Is Anybody Out There?

The Hospitalist. 2009 June;2009(06):

June 1, 2009|The Hospitalist

In a tale all too familiar to HM group leaders, whether they head two- or three-physician services or the large, multistate hospitalist companies, Heather Bellow, MD, FAAP, is trying to recruit a pediatric hospitalist to her midsize Midwest town.

Her sales pitch, though, seems to focus more on the bounties of Lansing, Mich., rather than the work to be done as the fourth full-time member of Sparrow Hospital Inpatient Pediatric Services. Dr. Bellow often talks up the culture, lifestyle, and the vibrant atmosphere Michigan State University provides the community. And yet, she struggles to find new hires.

Her story is the new norm: Group directors outside the nation’s largest markets agree that they often work for months at a time to recruit hospitalists. Some relent and hire a steady string of residents from nearby institutions. Others throw money at the problem, only to lose those well-paid hospitalists to other groups that throw more money at the problem. The problem is particularly acute in secondary- and tertiary-population areas, where hiring managers often find themselves battling each other for the same hospitalists.

Who’s Hiring Whom?

Recruitment is a two-way street. Groups need to have a clear hiring plan before they start interviewing, and candidates should take ownership of their job search. Inpatient Management Inc. of St. Louis offers these tips:

Employers should have a clear understanding of their practice culture, the work-life balance it affords, practice style, and patient volumes.
HMGs need to target “the” candidate, not “a” candidate. Type-A personalities might not be the best fit for HMGs with a business-casual approach.
Directors need to do their homework. Pre-interview assessments, review resumes for red flags, follow through on reference checks: All are basic and effective tools.
Hospitalists need to know their boundaries. Determine your perfect situation, then decide the parameters of employment. Know the things you are willing to compromise on and the things that are deal-breakers.
Job-seekers, do your homework, too. Research the practice you are interviewing with; check out patient volume; talk to the potential employer’s physicians.
Money isn’t everything. A signing bonus is nice, but if the fit isn’t right, it probably won’t be worthwhile to uproot and move across the country. If the job is right, the money tends to be less of a factor.—RQ

“That’s the million-dollar question,” Dr. Bellow says. “How do you find that outside person that’s willing to come to small-town USA? I really don’t know.”

One possible answer: A focused recruitment strategy should be considered its own subspecialty. Highlighting the growing importance of recruitment and retention issues, SHM offered its first recruitment course last month at HM09 in Chicago. More than 300 people attended the session, which looked at the hiring process from both perspectives. In anticipation of high demand, the presentation was one of only a handful of sessions that were held twice during the meeting, allowing those who missed the first-day session to attend the same session on the final day.

“It’s a crazy time in some ways,” says Kirk Mathews, co-founder and CEO of Inpatient Management Inc. in St. Louis. “In challenging times, people often abandon the fundamentals because they feel they’re in desperation mode. Just bring someone in, get a body in there—anything with an MD behind their name.”

Hospitalists looking to recruit to smaller markets say times are getting tougher. The job posting board at HM09—always a popular gathering site—was littered with fliers for practices in smaller markets: Albuquerque, N.M.; Coeur d’Alene, Idaho; Murphy, N.C. Most of the announcements focused on the natural beauty of an area, proximity to surf or sand, or the peaceful lifestyle a community affords. Few focused on compensation, rotation schedules, or whether malpractice insurance and continuing medical education would be reimbursed.