Much has been made of the fact that the practice of Hospital Medicine has become the fastest growing specialty in the history of American medicine. Most experts agree that there are approximately 30,000 physicians practicing as hospitalists as of 2010. The Society of Hospital Medicine reports a membership of approximately 10,000. Yet even with the rapid increase in hospitalist supply, the demand remains even greater. Many believe the demand will reach 40,000 hospitalists in the next several years.

As a result, recruiting competition for hospitalists is fierce. Therefore, it is imperative that hospitalist practices maintain a high performance recruiting function as a core competency. Recruiting physicians requires a good understanding of human nature, a proven process and the discipline to apply that process to a large number of candidates. It is hardly an exact science, yet there are several important principles that must be applied. This chapter will attempt to provide employers with a basic understanding of these principles as well as some tips and suggestions to enhance their recruiting performance.

Many employers make the mistake of believing they are actively recruiting if they run a recruiting advertisement in medical journals or perhaps even if they have engaged a recruitment agency. In most cases, these are merely passive recruiting efforts. Actively trying to locate candidates through existing relationships and Internet recruiting will yield much better results. In the current competitive recruiting environment, it is critical that the employer have an aggressive candidate sourcing strategy.

Every good candidate sourcing strategy begins with the establishment of candidate parameters, including training requirements (MD, DO, internal medicine, family practice, etc). It is important for the employer to have a good understanding of their customer, the referring physicians, when establishing the candidate parameters. For example, the decision to hire family practice physicians as hospitalists should only be made with the approval of the referring medical staff.

The candidate sourcing plan should be thorough yet budget friendly. The following are all potential sources of candidates that should be considered by the employer.

Existing Medical Staff

Often, the best hospitalist that a hospital could hope to hire might already be on staff. Confidentially asking formal and informal medical staff leadership about who might be a good candidate could yield great low-cost results. Medical staff leadership will probably know which physicians are the best clinicians as well as who might be thinking about exploring a change in their practice situation.

Medical Staff Referrals

Hospitals must be intentional about asking existing medical staff members for referrals. Most physicians are so busy they will not take time to really think about colleagues who would be good hospitalists without frequent prompting. Of particular value are recent additions to the medical staff. Newly trained physicians will be aware of physicians coming behind them in the next graduating class and recently relocated experienced physicians will be aware of former colleagues that might be good candidates. Employers should approach these new members of the medical staff and intentionally “jog” their memory to uncover these referrals. Some employers offer a financial incentive for candidates hired as a result of a medical staff referral.

Other Local/Regional Hospitals

Recruiting physicians from other local hospitals can be very effective since these physicians have already made the decision to live in the area. If the hospital is a “friendly” competitor or a patient referral source, some political and/or business caution should be exercised. It is also advisable for the employer to be attentive to signs that the local competitors might also be recruiting their physicians.

Journal Advertising

This popular sourcing tool can produce candidates when used properly. Journal ads should be eye-catching and brief. No ad can provide enough information for a candidate to decide they want the job, but it can provide enough information for them to decide they do not want the job. The goal of any ad is to prompt the candidate to take action—either place a phone call or visit a Website to learn more. Some of the more popular journals for sourcing hospitalists include The Hospitalist (a publication of the Society of Hospital Medicine), Annals of Internal Medicine, and The Journal of the American Medical Association. The employer should also look for ways to leverage their journal ad investment. Many medical journals also offer online job boards. Often, job postings on these boards are discounted or free for employers who run print ads. In some cases, these boards are only accessible to employers who run print ads. Employers should evaluate the relative value of print ad vs Internet job postings and minimize their print investment (small black and white ad vs full page color) if they believe the online posting is more valuable.

Online Hospitalist Job Boards

Internet recruiting has dramatically changed the business of physician recruiting as many candidates now do most of their investigations online. These sites charge employers to post their ads. Some provide employers with CVs; others provide a more detailed candidate profile of those candidates visiting their site. The Society of Hospital Medicine has developed an excellent candidate sourcing tool with their Career Center at www.hospitalmedicine.org/careercenter. Other popular sites include www.hospitalistjobs.com and www.practicelink.com.

Direct Mail

Direct mail has long been used to source physician candidates with varying degrees of effectiveness. Employers choosing to use direct mail should purchase a very targeted mailing list and design a mailer to prompt the candidate to action. Since direct mail campaigns usually generate a very low return, an inexpensive and colorful postcard is usually the most cost-effective direct mail tool.

Career Fairs

Career fairs can be excellent sources of candidates for hospitals within a reasonable distance of the event. These sponsored events are designed to assist second and third year residents to get exposure to various employers. These fairs allow employers to begin the recruiting relationship with any given candidate “face to face.” To enhance the return on the investment in such a fair, employers can contact (via e-mail, phone, or postal mail) residents in the area and arrange to meet them at the fair.

Residency Program Relationships

Employers should establish relationships with all the residency programs in their region. Getting to know the program directors of all the programs within 200 miles can yield outstanding low-cost results. Offering to provide a noon lecture or some other resource to the program director can be an excellent way to begin to develop the relationship. Such events also provide excellent exposure to the residents. This exposure is valuable for future recruiting—even exposure to first and second year residents.

Recruitment Firms

Recruitment firms are only as good as the individual recruiter assigned to complete the assignment. Many employers choose to use recruitment firms to extend their reach on difficult-to-fill searches such as hospitalist positions. Contingency-based companies only charge a fee if they are successful. This is a risk-free approach but this financial relationship creates a candidate-focused recruiting effort. A contingency recruiter will locate a good marketable candidate and then “shop” him to a variety of potential employers. With no real obligation to the employer, recruiters are most likely to shop their candidates to their most attractive client locations, increasing their chances for a placement. Retained recruiting firms typically charge a monthly fee in return for monthly effort to fill the assignment. Retained firms rarely offer a guarantee of success, so the employer is taking the risk of making a significant investment without successfully hiring a candidate. Both types of firms can produce results, so it is important for employers to be very comfortable with the recruiter assigned to their search before they engage any recruiting firm.

In summary, a candidate sourcing plan is similar to an investment portfolio—diversity is good. Placing all the eggs in one basket is a high-risk approach to sourcing good candidates.