Physician recruitment is hard, it’s inconvenient, and doing so successfully takes a lot of time, effort, and patience. Physician recruitment is as challenging today as it has ever been.
We are asking our directors to answer the tough questions in order to help our clients improve their recruiting strategies. We start the series with Tim Ketterman, Senior Director and Recruiter for Adaptive Medical Partners.
What is one of the biggest challenges facing physician recruitment in 2018?
Surprisingly, one of the less talked about challenges facing our clients isn’t recruiting at all, but actually retaining the providers we recruit, or are already on staff. We actually look at it as an opportunity though, and are eager to help our clients improve their retention strategies.
When meeting with clients, I am often surprised by the lack of attention retention strategies are given, even by the best-run organizations. Retention is one of the most important, yet overlooked recruitment strategies in our industry.
How can organizations improve their retention strategy and rate?
Step one, is to listen to what their doctors are asking for. One of the benefits of working for a firm that focuses on permanent physician placement is the access we have to active candidates, and the feedback those candidates provide us during the recruitment process.
Our recruiters speak to hundreds of physicians each week. Often times, the primary focus of those conversations is to identify the physician’s motivation to seek alternative practice options, to identify their pain if you will. Often the primary motivations given by physicians who are active in the market are not what you might think, and some are within the control of organizations that are committed to making “retention” one of their recruitment strategies.
So what do the doctors want?
In truth, we could spend hours discussing all the reasons physicians have given us, but; there are five key motivations relative to retention that we hear from doctors, and which are within the control of employers.
First, is work/life balance. There is a tipping point in every physician’s practice when the time invested no longer delivers his or her expected return. And by return, I don’t just mean financial. This tipping point is different for every physician. The challenge is, most employed practice models are inflexible, designed as one size fits all options. These types of practice models are becoming obsolete, and should probably be stored away in the same closet as all the old patient records and paper charts. We ask our clients: Do you know what that tipping point is for your physicians? Is your practice model adaptable enough to fit the individual needs of your providers while also accomplishing organizational goals? If not, we can help come up with solutions.
Next is often spun by physicians as limited support from the administration and leadership. What we’ve learned though, is it’s actually more about limited access than limited support. When physicians discuss concerns about their current practice with us, we always ask two questions; one, have they spoken to administration about their concerns and, two; if administration was able to address their concerns would they stay? The answer too question two is often, yes, they would stay. The answer to question one though is surprising. Far too often, their answer is no. They’ll say “our administration doesn’t care, I’ve not even had a one on one with our CEO since my interview”. Or, they’ll say “I’ve tried, but can’t even get a meeting with my CEO or CMO, they are too busy and I’m tired of waiting”.
We consult with our clients, and recommend that they are proactive with their staff. Regularly schedule check-ins, see how they are doing and if there is anything you can do to improve their experience. I’ve had one client who would randomly put himself on his physician’s clinical schedule, an office “well” visit if you will, just to do a little check up from the neck up with his providers. 10 minutes of one on one time made all the difference. That same organization had less than 5% turnover.
Surprisingly, changing just to change or adjusting the practice is not always necessary to keep a provider content. Simply providing access and letting them know their concerns have been heard can be enough.
The third issue we hear from physicians are concerns about overly complicated production models. Physicians, like all of us, are looking for simplicity, or more importantly transparency when it comes to compensation incentives.
Whether quality or production based, hidden caveats or “gotcha” clauses are not necessary. Whenever possible, the criteria to meet whatever incentives are available should be objective instead of subjective.
So our advice to clients is to keep things simple and transparent. It builds trust and loyalty with your medical staff. We’ve seen physicians accept lower guaranteed compensation because the incentive model was transparent and simple.
The fourth complaint we hear from candidates is that the RVU factor is not competitive. RVUs are not the mystery they use to be, and physicians today are as educated as they’ve ever been on what RVU factor is competitive. In fact, the RVU has become one of the most negotiated elements of a contract.
A reputable recruiting firm will provide this information to you, but the opportunity cost of losing your provider may be greater than the actual cost of bringing your RVU factor up to a competitive value. Physicians want fair models, that are competitive not only regionally, but also nationally, and that compensate them commensurate with their level of production. Providers who produce in the 75th percentile want to be paid in the 75th percentile and so on.
And finally, we are seeing more outmigration from larger systems. Primarily due to the perception of power being taken away from local administration. Whether accurate or not, perception is reality and organizations who struggle with these optics have trouble with retention. It’s surprising how often a physician shares with us their frustration of working for an organization that makes universal decisions from afar, with no understanding of how a system wide mandate may impact the local market. This is really about developing sound communication and implementation strategies for organizational changes. However, we do see that organizations who are nimble and able to respond to “LOCAL” market factors impacting local physicians are better at both retaining their current staff and attracting new providers.
So what do you have to do to tackle this challenge and seize this opportunity in 2018?
It is important to remind our clients that the expense of replacing a physician is often greater than the expense of retaining them. That’s why they hire us: we know what physicians across the country are asking for. And we will not only work to find the right fit, but will also help our clients ensure their retention plan will keep the new hire for a long time.
