In-House Physician Recruiters Form Backbone of Market for Large Employers

In-House Physician Recruiters Form Backbone of Market for Large Employers

Physician recruiters on staff in hospitals, health systems and large medical groups comprise an essential part of the market for physicians, translating the needs of their organizations into demand. The recruiters have important roles in keeping their organizations competitive and finding physicians who are compatible with their entities’ cultures, and their pay roughly parallels that of outside recruiters (see box, p. 10).

There are probably several thousand full time staff recruiters in such organizations, and they hire tens of thousands of physicians every yeah Most hospitals of 200 beds or more and most medical groups of 40 physicianns or more have a full time recruiter on staff, says Chris Kashnig, the recruiter at 90 physician, multispecialty Christie Clinic in Champaign, Ill. In larger organizations, there often is more than one recruiter, while in smaller ones the recruiter has other duties.

Kashnig says most searches take nine to 18 months, from the time a firm decision is made to recruit until the successful candidate begins work. A key component of the job, he explains, is making sure that the right people are meeting the candidates and all sides are prepared, so that the candidate and his or her potential colleagues at the group can quickly learn whether they want to work together.

Among the most numerous in house recruiters are the practice managers at thousands of small and medium sized physician owned groups, who take on recruiters’ duties as one of their functions. In very small groups and solo practices, physicians often do this task.

Outside recruiting firms comprise the smallest — but still a vital — sector of the physician recruiting industry These firms serve clients ranging from solo practices to multi state hospital organizations, and often work with in house recruiters on hard to fill positions. Most of the firms are paid only if a position is filled, usually a percentage of the physician’s starting salary, but some firms are paid by retainer. They recruit for both permanent and temporary positions, but permanent jobs are the focus in this article.

In-House Roles Vary by Organization

Sandy Lachman heads the three person physician recruiting staff at 550 physician, multispecialty HealthPartners, based in Minneapolis. Among the many jobs her staff performs are:

* Finding candidates who, from their CVs and letters, appear to be qualified and genuinely interested.

* Conducting initial phone interviews to further gauge interest and inform the candidate about HealthPartners.

* Informing specialty department chairs or clinic chiefs, depending on where each candidate would work, about candidates who pass this initial review; and getting the selection of candidates to pursue further:

* Setting up interviews with those candidates, including travel arrangements if needed. The interviews pinpoint not only if the physician leaders want the candidate, but also if the candidate wants HealthPartners. “Our job is to make the best match not only for our sys tem, but also for the physician,” Lachman says.

* Negotiating contracts with candidates the organization wants. This is when the money terms are set.

* Getting approval of the contracts from the department heads or clinic chiefs.

* Executing contracts, setting start dates, credentialing.

Lachman says that even in the rare instances when a search is given to an outside firm, her staff does all the same functions except finding the candidates.

John Larson, a recruiter at 483 bed Alexian Brothers Medical Center in Elk Grove Village, Ill., serves as a conduit between new physicians and the 317 outside practices (175 group and 142 solo) that supply the 780 physicians on the hospital’s medical staff. The hospital employs no clinical physicians.

The crux of his job, Larson says, is bringing residents and fellows who have trained in the Chicago area into contact with the outside practices that need physicians, usually because of growth or retirement. Once interview candidates are found, he advises both sides on what questions to ask and what not to ask, and aids in negotiating and finalizing the contract. At present, he’s assisting 30 practices in 19 specialties. And, like Lachman, he helps hire nurse practitioners and physician’s assistants.

In-House and Outside Roles Differ Widely

Kashnig, with 15 years experience as a physician recruiter including two stints as an outside recruiter, says in house recruiters have a big advantage over outside ones in having a much better idea what the group really wants in a given hire, and knowing about the internal politics of the group.

At search firms, he says, “I never quite knew exactly what happened” if a candidate he forwarded was not hired. The key to the outsider’s job in trying to get a referred candidate hired was often “fighting interference,” he recalls. “But if you’re there, you know what’s going on.”

The “chemistry” between the candidate and the physicians in the clinic or department with whom the candidate would work boils down to two main factors: personality and trust. As for personality, it is not essential that the candidate and existing physicians like each other, but it is helpful. They must at least feel comfort able together, because they will work closely.

Trust concerns mainly the style of practicing medicine. For instance, in prescribing drugs, some physicians are aggressive while others are passive. Physicians can usually “sit down [and talk about their styles] and figure it out in half an hour,” Kashnig says. Studies have shown that the leading retention factor for physicians early in their careers is whether they get along with their colleagues, he adds (PCR 7/26/00, p. 7).

Like practice managers who handle recruiting (PCR 6/01, p. 6), Kashnig says that money is not usually the key factor in an offer to most new residency and fellow ship graduates. The other key factors are location; the practice’s quality, reputation and culture; the program to bring in inquiries through ads, a Web site, word of mouth, networking and other means; and the courtesy and professionalism in handling the inquiries.

Contact Kashnig at (217) 366 5374; Larson at (847) 981 6502; and Lachman at (800) 472 4695 or sandy.j.lachman@healthpartners.com.

RELATED ARTICLE: In-House Recruiters: Earnings, Clearinghouses and Trade Groups

In house physician recruiters in hospitals and large medical groups have a variety of outlets where physicians looking for jobs can find openings, and several associations to exchange information.

Nelson Tilden of Bemus Point, N.Y., a consultant with Kansas based Medical Search Institute, took a survey of in house recruiters this past summer to track compensation, working conditions, and recruitment market trends. About 95 recruiters, mainly from the Midwest, answered his survey. Many experienced recruiters answered; 45% of his respondents have been physician recruiters for five or more years.

He found recruiter incomes ranging from $28,000 per year to $77,000, with an average of $48,270. A number of the lower figures are for part time recruiters, such as administrative secretaries who handle the coordination of physician job searches, he said. As a result, the full time recruiters are probably averaging at least $50,000. The average was about $56,000 for recruiters in multi hospital systems.

Tilden found 25% earning less than $40,000,28% earning $40,000 $49,999, 25%, $50,000 $59,999, $14%, $60,000 $69,999, and 8%, $70,000 or more.

Tilden’s figures are roughly comparable with earnings data for outside recruiters, compiled by the Florida based trade group, National Association of Physician Recruiters, from an early 2000 survey of NAPR members. The group’s data is for 1999; it is scheduled to publish 2001 data next spring.

NAPR reported median income of $50,000 $60,000 for recruiters with two to five years of experience at “retained” and “contingency” firms. Pay ranged from as low as $20,000 to as high as $200,000.

According to Tilden, in house recruiters are paid mainly by straight salary, or by salary with small bonuses for placements above a certain threshold, or discretionary bonuses. Most outside recruiters are paid mainly by salary plus commission or commission only, NAPR says. The commission is often 30% to 40% of the fee the firm earns for a placement.

The in house recruiters have several associations. The Association of Staff Physician Recruiters (www.aspr.org), based in the Twin Cities, is national. Michigan Recruitment Retention Network and Illinois Staff Physician Recruiters are two of about 10 state organizations, Tilden says.

ASPR lists physician jobs by specialty and state on its Web site. There are also sites for jobs in particular states, such as www. mimom.org (Michigan) and www.poponline.org (Pennsylvania). Jeffrey Towns, vice president of Michigan Health Council in Okemos, Mich., says his organization operates those two sites, and others for Ohio and Indiana (the latter to go live in February 2002) in conjunction with the medical and/or hospital associations of each state.

Contact Tilden at (716) 386 7770 or nelsontilden@aol.com; Towns at (800) 479 1666 or www.mimom.org; and NAPR at (800) 726-5613 or www.napr.org.

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