comphealth quarterly - locum...in on how they use locum tenens at their facilities. here are a few...

Q1 – 2016

CompHealthQuarterly

2 © CompHealth 2016/04

How hospitals can be successful in an evolving market.by Melissa Byington

What is locum tenens? How to explain it to a friend.

How to stop a revolving door of PAs and NPs.by Lisa Shock, MHS, PA-C

Creating an attractive company profile on your website is essential.

Ten interview tips for landing the right provider.

Be more productive this year.

Why become a member of ASPR.

#DataDriven: How ASPR members are changing the industry.by Carey Goryl

01

03

04

06

08

10

12

13

Since founding the nation’s first locum tenens company in 1979, CompHealth has grown into one of America’s largest healthcare staffing firms. Our more than 700 recruiters and consultants are expertly trained to provide temporary and permanent staffing of physicians, nurse practitioners, physician assistants, therapists, medical lab professionals, and other healthcare positions in hospitals, private practice groups, and government facilities across the country.

Table of contents

Q1 2016

866.288.1778 | CompHealth.com

1

For many hospitals across the country, business is booming. After a number of tenuous years caused by the Great Recession, followed closely by uncertainty around the impact of the Affordable Care Act, hospitals are adding jobs and profit margins are up.

Nevertheless, things have changed. With the rise of Medicare enrollment, more individuals purchasing health plans through exchanges, and fewer employers interested in offering health benefits, the payment model is shifting dramatically. To be successful in this new world, hospital leaders need a new approach.

An economy on the rebound.

Five years ago, the national unemployment rate was 10 percent. Today, it’s hovering around 5 percent. Many of those once-unemployed workers have found employment in healthcare. Since the passage of the Affordable Care Act in 2010, the healthcare industry has added more than 1 million jobs, making it one of the top sectors for job growth in the country. In 2015, the industry added 503,000 jobs—that’s nearly 42,000 new jobs every month.

Not only are jobs up, but total operating margins are also. During the 20-year span from 1993-2013, margins for not-for-profit hospitals jumped from 2.7 percent to 5.7 percent.* A few factors have contributed to the spike, including increased insured patient volume due to the expansion of Medicaid and the introduction of health insurance exchanges.

However, a strong economy comes with some drawbacks for employers. More open healthcare

jobs means physicians and other providers have more options to choose from. Back in 2009, there were six job seekers for every job. Today, there are less than two candidates for each open position.

As a result, it cost 16 percent more to hire a doctor in 2015 than it did in 2014, and it took in-house recruiters an average of 204 days to fill each job. Here’s an even more alarming number—last

summer, for every family medicine resident entering the job market, there were 56

open jobs to choose from. It’s no wonder that physician recruiters

are busier, and more stressed out, than they’ve ever been.

A changing landscape.

Despite the job growth and increase in operating margins,

hospitals have definite challenges ahead. Chief among them are changes

to the current payment models, which have been on shaky ground for years. Hospitals

have long made a living from commercial insurance, which reimburses facilities at around 150 percent of the cost of care. This overpayment has helped keep underpayment by the public in check (government plans pay just 86 percent of hospital costs).

With an aging population and enrollment in Medicare plans skyrocketing, hospitals will continue to see more patients and earn less per visit. In 2012, Medicare accounted for 42 percent of the average hospital’s payer mix. By 2022, Medicare payment is projected to account for 58 percent.

Thanks to exchanges, the number of individual purchasers is also on the rise. More than 9 million people have now purchased an insurance plan through an exchange—and they’re gravitating to

How hospitals can be successful in an evolving market.By Melissa Byington

2 © CompHealth 2016/04

low-cost plans. A number of high-profile employers, including IBM, Caterpillar, and GE have determined that it is better for them to push their employees to exchanges, rather than administer insurance plans themselves.

All of these changes mean hospitals are no longer insulated from market forces. Here’s a quick look at shifting consumer demands.

• More individual buyers—Thanks to their employers, employees have long been isolated from the true cost of care. Now that they’re buying their own coverage, they’re much more sensitive to cost.

• There are more product options—Broad network options are gravitating to narrow, custom networks.

• More transparency—Exchanges allow consumers to make apples-to-apples plan comparisons.

• It’s easier to change plans—When individuals aren’t tied to an employer plan, they’re more likely to change plans more often.

• Greater consumer cost exposure—Constant employee premium contribution and low deductibles will give way to variable individual premium contribution and high deductibles.

How to win in the new world.

