Employers paint a rosy picture when recruiting physicians—but is it accurate?

Some health-care facilities attempt to woo physician candidates with a limo at the airport and a steak dinner. In Weiser, ID, a rural town of 5,500 that is best known for its status as the “Fiddling Capitol of the World,” recruiters have been known to take a different tack: They trot out the town’s mayor and a full marching band to try and close the deal. 

“You would have thought the President was in town,” said Travis Singleton, executive vice president of physician search firm Merritt Hawkins, referring to one such recruiting trip. On that occasion, the local hospital in Weiser was attempting to recruit a new general practitioner. The prospect, who was already wary about practicing in such a small town, arrived at the airport grumpy after his flight was delayed and was ready to go straight to his hotel, according to Singleton, whose team helped put together the trip. But Weiser’s residents had other plans.

The hospital’s executives shuttled the doctor to the high school football stadium, where they interrupted the game to usher him onto the field and introduce him to the crowd with much fanfare, as the marching band gave him a hero’s welcome.

“He got a standing ovation, and he broke down and cried,” Singleton said. “Of course, he took the job.”

That was 10 years ago, and the physician is still happily practicing in Weiser, according to Singleton. Now, Merritt Hawkins touts the small town’s recruiting practices as a model for other communities that have trouble attracting physicians.

Already plagued with a nationwide physician shortage (there currently are more than 6,080 Health Care Professional Shortage Areas throughout the country, according to the Association of American Medical Colleges—double the number identified by the Health Resource and Services Administration 15 years ago), communities that might be considered less-than-desirable are having to work harder to recruit physicians. Some have imperfect weather (think Death Valley, CA, in August or Duluth, MN, in January) or are located in urban areas with heavy crime. A good portion are rural locations like Weiser that struggle to find physicians across virtually all specialties. One example: Texas alone has 185 counties with no psychiatrist, according to a study by Merritt Hawkins on behalf of the North Texas Regional Extension Center.

Mississippi, the state with the largest physician shortage, has approximately 186 doctors per 100,000 people, according to statistics from the Association of American Medical Colleges; by contrast, the District of Columbia, the most populous area for physicians, has 866 per 100,000 residents.

So, how does a rural or less-desirable community compete? It used to be that rural areas would entice physicians with compensation packages that were between 15% and 25% larger than pay in large metropolitan areas, according to a report by Merritt Hawkins. But consolidation of health-care practices in large cities has given these facilities deeper pockets, so the salary gap is closing. The most recent Merritt Hawkins report revealed that the average guaranteed income for family practitioners across the nation is $241,000; in rural areas it is about $252,000.

Now, Singleton’s team counsels health-care facilities in areas with physician shortages to get much more creative in “putting on a positive face” for prospective hires.

In Weiser, he said, the city’s hospital works with area businesses to place signs in store windows to welcome physicians when they visit. Other communities will make sure that the headlines on the Chamber of Commerce website are positive and highlight good news, rather than, say, stories of a recent crime or a company that’s gone out of business.

“You want to highlight positivity at every turn,” Singleton said.

At the Regional Medical Center in Manchester, IA, CEO Charlie Button gets the entire community involved with physician recruitment efforts. His team will create an itinerary that matches the hobbies and interests of the physician. A typical trip might span 2 full days and could include a meeting with the school district’s superintendent or a private worship session with a local pastor. Button himself likes to tout the small town’s mixed-use trails and its diverse economy.

“We only have about 5,500 residents, but we’re very progressive and we’re growing,” Button said. “That’s important to tell people. If you’re a physician committing to be in a community for 25 years, you don’t want to find out in 10 years that half of the population has left.”

Button also likes to have potential recruits meet with as many of the center’s 30 health providers as possible and grill them about the facility’s practices and their ability to leverage new technologies.

He recently hired a new OB/GYN who was attracted by the area’s low crime rate and the fact that the hospital performed robotic surgery. “She realized we’re not just a little hospital trying to get by,” he said. “We’re looking at the future.”

Other communities entice doctors with promises of flexibility that larger conglomerates typically can’t match. One example: United Health Centers of San Joaquin Valley, CA, offers physicians extra perks like 7 weeks of leave, a 40-hour work week, flexible hours, and the latitude to perform specific procedures they might not be able to practice in larger facilities. In addition, they guarantee physicians will have at least three dedicated exam rooms and two medical assistants.

“A lot of what smaller communities have to sell is autonomy,” Singleton said. “Some will sell physicians on the idea that they can call their own shots and be the doctor they’ve always wanted to be.”

Shawnequa Brown, MD, who just accepted a position as an OB/GYN in Selma, AL, said her new employer convinced her that she would be able to “make a difference” in a hospital that had only one other practitioner in her specialty. For that reason, she’s moving her family of five from the much larger Columbia, SC, to Selma, where “it looks like Walmart is one of the only good places to shop,” she said.

Joyce Grayson, director of the Rural Health Education & Services Department at the University of Kansas Medical Center, Wichita, KS, said many health-care facilities in her state have had success targeting physicians who have done international medical mission work.

“Some are surprised to learn that our population here represents similar populations that they’re serving abroad,” Grayson said, noting the large numbers of Somalian refugees, Asians, and Hispanics in some areas of Kansas. Not only will these physicians get to work with populations they have experience with, but many of their employers will allow them several weeks off each year to continue their mission work.

Another bonus: Doctors are often recruited in pairs so that they can collaborate with one another and cover for each other when one is traveling. “Physicians don’t want to be isolated,” Grayson said. “Even if a community can only hire one, we’ll find a nearby community that might need another, and we’ll try to recruit a physician’s friend to fill that spot.”

Of course, physicians need to go into recruiting visits with eyes wide open, especially if their potential employers might be working hard to paint as rosy a picture as possible. Singleton has heard horror stories of physicians who have gone on recruiting trips only to discover that a locale wasn’t as idyllic as they had been led to believe. In one case, he said, a physician who had some free time accidentally stumbled upon a meth lab while seeking directions. “He got on the next plane home,” Singleton said. Others have landed in Arizona in the blistering heat and decided immediately that the location wasn’t for them.

At the same time, recruiting experts warn health-care facilities against going overboard by falsely advertising what their communities have to offer.

Singleton has heard stories of recruiters flying physicians to desert locations at night during the summertime in an attempt to create a better first impression. He also knows of a physician who was told a hospital was just 45 minutes outside Chicago when it turned out to be 3 hours away.

“I think it’s very important to be as transparent as possible,” Button said. “Above all, you’re looking for a good fit.”

Singleton concurs. He recounted a recent case where he sent a doctor on recruiting trips to both the Upper Peninsula of Michigan and Green Bay, WI. “I was sure he’d take the job in Green Bay,” he said.

But Singleton was wrong. “He came back and said Green Bay was way too big of a city for him. That taught me to throw any of my preconceived notions out the door.”

“I firmly believe there’s a doctor out there to fit every community,” Button added.