Wednesday May 01, 2013

A New Approach to Recruitment and Retention

We invest years of time and energy into our more than 460 family medicine residencies -- selecting, training and preparing our bright new family doctors. But how well do we help our recent graduates find their ideal practice? And once they select a community in which to practice, who does the follow up to ensure that the "marriage" is a success?

What if there was a program for newly minted family doctors looking to find their ideal practice? What if the concept of the National Resident Matching Program (i.e., the Match) was applied to help rural and underserved communities showcase their unique opportunities and compete on equal footing with large health system recruiters?

Let's call it FamilyDocMatch.com.  

Perhaps there would be an application that included a personality survey and a desired practice profile, and for recruiting sites a detailed community profile emphasizing their uniquely attractive characteristics specific to workload, patient panel, call demands, scope of practice and community setting. 

During a recent visit to the Arizona AFP, I was intrigued by a discussion among new physicians, who voiced difficulty in finding their ideal practice setting. This was a concern especially for those who already were in their first job but looking for a permanent home. They were frustrated by the lack of answers to their questions about jobs, such as, "What is the call load really like?" or "Can I do a reasonable volume of obstetrics?" 

In their minds, there is no useful databank from which to compare and contrast jobs. 

Family doctors are the backbone of our medically underserved workforce, providing vital clinical leadership in our rural and safety net clinics. Family physicians have been the most sought-after physicians by recruiters for three years running. With worsening primary care shortages predicted due to expanded Medicaid eligibility and anticipated physician retirements, competition for family doc graduates is likely to heat up. Imagine, family doctors as a rare commodity! 

Communities that are not part of a larger hospital or health system network struggle to attract young graduates, as do small independent practices. Sometimes, opportunities are missed by virtue of poor visibility. Larger health care systems use central recruiting systems with recruiters who likely are unfamiliar with community specifics and cannot speak to the characteristics of a particular practice. Call responsibilities, patient mix, performance expectations, and practice leadership and philosophy are important aspects to consider in making a successful physician match, but such details are not common on a standard application and often are not available. 

Could a website like FamilyDocMatch.com help?

Consider the legal implications that surround negotiating an employment contract. Physician contracts are complex documents written in legalese with noncompete clauses and confusing eligibility for financial incentives programs. With more family physicians becoming employees, how can we educate ourselves on how to best negotiate appropriate pay for the level of work required? Unsuspecting recruits often are ill-prepared to address these issues, especially after they have left the safety net of residency. What if there was a job discussion site (i.e. a secure chat room) that allowed questions and answers to be posted about contracts? 

We already have sites such as Monster.com, Physician-Jobs.net, MDJobSite.com and PhysicianDepot.com to aid our searches, but job searchers have to sign up and trust that their personal information does not trigger inquiries from headhunters looking to fill a slot and get their commission.

Residencies often hold "Pick a Practice" opportunities for their graduates, and AAFP chapters, the AAFP and the AMA maintain job boards and career postings for those seeking new opportunities at all ages and stages of their careers. But where can you post a description of your ideal practice and share access to communities that might have the ideal placement for you?

FamilyDocMatch.com could be the answer. Just think, a personalized, confidential and reliable service for finding your ideal job that is not based on commercial exploitation and is not run by high-dollar headhunters. It would be a confidential match service dedicated to finding the best possible placement for the applicant. Maybe, just maybe, we can bridge the gap between rural and urban job placement and provide support and encouragement to retain our well-trained recruits in the job of their dreams.

Would a website like this would be helpful? Please share your comments below.

Barbara Doty, M.D., is a member of the AAFP Board of Directors.

Comments:

Having recently left a practice owned by a large hospital system I can vouch that that there is a large asymmetry of power between a large system and individual Family doctors who are usually very dedicated but meek when it comes to negotiation.There is a tremendous shortage of Family Physicians so capitalism should work in our favor.The AAFP needs to provide more than just information and matchmaking...they need to somehow provide negotiating muscle and backbone.

Posted by Louis Spikol on May 02, 2013 at 07:01 AM CDT #

Great concept, but there is no shortage of jobs, nor ability to find them, nor websites and headhunters. You'd have to provide information not available to the average graduate on the normal websites. Providing details on the websites that are not normally named - like terms or even presence of a restrictive covenant, compensation structure beyond the attractive first year, and so forth. I agree with Dr. Spikol. We family docs are too "nice" and we need to see the dirty laundry before we even interview, and allow the physician friendly worksites to advertise themselves as such. Lifestyle, organizational culture, compensation structure beyond the first year, and the dirty details (restrictive covenants, termination without cause clauses, mandatory resignation from medical staff if terminated) all need to be put "out there in front." The very large organizations can attract with high salaries, and then play gotcha, if they want to.

Posted by Gus Geraci on May 08, 2013 at 12:50 PM CDT #

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