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Physician Recruitment:
Center Stage in Organizational Growth Strategies
How to Hire the Candidates You Want to Further Organizational Success
Author: Allison McCarthy, MBA
Originally published in the November 2002 issue of Healthcare Marketing Report, the author updated the content in March 2009 to reflect the increasingly competitive recruitment environment.
It's a challenge in today's medical marketplace to keep the lid on costs while moving forward with new programs and services in the all-important race to capture market share. In order to stay healthy, hospitals, managed care organizations and group practices have had to do some hefty belt tightening. While cost reductions have been an industry focus for several years, trimming and tucking alone have not solved the financial crisis. Hospitals and large group practices are now turning to growth strategies to further improve financial performance.
Whether the strategic plan calls for an increased presence in a key market, a new clinical program, or improved overall market share, recruiting the right physicians to attract patients to the organization becomes all important in achieving strategic goals. Without physicians, there are no patients. Indeed, doctors have become key drivers in an organization's growth strategy. Simply put, finding and hiring the right physician is a prescription for success.
As a result, those responsible for strategic planning and marketing are now facing physician recruitment as a new job assignment. Healthleaders Media recently marketing leaders' survey uncovered, from the 89 participating respondents, that physician recruitment was the second strategic organizational priority — just behind quality and patient safety. They recognize that building an effective recruitment function within the organization is crucial to the long-term success of the strategic plan. What follows is some how-to advice on building and sustaining a topnotch physician recruitment operation.
It's Competitive
Be prepared to do battle. That's because many organizations are fighting over the same physicians. Add to that a shortage of doctors in key specialties and certain geographical areas and the process becomes that much more intense. How can you make sure you're on the winning side?
One way to finish first is to play up the positives in your opportunity and manage any negatives. Let's face it. Every place has its potential weaknesses, be it organizational politics, the geographical area, the cost of practicing and/or living in that area, to much or too little HMO penetrations, or soaring malpractice rates. But it's a balancing scale — and as long as the organization is more heavily weighted on the positive side and is demonstrating to candidates a willingness to work through potential issues then the physician recruitment market will consider those opportunities attractive.
Recruiting 101: A Basic Primer
So what do you need to know to manage an effective physician recruiting effort for your organization?
Understand that physician recruiting is a very sophisticated process that tends to be most effective when it's centralized within an organization. Organizations devote considerable time and money to do it well. And physician expectations have changed. Those fresh out of training today are savvier about what they should look for in practice opportunities; what their expectations should be around job satisfaction; and how they should be managed through the recruitment process. One small bump along the road in how you treat candidates on the phone or in person and they could decide to go elsewhere.
Assigning one person to guide the effort, with support staff if necessary, is the best way to go. One office can more efficiently and cost effectively covers multiple needs instead of each department running its own recruitment show. That's not to say you don't work closely with each department. They are an integral part of the recruitment process. But designating one person to manage candidates, CVs, site visits, and contract negotiations gives prospects a personal contact for any questions or concerns they might have.
Having acknowledged the sophistication of the effort and the centralization of the function, what's the basic recipe for success? In short, recruitment requires planning and preparation, organizational commitment, effective sales and marketing skills, process-driven strategies, and good retention practices. It boils down to nine key ingredients:
Prepare a Game Plan
You can't plan enough in this business. Treat this like a strategic marketing campaign. Talk with your physician leaders and key admitters to pinpoint niche services and outline strategic goals. Fold this information into a medical staff development plan that details how many doctors, and in what specialties, you'll need to bring on board to accomplish those goals. Outline timelines and budgets for each position you need to fill, understanding that it can take up to 24 months before the right candidate is in place.
Tap an Internal Team
It doesn't work to go it alone. You need to establish an in-house recruitment team of administrators and physicians to be part of the search process. Hold meetings to review goals, roles and responsibilities. Coordinate training sessions on everything from the "how to's" of effective telephone screening to tips for hosting site visits and mentoring new hires. Be certain your team understands the practice arrangement and compensation plan. Can they knowledgeably handle community and life-style questions? You need to coach them to sell not only the organization and the specific opportunity, but to evaluate the candidates at the same time to determine if they're the right fit for the job.
Do the Legwork
Review all the data you can find about market opportunities. Gather national and regional statistics about your target market. Rely on the American Board of Medical Specialties, the American Medical Association database, and other resources to learn about numbers and location of physicians in key specialty areas. What is the local market offering in terms of compensation and benefits for the specialty you're recruiting? The bottom line: How can you "sell" your position as the most attractive employment opportunity in the marketplace?
Put Your Best Foot Forward
You need written materials to recruit with pizzazz. Find or generate marketing promotional materials to describe your geographical location, hospital, group practice, community and schools. Don't be discouraged if your market seems to have less appeal — either because of geography or other features that you can't change. Hard-to-recruit markets take more effort in the way of mailings, personal calls, working with residency programs, networking and following—up with every candidate who seems the least bit interested. Statistics prove that a large percentage of physicians choose to practice where they have ties, either because they grew up in an area, went to school there, or have family nearby. Network to find physicians with a geographical kinship.
Review the backgrounds of your current medical staff. Do they come from the same geographical area or training program and if so, use that information to target that regional group. Ask your existing staff to work any connections they might have with medical schools or professional organizations. Don't exclude physicians already settled in your area as potential candidates. Consider internationally based physicians, particularly Canadians, many of whom already speak English. And in especially challenging markets, take advantage of U.S. Public Health Service, National Health Service and Indian Health Service opportunities for loan repayment to physicians who practice in underserved areas.
