Your Time, Better Spent

There are no shortage of things to do when running a healthcare facility. Chasing down responses from potential physicians can monopolize your time. That’s where AMP can help. The team at Adaptive Medical Partners bring a new approach to an old problem. By focusing on long term partnerships with healthcare facilities, they emphasize the right fit. AMP is not interested in a one-and-done placement. We’re ready to be invested in your long term success.

State of Physician Recruitment


THE COMPLEXITIES OF PHYSICIAN SUPPLY AND DEMAND – A PHYSICIAN RECRUITING PERSPECTIVE

It’s no secret that the physician shortage has impacted physician recruitment in the rural areas of our country for more than a decade. Those struggles continue, but now even our largest metropolitan areas are feeling the effects of the shortage. The Association of American Medical Colleges (AAMC) in its 2017 updated report titled, The Complexities of Physician Supply and Demand predict a shortage of 34,000 to 88,000 physicians by 2025, increasing to 40,000 to 105,000 by 2030.

…2025 is a short six years away, and the impact of this very real shortage is already upon us.

When the report was released in 2008, many of us felt the issues and implications sited were problems for a distant future, but now, 2025 is a short six years away, and the impact of this very real shortage is already upon us. If you have recruited or had a failed attempt to recruit a Family Medicine physician to a rural area you know all too well. What are the contributing factors? How will we remedy them? How severely will your facility and community be affected? What can you do now to weather the storm that is coming if not already upon you?   Contributing Factors

  • Population Growth – The United States is the 4th fastest growing country in the world, are a 12% increase in the population is expected over the next 12 years. A recent US News and World Report article showed that the United States grew by 2,307,285 from 2017 to 2018. In the same article they broke out the top 10 states by population growth which shows some areas are significantly out pacing the 12% expected overall growth. How does your state stack up?Top Ten States by Population growth percentage from 2017-2018 (US News and World Report, 12-19-2018):
    1. Nevada – 2.1%
    2. Idaho – 2.1%
    3. Utah – 1.9%
    4. Arizona – 1.7%
    5. Florida – 1.5%
    6. Washington – 1.5%
    7. Colorado – 1.4%
    8. Texas – 1.3%
    9. South Carolina – 1.3%
    10. North Carolina – 1.1%
  • Aging population – Over the next 12 years, we will see a 55% increase in our population over the age of 65 as the “Baby Boomer” generation enter their golden years. 66% of Americans over the age of 65 have at least one chronic illness and 20% of them see 14 physicians on a regular basis. The subsequent increase in utilization/demand will undoubtedly exacerbate the staffing shortages many facilities already feel the full force of today.
  • Aging Physician Population – More than 25% of practicing physicians are over 60 and likely to retire in the next 10 years.
  • Residency Program Shortage – The Balanced Budget Act of 1997 imposed caps on the number of residents for which each teaching hospital is eligible to receive Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) reimbursement. These caps have remained in place and have generally only adjusted as a result of specific limited and one-time programs. It’s a myth that we don’t have enough students going into Medical School. We have quality students graduating Medical School that do not match to a residency, due to the lack of available residency slots and the limited number of available programs.
  • Immigration Bottleneck – 1 in 4 U.S. physicians, are foreign-born and these physicians are serving primarily in our most underserved areas of the country. Each state is allotted 30 J1 Visa slots for physicians through the Conrad 30 J-1 Visa program regardless of its total population or underserved population. Many of these limited spots go unused because of the archaic distribution factors. There is one additional program that helps to expand the available J-1 visas in several of our Southeastern states called the Appalachian Regional Commission; it’s just not enough.

NATIONAL SCALE SOLUTIONS

While it may seem bleak at the moment, there is a solution. Let’s rephrase, there are several solutions, and it’s going to take all of them, along with a few we have not thought of yet to remedy the shortage. Here’s an excellent place to start.

  • Expanded Residency Programs – The AAMC strongly supports bipartisan GME legislation introduced in both the House of Representatives and the Senate, the Resident Physician Shortage Reduction Act of 2017 (H.R. 2267; S. 1301), which takes an important step towards alleviating the physician shortage by gradually providing 15,000 Medicare-supported GME residency positions over a five-year period. However, this legislation alone will not relieve the physician shortage.
  • Increase Visa Access to Foreign Physicians – The Conrad 30 J1 Visa program needs to be re-worked so that unused slots get redistributed where the need of underserved patient population is the greatest. Increase the total number of Visas available to foreign physicians. More programs like the Appalachian Regional Commission need to be created.. Create programs to vet the quality of international training programs, reducing the need for duplicating residency training or at least allowing a pathway where qualified foreign physicians are not required to repeat a full residency training program before establishing their full-time practice.
  • Innovations in Delivery – Significant expansions in Telemedicine are needed to bring virtual specialists into underserved areas. Technology needs to be better utilized to deliver prescriptions directly to the patient where risk is low and appropriate, reducing unnecessary physician visits whenever possible.
  • Continued Expansions in Physician Extender Support – A trend that has been ongoing for many years now and is sure to continue for many more. Specialization of these providers has been a natural progression as demand increases in areas like mental health and others.

