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Intended Audience: Health Systems looking to recruit primary care family or internal medicine physicians.

Different Health Systems have differing levels of success with recruitment. They’re the most prone to having an a process-induced recruitment difficulties.

Not all do. What follows is an interview between an ETS Family Medicine Recruiter and the most effective Health System we work with.

Key Points:
• Establish systems, document everything, and don’t let there be cracks for candidates to slip through
• Time is the enemy in recruitment; be quick

Give me rundown of your Health System’s recruitment process.

It’s somewhat intentionally long to make sure we’re finding the right fit for the patients and health system long term.

Whenever a candidate reaches my desk —whether it’s from a firm or from our own sourcing efforts or an internal referral —I try to reach out to the candidate within a half hour, try to get that first call scheduled within a day or two of receiving their information.

Time is the enemy in recruitment. I used to work as an outside recruiter like you.

Once I’ve screened them, we also do a vetting process here where we look up their board certifications, their license, DocInfo, and Google them. We make pages and pages of screenshots to make sure there are no red flags in the background. We send over the summary to leadership and then try to get that next call scheduled to leadership within a week. Once again, I don’t like to let things drag out.

Obviously, that depends on the physician’s availability and leadership’s. Just call with myself and then a quick 30-minute WebEx with one of the senior leaders and probably one of the physician site leads. If everyone’s in agreement, then we invite them on site right away.

The onsite interview consists of practice tours, hospital tours, a lunch, sometimes a dinner. We offered a hotel for a few nights. We connected with a realtor to do a community tour if they want to look at schools or housing or rental options.

After the on-site, we do ask all our physicians to turn in their rating sheets within 48 hours. If everything looks good, I’ll follow up with the candidate to discuss the final steps in our process, which is reaching out to their references

Once we have those back, we request a letter of intent. It’s not a legally binding document, but it’ll have everything spelled out: the base, the sign-on, the relocation, and the other benefits.
They sign and get it back to us, then we try to turn around the employment agreement with contracting and legal within a week. Typically, we give them a three-week deadline on the LOI and the contract. We’re not going to let an offer hang out there indefinitely.

Once the contract’s signed and if they’re given notice, we typically try to get them credentialed and started within 90 days post-hire. We do have them go to new provider orientation. They can air any grievances they have or anything they think we’ve done well.

We have new hire provider mixers where we bring out all the physicians and APPs for drinks and food, games, live music, whatever. It’s a chance for them to network and get to know each other.
We also have a provider relations team who will take the outpatient docs out into the community and introduce them to their other partners and whatnot.

That’s pretty much it in a nutshell.

All-in, what’s a normal amount of time between when you initially receive their information and they get a written letter of intent from your team?

It really varies depending on the physician. I’ve turned it around in as quick as a month or two. Some of them it’s a little bit slower played, like if they’re not finishing their training for 18 months. It could take up to six months.

There’s been situations where a candidate has had to pause for a family reason or something that we go back and revisit it. And shoot, sometimes I end up working with a doc for a year plus before we get them here. All depends.

I love it when everything falls into place, bang, bang, bang, and we wrap it up quick. That doesn’t always happen.

I’ve got one candidate I’m working with right now. She’s really highly regarded, but she’s in a different time zone and only wants to speak with me at 7 o’clock at night.
I have family commitments so I’m not talking to her until next Wednesday. That’s unfortunate.

I got her information on Tuesday—almost a full week before I connected with her. I’m going to be having the conversation, “Look, you got to make yourself available during normal business hours to the leaders. I’m the lowly recruiter here. I’m talking to you at 7 o’clock at night on a Wednesday but senior leadership’s not doing that. You’re an hour behind. Can you do 7:00 am our time and 8:00 am your time? Or can you do the lunch hour?”

It really depends on the candidate and how flexible they are.

We’re always looking for the right cultural fit here too.

If I get on the phone with them and they’re just drilling me on the wRVUs… you know, everyone’s concerned about the money. We all are, I get it. But if that’s your main focus, there’s no discussion of patient care or collegiality, I’m probably not going to move the candidate forward.

