Monday, January 16, 2006

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!


Thursday, January 12, 2006

The Physician Recruiting Marketplace, Part 4

As a member of the National Association of Physician Recruiters (, 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?


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.


Wednesday, January 04, 2006

The Physician Recruiting Marketplace, Part 3

As a member of the National Association of Physician Recruiters (, 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


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


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.


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.