With so many changes on the horizon, what can hospitals do to thrive in a market driven by individual consumers? According to the Advisory Board Company, a global research, technology, and consulting firm, there are a few attributes every hospital needs to be successful in the new world of healthcare delivery.

• Strong business acumen—New challenges demand robust executive leadership. Hospitals must develop and execute on a system-wide strategy to survive.

• Expansive cost accounting—In the past, some hospitals have paid little attention to their cost structure. In order to alter expense structures in a sustainable manner, cost transparency is a must.

• The right mix of volume and value—Shifting from fee-for-service to a fee-for-value model doesn’t happen overnight. Hospitals need to maximize accountable care success without destroying fee-for-service profits.

• Highly aligned network of care—Care transitions remain the source of high costs and low quality. Hospitals need to make sure they are aligning sites of care to provide expertise at the proper place and time.

• Defined value proposition—The consumer is now the customer. In order to win business, hospitals need to provide a more convenient patient experience.

Times are changing. Hospitals that don’t evolve will be left behind.

* Avalere Health analysis of American Hospital Association Survey

data, 2013, for community hospitals.

Melissa Byington is the president of the locum

tenens division at CompHealth and has worked

in healthcare staffing since 1997. She also serves

as President of the NALTO executive board.


3

Outside of the office, it’s unlikely that many of your friends or family have ever heard the term locum tenens. Now there’s a new site that explains how it works and why it’s so important.

Locumstory.com traces the history of the industry from frontier days to modern times and shows how these traveling physicians are used to combat the growing physician shortage. The story is inspired by the words of physicians who work these temporary assignments and the healthcare organizations that hire them. Illustrations were created especially for those looking for a quick overview of locum tenens.

The site aims to answer these questions:

• What is locum tenens?

• How do assignments work?

• What are the benefits to doctors?

• Why do hospitals and facilities use locum tenens physicians?

• How do locum tenens doctors help patients?

The site also features physician recruiters who weigh in on how they use locum tenens at their facilities. Here are a few quotes from videos on the site:

We use locum tenens for several reasons. The simplest are just vacation, pregnancy leave, or surgery. But what we’re facing more and more is a physician shortage. . . . Primary care is becoming an incredible supply and demand problem.”

—Tim Speece, Deputy Chief Operations Officer

Our members have an expectation that we’re going to provide service to them . . . the way we do that is by bringing in additional locum resources in the event a provider is out on extended sick leave, or whether they’ve left the organization, etc.”

—Bryan Cook, Director of Operations and Strategy

While the site is primarily directed to physicians who have never worked locum tenens, the information is presented in such a way that medical students, facility staff, and the general public will enjoy learning about this unique healthcare solution.

What is locum tenens? How to explain it to a friend.

“

“

© CompHealth 2016/044

Many healthcare systems embrace team-based healthcare delivery. In this model, physicians, physician assistants (PAs), and nurse practitioners (NPs) work together to ensure patients receive the best care possible.

While beneficial, this collaborative approach has created hiring challenges when members of the healthcare team leave the practice. It’s a problem that I frequently hear about from healthcare providers.

According to the Bureau of Labor Statistics, the need for physician assistants and nurse practitioners will increase more than 30 percent during the next eight years. Because these practitioners are in such high demand, it’s easier for them to shop around for other jobs if they’re not satisfied with their current employer. With increased demand for PAs and NPs comes the need to be more competitive when hiring and more mindful of retention.

If you are seeing high employee turnover with your PAs and NPs, it may be that their needs are not being met. And salary is often not the issue. For most clinicians money is a satisfier—not a motivator.

Here are a few things you can do to retain and engage these employees—many of which are often valued more than money:

1. The opportunity to learn and grow professionally.

It is critical that a positive learning environment be fostered for those who seek additional skills or experience. This can be challenging in the busy world of direct patient care but it will pay long-term dividends. PAs and NPs are looking for jobs that will provide them with new experiences, education, and training. They often accept a job for the opportunity

of learning a new specialty, regardless of the compensation.

2. Work/life balance is key.

Whether they are balancing child care, school schedules, or simply want more time away from work, many employees want workplace flexibility. Adding some leeway to an employee’s daily, weekly, or monthly schedule is often seen as a big win and can often be even more important than compensation.

3. Working relationships and mentorship are important for professional growth.

Do your employees have mentors? Is there someone they can go to for career advice? If not, you may

How to stop a revolving door of PAs and NPs.By Lisa Shock, MHS, PA-C


5

want to look into a formal mentoring program. Asking seasoned employees to guide those younger in their careers can help engage both the mentor and mentee.

