MD Recruiting: Finding the Right Fit

It's about a year from the beginning of process until a new nephrologist starts seeing patients

This information was provided by the Renal Physicians Association of Rockville, Md. (www.renalmd.org), which has partnered with Renal & Urology News to create this

department. This article is based on material that appeared first in RPA's newsletter, RPA News.

FOR NEPHROLOGY practices bringing a new physician on board and physicians searching for a practice, success ultimately is measured in terms of establishing a long-term relationship that meets the most critical needs of all involved and results in a seamless integration of new clinical staff.

“Everyone needs to think long-term because mistakes can be very costly to all in many ways,”explains Martin Osinski, MBA, a nephrology-focused physician recruiter and

president of NephrologyUSA. “Keeping retention in mind is key because it will cost significantly more to bring someone on, have them leave, and then have to replace them—in terms of goodwill with your patients, the community, your time, and the cost of the recruitment process itself.”

Logistically, physician recruitment takes on average a year to complete, from the beginning of the process until that person actually walks into the practice to see patients. Licensing and credentialing can impact that time frame significantly on either side. The foundation for the recruitment and search relies on both sides' honest expectations.

Avoiding mistakes, Osinski says, depends on a few vital points of clarity. “The practice needs to start by knowing why it is bringing a new person on, and how far they are willing to go financially because you don't make money on a new physician usually for the first year, sometimes two. Also what are your expectations in terms of work ethic, and how do you plan to distribute the workload? If you understand those elements, you're better suited to identify the right type of individual.”

The recruiting practice must lay out clearly its expectations for the candidate, including compensation, workings of the partnership as well as day-to-day operations, long-term sharing in additional revenue streams, ability to generate production, and work ethic.

The candidate

Nephrologists searching for positions have a wide range of options, but finding the right fit will involve time and careful assessments to understand which physician or groups of physicians, in which type of practice, and in which location, will be in sync with that individual's professional expectations, life-style, and spouse and family needs. Physicians just entering practice also may have young families, or may be planning to start families, and need to consider carefully how far they want to live from grandparents and extended family, a long-term personal issue that may not become evident for several years.

“The key element from the candidate's perspective is to think, ‘Is this situation going to meet my needs professionally and personally long term?'” Osinski says. “Look at whether the balance between work and lifestyle is going to make sense for you, and recognize how important a spouse's role is in this long-term decision. If the community and your role in the practice won't allow your family to be comfortable, or if the community's not a good fit professionally or personally for your spouse, the situation will not work out for you.”

Mr. Osinski is a frequent speaker at workshops for renal fellows sponsored by the Renal Physicians Association, a national membership organization for nephrology practitioners.

Candidates must ask questions about the range of clinical expectations and responsibilities, as well as issues surrounding the physician's integration into the practice, compensation, and governance, and be sure they get as specific answers as possible. Osinski listed several overarching topics and some baseline questions.

• Compensation: What is the starting compensation? What is the time to partnership? What are the practice's additional revenue streams and what are the long-term financial prospects?

• Introduction to community: Does the practice have a set plan to introduce you to the community for business development? Will they introduce you to referral sources and community leaders? Is there a mentor-physician to guide you?

• Clinical responsibilities: Will you practice nephrology only, or is there any primary care? What about management of transplant recipients or interventional options? What's the call schedule? Is the call schedule shared equally?

• Business growth: What is the long-term direction of the practice? What are expansion plans in terms of clinical staff, patient load, and ancillary business?

• Partner buy-in: How is the practice governed? Is it shared management among partners, or does one person make the decisions? How are costs calculated? What is involved in becoming a partner, and what are the benefits?

“You need to be direct in asking questions about compensation, your role within the practice, your expectations, time to partnership, and governance, but recognize there are appropriate times to ask specifics,” Osinski said.

“Everyone needs to think long-term because mistakes can be very costly to all in many ways,”explains Martin Osinski, MBA, a nephrology-focused physician recruiter and president of NephrologyUSA. “Keeping retention in mind is key because it will cost significantly more to bring someone on, have them leave, and then have to replace them—in terms of goodwill with your patients, the community, your time, and the cost of the recruitment process itself.”

Logistically, physician recruitment takes on average a year to complete, from the beginning of the process until that person actually walks into the practice to see patients. Licensing and credentialing can impact that time frame significantly on either side. The foundation for the recruitment and search relies on both sides' honest expectations.

Avoiding mistakes, Osinski says, depends on a few vital points of clarity. “The practice needs to start by knowing why it is bringing a new person on, and how far they are willing to go financially because you don't make money on a new physician usually for the first year, sometimes two. Also what are your expectations in terms of work ethic, and how do you plan to distribute the workload? If you understand those elements, you're better suited to identify the right type of individual.”

The recruiting practice must lay out clearly its expectations for the candidate, including compensation, workings of the partnership as well as day-to-day operations, long-term sharing in additional revenue streams, ability to generate production, and work ethic.

The candidate

Nephrologists searching for positions have a wide range of options, but finding the right fit will involve time and careful assessments to understand which physician or groups of physicians, in which type of practice, and in which location, will be in sync with that individual's professional expectations, life-style, and spouse and family needs. Physicians just entering practice also may have young families, or may be planning to start families, and need to consider carefully how far they want to live from grandparents and extended family, a long-term personal issue that may not become evident for several years.

“The key element from the candidate's perspective is to think, ‘Is this situation going to meet my needs professionally and personally long term?'” Osinski says. “Look at whether the balance between work and lifestyle is going to make sense for you, and recognize how important a spouse's role is in this long-term decision. If the community and your role in the practice won't allow your family to be comfortable, or if the community's not a good fit professionally or personally for your spouse, the situation will not work out for you.”

Mr. Osinski is a frequent speaker at workshops for renal fellows sponsored by the Renal Physicians Association, a national membership organization for nephrology practitioners. Candidates must ask questions about the range of clinical expectations and responsibilities, as well as issues surrounding the physician's integration into the practice, compensation, and governance, and be sure they get as specific answers as possible. Osinski listed several overarching topics and some baseline questions.

• Compensation: What is the starting compensation? What is the time to partnership? What are the practice's additional revenue streams and what are the long-term financial prospects?

• Introduction to community: Does the practice have a set plan to introduce you to the community for business development? Will they introduce you to referral sources and community leaders? Is there a mentor-physician to guide you?

• Clinical responsibilities: Will you practice nephrology only, or is there any primary care? What about management of transplant recipients or interventional options? What's the call schedule? Is the call schedule shared equally?

• Business growth: What is the long-term direction of the practice? What are expansion plans in terms of clinical staff, patient load, and ancillary business?

• Partner buy-in: How is the practice governed? Is it shared management among partners, or does one person make the decisions? How are costs calculated? What is involved in becoming a partner, and what are the benefits?

“You need to be direct in asking questions about compensation, your role within the practice, your expectations, time to partnership, and governance, but recognize there are appropriate times to ask specifics,” Osinski said.