Physician Career Fairs – Making the Most of Them

I recently had the pleasure of attending the CareerMD Career Fair in Chicago. For those of you who don’t know, CareerMD is a terrific resource for physician training and job finding info. Their website at www.careermd.com features a comprehensive and centralized source of information on physician training and employment opportunities. They also host career fairs in various locations throughout the US.

I did happen to notice that most of the physician attendees were prepared for the event, but also noticed that many hadn’t given much thought to their expected outcome. I’d like to make some suggestions on how you can get the most out of time attending career fairs.

As you know from other posts, I’m a huge believer of “beginning with the end in mind.” In this context that means that physician job seeking attendees would arrive expecting to: 1) talk with prospective hiring authorities about opportunities; 2) have additional copies of their CV’s in hand to share on the spot; and 3) know what types of opportunities they are interested in seeking and possible locations/geography as a destination.

Usually the career fair sponsor can advise you about the number of employers or recruiters to expect in attendance so you may estimate how many CV’s to bring with you. Also, in many cases the career fair sponsor will collect your CV and make all of the job seeker CV’s available to the hiring authorities who attend the event. This is a nice service so as an attendee you don’t have to schlep 150 copies of your CV. But, you do still want to have 15 to 20 copies to distribute to those companies/recruiters where you want immediate follow up.

Last, don’t hesitate to ask for the business card from practice situations you are especially interested in. You may need to contact them directly, if they are slow to get back to you. As a recruiter/hiring authority at these events, I know I’m juggling a lot of paper, and a display plus traveling and might not be as quick to respond as I like post event. I’m never put off if someone contacts me in follow up – I know they are very motivated about my opportunities and will be a good candidate.

Last, be flexible. It might be that as you are wandering the career fair event you learn something about a practice style or location that you haven’t previously considered. You never can tell when that info might come in handy as your career morphs over your lifetime.

Happy and healthy job searching.

Happy holidays too.
Lynden

Don’t Be a Turkey about Your Search

As most of the US is about to relax and enjoy the Thanksgiving Holiday, I know many physicians across the country will be taking care of patients. These patients are blessed with the healing and ministering skills not to mention the professionalism of the physician backbone of the American Healthcare System. Personally, I’d like to say thank you to those who serve. I’m proud to be a contributor in my own small way to the health and success of the healthcare delivery system in this country; I’m honored to work with many of you. Happy Thanksgiving.

I also want to remind those of you who are seeking a new practice situation, that this time of year can be great from a job search perspective. From my vantage as a recruiter, the holiday time is often one of the best times of the year to catch both candidates and hiring authorities. It is a time for healthy reflection about personal and professional wants and needs – again for both sides of the job search equation. So, please don’t make the assumption that nothing gets done between Thanksgiving and the end of the year. Quite the contrary, there is robust activity and only the turkeys who don’t know that suffer.

Happy and healthy hunting.

Lynden

Doctor - want a job? The best candidates are……

In the going on a jillion years that I’ve been in recruiting, there are similarities across the best candidates. The same is true of the best physician candidates - the best ones have the following attributes nailed. I’ve been working recently with lots of final year residents and fellows. I’ve noted that many aren’t clued into the job search process and don’t have their act together about what they want to be doing. I’m not faulting anyone for not having a crystal ball, however; being articulate and confident about what you want to do next is crucial if you want to rise to the top of the CV pile on a hiring authority’s desk.

