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The Standard Q3 2014

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Industry Perspectives

Five tips to boost physician retention

By: Andrew Rossi, Senior Director of Marketing, Delta Locum Tenens

As we learned from many of our readers at the 2014 Annual ASPR Conference, improving physician retention continues to be the top priority. Considering this, The Delta Companies sought to identify a series of situations where clients have seen exceptional success from their retention efforts; and, from this we have established five key elements in which facilities of all types may benefit. The following best practices have seen demonstrated success in improving retention of physicians from both permanent placement and reoccurring locum tenens’ assignments. 

1. Creating an effective orientation process, before Day 1
As we’ve discussed in previous articles, establishing a great first impression is essential to recruiting top talent to your team. A physician’s first few days of introduction to the team are equally essential to retention. During this time, facility representatives communicate expectations to the new provider, discuss the organization’s values and mission regarding patient care, and go over any procedures or daily housekeeping issues related to the staff (such as electronic medical record training and administrative responsibilities). 

Best Practice: Properly onboarding a new physician is critical to daily performance; however, it is also a way to help facilitate relationships between the new physician and existing staff. It is important to establish a facility representative to be responsible for coordinating a new physician in order to create a seamless and welcoming experience. For example, one of our clients in a rural hospital setting identifies facility champions that volunteer to show a physician around during the first days of orientation. This champion acts as a guide for the new physician, answering questions and helping to welcome the new physician to the existing culture of the organization. 

2. Get personal
Many employees rate the enjoyment of working with their colleagues among the highest of any employment attribute, according to research conducted by Inavero. Getting to know an incoming provider (and his or her priorities) can catalyze the facilitation of interpersonal relationships between new physicians and existing staff. 

Best Practice: One of our clients in the Midwest does an excellent job of welcoming new physicians to their team. During the interview process, the client tailors the physician’s experience to accommodate their interests, taking them to local points of interest such as a football game or museum, post-interview. Once the physician joins the organization, the client continues to personalize their onboarding experience by connecting the physician and their family members to interests throughout the community; i.e. connects the family to a church group; introduces the kids to the local soccer team’s coach; ensures the provider’s spouse knows the ins and outs of the community and employment options, etc. 

3. Let physicians have a voice
One of the best ways to gauge job satisfaction (particularly as it relates to retention) is going directly to the source. What kind of channels does your organization have in place to collect feedback from your staff?

Best Practice: As a multi-location healthcare system across the southern US, one Delta Physician Placement client keeps communication at the forefront of their recruitment strategy. Under the umbrella of this healthcare system, individual locations identify a physician representative to have a voice in how operations are managed throughout the healthcare system. These physician representatives are then invited to regularly scheduled meetings with administrators, who channel physician feedback up to the organization’s CEO. This keeps the organization’s leadership in the know about issues going on at an operational level while allowing staff to feel their interests are fairly represented. 

4. Treat your locum like a perm
Physician retention is not exclusive to permanent assignments. Many of our clients rely on locum tenens physicians to supplement staff. Often, our Delta Locums Tenens’ clients request repeat assignments from locums physicians that are a good fit for their organization.

Best Practices: One of our clients in rural Texas relies entirely on locums services to support their growing patient demand. At this facility, the organization’s physician recruiter greets each incoming locum doctor at the airport upon arrival, ensures the physician obtains a rental car, and then escorts the physician to his or her hotel. This same personalized treatment continues onsite as the physician recruiter walks the locum provider through orientation. Creating a physician liaison between locum providers and administration has exponentially increased locum retention for this facility, and often our providers request to return to this assignment whenever available. 

Another success we’ve seen is in a national urgent care group. This organization requires locums physicians to undergo the same three-day orientation as permanent providers; learning the values, mission, and procedures of the organization (such as EMR training and billing processes). After one locum assignment concludes, providers often opt to obtain licensure in other states and return to work for this client; returning to the organization knowledgably of the healthcare system’s processes and values. 

Another Delta Locum Tenens client took a creative approach to retaining locums providers by providing premium housing to contracted providers. This client wows locum providers by providing a furnished apartment in place of hotel accommodations and actually saves money by paying rent instead of long-stay hotel fees. This client has seen success in converting locum physicians into full time staff, in large part due to the extra effort they make to accommodate their providers. 

5. A quick tip on compensation
Offering a competitive compensation package is a necessary component to retaining top talent. Although healthcare providers have a variety of reasons for taking or choosing to stay in certain jobs, money always plays a hand. While increasing retention does not necessarily require you to be the highest paying organization in the nation, it does require that your physicians feel they are paid at a market competitive rate. If they feel they are being overworked and underpaid, often times they will walk away. 

Best Practice: Several of our clients have responded to the need to keep compensation competitive by offering a retention bonus to long-term physicians. By offering a five percent annual salary increase, these clients have seen successful upticks in their recruitment efforts and avoided the loss in revenue associated with losing a provider. 

Overall, physician retention continues to be a key priority to healthcare facilities throughout the country. One way to capitalize on this initiative is to differentiate your organization by increasing retention efforts and getting creative with your recruitment and retention strategies. 

