Welcome to our first newsletter aimed at helping physician recruiters in healthcare facilities. Working as a physician recruiter is tough work. You're given few resources, are often dealing with a lot of unknowns, and have to rely on a lot of other people to make your job happen.

We understand that struggle. We have been working in healthcare staffing for more than twenty years and have worked with countless facilities around the country, primarily helping them with their locum tenens staffing needs. The purpose of this newsletter is to share industry-related news and resources that will hopefully make your job easier or at the very least, give you insight into what is going on in the staffing landscape.

Our debut issue covers topics like how to successfully market to your facility to millennial physicians, extending a permanent contract to your locum physicians, and tips for recruiting in rural areas from the National Rural Health Association, to name a few. We hope you find the articles to be both relevant and useful. As always, we deeply appreciate the opportunity we have to work with you.

Bill Heller

President, Weatherby Healthcare

Hiring Millennials: How to successfully attract the fastest growing physician workforce

An ever-increasing number of Millennial physicians are graduating from medical school, and they're hungry to start working. As the largest generation yet, Millennials sport a unique set of values and skills that both benefit and challenge recruiters. Understanding their characteristics and knowing what they expect is vital to successfully hiring and retaining Millennial physicians. These four tips will have your organization pulsing with more Millennial blood.

Get with the program

Millennials are great friends of technology, and they'll expect your organization to be using the latest and greatest. They want to serve their patients in new and improved ways in order to reach their productivity goals. If your organization doesn't have an updated EHR system, it might be a negative for Millennial physicians.

High-tech fluency also means Millennials easily accept new technologies, making them an adaptable workforce that assumes learning new systems is a given. Baby boomers can often be more rigid, likely to resist change, and may not pick up new technologies as quickly.

So how do you start the recruiting conversation with a high-tech Millennial? Text them. Millennials often prefer texting to talking on the phone and there's a greater chance they'll be responsive to your recruitment outreach.

Appeal to their lifestyle preferences

Millennials are acutely aware of their educational debt, and they have high expectations of landing a position that'll help them pay it off. Still, they're actually less motivated by salary than their Gen-X and baby-boomer counterparts and more concerned with living a happy, balanced lifestyle.

Positions that give physicians more flexibility and autonomy over their schedule — so they can make time for family, friends, and travel — will attract Millennial physicians. If they're coming from a job with little flexibility, you can appeal to that pain point and win them over by offering more options. Millennials grew up watching their parents experience burnout in their jobs, and they want to avoid it at all costs.

Weatherby Healthcare urgent care recruiter, Brian Pretner, advises organizations to "paint a picture of what the community is like, talk about the town and any local fun things to do, instead of just emphasizing the job." He points out that making the community and lifestyle a focal point is important in appealing to millennial physicians. "They're more interested in the community itself. For them, it's about finding the perfect opportunity in every respect."

Give millennial physicians a microphone

Millennials don't want to be just employees; they want to contribute, collaborate, and become leaders. The more opportunities you can offer Millennial physicians to voice their opinions and be involved in the organization the better.

What are your physicians interested in? Give them a chance to pursue those interests by being part of a committee or a leadership program. Many Millennial physicians leave their employers because they feel like their ideas aren't being respected or taken seriously.

If you not only encourage them to share their ideas, but also show that you admire and respect the unique skill set their generation brings to the table, you'll stand out from competitors and attract and retain more of these sought-after physicians.

Tell them what's up

Millennials grew up with a high-level of support and feedback from parents and teachers, so they expect it from their employers. If you don't regularly let them know how they're doing, they may assume they're not doing things right. While this means you have to give Millennials more attention, it also gives employers an incredible opportunity for continuous improvement to their organization.

Because Millennials are so open to feedback and change, they can be easier to work with, and they strive for progress, efficiency, and optimization. Also, they're more aware of feedback from their patients and online reviews. They know the damage one bad review can do. Because of this, they may have a better bedside manner, are less formal, and may be kinder to their patients.

Ultimately, Millennial physicians know their worth and they're not afraid to leave employers who don't meet their expectations. They don't just want to work — they also want to enjoy their lives — and they prefer employers who can help them do both. Win over Millennial physicians by becoming involved in their journey and help them to envision a bright future with your organization.

Fixing the medical staff shortage problem in rural areas

Brock Slabach, senior vice president for member services, National Rural Health Association

Physicians are disappearing from the map of rural America. Twenty percent of the country's population lives in a rural area, and the ratio of physicians to patients is 1 to 2,500, which means that 60 million people are dealing with the impact of this shortage.

If even one rural physician or nurse decides to move or retire, it can precipitate a health care coverage crisis in the community. Hospitals and clinics in rural areas work on thin margins, limiting their financial ability to entice new medical personnel, and each new shortage leaves them at a fresh crossroads.

