Recruitment andRetention SampleAction Plan forCHCs

IntroductionThe following addresses steps for recruiting primary care clinicians. Recruiting theright primary care provider is vital to the day-to-day operations of a community healthcenter (CHC). As we go through the following steps, it is important to remember theRecruitment and Retention team at your facility could be comprised of one person ortwenty. We have suggested typical roles found at most CHCs to provide information ortake responsibility on each component of the steps.

Step 1: Assess the need for additional providers and define your opportunityAssess the NeedDetermine Potential Income for new providersRoles: CFO, Billing Manager, HR Director, Medical Director Clinic CPT codes/average charge per CPTDetermine provider supply and demandRoles: CFO, Medical Director, HR Director Determine CHC service area Calculate Provider Supply Calculate Provider Demand Utilize health professional shortage area information NHSC NHSC Loan Repayment9 Provider Incentive PaymentsDefine the OpportunityPractice SettingRoles: Medical Director, Executive Director, CFO What primary care specialty are you seeking? Are you specifically seeking an MD or DO? Board certified? Experienced or new graduate? Nurse practitioner (what type) or physician assistant? Educational requirements and certifications?ResponsibilitiesRoles: Medical Director, Executive Director, CFO When/Where services provided Clinical and administrative hours Coverage arrangementsPractice SiteRoles: Medical Director, Executive Director, CFO The size of the facility. The layout, age and condition of the facility. The technology available. The administrative and clinical support staff. Other human and technological resources at the clinic. The location of clinic in relation to the hospital and nursing home.

Other Healthcare ResourcesRoles: Medical Director, Executive Director, CFO Local Health Care Providers Other Clinic healthcare Dental Mental Health OB

Step 2: Gain support from your medical and business communitiesMeet with medical staff and discuss recruitment needs.Roles: Medical DirectorDemonstrate the community’s sincere interest in a new provider.Roles: Executive Director, Medical Director, HR DirectorBegin building a patient base for the new provider before he or she begins.Roles: Medical Director, Clinical ManagerMake the new provider and his or her family feel more welcome in thecommunity.Roles: Executive Director, Medical Director, Physicians, HR Director

Step 3: Form recruitment teamCommunity Health Center Executive Director or PresidentCommunity Health Center Board MembersMedical DirectorChief Financial Officer (CFO)Human Resources (HR) Director3RNet MemberMarketing CoordinatorAdministrative AssistantBilling ManagerPhysicians/NursesSchoolsResidents from potential community where provider may liveMediaCivicRecruiterNurse ManagerStaffIT Manager

Step 4: Define benefits/fringeEstablishing a fair and competitive compensation arrangement for clinicians.Roles: HR Director, CFO, Medical DirectorAscertaining the clinician’s needs and wants before negotiationsRoles: HR Director, RecruiterDollars — what are the clinician’s financial needs? This can includeoutstanding student loans or need for a down payment on a house. Whileit may be inappropriate to confront a candidate with these questions, theanswers are often revealed during the recruitment phase.Vacation/time-off — many clinicians today are motivated by quality-of-lifeissues. More time off is often an effective incentive, even if it means lesspay.After-hours duty (call) — this is foremost in the minds of all physiciansand some other clinicians. How much call, when it is, and with whom it isshared need to be considered prior to recruitment.Fringe benefits — Different benefits for different employees arebecoming more and more popular. Consider automobile stipends,deferred compensation and other innovative benefit packages. The limit isimagination, inventiveness, and flexibility of the parties.Administrative duties — some physicians are content with only amedical role; others will want to play a part in the administration andmanagement of the health center. By being flexible, a health center cancater to both approaches. If a clinician accepts both administrative roles, itis important to formally recognize the two roles so they will not feelabused.

Step 5: Define your ideal candidateDefine the ideal candidate. Personal and professional background should behighly compatible with the needs of the health care system and with thepersonality of the community.Roles: Medical Director, HR Director, Executive Director, CFOEach group member should list the professional attributes needed for youropportunity such as: specialty, scope of clinical knowledge and expertise, etc.Roles: Medical Director, Physicians/Nurses, Nursing ManagerShare items from each member’s lists to promote building upon each other’sideas.Roles: HR Director, RecruiterRecord all comments.Roles: HR Director, RecruiterGo over the list to clarify, discuss, change and gain consensus on characteristicscontained in each list.Roles: HR Director, RecruiterPrioritize characteristics by voting on the list.Roles: Medical Director, Executive Director, HR Director, CFO

Step 6: Create a recruitment budgetPromotion/PublicityRoles: Marketing Coordinator, CFO Includes photography, artwork, video, etc. Printing (display ads, brochure, flyer, duplication). Materials (stationary, envelopes). Advertising (journals or other media such as Internet). Recruitment firms. Direct marketing (mailing lists, postage). Person-to-person recruitment (residency programs including travel,conference).Candidate ScreeningRoles: Recruiter, HR Manager, CFO, Billing Manager Phone interviews. Credentials check (National Practitioner Data Bank, credentialverification, other). Reference checks (phone interviews, etc).Site Visit and Personal InterviewsRoles: HR Director, Medical Director, Administrative Assistant Airfare. Ground transportation. Lodging. Meals. Mileage reimbursement. Site visit/social gathering (caterer/sponsored meal).PersonnelRoles: HR Director, CFO Current personnel (time away from primary duties, bonus pay for extraduties). Temporary personnel (hired local recruitment coordinator, locum tenenscoverage until new provider is recruited).

