble.”
→ Continue reading at khi.org.