Demand for Psychiatric Specialties Continues to Grow

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A December 2018 report from the University of Michigan concluded that the passage of the Affordable Care Act fueled the ever-increasing demand for Psychiatrists.  Upon its passage, the ACA expanded access to behavioral healthcare to more individuals, and current projections are that the shortage of psychiatric professionals is expected to worsen by 2025. To illustrate this shortage from a national perspective, the National Council for Behavioral Health noted that 77% of U.S. counties are considered to be underserved. The largest increase in demand might be around the corner still.  In an article from the JAMA network about the impact COVID-19 has on the mental health of healthcare workers, Dr. Perlis writes, “Across the world, physicians, nurses, and other frontline health care workers do heroic and lifesaving work in stressful settings on a daily basis.  However, the toll that providing such care takes must also be recognized: sooner or later, every clinician is also a patient.”

Given the demand for psychiatric specialties, healthcare administrators are finding it increasingly difficult to fill vacancies. Currently, the average time to fill for a psychiatry vacancy is almost eight and a half months forcing healthcare administrators to be more creative and proactive in their recruitment efforts.  The average monthly gross revenue generated by a physician is more than $81,000 making an extended vacancy quite costly. You can see the impact reducing time-to-fill on your practice’s revenue by using our Physician Recruitment ROI Calculator.  Below is a snapshot of how healthcare administrators can effectively recruit psychiatry professionals.

Be Proactive

Administrators have to plan ahead for vacancies.  To avoid being caught off guard, it is critical to maintain good relationships and open communication with your psychiatry staff.  This is the easiest way to stay informed about potential retirements or impending vacancies.  Maintaining strong relationships with your physician staff also helps when it comes time to recruit. Having physicians that are willing to reach out to their personal network of colleagues is always helpful to your recruitment efforts.

Cast a Wide Net

Given the increased demand we have already referred to, hospitals and health systems have a lot of competition for psychiatry specialists. Being creative in sourcing candidates is crucial to attracting a Psychiatrist to fill your vacancy.  In many cases, your search has to be nationwide in order to increase your candidate pool.  Another way to expand the candidate pool is to establish relationships with university residency programs and ask your current staff for recommendations from their professional network.  Lastly, an often overlooked way to keep your brand top of mind is to take as many opportunities as possible to present at physician and other healthcare-related conventions.

Guaranteed Salaries and Incentives

In addition to inequities in Medicare reimbursements for psychiatric services, cancellations and missed appointments are much higher for psychiatry appointments than other specialties.  Complicated salary structures for psychiatry professionals can be a deterrent when trying to fill a vacancy. As they have with other hard to fill specialties, healthcare administrators are turning to better compensation packages as a way to attract and hire candidates. These packages include signing bonuses, loan forgiveness, generous relocation reimbursements, and other incentives.

Work-life Balance

Psychiatrists are no different than other physicians when it comes to their desire to achieve a better work-life balance.  As part of any employment offer, administrators are becoming more creative in designing schedules and offering increased vacation and personal time to attract candidates. Another way that administrators can help their psychiatrists reduce the amount of time they are spending in the office is by expanding their commitment to virtual office hours. Expanding virtual services allows the physician to “see” patients at times that are better suited to their home life.

Find a Search Partner

No matter how effective a healthcare system’s in-house recruitment team is, for hard-to-fill vacancies, finding a trusted recruitment partner can help reduce fill times.  For example, having a partner such as Jackson Physician Search will give you access to a larger candidate pool and deploy digital recruitment tools to find the qualified candidates you need.  Also, having a trusted search partner allows your in-house team to focus on other staffing needs, coordinating site visits, onboarding, and other critical components of a successful hire.

There is no single approach that can solve hard-to-fill physician vacancies.  Instead, a full-spectrum approach where you are employing many different strategies, including finding outside help, is the most effective means to successfully recruit psychiatric professionals.

Jackson Physician Search has decades of physician recruitment experience. Contact us today to find out how we can help you meet your physician recruitment challenges.

 

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Three Things to Know Before Deciding if a Medical Practice is the Right Career Path for You

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Choosing the type of organization in which you want to practice is a big decision for all physicians. Despite the financial hit many medical practices incurred during COVID-19, you might have dreams of starting your own practice. Or, you might see yourself working in a hospital where the business burden of healthcare is on someone else’s shoulders, not yours.

Medical practices often offer unique benefits that those two options cannot. For example, partnership tracks offer enhanced income, profit sharing and other perks for physicians in established medical practices. And unlike starting out on your own where you’ll need time to build your patient load, working with an established practice means you’ll be up and running quickly with your own patient panel.

Still, medical practice work isn’t for everyone. Here are some tips on evaluating whether it is the right choice for you.

 

  1. Research the compensation median and bonus structures available for the specialty and region.

We offer an online physician salary calculator to help you easily access physician compensation data customized by specialty, state and type of location. Other resources are helpful, too. The Medical Group Management Association (MGMA) sells a DataDrive Provider Compensation report with valuable information on the compensation differences among physician-owned, hospital-owned and academic practices for a variety of regions, practice sizes and provider experience levels.

For example, the 2019 report shows that median compensation for established providers increased 3.4% for primary care physicians from 2017-2018. Specialty physicians had a 4.4% increase.

The report also shows how median total compensation for primary care physicians varied greatly by state from 2017-2018. The District of Columbia was the lowest paying, with $205,776 in median total compensation. Nevada was the highest paying state with $309,431. States that saw much larger increases in median total compensation compared to the national rate were Wyoming, Maryland, Louisiana, Missouri and Mississippi. Two states—Alabama and New York—saw decreases in median total compensation for primary care physicians.

