1. Recruitment and Retention
Retention begins with good recruitment

2. 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!!!!

3. 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)

4. 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

5. 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

6. “Once you have them… keep them”
Retention

7. 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

8. 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

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

10. 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)

11. 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

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

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

14. 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)

15. 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”

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

17. 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

18. 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)

19. CHC Workforce Challenges?
CHCA Can Help!
Contact: Richard Berthelot, Workforce Development Coordinator