Recruitment and RetentionRecruitment and Retention

Retention begins with good Retention begins with good recruitmentrecruitment

Workforce ChallengesWorkforce Challenges

Number of available providersNumber of available providers

Urban verses rural settingsUrban verses rural settings

Number of providers entering “Primary Care”Number of providers entering “Primary Care”

Health Care Reform and assuring “access”Health Care Reform and assuring “access”

Geographic preferencesGeographic preferences

Competition!!!!Competition!!!!

Recruitment Challenges for CHCs Recruitment Challenges for CHCs

COMPETITION!!!!COMPETITION!!!!

Rural Areas Rural Areas

Few professional opportunities for spouseFew professional opportunities for spouse

Education for childrenEducation for children

Limited access to network of physicians Limited access to network of physicians (isolation)(isolation)

Provider expectations (salary, benefits, hospital Provider expectations (salary, benefits, hospital rotations, after-hours)rotations, after-hours)

The Cost of RecruitmentThe Cost of Recruitment

2005 =$25K - Today: $30K-$35K 2005 =$25K - Today: $30K-$35K (not including sign on bonus/ relocation)(not including sign on bonus/ relocation)

Promotion and PublicityPromotion and Publicity– Printing / material development Printing / material development

– AdvertisingAdvertising

– Recruitment firms Recruitment firms

– Direct marketing (mailing lists, postage)Direct marketing (mailing lists, postage)

– Person to Person recruitment (residency programs including travel and conferences)Person to Person recruitment (residency programs including travel and conferences)

Candidate ScreeningCandidate Screening– Phone interviewsPhone interviews

– Credentials checkCredentials check

– Reference checksReference checks

The Cost of RecruitmentThe Cost of Recruitment

Site Visit and Personal InterviewsSite Visit and Personal Interviews– Travel Costs (ground transportation, lodging, meals, mileage Travel Costs (ground transportation, lodging, meals, mileage

reimbursement) reimbursement)

– Site visits/social gathering (caterer/sponsored meals)Site visits/social gathering (caterer/sponsored meals)

PersonnelPersonnel– Current personnel (time away from primary duties, bonus pay for extra Current personnel (time away from primary duties, bonus pay for extra

duties)duties)

– Temporary personnel (hired local recruitment coordinator, locum tenens Temporary personnel (hired local recruitment coordinator, locum tenens coverage until new provider foundcoverage until new provider found

Time!Time!– Everyone’s involvedEveryone’s involved

RETENTIONRETENTION

““Once you have them… Once you have them… keep them”keep them”

Why Retention?Why Retention?

Retention less expensive than Retention less expensive than recruitment recruitment

“ “Physicians go where they are invited, stay Physicians go where they are invited, stay where they are well treated and grow where they are well treated and grow where they are cultivated.” where they are cultivated.”

---- Roger Bonds---- Roger Bonds

Retention ChallengesRetention Challenges

Geographic locationGeographic location– Professional and social isolationProfessional and social isolation

Diversity of patient populationDiversity of patient population– Age, culture, gender, socioeconomic, disease processes, and Age, culture, gender, socioeconomic, disease processes, and

management can be challenging to new practitioners.management can be challenging to new practitioners.

Community presenceCommunity presence– Accepting all patients regardless of ability to pay, outreach functions, Accepting all patients regardless of ability to pay, outreach functions,

Board Governance Board Governance

Economic challengesEconomic challenges– Grant dependent to an extent, need to stay fiscally competitiveGrant dependent to an extent, need to stay fiscally competitive

Retention ToolsRetention Tools

A written retention planA written retention plan

Extensive provider orientation and Extensive provider orientation and supportsupport

Retention tracking toolsRetention tracking tools

Retention PlanRetention Plan

Involves commitment from the organizationInvolves commitment from the organization

Recognizes importance of a positive clinical Recognizes importance of a positive clinical work environmentwork environment

Includes a written board approved salary and Includes a written board approved salary and benefits package competitive in the benefits package competitive in the marketplace.marketplace.

