Small Hospital Challenges Monthly: Retention is as crucial as recruitment

Dear medical staff leader and professional,

People in the United States are living longer, more active lives and thus in need of more healthcare than generations past. In addition, many intelligent students are choosing professions other than medicine. These factors, combined with several others, including an aging physician population, has lead the Association of American of Medical Colleges to predict that demand for physicians will outweigh supply by 2020. This prediction is bad news for small, rural hospitals, which are already competing for the few physicians who want to practice in the remote corners of the country. But there are some steps small hospitals can take to mitigate recruitment problems before they worsen.

First, familiarity leads to comfort—offer ambulatory experiences to medical students and residents more than a year before their anticipated graduation. Many students and residents, like a lot of people, tend to stay in areas in which they feel comfortable. Many have not had the small-hospital experience and so choose not to practice in one after graduation. But once some of them are able to experience the practice life of a small hospital (and for many, a better family environment) they may choose not to return to the bright lights of the big city. Align yourself with state-wide medical schools and residency programs to offer these opportunities to students and residents.

Second, recruit locally. Many local students want to stay local, so see if the community can offer educational scholarships for those entering healthcare professions. Some communities will offer tuition assistance for medical school in return for time practicing in the community (with penalties if the student chooses not to practice there after graduation). These individuals know the pros and cons of a community before ever starting practice there.

Third, be aware of the multiple incentives that can be used in recruitment, especially in areas suffering from an acute physician shortage. These can involve above market-value compensation, student loan forgiveness, preferred lending rates at local banks, recruitment for spouses, etc.

And lastly, when you recruit a physician, be in tune to the needs of his or her family. Is there anything the hospital can do to find employment for his or her spouse? Can you involve a local real estate agent to ensure the family finds appropriate housing? And don’t forget the educational and recreational needs of the family. Many hospitals find out too late that they did a great job recruiting the physician but a poor job recruiting the family.

Best regards,
Mary Hoppa, MD, MBA, CMSL
The Greeley Company