Things to think about (outside the CV):
1) Know your strengths and what you can add to a new practice situation (whether it is an employed or partnership track opportunity). Even if you are new to being in private practice you still have something to offer in the form of cutting edge skills, a manner of dealing with and contributing to patients, or your personal disposition – a steady eddy or a humorous harriet. Be prepared to distinguish yourself from all the others. I know I know you’ve been studying for the last quarter of your life and don’t think of yourself as needing to have self promotion skills but in the job search process you need to blow your own horn.
2) Know the part of the country in which you’d like to work. Hiring authorities are going to be interested in you if you have some link or tie to the community. If you want to practice in Dallas for example, it helps that your wife’s family all live in the area. That makes a difference. The bottom line is that the hiring authority wants to have you fit in with their medical community and if they are going to be making an investment in hiring you they want you to stay in their community.
3) Know the size of community you want to be in if you don’t have an absolute destination in mind. Also know how close you want to be to a metropolitan area or to a larger/international airport. This can make a difference as you are reviewing job openings
4) Know how much call you prefer and know the type of practice you want – solo, solo with call, join one (partner); more than two single specialty group, multispecialty group, hospital employed or other employed or academia? Or industry? Where do you want to be?
5) Know when you can start – this should be as unambiguous as possible.
6) Know if you will need special help with your relocation – do you have a special needs child or a spouse whose career will need to be relocated too! This shouldn’t make a difference as you go through discussions about your qualifications, but will make a difference once you have an offer and are considering all the issues about how to get you to your first day.

There are many things to consider, but getting clear about them in advance of your conversations with a recruiter or hiring authority is important if you want to be perceived as a key candidate or player in the search process. If you’d like help with aspects of this process check http://www.mdcareercompass.com for job search tools to help you manage your search more effectively. If you get clear about the six points mentioned above you will be well on your way to launching the search process and giving yourself a running start.

Happy and healthy job searching!
Lynden

Great Employment Law Resources

I wanted to share two resources with you regarding employment law issues. You can never be sure when you might need assistance in this area. I want to recommend two sites.

The first is George's Employment Blawg at http://www.employmentblawg.com/recommended-links
I found this site as a recommendation featured in one of the many recruiting industry newsletters we receive - Airs News in an article by Paula Santonocito. This site is by "George Lenard, managing partner of Harris Dowell Fischer & Harris, a management labor and employment law firm based in Chesterfield, Mo. The blog shares workplace observations on legal matters and other trends. However, via a disclaimer, Lenard points out that information is general and does not constitute legal advice. Lenard's notation points to a sometimes overlooked aspect of blogs: Although they are often written by experts, they tend to be individual musings. In other words, it's important to consider the source and the context in which comments are made."

The next site I'd like to recommend features details about work visa related issues for those of you who might have interest in hiring a visa candidate or if you are an international candidate there is great information for you. What I particularly like, is that the site is hosted by a law firm (again like the one above) and provides up-to-date information about immigration issues. The law firm behind the site is Siskind Susser Bland and they say, "our firm's web site, which was launched in June, 1994, was the first immigration law firm web site and one of the very first law firm web sites in any category. Since then, it has remained one of the most immigration sites on the World Wide Web. Our site typically receives more than 1,000,000 hits every week from more than 150 different countries." I can't say enough positive about it. Also of note is the site has a section dedicated exclusively to healthcare visa issues in the Healthcare Info Center. Check it out at http://www.visalaw.com/IMG/resources.html

I think you'll find both to include a wealth of information and links that will assist you with most every employment law need. Good luck.

Happy and healthy job hunting and hiring!

Lynden

Email Options – Gmail

One of the suggestions that I often make to candidates who are launching into a job search is that they set up an email account to manage all their search related correspondence. This keeps the info organized and in one place for easy follow up. The article below details one such option. I hope it is helpful if you are considering this service.

The following is from an article published in the AIRS “REALTOOLS” Newsletter. It is written by Paula Santonocito. AIRS can be reached at 58 Fogg Farm Road, White River Junction, VT 05001; 800-466-4010.

The Gmail Option

Even with the folders, routing, and search features of Microsoft Outlook, it can be difficult to manage the onslaught of email. It often becomes more about keeping up rather than creating a process that allows for optimum efficiency.

If you're still trying to manage your electronic correspondence using one account and feel overwhelmed, it's worth considering how a second or even third account might benefit you.

Creating a separate account for newsletters, for example, allows you to separate reading material from correspondence requiring immediate attention. Using an account for personal correspondence also helps keep your business account professional and less cluttered. The same is true with online shopping. Do you really need email purchase confirmations and ongoing advertisements showing up in your primary account?

When organization is an objective, web-based email accounts can prove helpful.

Most people are familiar with web-based email services like Mail.com, Yahoo! Mail, and MSN Hotmail. Each offers slightly different services for a fee, but free offerings are basically the same, as is the process. You create an account and have access to limited storage.

