Doctor gets tax breaks for settling in rural community

She accepts $20,000 in rent subsidies and parking lot improvements for opening the only primary care office in a small Texas town.

By Mike Norbut, amednews staff. Aug. 18, 2003.

Cities and counties are known to offer economic incentives to businesses in hopes of luring them to the area. But mostly rural Johnson County, Texas, has taken the idea a step further, sweetening the pot to entice a physician to practice there.

The beneficiary is Jennifer Weatherly, DO, a family physician who last month opened the only primary care practice in Grandview, a town of 1,400 residents about 35 miles south of Fort Worth. To seal the deal, the county's economic development commission offered a $20,000 package, including rent subsidies and a $3,500 commitment to help repair the parking lot in front of Dr. Weatherly's office.

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In exchange, Dr. Weatherly, who also has a practice in Lancaster, Texas, just south of Dallas, will practice in Grandview at least 20 hours a week. A cardiologist who helped her in the decision-making process, Fred Maese, MD, also will have office hours in Grandview once a week, she said.

City and county officials are hoping Dr. Weatherly's impact will provide a noneconomic incentive for businesses to relocate to the area. The rent subsidy is worth it to build a health care infrastructure, they said.

"This is the first time I've seen [incentives offered] when it wasn't associated with a hospital recruitment," said Mark Willis, executive director of the Johnson County Economic Development Commission. "It will be more convenient for current businesses, and hopefully it will make it more attractive for people moving down there."

Dr. Weatherly, who spent a portion of her residency in a rural area, said she liked the country atmosphere of Grandview, and the incentives offered to her were just a bonus.

Question What did you find attractive about Grandview, a small town with no primary care physician?

Answer It's a really nice, clean, quiet town, and the people have been extremely nice and welcoming. The patients have said, "We're so glad you're here." Before I opened, I stopped by a Subway [sandwich shop] and said, "It looks like you can use a doctor here." Someone said, "Yeah, but I doubt we'll get one." And then, when I told her I was coming, she said, "Really? That makes my day!"

Q When you first started looking into building a practice there, did you sense a business opportunity immediately?

A Definitely. It's a given Dr. Maese and I wanted to give the best care possible to our patients, but here's a town that has no doctor for six or eight towns around. [The economic development commission] did a perspective a couple years ago on the need for a pharmacy, and they figured there were 14,000 people in the area, and no pharmacy. They figure it's 16,000 to 18,000 now, and they have no medical care. So definitely businesswise there's a lot of potential.

Some of the patients are going to be Medicare and Medicaid, so the reimbursements aren't going to be as high, but the volume has got to be huge long term.

Q The county's economic development commission is going to subsidize your rent and help pay for parking lot improvements. Were you surprised to be offered incentives usually reserved for big businesses?

A We've already had about three different pharmacies show an interest in coming to town. Their thought is, if you get a doctor out there -- they already have a dentist and a veterinarian -- all the big businesses will come out here. Long term, they see this as being a big pull for the town. We were happily surprised by the offer. We weren't depending on it, and they offered it. We didn't ask. They've already paved the parking lot, and I have no rent for a while. That's even going to continue to a lesser extent after a year or so.

Q The city and county aren't sure what economic impact your presence will have, but they obviously have high hopes, saying a health care infrastructure is vital to growth. Does that put extra pressure on you as a physician?

A Not at all. As long as I deliver good quality care, I think it will work out. Unless you're in an area that's overpopulated with physicians, you have a good chance of succeeding. A lot of people have said they plan to make appointments. I hear we already have a pretty good reputation in town.

Q What are your ultimate goals for your practice?

A Truthfully, I don't know if I'm going to end up with both practices, or just one. If I feel like I'm overwhelmed with patients, I can always get a nurse practitioner to help out. Long term, I would like a thriving practice. I'm kind of a businessperson waiting for things to take place.

When you're in school, they don't teach you anything about business. They just throw you out there and tell you to manage a practice, hire staff, do the books, everything.

Q Has hiring staff been a challenge?

A We've had a lot of resumes coming in. A lot of people live in Grandview but work far away because there just aren't that many jobs here. If you're a [medical assistant], you're not going to find a job around here because there's no doctor.

But there's been a lot of interest, so it's been a good deal.