In addition, consider offering a budget for continuing medical education and time off to take those courses. This will help engage employees and lets them know you want them to stay up on the latest practices and procedures. The added focus on professional growth will also help attract new employees to your facility.

4. Expanded scope of practice improves engagement.

Another way that PAs and NPs can grow in their careers is by giving them more autonomy. The more clinical experience they have, the more independently they can work.

There should be a consistent growth pattern for nursing practitioner job responsibilities in relation to their collaborations with physicians and PAs. This leads to better team-based medicine, as each practitioner can better fulfill their roles in concert with each other. Expanding the scope of practice in the clinical setting should occur as more trust is developed.

In time, both the PA and NP should be practicing at the top of his or her license. This not only helps these providers be more engaged it also prevents physician burnout.

Focusing on these four areas should help stymie exiting PAs and NPs from your facility. It will also help you recruit a smarter, more engaged workforce, enabling you to achieve your business goals.

Lisa P. Shock, MHS, PA-C, has a part-time

clinical practice and is president and CEO of

Utilization Solutions in Healthcare, a consultant

company for physician practices and hospitals.


Gone are the days of sifting through newspaper ads to find a good job. The job market is competitive and providers expect more than just an email address and job description. If you truly intend to attract the best providers, you have to go beyond a simple About Us statement and a list of current vacancies.

Many companies state people are at the heart of their business, but few take the time to demonstrate it on their website. In today’s job market, a career blog is becoming an essential component for a company to promote its culture and entice potential job candidates. Job seekers are employing social and professional networks to evaluate a company, as well. More than ever, providers want to learn about the culture of a facility and potential career paths. At the same time, they don’t want to drown in information. They simply want an organization to show its know-how in more than an educational way. They’re looking for answers to: Why should I work with you? Is this the right place for me? What will my workday really look like?

Give providers a glimpse of what they can expect if they work at your facility.

Microsoft, for example, provides potential candidates with insights into what they can expect when working for the technology giant. Their career blog shares stories of what employees enjoy about working there as well as career tips. Even though a

person may not necessarily get a job at Microsoft, he or she will walk away with information to apply to future searches.

Consider adding a “Reasons to Join Us” section.

List five to ten good reasons to work at your organization. Ask your current staff what they would say to someone if they were trying to persuade him or her to join your team. You might be surprised by what people find important. Don’t be afraid to be creative, and remember that you are selling your facility to a provider as much as he or she is selling to you.

Share stories and pictures from the employees.

Pictures of employees enjoying company events and team-building exercises are a must-have. Make sure you post some photos of the office environment, too. The more a provider can see what it’s like to work at your facility, the more likely he or she is to apply.

Creating an attractive company profile on your website is essential.


7

Include stories told directly by full-time providers. And stories about networking for success or essential career tips from leaders are nice extras that show you are willing to share information even if a provider doesn’t pursue a position with you.

Use video to tell the story.

A section titled something like “What it’s like to work at . . . ” can be a simple way to give potential providers straightforward information in a testimonial format. Instead of standard statements by a few leaders stating your facility has a fun atmosphere, record a couple of short interviews with staff members who talk directly about what it’s like. It gives your facility a human face and will sell your organization more than words on a page ever can.

CHG Healthcare Services, parent company of CompHealth, features an employee profile section on their website called “Free to Be Me at CHG,” which shares stories of what employees enjoy about working at CHG. The stories focus on the company’s belief in celebrating diversity. Potential candidates can see how easy it would be for them to fit into the CHG environment.

The site also includes a “Making a Difference” section. In this section, locum tenens providers talk about the experiences they have had working locum tenens assignments. These stories help educate providers about the kinds of experiences they can have in this particular relationship with the company.

Include links to social platforms.

Make it easy for people who visit your website to share what they see with others they know on Linkedin, Twitter, Facebook, or by email. Get your IT team to include these social options at the top of every blog page (don’t worry, providers will know what to do with them).

The growth of sites like YouTube, LinkedIn, Facebook, and Twitter goes hand-in-hand with the increasing expectations of job seekers. They expect companies to provide complementary content on all channels. The company website establishes itself as the main entrance to finding job opportunities, but job seekers identify Facebook and others as the next places they go to find out about you.

The more personalized and contact-friendly ways you provide information, the more likely a provider is to stay interested in pursuing a position with you.


Have a defined role. Most providers are curious about what a typical workday looks like. Be sure you understand the job role for which you are interviewing, including the schedule, patient load, and necessary experience. It’s also beneficial to know the pay range in case a candidate asks.