Limited storage can be an issue with free web-based services. Space gets used up quickly, particularly if you're an email packrat. Generally, if you want greater capacity with web-based email services, you have to pay for it. Not so with Gmail, which offers greater capacity.

G isn't for greater, gargantuan, or gigabyte (which was the storage capacity originally offered gratis). If you haven't already guessed, G is for Google.
Gmail has been around for a while, but like everything else at Google it is in a state of constant evolution. The current version of Gmail is based on the premise that email can be eternal; or, as Google says, "Don't throw anything away." With this mind, the search engine giant now offers more than 2 gigabytes of storage and counting (see the clock that ticks off the additional space at the main Gmail page).

Google's product has met with accolades. It was voted number two in PC World's Top 100 products of 2005, the company notes.

Then why aren't more people using it? "It can be a pain to switch to a new email address," Google says, pointing out it makes it easy. To this end, Google attempts to resolve concerns. It actually has a "help me switch" feature where you enter an existing email account, import contacts, announce a new address, and send reminders to friends. The feature also allows you to keep your old address.

Of course creating an entirely new account is also an option. Whether you replace an existing account or create a new one, you'll quickly discover that Gmail has a lot of convenient features. Its search features make it easy to find messages. It also groups each email and its replies into a conversation, so you can follow the back and forth of an email exchange. And of course there's the storage capacity, which means you can save all the messages you want.

Google continues to offer enhancement to its product, the latest being Reply by Chat, which is basically an instant messaging feature within Gmail. If you and another Gmail user are online at the same time, you can chat rather than email.

Okay, so what's the rub? Why aren't people receiving more emails with Gmail in the address?

There are currently only two ways to sign up for Gmail; one is by invitation and the other is by using a mobile phone with text message capabilities.

Google claims the system helps prevent spam and other email abuse. Unfortunately, it seems to also deter sign up.

Nevertheless, if you do follow the process, which involves entering your mobile phone telephone number in a box and copying characters into a box, you will receive a text message code on your mobile phone immediately. Then all you do is enter the code at the site and you've got Gmail.

If managing your email is a goal, and you're considering creating another account, give Gmail a look. Despite the unusual signup method, Gmail is a great mail service.

Happy and Healthy Job Searching

Lynden

Bum References – Physicians Beware

Most of us take for granted that if we provide the names and contact information of colleagues to prospective employers that the colleagues or attending physicians recommending us will be objective, fair and supportive of our professionalism in their comments.

I recently had a candidate who was very forthright about sharing reference letters. He easily forwarded letters written on his behalf early in the recruitment process. Because of his “up front” management of that issue, I suspect many prospective employers didn’t actually call the references for more background but relied instead on the letter exclusively as the reference check.

Beware to the practice that hires going only on a written letter of reference AND beware to the job seeking physician who thinks that his references won’t be contacted directly.

In the example above, one of the practices where this candidate was seeking employment actually called one of the references instead of simply relying on the letter. What the hiring practice heard from the reference wasn’t flattering to the job seeking physician candidate. In fact it was so poor that the group decided not to issue an offer and called another practice where the candidate was interviewing in the same community to share what they learned. The second practice verified the info and actually withdrew their offer before it was accepted. The job seeking physician was left wondering why and what happened.

As a candidate, you shouldn’t be left wondering why. When you ask someone to be a reference for you, also ask how they handle references and if they will speak fairly of your skills and experience. Don’t assume they will be a good reference without asking them if they have a good impression of your work and experience. If you get any kind hint of negativity in their answer – find another reference. When you are at the finish line headed into offer negotiations, the last thing you want to do is fall on your face because a reference was negative or even neutral.

If you suspect that a reference may not be as strong as you’d like – ask them about their comments or have someone objective speak with them on your behalf. If you are working with a trusted independent physician recruiter – the recruiter can call to check a reference in anticipation of working with you. That recruiter should then be able to verify for you if your references are as strong a resource as you need for your job search campaign. (Note: I suggest an independent recruiter versus an internal recruiting professional because the results would bias an internal recruiter’s conclusions about your candidacy with their employer).

