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344 www.mpmnetwork.com 800-933-3711 Would you respond to a want-ad that touted a “min- i mum 60-hour work week” or one that promised “50% on- call burden”? Even worse, would you be intrigued by an offer that described a “variable reporting structure with- out clear leadership”? Of course not, yet these are some of the requirements and stipulations presented to physicians when recruiting for private practices or hospitals. For ob- vious reasons, such job descriptions often fail to garner even minimal enthusiasm for the positions they are seek- ing to fill. Thus presenting an accurate, though attractive job description to potential candidates can be challenging.

Furthermore, the means of promoting open posi- tions to the right candidates can be equally challenging Would you post a bulletin at the grocer y store, or place an ad on the place mat at a local diner? Of course not, but some of the technologies that people are relying on to spread their message are just as archaic.

So how do you develop an effectiveprogram to at- tract and retain talented physicians to your practice, get- ting the right message to the right people at the right time?

Unfortunately, there is no easy solution. Corazon believes that successful physician recruiting is an ever- changing paradigm that must have resources dedicatedto continually reevaluating the best way to accomplish goals each and ever y day. Based on our experience re- cruiting heart and vascular physicians to programs across the countr y, there are some core principlesthat will allow you to improve your recruiting “machine” and keep it “well-tuned” in this dynamic market.

The first approach is to treat physician recruitment as you would any other executive recruitment. This sounds simple enough, but few people really put this theor y into action.

Here are the key the elements of executive search that should likewise be applied to physician search: Explain the salar y. When searching for a CEO, presi- dent, or other executive-level hire, the recruiter would have a full description of the total compensation pack- age, including fringe benefits and bonuses, available to discuss with potential candidates. This seems to never occur with physicians. Furthermore, physicians rarely get an explanation of what their true responsibilities to the organization will be beyond patient care, or even the full scope of the patient care expected. Important details of day-to-day work, such as the availability of physician extenders and/or hospitalists on-site, are never discussed. Indeed, these are strong selling points for a position, though they are often lost amidst other details before an offer can be negotiated. Is the Doctor In? Proven Strategies for Physician Recruitment and Retention James Burns* *Vice President, Corazon, Inc., 5000 McKnight Road, Suite 300, Pittsburgh, PA 15237; e-mail: [email protected].

Copyright © 2009 by Greenbranch Publishing LLC. hysician recruitment has been more difficult in this decade than at any time in the past. Successful physician recruitment— whether for a private practice or hospital—has its challenges.

With serious physician shortages in the majority of clinical spe- cialties, a complete overhaul is necessary in terms of how searches are conducted, how offers are made, and the skill set re- quired for the new generation of physician recruiters. This ar- ticle will discuss the key elements of any successful recruitment effort, and then address the challenges of physician retention in today’s competitive mar- ket for physician talent. Key words:Physician recruitment; physician search; physician retention; re- cruitment tips. P Create a job description. Candidates for a leadership position would never be offered a position without having a full understanding of where they will perform most of their duties, who will be monitoring their per- formance, and what specific functions they need to oversee. Physician candidates should always understand what is expected from them in terms of patient care within the organization and how they will be moni- tored. There should be an understanding of workweek hours, the areas they are responsible for , and how or- ganizational changes will be related to them. Support the position statements with data. After telling candidates they will be on-call five nights per week, be prepared to explain how many times they will actually be required to come to the facility based on historical data. Moreover, if they have to be part of certain com- mittees, they should be told a realistic estimate of the time commitment. Furthermore, the rationale for adding this position to the organization should be shared. Data showing volume growth and market de- mand greatly support efforts to help physicians deter- mine whether they can fit within the organization and/or grow enough business to support a practice. In fact, well-planned market and volume data have been able to lure many physicians away from higher mone- tar y offers, simply because of the work completed to show the organization’s commitment to growing its business through the recruitment of physician talent. Understand changing lifestyle issues. Lifestyle issues are the number one factor in determining whether a physi- cian will accept or decline a position. And if a beach or sprawling metropolitan area is not nearby, the chance of securing young talent becomes significantly less probable. Savvy organizations have invested large sums of money into determining how physicians and other highly educated people can acclimate to their region.

Many physicians are married, and today more than ever, spouses have significant input into career and reloca- tion decisions. Schools, daycare, and extracurricular ac- tivities are other considerations that must be factored into the equation. On this front, leading organizations in less-developed areas have addressed chambers of commerce and civic organizations to help lure busi- nesses and money into the region to help with this problem. This is a big concern—big enough that re- cruiters now invest a lot of creative energy into finding win-win solutions for candidates and hiring organiza- tions, and by doing so, have quelled some objections.

As a result, physicians can be more easily recruited us- ing the surrounding area as a benefit.

So we have talked about the job and creating an at- tractive foundation, but what should change for the re- cruiter or recruitment process? In a word, ever ything!

Gone are the days when a candidate would sit and patiently listen and converse with a recruiter regarding aposition. We are in the high-tech, 30-frames-per-second age, and a stammering, ill-prepared recruiter is doomed.

