Avoiding the Most Common Mistakes in Developing Your In-House Recruitment Program

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In previous issues we have reviewed several of the major mistakes for in-house physician recruitment, and based on the response from readers, these “problems” have affected hundreds of healthcare organizations.  When we teach this type of material at our in-house recruitment training programs, we are often asked by administrators which of the major mistakes is the most prevalent.  While every hospital, clinic and managed care company is significantly different, we must say that in numerous organizations, a common mistake is setting up an in-house program in the wrong place within the organization, and with limited or no authority, or set up under a weak manager.  Over a third of the healthcare organizations with formal recruitment programs have this problem.

This is often puzzling as administrators seem to agree that the recruitment function is a top priority.  Yet when setting up a formal in-house program, the activity is delegated down, sometimes three and four levels, even at small hospitals.

Recruiters cannot be expected to hit home runs when they are hampered by having to work their way up the chain of authority to get decisions.  Likewise this is doubly hard if placed in a “department” that has little clout, or under a manager who does not understand recruitment of physicians.

But there is a rule-of-thumb for placement of such a program.  Simply, the recruiter must either have the full authority to negotiate contractual relations with new physicians, or have direct and easy access to whoever does have that authority.  If the chief administrator will continue making all decisions, then the recruiter must report to the administrator.  If there is a vice president or director with the authority, then the recruiter appropriately reports to him or her.

Last year, a 420-bed hospital in California formed a new physician services department, which included recruitment.  With the goal of recruiting 26 physicians in twelve months, they reasoned that their new in-house recruiters could handle this, and report through the department director.  After dismal results (only 8 new physicians in a year) the situation was evaluated.  While there were other problems, the most glaring was having the recruiters reporting two levels below the administrator and having a vice president of finance involved as well as an in-house attorney.  This would have been fine if the department director or the recruiters had authority, but that was not the case.  To correct this, the recruiters were removed from the department, and placed directly under the administrator. The VP of finance and in-house attorney were then only consulted as needed, instead of asking their permission at various stages.

In another case, a mid-size clinic in New England had a similar situation with the function too far down in the organization, and lacking authority.  However the politics of the organization would not allow for dramatic restructuring of the function.  To reach agreement with all parties, we simply designed dotted line reporting from the recruiter to the clinic administrator, with the solid line remaining to the department head.  The department head still doesn’t like it, but this redesign is a response to getting results and not overacting to middle management’s ego.  They have now tripled their recruiting results in the past six months, compared to the previous period.

In another case, Tom Bauer, vice President of Business Development of La Porte Hospital, La   Porte, Indiana, set up a new physician recruitment department to replace the failed “function” that had very poor results.  This mid-sized facility made a decision at the senior level to become more aggressive on their recruitment program and pulled out all the stops.  “We’re doing this right the first time,” said Bauer.  “While our new recruiter has significant authority, I have additional authority, and together we can make most decisions.”  The president of La Porte, Leigh Morris, feels good about this as well.  “We hire qualified individuals and expect them to perform,” he said.  “Of course I’ll always be in on many of the final decisions regarding recruitment, but our recruiter has immediate access to me at any time.  Anything short of this would obviously give the competition an edge, and we will not make that mistake.”


Physician Recruitment is challenging enough without our own self-made problems. Learn more about AAMM’s seminars and resources.

Roger Bonds is the founder of the American Academy of Medical Management and president of The National Institute of Physician Recruitment & Retention, based in Atlanta, GA. Find AAMM on FacebookLinkedIn, Twitter.and YouTube. Email AAMM at [email protected], or call their main office at 770-649-7150.