 

  1. Understand the different employment models available (employed, partnership track)

There are five basic employment models used by physician practices.

Straight Salary
The physician has a sense of security and a guaranteed level of income. The con aspect is that a straight salary model does not encourage innovation or cost reduction efforts.

Salary Plus Bonus
As a means of encouraging physicians to increase practice income, reduce costs or achieve other predefined performance metrics, a salary plus bonus payment model provides physicians with a guaranteed salary while also having an opportunity to earn a bonus.

Equal Shares
Divides revenue equally among the group of physicians after expenses are covered.  One of the pros of an equal shares model is that there is a natural aversion to the overutilization of resources. A downside of this payment model is that there is no incentive for creating efficiencies or higher productivity.

Pay-for-Performance
More physicians are finding that systems are implementing variations of a pay-for-performance model as a way to tie financial incentives to the achievement of predetermined performance goals.  Physicians are being encouraged to innovate.

Productivity-based
In this model, physicians receive a percentage of their billings, or are paid according to a scale that is based on procedures being performed or the type of patient visit. An advantage of productivity-based models is that physicians are rewarded for extra effort, and they are also encouraged to be mindful of excessive overhead costs.

According to MGMA, a 50% or more salary-based compensation plan with added incentive payments is the most common plan, with productivity-based compensation a close second. Which plan is right for you? With a myriad of factors and choices, we can help you ask the right questions to negotiate a package that is fair and aligned with your goals.

There are three basics:
Ask about the structure, how the model works, specifically what production, quality and patient satisfaction metrics you must achieve to earn an incentive bonus.

Ask about incentives, such as a stipend while still in training and student loan repayment options.

Ask about transparency, including a review of the practice financials, how much current physicians are making and how long it took them to ramp up to that level.

You can find additional advice from our experts on the most important questions to ask here.

 

  1. Partner or employee?

The idea of becoming a partner in a medical practice was once the dream of many young doctors. The advantages are many: an equal vote on practice issues, due process protections, a culture of partnership. But there are risks involved when medical practices offer partnership tracks, including the burden of extra administrative duties and a buy-in process that can lower initial salary payments.

If you’re interviewing with a medical practice that offers a partnership track, be sure to discuss the length of the buy-in period and how the process works. Before accepting any offer, consult your own legal and financial advisers to be sure your bases are covered.

 

Make sure it’s a cultural fit

There are some simple questions you can ask yourself to see if the culture of the practice will be conducive to your happiness and success.

  • Do you feel there is a shared mission that is clearly defined and followed at every level of the organization?
  • Are behaviors and corporate decisions aligned with your own personal values?
  • Is communication transparent from top to bottom?
  • Does the organization value things like work/life balance and demonstrate a commitment to the well-being of the employees?

Notice how none of these questions involves compensation. Sure, you want to do your due diligence in finding a practice with a compensation plan that suits your needs, but you also want to be sure it feels good, too. Getting answers to these questions during the initial interview can make the difference between a successful experience and burnout.

Contact us if you’d like additional insight into working with a medical practice.

 

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Going Beyond Compensation: 3 Tips to Win Top Physician Candidates

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The volume of physicians who are looking for their next opportunity is surging right now. And with many states moving well into the re-opening phase, these physicians are accepting new roles. To win them over, it’s important to offer a competitive and well-rounded compensation and benefits package. But money alone isn’t likely to provide you with a steady stream of high-quality candidates who fit the culture and will succeed in the role.

To recruit and retain your ideal candidates in today’s crowded recruitment environment, it’s time to get creative. Here are three tips for success.

Know your ideal candidate’s needs and tailor the compensation/benefits package to that physician.

If you’re looking at early careerists, offer a student loan repayment or signing bonus. If you’re looking for a mid- or late-stage careerist, offer a retention bonus as a reward for staying put over a certain period of service, or a broader insurance package that might include long-term care insurance.

Offer a flexible work schedule, especially if you know the candidate has child rearing or parental responsibilities. Knowing your candidate also means knowing if he or she has reservations about the business obligations of working in a practice versus a hospital.

Be prepared to proudly show your investment in software and support staff to ease the burden of practice management. Consider the benefits of recruiting a “clinical scribe” from within the local community to enter EMR data, giving physicians more time to focus on their patients. Show your dedication to the value-based practice model and your commitment to preventing burnout on staff.

You might also impress candidates by being on the cutting-edge of the revival of the physicians’ lounge as a place for doctors to come together, gain a respite from the action of work and share ideas. Out of fashion for a time, the physicians’ lounge is making a comeback as a powerful deterrent against burnout, as described in a 2019 Canadian Medical Association Journal (CMAJ) article.

 

Solidify your recruitment process and marketing plan to attract your ideal candidate.

The new generation of physicians are savvy – and that goes beyond their preference for communicating via text, email, and social media. Many of them tell us that most mass-produced marketing materials go in the trash without a second look.

They know a canned sales pitch when they see or hear one, and they resent the intrusion on their personal and professional lives. What they appreciate most is personalized communication tailored specifically to them—illustrating an intricate understanding of their skills and background.

That doesn’t mean you should throw out social media and other digital forms of recruitment. Quite the opposite, in fact – physicians prefer to receive job opportunities via email. Also, check out a candidate’s Facebook and LinkedIn pages to get to know him or her early in the recruiting process. Some recruits even have their own blogs that provide keen insight into their interests, work ethic, and career goals. If you’ve developed a successful candidate persona—and you should have one—it’s a good way to see which candidates will be the best fit.

