Thursday, May 20, 2010

Physician Recruiting and Retention

Yesterday I interviewed Lori Schutte, President of Cejka Search, a St. Louis-based physician recruiting firm. The interview focused on a 2009-2010 Physician Retention and Recruitment Survey conducted in partnership with the American Medical Group Association (AMGA).

The AMGA represents 95,000 doctors in group practices , 67% of whom practice in multispecialty groups of 50 or more. The survey was sent by email to all AMGA members. The response rate was 11% and included 12,452 physicians.

I will not go into the details of the interview which is now being transcribed. Lori and I and another Cejka executive, Mary Barber. Vice-President of Recruitment Partnerships and Marketing , covered the physician retention and recruitment landscape.

Lori said she was surprised that there was so little change since the previous four surveys conducted with AMGA. She did note that an upsurge in demand for part-time work, more among male physicians than female. And she observed that recruited physicians these days often come in pairs, husband and wife, and creativity is required to create a place for the couple within one organization.

The survey was conducted before passage of Obamacare, and the physicians surveyed at the time apparently had few strong opinions about reform, other than being interested in prospects for increased pay for primary care to compensate for shortages and where the medical home concept might be headed.

The strongest recruitment drawing cards were: compensation 65%, income guarantees, 61%, and signing bonuses , 42%. Groups with established EMR platforms strongly attracted IT savvy young physicians. Both younger and older primary care physicians often asked about hospitalist support. With regard to hospitalists, Lori said, physicians tended to be for hospitalists or against them. The against doctors preferred to follow their patients throughout their hospital stay.

We also spoke at some length about the special needs of women physicians who have a greater need for flexible hours than their male counterparts, particularly early in their careers.

We discussed physician turnover, which has modestly decreased over previous surveys, perhaps because physicians preferred to stay put during the economy and real estate uncertainties. . Turnover tends to peak at about 11% in the third year after recruitment when the “bloom is off the rose,” but is less than 6% overall.

Groups, Lori explained, are growing in size and are acquiring solo or small group practices to establish more of a market presence. She also said hospital-physician consolidation into integrated delivery systems is picking up in intensity.

We touched on the need for innovation. This need is usually not formalized, but is addressed under the mantras of increased efficiency and continuous quality improvement.

Many practices are marginally concerned about physician burnout, but most have not yet come to grips of how to deal with it in a formal way, such as sabbaticals. Physicians leadership and administrative duties are a growing concern , and identifying physician leaders and appropriately rewarding them is another emerging issue.

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