By January, doctors who practice part-time at the University of Mississippi Medical Center must take on full-time jobs there or sever times with the teaching hospital.

Under the new closed-staff policy, which is designed to stabilize finances and better monitor care, doctors also will be encouraged to refer patients inside the system. The policy affects about 20 positions, UMC officials said, and has been phased in over the past year.

“As with any decision, there are always going to be advantages and disadvantages,” Dr. Dan Jones, UMC’s vice chancellor for health affairs and dean of the School of Medicine, said Monday.

“But these changes are intended to try and make us a stronger and healthier place to respond to the changing health-care environment in this state.”

UMC officials said the affected departments include medicine, ophthalmology, neurosurgery, neurology and psychiatry.

The change does not affect those who teach part-time at the medical center or any private practice that doctors participate in as part of their clinical training.

For now, only adult services — those for patients 16 and older — are being considered, said Dr. Scott Stringer, president of the University Physicians, UMC’s clinical practice plan.

He said another reason for the change is continuity of staff responsibilities.

“You’re essentially playing for two teams … and not carrying your full share of the burden of the indigent and underfunded within the institution. We all need to be doing the same thing,” said Stringer, who is also chairman of the Department of Otolaryngology.

UMC has plans to expand the School of Medicine faculty in the next several years.

The hospital started the new fiscal year in July with an 18 percent vacancy rate. Many public academic medical centers have staffing problems partially because physicians can make more money in private practice or at a private hospital where they see fewer indigent patients.

By law, at least 50 percent of the patients at a public hospital must be uninsured or on Medicaid, but at UMC, about 67 percent fall into one of those two categories. The institution has struggled to stay afloat under the increasing burden.

In an effort to keep paying patients, the medical center is also strongly encouraging physicians to refer internally “if it’s clinically appropriate,” Jones said.

“Clearly, the more that go through the system, the better for the system,” said Will Ferniany, UMC’s CEO and associate vice chancellor for health systems. “Anything that goes out, you can’t quantify. You can’t tell if it was $1,500 or $500,000.”

The patient’s needs and desires always will come first, Jones said.

Stringer said closing staff and referring internally are quality-of-care issues.

“When you have the same group of doctors caring for one patient, they tend to work better as a team,” he said.

Not all Jackson area hospitals are moving toward a closed staff, though.

For example, at Baptist Medical Center, “physicians are not employees,” spokesman Robby Channell said in an e-mail.

“For the most part, they have their own practice,” he said. “They receive privileges at Baptist once they meet qualifications (based on the Mississippi State Board of Medical Licensure).”