In addition, your recruiting firm can help you narrow your choices to those candidates who are native to your state, who grew up or went to school there, so you can emphasize that connection when you communicate with them.

As an executive partner with the Medical Group Management Association (MGMA), we share best practices with the organization on the unique challenges of recruiting specifically to medical practices. Writes David N. Gans of MGMA’s industry affairs team, ideal candidates might be fully capable of starting their own private practice. Why would they want to sign up with an existing one? One reason is the ability to see nearly a full patient load from the start without taking the time to build their own patient panel. “That is a boon that sometimes you may not think about,” Gans says.

It’s a message well worth remembering in your communications with the candidates you want.

Ensure your interview process and candidate site visit is candidate- and family-focused.

Include key stakeholders, a tour of the community when travel is more practical again and be prepared to offer a sample contract if the candidate is your ideal fit. Remember that physicians and advanced practice providers are people, not numbers. They have families, friends, hobbies and interests that are important to them. Their individual needs, motivations, values and work styles significantly influence how and where they will choose to practice medicine. The more you can learn and adapt to these factors, the greater the opportunity to hire physicians who will fit, succeed and stay.

Invite key stakeholders to coffee or dinner to share their perspective on living and working in your area—what the schools are like, what elder care options are available if the candidate has aging parents, favorite recreational, social and cultural activities. Especially if your practice is in a rural community, it’s much easier for a candidate to imagine a transition to country life if he or she hears firsthand the stories of those who have already made it.

Contact us if you’d like additional insight into your own recruitment strategy as well as recommendations on ways to meet demand and attract the right physicians to your healthcare organization.

 

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Teamwork Makes the Placement Work

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Not much about life in the United States at the present moment resembles our usual definition of normal, but still life goes on and so does physician recruitment.  A hospital in Western Kentucky needed to hire a Cardiologist and reached out to Jackson Physician Search for help with the search in early February.  Fortunately, at that time, the devastating impact of Covid-19 was not yet taken hold, and JPS Senior Search Consultant Ross Hegenwald jumped on the opportunity with his usual energy.  He immediately traveled to meet with the hospital system executives and interviewed several of the other physicians on staff to formulate an idea of what personality traits would be a good cultural fit for them.

Shortly after the site visit, the pandemic had become serious within the United States.  Ross and his recruitment counterpart with the hospital system knew they needed a completely different game plan for this critical placement.  With the hospital campus shut down for on-site interviews or site visits, they collaborated on a video and virtual approach to recruiting candidates.

First, the hospital created a video to display the their campus, both inside and out, to ensure that potential candidates had an opportunity to see the facility and surrounding areas.

Then, Ross began screening candidates and quickly connected with Dr. A., a Cardiologist that was practicing in Wisconsin. Dr. A. explained to Ross that he had previously practiced in Kentucky, in a town about two hours away from the current opportunity.  He went on to say that he and his family were interested in moving on from the colder winters in Wisconsin.  Ross sent him the newly created video of the facility, and quickly arranged for Dr. A to participate in virtual interviews.

Before Covid-19, a well-planned site visit would have been organized with Dr. A. and his family to allow them to have an opportunity to visit the campus and meet with administrators and other physicians and staff.  Instead, to keep the recruitment process moving quickly, many of the staff members participated in video conference calls, where it was established that Dr. A would be a good fit culturally and professionally.

However, the challenge remained that Dr. A. wasn’t going to have an opportunity to experience a typical site visit.  To put his and his family’s minds at ease, they decided to hop in the car and make the eight-hour drive from their Wisconsin home to visit the community.

Upon arrival, everyone “masked up” and met with a real estate professional that worked with the hospital system. She showed Dr. A. and his family around town – driving through several local neighborhoods which allowed them to get a good sense of the area.  While certainly not a typical site visit, Dr. A. was sufficiently impressed, and after spending a couple of days, he decided to negotiate an employment offer.

One of the most amazing aspects of this particular placement is that the typical time needed to fill a cardiologist vacancy can be anywhere from six to eight months.  In this case, even in the middle of a pandemic, and with so many challenges to overcome, Dr. A. accepted the offer within 30 days.

It is no coincidence that this vacancy was filled so quickly and under such challenging circumstances.  This placement culminated because of the excellent teamwork between Ross and his hospital system recruitment counterpart.  Fortunately, Ross didn’t delay his visit to the hospital to see the facility and meet with the staff at the beginning of the search. This allowed him to have first-hand knowledge of the hospital, its people, and the community, which in turn allowed him to share that with the candidate. The creative use of video to showcase the campus and community and several of the hospital’s physicians on staff getting involved in the virtual interview process also played a huge role in this successful placement.

Every recruitment experience is inherently unique, but this one in particular inspires all of us. The hospital administrators forged ahead during a pandemic knowing the need for a cardiologist was still going to be there whenever life returned to normal. Their willingness to adapt in real-time to create a candidate experience that would attract a top-notch physician is a testament to their culture of excellence. Equally moving, for a physician to take a leap of faith and accept a position after a two-day road trip is more proof that healthcare providers can overcome just about any obstacles and challenges placed in their path.

The Jackson Physician Search team is comprised of healthcare industry professionals who have the skills, experience, and relationships to be your trusted physician search partner. Our recruitment professionals have access to industry-best technology to streamline your recruitment process and find quality candidates under even the most difficult circumstances.  Contact our recruitment team today and learn how we can make a difference for you.

