Effectively Recruiting and Retaining Physicians: A Strategic Approach for 2020

 

By Dr. Peter Alperin
March 4, 2020

A 2019 survey found that over 20% of doctors plan to make a career change within 12 months. And, as many as 70% of physicians across all specialties change jobs within their first two years.

A 2019 survey from the Medicus Firm found that over 20% of doctors plan to make a career change within 12 months. The data confirms about 11% are “definitely” leaving and 14% are “likely” switching jobs. What’s more, as many as 70% of physicians across all specialties change jobs within their first two years according to Today’s Hospitalist. While half of physicians do stay in the area 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. As Maiysha Claiborne, MD, points out in this terrific OpMed article, doctors often fail to identify what the real problem is with their current position or the vision of what they want in an ideal job (or life for that matter). They also often fail to get the right mentorship and guidance.

The best advice for physician recruiters working with these candidates is to get to the heart of the matter: why does he or she want to change jobs? Help them identify what the current problems are – and what they (and their families) really want in the future. Then, you’re bound to find physicians that stick.

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

How they spend work hours: 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, and a study published in the Journal of American Medical Informatics Association found that the use of electronic health records can take up a significant amount of a family physicians workday, making it more difficult for them to focus on their jobs and contributing to burnout In addition to wanting more time for themselves, physicians want to spend more of their working time caring for patients. It’s important to take these factors into account to create a sustainable work culture at your practice or hospital.

Change of location: Some doctors may just 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 U.S. remains the most desired region to work) according to a 2019 Physician Practice Preference & Relocation Survey. In fact, the National Institute of Health reports that about 1 of every 5 U.S. citizens live in rural locations – while only 1 of every 10 physicians reside in rural areas. The good news is if you’re recruiting for rural positions, doctors are more willing to make a change if their current position isn’t meeting their needs (we’ll touch on rural recruitment more specifically later)

Career advancement: Advancing their careers is another motivating factor of doctors looking for a new job. This could mean they want fewer administrative duties, a new practice partner or to leave independent practice altogether. Merritt Hawkins found that the great majority of residents (91%) 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 go at it 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 #8 overall of the Best Jobs in the U.S. But the challenge for recruiters is that unemployment rate for physicians is also a mere 0.5% according to the U.S. Bureau of Labor Statistics, so you’ll really need to hone in reasons physicians tend to change jobs and offer the right kind of culture and incentives that attract and retain talent.

Tactics for Recruitment

The job market for doctors is booming, and competition is fierce, so it’s important to differentiate yourself while you’re recruiting valuable candidates.

Culture: Let’s start with culture. There are plenty of good places to live, but sometimes a higher salary rarely makes up for a location that isn’t right for a candidate or their family. Physicians tend to accept jobs that “feel right,” so 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: It can also be helpful to offer incentives. Many organizations offer top talent perks such as health benefits malpractice insurance, relocation allowance, continuing medical education (CME) allowance, educational loan repayment, retirement/401K plan and/or a signing bonus. These types of perks can go a long way in swaying a physician to join and stay with your organization.

Engaging physicians online: Another proven tactic is to use technology as part of your 2020 strategy. 90% of job seekers are using mobile technology (45% of those search for jobs online at least once a day) and 70% of employers said they have successfully hired from social media. In a high demand market like this one, social recruiting has become especially important because it allows you to broaden your candidate pool and connect with both active and passive job seekers you wouldn’t otherwise be able to reach. Current surveys have found that over 70% 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. While a job board might reach a mere 11% of candidates, a SHRM survey found social recruiting has the potential to appeal to over 80% of candidates. Establish a presence on the network(s) you choose. Just like how recruiters like to learn about candidates based off their online presence, candidates will be interested in learning about you, too. Your social profile is often going to be the first thing a candidate sees about you, so make sure you strongly represent yourself and your company.

Taking it offline: Technology should be part of your strategy, but it’s also important to leverage the phone as well. The email inboxes of physicians are bombarded with recruiting messages (and more). Newly minted doctors are often recruited like they are sports stars courting a Nike deal, so get personal and build a relationship by picking up the phone. This kind of personal touch may make or break your strategy moving forward.

Referrals: It's also important to rely on your best asset on hand – physicians who already work with you or at your facility. Their experience is a great way to judge a candidate’s suitability, plus they are a reflection of your culture.

Rural Recruiting

When it comes to more rural positions, recruiters will experience unique challenges. In rural America, physician recruitment is a life or death issue for patients and hospitals alike. The National Rural Health Association (NRHA) reports that more than 25% of the U.S. population lives in rural areas, yet less than 10% of the country’s doctors practice there. In fact, a recent poll indicates that one out of every four people living in rural areas said they couldn't get the health care 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 reigns, 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), the reality is that salary alone isn't enough to incentivize doctors to work in rural communities. But there are a few things to consider when you’re selling candidates on rural jobs. First, 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, though the New England Journal of Medicine (NEJM) 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 in central Idaho, where elk and bears outnumber the human population, says the cornerstone of their recruitment is ten weeks of paid sabbatical a year.

Beyond bonuses and paid sabbaticals, there are other important points to note about rural opportunities. Many doctors want to get back to their roots, enjoy a slower pace or be part of a small-town family and 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, according to locumtenens.com.

A lot of people think rural doctors don’t get to see interesting cases or that their medical skills will atrophy, but that’s simply not true. Dr. Leslie Hayes who practices family medicine at El Centro, the rural health care network in New Mexico, encounters new challenges on a daily basis. The PBS film The Providers  chronicles the lives of Dr. Hayes, and other physicians at the clinic, as treat patients with chronic conditions, substance use disorder, deliver babies and more.

Also, take the environment into consideration. Do you know candidates who love the great outdoors? If they like to hike, bike, fish, etc., they’re bound to enjoy certain rural locations. Ogallala Community Hospital in Ogallala, Nebraska says recruiting doctors to their hospital has required them to become “social matchmakers” to better integrate them into the community. In smaller locales it’s easier to set up those types of relationships. For example, if a doctor likes sports, administrators suggest they volunteer as team physician at the high school; or if they are an art lover, they could volunteer on the planning committee for the local arts festival.

The cost of living takes into account several necessary expenses that most of us need to live from day to day, including housing, food, childcare, educational, transportation and medical costs. While a lot of factors influence how people spend to live, it can make a big difference for doctors who are paying off medical school debt. Do some homework on the cost of living for areas you’re recruiting for. One good example is Missouri, which comes in fourth lowest on the cost of living index but also has the most rural health clinics (369). Here’s a breakdown of rural health clinics in all 50 states. 

In summary, it’s important to start from a place of understanding of what spurs 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 also retention in the years to come.

Peter Alperin, MD trained as an internal medicine physician at UCSF and is currently vice president at Doximity where he leads the development of products geared towards clinicians. He has also had roles in product development with Archimedes and ePocrates as well as serving as director of informatics with Brown and Toland Medical Group. He also remains in active practice at the San Francisco Veteran’s Affairs Medical Center. 

Contact Dr. Peter Alperin at palperin@doximity.com

This article appeared in the Mar/Apr 2020, Physician Leadership Journal

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