Recruiting physicians into existing private practices is recognized as the ideal medical staff development scenario. The private practice expands its service and revenue base while adding only incremental expense. The existing practice provides a learning platform for newly minted physicians to understand the dynamics of daily patient care and practice management, and the practice legacy is guaranteed during physician retirements. At the same time, the hospital expands its physician base and, in specialties where physician shortages may be on the horizon, ensures access to services for the community.
But the private practice environment often presents physician recruitment challenges. Orchestrating an attractive recruitment process to potential candidates is critical. And private practices often fall short. This takes many shapes and forms including:
• Lack of timely response: Many of today's physicians entered practice in a less competitive environment and don't recognize responsiveness as key to demonstrating interest and capturing prospect attention.
• Lack of traction: Practicing physicians may give their nod of interest to adding another colleague, but procrastinate on interacting with the prospect. Searches then waste resources and fail to develop good momentum.
• Lack of engagement: During the site visit, they can present a weak case to the candidate — either because they lack recruitment experience or are "laissez faire" about a new practice addition.
• Lack of cooperation: There are situations where outright sabotage is in play. The practice physicians work very hard to ensure new competition does not arrive in their market.
When a practice first considers recruiting a new colleague, their initial thoughts jump to the increased cost to their practice and to themselves. How much start up expense will be incurred? Will the new physician actually add volume or just draw upon their existing patient base? There is also the shock of realizing new physicians are earning initial salaries equal to or greater than their current compensation.
Adding physicians to the practice can require other investment obligations, like technology, equipment and staff. Changes may be needed in practice style if it is outdated and unattractive to the new generation of physicians.
The cost of running a practice continues to rise. Juxtapose the increased expenses with lagging revenue. The results are shrinking net margins — fewer dollars available to invest in practice growth — including physician recruitment.
With that base of understanding, hospital leaders can engage more effectively with private practices around recruiting efforts. More time may need to be invested to effective address their concerns. This is often where we on the hospital side cut things short.
Several touch points in the recruitment process can be used as influencing vehicles.
Medical staff development plans. During medical staff development planning, gathering physician input through interviews or group discussions helps validate analytical findings while gaining their buy-in around recruitment need. Resisting search priorities may be hard when their medical staff peers indicate that patients are seeking care elsewhere due to service limitations.
Many senior leaders are hesitant to communicate study results to the broader medical staff. Small group discussions — by practice or by specialty — to have frank discussions around access concerns, unmet needs of specific population segments, etc., may be more comfortable and productive.
Practice-opportunity assessments. Once the decision is made to conduct a search, internal meetings with the practice provides the opportunity to lay out the recruitment process, timeline expectations and accountabilities. This is not likely a single meeting, but rather several conversations to get the information needed, communicate with every member of the practice and ensure everyone is prepared and engaged.
A final review session with the group to "sign off" on the details may also help. This is when potential shortcomings in either their offering or the recruitment process can be shared. A delay may be necessary to make changes to improve the offer’s attractiveness.
Recruitment orientations. Hospital leaders often have to master the art of subtlety to ensure the practice is ready to put their best foot forward. One way to help is to share a prepared toolkit under the premise of "in case you need it." The tool kit includes suggested interview questions (specialty specific), sample site visit itineraries, lead physician job descriptions, post site visit evaluations, etc. These tools give the process some structure and help the private practitioners understand the effort required.
Tracking results. Physicians respond to data — it’s how they make daily decisions — so the more we translate recruitment results into that language, the more likely we will get them to make needed changes.
Examples can include:
• Summary of which promotional tools generated leads
• Comparing the number of generated leads that fit the search criteria versus those that did not.
• Reasons why prospects were lost in the search process (i.e., lack of attentiveness, compensation not attractive, call coverage too onerous, etc.).
• Illustrating the average time the group moves candidates from one stage of the recruitment process to another
One is the physicians' time. If physicians are not seeing patients, revenue is not being generated. Working around these time constraints builds credibility for the recruitment effort. For example, forwarding only superior leads rather than presenting just any prospect to showcase activity is the best approach to garner respect and desire to participate.
No matter how much trustworthiness we have established with private practice physicians, they are often just not comfortable sharing business details with hospital representatives. We must rely on our expertise to differentiate between the information we "must have" versus "nice to have." Not having the answer to every prospects potential question is ok. We just explain to the lead that we respect the practices right to privacy and note that the group will directly provide desired information.
In situations where there are multiple practices in the same specialty recruiting, showcasing recruitment leads with every practice simultaneously can encourage detrimental competitive behavior. Assess the recruitment readiness of each opportunity in advance and identify the practice that is most likely to close the deal first. Qualified candidates rejected by the lead practice can then be presented to the others. Once the first group is completed, we can move on to the other practices. Working with one at a time, it keeps those competitive spirits under control.
Barlow/McCarthy is nationally recognized as one of the few consulting firms that is devoted exclusively to balancing the needs of hospital leadership with the needs of the medical staff. Their founding partners, Kriss Barlow and Allison McCarthy, have more than 40 years of combined experience in physician relations, medical staff development, recruitment and retention and relationship building.
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But the private practice environment often presents physician recruitment challenges. Orchestrating an attractive recruitment process to potential candidates is critical. And private practices often fall short. This takes many shapes and forms including:
• Lack of timely response: Many of today's physicians entered practice in a less competitive environment and don't recognize responsiveness as key to demonstrating interest and capturing prospect attention.
