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Joining a Practice “is like marrying five or six people at once.”


by Peter Downs, Staff Writer, The Medical Business Journal, July 1998.

These are busy times for physician recruiters. Changes in health care in the last five years have prompted doctors to move more than ever before, says Lynn Sher, President of Lynnco Ltd and president-elect of the National Association of Physician Recruiters (NAPR). “We’ve seen the number of doctors looking for new positions skyrocket.”

The request for physicians is holding steady, but with more doctors looking for new positions, recruiters have a bigger pool of candidates to sift through for their clients. More competition between physicians seeking positions can be good for the group seeking to add a doctor, unless its recruiter doesn’t do a thorough job.

A good match benefits everyone. A bad match is a horrible, expensive mistake. Good recruiters offer guarantees such as replacing a doctor who doesn’t work out. Nothing, however, replaces the irritation, anger and sense of wasted time that goes with a bad match. Good recruiters want to avoid those situations as much as possible.

Recruiters work for the organizations seeking physicians: hospitals, group practices and managed care organizations; these are the ones who pay the recruiter’s fee. A physician seeking a position who is asked to pay a fee by a recruiter should turn and walk away from the recruiter, fast. “It is illegal to charge a doctor for a job,” says Sher.

Physicians and recruiters alike liken recruiters to matchmakers. When a physician joins a practice, whether in a hospital, managed care organization or a multi-physician group, it is like a marriage. The parties have to be comfortable not only with each others’ skills and competence, but their work habits and personalities have to mesh as well. “There are excellent physicians who will do very well on their own, but not so well in a group,” says Dr. Edmond Cabbabe, a partner in Plastic Surgery Consultants, Ltd.

That is one reason members of the NAPR consider it unethical to broadcast physician curriculum vitae across numerous fax lines or the internet. An ethical recruiting firm “will talk to the candidate first, tell him about the organization that is seeking a physician, and get his permission to present his CV,” says Michael Broxterman, and Chief Operating Officer of Pinnacle Health Group, and a board member of the NAPR. “Someone who is honest shares all the details of the opportunity with you before submitting your credentials,” says Sher.

It is a truism that formal rules arise in response to counter problems that the NAPR is fighting. “People did get burnt,” says Siano. “The industry hurt itself, because people took fees and didn’t necessarily perform.” That, says Sher, is why the future of the industry is contingency. The advantage for the customer is that “he doesn’t pay any money until I settle a match,” she says.

Pinnacle, a fee-based firm, has a different solution: a performance guarantee. “We guarantee we will give them three viable candidates in six months or we will refund 50% of professional fees,” says Broxterman. “That is our assurance that we will give them activity and results,” he adds. Pinnacle is one of the top physician recruiting firms in the country.

The advantage of fee-based service is that it is full service, says Broxterman. Contingency-based recruiters speak of getting to know their clients by “spending several hours with them on the phone.” Pinnacle, a fee-based firm, visits the client. “We take on a limited number of opportunities and limit the number given to each recruiter,” Broxterman explains. He speaks in terms of hundreds of clients, while some contingency-based recruiters speak in terms of thousands. The potential problem with contingency is that recruiters will take on many clients and give each of them scant attention. “Sort of like throwing spaghetti against the wall and seeing what sticks,” says Broxterman.

Since health care organizations can work with many contingency-based recruiters simultaneously, it is not uncommon for multiple recruiters to submit the same candidate, says Sher. A recurring problem is an argument over who gets paid. Normally, the first company to get the name earns the fee. That is an incentive to broadcast CVs. If the first company is one that sent in the CV without first consulting the physician,” the company that did consult the physician will challenge the fee and argue that it is the bona fide recruiter,” she says. Inevitably, client and physician get dragged into the argument, which neither of them want. Often, the loser is the physician, because the client will pass on his name in order to avoid a hassle, says Sher.

Recruiters often talk about the distinction between fee-based service and contingency as if it were the main dividing line in the industry. It is not. Neither payment system is a bar to unethical behavior. Neither system guarantees good service. The ethical standards and philosophy of recruiters may tell you more about the kind of service you can expect than the fee arrangement.

“A physician group hiring a recruiter should make sure they have a contract in place and they know the terms,” says Sher. Be specific. If you want a firm to take care of the details, give clear and thorough instructions about those details. A doctor looking for a job should look for someone honest, someone who will share all the details of the opportunity and will not broadcast his or her CV, Sher says.

This is one of the most important decisions you will ever make, says Broxterman. The result can be a short term nightmare that will cost a lot of money, or a long term success that benefits everyone.

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