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Advanced Practice Providers Serve a Critical Role in Patient Care and the Primary Care Shortage

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There is no questioning the importance of Advanced Practice Providers (APPs) in modern healthcare. The roles of Nurse practitioners (NPs) and physician assistants (PAs) came into existence in the 1960s as a way to mitigate the impact of the emerging primary care physician shortage. Today, these care providers are even more prevalent in healthcare. In fact, it’s a common occurrence for patients to be offered an appointment with an NP or PA as a way to get into the office sooner.

Considering the expanding role that APPs have in our primary care system, healthcare administrators are beginning to focus on their recruitment and retention in the same manner as physicians. Let’s look at some of the differences between APPs and primary care physicians in terms of education, training, and scope of practice, as well as how to increase access to care by recruiting these professionals as part of your staffing plan.

Education and Training Requirements

Interestingly, there is lack of consistency for the education, training, licensure, certification, and scope of practice for APPs.  Each of these areas varies significantly from one state to the next.  Nurse Practitioners generally achieve education and clinical training at the master’s or doctorate level, along with the completion of at least 1,000 hours of clinical practice in a focused area.  The specialized focus is typically in pediatrics, adult, or geriatric medicine.  Oversight for NPs is provided by the state nursing boards.  To demonstrate how NPs are treated differently between the states, nearly half have laws allowing NPs to practice independently without oversight.  All states allow NPs to have prescription writing authority, even for controlled substances.

Physician Assistants are typically trained alongside medical students, for two years before receiving their master’s degree.  Before graduating, PA students will have completed 2,000 hours of supervised practice.  While state nursing boards regulate NPs, the PAs come under the jurisdiction of the state medical board, and have to practice under a supervising physician.  As with NPs, prescribing authority is afforded to PAs; however, Kentucky is the lone state that doesn’t allow PAs to prescribe controlled substances.

Contrasting this training to a typical family physician illustrates one of the reasons why we have a primary care physician shortage.  A family practice physician completes 15,000 hours of clinical work through five years of additional training and residency.  In that same amount of time and cost, more than 3 NPs could be trained.

Scope of Practice

NPs and PAs have a significant overlap in scope of service when compared to their physician counterparts.  For example, in VA hospitals, nearly half of all inpatient services are performed by APPs.  Administrators within the VA system are relying heavily on NPs and PAs and recognize that there are only minor differences in a patient’s perception of care.  Another area where APPs are being relied upon are in rural and underserved communities.  A study published in 2015 by the National Institutes of Health cited NPs are more likely to deliver care in inner cities and rural settings than primary care physicians.  Additionally, the study concluded that an increase in the numbers of primary care NPs would serve to expand access to primary care for vulnerable populations.

Recruiting APPs

According to the Bureau of Labor Statistics, demand for NPs and PAs will not be slowing down anytime soon.  Both occupations are still listed in the top ten fastest-growing occupations and are expected to grow by up to 30% through 2028.  This demand is a sign that healthcare administrators need to treat the recruitment of APPs the same as they do physicians.  Here are a few ways that administrators can proactively attract APPs to their organizations.

  • Work with local or regional university systems. You often hear of healthcare systems establishing relationships with medical schools to provide opportunities for student doctors.  This same approach should be developed for APPs.  Bringing advanced practice students into your clinical setting provides you with a perfect opportunity to evaluate how their skills and personality translates to your care team.  In the long run, if they are a good fit, you have an excellent opportunity to retain them upon graduation.
  • Work with your state’s professional associations. The American Association of Nurse Practitioners (AANP) and the American Academy of Physician Assistants are two organizations that healthcare administrators should have an established relationship.  Most states have chapters that support graduating and experienced APPs in their job search.
  • Have a social media strategy. While physicians tend to rely more on physician-specific job boards and websites like Doximity, APPs are more prone to utilize traditional social media sites.  Many APPs are very active on professional networking sites, such as LinkedIn.  Understanding this critical difference between how physicians and APPs use social media can help administrators more effectively tailor their recruitment strategy.
  • Be creative with scheduling. Like physicians, APPs value work/life balance and are more attracted to positions that allow flexibility.  Healthcare administrators who are expanding their utilization of APPs, need to be creative in developing part-time positions, building in Telemedicine hours, and finding other ways to offer flexibility and variety into their APP schedules.
  • Work with a recruitment partner. Finding a trusted recruitment partner has been an essential component of physician recruitment for healthcare administrators for years.  As demand for APPs continues to rise, it is becoming increasingly more important for healthcare organizations to expand their reach in finding qualified candidates.  Recruitment firms have access to candidates that administrators may not otherwise reach for their vacancy.  Finding a recruitment partner that has a nationwide candidate pool, plus the technology and means to cast a wider net, can be the answer to your hard-to-fill vacancies.

Jackson Physician Search can be the trusted recruitment partner that your organization needs.  Whether you are looking for physicians or advanced practice providers, our team of experienced healthcare recruiters can help you reach more qualified candidates.  Contact us today.

 

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Looking for Your Next Job? Understanding Physician Compensation, Benefits, and Bonuses

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This article is Part III in a series dedicated to helping physicians plan their next career move. Click here for Part I and find Part II here.

Medical school training is both comprehensive and exhaustive for today’s physicians, and the one area that too little time is spent talking about is compensation.  After all, physicians don’t want to spend almost ten years training for a career and not have a clear understanding of how they are going to be paid.

Part of the challenge in understanding physician compensation models is that they vary across the board. Often times, when weighing one job opportunity against another, it is difficult to make an apple-to-apple comparison regarding the salary structure.

