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Recruitment Revised


Recruiting hospitalists—or any other medical personnel—is all about supply and demand. Right now, the demand for hospitalists exceeds the supply. Many hospital medicine groups are growing rapidly, and more such groups are being created across the country. These groups are aggressively recruiting residents and physicians from the relatively small pool of hospitalists for hire, even as they lament the lack of candidates.

“Recruiting hospitalists is as competitive as I’ve ever seen,” says Vikas Parekh, MD, assistant professor and director, Non-House-staff Hospitalist Services, Department of Internal Medicine, University of Michigan, Ann Arbor. “This even trumps the primary care crisis of years ago.”

Hospitalist Roles at U of M

The University of Michigan’s University Hospital has more than 800 beds and had 15,000 admissions in 2005. Hospitalists perform a variety of roles on the inpatient medical wards, including teaching on resident services, attending on non-resident services, and providing medical consultation and surgical co-management. In 2007, hospitalists will take care of more than half on the inpatient population.

Hospitalists provide inpatient general medical consultation when requested. They staff a Medicine Pre-op Clinic; hospitalist faculty are part of the university Department of Medicine educational program; and all hospitalist faculty are involved in research within the field of hospital medicine.—JJ

The Carrot: Repayment of Student Loans

Like many healthcare organizations today, the University of Michigan’s Department of Internal Medicine has a fast-growing hospitalist program, and continues to seek out additional physicians. “Our group of hospitalists went from zero to 16 by the end of this year—all in two years,” explains Dr. Parekh. “We’ve literally doubled each year.”

The university has implemented a unique method that provides an advantage against competition in recruiting new hospitalists. Beginning in 2006, they are offering a “loan forgiveness” program for new hires to their hospitalist program. Any hospitalist who joins the program this year can get up to $50,000 of student loans paid off by the university.

“The university did this about 10 years ago, when primary care had a similar problem,” recalls Dr. Parekh. “It was very successful.”

Hospitalists at the University of Michigan believe they have a unique benefit for recruitment. “I don’t know if any other hospitalist programs are doing this—there aren’t many [loan forgiveness programs] for physicians in general,” says Dr. Parekh.

The University of Michigan loan forgiveness program will pay back any student loans, with a limit of $10,000 per year for five years. The university makes direct payments to the loaning institutions, which are typically federal government agencies.

How Loan Forgiveness Works

The University of Michigan loan forgiveness program will pay back any student loans—with a limit of $10,000 per year for five years. The university makes direct payments to the loaning institutions, which are typically federal government agencies. The newly hired physician is not under contract to stay until his or her loan is paid. “It works year to year,” explains Dr. Parekh.

The value of loan forgiveness can be overlooked. “People negotiate salary, but they don’t think of this,” says Scott A. Flanders, MD, associate professor and director, Hospitalist Program, Department of Internal Medicine, University of Michigan. “When you add up the value of benefits and loan forgiveness, that can add up to $50,000 to your compensation.”

Offering loan forgiveness on a set amount is more economical than offering a higher starting salary. The employer can set the cap on how much they’re willing to pay, thus controlling the investment in each new hire.

Loan Forgiveness Facts

Loan forgiveness, or loan repayment, is the practice of paying part or all of an employee’s school loans. Most often, employers will offer loan forgiveness to newly hired teachers and social workers. The federal government also offers loan forgiveness programs to individuals who serve in AmeriCorps, the Peace Corps, and similar organizations.

More infrequently, loan forgiveness may be offered to physicians and other medical personnel to entice them into geographical areas or specialties that are short-staffed.—JJ

Recruitment Realities

The University of Michigan hospitalist program has been recruiting physicians through the university’s residency program, as well as advertisements in national journals.

“We’ve had a lot of success locally, but we’ve also seen response from around the country,” says Dr. Parekh. “We’ve had good success already; we’ve already recruited 75% of the physicians, in part due to the loan forgiveness program.”

The concept of lifting student loans from the shoulders of new physicians is a perfect fit for hospitalists in particular. “Hospital medicine is a young field, so by definition the physicians are young,” Dr. Parekh points out.

Dr. Flanders adds, “You’re not going to attract 40- or 50-year-old physicians who want to go into academics. But this [might] apply to someone shifting from one academic field to another.”

One problem that loan forgiveness can’t solve, however, is the number of residents choosing hospital medicine. “Internal medicine needs to get more people to pursue hospital medicine,” says Dr. Flanders. “And as it is, there’s only a small trickle of people pursuing internal medicine.”

For more information on career development, attend the “Promoting Hospitalist Career Satisfaction” session on Thurs., May 4, from 2:55-4:10.

The short supply of trained hospitalists severely affects the ability of hospital medicine groups to find and hire new physicians. Investing in value-added offerings such as loan forgiveness may prove worth the cost, if the investment brings quality candidates to your group. TH

Contributor Jane Jerrard regularly writes for “Career Development.”

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