How Mercy And LECOM Build A Rural Physician Pipeline

Rural healthcare doesn’t fail all at once. It slips when communities can’t recruit physicians, when training happens far away, and when young people who want to serve at home don’t see a clear path into medicine. We sit down with Mercy Jefferson President Dan Eckenfels and Dr. Karthik Iyer to talk through a practical solution: building a local medical education pipeline through a Mercy and LECOM partnership that’s designed to strengthen care in Jefferson County and across rural Missouri.

We get specific about the “why” behind hosting medical students at a community hospital and how teaching improves patient care by keeping clinicians sharp, curious, and current. We also unpack why LECOM is the right fit for Mercy’s not-for-profit, faith-based mission, and how selecting the right school shapes the kind of physicians a region can grow. You’ll hear what students actually do during third- and fourth-year clinical rotations, how mentoring works, and why primary care focused residency programs like family medicine and internal medicine matter so much for local access.

We also talk about confidence and cost barriers that keep talented students from even trying, plus how research, case reports, and quality improvement projects help learners build real skills and contribute ideas that can make hospitals more effective. If you care about rural health, medical education, physician shortages, or creating opportunities for local students, this conversation lays out the long game and the steps that start today. Subscribe, share this with a student or parent, and leave a review with the biggest healthcare need you see in your community.

Transcript

SPEAKER_00 0:01

I'm David Hagg, Superintendent of Jefferson R7th School District, just outside of Festus, Missouri, and I'm joined by Mercy Jefferson President Dan Eckenfels and Dr. Karthik Iyer, the Chief Medical Officer, and also the regional dean for LECOM. Thank you for joining me.

SPEAKER_02 0:17

Thank you for having us.

The Rural Doctor Shortage Problem

SPEAKER_00 0:18

We're going to talk specifically about the investment of Mercy with the collaboration with LeeCom as far as services in our county and the region, greater region as well. So, what is the vision or concept of the LECOM program that you see benefits those the situation we have here?

SPEAKER_01 0:37

That's a great question. This really started with discussions really years ago of as we looked at healthcare in our communities and really the rural communities that we serve. It become more and more difficult to recruit new physicians into our community to find folks who are interested in serving in these geographic areas. Quite often, uh folks will go to a residency program in an urban setting. That's where most residency programs are. And so they end up staying in an urban setting, which made it difficult for us to recruit folks in. Is your typical physician that a lot of us got used to growing up, who were the hometown physician, they don't exist as much anymore. And so we were losing those folks. So our discussion became well, could we create a residency program here that would that would be local? That was the first question to ourselves, which I wondered if what would be possible or not with the group that we have uh down here at Jefferson. Uh, but thanks to Dr. Iyer and all the work that he put in over the years, really leading up to this potential, uh, we got enthusiasm uh out of our medical staff. So that that was that was a key factor. Uh and so what we wanted to do is be able to create a program where we could work with local schools, high schools, and say, is there an opportunity where someone could go to a local high school, go away to a college somewhere, or a local college if we could get to that point, and then come back here to do their training in the residency program. This came to fruition through relationships that were built up over time. So uh previous uh president at Mercy Jefferson, Eric Ammons, had a relationship with a doctor, Dr. Jolly, uh, who was affiliated with Lead Comp uh in its Florida location, and they made the introduction. We got to go up and meet uh Dr. O'Wayne, uh, you would see on another podcast, had a great uh discussion with him, and kind of we learned what the opportunity could be uh for a community like Jefferson. And it really matched what we wanted to try to accomplish, which the key is to be able to offer an opportunity to local students and create the win for all those communities so that those local students could one day, some of them, come back and practice in those locations. And uh therefore we wouldn't create uh physician deserts, uh, if you will. And we'd be able to care for our communities going into the future.

Why Mercy Trains Students Locally

SPEAKER_00 2:44

I think this is a broader vision of Mercy than just the Jefferson location. Um, growing having grown up in Southeast Missouri and still having ties there, I know the struggles in medical care, or at least have been made aware of them. Um and you also have a connection with Mercy Southeast and Cape Girardeau. So, really, this is kind of a broad view of Mercy Jefferson, or I'm sorry, the uh Mercy in general to connect to rural care and connect those students into a um really an early entry program and provide that guidance all the way through. So I guess at the end of the day, what's the advantage or why did Mercy Jefferson or Mercy Southeast want to host medical students?

SPEAKER_02 3:23

I can take that off. So training the next generation of uh physicians right here at home uh basically addresses some of the problems Dan just highlighted. I mean, challenges with recruitment, a lot of turnover. I mean uh bringing students in uh I mean uh it keeps everyone on their tools. They I mean you have to constantly stay in touch with medicine to actually educate the students. And um I mean this has been great because as part of uh some of our recent recruitment success uh has has pretty much been thanks to uh the LeeCom affiliation as well. So um so I feel this is a great opportunity to to bring students in because education is a part of patient care. So uh so we want to make the best of this opportunity.