Be organized. First impressions are everything. Create an exact itinerary of the interview. Getting from point A to B is much easier with a map, and outlining the interview ahead of time will allow you to feel relaxed and prepared. There’s nothing worse than feeling scattered when a candidate sits down for an interview.

Write down your questions ahead of time. The best way to know if the candidate is right for the position is by learning everything you can while they are there. Having the questions ahead of time will also show the candidate you are interested in getting to know them.

Save the most time for the hiring supervisor. Give the hiring supervisor as much time as possible to build a relationship with the candidate—at least an hour. It’s important for the provider to get to know the person they will report to. Keeping this in mind during the interview ensures you won’t have to bring the provider back for additional questions.

Have benefits information available. Be as detailed as possible about the benefits your facility offers. Including medical, dental, CME, vacation, and any additional perks that set your organization apart from others will help the provider make a more informed decision.

Give the provider the opportunity to meet peers. Giving the provider a clear idea of the team he or she will be working with helps give a better understanding of the work environment and starts the important trust-building process.

Provide a tour of the facility. Hold the interview at the facility rather than at an outside location, e.g., a local coffee shop. Letting the provider see the facility allows him or her to determine if an environment is a good fit. Be sure to emphasize any areas that are unique to your facility and that you are especially proud of.

Ten interview tips for landing the right provider.

1

2

3

4

5

6

7

Today it’s a job seeker’s market. A key component of attracting and hiring the provider you want is the interview process. Interviewing potential providers can be uncomfortable for many, but the good news is, effective interview techniques can be learned. Below are 10 tips to help you feel prepared.


9

Provide a tour of the city. A realtor or staff member are excellent choices for showing off the community and helping the provider get a glimpse of what the area has to offer. Like the old adage says: location, location, location.

Have a firm offer process. Know the steps you’ll take after an interview and be prepared to share them with the candidate. Just as being prepared before the interview is important, it’s also important to understand what comes next. If a provider is left hanging, you may lose him or her to another position.

Explain the onboarding process. An official, effective onboarding process provides a candidate with clarity and lets him or her know that you are an organized, responsible facility with the provider’s best interests in mind. A provider wants to know that he or she will be treated just as well once work begins as during the interview process.

Following these tips will help you provide an effective interview process and make your provider candidates more comfortable. The best part is, you’ll feel more prepared and ready to make the right hiring decision.

Many tips given to providers preparing for an interview also apply to the person conducting the interview. Consider the following:

• Arrive promptly; don’t keep a candidate waiting

• Dress in a way that reflects your facility appropriately

• Behave courteously and professionally

• Maintain eye contact and sit comfortably

• Make sure the candidate understands each question

• End the interview with a firm handshake

• Express your thanks for the candidate’s time

First impressions.

8

9

10


Because we value our relationships with physician recruiters across the country, we wanted to understand what productivity challenges you face each day. To that end, we recently conducted a survey of physician recruiters. Here is what we learned.

Based on the findings from the survey, here are tips for dealing with common daily challenges.

Be more productive this year.

Overflowing email box 59%

Too many phone calls 49%

Inefficient work processes47%

Coworker interruptions 35%

Unnecessary/unproductive meetings 27%

Lack of direction 23%

Biggest barriers to productivity:* Cutting down on email clutter.

Establish a routine. Rather than immediately responding to every message, set up a few specific times each day to check email.

Reuse sent messages. If you frequently send similar messages, save them as templates and use them again.

Use “to:” wisely. Only use the “To:” line for those who need to respond to the message. Everyone else belongs in the “Cc:” line.

Keep it short. Save everyone time by being clear and getting straight to the point. It’s easier for the recipient to understand and it will likely result in a shorter message back.

Unsubscribe. If you receive newsletters or messages you never read, it’s time to unsubscribe.

Create archives. If a packed inbox gives you stress, auto-archive old emails. You’ll still be able to access your messages but they’ll be out of sight.

Send less. If you want to receive less email, send less email.

1

2

3

4

5

6

7

Overflowing email box 59%

Too many phone calls 49%

Inefficient work processes47%

Coworker interruptions 35%

Unnecessary/unproductive meetings 27%

Lack of direction 23%

Biggest barriers to productivity:* Cutting down on email clutter.

Establish a routine. Rather than immediately responding to every message, set up a few specific times each day to check email.

Reuse sent messages. If you frequently send similar messages, save them as templates and use them again.

Use “to:” wisely. Only use the “To:” line for those who need to respond to the message. Everyone else belongs in the “Cc:” line.

Keep it short. Save everyone time by being clear and getting straight to the point. It’s easier for the recipient to understand and it will likely result in a shorter message back.

