How to Recruit and Retain Physician Candidates

With current or anticipated physician shortages in nearly all clinical specialties, hospitals across the country must be committed to recruitment and retention of their doctors. Failure to find, and then keep, top-quality physicians — especially in revenue-leading service lines such as cardiovascular and neuroscience — can have serious implications across the continuum of care in these specialties and elsewhere… The numbers are staggering! According to the Council on Physician and Nurse Supply, the United States will be lacking approximately 200,000 physicians by the year 2020. Further, the U.S. Bureau of Labor Statistics predicts that there will be approximately 212,000 physician openings by 2014. Shockingly, this number represents 25% of the current physician workforce. And finally, the Bureau also expects that in the next decade, 1.6 million healthcare jobs will need to be added to provide adequate care for our aging population. We believe that competition for physicians within key specialties — among them cardiology, dermatology, hematology/oncology, neurology, neurosurgery, orthopedics, and radiology — is becoming more intense than ever. We see this at client sites in every region of the country as programs expand and as hospitals look for ways to differentiate using physician quality. Cardiology is just one example of a specialty with dramatic statistics related to physicians in practice. Today, there are an estimated six general cardiologists per 100,000 U.S. residents, with nearly two-thirds of these physicians being over the age of 45. Many cardiologists will retire over the next 10 years, and there will not be a sufficient number of new specialists available to replace the retirees. Is your organization prepared to handle the described shortages, or are you just “waiting it out” to see if physician staffing will become an issue for you? Organizations that are poised to have the greatest success with physician staffing will devote as much attention as possible to recruitment and retention. Unfortunately, in our experience, many organizations are not focused on this issue and will spend less money on the process of physician recruitment as opposed to buying new hospital equipment. Yes, the cost of owning and operating a hospital-based physician group can be much higher than many other investments; but, it is the physicians who generate the hospital’s patient/referral base, which has the greatest impact on the overall bottom line. Here’s another statistic: Corazon has found that four out of five of the top physician candidates will turn down an offer made by a hospital. Whether it is a large academic center near New York, or a small community hospital in Oklahoma, hospitals make common mistakes when recruiting physicians. It is the recruiter’s job to find candidates to fill the open position; however, the ultimate success of a placement depends heavily on the hospital’s commitment to recruitment. Some of the most common mistakes (and ways to avoid them) include:

1. Waiting too long to make initial contact with the physician

Some organizations wait to make contact with the candidate until everyone in the organization has reviewed the applicant’s information. From the physician perspective, it could appear as if hospitals are trying to find something wrong. It is best to make contact and schedule an interview with a physician within two business days. Part of Corazon’s role is to work diligently to keep the recruitment process moving from its start, especially in the early stages when the position is new and generating a lot of interest. If an organization waits, this makes a bad first impression, and the physician feels like he or she is not important. As time passes, the organization also runs the risk of losing the physician from the candidate pool. Keep in mind that physicians, especially preferred ones, are not just looking at your facility, but many others.

2. Ending the first communications with an open-ended approach

Just as a salesman needs to close a deal, the physician recruiter/hospital administrator needs to “close” the initial call by scheduling a site visit to the hospital. Often hospitals end the call by saying “we will be in touch soon to have you speak with….” This not only lengthens the recruitment process, but the physician becomes disengaged. If it is necessary to have a physician or another administrator be involved prior to the visit, then get them involved after the visit is planned by scheduling a conference call at a set time. Keep in mind that a visit can always be cancelled if members within your organization wish not to pursue.

3. Often physician recruiters/hospital administrators plan the visit based on their own internal preferences.

Tailor the physician’s visit around their character and personal/professional interests. We often see hospital recruiters/administrators plan a site visit without talking with the candidate about what they’d like to see or do while there. Consider that each physician is different, and might be interested in meeting with certain people or seeing certain things at the hospital. We recommend that organizations ensure that a tour kicks off the visit, especially so the candidate can get an overall sense of the hospital and what differentiates it. Also, we advise that you never let the physician be left alone during this time. Every organization has individuals that dwell on the negatives rather than on the positives. We have found that a physician left to roam the hospital alone, and/or visit the city without a guide, often come back with a more negative impression than those who are given more attention while on site.

4. Most organizations do not have a process for physician contracting or compensation determination.

Our advice is to always make an offer to the physician within one business week of the site visit — even if it is just a Letter of Intent, rather than a formal offer. This shows the organization’s level of interest in the candidate, its commitment to recruitment, and the overall intent to build and/or improve the service line or specialty program. This will also begin negotiations at just the right time. Contract negotiations are almost always a lengthy process, especially when two attorneys are representing the different sides reviewing the information. So, the sooner this process begins, the better it will be in terms of arriving at an agreement in a manageable timeframe. Lastly, we recommend that if you need assistance defining the compensation package, refer to the Medical Group Management Association’s “Physician Compensation and Production Survey.” This information is reported on a yearly basis, and the majority of physicians refer to it when comparing job offers. In order to be competitive in this tough market, we recommend that organizations offer a salary that is at least between the median and the 75th percentile. Even if the offer made is competitive, and looks great on paper, that does not guarantee that the physician will automatically accept the offer. Not only do organizations need to do all of the above to be successful, but they have to make the physician feel special: both wanted and needed. When comparing positions, Corazon has found that physicians ask themselves the following before making a decision: • Will I have work-life balance? • Are there enough patients within the area to have a prosperous practice? • What is the competition in the area? • Do the physicians within my specialty and the referring physicians want and need me there? • Will I have continued support from administration? To achieve success, organizations need to make physician recruiting a top priority. Considering how candidates will answer the above questions will give great insight into how they perceive your organization. Further, these questions can create a framework as to what might need to change in order to begin attracting physicians to a position that might be difficult to fill. Indeed, the entire selection committee needs to start thinking like a physician. Our best advice is to take the time to understand their wants and needs, while likewise defining yours. Only then will a “perfect match” be made. The knowledge and information listed above is a high-level presentation of issues that need to be managed within your organization in order to recruit high-caliber candidates. For additional information, or a more in-depth assessment about how Corazon could help your recruitment process, call (412) 364-8200. Corazon offers consulting, recruitment, and interim management services for the heart, vascular, and neuro specialties. Visit www.corazoninc.com to learn more. To reach Jessica, email jbarrick@corazoninc.com.

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