• Lack of traction: Practicing physicians may give their nod of interest to adding another colleague, but procrastinate on interacting with the prospect. Searches then waste resources and fail to develop good momentum.
• Lack of engagement: During the site visit, they can present a weak case to the candidate — either because they lack recruitment experience or are "laissez faire" about a new practice addition.
• Lack of cooperation: There are situations where outright sabotage is in play. The practice physicians work very hard to ensure new competition does not arrive in their market.
Our first obligation – Stand in their shoes
Because private practice recruitment efforts may fall short, hospital leaders should take as active a role in private practice recruitment and independent groups will allow. To work with private practices effectively, hospital leadership first has to understand physician recruitment's impact on the physicians' business. Private practice physicians today work hard to maintain professional satisfaction while keeping their businesses financially strong. Current practice economics makes this a significant challenge.When a practice first considers recruiting a new colleague, their initial thoughts jump to the increased cost to their practice and to themselves. How much start up expense will be incurred? Will the new physician actually add volume or just draw upon their existing patient base? There is also the shock of realizing new physicians are earning initial salaries equal to or greater than their current compensation.
Adding physicians to the practice can require other investment obligations, like technology, equipment and staff. Changes may be needed in practice style if it is outdated and unattractive to the new generation of physicians.
The cost of running a practice continues to rise. Juxtapose the increased expenses with lagging revenue. The results are shrinking net margins — fewer dollars available to invest in practice growth — including physician recruitment.
With that base of understanding, hospital leaders can engage more effectively with private practices around recruiting efforts. More time may need to be invested to effective address their concerns. This is often where we on the hospital side cut things short.
No quick fixes
Recruiting into these situations requires time, patience and hard work to be successful. One hospital leader described it as "lots of shoe leather time" to influence medical staff interest in and support of physician recruitment. But the existing physician community must be a part of the effort. Candidates quickly recognize colleague apathy or resistance — then quickly flee to other, more inviting opportunities.Several touch points in the recruitment process can be used as influencing vehicles.
Medical staff development plans. During medical staff development planning, gathering physician input through interviews or group discussions helps validate analytical findings while gaining their buy-in around recruitment need. Resisting search priorities may be hard when their medical staff peers indicate that patients are seeking care elsewhere due to service limitations.
Many senior leaders are hesitant to communicate study results to the broader medical staff. Small group discussions — by practice or by specialty — to have frank discussions around access concerns, unmet needs of specific population segments, etc., may be more comfortable and productive.
Practice-opportunity assessments. Once the decision is made to conduct a search, internal meetings with the practice provides the opportunity to lay out the recruitment process, timeline expectations and accountabilities. This is not likely a single meeting, but rather several conversations to get the information needed, communicate with every member of the practice and ensure everyone is prepared and engaged.
A final review session with the group to "sign off" on the details may also help. This is when potential shortcomings in either their offering or the recruitment process can be shared. A delay may be necessary to make changes to improve the offer’s attractiveness.
Recruitment orientations. Hospital leaders often have to master the art of subtlety to ensure the practice is ready to put their best foot forward. One way to help is to share a prepared toolkit under the premise of "in case you need it." The tool kit includes suggested interview questions (specialty specific), sample site visit itineraries, lead physician job descriptions, post site visit evaluations, etc. These tools give the process some structure and help the private practitioners understand the effort required.
Tracking results. Physicians respond to data — it’s how they make daily decisions — so the more we translate recruitment results into that language, the more likely we will get them to make needed changes.
Examples can include:
• Summary of which promotional tools generated leads
• Comparing the number of generated leads that fit the search criteria versus those that did not.
• Reasons why prospects were lost in the search process (i.e., lack of attentiveness, compensation not attractive, call coverage too onerous, etc.).
• Illustrating the average time the group moves candidates from one stage of the recruitment process to another
Built In barriers
In working with private practices, there are some structural factors that are just not in our favor.One is the physicians' time. If physicians are not seeing patients, revenue is not being generated. Working around these time constraints builds credibility for the recruitment effort. For example, forwarding only superior leads rather than presenting just any prospect to showcase activity is the best approach to garner respect and desire to participate.
No matter how much trustworthiness we have established with private practice physicians, they are often just not comfortable sharing business details with hospital representatives. We must rely on our expertise to differentiate between the information we "must have" versus "nice to have." Not having the answer to every prospects potential question is ok. We just explain to the lead that we respect the practices right to privacy and note that the group will directly provide desired information.
In situations where there are multiple practices in the same specialty recruiting, showcasing recruitment leads with every practice simultaneously can encourage detrimental competitive behavior. Assess the recruitment readiness of each opportunity in advance and identify the practice that is most likely to close the deal first. Qualified candidates rejected by the lead practice can then be presented to the others. Once the first group is completed, we can move on to the other practices. Working with one at a time, it keeps those competitive spirits under control.
Lots of dialogue
To positively influence physicians about recruitment, we need to demonstrate understanding around the impact recruitment can have on their businesses. Dialogue is needed to uncover and work through misgivings. Through knowledge exchange, understanding and communication we can adapt to encourage participation and work more effectively as partners in the effort.Barlow/McCarthy is nationally recognized as one of the few consulting firms that is devoted exclusively to balancing the needs of hospital leadership with the needs of the medical staff. Their founding partners, Kriss Barlow and Allison McCarthy, have more than 40 years of combined experience in physician relations, medical staff development, recruitment and retention and relationship building.
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