As the gap in rural health care coverage grows, more people are finding ways to acknowledge and address the shortage.

Schools and programs are starting to address needs

More medical programs are recognizing this need and are moving to place residents in rural hospitals and clinics. This shift is an opportunity for more physicians and nurses to understand rural medicine and erase misconceptions.

Medical schools are also becoming sensitive to the rural shortage. Some institutions have begun accepting more candidates from rural areas to their programs in hopes that they will return home to practice and encourage more people to seek out rural positions. Several schools now have rural-specific training, like the Scholars in Rural Health program at the University of Kansas Medical Center's KU School of Medicine. As the students advance in their schooling, they gain practical experience in rural areas at the side of a mentor.

Although the KU School of Medicine has been a leader in training rural physicians for many years, other institutions are also starting to put programs in place to prepare students for the unique challenges and opportunities of rural medicine. The Rural Training Track (RTT) Collaborative currently partners with schools of medicine in rural communities and residency training programs with a rural campus or rural pathway for select students. The RTT Collaborative has been influential in establishing medical training programs and placing residents in rural hospitals.

Another tool used in rural recruiting is the Community Apgar Program (CAP), a recruiting structure developed by researchers, educators and clinicians at Boise State University. The CAP identifies strengths and opportunities for improving rural medicine within specific communities, as well as identifying specific challenges that could hinder future growth. The CAP and related programs have enhanced the probability of attracting and placing a practitioner for many rural communities.

Hospitals are selling the rural lifestyle

The rural lifestyle has been an effective recruiting tool for many hospitals addressing shortages. Although it's easy to shrug off as the stuff of Hollywood films, there is real appeal in rural living for the right person. Physicians can find wonderful community living among rural people, where deeply appreciative relationships can be built on for years.

The people appeal is not just with patients; working with rural practitioners is equally worthwhile. Other practitioners in the area are usually eager to help and will make the new professional's stay a better one.

The pace of rural life can increase job satisfaction. Physicians do not deal with the same business pressures of urban practices and can focus on patient care. The lifestyle is less stressful, with more recreational possibilities, and often in beautiful parts of the country. Plus, a rural doctor almost never has traffic on the way to the clinic.

Finally, physicians concerned about upcoming changes to the Medicare Access and CHIP Reauthorization Act (MACRA) may also want to consider rural medicine. Clinicians practicing at a Rural Health Clinic (RHC) or Federally Qualified Health Center (FQHC) are exempted from certain reporting and adjustment requirements.

Using locum tenens physicians raises the profile of rural providers' staff

Another solution to the rural healthcare shortage is the use of locum tenens physicians, where medical providers travel to work in underserved areas on temporary assignments. More than 90 percent of hospitals in the U.S. use locum tenens to supplement their full-time staff. These temporary assignments are especially important for hospitals in rural areas where it can take longer to recruit a full-time provider, and where staffing needs change regularly from one day to the next.

Along with filling in for full-time staff members, locum tenens providers give relief during busy seasons, assist in initiating new operations, and help meet the need for in-demand specialties. For example, an area of constant shortage for rural hospitals is in obstetrics and gynecology. In cases such as these, locum tenens physicians are able to step in and fill those gaps to provide relief. Rural hospitals can also use locum tenens physicians to test out new operations and make sure new personnel are a fit before investing in a full-time team member.

Locum tenens placements increase as healthcare providers and facility administrators understand the significant positive impact it can have on the quality of care for rural patients. For example, providers from Weatherby Healthcare, one of the largest locum tenens companies in the industry, delivered care to more than 5.3 million patients in 2017 alone.

These strategies of addressing the physician shortage in rural areas show promise of being effective in the medium to long term. Raising awareness of both the problem and the ways of addressing it can provide incentive to physicians to go rural.

This article was originally published in Becker's Hospital Review. June 20, 2018

Use locums to find your perfect perm doctor

"All of us are trained to go to college, go to med school, go to residency, get a position someplace: You never stop to look around. I should have looked more," admits Demetri Poulis, MD, AdventHealth Medical Group Wound Care and Hyperbaric Medicine.

The above statement generally describes the bulk of Dr. Poulis’s career before switching to locum tenens a few years ago. That transition presented opportunities for the general surgery specialist to experience working at many different facilities in different communities, including AdventHealth Hendersonville. At the time, the North Carolina hospital faced an immediate staffing void. Rather than scale back on surgical services available to patients while recruiting new staff, administrators decided to utilize locum tenens. They reached out to Weatherby Healthcare, and their consultant, Steven Grisak, connected them with the right surgeon for the job: Dr. Poulis.

“I was there for about seven months for my first assignment, and then a week or 10 days at a time on a recurring basis for another year,” he says. “I don’t know how else to say it except I just fit in there.”

Indeed, Dr. Poulis was so comfortable in the environment and with staff and patients that he decided to stop looking around and, in 2018, accepted a full-time position with the facility.

