TRENDS
Getting Started
Hospitals and surgical centers desiring to hire physician(s) should use tactics that effectively manage and grow their strategies, especially in high demand, low-supply specialties. Organizations that are proactive and strategic will be better able to recruit the best physicians, maintain and increase revenue and market share, and increase physician loyalty and participation in quality improvement and care/cost management initiatives.
A formal physician recruitment strategy should be developed and reviewed on an annual basis. This plan should start by having a neutral third party conduct a physician workforce assessment that investigates physicians' perception of the hospital and their ideas on potential opportunities and challenges. It is also important to assess quality, availability of care, and current and future recruitment needs based on physician age and their specialty in order to plan for future shortages.
Review your compensation plan and look at such benefits as salary, salary plus bonus, and/or productivity. It is not uncommon to have an employed physician start out salaried and then over time (perhaps two years) become a partner in the facility, obtaining more benefits and having shares in the organization. Other common incentives include paid relocation, CME, and health/malpractice insurance. Increasingly, relocation allowances, loan forgiveness and signing bonuses are used. A unique benefit might be the assignment of a preceptor for assistance in socializing into the hospital family and culture.
Lastly, try to maintain a consistent physician contracting and compensation program, and review your package to see if you are competitive with the current market. It is costly to maintain individual contracts and inconsistent practices are often cause for a high percentage of physician turnover rates. If a new physician is going to be an employee of the hospital or practice, make sure there is an employee contract in place that spells out all obligations and agreements. This will help prevent issues from arising in the future.
Physician Recruitment
Start early and prepare for the long-term. You should start hiring for a physician one-to-three years prior to your need. Even better, project future needs three-to-five years out. Have a long-term plan by projecting which physicians might leave the area or retire and assess which specialists might be best to serve your area in the future.
Resumes should be closely reviewed. If there are gaps in their employment history or a candidate moves around a lot, further investigation should be done. Be sure to get the physician's spouse or life partner involved in the hiring process to be sure the candidate's family will feel comfortable in the community and culture. This factor can be very important to the retention of the physician.
Clearly define which community demographics might be attractive to potential candidates. Positive community features include proximity to big-city amenities, low Medicare/Medicaid population, and high-income areas with high population growth. Other considerations include the area cultural and recreational activities. If there are any negative community attributes, prepare one interviewer to deal with this potential issue. Make sure they are honest but prepared to provide alternatives to overcome any negative attribute.
Know the psychographics. Generation X physicians will have different employment values from Baby Boomer doctors. Items most important to younger physicians now are balance for time for family/personal life, flexible scheduling, up-to-date technology, no or limited on-call requirements, minimal practice management responsibilities, career/income, practice income, long-term income potential and the opportunity to advance professionally. Things to consider when recruiting include utilization of the Web, emphasis on the organization's vision for the future and the availability of job sharing, flexible schedules and part-time positions, and information regarding call schedules.
Retention
Retention is just as important as recruiting. It will be increasingly important to hold onto the physicians you have because recruiting new physicians will become more difficult in the coming years due to physician shortages. Once a candidate is hired, assign a mentor to them for at least one year in order to help him through the initial transition. And introduce him to other physicians in the community, particularly those in his or her specialty. Plan a detailed orientation program. Make sure he knows which resources are available throughout the organization.
Interview or survey staff physicians to determine what they like about your facility and what they would like to see enhanced. The hospital leadership should regularly review physician relationships, including specifics for each major specialty, with the hospital and make recommendations for future engagement opportunities. Once recommendations are decided, initiatives should be assigned to specific leaders throughout the organization.
Kim Krause, group vice president, Nueterra Healthcare