SPEAKER_00 4:17

And so al alongside that, this is this correct me if I'm wrong, this is the second year of the cohorts for Mercy Jefferson, and I believe the Cape Girardeau uh Southeast has their first section going through now, so it's kind of stair stepping in, correct?

SPEAKER_02 4:31

Correct. So in in many ways, we we've kind of taken the lead, like as in uh we started a year earlier. Sure. And uh our our cohort currently is uh slightly larger than theirs. Uh but s slowly they are going to ramp up to be where they need to be. Oh, absolutely. So uh so obviously uh we we are going off of a lot of our own personal experience. Uh you know, no process is perfect. So uh so at least whatever challenges we might see, we can tweak them for uh for Mercy Southeast.

SPEAKER_00 5:03

Just make that path a little smoother. And really the investment here is kind of twofold. I as as I see it as superintendent of schools. You know, my job, I believe, at the end of the day is to get kids where they want to go and where they want to be. And so you're not only creating an opportunity for an early entry program, and if you would check into the other videos too, if you're interested in this, more interested as a student in this process to learn about that program, there's a lot of upside for it, including costs, uh no MCATs, but also a very rigorous program all the way through. But really at the end of the day, through these uh partnerships and having the students come back to do their I'll call them internships here, their their residencies, um, is to hopefully have a group of those stay in the communities.

SPEAKER_02 5:45

Sure. The evidence uh is out there that when um when you actually have learners, and I'll just include uh students as well as residents, uh when when you actually stay in a community for for at least five years, five plus years, you are more likely uh to have a bond with the community and practice there. So uh I mean uh there are many societies that put out uh all uh this evidence which clearly suggests that uh if we invested uh in uh in what we are doing right now with LeeCom and uh the whole Mercy partnership that we have, I I think it'll be it'll be great. I mean, we are looking at something eight to ten years from now. I mean, right now, as uh one of our other speakers mentioned, they are coming from all over the country. But uh in the future, especially with the early acceptance program, we we hope to have uh more kids from our own community.

Why Mercy Chose LECOM

SPEAKER_00 6:46

And so um it is the long game. This isn't something that's gonna happen overnight, and it's a process that we're starting today that some of us may not be in positions when this starts to, you know, like myself, I'll probably be retired in 10 years from this. But uh hopefully the fruits of that labor will pay off as far as messaging and getting that out. But why why LeeCom specifically? Why why uh why this why this uh school?

SPEAKER_01 7:09

Yeah, because some we we got that question from folks. So why would you choose Leecom? They're not even in the state of Missouri. So there's a really good answer for that. When you look at the types of universities or colleges that we can affiliate ourselves with, we want to be very selective. Uh and so when LeeCom came up as an opportunity, one thing to know, and you'll you'll hear about this probably from some of the other podcasts, they're another, they're a not-for-profit uh organization. As Dr. Wayne, you might have heard talk about the the original founders of LeeCom and what their intentions were. Uh you know, that's that's the type of organization that we want to work with. At Mercy, uh, we are a not-for-profit faith-based organization who's very intent in taking care of our caregivers who work with us and our patients that that we work for as well. Same thing to extends to all of our providers, the physicians and the nurse practitioners. So we knew if if we hoped to recruit from this program someday, what type of physician were they going to be producing? And LeeCom produces the exact type of physician we want. The experience that we've had with this, these first few cohorts are just amazing. These are top-notch individuals. So they come, you know, with that type of attitude. That's the type of young learner that the LeeCom is recruiting in. But it's also their intentional work when they get to that campus of wanting to create a good citizen uh into uh the the facility that they may end up partnering with. So LeeCom is a perfect match for us, and we're we're excited about that. And I'm just excited we had the opportunity to work with them.

SPEAKER_00 8:33

I think what's interesting too is when you work with a group like Leecom and all the legwork that had to go in ahead of time, um, you've got two organizations trying to get to the same goal, producing great uh medicine, you know, medical professionals essentially at the end of the day. What are some steps that Mercy is doing to support those individuals once they're in residency here to make to ensure those individuals are successful? That's where the dean comes in, actually.

SPEAKER_02 8:59

I'm just kidding.

SPEAKER_00 8:59

So so we currently don't have a residency program, but we do have approval of the I'm sorry, they're they're in their first uh what like rotations and then hopefully getting to a residency. So I apologize. Correct.

SPEAKER_02 9:12

So so the first two years of classroom medicine uh is is what they uh do in Eri Pennsylvania. And then uh year three and year four, which is where they get all their clinical exposures.

SPEAKER_00 9:25

Yes, clinical exposure.

