Medical Staff Development Planning: Get Physicians’ Buy-in Before You Bottom Out
By Jennifer Metivier, FASPR, ASPR Executive Director. This article originally appeared in HR Pulse Magazine, January/February 2012.
It’s a situation that every hospital will find itself in at one time or another. You need to recruit a specialty physician to provide the medical care that your patients need, but the existing physicians are not supporting the hospital’s recruitment initiatives. How can you get buy-in from the physicians so that you can work together to successfully recruit the needed physicians?
If physicians do not understand why the hospital is recruiting for another physician, they may not be supportive of the hospital’s recruitment efforts. This could result in a stressed relationship between the physicians and hospital administration. How can you prevent this from happening? You must engage physicians throughout the entire process of your medical staff development planning and implementation. You must establish transparency in the process and open communication between the hospital and the medical staff right from the beginning.
Whether a hospital conducts its own medical staff development plan or contracts with a consulting firm, it’s critical to involve both the hospital-employed and the independent physicians on the medical staff throughout the entire process. By involving physicians from inception, you’ll provide an opportunity for them to be engaged in the process and better understand the hospital’s goals and findings.
The initial step of a comprehensive needs assessment should include input from physicians in the form of surveys, one-on-one interviews, and/or focus groups. It should include the opinions of primary care physicians who have insight into specialist referral issues and the opinions of the specialists as they may have insight into other issues impacting their ability to see patients in a timely manner. The physicians may also confide in the hospital regarding their retirement plans — which is critical information to obtain during the assessment.
Another crucial piece of the needs assessment should be examining physician referral patterns and potential “leaking” to competing practices outside of the hospital’s service area. Physicians often have no idea that the long wait times for patients to be seen has resulted in the referring physicians and potential patients becoming frustrated. This frustration ultimately leads to patients being referred outside of the service area resulting in a loss of potential revenue to their practice (and to the hospital). Realizing this may help the physicians better understand the true need and may help them become more receptive to recruiting a physician into their practice.
Once all of the relevant information and data from the needs assessment have been analyzed, the hospital is now able to develop its plan to address any current or impending physician shortages to ensure medical coverage for the patient population. Physicians will better understand the community needs because they were engaged and involved with identifying them. This understanding helps lay the groundwork for the physicians and hospital to work together to determine the best way to fill the gaps.
The physicians’ involvement and understanding of the needs assessment findings should garner their support for the hospital’s recruitment strategies. However, they may still push back when it comes time to actually recruit a new physician due to fears regarding competition. According to Joelle Hennesey, MHA, FASPR, director of physician recruitment at Manatee Healthcare Systems in Bradenton, FL, “The best approach is to try to recruit the new physician into an existing practice. This is preferable for both the existing practice and the new recruit and reduces the concerns regarding competition.”
Hospitals may be able to provide recruitment assistance to the existing practice to help them recruit a new physician. Assistance may come in the form of sign-on bonuses, relocation, and/or income guarantees. Hennesey says, “Once these options are presented to the existing practice, the physicians are more motivated to figure out how to add a new physician to their group. The financial incentives provide relief to the practice, so they don’t need to take full financial responsibility for the start-up of the new physician.”
Successful recruitment into an existing practice results in a satisfactory outcome for everyone. The hospital has filled the identified need, the recruiting practice has expanded its ability to treat patients and bring in additional revenue, and the newly recruited physician has the advantage of joining a well established group that provides him or her with support and guidance.
Unfortunately, it doesn’t always end up this way. If the existing physicians are still opposed to recruitment and are not willing to bring a new physician into their practice, the hospital is faced with recruiting the needed physician into a hospital employed position, supporting the physician in a solo practice, or starting up a brand new group. These alternatives may be met with discontent from the existing physicians, but are necessary in order to provide the care that your community needs.
Regardless of which practice setting the newly recruited physician ends up in, the hospital has done its best to engage the existing physicians, remain open throughout the process, and offer options that would eliminate fear of competition. These efforts should result in a less adversarial relationship and greater level of trust between hospital administration and the medical staff.