As in everything you do, the devil is in the details and knowing you have solid professional references is key to success in your career search.

Job Seeking Success,

Lynden

Physician Compensation and the Interview

One of the great things about physicians is that you/they are bright and very talented at many things. As self reliant, sophisticated professionals it is easy to assume that taking about compensation details in an interview should not be complicated. WRONG. I’d like to suggest a more effective strategy that will produce a better outcome.

Time and again it is shown that when the “principals” are involved in negotiations (in this case the principals are the physician and the hiring authority directly) the risk for miscommunication and harm for rapport development are high. You may be wondering why that would be the case when the key players to the agreement are the ones who are part of the discussion.

Simply, the personal gets in the way of the factual. Approaching the compensation negotiation without an “agent” or intermediary can result in a less than win-win outcome. As a search executive with years of experience, I’ve seen where the discussions get sensitive because of expectations not being met or because of subtle details not being heard and/or understood.

Communication is imperfect as we all know. When an employer says the salary range is between $250,000 and $300,000 they usually mean that the starting salary is $250,000. The candidate consumes that info often as, “wow I could get an offer for as much as $300,000.” It might be that the candidate believes that s/he should be starting at $300,000 and so assumes that number should be what is offered. I don’t know a hiring authority on the planet that will negotiate an offer from the highest point first. It is simply contrary to good business strategy. Hence the two parties may already be set up for disappointment – the candidate who had hoped to hear a “higher number” and the employer who is surprised that the candidate isn’t delighted by what they feel is a very generous offer.

Other things happen too. There may be more details to explain. Perhaps the base is light, but the productivity bonus is rich. If the candidate involuntarily groans at the low base before the hiring authority completes discussion of the productivity bonus formula, the hiring authority might get the impression that the candidate is reactive, doesn’t listen well, is greedy or may make any number of other assumptions. Usually the assumptions aren’t to the benefit of the candidate.

Simply put, the communication process can fail to achieve the most desirable outcome. When the issue is negotiating compensation, it is always best to have someone in the middle. If you are working with a recruiter or with a placement agent you can expect them to level the playing field. A hiring authority is not going to negotiate in the candidates’ best interest; they are going to strike the best deal for them.

Let me give you an example. In anticipation of the negotiation, the recruiter/agent will check with the physician candidate about her/his expectations of compensation. Thus it is known that the expectation is $300,000 on the candidate side. When the recruiter/agent is later working with the hiring authority on the offer proposal and the offer target discussed is $250,000 the agent can indicate that the candidate already has a different number in mind. Then if there is room for advance negotiation it can happen in the background rather than the foreground.

Assume the hiring authority can’t budge on the base, then the agent can work with the hiring authority to secure other options such as a higher sign on or commencement bonus; a richer productivity bonus plan or shorter track to partnership. Again all of this negotiation can be taking place in the background refining and reforming the offer until it seems most palatable for each party. Then when the offer is presented, there are NO surprises. Each side is prepared for possible reactions to offer details.

My best advice is that if you have the opportunity to have a recruiter or agent as a buffer and catalyst for the negotiation process – take advantage of it. It does product the most win-win outcomes.

Happy and Healthy Getting Hired.

Lynden

Conducting Panel Interviews as Part of the Hiring Process

Conducting Panel Interviews as Part of the Hiring Process

In case you aren't familiar with the term, a panel interview is an interview where the interviewee meets more than two interviewers at the same time. Usually the panel size is between three and five interviewers.

It isn't unusual to want to expose your healthcare teams to potential new hires. In many situations it is important that all feel comfortable with the new addition or to assess potential "chemistry" among all players. However, if a panel interview format is to be used then certain considerations must be anticipated.

First, because of the intimidating nature of the panel interview all the panel participants should clearly understand their role in the process. It usually works best if each panel member is responsible for a portion of the interview content. In that scenario the individual panel interview team member then is the one who develops or manages the questions about a particular skill set, experience or educational aspect of a candidate's background. All the panel members have responsibility for getting information about their topic within a given time frame. Clearly ground rules and organization are important to keeping the panel effective and designating a panel team leader might be important to keeping the meeting on time, on point, on purpose and as interactive as possible.