Rotations Now Residency Next

SPEAKER_02 9:26

So uh I mean they have a variety of options to choose from uh uh within the LEACOM organization, uh their partnerships. But in this case, I mean uh if if these were students who actually are from from our communities, then uh then obviously the path is very clear for them to actually come back, be in their own community, and then um spend year three and year four, get great clinical exposure in Mercy, Jefferson. And then as we work on uh next steps, which is a residency program, uh what that would do for them is because once you've completed uh year three and year four in med school, then obviously you need to do your residency training before you start practice. And uh it could be three years, four years, uh, and maybe more depending on what residency program you choose. So uh I mean um we we obviously want to invest more in uh primary care-based programs because that's kind of the need for our community, as opposed to some uh some sub specialty or subspecialties that that probably is is best in uh the university settings. Okay. So so we know what our community needs are and our focus is very much on on that. And uh our residency programs are very much going to be focused on that, like in terms medicine, family medicine, um, and and there there's talks on a couple more residency programs.

SPEAKER_00 10:59

Gotcha. Very good. Um what what can students I know we cover this a little bit more in depth, but from your perspective, what is what can students expect from the steps if once they enter the program? Um, as far as kind of top to bottom.

SPEAKER_01 11:15

Yeah, I don't think you're even selling yourself short because you're discussing the last question there. So when they show up, so when we greet them, uh but beyond greeting them, I don't think you understand what everything that Dr. Iyer and Jenny, who's our our manager over that service, do is they get to know the student personally, one-on-one. They do an interview with them for an hour apiece, just getting out who the individual is, uh what their desires are. Because everyone, when they're coming in as a third or a fourth year student, they don't know exactly what they want to be yet. Do they want to be a family medicine physician? Do they want to be a radiologist, anesthesiologist, emerging medical? There's a lot of options that they have uh facing them. So with LeeCom, we partner to put them through a good set of rotations, and Dr. Ar is then meeting with them on a routine basis, kind of how's the experience going? What do you get out of this? What what endeavors do you want? And you do more than that. You should talk about uh some of the uh the research that you do uh with the students as well, just to create that really rewarding experience.

SPEAKER_02 12:08

Sure. And and thanks for bringing that up. So uh I mean um in addition to the clinical exposure that they again, I mean they see patients, I mean, uh I mean, uh they are in the office setting, they are in the inpatient setting, I mean uh they may be in uh the operating room, in the ICU. I mean, all that is great. Uh but at the same time, uh we are also getting them into the habit of if you see something, something great, something exceptional, uh you should get into the habit of writing things out. I mean, uh and by by that I mean uh submitting papers to journals. I mean uh some people have a knack for it, some don't necessarily do, but but we have to encourage them to do that. Sure. So they shouldn't feel we are in a uh a relatively smaller community hospital, so uh so they can't sell themselves short. So uh I also encourage our students to actually come forth with good ideas. And uh I think we at Mercy are a strong believer in we want to hear what what individuals have to say. Everyone has a voice. So that way, I mean uh the the most uh novel suggestion may come from a student, like hey uh I saw this as a problem, and uh I feel if we did it this way we might we might we might be more efficient and absolutely we we want to hear them out. So that's what we call any QI initiative quality improvement. So that is something we encourage. And uh a couple of our students uh actually worked uh very hard towards uh writing of a couple of case reports. I mean some interesting cases that uh that honestly even I hadn't seen uh in in my career until now. So uh so we so obviously they got published, and uh we are currently in the process of uh two uh two papers that are actually in peer review. Yeah uh and uh it seems very likely they might get published as well. And actually these two are in very reputed journals. That's awesome. So uh so so I think they are having a good time in terms of not only the clinical uh experience that they get at Mercy Jefferson, but uh we are blessed to have a group of uh physicians, providers, even our advanced practitioners who who have really welcomed them at uh at Mercy Jefferson. And um most of these students actually live in the community, and uh during my routine interactions with them, they speak so highly of the community. Like everyone's been so welcoming, and uh I mean everybody uh likes to teach. They actually that take their time out of their uh day to actually um insist on how important uh learning teaching is. So so I think they they they can see that because these are all physicians who for long have been practicing in the community.

SPEAKER_00 15:10

Right.

SPEAKER_02 15:10

And uh we had no idea. Yes, so we had no idea that they would actually love to actually have students, and it has been working great. That's awesome.

Closing Guidance For Families

SPEAKER_00 15:20

The one thing I keep hearing is I've as we've sat through um Zoom meetings talking about this, I've been to several introductory meetings as a superintendent a couple years ago. I keep hearing that you're listening to your students, uh you're reducing barriers for students uh to get into this path. And I think the very simple concept here um is that yes, Mercy's looking at it from 10,000 feet to say if we can get our local students back into our hospitals to help our communities, that will benefit everybody across the board. But from the ground floor up, giving individual students the opportunity to become doctors that maybe they think they couldn't, whether it be cost and or just maybe lack of confidence. So I'll close this out. Thank you both for joining me, but I think the simple concept as we get to the end of this, if you're a student and or a family and you're you have an interest in the medical field, is really critical to give yourself the opportunity and contact LeeCom to talk about that process. Is that a fair statement to close this out? That is perfect. Thank you so much for joining us and uh thanks for what you're doing for our community and students as well.

SPEAKER_02 16:24

Thank you. Thank you for this opportunity. Thank you.