Recruiting, Retaining Physicians Requires Finesse

Team oriented. Tech savvy. Quality-driven.

Those are just some of the key characteristics that hospitals and physician groups want to find in the doctors they recruit, says Jim Stone, president of The Medicus Firm, a physician search firm in Dallas, TX. Beyond that, there are practical and emotional considerations: How do the physicians manage stress? How far would they be willing to move?

In the meantime, employers might consider offering signing bonuses and/or relocation allowances. Will they truly "welcome" the potential candidate?  And for physicians, are would-be employers allowing a flexible schedule and making their family fit into the overall employment plan? Is a balanced life possible?

A false move by either party can result in no deal.

Over the last several years, recruiting and retaining have been challenging, especially with uncertain economic conditions. Experts say it's unlikely to get easier soon: A national physician shortage, coupled with restrictive regulations and reimbursement cutbacks, could spell trouble if hospitals and physician groups don't embrace innovative strategies to recruit and retain physicians.

It's not like physicians are exactly in the driver's seat, either. A great clinician who has terrible bedside manner or is uncooperative with colleagues isn't likely to get the job, despite his or her sparkling resume. Behavioral issues weigh more heavily with employers these days.

Moreover, a hospital may offer great benefits and a terrific salary, but be located thousands of miles from where a physician wants to work, thus throwing a monkey wrench into a potential match.

Competing forces complicate the hiring of physicians. The demand for more primary care physicians is juxtaposed against the backdrop of the healthcare transition from "volume of care vs. quality of care," says Stone, who also is president-elect of the National Association of Physician Recruiters.

Nothing can be taken for granted, says Floyd Wilson Jr, executive VP of marketing, physician relations and community outreach at Metro Health System in Wyoming, MI. "It's a great game-changer, volume versus value," Wilson says.

"There are a limited number of providers and everybody is looking for them," Wilson adds. Who gets hired has changed. Bringing on board "the person who has a horrible bedside manner and great outcomes, for the most part, is done," Wilson says. "If you are recruiting a physician, we are looking at the team-focused concept, and everyone coming together in a multidisciplinary team." That would result in improved patient satisfaction scores, for instance.

As Metro Health works to recruit physicians, one of its selling points is the fact that Western Michigan is a "beautiful place," Wilson says. And who helps make the sale? Physicians who already work for the health system, he says.

"The physician group has a very important role in recruiting, especially for those physicians who are from other areas. They are important for the retention piece, too. The physicians who work here are huge, in sharing that message."

In the meantime, hospitals are also considering how adept physician prospects are at using technologies such as electronic medical records and social media, Stone says. They also question their motives in hiring. Hospitals and physician groups are asking themselves these questions: Do we want the physician who's good with a robot? And do we really want a specialist just because the nearby hospital brought one on board?

"We see a lot of competition among hospitals and physician groups to offer the best quality and best variety of services," Stone adds. "I can't tell you how many times across the country a hospital recruited a urologist after another hospital recruited a urologist, or went to buy a robot after another hospital got one, while the patient population may not support two urologists or robots."

"It's a competitive dynamic that drives the recruitment effort, resulting in lengthy and expensive searches," Stone says. "Difficult searches vary from specialty to specialty. Certain searches are always difficult because of overall shortages."

At the same time, employers hurt only themselves by limiting how they carry out hiring searches, Stone says. "I think, unfortunately, employers put up walls and road blocks based on parameters they define at the outset of the search," he adds. Those parameters could be age or training, or other factors.

Stone says that hospitals also may not prepare themselves adequately in the hiring process, whether it's failure to properly plan interviews or draw up a contract.

As physicians consider their prospective employers, they will certainly expect slightly higher salaries this year than in 2012.  Budgeted salary increases have risen 2.6% this year, according to the Hay Group's 2012 Physician Compensation Survey. That compares to a 2.5% increase from 2011 to 2012. Hay Group is a global management-consulting firm that works with leaders to transform strategy into reality.

Generally, physician pay increases will continue, with shrinking labor pools, says Jim Otto, senior principal at the Hay Group, and a leader of the company's healthcare executive compensation practice. But Otto doesn't expect extravagant pay increases, not by a long shot.

"Healthcare organizations and physician groups are dealing with shrinking revenues and increasing demands," says Otto. "How you deal with that is by providing more efficiency. You are going to see continued increases but you are not going to see a spike in primary care salaries."

The major focus, to no one's surprise, is on primary care physicians, Otto says. Those employed by hospitals can expect a 2% salary increase in 2013, while group-based primary care physicians can expect a 3% salary hike. That is compared to an actual increase of 5% in 2012 for group-based primary care physicians, and a 2% salary increase for hospital-based primary care physicians, he says.

"The hospitals are saying, 'we're not going to try to pay what a private practice does' and the reality is that there are benefits to being hospital employed; you have more control over your life than in private practice," Otto adds.

As a physician recruiter, Stone also sees primary care as "the main issue for most employers." While his firm works on hundreds of recruiting opportunities at a time, at least half of those involve primary care and internal medicine, he says. "That's a lot, considering the breadth of specialties there are. I don't think the competition for (primary care) is going away," Stone says.

"Everything within the context of healthcare is going to be dependent upon enough primary care providers or physician extenders to coordinate care," Stone says. Ultimately, those physicians who are able to fall in line with organizational objectives are likely to make more. Those unable to do so are likely to make less."

(A HealthLeaders Media Webcast, Recruiting and Retaining the Right Physicians for the Post-Reform Era is slated for Friday, March 22, with Jim Stone, president of The Medicus Firm, and Floyd Wilson, Jr, executive VP of marketing, physician relations and community outreach at Metro Health System in Wyoming, MI.)