Hopefully, by the time you reach the end of this article, you will have a better understanding of the different types of compensation packages and will feel more confident in negotiating an offer that is fair and aligns with your personal and career priorities.

Types of Compensation Packages

Straight Salary

Without question, the easiest compensation model to understand, in any industry, is the concept of a preset level of income for the hours and work that you perform.  To support the salary level, physicians are typically required to achieve pre-defined, reportable metrics, such as productivity and quality.  With a straight salary model, physicians will have a sense of security due to the guaranteed level of income, but may not be motivated to pursue innovation or cost reduction initiatives.

Salary Plus Bonus

As a mechanism to encourage innovation, reduce costs, or achieve other performance metrics that aren’t tied to a guaranteed salary, administrators often implement a bonus structure on top of the straight salary.  For many healthcare organizations, this is a popular method of physician compensation. An important consideration for physicians negotiating the bonus portion of the offer is to ensure the appropriate metrics are included and are transparently reported regularly.

Pay-for-Performance

One of the more complex and administratively burdensome pay structures is the pay-for-performance model.  Health systems are increasingly moving to tie financial incentives to the achievement of predetermined performance goals.  This model has an obvious benefit to the organization as physicians are being incentivized to achieve performance and quality targets.  Pay-for-performance models also succeed in motivating physicians to find innovations and efficiencies.  When this type of compensation model is contained within an offer, it is important for physicians to understand all of the individual components that are going to be impacting their salary.

Value-based Measures

Ever since the enactment of the Affordable Care Act, the healthcare industry has been evolving toward value-based outcomes.  Similarly, physician compensation models are gravitating toward value-based compensation.  In the past, physician compensation was often driven by patient volume and the number of procedures performed.  Today, many other factors are included, such as costs of care, patient experience, coordination of care, quality, and productivity.  And, while productivity still comprises the largest factor in physician compensation, a mix of value-based factors can contribute up to 20% of total compensation.

RVUs

Another trend that was more pronounced after the passing of the Affordable Care Act was a move toward mergers and consolidations across the healthcare industry. Relative Value Units (RVUs), a concept introduced in the 1990s, have not only played a role in physician compensation, but also in determining the value of medical practice buyouts and mergers.  In its simplest form, an RVU accounts for physician time, technical skill and effort, mental effort and judgment, and stress as components of providing a service.  Some physician compensation models use a base salary, but add to it a bonus factor that is based on the number of RVUs generated.  This is another example of a compensation structure that needs to be carefully studied when considering employment offers.

Stacking

When a compensation model includes stacking, physicians can be sure that it will have a higher level of complexity.  Stacking occurs when a physician is performing multiple roles and being compensated for each individually.  For example, hours spent working as the medical director or other leadership capacities will be paid at a different level then hours worked in their regular capacity.  This type of arrangement can serve as a motivator for doctors who may be considering a leadership position, or possibly a move to a different position altogether.  Stacking models can lead to higher compensation for physicians but is more challenging to track to ensure you are being paid for work performed.

Guaranteed Salary

Just looking at the name, physicians may think that this compensation model is the most straight forward and easiest to understand.  Not necessarily.  In some cases, your contract may state that you are 100% guaranteed to earn a specific salary annually.  In other contracts, your guaranteed salary may be a lower overall number that is guaranteed but includes incentive triggers that allow you to increase your compensation.  Just because the name suggests a guarantee, it is still wise to have your lawyer examine the contract to ensure you understand what is guaranteed.  Whenever incentives are involved, it is important to understand how the RVUs are calculated and how they are tied to your salary.

Common Bonuses

As we have discussed, in most compensation models, your compensation doesn’t consist solely of a base salary.  Most employers combine an agreed-upon salary with variable components that affect total compensation. You need to determine – and be comfortable with – how much of your pay will be based on your individual performance, organizational performance, and other factors like patient satisfaction. It is fair to ask how those variables have affected compensation in recent years – and why.

Bonuses are playing an essential role in physician compensation.  They can be productivity-based, quality-based, or a combination of both.  Factors that impact a healthcare organization’s bonus structure include payer mix, overhead costs, percentage of self-payed patients, RVUs, and more.  Let’s take a closer look at how bonuses can be used in a physician’s compensation package.

Quality Bonuses

As mentioned above, the passage of the Affordable Care Act ushered in a new era in healthcare, where more emphasis was placed on the quality of care.  Healthcare administrators are increasingly looking for ways to incentivize the achievement of quality indicators.  Part of that effort is in the form of quality bonuses for physicians.  Quality bonuses can be tied to many factors, such as patient satisfaction, throughput time, paperwork/medical records completion, etc.  One way a physician can determine the fairness of the quality bonus structure is to ask what percentage of employees are earning the quality bonus. This will give you an indicator of whether the bonus plan is achievable.  You will also want to know how often the bonuses are paid out, as some are quarterly, bi-annually, or annually.

Sign-on Bonus

As the physician shortage continues to drive up the competition for services, sign-on bonuses have become a differentiator for healthcare organizations when filling vacant positions.  Something for physicians to consider is that sign-on bonuses are impacted by geographic location.  In some areas, physicians can expect signing bonuses of up to $40,000. By contrast, in other localities, bonuses of $10,000 or less are common.  Physicians who are not tied to a specific location can seek out more lucrative offers if they are willing to relocate.

