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Emergency Medicine News:
doi: 10.1097/01.EEM.0000307646.75125.be
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Physician Retention: Choose Wisely: Part 1 in a Four‐Part Series

Katz, Barbara

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Author Information

Ms. Katz is the president of the Katz Company, an emergency medicine consulting firm dedicated to providing expert physician recruitment services and training emergency medicine residents in effective job searching.

The current marketplace, with its high number of job openings and low number of candidates to fill them, emphasizes the urgent need for ED employers to retain the physicians they have. Practices with low turnover rates are far more attractive to potential candidates than those with a revolving door history of hiring. This four-part series will focus on the ways of keeping good physicians on staff and not looking for the door.

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Physician retention begins at the initial interview: choosing the right physician candidate for the right reasons in the first place. Just because a candidate has the proper clinical capabilities and training doesn't make him the right physician for your ED team. Employers need to concentrate on hiring the person as well as the doctor. Clinical credentials are often on par among candidates, but personal qualifications never are. Employers need to evaluate, as a team, the type of personality that fits best into their department and in the hospital as a whole. In fact, the entire department and hospital should have involvement in the interview process. Have candidates meet with administrative leaders, other department heads, nurse managers, and as many members of the emergency physician team as possible. Not only will their input help hiring authorities make a decision, it will aid the candidate's decision-making process as well. The more details he has, the more informed decision he is capable of making.

Figure. A candidate ...
Figure. A candidate ...
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As much as an employer may want a physician candidate to choose its opportunity, for the purpose of longevity, they should want the candidate to choose their opportunity for the right reasons. That means keeping the dog-and-pony shows to a minimum. Candidates, particularly graduating residents, can be too susceptible to overwhelming wine-and-dines, grandiose promises, and shiny sign-on bonuses. They can get so caught up in the pretty perks that they forget their pre-set goals and take jobs for the wrong reasons. A year or two later, they're job hunting again. Employers need to stick to the things that really matter.

Having said that, with today's market, it's nearly impossible to avoid using incentives to attract candidates. Experienced, boarded physicians are as scarce as hen's teeth due to the sharp decline in the real estate market. Those who would ordinarily welcome new opportunity are prevented from doing so because they would probably take a big loss on the sale of their homes, if they could sell them at all. Employers who are seeking creative ways to provide incentives for boarded physician candidates might want to consider investing in real estate. Barring that, the candidate pool is permeated with graduating residents in the job market for the first time. To avoid falling into the statistic pool that has more than 50 percent of graduating residents leaving their first job within two years, employers must apply retention-driven interview tactics that focus on the following:

* The physician's prior ties to the community.

* Proximity of the area to the physician's family and that of the spouse.

* The personality fit for the emergency physician team.

* How the practice profile complements the candidate's professional goals.

* How the practice compensation complements the candidate's financial goals.

* How the community fulfills the candidate's and his family's personal goals, including schools, recreation, sports, proximity to colleges, and places of worship.

Any candidate who has family ties or prior experience living in the employer's community is far more likely to stay on a long-term basis than one who is trying the area for the first time. Hiring authorities also should be wary of physicians who are job searching with their time off as priority. For example: “Why are you interested in our job in Denver?” the director asks. “Because I love to ski,” responds the candidate. This guy is going to be counting the minutes during every shift until he can hit the slopes — not exactly a savvy hire. If the physician's family or in-laws are in the area, particularly if he is married with young children, that is another major plus in that candidate's favor.

Personality conflicts can be quite destructive in a team environment. During candidate site interviews, employers should arrange social events that include other department physicians and their spouses or significant others. This is the best way to ascertain how the candidate interacts with other members of the team. It also will give employers a good example of the candidate's interpersonal and social skills. This is of particular importance if the department physicians play as well as work together.

Potential employers often do not ask a candidate about his long-term career plan, but ideal candidates should have a five- to10-year plan achievable in that employer's ED. The candidate's financial goals also should be achievable within that time frame. This area of screening will help the potential employer determine if the candidate has realistic priorities that match those of the department or group.

Finally, the motivated employer will have a relocation specialist, either someone from the hospital physician services/recruitment department or a top, local real estate agent who can answer questions about schools, housing, shopping, recreation, and places of worship, and conduct an enticing area tour geared to the specific candidate. These are all important lifestyle elements, and will help determine if the physician and his family will be happy in the community on a long-term basis.

Hiring the first qualified physician who comes down the chute and is willing to sign on the dotted line can too easily result in having to do it again within a year. If you are in hiring mode this season (and who isn't?) and you want to retain the physician you hire for more than one or two years, do the homework, ask the right questions and conduct your interview process with long-term retention as the top priority.

© 2008 Lippincott Williams & Wilkins, Inc.

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