YOUR FACILITY SOLUTIONS

While we all play a part in these large national focused solutions, there are solutions you can employ right now in your facility. Preparation and strategy will help you weather the shortage that will be the demise of many who are ill-prepared for the increasing challenges on the horizon.

  • Retain Your Current Staff – The best and easiest physician you will ever recruit is the one you already have. Physicians need the same things all of us need in a work environment. A fair and equitable workplace, positive core leadership, open and transparent communication and having a voice all add up to a great environment. You don’t have to look too far to find an article or blog post on Physician Burnout. Remember, no one will feel the physician shortage more severely than the practicing physician.
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  • Defined Recruiting Strategy – There are many variables that you will need to consider. Finding the right strategies will take time and money. Physician recruiting is a moving target that may require a different approach for different specialties or practice settings. Every community or facility is different with their unique challenges, and potential offerings or upside to the physicians you are working to attract.The best place to start recruiting your next physician is with your current physician staff. Nurturing your physician staff’s relationships allows you to turn every member of your physician staff into a physician recruiter every time they attend a conference or speak to a colleague. There was a time in the not so distant past when this was the only way physicians were recruited at many facilities, of course, there are several other methods these days, primarily born out of supply and demand. There isn’t one method that works every time for every situation or specialty. You will need to have layers in your physician recruitment strategy that are weighted by urgency, specialty, and budget. Finding the right physician recruiting partner or employing your own in-house recruiting team is likely already a large part of your physician recruiting strategy. If you have a trusted physician recruiting firm placing providers for you, stick with them. If you don’t, find one. Experience and the quality of character in your recruiter are of the utmost importance. Second to that, is the quality of the sourcing tools they have at their disposal and how they leverage those tools. Communicating your position to the market in a robust way that cuts through the noise of the competition is a complex task. You can’t build a home using only a hammer, and you certainly can’t recruit a physician with just one sourcing method. Physicians communicate and receive information differently. Text or e-mail may be the preferred method for some, especially the younger physician market, while more seasoned providers may prefer an email followed with a phone call. Finding and utilizing the smartest technology to communicate your opportunity across multiple platforms to ensure you’re getting the message out to the right market with the best analytics is key to your physician recruiting success.
  • Home Grown Physicians – Promote opportunities for students in your community to explore careers with your facility. Proctorship programs along with tuition incentives will encourage these young students who are from your community with deep family ties who could serve your facility in an uncertain future. Imagine the pride of seeing someone come home after residency to serve their community. Imagine how much easier it will be to retain them.

Even if there are significant changes to improve the current physician shortage, it will take years to take effect in any meaningful way. Understanding your unique challenges and developing a physician recruitment strategy will put your facility in a better situation than those who do nothing or continue with outdated methods. Preparation, innovation, and strategy are crucial to weathering the shortage.

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Passive Versus Active. We hear this all the time but what does it even mean?


It depends on whether you are talking about the candidate or the recruiting approach. A passive physician candidate is a good thing while a passive approach to physician recruiting is not.

Active marketing finds passive candidates while passive marketing finds active candidates. Passive versus Active Candidate The Passive Candidate – A passive candidate is someone who is interested in pursuing new opportunities but has not yet taken any action to put themselves into the open market; therefore, they are not getting solicited day and night from every physician recruiter in the country. An interested passive candidate is the best candidate you could interview for one simple reason. These candidates have less competition on them than the candidate who is actively looking for opportunities. Given how competitive physician recruiting has become now that we are in the throes of a real physician shortage having a captive audience with a candidate, or at least diminishing the number of other opportunities they are looking at increases the odds of actually signing them. Sourcing the passive candidate requires a form of direct contact. It could be a candidate you found through word of mouth from your physician staff or network. It could also be a response to a web or print posting you have out, but I’m sure you would agree that sourcing a passive candidate with a passive source like a posting is akin to attracting a unicorn with pixie dust. Typically getting a response from the passive candidate market is the result of direct marketing emails, text, physician-specific social media targeting or utilizing a retained physician recruiting firm who has access to an extensive database of providers along with access to the latest direct sourcing tools. The Active Candidate – The good news about an active candidate is that one thing is sure, they are looking for a new position. The bad news about the active candidate is that because they are putting themselves out to the market by sharing their CV on multiple job boards, they are looking at numerous opportunities at once and engaged with who knows how many recruiters. If your location is ideal, your facility is new and beautiful, and your compensation package is north of 75 percentile MGMA you are probably in luck. The problem is that stringing together this sort of trifecta only accounts for about 1% of facilities out there If you don’t fall into that 1%, then you are going to be competing with other offers during your closing process. In other words, these candidates are fickle and likely to take another position after wasting a great deal of your time and resources. Something else to keep in mind is that recruiting from the active pool of candidates will require more interviews overall. This will increase your recruiting cost and time investment (yours and your staff) significantly. Another factor you may not have considered is the psychological impact of your current physicians when they see candidate after candidate interview for a position that remains open. It may have them begin to question whether or not they are in the right place themselves. After all, they are getting solicited every day to look at other opportunities too. Physician burn out is exacerbated when your physician staff is spread too thin and seeing candidates pass on the position they are working in can have a negative impact on their attitude.   Passive Recruiting Approach – Often referred to as “Post and Pray” recruiting. It’s like setting a trotline and hoping the fish bite. Postings of any sort fall into this category. If you aren’t actively pursuing the candidate with some direct contact, you are recruiting with a passive method.