Student Loan Forgiveness

Most physicians finish medical school training with an incredible amount of student loan debt.  That kind of pressure adds stress to a young physician who is starting their career.  Student loan forgiveness and assistance is another way healthcare administrators are attracting physicians to fill their vacancies.  In most cases, a physician will receive a set amount of student loan assistance for a contractual commitment to stay in the position for a number of years.  In the past, student loan forgiveness was a key drawing card for rural and community health systems to aid their recruitment efforts.  Now, as the competition for physician services becomes fiercer, organizations in all settings are using student loan forgiveness as a recruitment tool.

Retention Bonuses

As the costs to recruit and hire physicians continue to escalate, healthcare administrators are paying more attention to finding ways to keep the doctors they already employ. One way administrators are addressing this is through the implementation of retention bonuses.  These bonuses are typically paid at periodic intervals throughout the length of an employment contract, but some are held until a physician has completed the entire agreed upon term.

Benefits

Malpractice/Liability Insurance

Arguably the most popular benefit that healthcare organizations are providing to their physicians is insurance against malpractice claims.  These benefits can include variable coverage limits and other claim specific details.  This is another essential clause for your lawyer to review, so you understand your coverage, limitations, and what happens should you leave the position.

Relocation Stipend

Many healthcare organizations are sweetening their offers by offering relocation benefits to physicians who are willing to move to a new location to accept a job offer. Relocation benefits are typically negotiable based on the geographic area and other location-specific circumstances.  Physicians should be sure to understand the specifics of what is required to earn the stipend and how it will be paid out.

Miscellaneous Benefits

Other bonuses and stipends can be available but are less common.  In some geographic locations, physicians may be offered a vehicle stipend, housing allowance, parking stipends, and more depending on specific challenges in that area.  Other benefits include paid time off (PTO), retirement plans, health insurance, and continuing education programs.

Recruiter Help

Throughout the years of medical training, the person a physician relies upon the most, is themselves.  Physicians are naturally born problem solvers, and most are fiercely independent.  One time that being self-reliant should be reconsidered is during a job search.  When a physician is ready for their first position or seeking the next step in their career, a recruiter can help navigate the myriad of unforeseen challenges.  A trusted, experienced physician recruitment professional will have access to open positions that you may not find on a typical job board.  They will be with you every step of the way throughout your search and can provide you with critical information about the organization, the leadership team, geographic considerations, and compensation expectations.

The key is to find a reputable physician recruitment firm.  One that has a nationwide network and experienced healthcare industry professionals who can help you find the best fit for your personal and professional goals.  Your recruiter is a great sounding board and can help you polish up your CV and provide you with the tips you need to ace the interview process.  When it comes time to negotiate an employment offer, your recruiter can give you seasoned insight into what to expect, how achievable the bonus structure is, and a number of other details that will impact your earnings.

To connect with a nationally recognized physician recruitment firm, reach out to the healthcare industry professionals at Jackson Physician Search today.

Take Charge of Your Career as a Physician

Take Charge of Your Career to Avoid Physician Burnout

According to the Bureau of Labor Statistics, through the year 2026, physician employment is projected to increase by 13%.

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Advice on Choosing the Best Practice Opportunity to Fit Your Life

We recently published an article about taking charge of your physician career to avoid burnout. To aid you in that effort, it is time to focus on the major factors…

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Tony Stajduhar Featured in HealtheCareers Article – Recruiting in the Age of Coronavirus

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President of Jackson Physician Search, Tony Stajduhar, was recently interviewed for an article published by HealtheCareers.com. Below is an excerpt from that article.

At Jackson Physician Search in Alpharetta, Georgia, President Tony Stajduhar is all in for the greater good. “We’re in a cool position to be a part of something greater in healthcare right now, to be able to do so many things to help so many people in different ways,” he says. “We’ve always been a company that puts others first, and we are living those values. It’s refreshing.”

Click here to read the full article on HealtheCareers.com.

The Physician Recruitment Process Under Transformation: Will Video Interviews Become the Norm Post-COVID-19?

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President Donald Trump recently laid out plans to start reopening the country. A slow return to a new normal means some of the 20+ million displaced Americans will begin returning to work, and financially hard-hit medical groups will schedule previously postponed elective procedures. Additionally, hospitals and other healthcare organizations can start hiring more physicians to handle the inevitable rush of patients and to meet 2020 staffing planning goals.

Of course, there’s great concern among the medical community, political officials, and citizens that successfully reopening the country come in tandem with improved diagnostic testing to keep the virus at bay. As history has taught us, a pandemic seemingly under control can return for a second wave with a vengeance. We are right to be cautious, which means some degree of social distancing will remain part of our daily lives for months to come.

Surprisingly, as a physician recruitment firm, we have found that the current shelter-in-place orders, travel restrictions, and banned onsite interviews haven’t halted physician recruitment. We’ve seen an increase in candidate activity, likely because physicians remain future-focused, and summer is an ideal time to make a major move to a new part of the country.

Knowing that 50,000 physicians are expected to relocate before the end of 2020, the majority of healthcare administrators have also kept an eye on the future even while battling the pandemic. We learned from a live poll taken during last week’s MGMA20 | The Operations Conference Online that only 14% of medical groups aren’t currently interviewing due to COVID-19. For those that are, they’ve adapted the interviewing process to continue filling key vacancies and to keep candidate pipelines full.

With the light beginning to appear at the end of the COVID-19 tunnel, it’s becoming clear that the initial, in-person physician interview seen as a staple in the recruitment process may not always be necessary.

Video Interviews are Here to Stay – Potentially Reducing Recruitment Costs and Time-to-Fill

Another discovery during last week’s MGMA conference poll is nearly 63% of medical groups are currently interviewing candidates via video and phone, and some have no intention of stopping, as was uncovered during the subsequent Q&A. In the executive search realm where competition for candidates is sometimes less intense, the initial slate of candidates is usually interviewed via video. Only the final contenders are invited onsite for face-to-face interviews, as well as facility and community tours.

