Recruitment and Retention Retention begins with good recruitment

Workforce Challenges Number of available providers Urban verses rural settings Number of providers entering “Primary Care” Health Care Reform and assuring “access” Geographic preferences Competition!!!!

Recruitment Challenges for CHCs COMPETITION!!!! Rural Areas Few professional opportunities for spouse Education for children Limited access to network of physicians (isolation) Provider expectations (salary, benefits, hospital rotations, after-hours)

The Cost of Recruitment 2005 =$25K - Today: $30K-$35K (not including sign on bonus/ relocation) Promotion and Publicity Printing / material development Advertising Recruitment firms Direct marketing (mailing lists, postage) Person to Person recruitment (residency programs including travel and conferences) Candidate Screening Phone interviews Credentials check Reference checks

The Cost of Recruitment Site Visit and Personal Interviews Travel Costs (ground transportation, lodging, meals, mileage reimbursement) Site visits/social gathering (caterer/sponsored meals) Personnel Current personnel (time away from primary duties, bonus pay for extra duties) Temporary personnel (hired local recruitment coordinator, locum tenens coverage until new provider found Time! Everyone’s involved

“Once you have them… keep them” Retention

Retention less expensive than recruitment Why Retention? Retention less expensive than recruitment “Physicians go where they are invited, stay where they are well treated and grow where they are cultivated.” ---- Roger Bonds

Retention Challenges Geographic location Professional and social isolation Diversity of patient population Age, culture, gender, socioeconomic, disease processes, and management can be challenging to new practitioners. Community presence Accepting all patients regardless of ability to pay, outreach functions, Board Governance Economic challenges Grant dependent to an extent, need to stay fiscally competitive

Retention Tools A written retention plan Extensive provider orientation and support Retention tracking tools

Retention Plan Involves commitment from the organization Recognizes importance of a positive clinical work environment Includes a written board approved salary and benefits package competitive in the marketplace. Provides opportunity for clinical staff collaborations Provides opportunities for “advancement” (leadership)

Retention Plan Includes quality improvement plan that addresses clinical services Provides systems and resources to assess and document performance and reward clinical excellence Ensures staff access to CHC supported continuing professional education

Documents for Retention Plan Needs assessment Strategic plan Business plan Healthcare plan Recruitment and retention plan Quality improvement and management plan Clinician satisfaction survey

Documents in Retention Plan Patient satisfaction surveys and results Sample provider contracts and position descriptions Provider productivity reports Clinicians salary ranges and benefits packages

Provider Orientation and Support Continuous communication with providers regarding clinical and administrative issues Knowledge/understanding of expectations of management and organizational mission Workplace enhancement- extensive clinical staff orientation and mentoring, supervisory training, peer activities, career development programs Remember - to new providers “all patients” are new patients and should be scheduled appropriately Analyze competiveness of compensation and benefits packages for all positions (annually)

Provider Orientation and Support Provide for clinical input to appropriate administrative decisions (i.e., medical supplies, equipment, clinical procedures, staffing) Provides for community involvement Recognizes and values “provider excellence”

Retention Tracking Tools Staff list Suggestion lists Satisfaction surveys (staff and patient) Performance reports Complaints Exit interviews

Recruiting for Retention Recruitment is relationship “building”…. retention is relationship “strengthening” “MATCH” - (personal, professional, and social needs of clinician and their family) Open communication (provider/administration) “Check-In” often Excruciating honesty (practice profile, community profile) Confirm provider “realistic” vision of rural lifestyle

Recruiting for Retention Provide opportunities to “contribute” to the CHC mission Offer opportunity for clinicians to serve on management team Agree on production standards. Providers must participate in managed care decisions about their patients Offer a reasonable call schedule “Know your Competition” (compensation, benefits)

CHC Workforce Challenges? CHCA Can Help! Contact: Richard Berthelot, Workforce Development Coordinator 501-374-8225 rberthelot@chc-ar.org www.chc-ar.org