Unsubscribe. If you receive newsletters or messages you never read, it’s time to unsubscribe.

Create archives. If a packed inbox gives you stress, auto-archive old emails. You’ll still be able to access your messages but they’ll be out of sight.

Send less. If you want to receive less email, send less email.

1

2

3

4

5

6

7*Based on a 2014 CompHealth survey of Physician Recruiters.


11

Minimizing distractions.

Rather than immediately responding to every message, set up a few specific times each day to check email.”

Keep a list of the most important tasks right in front of you

Cut down on external noise

Schedule time for chatty coworkers

Get needed rest for optimal focus

Escape to a quiet place if necessary

Tell others when you need to concentrate

Making the most of meetings.

Efficiency tips from healthcare pros.

Distribute an agenda in advance

Start on time

State the purpose of the meeting

Stay on track and allow time for feedback

Clearly define next steps/assignments

End on time

“

“Do not try to do everything. Delegate if possible. Multi-tasking is overrated.”

“Everyone should be looking at Lean methodology and trimming the waste in their processes.”

Planning your day the previous afternoon is a major help.”

“


The Association of Staff Physician Recruiters (ASPR) is a professional organization focused exclusively on supporting and enhancing the careers of in-house physician recruitment professionals. Its members, totaling nearly 1,400, are employed by hospitals, clinics, physician practices, academic medical centers, and managed care organizations across the United States and Canada.

Benefits of ASPR membership.

Being a member of ASPR places you in the company of other in-house physician recruiters who understand the challenges—and rewards—of the profession. As a member of the only organization run by in-house physician recruitment professionals, you’ll find common ground and an uncommon level of support among your peers and can:

• Develop relationships with physician recruitment professionals across the United States and Canada, and learn from their ideas and strategies.

• Access high-quality educational programs such as the ASPR fellowship certification program, annual conference, free monthly webinars, and quarterly Journal.

• Benefit from a multitude of tools and resources including access to a listservs, an online resource library, a recruiter job board, and benchmarking and salary surveys.

The ASPR Annual Conference

Attendance at the ASPR Annual Conference exposes recruiters to the most up-to-date industry tools and trends available for recruiting, onboarding, and retaining physicians and advanced practice providers. The conference also offers invaluable opportunities to network with colleagues from across the U.S.A. and Canada.

Conference topics are geared toward all levels of experience and involvement—from administrators to coordinators. Any staff member involved in the recruitment and/or retention of physicians will find the experience valuable.

The 2016 conference will take place in New Orleans, May 14–18, at the New Orleans Marriott. Keynote speakers include General Russel L. Honoré and Seth Mattison, the founder and CMO of FutureSight Labs.

More information about ASPR membership and the annual conference can be found at www.aspr.org.

Why become a member of ASPR.

Photo by Darrin Christensen.


13

The Association of Staff Physician Recruiters (ASPR) has long known that our physician recruiters are industry leaders and trendsetters. From our annual conferences to regional meetings, ASPR has historically focused on peer networking and data sharing to further our mission of empowering industry experts through education, research, and engagement.

Emily Oster, an associate professor of economics at Harvard University, recently observed:

“The key to good decision making is evaluating the available information—the data—and combining it with your own estimates of pluses and minuses. As an economist, I do this every day.”

Professor Oster touches on an important point and one I don’t take lightly within our organization: Our strength is two-fold; it’s in our members and in our data. Being data driven creates an exchange of work experience from our members to insights to our organization and beyond. We do this in a myriad of ways, none better than our annual Benchmarking Survey.

Our Benchmarking Survey captures data on compensation, placement, and performance. We’ve seen significant changes since 2010. Our most recent survey (conducted in 2015) found the following:

• The typical responding organization performed 35 active searches during 2014. This demonstrates a steady, year-over-year increase from the 26 searches reported in 2013 and the 20 reported in 2012.

• The number of active searches per recruiter has climbed from 13.3 in 2010 to 19.5 in 2014. These metrics help explain the increase in the typical recruiter’s workload over the past several years.

To study our most recent data, you are welcome to purchase the 2015 survey at www.aspr.org.

Not only is ASPR changing how we look at the physician recruitment industry, we believe we’re influencing our industry more than ever before.

Carey Goryl is the Executive Director of ASPR

overseeing day-to-day operations and working

closely with the Board of Directors.

#DataDriven: How ASPR members are changing the industry.By Carey Goryl

Photo by Darrin Christensen.

comphealth quarterly - locum...in on how they use locum tenens at their facilities. here are a few...

Documents