In a tale all too familiar to HM group leaders, whether they head two- or three-physician services or the large, multistate hospitalist companies, Heather Bellow, MD, FAAP, is trying to recruit a pediatric hospitalist to her midsize Midwest town.
Her sales pitch, though, seems to focus more on the bounties of Lansing, Mich., rather than the work to be done as the fourth full-time member of Sparrow Hospital Inpatient Pediatric Services. Dr. Bellow often talks up the culture, lifestyle, and the vibrant atmosphere Michigan State University provides the community. And yet, she struggles to find new hires.
Her story is the new norm: Group directors outside the nation’s largest markets agree that they often work for months at a time to recruit hospitalists. Some relent and hire a steady string of residents from nearby institutions. Others throw money at the problem, only to lose those well-paid hospitalists to other groups that throw more money at the problem. The problem is particularly acute in secondary- and tertiary-population areas, where hiring managers often find themselves battling each other for the same hospitalists.
“That’s the million-dollar question,” Dr. Bellow says. “How do you find that outside person that’s willing to come to small-town USA? I really don’t know.”
One possible answer: A focused recruitment strategy should be considered its own subspecialty. Highlighting the growing importance of recruitment and retention issues, SHM offered its first recruitment course last month at HM09 in Chicago. More than 300 people attended the session, which looked at the hiring process from both perspectives. In anticipation of high demand, the presentation was one of only a handful of sessions that were held twice during the meeting, allowing those who missed the first-day session to attend the same session on the final day.
“It’s a crazy time in some ways,” says Kirk Mathews, co-founder and CEO of Inpatient Management Inc. in St. Louis. “In challenging times, people often abandon the fundamentals because they feel they’re in desperation mode. Just bring someone in, get a body in there—anything with an MD behind their name.”
Hospitalists looking to recruit to smaller markets say times are getting tougher. The job posting board at HM09—always a popular gathering site—was littered with fliers for practices in smaller markets: Albuquerque, N.M.; Coeur d’Alene, Idaho; Murphy, N.C. Most of the announcements focused on the natural beauty of an area, proximity to surf or sand, or the peaceful lifestyle a community affords. Few focused on compensation, rotation schedules, or whether malpractice insurance and continuing medical education would be reimbursed.
“These ads try to appeal to your life other than medicine,” says Cecelia Wong, MD, a hospitalist with Med One Hospitalist Physicians in Columbus, Ohio.
Rohit Uppal, MD, medical director of the hospitalist program at Grant Medical Center, also in Columbus, says job hopefuls now know they can be picky when it comes to looking at positions in markets struggling to maintain a job candidate pipeline. Dr. Uppal uses a fellowship program as a recruitment tool, but he concedes he’s not in a power position when it comes to negotiation. “We’re not saying ‘Here’s our great hospitalist group, move to Columbus,’ ” he says. “We’re hearing ‘I’m moving to Columbus ... looking to be a hospitalist.’ ”
Sweeten the Pot
Another potential recruiting tool some groups might overlook is physical office space. While many groups search for cost savings by moving to a “virtual office,” don’t underestimate the value a candidate might place in having a nice office to do their paperwork, says Joseph Ming-Wah Li, MD, FHM, SHM board member, director of the hospital medicine program at Harvard Medical School and associate chief of the division of general medicine and primary care at Beth Israel Deaconess Medical Center in Boston. “What does that say to a hospitalist?” Dr. Li asks. “I take them to this nice suite with outside-looking windows—it sends a nice message of how you’re valued at your institution.”
Just don’t tilt too far toward fancy offices and big salaries. Mathews cautions clients not to focus solely on compensation, because it doesn’t solve long-term recruitment issues and might attract candidates only interested in short-term commitments. “It’s not wise to buy loyalty, because then you never know when it’s paid for,” Mathews says. “I’m going to throw a $40,000 signing bonus at this doctor. … Two years from now, somebody else can throw $50,000 at them and they’re gone. It’s not the candidate’s fault. They’re at the smorgasbord table.” TH
Richard Quinn is a freelance writer based in New Jersey.