- Associated Press - Wednesday, February 11, 2015

FULTON, Miss. (AP) - After 2-1/2 years as a family physician in Fulton, Dr. Ben Kilman is exactly where he wants to be.

His patient population stretches from newborn to 99. He already can claim a handful of four-generation families.

“I’ve wanted to do family practice since I was 5 years old,” Kilman said. “I liked knowing about everything. In rural family practice, you get to go very broad.”

The 31-year-old Kilman has gotten his wish. He routinely finds himself managing cases that he would refer if he were practicing in a town like Tupelo, where specialists are available around the corner. His older patients often would rather not drive out of town.

“We do things here I would not if I was in a bigger city,” Kilman said. “Being in Fulton enables me to go a lot more in depth in certain diseases.”

Kilman is one of five primary care physicians in Itawamba County clinics. They, along with 10 nurse practitioners, cover the 23,300 people who live in Itawamba County as well as much of the surrounding rural areas along the state line. Like most Mississippi counties, it’s considered a shortage area.

“Fulton is fairly well covered,” especially compared to some areas, Kilman said. “No extended hours is the biggest gap.”

Personally and professionally, Kilman was predisposed toward rural primary care practice. He grew up on the outskirts of Clinton, and his wife Nicole grew up in very rural Start, Louisiana. A big city wasn’t on their wish list.

His aspirations to focus on primary care in a rural area got another lift in medical school with a rural medicine scholarship that required him to work in an underserved area.

“It helped me leave medical school with a smaller burden,” Kilman said.

His initial plan was to stay in rural central Mississippi, but he was impressed with the North Mississippi Health Services system, so he came to NMMC Family Medicine Residency Center for post-medical school training.

“I loved the system,” Kilman said. “I feel like it’s the strongest system in north Mississippi.”

Kilman’s experience highlights the need to have primary care training sites spread around the state, said Dr. John Mitchell, director of the Mississippi Office of Physician Workforce and a former faculty member at the NMMC Family Medicine Residency Center.

“Most physicians stay within 100 miles of where they train,” Mitchell said.

Like many physicians, Kilman feels like insurance is calling too many of the shots.

“It’s not necessarily the best medicine, but it’s the medicine they can get,” Kilman said.

He’s been particularly frustrated with Mississippi Medicaid managed network.

Kilman ends up working through every possible option, long past when he normally would have referred the patient to a specialist. But because the Medicaid managed care network is so narrow, the in-network specialists available are all in Jackson.

“The real issue is transportation,” and it’s unnecessary given the depth of specialists in Tupelo, Kilman said.

For the most part, Kilman feels like he has few problems, and he’s encouraged by the focus on patient-centered medical homes, which emphasize personal relationships and comprehensive, coordinated, accessible care.

“The best model for health care is where we’re quarterbacks,” Kilman said. “When we need specialists to get an expert opinion, we reach out I love the continuity of care.”

Being part of a clinic system is a good fit for Kilman, too. Although he admires his colleagues who have a desire to be physician entrepreneurs, he personally has no desire to tackle the business end of health care.

“I am very skilled at taking care of patients,” not digging into accounting, and insurance regulations, Kilman said. “There are doctors that love that; I’m not one of them.”

Kilman said he has every hope of being one in a long line of physicians who retire after taking care of Fulton for decades.

“This town has a history of longevity,” Kilman said.


Information from: Northeast Mississippi Daily Journal, https://djournal.com

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