Physician Recruitment News and Tips, & Advice

Recruitment News  •  Tips & Advice

News

America's Best Places to Practice
With primary care physicians in demand almost everywhere, there's not a region in the nation that wouldn't love to claim you as its own. The question is: Which state is best for your bank account, your career, and your peace of mind?  Modern Medicine/Medical Economics has determined the best places for physicians to practice.  Wisconsin Ranks Second!

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FEDERAL REGISTER NOTICE: Increase in the threshold HPSA "score" for National Health Service Corps (NHSC) Scholarship physicians for the 2009-2010 cycle. The minimum "score" was increased from a 14 to a 17. This effectively reduces the number of eligible facilities here to roughly five community health center-type clinics: Appleton, Milwaukee (MHS), Wausau, Beloit, and Racine. Hospital and clinic-based positions in communities such as Sparta, Hayward, Spooner, and Shell Lake (to name some), are no longer eligible to recruit physicians who have a scholarship obligation to fulfill to the NHSC. This is very distressing news given that the rural communities here already struggle greatly to recruit new physicians, and now a potential group of physician candidates has been pretty much been eliminated for the coming year. Communities and facilities may well be served to submit new HPSA data to the State Dept. of Health Services and/or the Wisconsin Primary Care Association to make sure their "scores" are reflective of their actual need. It is possible that changes in the provider composition of a community/area, and/or population changes could increase a HPSA "score" to a level high enough to again be eligible for NHSC Scholarship physician to fulfill their obligations there.

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The numbers related to the 2009 National Resident Matching Program (NRMP) have been released, and the results seem to be a mixed blessing.

The NRMP is the program that assists medical students locate post-graduate (i.e.: residency) programs where they can complete their medical education, so they can become board eligible and/or certified in their chosen medical specialty and eventually seek employment. For the 2009 match, the NRMP recorded submitted data from a total of 46,309 medical students (23,343 being graduates of U.S. medical schools) and 3,575 residency programs (22,427 resident PGY1 positions total).

This data was then analyzed to “match” the medical students to the programs that both have selected, based on the data that each submitted to the NRMP. In this year’s match, 56.5% of the U.S. trained medical students were matched with their first choice of residency specialty and program. Non-U.S. trained students matched at a slightly lower rate (48.7%).

The good news in this year’s match is that it included over 1,100 more applicants than the 2008 match, and over 4,500 more than the 2004 match. This is indicative of an increase in class size for many medical schools, as well as the development of several new schools. The disheartening news is that family medicine, considered by many to be the core primary care specialty, and had the number of available residency positions reduced in this year’s match by 101, even though there was only a reduction of 2 in the total number of family medicine residency programs. And even with this reduction in available positions, only 91% of the available positions were “filled” in the match for a total of 76 fewer family medicine resident physicians than in 2008. Almost all of the other medical specialties filled at rates above 95%, and many filled completely (100%).  Eighty-eight family medicine residency programs (out of a total of 453) did not completely fill all their positions in this year’s match. No other medical specialty was even close to this total number of unfilled residency programs (next most was preliminary internal medicine at 41 total programs). Additionally, only 42% of the family medicine residency positions that did fill in the match went to U.S. medical school graduates.

So while the overall number of future physicians seems to be on the increase, the type of physicians needed most in rural communities (and especially those with underserved populations), actually decreased from the 2008 match. This is indeed not the news we needed to hear and an area that must be addressed sooner rather than later. The time is now to promote primary care to fullest to medical students by removing the disincentives that currently exist, and by implementing incentives that will increase the number the medical students choosing primary care as their career choice.

 

Tips & Advice


Tip:  Sourcing Physician Candidates: most bang for buck

There are a myriad of options available when it comes to seeking a new physician for one’s clinic or hospital. Seasoned physician recruiters deal with these every day in their jobs. Many are assigned to make decisions on what to use and when. Having this assignment with the New Physicians for Wisconsin program, I have come to rely on several sources year-in and year-out that seem to generate the largest number of potential candidates for the positions that are available to Wisconsin clinics and hospitals. These are (in no particular order):

