Recruiting And Retaining Physicians: A Strategic Approach For 2020

More than 20 percent of doctors plan to make a career change within 12 months, according to a 2019 survey from the Medicus Firm.(1) The data suggest about 11 percent are “definitely” leaving and 14 percent are “likely” to switch jobs.

What’s more, as many as 70 percent of physicians across all specialties change jobs within their first two years in the profession, according to Today’s Hospitalist.(2) While half of physicians stay in the area in which they trained, many will be tempted by new opportunities.

Why Physicians Change Jobs

When it comes to changing jobs, doctors can be their own worst enemy. Maiysha Claiborne, MD, points out in her OpMed article “3 Mistakes Made by Physicians Changing Careers,” that doctors who are considering changing jobs often don’t identify the real problem with their current position or what they envision as their ideal job (or life, for that matter).(3) They also often fail to get the right mentorship and guidance.

Physician recruiters should get to the heart of why these doctors want to change jobs and help them identify what the current problems are and what they (and their families) really want for the future. By addressing these factors, recruiters are better able to secure physicians who will want to stay. Some of the factors that contribute to physicians’ decisions to leave their position include:

Compensation: The need or desire for better compensation tops the list of reasons physicians leave their positions.That’s why it’s important for physicians and recruiters to have an accurate view of how (and how much) physicians are paid. Doximity’s 2019 physician compensation report(4) is a good starting place for that information and can help recruiters benchmark salaries according to specialty and location.

Work-hour requirements: We are in the midst of a burnout epidemic. Too many scheduled work hours or excessive on-call time can be a major burden. Physicians want to spend more quality time with their friends and family. Other contributing factors to burnout are bureaucratic responsibilities like charting and paperwork. A study published in the Journal of American Medical Informatics Association(5) found that the use of electronic health records can take up a significant amount of family physicians’ workday, making it more difficult for them to focus on their jobs and contributing to burnout.

Physicians want more time for themselves and they want to spend more of their working time caring for patients. It’s important to consider these factors when creating a sustainable work culture at the practice or hospital.

Change of location: Some doctors may want a change of scene, to work in a better climate, or to relocate for family reasons. Physicians tend to prefer practices in major metropolitan or suburban areas (the southeast region of the United States remains the most desired region to work) according to the 2019 Physician Practice Preference & Relocation Survey.(1) In fact, the National Institute of Health reports that about one of every five U.S. citizens lives in a rural location while only one of every 10 physicians resides in rural areas. (We’ll touch on rural recruitment more specifically later.)

Career advancement: Advancing their careers is another factor motivating doctors to look for a new job. They may want fewer administrative duties, a new practice partner, or to leave independent practice altogether.

Merritt Hawkins(6) found that the vast majority of residents (91 percent) would prefer to be an employee of a hospital, medical group, or other facility than to be in independent private practice; and four out of five residents will start their medical career working for a hospital. After all, it’s getting more difficult for independent practices to succeed alone, so employment at a hospital or within a healthcare group (with more financial security and less risk) is appealing.

The good news for physicians is that it’s a great time to work in healthcare. Being a physician ranks No. 8 overall in the U.S. News & World Report ranking of the “Best Jobs in the U.S.”(7) But the challenge for recruiters is that the unemployment rate for physicians is also a mere 0.5 percent according to the U.S. Bureau of Labor Statistics, so they need to offer the right kind of culture and incentives that attract and retain talented physicians.

Recruitment Strategies

The job market for doctors is booming and competition is fierce, so it’s important that recruiters differentiate themselves when engaging with desirable candidates.

Culture: A higher salary rarely makes up for a location that isn’t right for a candidate or his or her family. Physicians tend to accept jobs that “feel right,” so it’s critical to know the market demographics, understand the local cost of living, and know how to sell everything from local schools (for candidates with children) to recreational and cultural activities. And don’t forget about job prospects for partners and spouses.

Perks and incentives: Many organizations offer top talent perks such as health benefits, malpractice insurance, relocation allowance, continuing medical education reimbursement, educational loan repayment, retirement/401K plans, and/or a signing bonus. These types of perks can go a long way in swaying a physician to join and stay with an organization.