Other Health Systems have a very committed process. A recruiter will have to get consent from someone else and follow up and a lot of time delays. How much authority/leeway do you have in the process?

Quite a bit. I’m part of the lead physician group executive branch. If I determine the candidate’s not a fit, I have full clearance to disposition them out.

If it’s gotten to an on-site interview, that call needs to be made by our a Director or VP. If we’ve spent thousands of flying down here, put them up in a hotel, get them a rental car, take them out to dinner then it can’t just be what I say. It’s not my call at that point.

But in the initial screening, yes, I can absolutely rule out a candidate.

What’s your philosophy on speaking with candidates who have a malpractice or board action history?

If I uncover something malpractice related, I’ll document it and then I’ll ask the physician about it. I’ll ask them to provide me something in writing, whether it’s their words or from their attorney. I run it by our med staff credentialing department to say, “Hey, is this an issue?”

For example, I had one candidate who was a war veteran. He came back, suffered from PTSD, got back-to-back DUIs—but that was 10 plus years ago. He went into the physician monitoring program and has never had an incident since. That was obviously not patient-related. I ran that by the director in that department. She said it wasn’t an issue.

If we didn’t hire everyone that got a DUI, 10, 12, 15 years ago, we’d have half the medical staff. If it’s a litigious field like obstetrics and they’ve got $1,000,000 settlement, that’s not a deal breaker for us.

I’ve seen an instance where a physician had a sexual relationship with a patient. That’s an absolute no-go. I’ll rule them out right then and there. There are certain red flags that just be an absolute no. It’s not about to go into a committee or anything like that.

If there’s any question, I just go to med staff and they’ll give me an answer within a day or two.

What if it’s something less definitive, like maybe they’ve left employers a little bit more frequently than you’d like?

If they’re a job hopper, I’ll ask them. Oftentimes there are reasons for the job changes. Whether that was COVID or just not the right fit. I know a lot of residents change jobs.

If they’ve had a long history of staying somewhere three months to six months, that’s different. Even if they can provide reasons for every job move but there’s been 12 moves in 8 years, we’ll pass.
It’s really a case-by-case basis. It’s oftentimes where the employers pull a bait and switch on them. We are looking for good work history.

You are, hands down, the quickest person to respond to name clearances. How do you make that process so fast?

Well, I work my butt off. I came from your side of the desk, making 100 outbound calls a day.

I’m not going to leave you guys hanging. I’m not going to pull any tricks and go searching to see if I can find the candidate of my own. If I haven’t spoken with them directly in the past year, I’ll clear them.

How do you document? What’s our Applicant Tracking System? How do you know if you’ve spoken with them in the past year?

I’m just checking our trackers. We use a program called SmartSheets. It’s similar to Excel, but it’s got a lot of other features. Multiple people can be in there working at the same time. It’s just as simple as seeing if we’ve worked with them on a perm or a locum basis. If the candidate has reached out to us directly and we put them on hold for whatever reason. It’s been within the past year. I’m not going to clear.

We spent tens of thousands on our own advertising, but if it’s not something we’ve had communication with, I’ll clear them.

Candidate for other health systems often slip through the cracks. How do you prevent situations like that?

Timely follow-up and documenting. I’m not going to chase someone. If I’ve reached out to them two, three times and they’ve blown me off, I’ll let them go. I use my Outlook calendar for reminders. There’s lots of systems we have in place.

We don’t have a Swiss Cheese Effect here.

Being an in-house recruiter, what is the most important lesson you’ve learned?

Document, document, document. Open book test. You don’t have to remember something that you talked about three months ago if you documented it.

We’re not the only outside recruiter you work with. What advice do you have regarding working with outside agencies?

Make sure they’re doing a thorough job screening the candidate. I’ve cut some agencies loose that I found were just sending names blindly so they could get their foot in the door and be covered on the referral. I expect the recruiter to have spoken directly with the candidate on a thorough security themselves before they make it to my desk.

This interview was edited for clarity and anonymity.

Artificial Intelligence was not used in the creation of this article.

The image of the hospitals on a winner’s podium was created using ChatGPT.