Also important is to clarify the role of each panel interviewer in the decision making process. Some panel members may assume they have a full vote as in a democratic selection process and can possibly block the hiring of a prospective candidate. If this is not the case and the hiring manager is inviting participation and recommendations but going to weigh panel interview team participation differently - not giving any single member veto power - that should be explained up front so there in no ambiguity as to who is ultimately making the hiring decision.

The candidate who is being interviewed should be offered an introduction to each panel member; to learn the role of the panel participants and how the position that they are interviewing for interacts with each panel member's job. The panel interview can cause panic with candidates who aren't comfortable with group speaking situations, so prepare the candidate as much as possible in advance of the panel interview.

On the whole the panel interview can be a very effective and efficient way to expose candidates to your healthcare team. It also allows the panel team members to participate in the hiring process; have a sense of ownership in the process and to develop espirit with potential new hires, which can make new hire on boarding easier too.

Happy and healthy hiring,
Lynden

Women Physicians Making a Difference in Your Practice

In 2004, women accounted for 25.2% of the physician workforce and 41% of physicians in training programs. This number is expected to increase since women made up the majority of medical school applicants in 2003-2004. It is predicted that by the year 2010, approximately 40% of US physicians will be women.

As you know, before women could build careers as physicians they had to fight even to be allowed to attend medical school. After proving that they were as capable as men, they went on to campaign for additional professional training and other career opportunities.

Today women physicians are serving in the highest ranks of the medical profession, caring for whole communities and responding to new challenges in health care around the world. As high-profile leaders they offer new examples of roles for women today, and they institute strategies to help more women reach the very top of the profession.

The National Library of Medicine is offering an exhibition on Women Physicians that might be of interest. http://www.nlm.nih.gov/changingthefaceofmedicine/exhibition/ Check it out.

Women are making a difference in the landscape of medicine as their numbers increase. They want to be "employees" more often with flexible schedules. The AMA indicates that women are in employed roles 60% of the time compared with their male counterparts who assume employed roles only 31% of the time. Female physicians on average work 25% fewer hours than male physicians. Employers of physicians - listen up! Female candidates require more flexibility in their work environment. If they don't have it they find jobs where they can have it. If you need to be fully staffed, you need to think about how flexible your working environment can be.

A survey of 2,443 women and 653 men, co-authored by Sylvia Ann Hewlett of the Center for Work-Life Policy, found only 5 percent of mothers who return to work even want to go back to their former employers; instead, they seek flexibility at smaller firms or by starting their own businesses. Making it all the more important for larger firms to address the issue.

A growing number of employers are taking major steps to help women with an age-old problem: Returning to the work force after taking time off to raise kids. A study of 13,838 employees, found women ages 25 to 40 making more than $75,000 a year had turnover rate of 11.4 percent a year. But research also shows these women seek to return to the work force fairly quickly, as long as they have a workable and appealing setup.

Healthcare employers need to be cognizant that the female employee is an important part of the work force. Physician employers need to know that they can accommodate the surge in female physicians, but their success will be in creating a employment culture that has more give and shorter hours.

Happy and healthy hiring.

Lynden

Changing Jobs – The New Healthcare Employer’s Perspective

Did you know that a new employer not only wants to hire the best candidate they can find, but one who is the most highly adaptable or able to flex and change. The best companies in the world are those that are agile and able to adjust themselves to the varying realities of the market place. Hence, when they set out to hire, they are seeking those who have well honed “change management” mechanisms.

To substantiate this point, a May 2005 Fast Company article entitled, “Change or Die” by Alan Deutschman addresses the issue of change.

Changing the behavior of people isn't just the biggest challenge in health care. It's the most important challenge for businesses trying to compete in a turbulent world, says John Kotter, a Harvard Business School professor who has studied dozens of organizations in the midst of upheaval: "The central issue is never strategy, structure, culture, or systems. The core of the matter is always about changing the behavior of people." Those people may be called upon to respond to profound upheavals in marketplace dynamics -- the rise of a new global competitor, say, or a shift from a regulated to a deregulated environment -- or to a corporate reorganization, merger, or entry into a new business. And as individuals, we may want to change our own styles of work -- how we mentor subordinates, for example, or how we react to criticism. Yet more often than not, we can't…Kotter has hit on a crucial insight. "Behavior change happens mostly by speaking to people's feelings," he says. "This is true even in organizations that are very focused on analysis and quantitative measurement, even among people who think of themselves as smart in an MBA sense. In highly successful change efforts, people find ways to help others see the problems or solutions in ways that influence emotions, not just thought."