Set the Parameters
Before the prospecting begins establish your search criteria by defining educational requirements, professional experience needs, and the personality type necessary to fit into your medical community and practice. Decide if your organization has any special requirements, such as language skills or ethnic backgrounds, to meet the needs of your patient population. Compose a one-page synopsis of the practice opportunity and fire it off to prospective candidates. Ensure that financial pro formas and contracts are ready to go.
Fill the Funnel
Keeping the funnel filled is the best-kept secret about physician recruiting. You can't wait for physicians to beat a path to your door. You have to chase the doctors you want. Some specialties have large numbers of physicians to access while others (such as pediatric specialties) have only a few hundred even available nationally. The point is to continuously generate new leads so as to have screening and selection options. Here's how to fill the funnel:
Purchase a list of physicians culled from criteria such as medical specialty and current geographical location. The American Board of Medical Specialties, the American Medical Association, and licensure boards can supply these lists. Send direct mail announcing the opportunity and then do some outbound calling as well. If the physician you reach is not interested, ask if he or she knows someone who is.
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Attend recruitment fairs and specialty meetings.
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Advertise in medical and specialty journals and on the web.
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Solicit residents by posting flyers and announcements at area programs.
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Ask your medical staff for recommendations.
Show Your Cards
After you complete phone calls and check credentials and references, it's time to lay your cards on the table and issue invites to a handful of star candidates. A typical two-day visit involves meetings with administrators to talk about organizational philosophy and budgets; tours to orient them to the hospital and office location; meetings with potential colleagues; a community tour with a local Realtor; and dinner gatherings with your internal recruiting team, medical staff and spouses. Ask your recruiting team to help you evaluate prospects on: communication skills, work ethic, interpersonal skills, maturity, judgment and common sense, long-term interest, education and experience, ability to manage a practice, cultural fit with your community, and ability to work with your medical staff.
Clinch the Deal
You have to be prepared to go the extra mile for your final candidates. You may need to sweeten the deal with relocation assistance, volunteer to help spouses find new employment, or gather information on special needs and school issues for children. Your recruiting team should put the prospect in touch with Realtors and banking resources, and set up get-acquainted dinners with medical colleagues and spouses.
Hold Mentors Accountable
Like seedlings in soil, new people on board require special attention early on to be sure all is well and that they're settling in nicely. In other words, you want to nurture your long-term investment. Select a person on your recruiting team to watch over the new hire as he or she settles into the job and community. Have your mentor schedule weekly, then monthly, and finally quarterly conversations to address and resolve any issues that might arise. Mentors should also host them in key meetings and activities.
What Makes a Top-Notch Recruiter?
It's best if you have at least one knowledgeable person on the inside who really understands your administration and medical community, can persuasively sell your employment opportunity to the right candidate, and who can confidently handle the contract negotiations. Your prospects and internal team will value the recruitment process even more when it's driven from the inside.
So what skills should the insider have? Think 3D's: diplomacy, discretion and determination to land the right person. Diplomacy is especially important. Not every member of the medical staff always agrees that a position needs to be filled in the first place. A successful recruiter has to be savvy enough to manage those differences of opinion.
Good recruiters enjoy being with people, talking on the phone, going out to dinner. Excellent interpersonal skills are essential. Sound business skills are an asset when it comes to managing budgets wisely, and it helps to be organized, as there are many balls to juggle as the process moves along.
Another key consideration is accessibility to the CEO and top layers of the organization. An effective physician recruiter has the CEO's ear to share the medical staff's differing opinions and perspectives, and to solicit input on conflict resolution.
Consultants Can Help
Consultants can bring added value to the recruiting process. You may want to use external agencies to help with a politically charged search or a search of unusual complexity. Some recruiters focus solely on certain specialties, such as cancer or cardiology, while others are more general. You can also retain consultants to create the medical staff development plan or to manage senior leadership buy-in to the recruitment initiative.
Exclusive retainer relationships are your best investment for superior service. That way you partner with a consultant who has your organization's best interests in mind. You want your outside recruiter working for your opportunity and organization, instead of directly for the physician who is shopping around to see what positions are available. Understand that compensation is different in both cases. Some hospitals prefer contingency relationships because you don't pay the consultant unless the physician they represent is hired. In a retainer situation, you pay for loyalty and regular service. Another benefit of hiring an outside person is that because they know what other organizations are offering, they can give you a better sense of your compensation package's competitive attractiveness in the marketplace. And they have a bigger funnel of qualified candidates to source from.
How Do You Measure Success?
Before you contract with any consultant, ask for a client list so you can check on their results. Once hired, judge your consultant's success by looking at the quantity and quality of the candidates generated. Is your consultant filling the funnel? Checking references? Sending along qualified candidates who are as interested in you as you are in them?
Whether it is your internal recruiter or consultant, ask them to submit regular reports about the work being done on your behalf. Look for number of solicitations made versus responses received. If the recruiter contacts a sizeable group of physicians and a significant majority is not interested, you might need to reexamine the attractiveness of your practice opportunity.
Hire the Candidates You Want
You must rely on your own powers of persuasion, consultants when you need them, and physicians already on staff to help position your organization. To be effective at physician recruiting, and further the strategic success of your healthcare organization, you need a good opportunity, a market-competitive package, internal support, solid organization, and the determination and drive to go after, and hire, the candidates you want.