1. Don’t expect practices to recruit. Hospitals can no longer depend on practices to recruit new physicians when needed. Mr. Gott says many physicians are too anxious about the future to make plans. “The doctors are hunkered down,” he says. “Rather than take a risk they’d rather keep things the way they are.”
2. Work with practices. Even if practices strongly resist recruiting a new partner, it makes sense to continue to try to work with them. They may be concerned that new recruits might tap into their patient base or reduce the practice’s income. To address this concern, the hospital can offer income guarantees to the practice to add a new physician.
3. Start with quantitative assessment. Basically, a quantitative assessment involves dividing the local population by the number of physicians in each specialty and comparing that ratio to national benchmarks. Simply stated, when supply is below the benchmark, more physicians appear to be needed. However, it’s much more complicated than that, which is why the quantitative assessment needs to be followed up with a more extensive “qualitative” assessment.
4. Look beyond the numbers. Raw numbers in the quantitative assessment can be very deceiving. For example, the numbers may show a sufficient supply of ob-gyns, but it may turn out that many of them don’t perform obstetrics. Likewise, some neurosurgeons may only perform spine surgery and some general surgeons may not do vascular surgery. However, the raw numbers are still good tools when used in tandem with other sources.
5. Survey physicians. The best way to gain a deeper understanding of supply and demand is to contact physicians in the community through e-mail, surveys or individual interviews. “The doctors know who’s accessible and who’s not,” Mr. Gott says. “They know what the patients are saying.” For example, a sub-specialist will know whether patients are having trouble getting an appointment with a primary care physician. However, physicians can throw investigators off by insisting no specialists are needed in their field.
6. Look at outmigration. The hospital may have already lost patients to another community. This can happen when patients have trouble accessing local physicians or simply do not like them. Find out what the issue is and develop a strategy to lure these patients back. This could involve working with existing physicians to improve access or recruiting new ones.
7. Reconsider centers of excellence. In a multi-hospital market, the assessment will show the strengths of each hospital. For example, your hospital may have fewer heart surgeons than the competing hospital because that hospital has a heart center of excellence. It may be time for the CEO and board to decide whether they want to compete or cede that area to the other hospital.
8. Be flexible. Some kinds of physicians are difficult to recruit, such as a general internist. In these cases it helps to be flexible. For instance, instead of waiting for a new general internist, consider recruiting a family physician or midlevel provider.
9. Be prepared. Since recruiters need to act fast when a physician is available, the hospital needs to be prepared for a variety of eventualities, such as having a compensation plan in place for employed physicians or a subsidy for independent physicians.
10. Look before you leap. When existing groups don’t want to recruit new physicians, it might be time for the hospital to directly hire a physician in that specialty. But such a decision has to be made carefully, because it can cause a lot of bad feelings. Go down this path with eyes open wide.
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