  1. PracticeLink [a physician recruitment website that send e-mails daily with the names and contact info of candidates they have identified and received information from. Geographic preference is noted.]
  2. The National Rural Recruitment & Retention Network (3RNet) [a physician organization comprised of NFP state & university-based physician recruitment programs. Sources physician candidates and sends e-mail with names and contact info. Limits this mainly to those interested in one’s respective state. Only accessible to the Wisconsin Office of Rural Health through the New Physicians for Wisconsin program].
  3. Residency Program Presentations [having the privilege of speaking directly to resident physicians regarding the job market in Wisconsin. Not accessible to everyone. The New Physicians for Wisconsin program speaks annually at all 10 family medicine residency programs statewide.
  4. The American Academy of Family Physicians journal & website [still a consistent source of family medicine physician candidates interested in jobs here in Wisconsin. Has the largest circulation of any family medicine journal. Widely read by family physicians. Website advertising becoming the preferred venue over print ads in journal, but both are still valuable]
  5. HealthECareers [a website that has become the official job-listing forum for several national physician societies and organizations. Excellent source of physician candidates in the specialties of ob/gyn, general surgery; and psychiatry]
  6. AAOS Placement Service [a good source of physician candidates in orthopedic surgery. Is the official website of the American Academy of Orthopedic Surgery]

There are many other websites and journals that one can utilize depending of the physician specialty being recruited. The ones listed above are the ones that the New Physicians for Wisconsin program seems to have the best “success” with year-in and year-out. Perhaps if your budget allows, you too may wish to consider one or more of these sourcing venues to assist you with your physician recruitment needs.

Tip:  The “site visit” by a physician candidate is obviously a very, very important component of the entire physician recruitment process. The old saying” you only get one chance to make a good first impression” rings true during the few hours/days when a candidate is at your facility. Physician recruiters are keenly aware that EVERYONE needs to be on the “same page”, and demonstrate a friendly, positive attitude toward the candidate. It only takes one negative person or conversation to ruin everything positive from all the others involved. Here are a few tips to make the site visit run as smoothly and positively as possible:

  1. Always remember that the candidate is interviewing you, just as you are interviewing them. Be sure to give the candidate time to talk about both professional and personal issues.
  2. Little things make big impressions: have your staff address the candidate by name, not simply “Hello, how are you?”.  Set yourself apart from the competition. Make the candidate feel “special”. Everybody wants to be wanted!
  3. Make sure everyone knows what their involvement in the interview entails and where they HAVE to be at a certain time. Making a candidate wait is never a good thing, it can be taken as indifference, and that is always a negative. How would you feel?
  4. If you are in a rural community, get the entire community involved. While the professional side of the interview is obviously important, many times it’s the personal side that is the deciding factor. Learn as much as you can about the candidate and his/her spouse and family BEFORE the interview. You can arrange a meeting with the school principal, the mayor, a CEO of a major employer, the police chief, and a realtor. All these community members have a unique perspective on your town that they can share in a positive way. If you know the candidate and/or spouse like to hunt and/or fish, try getting the head of the local rod & gun club talk with them a bit about outdoor activities in your area. I bet that will make an impression they won’t forget!
  5. Try having dinner at one of the physician’s homes, instead of a restaurant. This works especially well if there are quite a few physicians in the medical group the candidate may be joining. Restaurants are fine, but someone’s home is much more intimate and offers a better chance for everyone to interact with the candidate/spouse. You can cater in food if need be.
  6. On a physician interview, there is a lot to talk about and see in a short period of time(ideally 2 full days).  However please try to set aside 3-4 hours at some point for the physician candidate and his/her spouse to simply relax and take-in all that they have seen/heard. Running from person to person and place to place is tiring, even over just a couple days. Give the candidate time to “recharge” a little.
  7. Lastly, and maybe most importantly, simply be prepared. Good physician recruiters are all too aware of this. Have everything and everyone ready and willing. Some may view the site visit as a “first date”, but actually it’s more than that. If preparations have been done thoroughly, this is not so much a “let’s learn about you” meeting, as a “lets’ confirm or not confirm” what we already know about each other meeting. Those who prepare the best, even with a “lesser product”, tend to be more successful than those who take things

Tip:  “And the times they a changing….” (and will be even more)…..