Engaging physicians online: Undercover Recruiter found that 90 percent of job seekers use mobile technology (45 percent of those search for jobs online at least once a day) and 70 percent of employers say they have successfully hired using social media.(8) Consequently, technology should be a recruitment tactic for 2020.

In such a high-demand market, social recruiting has become especially important because it allows recruiters to broaden their candidate pool and connect with both active and passive job seekers they otherwise wouldn’t be able to reach. Surveys have found that the vast majority of U.S. physicians are passive job seekers, which means they are open to exploring new job opportunities, but only if the opportunity comes to them.(9)

A job board might reach a mere 11 percent of candidates; however, a SHRM survey(10) found social recruiting has the potential to appeal to more than 80 percent of candidates. Recruiters should establish a presence on the network(s) they choose. Just as recruiters like to learn about candidates based on their online presence, candidates are interested in learning about recruiters also. The recruiter’s social profile often is the first thing a candidate sees, so it should offer a positive representation of the recruiter and the company.

Taking it offline: Technology should be part of the recruitment strategy, but it’s important to use the phone as well. The email inboxes of physicians are bombarded with recruiting messages and more. Newly minted doctors often are recruited as though they are sports stars courting a Nike deal, so picking up the phone and building a relationship is key. This kind of personal touch may make or break a strategy moving forward.

Referrals: It’s also important to rely on the best asset on hand: physicians who already work with recruiters or at their facility. They are a reflection of the organization’s culture and can be an asset in judging a candidate’s suitability.

Rural Recruiting

Recruiting for rural positions presents unique challenges. In rural America, physician recruitment is a life or death issue for patients and hospitals alike. The National Rural Health Association reports that more than 25 percent of the U.S. population lives in rural areas, yet less than 10 percent of the country’s doctors practice there. In fact, a recent poll(11) indicates that one out of every four people living in rural areas said they couldn’t get the healthcare they needed and about a quarter of those said it’s because providers were too far or too difficult to get to.

Supply and demand still reign, so compensation is always a factor. While it’s true that less-populated areas still tend to have a higher average compensation than larger cities (according to findings from Doximity’s 2019 compensation report)(4), the reality is that salary alone isn’t enough to incentivize doctors to work in rural communities.

There are a few things to consider when selling candidates on rural jobs. A signing bonus and paid sabbaticals are at the top of the list of desirable incentives. In 2018, the average signing bonus for physicians was $32,692 according to the 2019 Review Recruiting Incentives from Merritt Hawkins,(6) although the New England Journal of Medicine (NEJM)(12) reports that some doctors have seen signing bonuses for non-urban opportunities as high as $100,000 — particularly for primary care. Lost Rivers Medical Center in Arco, Idaho, where elk and bears outnumber the human population, says the cornerstone of its recruitment is 10 weeks of paid sabbatical a year.

Beyond bonuses and paid sabbaticals, there are other draws to rural opportunities. Many doctors want to get back to their roots, enjoy a slower pace, or be part of a small-town, tight-knit community. They also want to spend more time with patients — and in a rural setting there’s not only an opportunity to help underserved patients, there’s more opportunity to build better patient relationships. Most physicians who have practiced medicine in rural areas agree that their relationships with patients are better than they are in urban or suburban practice.(13)

Many people mistakenly believe rural doctors don’t see interesting cases or that their medical skills will atrophy. Leslie Hayes, MD, who practices family medicine at El Centro, the rural health care network in New Mexico, encounters new challenges every day. The PBS film The Providers chronicles the lives of Hayes and other physicians at the clinic where they treat patients with chronic conditions and substance use disorders, deliver babies, and more.

Candidates who like to hike, bike, fish, etc., likely will enjoy certain rural locations. The key is helping to integrate the doctors into the community. Personnel at Ogallala Community Hospital in Ogallala, Nebraska, say recruiting doctors to their hospital has required them to become “social matchmakers.”(14) If a doctor likes sports, administrators may suggest they volunteer as team physician at the high school; or if they love art, they could volunteer on the planning committee for the local arts festival.

The lower cost of living can be inviting in rural areas. While many factors influence how people spend to live, it can make a big difference for doctors who are paying off medical school debt. Missouri, which comes in fourth lowest on the cost of living index(15) has 369 rural health clinics.(16)

Multi-Pronged Strategy

In summary, it’s important to start from a place of understanding what motivates physicians to look for jobs. Building a multi-pronged recruiting strategy that uses the right channels to attract physicians and offering incentives that can seal the deal will help with recruiting and retention in the years to come.

