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First Impressions

Elyas Bakhtiari, for HealthLeaders Media, February 21, 2008
The opinions a physician forms about a new practice or hospital during the recruitment process set the tone for the remainder of the professional relationship. These initial impressions can determine whether the physician becomes an integral member of the facility or moves on after a short stint. But it's hard for physicians to come away with a good first impression if they don't trust the first person they typically meet during the recruitment process--the physician recruiter.

Unless a physician had a previous relationship with the facility or found the opening through word of mouth, it's increasingly likely that he or she was contacted by a recruiter, either from a search firm or based out of a hospital.

And there's a good chance that recruiter won't be well-received. A member of a physician-only social networking site recently asked colleagues if they had ever been lied to by a physician recruiter--only 6 percent of the 107 respondents to the online poll said no. More than 90 percent said they had been lied to directly or heard second-hand stories of recruiters being untruthful. Granted, this wasn't a scientific survey and the results should be taken with a grain of salt. But it does point to a growing distrust of recruiters that hospitals and practices should be aware of. Physicians often feel that recruiters in placement firms are salesmen who will say or do whatever it takes to get a commission, even if they aren't able to live up to the expectations they set, says Matthias Muenzer, MD, a Boston-based physician and author of the blog, "A Physician on Job Search and Practice."

The distrust isn't limited to professional recruiters--physicians have horror stories involving CEOs, administrators, and even other physicians involved in the recruitment process. In response to the poll question, one physician recounted being pressured by a hospital CEO and a board member to sign a contract that would have shortchanged him tens of thousands of dollars: "They made all sorts of promises that they couldn't keep. Subsequently another doctor came to town, signed up, and was met with financial and professional disaster. I have seen many doctors victimized."

As the editor of Physician Compensation & Recruitment, I regularly hear from physicians as well as recruiters and administrators, and though I understand physicians' frustrations, I don't think recruiters are bad people. At the heart of the distrust is the fact that the recruit and the recruiter have different, and often competing, interests.

Facing an estimated cost of nearly three times a physician's salary to find a replacement, facilities face mounting pressure to sign a physician as quickly as possible; professional recruiters get paid to make that happen. But it's in the physician's interest to delay the process, to shop around for a while to find the best opportunity. If these priorities don't align and both parties are up-front about it, they can usually reach a middle ground or recognize that it's not the right fit and move on.

However, problems arise when the two parties aren't on the same page and don't effectively communicate their intentions. Unfortunately, this miscommunication happens quite often, in part because physicians are at a disadvantage at the negotiating table. Doctors are trained to heal the sick, not rewrite contracts or haggle with recruiters. The lack of business training effectively leaves physicians holding a knife at a gun fight.

"Physicians, especially graduating residents, come from a completely different world," Muenzer says. "They work 100 hours a week and are in an education environment where what people tell them is important and is true. And now all of the sudden they meet a group of people that are not advisors and do not have the physician's interest at heart."

Unfortunately, the hurried pace of recruitment tempts many facilities to gloss over issues that don't fit with what the physician is looking for. In the long run, those facilities lose money and physicians. If the compensation, culture, or even the estimated driving time to the nearest city don't match what the recruiter or administrator promised, the physician isn't going to be happy and probably won't stick around.

There are some steps physicians can take to ensure they don't get a raw deal out of the recruitment process. It starts with communication; if you're a physician searching for a new opportunity, don't hesitate to provide feedback to the hospital or practice. And ask questions. If you're unwilling to move more than an hour outside a major city, tell the recruiter to stop sending you positions that don't meet your criteria. If you don't understand every word of a contract, don't sign it.

You can practice with me. If you have any questions or comments about what I write in this space, shoot me an e-mail. Let me know what you want to read more about and what you're tired of hearing. That's the only way to ensure we're on the same page.


Elyas Bakhtiari is a managing editor with HealthLeaders Media. He can be reached at ebakhtiari@healthleadersmedia.com.

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