How a Unique PTO Program Draws a Mission-Driven Workforce

For mission-driven hospitals struggling with employee and physician recruitment, offering generous paid time off may be a solution.

Recruiting quality employees and physicians can be a challenge for many hospitals and health systems, especially those located outside of major metropolitan areas. Physicians prefer to practice in urban areas: only about 7.2 percent of practicing physicians and 1.8 percent of residents prefer to live in a rural area, according to The Medicus Firm's 2013 physician survey. Benjamin Anderson has experienced the struggle firsthand as administrator and CEO of Kearny County Hospital in Lakin, Kan., about 230 miles west of Wichita.

Prior to joining Kearny County Hospital, Mr. Anderson served as CEO of Ashland (Kan.) Health Center, another rural hospital. "We had no doctors," he says. Instead, there was one physician assistant who worked 24-hours, five days a week, and the health center used locum tenens coverage on the weekends.

As Mr. Anderson saw the PA show more signs of burnout, he grew more serious about physician recruitment. He visited the Via Christi Family Medicine Residency in Wichita, Kan. "I asked faculty, 'What do I have to do to get your graduates out [to Ashland]?'"

Todd Stephens, MD, a faculty member at the residency program, had the answer: Give them eight weeks of paid-time off for mission work. He also recommended Mr. Anderson participate in a mission trip to see if he would be serious about implementing the recruitment model. Soon, Mr. Anderson was on a plane to Zimbabwe for a mission trip. "I didn't know what I was getting myself into," he says. "But it changed my life and I've been back every year since."

When he returned from his first mission trip, Mr. Anderson implemented the eight-week PTO model at Ashland Health Center, effectively recruiting two physicians and key staff. Now he has brought that recruitment model to Kearny County Hospital, which he joined in June. Kearny County Hospital is now in the process of building a PTO policy that allows all of its existing 220 staff members and any newly recruited employees and physicians between four and eight weeks of paid time off each year, primarily based on time of service. Employees can do what they like with the PTO — many choose to use it for mission trips overseas. Though everyone has between four and eight weeks of PTO, they usually use it for one or two weeks at a time, so no one employee is gone for eight weeks at a time, Mr. Anderson explains.

"During medical school and residency, I had an interest in mission-focused medicine in the U.S. and overseas in underdeveloped areas," says John Birky, MD. "I was looking for [a hospital] that would allow time off to do mission-focused medicine." Kearny County Hospital's unique PTO program is what ultimately attracted him to practice there, he says.

How it works

"It's about intentionally attracting people who are drawn to serving vulnerable people," Mr. Anderson explains. "The people [who] are willing to serve in underserved countries can serve in underserved counties. They're not after Nordstrom, Starbucks and large airports — they're after the opportunity to serve." In other words, the PTO program helps attract employees and physicians who want to serve in rural or underserved areas of the country, like Kearny County, Kan.

During the recruitment process, Mr. Anderson visits with employee and physician candidates to discover what drives them personally. Then, during the candidate's visit to the hospital, the traditional recruitment model is somewhat reversed compared to what other hospitals do when trying to woo a physician.

"We focus on the community areas of greatest need, houses that are falling down…areas of the community that need work," Mr. Anderson explains, instead of showing off the best parts of the community like hospitals usually do. "We focus on the disparities, and that's what drives people here."

As for the cost of giving such generous PTO, Mr. Anderson says the program is actually saving the hospital money. "We did a simple cost/benefit analysis. With what we were paying in locum tenens coverage and total coverage, and what we need to pay physicians with that time off, we would see savings immediately," he says. He also notes since hiring two mission-hearted physicians, patient volumes have increased significantly at the hospital.   

Mr. Anderson says there are two main steps to making this recruitment tactic work at any hospital or health system.

Mission alignment. The organization must first understand its own mission, vision, core values and organizational goals in order to communicate those to a candidate who is mission-driven, Mr. Anderson says. That way, potential employees or physicians can decide if their personal mission matches that of the facility.

Kearny County Hospital's mission is to "provide quality, compassionate healthcare services for our community to enrich the lives of our family, friends and neighbors." Mr. Anderson says the mission statement is posted in visible place in the facility, and he really feels as though it's upheld throughout the hospital's culture.

Administrative support. To get the mission-driven, high-quality employees and physicians to commit to the hospital under this PTO model, the administration needs to believe in that mission. If the hospital does succeed in recruiting mission-oriented employees and physicians but leadership is not genuinely behind the cause, the new employees likely will not be there for long.

"You need to be committed to this kind of work," Mr. Anderson stresses. "The CEO and the board need to be just as committed to serving vulnerable people as the physicians, and if they're not, the physicians will sense it."

Overall, for hospitals that are committed to a mission of serving underserved communities, implementing a similar program should help attract the right, mission-driven workforce to the facility.

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