Medical students are ever more increasingly staying away from the primary care specialties that may demand more of their time than many of those in specialty care fields. It is becoming ever more popular to choose a specialty that fits one’s lifestyle, rather than choosing one that potentially can “consume” it. More than ever, choosing a field of endeavor in medicine involves choosing one that balances both the professional demands of the job with the personal needs of the physician and her/his family. With certain physician specialties, it’s much more likely that once you leave your clinic, you can turn your beeper off and/or not have to be ready to run into the hospital for a patient. With others (such as primary care, general surgery, etc.), there are certain responsibilities that come with the job that entail work beyond that once the clinic doors close for the day. And this leads to a lifestyle that is much less “controllable” than a young physician may desire. One off-shoot of this trend is the increase in “outpatient-only” type primary care positions, where the physician only sees patients in a clinic-setting, and all hospital care for the provider’s patients is provided by other (hospitalist) physicians. This type of position has become popular and ever-increasingly in demand not just in family medicine, but in internal medicine and pediatric medicine as well. So “flexibility” in recruitment of providers has become a necessity for success. While taking care of patients is what a physician does, nowadays most feel they must be able to take care of themselves first.

Tip:  When a potential candidate is sourced, remember that responsiveness is an absolute priority.  Make the phone call or send the e-mail message ASAP to let this potential future colleague know just how interested you are in them.  Nothing makes a better first impression and says “We want you!” more than a prompt initial reply conversation.  Postponing this only allows for the competing organizations that the candidate has also approached to “get there first”, and to make the candidate feel they sincerely value them above the others who have not felt the need to be so responsive.

Tip:  When you do contact a candidate for the first time, please be prepared.  Review the candidates resume thoroughly.  You don’t need to waste time asking them where they did their medical education….it’s right there on the resume! Have a list of pertinent & ethical questions ready to go.  Know exactly what it is you seek in a new colleague, from both a professional and a personal standpoint.  During the conversation, allow the candidate to ask questions of you as well; for they are interviewing you just as much as you are interviewing them(and maybe even more these days!).  Get back with them promptly with any information you were not able to give them in the initial conversation.

If the initial contact suggested the candidate may be a good “fit” for both sides, then share all information you gleaned from your initial conversation with the others in the medical group.  If necessary, perhaps another member of the group can also call/write with additional information the candidate requested or if the group has further information from the candidate it requires, or simply to say “Thank you” from the entire group for his/her interest.  Making a candidate feel sincerely wanted many times is the difference between the candidate coming for an interview with you instead of the 3-4 other clinics down the road(who probably have just as much if not more to offer!).  Put yourself in the mindset of the candidate: how would you want to be treated if the roles were reversed? The shortage of physician candidates these days coupled with an ever increasing number of available jobs, simple things like showing sincere interest through promptness and preparedness can be the difference between a candidate coming to visit your facility, or your competitors.

Tip:  Should we hire a new provider?

Everybody these days seems to be looking to hire a new primary health care provider, much more so than even a few years ago. In many primary health care specialties, the demand has totally out-stripped the supply, making recruitment extremely difficult. Realizing this, how does a clinic or hospital go about determining if a need really does exist at their facility? The following are some considerations one may choose to utilize to determine this, and if indeed recruitment is justified.

  1. Determine the ratio of service area population compared to the FTE of providers you currently have. Is it within national and/or regional standards? Does “supply” not meet “demand”?
  2. What is a patient’s “wait time” to get in to see your providers?
  3. Are your facilities profitable currently? Could your current providers handle additional patient loads instead?
  4. Do your providers seem overworked and “stress-out”? Is being “on-call” too often constant source of complaint?
  5. Are any of your providers nearing retirement? What about 3 years from now?
  6. Have any of your providers talked of “scaling-down” their practice or dropping some services/procedures they have previously always provided?
  7. What is the population growth of your service area?
  8. Has there been provider defections from other facilities in/near your service area?
  9. Are you losing patients to other nearby clinics/hospitals because patients cannot be seen on a timely basis?
  10. Is there a demand for additional services currently not provided or under-provided?
  11. Are the needs of your patient population changing?
    a.  Gender
    b.  Age
    c.  Hospital usage
  12. Can you afford the start-up “costs” involved with hiring a new provider?
    a.  Initial salary & benefits
    b.  Office space and equipment
    c.  Marketing expenses
    d.  Will the moral of current employees be affected negatively by the addition of a new provider?

There may be other criteria that you utilize to determine your specific needs. Whatever the criteria is that you choose to use, if the decision is made to actively recruit a new provider the important thing is to have a concrete recruitment plan and dedicated individuals who know their respective roles to carry this plan forward. And broad-based community support is essential for success.