So, if a hospital is recruiting more than five physicians annually, or it expects a large number of retirement vacancies in the next few years, the dollars could add up quickly, notes Walker.
For example, Carolinas HealthCare System in Charlotte, NC, which employs more than 1,400 physicians, is third largest nonprofit public system in the nation. In 2008, CHS had 280 physician openings, according to Sandi Buchanan (Brewer), assistant vice president of physician services. Had it paid a physician search firm $18,000 to $30,000 per candidate, it would've cost the facility between $5.04 million and $8.4 million to fill those slots. Compare that to the cost of the in-house recruiter. For instance, CHS has five physician-only recruiters who not only search for physician candidates, but they also help these docs through the process. If the salary of one FTE is as much as $70,000 and each staff recruiter brought in approximately 56 candidates last year, then the cost to recruit a candidate using the in-house team is approximately $14,000 versus the $18,000 to $30,000 of an external recruiting firm.
"The reason we've kept recruiting primarily in-house is because we can do whatever an external firm can do for less, and we care about the facility and who we recruit. We want them to be a good fit, because they are going to be part of our community," adds Buchanan (Brewer).
Additionally, Jamison notes that some physicians are more willing to talk to an in-house recruiter because they know the recruiter works for the organization and that they will be able to get all the information and insights the physician needs to fully understand and evaluate the job. "External firms do a good job getting to know a facility, but unless you work there every day, you can't know the nuisances," she says. "It makes the experience more personal."
Keep outsourcing option
Though moving the majority of recruiting in-house can save hospitals a bundle, external firms do serve a very important purpose: They're fast. Given enough notice, in-house recruiters can locate quality candidates in about three to six months, but when a role needs to be filled immediately, most facilities don't have a ready pool to dip into.
"When we have a physician leave unexpectedly, we'll go to a locums firm to help us fill the slot in the transition," says Buchanan (Brewer). She adds that CHS has a reserve pool to draw from its retired and temporary physicians.
Although Jamison and Walker have well-established in-house recruiting, they don't rule out the use of locum tenens when an immediate need arises or when a unique specialty vacancy needs to be filled. Walker adds that smaller facilities that are only recruiting a couple of positions a year should use such services or have an in-house recruiter who also fills another role, such as compliance officer.
"Hospitals may not see result the first year this program is in place. It takes a true two- to three-year commitment to make this program work; it's not a quick fix," Walker notes.