Radiologist Recruitment and Retention: Misconceptions and Best Practices

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Chip AndersonRecruitment and retention of the right physicians is one of the most critical practice-building activities in which radiology groups engage, but misconceptions and missteps abound. While the market for new radiologists is less tight than in recent years, practices must exercise caution to ensure they are hiring the right staff members—and must avoid attrition by developing strategies and procedures for effective physician retention. With market and economic changes also come changes to best practices for recruitment and retention, of course. For instance, just a few years ago, it was becoming increasingly common for radiology practices to provide short paths to partnership in order to remain competitive in recruiting qualified young physicians. With the market less stringent today, practices might want to reconsider rushing their newest members along the partnership path, especially if the future independence of the group is uncertain or in jeopardy. Recruitment: The Hard Sell Radiology groups should remember that recruitment is, at its core, the process of selling the practice to the best possible candidates. To that end, the group’s recruitment committee should be chosen carefully, to include current physician leaders who are outgoing, are thorough, and are strong communicators. Practices cannot effectively select job candidates based on CVs alone; a candidate’s qualifications and credentials are important, but equally important is whether he or she will fit within the existing culture of the practice. Practices should bring potential new candidates to town for in-person evaluations at which the practice has the opportunity to evaluate each candidate’s work style, bedside manner, ability to get along with colleagues and technologists, and other personality-based elements. They should also go beyond candidates’ references—people typically list only positive references, after all—by tapping the experiences of colleagues from their professional or academic networks who might know the prospective recruits. Equally critical are spending time with candidates outside of work hours and engaging their spouses in the process. If a new recruit moves his or her family to join the practice and the family winds up dissatisfied with the change, the recruit might go just as quickly as he or she came. Like all sales processes, recruitment should be proactive. Practices need to look ahead to anticipate their future staffing needs and should be talking to desirable candidates while they are still in medical school, if necessary. Ultimately, the priority that practices should have in mind is stability: Ideal candidates will contribute to (not disrupt) the long-term stability of the group. Fortunately, stability is what many candidates are looking for as well: Strong practice leaders, good hospital relationships, and a collegial environment will be as important (if not more important) to them as standard requirements such as competitive pay and benefits, especially in an era of uncertainty regarding radiology’s future. Practices can afford to be choosier about their new radiologists in this market, and they should not rush to fill a position if the right candidate has not yet been found. Filling in with extra hours or locum tenens coverage until the best recruit becomes available will pay dividends down the line. Retention: Staying Competitive Retention is similar to recruitment in that it requires practices to stay competitive in what they offer their physicians, both in terms of compensation and benefits and in terms of intangible elements such as culture. Once again, stability is a key component in today’s rapidly changing health-care environment: Practices that work to grow their market shares and deepen their business relationships will see that stability reflected in the makeup of their radiologist staff. Today, many practices also have implemented mentorship programs that pair newer radiologists with older colleagues for guidance and professional development. The advantage of these programs is that they provide an organic means by which to address the most common complaints that can drive away talented physicians: having no recourse for issues that need to be addressed, having little support for their professional development, and feeling that their opinions are unheard by practice leaders. A common misconception regarding retention is that losing a radiologist is always a bad thing. In fact, practices should have policies and procedures in place for identifying troublesome, disruptive radiologists—and they should have a structured timeframe in which they let these physicians go, if they do not improve. In these cases, practices actually bolster retention by creating a more positive work environment for the staff members they would like to keep. A bad physician can become like a virus, infecting hospital relationships, referring-physician relationships, and the culture of the group; getting rid of these bad apples helps to maintain the stability of the group. Practices can (and should) learn from the radiologists who do leave them. Few practices have a formal exit-evaluation process, but all would do well to establish one. It can yield surprising insights into the issues that might drive away talented physicians, and it can help practices take a more proactive approach to retaining staff in the future. Chip Anderson is a director of practice management with Medical Management Professionals (MMP).