Employers are listening for details in how candidates will make a difference in the success of their businesses – smart employer interviewers are also listening to the emotional underpinnings or values expressed by the candidates they seek to hire. They are listening for motivation, enthusiasm and spark. They are listening for evidence that the new hire wannabe has an internal passion, roadmap for success and adaptability about themselves that makes them great contributors in the workplace.

The secret then to hiring the best is to “put your ears on” when interviewing; listening for a sense of purpose, contribution and passion about being in the work place and not just finding candidates who arrive as a place filler, but as a true agile team player to flex and grow with your business over the long term.

Happy and healthy hiring!

Lynden

The Physician Recruiting Marketplace, Part 4

As a member of the National Association of Physician Recruiters (http://www.napr.org/), I've recently had the privilege of seeing an article prepared by Tammy Jamison, a Senior Physician & Executive Recruiter with the Lehigh Valley Hospital & Health Network in Allentown, PA. Tammy's article is filled with statistics about the physician recruiting market. I'd like to share some of her well researched details with you.

Solutions to Recruiting Challenges

Expand Candidate Pool

As the face of medicine has changed, so too must the expectations of today’s employers. While it is often the case that hospitals and practices want to hire physicians who are fully schooled in the US, the employers must recognize that the candidate pool is limited and that in order to fill positions, they must be willing to consider well trained international medical school graduates. Hiring IMGs is ideal to increase diversity in the physician workforce in order to mirror the diversity among patient populations. It is also important to remember that even if physicians have completed medical school and residencies in other countries, they have to repeat their residency training in this country in order to be eligible for board certification.

Since it is predicted that be the year 2010 approximately 40% of US physicians will be women, it is natural to assume that hospitals and practices will be hiring more women in the future. Due to family demands, many women choose to work part-time or flexible hours. Employers need to respond to those desires by considering job sharing, or by being willing to offer flexible hours to new female recruits.

Know Your Audience

Employers that creatively address the preferences of the younger workforce will be more successful than those that don’t. Hospitals that employ physicians, and private practice leaders who hope to add partners, need to be educated about the realities of the recruiting market in terms of numbers and about the expectations of the emerging workforce. They need to be able to relate to this faction of the workforce by understanding what is important to them and responding to those needs.

Gen-X workers place a high value on relationships, so the recruitment process should be relationship-oriented and be a thorough and positive process. After the physician has been hired, the pre-employment phase should include frequent contact with the soon-to-arrive new physician. Because the Gen-X workforce has witnessed parents and friends being downsized from organizations, they tend to feel less loyal to an organization than those of their parents’ generation. What they value are employers who help them build marketable, portable skills that will help them to be successful wherever they go. This group of physicians will be attracted to employers who:
« Provide comprehensive orientation programs
« Develop mentoring programs that help them with decision making, maximizing collections, etc.
« Educate them about internal practice management guidelines to aid them in achieving high productivity
« Communicate clear expectations about performance
« Provide regular and frequent feedback about performance and offer help where they fall short

This study reveals some good and not so good news for physician recruiters. While it is clear that recruiting physicians is challenging, and will most likely become more so as the impending shortage becomes more evident, physician groups and healthcare organizations will rely very heavily on physician recruiters to accomplish their goals of filling their physician opening. And, it is great to be needed, isn’t it?

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I’ve appreciated the wisdom that Tammy has shared with us and hope that learning more about the nuances of physician recruiting has been helpful.

This is a great industry to be a part of ….a great time to be in the business…and wonderful rewards await the employers who get it, the candidates who go through it and the recruiters who support it!

Happy and healthy hiring.