Now that tech-savvy healthcare organizations and recruitment firms who were already set up to deliver a digital, yet personalized, candidate recruitment experience have learned that the initial interview can be effectively done via video, it may be difficult to justify going back. Yes, for those physician searches that are ultra-competitive or where the need is immediate, the initial onsite interview may be the best approach. But for others, time and expense can be saved early in the recruitment process. Here are a few tips to provide an outstanding candidate experience:

  • Choose a Professional Location Where You Won’t be Interrupted. Make sure your office is well-lit, avoid having visible clutter, and eliminate the risk of interruption. You want to provide a professional atmosphere just as you would if the candidate was onsite with you in a boardroom.
  • Test Your Setup. Even if you are familiar with video conferencing technology, always do a test run with a colleague. This is to make sure your internet connection is stable, your webcam produces a clear picture, and your audio is working well.
  • Close Unnecessary Tabs and Turn Off Your Cellphone. Before the video call, shut down programs on your computer that aren’t needed and turn off your cell phone. The candidate is your number one priority.
  • Have the Candidate’s CV and Prepare Your Questions. In a typical interview environment, you would have questions ready. Physicians want to know that you are prepared and respect their time just as you want the same.
  • Focus on Connecting with the Candidate. Demonstrate engagement by maintaining eye contact, nodding, and smiling as you normally would. Remember, culture fit plays a huge role in a candidate’s decision to accept a job offer. So, be yourself and connect with the candidate authentically.
  • Follow-up. Provide timely follow-up and next steps, so that candidate interest remains high during any delays.

Create a Virtual Community Site Visit that Increases Enthusiasm

During the MGMA20 | The Operations Conference Online, a medical group administrator asked if the virtual site visit will also be the norm post-COVID-19. Permanent physician recruitment is unique in that it almost always requires relocation. Even the most adventurous prefer to visit the new location before uprooting family. But this doesn’t mean the virtual site visit can’t play a role even when travel resumes.

As recruiters, we’re accustomed to physicians occasionally rejecting a location before visiting. It’s our job to help them consider the total picture, which often includes a professional opportunity that could be a great stepping-stone towards their goals or a culture that is better aligned with their values. When this happens, we use a variety of tools that the travel and tourism industry has been using for decades to create a virtual visit. It’s effective in combatting pre-conceived notions about a region, state, or city.

As we anticipate seeing the initial interview done more often via video, consider adding a virtual site visit as part of your organization’s candidate experience. Here are some tips:

  • Schedule a Video Chat with Fellow Physicians. Typically, the site visit is an opportunity for physicians to get a first-hand look at the facility and to meet potential colleagues. If there’s a mismatch in personalities or culture, it can result in a lost candidate. This is an efficient way to introduce candidates to potential colleagues sooner in the process. Ideally, you would also connect the physician with someone who recently relocated and can relate to what the candidate is facing.
  • Show Off the Best Side of Your Community and Facility. Physicians are concerned with the well-being of their families when considering relocation. While you will still invite a candidate onsite for a final interview, don’t delay building excitement about the community and your facility. If your organization hasn’t already delved into video, hire a film crew to interview key stakeholders and get drone footage of your facility. Then, look to travel and tourism websites to find video footage of the community. Whether you upgrade the careers section of your website or have a standard email you share with candidates, these can go a long way.
  • Introduce Physician Candidates Early to Professional Resources. Candidates facing a relocation will seek out a real estate agent to assess the housing market. Save them time by vetting these professionals. Also, you could include school district information, religious institutions, personal banking advisors, sporting and cultural events, and anything else unique to your community.

For many of us, life feels upside down. We are optimistic that the world is starting to come through to the other side thanks to the tireless and heroic efforts of healthcare providers and other front-line service workers. While many lessons learned will be focused on improving the procurement of testing supplies and personal protective equipment, as well as accurate anti-body testing and vaccine development, there will undoubtedly be other valuable lessons available in all walks of professional and personal life.

More than 50,000 physicians will relocate in 2020 – Here’s how your organization can get ahead of the curve and hire faster post-COVID-19.

Once you identify there is mutual interest between your organization and a candidate:

  • Set up a phone call or video conference between the candidate and key stakeholders to conduct an initial interview.
  • If interest remains high, stay in touch weekly with the candidate, arrange additional discussions with potential colleagues, and send links to community information.
  • If appropriate, share potential agreements with the candidate.
  • Tentatively schedule the final onsite interview and explain the post-interview process.

Jackson Physician Search is currently the fastest-growing physician recruitment firm in the nation. A decade ago, we pioneered an all-digital recruitment methodology that helps hospitals, health systems, academic medical centers, and medical groups to recruit physicians, physician leaders, and advanced practice providers.

We are recognized for our track record built on trust and transparency of processes and fees. Lean on the Jackson Physician Search team for guidance on how to jumpstart your hiring.

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Time is money, especially when it comes to the amount of time it takes to fill a physician vacancy.  The costs that are accrued from the time a position becomes…

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Much of the recent discussions regarding the impending physician shortage include the reality that by 2020, one in three physicians will be of retirement age.

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Coping with Stress: How Physicians can Maintain their Well-being During COVID-19

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No one is immune to the physical, emotional, and even financial side effects of COVID-19. Stress levels are at an all-time high worldwide, as everyone is grappling with the uncertainty of when life will return to normal.  But for physicians, staving off feelings of fear, anxiety, and burnout is as critical as saving lives while getting through this pandemic.