“I have to say, it was one of the easiest things I’ve ever done,” he notes. “There were no bumps in the road.”

Mutually beneficial

Although Dr. Poulis didn’t set off on locum tenens assignments with the intent to secure a permanent position, the situation presented itself nonetheless. And because he had the luxury of experiencing the clinical environment first-hand, the surgeon felt confident in making the career change.

That same real-time evaluation can be an advantage for healthcare facilities, too. In fact, Dr. Poulis is an example of how facilities can use locum tenens as a key physician recruitment tool for permanent positions.

“We put lots of time and effort into making sure people are the right fit,” says Emily Ducat, a physician recruiter for AdventHealth Hendersonville. “Permanent candidates can’t come in to do a demo surgery. Having Dr. Poulis here allowed us to get a good, solid evaluation of his skills and see just how great he is. It was really valuable knowing that.”

First impressions were positive, but as time passed and a familiarity grew between staff, administrators, and physician, Ducat says it became evident Dr. Poulis would be a beneficial addition on a permanent basis.

“Our mission and commitment to whole-person care — mind, body and spirit means cultural fit is a huge deal at AdventHealth Hendersonville. He was dedicated to us from day one, making sure all of our patients had the care they needed,” she recalls. “Knowing Dr. Poulis’ demeanor and dedication was invaluable.”

The hospital proffered the surgeon a full-time job on more than one occasion; however, Dr. Poulis hesitated at first. He didn’t wish to return to an over-demanding schedule that could lead to burnout like he previously experienced in other permanent positions. So after some negotiation between clinician and recruiters, a deal was reached to create a new position that allowed him to focus on wound care and cover general surgery call.

“He actually has filled a niche we weren’t even hiring for; that’s how good of a fit Dr. Poulis is. It’s rare to find someone who you keep on even though there wasn’t a specific opening,” notes Ducat.

Contract renegotiations

Converting Dr. Poulis’s contract from locum tenens to permanent began with a call to Steve at Weatherby Healthcare and the process got rolling quickly. Both Ducat and Dr. Poulis confirmed the agreed-upon details, including his official start date as the hospital’s newest staff member. At that point, Weatherby Healthcare invoiced the facility with a pre-arranged, market-rate-based buyout fee as per the language in the client agreement, and the deal was sealed.

“It was very straightforward,” Ducat comments. “Finding a company that is going to be another member of your team looking out for what’s best for the facility, is a great option.”

Of course, not all temporary assignments will end up with facilities hiring locum tenens for permanent positions, but when circumstances align for both parties, it’s definitely a win-win scenario, and worth a look.

Recruiters: How to get a quality locums every time

Locum tenens providers can be a lifesaver when you need extra help on your team, but they can also be a problem if they aren’t the right fit for your facility. Fortunately, by asking the right questions to the right people, you can get the answers you need to make an educated decision about the quality and suitability of a locum tenens candidate. Here are a few sample questions to get you started.

Questions to ask the provider

When interviewing a provider candidate — either on the phone or in person — include a combination of behavioral and practice-related questions. The range of responses you receive by asking both types of questions will help you to better understand the provider than just practice-related questions alone.

Behavioral questions

Questions like the ones below will help you identify how a provider perceives and interacts with others as well as the clinical environment. Be sure to dig deeper if you feel the initial response isn’t giving the full story.

  • Describe a situation where you had a difficult patient and how you worked to resolve the issue.
  • How do you explain complicated instructions to a patient?
  • Describe a time that there was conflict with other physicians, nurses, or staff and how you dealt with the situation.
  • How do you deal with someone who is very upset?
  • What kind of people do you work best with?
  • What kind of people do you struggle to work with?
  • What are your steps for fixing a problem when you make a mistake?
  • What do you do when you disagree with a policy?
  • What do you do when you see an opportunity to make an improvement in a process or policy?
  • What is the most difficult problem you face on a regular basis? And how do you deal with it?

Practice questions

The questions can be difficult to ask but the answers are critical. Be as tactful as possible, but definitely include these questions in every interview.

  • Have you ever had your employment as a provider terminated?
  • Have you ever had your medical license denied, investigated, suspended, or revoked?
  • Have you ever withdrawn a medical licensure application from a state licensing board?
  • Have you ever withdrawn an application for medical staff membership at any facility?
  • Have you been investigated by a health insurance program?
  • Are you the subject of any pending medical malpractice claims or settlements?
  • Have you been censured by a medical association?
  • Have you been convicted of or indicted for alleged criminal activities?
  • Do you have a dependence on any chemical substances?

An affirmative response isn’t always a deal killer, but it is helpful to discover any potentially disqualifying concerns early in the process.

Questions to ask the agency

One advantage of working with a locum tenens agency is that they have a pre-existing relationship with the provider. The agency recruiter usually knows the provider much better than you can after one or two interviews. Leveraging that relationship will help you gain new insights into the candidate.