“POST AND PRAY” is not an effective recruiting strategy.

Active Recruiting Approach – Just what it sounds like. Actively sourcing candidates. Cold calling, emailing, texting, messaging through physician-specific social media sites and so on. To keep with the fishing analogy, this is more like fly fishing. Using a specific fly to cast into an area where you see the trout swimming and sticking with it until you land a basket full. Actively recruiting the Passive candidate is the preferred method of any experienced physician recruiter. Reducing competition any chance you get is key to increasing your odds of success in a market this competitive.

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5 common interview scenarios to avoid


In a recent dialogue with Dan Jones, Associate Director of Recruiting here at AMP, we discussed several scenarios in the interview process that occur on a regular basis that doesn’t serve the candidate or employer well. Below are some things that may prevent success during your hiring process.

  1. Not engaging the staff and key personnel in the interview process – Candidates like to meet with potential colleagues and gain insight into what it’s like to work for an employer. Similarly, if someone is involved in the decision process, then they need to meet with the candidate.
  2. Poorly organized itinerary or a complete lack of an agenda altogether – A “fly by the seat of your pants” approach for interviewing signals dysfunction, muffles your company vision and seeds doubt in the candidate’s mind about your seriousness in hiring them.
  3. Not engaging the spouse – If relocation is involved, you are recruiting the spouse as well as the provider. Find out what the spouse needs are and do your best to accommodate those needs while they visit onsite.
  4. Not addressing concerns about a candidate – If you have questions about a candidate, the interview is the time to address those concerns. By the end of the interview, you should have enough information to know if you are going to move forward with an offer of move on to other candidates.
  5. Not providing a professional, insightful community tour – When providing a tour of the community for the candidate and spouse, it needs to be conducted by someone who can provide accurate and pertinent information, i.e., demographics, school ratings, state of the real estate market, etc. Just pawning a candidate off on someone to drive them around town for a while will not impress candidates.

As much as you are interviewing them, candidates are evaluating you to determine if your opportunity and community are a good fit for them and their family. Spend time curating a detailed interview process, and you will see it pay dividends. While not an exhaustive list, based on candidate observations, these are the most common mistakes which lead to negative interview feedback.

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Organize
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If you are looking for a firm who can not only deliver, but match a candidate to fit what your profile looks like and one that will stay for year…Adaptive is the way to go.

Administrator | Texas Hospital

Our community is now being seen by well qualified “top-notch” providers and they owe Adaptive Medical Partners a big “Thank You” for bringing cared to our community. Each provider placed by Adaptive is a great fit to our hospital and area and are indeed well worth their weight in gold.

Director of HR | Arizona Hospital

From the outset of our relationship we found Adaptive Medical Partners to be flexible and enjoyable to work with. Their onsite consultation, market insight and assistance in forming a successful strategy were invaluable. We also appreciated the constant communication and availability of our recruiter, who we could reach at any time, day or night, week day or weekend.

Founder & CEO | Georgia Psychiatry Practice

Adaptive went far and beyond what was required of him to make sure that my application process, interview, and employment securement went as smooth and hiccup free as possible. I felt secure in knowing that Adaptive was on my side and was looking out for MY best interest.

Psychiatric Nurse Practitioner | Kentucky

In healthcare, time is money and Adaptive Medical Partners’ hard work has allowed us to keep our complete services up and running. We are not a large organization and finding the time to conduct a successful recruiting effort would have been very difficult without Adaptive Medical Partners.

CEO | Nebraska Medical Clinic

Adaptive had innovative ways for sourcing candidates and even some technology features that I hadn’t seen before from other firms. They were very easy to work with and their customer service is second to none.

CEO | Western Kansas FQHC

We have worked with Adaptive for years and placed many find physicians through your firm, and there is not another retained firm that I would consider engaging.

Director of Physician Recruitment | Tennessee Medical Center

We have found Adaptive to be a beneficial partner and continue to utilize their services for ongoing recruitment.

Hospital Administrator | Pennsylvania Hospital

Adaptive Medical Partners took the time to understand our practice and focused on securing
providers that would be a good fit, not only for our practice, but also for our community.

Executive Director | Family Services Non-Profit

We recently engaged Adaptive to help recruit board certified physicians for our rural health centers. In less than seven months, we have signed agreements with six physicians. Our location is in a rural area and has always presented a challenge. Together with our recruiting consultants, we have developed a strategy and process to target and retain the right physicians for our community.

CEO | California Health Center

Our relationship with Adaptive Medical Partners has been a great move for our physician recruitment efforts. We have placed one very difficult search and have had several good candidate interviews for another search. I look forward to continued success with Adaptive.

CEO & Administrator | Tennessee Hospital

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