Placements & Interviews

Placement Data by Specialty

This data represents average statistics of placements and interviews by Delta Physician Placement over the twelve-month survey period. Since these averages only include placements and interviews, the compensation information presented indicates the rate at which candidates are choosing to interview or sign. Average days information can be used to forecast a probable timeline for a recruitment effort in a particular specialty.

Average Compensation Average Days
Starting Compensation Sign-on Bonus Potential Compensation From Interview to Placement Total Placement Fastest Days-to-Fill
Primary Care
Family Medicine $212,044 $30,885 $259,741 35 119 21
Internal Medicine $218,833 $24,167 $291,250 42 158 40
Pediatrics $192,000 $10,500 $216,667 38 126 33
Psychiatry $233,333 $22,778 $225,555 70 169 22
Obstetrics/Gynecology $327,500 $32,500 $406,250 14 95 43
Surgery
General Surgery $374,444 $32,857 $435,556 107 198 37
Orthopedic Surgery $566,667 $41,667 $716,667 44 144 134
Otolaryngology $487,500 $67,500 $550,000 31 107 93
Urology $541,667 $45,000 $708,333 27 79 72
Sub-Specialty
FM- Obstetrics  $250,500 $22,500 $287,500 33 117 79
Neurology $287,500 $30,000 $437,500 59 17 33
Pulmonary Critical Care $310,000 $35,000 $377,500 33 75 16
Hospital-Based
Occupational Medicine $245,000

$12,500

$257,500 48 118 95
Hospitalist $234,833 $24,167 $256,667 31 135 33
Emergency Medicine $304,376 $32,000 $337,000 19 72 15

Data indicates sources of candidates for placements and interviews from October 2013 through September 2014.


Placements by Population

Placements by Population

Data indicates sources of candidates for placements and interviews from October 2013 through September 2014.

Candidate Sources

Candidate Sources

Data indicates sources of candidates for placements and interviews from October 2013 through September 2014.

Market Demand



Specialty Demand Comparison

3rd Quarter 2014 3rd Quarter 2013
1. Family Medicine Family Medicine
2. Psychiatry Psychiatry
3. Internal Medicine Hospitalist
4. Orthopedic Surgery Internal Medicine
5. Family Medicine - Obstetrics General Surgery
6. Hematology/ Oncology Emergency Medicine 
7. Hospitalist Obstetrics and Gynecology
8. Obstetrics and Gynecology Dermatology
9. Pediatrics Family Medicine - Obstetrics
10. Dermatology Pediatrics
11. Maternal Fetal Medicine Urology
12. Medical Oncology Anesthesiology
13. Ophthalmology Endocrinology
14. Physical Medicine & Rehabilitation General Practice
15. General Surgery

Nephrology

Data indicates sources of candidates for placements and interviews from October 2013 through September 2014.

Nationwide Search Distribution

Nationwide Search Distribution

Data indicates sources of candidates for placements and interviews from October 2013 through September 2014.



Candidate Placements

Top 5 States Providers Have
Taken New Opportunities
1. Texas
2. Iowa
3. Wisconsin
4. Louisiana
5. Oklahoma

Data indicates sources of candidates for placements and interviews from October 2013 through September 2014.

Locum Tenens

Days Requested - Top Specialties

Days Requested

Data indicates the top specialties by days requested from October 2013 through September 2014.

Nationwide Physician Distribution

Nationwide

Data indicates sources of candidates for placements and interviews from October 2013 through September 2014.

3rd Quarter 2014 
October 2013 - September 2014

Industry Perspectives

Hiring for cultural fit: The effects on patient care

By: Natalie Notko, Recruiting Principal, Delta Healthcare Providers

Ask anyone to define “organizational culture” and its impact on operations, and you may get varying degrees of explanation. A fluid, multifaceted concept, it is hard to stick a universal definition on what organizational culture is and how exactly a culture originates. Culture is, however, widely accepted as part of an organization’s DNA and plays a crucial role in shaping an establishment’s behaviors and operational output. 

In any organization, employees are the embodiments of their entity’s culture—their behaviors, values, rituals, are all a reflection of their parent organization. Although an organization may have formal values, mission, or goals outlined, it is the employees that execute these principals and define how the culture is perceived. 

In a healthcare setting, caregivers communicate more to patients than just information about their case. A provider’s actions determine a patient’s experience with the facility; and, ultimately the culture (behavior) a provider presents is the one the patient walks away remembering. This logic applies to internal interactions among staff as well, as daily behaviors (and the outcome to these behaviors) set the standard of what employees expect from each other and from organizational leaders. This is why finding the right fit for your team is essential to creating cohesion among your staff and quality care to your patients. 

What does this mean for recruitment? Since employees drive an organization’s culture and directly impact the day-to-day operations of a facility, a fundamental practice in influencing your facility’s overall culture is in ensuring that the values and attitudes of the providers you hire align with the values your organization represents. 