REFERENCES

1. The Medicus Firm. 2019 Physician Practice Preference & Relocation Survey. The Medicus Firm. Atlanta, GA. 2019. Accessed at https://www.themedicusfirm.com/pdf/TMF_2019_Physician_Practice_Survey.pdf

2. Gesensway D. Leaving So Soon? Today’s Hospitalist. October 2011. Accessed at https://www.todayshospitalist.com/leaving-so-soon

3. Clairborne M. 3 Mistakes Made by Physicians Changing Careers. Op-Med. May 29, 2018. Accessed at https://opmed.doximity.com/articles/3-mistakes-made-by-physicians-changing-careers

4. Doximity. Doximity’s Third Annual Physician Compensation Report. Accessed at https://info-tf.doximity.com/2019compensationreport?hsCtaTracking=789a75e8-fc81-4be9-b6f3-0cff91301747%7C3030d173-b614-4997-bf46-a837bcf0c1aa

5. Gardner RL, Cooper E, Haskell J, Harris DA, et al. 2019. Physician Stress and Burnout: The Impact of Health Information Technology. Journal of the American Medical Informatics Association. 26(2):106-114. Accessed at https://academic.oup.com/jamia/article/26/2/106/5230918

6. Merritt Hawkins. 2019. 2019 Review of Physician and Advanced Practitioner Recruiting Incentives. Dallas, TX: Merritt Hawkins. Accessed at https://www.merritthawkins.com/uploadedFiles/MerrittHawkins_2019_Incentive_Review.pdf

7. U.S. News & World Report. 2019. 100 Best Jobs of 2019. U.S. News & World Report. Accessed at https://money.usnews.com/careers/best-jobs/rankings/the-100-best-jobs

8. Guest Author. 5 Global Stats Shaping Recruiting Trends. Undercover Recruiter. Accessed at https://theundercoverrecruiter.com/global-stats-recruiting-trends

9. NEJM Group. 2013. Understanding the Physician Passive Jobseeker: A Profile of Physician Jobseekers. White Paper. NEJM CareerCenter. Accessed at http://employer.nejmcareercenter.org/physicianpassivejobseeker.pdf

10. SHRM. 2017. Using Social Media for Talent Acquisition — Recruitment and Screening. Society for Human Resource Management. Accessed at https://www.shrm.org/hr-today/trends-and-forecasting/research-and-surveys/Documents/SHRM-Social-Media-Recruiting-Screening-2015.pdf

11. Harvard T.H. Chan School of Public Health, Robert Wood Johnson Foundation, NPR. 2019. Life in Rural America, Part II. Harvard T.H. Chan School of Public Health, Robert Wood Johnson Foundation, NPR. Accessed at https://media.npr.org/documents/2019/may/NPR-RWJF-HARVARD_Rural_Poll_Part_2.pdf

12. Darves B. 2019. Demystifying Urban Versus Rural Physician Compensation. NEJM Career Center. March 4, 2019. Accessed at https://www.nejmcareercenter.org/article/demystifying-urban-versus-rural-physician-compensation

13. LocumenTenens.com. Rural Recruiting Resource Center: The Advantages of Practicing Rural Medicine. Rural Recruiting Resource Center. Accessed at https://www.locumtenens.com/physician-recruitment/rural-recruiting

14. Siegler K. 2019. The Struggle to Hire and Keep Doctors in Rural Areas Means Patients Go Without Care. National Public Radio’s All Things Considered. May 21, 2019. Accessed at https://www.npr.org/sections/health-shots/2019/05/21/725118232/the-struggle-to-hire-and-keep-doctors-in-rural-areas-means-patients-go-without-c

15. World Population Review. 2019 Cost of Living Index by State 2019. World Population Review. Accessed at http://worldpopulationreview.com/states/cost-of-living-index-by-state

16. Dyrda L. 2019. State-by-State Breakdown of Rural Health Clinics — Missouri No. 1 at 369. Becker’s Hospital Review. May 24, 2019. Accessed at https://www.beckershospitalreview.com/rankings-and-ratings/state-by-state-breakdown-of-rural-health-clinics-missouri-no-1-at-369.html