Lynden

The Physician Recruiting Marketplace, Part 3

As a member of the National Association of Physician Recruiters (http://www.napr.org/), I've recently had the privilege of seeing an article prepared by Tammy Jamison, a Senior Physician & Executive Recruiter with the Lehigh Valley Hospital & Health Network in Allentown, PA. Tammy's article is filled with statistics about the physician recruiting market. I'd like to share some of her well researched details with you.

Economic Pressures - Malpractice and Shrinking Take-Home Pay

Malpractice

Economic pressures such as the rising cost of malpractice insurance, increased practice operation costs and reduces reimbursements are impacting the financial stability of hospitals and practices, which is also negatively affecting physician recruitment efforts.

In the past decade, the cost of medical malpractice insurance has skyrocketed in many states, such as Pennsylvania. Some practices are letting partners go because their insurance costs are too high for the practice to absorb.

Due to the malpractice crisis, surveys of physicians in "malpractice crisis" states indicate that many physicians are now cherry-picking patients, others are considering early retirement or relocation, and still others are practicing litigation-avoidance medicine (ordering extra tests, etc.) Additional studies show that due to their fear of being sued, physicians are choosing to work in states with the most significant liability reforms.

Increased Costs

Liability insurance is only one of the expenses that have been increasing for hospitals and practices. According to MGMA, practice costs have risen at an average of 6.5% annually for the last ten years, and median operating costs are now 60.2% of gross revenues, up from 54.4% in 1992. Increasing practice expenses are eroding physician incomes, and due to labor shortages of nurses and other professionals, practices are being forced to pay their staffs more than budgeted in order to attract and retain staff members.

Solutions to Recruiting Challenges

Education

There is little that hospitals and practices can do to affect the shortage of physician candidates other than to support efforts to increase the number of medical student and residency positions, and to support the elimination of the Medicare GME cap. However, physician who are educated about the reality of the physician marketplace are more likely to be successful in recruiting than those who are unaware of some of the current dynamics.

What employers can do is enhance their recruitment processes to increase their likelihood of being successful. Employers must figure out how tot get the attention of potential candidates through diverse and comprehensive recruitment approaches. They also need education about what today's workforce looks like and responds to then them they must adjust their approaches and attitudes based upon those learnings.

Successful recruitment requires planning and commitment. The earlier that physician needs can be projected, the better an employer's chances of being successful in recruiting new physicians. Employers must also commit time and money to the search process.

Getting Candidates' Attention

Recruiting efforts are more likely to be successful when the positions are well defined, the expectations and compensation are fair, and sufficient time and resources are allocated to the search process. Recruiting campaigns must be diverse in order to reach the widest possible audience, and must include Internet advertising, print advertising, direct mail and networking. Recurring budgets will very based upon the type and degree of difficulty of the search, with more difficult searches often requiring more time an resources.

Since the competition to get the attention of good candidates has increased exponentially over the past ten years, it is important that recruiters determine what methods young physicians are using to seek positions, and utilize the most effective ones.

Being Competitive

While employers must first get the attention of potential candidates, the next hurdle is to "land" the candidate, and that involves making a competitive offer. This includes not only cash compensation, but also benefits and recruiting incentives.

It's also important that employers know which recruiting incentives have become common place. A 2005 review of physician recruiting incentives reports the following:

99% are offering relocation in an average amount of $8,850

46% are offering signing bonus' in an average amount of $14,030

14% are offering education loan repayment as a benefit

According to an independent study conducted in 2004 for the New England Journal of Medicine that asked job seekers to rank benefits and incentives by degree of importance, malpractice was the most important benefit, followed by signing bonuses, CME time allowance, disability insurance and education loan forgiveness. Primary care physicians and specialist diverged on priorities. Loan forgiveness and CME expenses were more important to internists, while subspecialists valued relocation expenses an disability insurance. As one would expect, education loan forgiveness is important to physicians who are 35 and under while physicians who are 41 and older place a greater value on disability insurance.

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Paying attention to the competitive landscape is crucial for hopeful physician employers as they seek new hires. Being aware of the candidate's expectations and being willing to work with them on their "hiring priorities" is a key step in being successful.

More of this to come.

Happy and healthy hiring.

Lynden