by Rob Followell
In my 25 years as a hospital executive, I always shared with physicians I was recruiting that three buckets must be filled for a physician to accept the position and be successful and happy long-term. Those are the personal, professional, and financial buckets. If any of the three are not filled, they will not be satisfied long-term. However, even with this framework, I still made several mistakes. The following is my top 10 list of mistakes made in physician recruiting (and yes, most of these I made myself).
1. Lack of Pre-search Planning
Pre-search planning may be the most critical and often overlooked step in the recruitment process. Understanding where the market is, what you can bring to the right candidate and exactly what you are looking for in a candidate is key to every recruitment effort. The four ‘keys’ to every recruitment effort are:
- Compensation. Before starting any search you need to understand the market both locally and nationally for typical compensation. Because you recruit candidates locally and nationally, you have to consider that to determine what you can offer and how flexible you can be for the ideal candidate. Few physicians will move to a community and make less than they are currently making and because of the demand for physicians you cannot just offer a good opportunity to make money, you have to guarantee income from the very beginning. Having compensation range and flexibility upfront avoids losing candidates by taking too long to make an offer, a common problem among some organizations.
- Candidate Parameters. Determining the ideal candidate, DO or MD, foreign trained physicians or American trained, what kind of specific training for each specialty or practice focus, or any other needs that fit the abilities of the physician to the needs of the community. Each parameter typically reduces the amount of candidates that are ideal targets so you have to be realistic and flexible depending up the situation.
- Community. Less that 10% of your candidates are open to a rural community and 90% are open to large metropolitan opportunities. This means you must be open and flexible if you are in a smaller community and you can be more selective if you live in a urban setting. It is simply the law of numbers, you will have more candidates to consider. What your community offers can effect the compensation and candidate parameters as the less there is to offer the fewer candidates that are typically interested.
- Community/Candidate Politics. This represents the story of the opportunity overall. Why you are recruiting, what a great opportunity or what problems you might have to overcome. As long as candidates know about challenges upfront, you can often overcome them, but if they find out able problems later in the process, you will find they typically pass.
To adequately plan, one must research the current market for all the issues listed above. As the old saying goes, “you get what you pay for.” As a team, identify your negotiating ranges within your financial package during the planning stage. Anticipating and being prepared to answer potential questions will not only move the process along quicker, but more importantly, it will instill confidence, and show the physician that you are serious about creating an environment where they can thrive. Identify a group of individuals who will serve as the recruiting team. Tailor each visit and team to the specific candidate.
2. Narrow Search Parameters
Many people set their search parameters far too narrow. The current ratio of the physician supply and demand necessitates widening your search parameters. Expanding your parameters will generate more candidates who can meet your core needs.
3. Not Utilizing a Physician Recruiting Firm
One mistake often made is not using a physician recruiting company to assist in the search. Using a firm can be expensive, but not nearly as expensive as not having the right physician in place. Physician recruiting companies have the expertise, capacity, and the economies of scale when it comes to advertising, and access to candidates that makes using them well worth the expense. They also offer the ability to develop trust with the physician and act as a mediator, which is incredibly valuable in the recruitment process.
4. Accepting the First Candidate
There is a delicate balance between taking the first candidate and not moving quickly enough. This is where pre-search planning pays big dividends. Identifying your “must-haves” from the start, it helps you determine if a candidate fits your basic needs.
If a candidate has 80% of your “wish list items,” fits your basic needs, and the team believes they would be a good fit, make an offer. Making an offer does not mean you cannot continue to search. Waiting for 100% may never come, and in doing so, you may forgo a lot of revenue and rob the community of needed medical care in the process.
5. Lack of Urgency
When physicians are ready to make a move, time is of the essence. Generally, when a physician is ready to explore other opportunities, they have made the emotional commitment to change. As discussed previously, with the current physician shortage, it is a “buyers market” for physicians. Maintaining movement and momentum is critical to the success of the recruiting process.
6. Lack of Transparency
It is imperative that you are transparent. Tell the good, bad, and ugly. Understand that you are asking the physician to move their practice, and most often, their families. Sooner than later, they will find out that the streets are not paved with gold and where your warts are, and they won’t be pleased. Building a successful relationship starts with trust. Honesty is always the best policy.
7. Lack of Investigation
The site visit should primarily be about determining fit for both parties. Addressing as many anticipated questions (as established in pre-search planning and uncovered by the recruiter) on the front end will allow for a much more relaxed and meaningful visit. Before sourcing the very first physician candidate, it is essential to explore, understand, and gain consensus on key issues related to the three buckets that must be filled to recruit and retain long-term.
- Personal – Understanding what may be relevant to an individual physician, and their family’s happiness is paramount. While the physician may be abundantly satisfied with the practice, they and the family must be happy with the community. These issues include but are not limited to local educational options, available housing, entertainment, churches, etc.
- Professional – These issues are specific to each specialty. Will there be enough volume to keep the physician busy but not so busy that they do not have time for the family? Will they be able to do the things they were trained for and love to do? What is the relationship with other physicians in the market? What is the relationship with the administration? What equipment is available? How efficient is the office and the hospital? What computer systems are utilized? What vendor products are available? How many days per week/month are they expected to work? What are the call arrangements? Marketing expectations?
- Financial – Salary structure, bonus structure, worked RVUs, supervision, benefits, pay for call, PTO, vacation, CME’s, loan forgiveness, stipends, contract language, letter of intent, etc.
Each candidate is looking for their needs in each of the ‘buckets’ above. Communicating how we help them meet their needs is how we ‘fit’ each candidate and how we place physicians over the short and long term. Always learn what the candidate is looking for and see what you can do to meet those needs. This is how the best organizations determine fit way before the candidate is even brought in for the interview.
8. Too Much Talking, Not Enough Listening
Avoid the urge to sell the opportunity versus finding the right fit. Spend more time listening than talking. Ask lots of open-ended questions. Pay attention to what is not said or avoided; it may be as important as what is said. Watch body language. Listen to the whole family, particularly the spouse. Engage the spouse in activities of interest to them.
9. Lack of Clarity Regarding Expectations and Goals
This is a recipe for disaster. Setting clear expectations and goals on the front end gains commitment and builds trust. Be sure to discuss anticipated volumes, marketing expectations, define roles and responsibilities, etc. The goal is to set everyone up for success.
10. Failure to Close in a Timely Manner
Back to a sense of urgency and a buyers market for physicians, the physician should have a Letter of Intent in hand as they return home. Far too many physicians move on to the next opportunity because they could not get the information they requested, or a contract they could act upon. Do your homework ahead of time, have an LOI ready, a sample contract, and know the pre-approved ranges from which to negotiate. Close the deal!