Facility recruiters can accomplish this by utilizing a more evolved prescreening process for candidates during the interview process, according to a 2014 webinar published by The Advisory Board Company. Look beyond standard screening elements like education and practice history, and incorporate personality assessments and behavior-based interviewing techniques into your conversations. In addition to screening candidates for cultural fit with your organizations, findings from these assessments can be used to tailor orientation and integration processes for the hired provider. 

The ability to collaborate with colleagues, relate to patients, be open to new processes and technologies—all are examples of something that differentiates an adequate healthcare provider from the ideal candidate that can help your facility thrive. It is also possible that hiring for fit (i.e. hiring a candidate that proves to be relatable and congenial) may outweigh hiring for experience, as it relates to patient care and satisfaction. For example, a recent study by the Oxford Journal of Medicine & Health explored the relationship between a patient’s trust in their provider and how the patient perceived the outcome of their treatment. The study found patients with a lower level of trust in their healthcare provider are less satisfied with their care, less likely to follow healthcare advice, and less likely to see symptom improvements over the span of two weeks. This would argue that enhancing efforts to build patient trust would lead to improved treatment outcomes for patients. 

Once you have identified a candidate that fits with your personality and behavioral expectations, you can utilize your facility’s orientation process to educate the new provider on organizational values, goals, and processes. Using this time to acclimate a new hire into the facility culture not only ensures that the provider and facility expectations are aligned, but also helps to orient the provider with the facility community, strengthening interpersonal relationships and increasing chances of retention.

Placements & Interviews

Placement Data by Specialty

This data represents average statistics of placements and interviews by Delta Healthcare Providers over the twelve-month survey period. Since these averages only include placements and interviews, the compensation information presented indicates the rate at which candidates are choosing to interview or sign. Average days information can be used to forecast a probable timeline for a recruitment effort in a particular specialty.

Average Compensation Average Days
Starting Compensation Sign-on Bonus Student Loan Repayment Relocation Reimbursement From Interview to Placement Total Placements Fastest Days-to-Fill
Rehabilitation
Physical Therapy $82,641 $11,704 $17,281 $4,282 11 90 3
Occupational Therapy $78,459 $13,200 $28,750 $3,694 8 83 1
Speech Language Pathology $79,333 $7,500 - $5,000 4 46 51
Extenders
Nurse Practitioner $102,904 $6,900 $44,567 $5,794 19 98 9
Physician Assistant $123,932 $6,600 $20,000 $5,250 16 61 8
Allied/Other
Registered Nurse $64,787 $7,450 $11,583 $4,679 6 87 4
Medical Technology $51,650 $4,000 - $3,000 2 34 1

Map represents searches initiated by Delta Healthcare Providers on behalf of healthcare facilities from October 2013 through September 2014.


Placements by Population

Placements by Population

Data is compiled from assignments placed by Delta Healthcare Providers from October 2013 through September 2014.

Years of Experience

Years of Experience

Data is compiled from assignments placed by Delta Healthcare Providers from October 2013 through September 2014.

Market Demand

Nationwide Search Distribution

Nationwide Search Distribution

Map represents searches initiated by Delta Healthcare Providers on behalf of healthcare facilities from October 2013 through September 2014.



 Candidate Placements

Top 5 States Providers Have
Taken New Opportunities
1. Texas
2. Alaska
3. Wyoming
4. New Mexico
5. Virginia

Data is compiled from assignments placed by Delta Healthcare Providers from October 2013 through September 2014.

Specialty Demand Comparison

3rd Quarter 2014 3rd Quarter 2013
1. Physical Therapist Physical Therapist
2. Occupational Therapist   Nurse Practitioner
3. Registered Nurse Occupational Therapist
4. Nurse Practitioner Registered Nurse
5. Dentist Physician Assistant 

Data compares the top 5 most requested searches initiated by Delta Healthcare Providers in the third Quarters of 2013 and 2014.


Staffing

Facility Demographics

Facility Demographics Charts


Assignments by Specialty

Specialty Average Length Contract
to Start Date
Average Length
of Assignment
Occupational Therapy 4 weeks 10 weeks
Occupational Therapy Assistant 8 week 10 weeks
Physical Therapy 4 weeks 11 weeks
Physical Therapy Assistant 6 weeks 9 weeks
Speech Language Pathology 3 weeks 10 weeks

Data is compiled from assignments placed by Delta Healthcare Providers from July 2014 through September 2014.


Top Licensure States

top_licensure_states

Data is compiled from travel assignments placed by Delta Healthcare Providers from July 2014 through September 2014.

Years of Experience 

Years of Experience

Data is compiled from travel assignments placed by Delta Healthcare Providers from July 2014 through September 2014.


Licenses Per Quarter

Licenses Per Quarter

Data is compiled from assignments placed by Delta Flex Travelers from July 2014 through September 2014.


Licensure Cost

Specialty Average Cost of License
Physical Therapist $221.88
Physical Therapy Assistant $280.17
Occupational Therapist $234.89
Occupational Therapist Assistant $180.00
Speech Language Pathologist $95.00

Data is compiled from assignments placed by Delta Healthcare Providers from July 2014 through September 2014.