Sample questions to ask the agency:

  • How long have you known/worked with this provider?
  • What is their work history with your agency?
  • Have you completed credentialing, licensing, and/or hospital privileging with them and how did it go?
  • How responsive were they in providing needed paperwork?
  • Is there any history of malpractice?
  • Has this provider worked at facilities/geographic areas similar to mine?
  • What issues have come up on previous assignments and how did they respond to those issues?
  • How do they get along with other staff doctors/nurses?
  • How flexible are they to changing conditions? Do they roll with the punches?
  • On a scale of 1 to 10, how would you rate them as a team player?

Questions to ask both the agency and the provider

It’s a good idea to ask some questions to both the healthcare provider and the locum tenens agency. You may get similar responses, but you will usually learn something new that will help your overall understanding of who the provider is and how well they will fit with your organization.

Example questions to ask both the provider and the agency:

  • How long have they doing locums?
  • How long do they plan on doing locums?
  • Do they do locums full-time or is it a side job?
  • What motivates them to work locums (e.g. travel/tourism, extra money, experience in a different clinical setting, etc.)?
  • What do they look for in a work environment?
  • How do they handle admissions?
  • Are they good with computers/EMRs, etc.?
  • What are their family relationships? Do they have family who live near my facility?
  • What work/life balance issues are important to them? And how do they work maintain that balance?

Bringing on a new provider is a lot of work. Make that work pay off by improving your chances of finding a quality provider by asking the right questions to the right people.

The Real Cost of Vacancies and Provider Turnover

When it comes to finding new providers to replace those leaving for new opportunities, you know what a challenge it can be. But do you know how much turnover really costs your facility? A staggering seventy-five percent of medical groups don’t quantify the cost of turnover, which means they have no idea how much it can impact their bottom lines.

In this article we explore some of the hidden costs facilities face when employees leave. We’ll also reveal how you can reduce turnover at your facility.

Advertising is expensive.

While it doesn’t seem like a massive cost on the surface, paying for print or online ads, listing jobs with third-party sites like Monster or Indeed, and even promoting job posts on social media can quickly add up.

The cost of recruiting and interviewing.

On average, it can take up to eight months to get a physician on board, which means months of creating job descriptions, sifting through CVs, calling references, scheduling appointments, conducting phone and in-person interviews, and eventually putting a contract together and extending an offer. The estimated annual recruiting cost for a full-time employee is $61,000.

Loss of revenue.

When you lose a physician, you also lose the revenue generated by that physician. This averages average around $990,000 a year. In a recent study, 74 percent of medical groups said they would hire more primary care physicians in the next year than they had the previous year. While you’re waiting to fill gaps, you’re losing millions in revenue you would have otherwise earned.

Relocation and travel costs.

In today’s competitive marketplace, providers have plenty of options. It’s likely you’ll need to cast a wide net to attract top talent to your facility. If you’re not lucky enough to find the right candidate from your local pool, you’ll be paying several thousand dollars to fly physicians to your facility for in-person interviews, and if a doctor accepts your offer, you’ll likely need to cover moving expenses as well. Travel and relocation costs, along with advertising, search agency fees, recruiter costs and employee referral bonuses, make up 90 percent of hiring expenses.

Onboarding and training.

Once you’ve hired a physician, it takes time and money to onboard and get him or her up to speed. Training can be costly and keeps other physicians and healthcare providers away from their jobs. It can take up to two years for a new physician to be fully integrated in their job and able to take on the same workload as an established staff member. The average annual start-up cost for a new doctor is $211,000.

With an average of $1.2 million in turnover costs per physician, including recruiting and start-up costs and lost revenue, it’s clear that retaining your physicians is important and saves your facility a lot of time and money. Here are some ways to keep your staff happy:

  • Survey your employees frequently. You won’t be able to reduce turnover unless you find out why physicians are leaving your hospital. Have candid, one-on-one meetings at least once a quarter to talk about what’s going well and what you both could improve on, and administer online surveys to see what your staff likes and dislikes about their work.
  • Hire the right people. If you’re losing a lot of doctors and seeing lower morale among employees, you may need to look at the types of people you’ve hired recently. Do their values align with your organization’s values? Are they team players and willing to pitch in when needed? Do their personalities fit your company culture? Start asking behavioral questions as well as skill-based questions to find the right candidates.
  • Make your current employees feel valued. When is the last time you wrote a hand-written thank-you card to one of your physicians or thanked her in person for a job well done? Showing gratitude is a simple way to show staff members you appreciate them, as is occasionally bringing in lunch or dinner, showing interest in their life outside of work, and making time to talk with them regularly.

While employee turnover can be costly, following these simple steps can help you reduce it and maintain the great staff members you already have.

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