Examining Relationship Based Physician Recruitment

Physician recruitment involves several considerations, such as an evaluation of physician need across practice areas, sourcing and recruiting viable candidates, promoting the healthcare facility and community to top candidates, and ensuring a work style and culture fit. Further complicating the effort is the physician shortage, due to retirement or recidivism due to low reimbursement or costly malpractice premiums. A March 2015 report by the forecasting firm HIS, Inc., The Complexities of Physician Supply and Demand Projections from 2013 to 2025 shows that the demand for physicians will exceed supply by a range of 46,000 to 90,000 by 2025. Total shortages in 2025 vary by specialty grouping and include:

• A shortfall of between 12,500 and 31,100 primary care physicians
• A shortfall of between 28,200 and 63,700 non-primary care physicians
  • 5,100 to 12,300 medical specialists
  • 23,100 to 31,600 surgical specialists
  • 2,400 to 20,200 other specialists

This situation has resulted in more resources being devoted to the recruitment function, with many health care administrators developing relationship-based, in-house programs to attract both primary care physicians as well as specialists. Such programs reduce real opportunity costs in terms of high acceptance-to-recruiter ratios, along with high acceptance-per-facility visit rates. Each of these metrics ties directly into the relationship-based nature of the recruitment process. The following article will outline effective relationship-based recruitment strategies to include sourcing methods, tailoring site visit to candidate interests, obtaining spouse buy-in, and performing careful screening to eliminate less viable candidates.

Physician Recruitment Strategies

Recruitment Planning—Before starting a physician search, all stakeholders–typically facility administrator, recruiters, and hiring physicians—should agree on position description, critical success factors, requirements and qualifications, and compensation and incentives (e.g. relocation assistance). They should prepare a detailed recruitment strategy aligned with applicable employment law. Sourcing Methods—To identify top candidates, most recruiters employ a variety of methods from traditional to innovative: Traditional

• Internet job postings to healthcare job boards
• Posting to medical journals
• Posting to Web site of professional associations
• Review of internal applicant database
• Contacting medical school career services office
• Networking with medical schools

Innovative

• Referrals from current staff physicians
• Direct mailing; e.g. obtaining mailing lists of medical journals
• Attending medical conferences
• Contracting military physicians who will be leaving the service within a short period of time.
• Contacting medical groups in those cities where malpractice insurance is especially costly. According to a leading malpractice insurance carrier, a General Surgeon practicing in Oklahoma with a $1 million/$ 3million policy limit will pay $62,256 per year. However, the same General Surgeon practicing in Missouri with an identical policy will pay $25,195 for the first year or a 300% increase.¹ In light of this, many physicians may value the opportunity to relocate to an area where these premiums are reduced.
• As recruiters have identified geographic preference as an important factor in a physician choice of employment, it may also be a valuable tactic to post the role to locally based media in those cities where the cost-of-living is comparatively high or where the physician has personal ties via family, friends, or colleagues.

Direct Mail–Once a viable candidate has been identified, recruiters can then send an email, but it serves the relationship better to send a more personalized letter/postcard. The purpose is to advertise the role, promote the facility, and introduce the surrounding community. The recruiter’s contact information should be included. While the letter or postcard needs to convey essential information, be careful of providing too much detail, as it could motivate candidates to remove themselves from consideration. The goal is simply to motivate candidates to reach out for additional information. Telephone screening—Pre-screening candidates saves time and money on each end. In most cases, the recruiter will conduct the initial phone screen, followed by three or four calls with peers and physician hiring managers. References may also be checked at this stage, and it’s often advised that the hiring physicians perform this task, as they have a better understanding of clinical requirements than do most recruiters. ² It is not uncommon to spend about 6 hours conducting phone screens of each candidate prior to the site visit. Again, the purpose here is to not only to elicit relevant professional background but also to begin building rapport and comfort on each end. Preparing for Site Visits—Site visits should be tailored to the professional interest/practice area of each candidate. The recruiter should conduct the planning in close collaboration with hiring managers. Common itineraries include a tour of the facility, tour of the specific department, tour of homes for sale (with physician’s family), introductions to other physicians in the practice area, as well as introductions to facility administrators. The site visit is an ideal opportunity for administrators to show their interest in candidates and form a strong bond. Consideration may be given to hosting a special event in the candidate’s honor, such as a luncheon so that s/he may meet potential future colleagues in a non-formal atmosphere. It is very important to keep in contact with candidates and their families after the visit to continue building the relationship and promoting the opportunity. Family Buy-in—As much as you are recruiting the physician, you are also recruiting his or her spouse and children, so it’s important to engage with families to explain the role, promote the community and leisure activities, and learn about the spouse’s career (if any) and potential job opportunities in the area. For families with school-age children, schedule tours of surrounding public and private schools and provide a listing of family and pediatric physicians. Family input will be critical during the decision-making process, so they should be an integral part of the recruiting process. Financial considerations—Financial considerations include direct compensation package, signing bonus, loan forgiveness programs, tuition-free continuing education, as well as relocation assistance. Health care facilities are also increasingly offering “income guarantees” that include a forgiveness clause allowing an income guarantee loan to be forgiven if the physician remains in the service coverage area for an agreed upon time period. Onboarding Support—It’s critically important to ensure that sufficient early support is offered to new physicians and their families so they may acclimate comfortably to both the facility and community. Such on-boarding services can include help with finding a new residence, issuing a press release announcing their arrival, adding their name and bio and photograph to the online directory, arranging special events for physicians and families to meet the administrative and clinical staff that didn’t participate in in site visits. Conclusion Competition for top doctors is and will remain a critical challenge facing health care facilities of all types. The recruiting process is both a timely and costly process. As per the Association of Staff Physician Recruiters (ASPR), it can take upwards of 180 days to hire a new physician. Following a relationship-centered approach as outlined in this article can prove to be an effective method for attracting and retaining not only top talent but best- fit talent in a highly competitive market. After all, it does no good to hire a superstar if that superstar is not going to comfortably fit within the existing workplace culture or is too high maintenance, thereby draining resources.