Provides opportunity for clinical staff Provides opportunity for clinical staff collaborations collaborations

Provides opportunities for “advancement” Provides opportunities for “advancement” (leadership(leadership) )

Retention PlanRetention Plan

Includes quality improvement plan that Includes quality improvement plan that addresses clinical servicesaddresses clinical services

Provides systems and resources to assess and Provides systems and resources to assess and document performance and reward clinical document performance and reward clinical excellence excellence

Ensures staff access to CHC supported Ensures staff access to CHC supported continuing professional educationcontinuing professional education

Documents for Retention PlanDocuments for Retention Plan

Needs assessmentNeeds assessment

Strategic planStrategic plan

Business planBusiness plan

Healthcare planHealthcare plan

Recruitment and retention planRecruitment and retention plan

Quality improvement and management planQuality improvement and management plan

Clinician satisfaction surveyClinician satisfaction survey

Documents in Retention Plan Documents in Retention Plan

Patient satisfaction surveys and resultsPatient satisfaction surveys and results

Sample provider contracts and position Sample provider contracts and position descriptionsdescriptions

Provider productivity reportsProvider productivity reports

Clinicians salary ranges and benefits Clinicians salary ranges and benefits packagespackages

Provider Orientation and SupportProvider Orientation and Support

Continuous communication with providers regarding Continuous communication with providers regarding clinical and administrative issues clinical and administrative issues

Knowledge/understanding of expectations of Knowledge/understanding of expectations of management and organizational missionmanagement and organizational mission

Workplace enhancement- extensive clinical staff Workplace enhancement- extensive clinical staff orientation and mentoring, supervisory training, peer orientation and mentoring, supervisory training, peer activities, career development programsactivities, career development programs

Remember - to new providers “all patients” are new Remember - to new providers “all patients” are new patients and should be scheduled appropriatelypatients and should be scheduled appropriately

Analyze competiveness of compensation and benefits Analyze competiveness of compensation and benefits packages for all positions (annually)packages for all positions (annually)

Provider Orientation and SupportProvider Orientation and Support

Provide for clinical input to appropriate Provide for clinical input to appropriate administrative decisions (administrative decisions ( i.e., medical supplies, i.e., medical supplies, equipment, clinical procedures, staffing) equipment, clinical procedures, staffing)

Provides for community involvementProvides for community involvement

Recognizes and values “provider excellence”Recognizes and values “provider excellence”

Retention Tracking ToolsRetention Tracking Tools

Staff listStaff list

Suggestion listsSuggestion lists

Satisfaction surveys (staff and patient)Satisfaction surveys (staff and patient)

Performance reportsPerformance reports

ComplaintsComplaints

Exit interviewsExit interviews

Recruiting for Retention Recruiting for Retention

Recruitment is relationship “building”…. retention Recruitment is relationship “building”…. retention is relationship “strengthening”is relationship “strengthening”

““MATCH” - (personal, professional, and social MATCH” - (personal, professional, and social needs of clinician and their family)needs of clinician and their family)

Open communication (provider/administration)Open communication (provider/administration)

“ “Check-In” oftenCheck-In” often

Excruciating honesty (practice profile, Excruciating honesty (practice profile, community profile)community profile)

Confirm provider “realistic” vision of rural lifestyleConfirm provider “realistic” vision of rural lifestyle

Recruiting for RetentionRecruiting for Retention

Provide opportunities to “contribute” to the CHC Provide opportunities to “contribute” to the CHC missionmission

Offer opportunity for clinicians to serve on Offer opportunity for clinicians to serve on management teammanagement team

Agree on production standards.Agree on production standards.

Providers must participate in managed care Providers must participate in managed care decisions about their patientsdecisions about their patients

Offer a reasonable call scheduleOffer a reasonable call schedule

““Know your Competition” (compensation, benefits)Know your Competition” (compensation, benefits)

CHC Workforce Challenges?CHC Workforce Challenges?

CHCA Can Help!CHCA Can Help!

Contact: Richard Berthelot, Workforce Contact: Richard Berthelot, Workforce Development CoordinatorDevelopment Coordinator

501-374-8225501-374-8225

rberthelot@chc-ar.org

www.chc-ar.org