Step 7: Create Site Marketing MaterialsRoles: Marketing Coordinator Develop job postings for electronic ads, social media and print ads Develop promotional packets for the practice opportunity Develop promotional packets highlighting professional and personalaspects of community Ensure your facility’s online presence is not damaging (If you search foryour facility online, what comes up first? Do you need to update yourwebsite or other online information?)Step 8: Search for and generate candidatesRoles: 3RNet Member, Recruiter, HR Director, Board of Directors, Schools,Media, Residents, Civic Leaders Generate a list of possible sources of candidates locally, statewide,regionally and nationally Locate free sources of candidates such as: State Offices of Rural Health,residency programs, or medical schools

Step 9: Develop process for candidate communicationsRoles: HR Director, Administrative Assistant Assign key person to be point of contact on all candidatecommunications and ensure timeliness of each communication point. Develop a chart for tracking all stages of candidate recruitment andretentionStep 10: Interview candidatesDevelop candidate and spouse interview teams.Roles: HR Director, Medical Director, Executive Director, CFO, Nursing Manager,Physicians/NursesCreate interview questions and scoring guides. Conduct mock interviews toensure legal compliance.Roles: HR DirectorStep 11: Conduct reference and credential checksCheck candidates credentialsRoles: HR Director or Billing ManagerCheck candidates references, including two not provided by candidateRoles: HR Director

Step 12: Conduct a creative (but honest) site visitRoles: HR Director, Medical Director, Executive Director, Physicians/Nurses, StaffCreative things that could be included in the site visit: Meet key community leaders and medical staff away from the communityhealth center. Participate in an activity (as an ice breaker) that may allow the candidateand his or her family to see the selling features of the community. Ifpossible, include the key community leaders and medical staff in theactivity. Tour and experience the community, first with an escort and then alone,allowing the candidate and spouse to see the pros and cons of yourcommunity. Tour the clinic location of the practice. Meet and visit with each physician one-on-one, unless it is a very largepractice, in which case it may be more appropriate to select several keymembers of the medical staff to meet with one-on-one. Visit at length with the lead medical staff member on the recruitmentteam. Tour the hospital and meet key hospital staff members, especially theadministrator and the director of nursing. Tour other relevant health care facilities. Visit places of particular interest to each candidate and spouse — askthem before the site visit. Have a social gathering with the recruitment team. Conduct a business interview between the recruitment coordinator,contract negotiator, the benefits coordinator at the practice site and thecandidate. Ask the spouse what he or she would like to do or see while thecandidate is involved in itinerary stops of professional concern. In casehe or she does not have a long list of interests, create an itinerary to beled by the spouse recruiter.

Step 13: Make an offer and follow upCreate offer via contract, conduct negotiations, execute final contractRoles: HR Director, Executive Director, Medical Director, CFOSend new hire paperwork and community packet.Roles: HR DirectorStep 14: On boarding and AssessmentDevelop and implement candidate integration plan upon execution of contractincluding office space, computer and access, new hire orientation, spouseorientation, financial policies, etc.Roles: HR Director, IT Manager, CFO, Director of Operations, Executive DirectorAssess and identify barriers if candidate rejects offer and implement strategies toovercome barriers.Roles: HR Director, Executive Director, CFO, Medical Director

Step 15: Develop a Retention PlanCreate schedule to meet with new provider on monthly bases to assessintegration progress.Roles: Medical Director, HR DirectorTalk with spouse and family about integration progress and decide how often tomeet.Roles: Medical Director, HR DirectorMeet with all primary care providers on quarterly bases to discuss retentionissues and address concerns.Roles: Medical Director, HR DirectorConduct retention questionnaire with medical staff.Roles: HR Director, Medical DirectorWork with medical staff to develop long-range development plan.Roles: Medical Director, Nursing ManagerIdentify potential barriers to retention and addressRoles: Medical Director, HR Director, Executive Director, CFO Few benefits. No- or low-compensation guarantee. Excessive call and coverage schedule. Few professional opportunities for spouse. Poor clinic billing and coding practices. Lack of experience practice managers in your office. Inter personal conflicts between hospital and physicians. Turmoil in leadership. No other local physicians. Large Medicare/Medicaid population. Lack of basic consumer services and amenities. Inadequate clinic facilities

Annual Recruitment Plan - Quarterly ActivitiesJANUARY – MARCHSurvey active medical staff to determine: Provider needs/practices needing assistance Need for new practices in the community. Hospital-based physician needs for calendar year. Mail second recruitment letters to practicing physicians (first letter sent in October). Compile statistics from January medical staff survey. Prepare for initial provider/practice assessments. Complete follow-up action on providers who have completed site visits in December andJanuary. Establish funding limits for calendar year from finance department. Prepare opportunity descriptions. Update printed recruitment materials. Identify residency programs and contact program directors/advisors. Identify recruitment conferences and exhibit possibilities. Meet with the provider recruitment committee to explain this year’s campaign and theirinvolvement (for example, interviews). Fine-tune the campaign with their input. Conduct initial provider/practice assessments to clarify provider recruitment needs inresponse to January medical staff survey. Mail second recruitment letter to next year’s graduating residents/professionals (first lettermailed in October).APRIL - JUNE Begin preparation for regional residency marketing seminar (seminar about how to marketpractices and what to expect in recruiting). Meet with administrator to establish recruitment priorities. Send third recruitment letter to next year’s graduating residents/professionals. Semi-annual physician/provider manpower recruitment committee meeting. Assist newly recruited providers by facilitating their arrival and transition.

JULY - SEPTEMBER Register a search with the AMA and other placement services. Contact physicians in government service (National Health Service Corps/Indian HealthService). Write other health care administrators in the region regarding a search for a health careprovider for the community. Contact state licensure board for names of provider licensees and send letters to. Inform pharmaceutical and medical supply vendors of provider searches. Contact military installations in region for names of providers leaving service and ask aboutopportunities to communicate with them. Contact medical specialty associations to obtain information on meetings, publications andplacement services. Identify provider recruitment opportunity fairs f