Jackson Physician Search president Tony Stajduhar has been checking in via video calls with several of his physician and healthcare administrator friends and most report feeling growing levels of fear and anxiety.  Each has isolated themselves in homes separate from their spouses and children in a valiant effort to protect.  That means after a long day, suited in full protective gear that is anything but comfortable, they arrive to empty homes.  More than ever, physicians could benefit from the support and companionship of their loved ones.

Feelings of burnout were already prevalent among physicians, but now loneliness is settling in as well.  The one constant in COVID-19 is that we are continuing to learn as we go.  Fortunately, many organizations are trying to get in front of a mental health crisis by putting together resources and daily practices that healthcare providers can use to protect their mental health.  Let’s take a look at some coping strategies that you can practice to maintain your emotional and physical well-being during this challenging time.

Prioritize Your Health

Your health and well-being are essential during this global health crisis.  The world relies on you to help us get through this unprecedented event, and we’ll also need you for all our health issues that are currently taking a back seat. As you know, the benefits of eating well and partaking in physical activity are both physical and mental.  Continue your exercise routine and, if you can get outside and enjoy the spring weather while doing so, that’s all the better. Don’t be afraid to indulge once in a while in some comfort food or a guilty pleasure.

Take Breaks

While taking a break may seem impossible when the flow of patients doesn’t appear to let up, fatigue and stress have a direct impact on performance.  The same applies to your nurses and other support staff, making it even more critical to set the example and find time for regular breaks.  Stepping away for a few minutes will provide you with an opportunity to pay attention to your mind and body.

Prioritize Sleep

No one needs to explain to you how a lack of, or poor sleep, can affect an individual’s mental and physical well-being.  The challenge is that as stress levels increase, sleeping well becomes more difficult. Adding to that, many physicians and healthcare professionals respond to elevated patient loads by working excessively long hours at the expense of their own well-being.  Unfortunately, the less time your body spends in sleep, the more compromised your immune system becomes. In a pandemic, that is an especially dangerous combination.

Practice Mindfulness

Mindful meditation is usually practice seated and can be done for as little as one minute. This breathing practice is an excellent time to exercise compassion towards yourself, so don’t let your mind wander to negative thoughts and keep your attention on your breathing. Body scan exercises, available online, are a great way to assess your mental and physical well-being while giving yourself a chance to relax and decompress in the process.

Stay Positive

Controlling negative emotions during a crisis is probably one of the most difficult challenges front-line healthcare workers face right now.  Like finding time for a break, and allowing yourself to sleep, being kind and compassionate to yourself starts with a positive mindset but requires intentional effort. It is important to acknowledge the fact that you, your family, and your colleagues are experiencing similar challenges.  Taking a supportive and positive approach during such a difficult time goes a long way toward helping everyone successfully navigate another day.

Connect with Family and Friends

Call someone you love every day and talk about something meaningful. Use Facetime or another video calling tool to get a digital face-to-face conversation with someone you haven’t seen in a few weeks or even a few years. Resist the urge to binge-watch Netflix alone and instead find something more engaging. If you are going to watch a show or tv to unwind, netflixparty.com allows you to with others using the Chrome browser on your computer.

Ask for Help – Know That You’re Not Alone

Reaching out for help is a sign of strength and emotional awareness.  Many hospitals and health systems are ramping up the availability of psychological therapists to help their front-line healthcare professionals during this time.  If you don’t want to sit down with a therapist, reach out to a trusted friend or a mentor, and allow yourself to verbalize your feelings. Talking to someone you trust can be liberating and may help you emotionally process the situation.

Get Ahead of the Physical Toll

While the emotional toll of COVID-19 is high now for all healthcare providers, the physical toll is yet to come. Many of you are have patients with elective procedures and other treatments that are currently being postponed. Adopting a good set of coping strategies now only serves to help you through the rush of patients that will follow this crisis.

There’s no doubt that COVID-19 will leave many lessons learned in healthcare and in all areas of life. May some of those lessons be a new emphasis on managing mental health and achieving a healthy work/life balance. For immediate support, we’re pleased to see that The American Medical Association has curated mental health resources to help physicians during COVID-19. You can find more information here. If prioritizing a better work/life balance or moving closer to home is best for you and your family, trust Jackson Physician Search to guide you through the job search process. You can search our open jobs and apply today by visiting jobs.jacksonphysiciansearch.com.

 

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We’ve reached a point where the coronavirus, or COVID-19, is affecting us all. While this is uncharted territory for many, our healthcare system has successfully…

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Tony Stajduhar Featured in MGMA Connection Magazine – Combat the Turnover Trap

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Medical group and hospital administrators face constant demands to maintain high-quality patient care while also meeting and exceeding revenue targets, and a major player in both pressure points is physician staffing. The nation’s aging population, legislative efforts to increase the number of insured individuals and a physician population in which 30% are at or near retirement age mean administrators must grapple with a growing shortage of doctors and an ultra-competitive recruitment market.1

The ongoing physician shortage has repercussions for the time to fill physician positions, particularly in certain medical specialties. In a 2019 Association for Advancing Physician and Provider Recruitment (AAPPR, formerly ASPR) annual survey, 40% of vacancies had gone unfilled by year-end 2018,2 and a 2018 report from the Society of Hospital Medicine (SoHM) showed 66.4% of hospitalist positions were unfilled at adult-care medicine groups.3

 

Read the full article on Combating the Turnover Trap on MGMA.com.