Recruiters who are change-adverse, with personalities that don’t like rejection may need to change careers, as the fu- ture of this industr y will be constantly shifting. However, those driven by success, who are inspired, rather than de- flated by challenges will best succeed.

Based on Corazon experience, the key elements of the successful physician recruiter in this new age are as follows: Always have key search tools with you:a PDA, business cards, pen and notebook, and a flyer about your posi- tions. You never know who you will meet, and oppor- tunity only knocks once, and sometimes unexpectedly. Always be networking (ABN).You never know where potential candidates will be, or who knows who in your personal or professional circle. A chance meeting of strangers has the potential to evolve into a great net- working opportunity. It’s important to grow your net- work of professionals, including fellowship leaders and deans, malpractice carriers, etc., in order to widen the pool of people who can assist you in your searches. Keep the message simple. When physicians talk to you about a position, respect their time and offer only what they ask or what you feel is critical for them to under- stand. You can tell them more of the in-depth details when the process moves for ward. Use technology wisely. Cell phones are a must. Texting is also growing in popularity, especially considering the ability to quickly send a message and respond—which can make this a preferred communication method for busy physicians. E-mail is also a must; but be warned, most e-mail is deleted before it is read if there is noth- ing personal to make it stick out. Use the Internet, but not in the way you think.Pro fessional job sites are usually not the best place to find high-end candidates. Some people post simply to compare their current job. Others leave their resumes availablethough they have no intention of switching jobs. Statistics show that most people mentally leave a job about six months before they actually do. The reasons for this are varied: family needs, remarriage, children’s college, etc. Savvy recruiters search lifestyle pages as well as other non-job-specific areas to search for people to cold call or approach. Be creative to look for program closures, leadership changes, and other such factors that would result in displaced physicians. Understand the rules.Physicians become ver y inpatient with, and are turned off by, recruiters who do not know state specifics for licensure and immigration laws that may apply to them (e.g., J1, V1, and others), along with Stark and Anti-Kickback issues. With any potential offer, the recruiter should know all the de- tails about these issues, having researched how they could be a factor with the candidate. For the amount of credibility that can be gained, it is well worth the Burns/ Physician Recruitment345 www.mpmnetwork.com 800-933-3711 www.mpmnetwork.com 800-933-3711 few days per year that need to be spent on research to remain “in the know” about these changes.So now that you have successfully recruited expert physicians, how do you keep them? This seems to be the dilemma facing a number of program leaders in recent years. And while there is no easy answer, it’s no doubt better to spend limited resources on retaining current physicians than to look for replacement hires. The biggest key to retention is an open dialogue.

Listen to what your physicians say, and ask questions in order to understand their concerns. Having open and honest discussion about what can and cannot be changed or addressed is important to building a successful and long-term relationship. The job description can again be useful as a guide detailing what behaviors and actions are expected and tolerated, and those that are not Oftentimes, people chose to leave a job months be- fore they do, which is why ongoing dialogue is so ver y important. The adage that no news is good news is sim- ply not true. Physicians can have up to 100 contacts per month from other organizations looking to hire them. If they pay attention only to even just 1%, that equates to 12 times per year that someone is telling them a better opportunity awaits elsewhere. Regular dialoging also helps hospital and/or practice leaders understand the needs of other physicians, and creates the opportunity to inter vene in situations that may not have other wise been brought to the surface for several months. While money is important, leadership autonomy and having a voice are almost always cited as key job sat- isfiers for physicians; conversely, the lack of these things is most often cited as the main reason for job dissatis- faction. And then there are quality-of-life considerations as well. None of these situations are insurmountable, but they require persistent discussion and exchange of ideas, along with action to keep physicians engaged. Having fre- quent discussion is only the beginning; using these con- versations as a starting point for organizational change is the goal. And lastly, as fewer people take on more re- sponsibilities and time is in short supply, keep in mind that creative communication methods and to-the-point conversations carr y great value. The more efficient the communication, the more effective it will be as well. Too often, we seek to use outdated methods to re- cruit in a world that has moved far beyond them. Phy - sician recruitment and retention in today’s competitive healthcare landscape requires a dynamic, proactive ap- proach and well-thought-out solutions. We also need to understand that the person that was successful in these tasks 10 years ago may not be able to fill the bill today.

While less emphasis is placed on interpersonal relation- ships and more on rapid turnaround, quick recall of peo- ple and situations, and the ability to immediately act on new knowledge, this industr y is constantly evolving . . .

don’t be left behind! ■ 346Medical Practice Management May/June 2009 “Not enough time, not enough money, too many demands,” is the lament of the practice administrator. “Judy’s analysis and recommendations are, as always, specific, practical and direct.” W. Lee Wan, MD Coastal Eye Specialists (800) 933-3711 •www.mpmnetwork.com THE JOURNAL OF MEDICAL PRACTICE MANAGEMENT GREENBRANCH PUBLISHING P.O. Box 208, Phoenix, Maryland 21131