Employers: Clinician Recruitment & Retention

Promising Practice Integration

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Recruitment and Retention

Patient visiting the dentist

Finding good clinicians, and keeping them, rate high on the priority lists of most migrant and community health centers. Quality clinicians are crucial to the success of the health center, where the primary goal is providing excellent patient care. Many administrators know the aggravation of coping with the unexpected departure of a clinician. Clinical staff vacancies don’t just affect health center earnings: other providers are stressed by an increased patient load, continuity of care is interrupted, and organizational morale drops.

Health centers serving large numbers of migrant patients face some unique challenges in building a clinical staff that possesses the specialized skills needed to work with a mobile multicultural population. Clinicians in these settings also face unusual demands, such as professional isolation, the complexity of services needed to provide basic health care, and seasonal changes in workload. New providers often find that their training programs did not adequately prepare them for what can seem like overwhelming needs. More seasoned clinicians, on the other hand, are vulnerable to burnout as their idealism fades.

In response to the critical need to both find and hire new providers and retain those that are currently in practice, MCN has created and compiled some relevant tools, listed in the Resource sidebar. A good starting point for organizations is to develop a Recruitment and Retention Plan [1].

Health Center Recruitment and Retention Tools

Where have all the clinicians gone?

Editor’s Note: This is an exerpt from an article written by MCN’s Candace Kugel, which first appeared in Streamline [2], MCN’s clinical publication providing information and resources to frontline clinicians working with mobile, underserved populations.

The recruitment and retention of clinicians are typically overseen by the organization’s chief medical officer (CMO), with the assistance of the CEO, human resources department, and others. The board of directors needs to be kept informed of clinical staffing needs and plans.

Start by taking MCN’s online Recruitment and Retention Self-Assessment Survey [3]. This brief questionnaire serves as a quick self-assessment for health center leadership to determine readiness for effective recruitment and retention of clinical staff and provides a score indicating the level of preparation.
For more in-depth planning, use the MCN Recruitment and Retention Review Tool [1]. This tool provides a roadmap for evaluating aspects of the organization that relate to clinician recruitment and retention, and for developing an improvement plan. It includes the self-assessment survey mentioned above, as well as a Clinician Retention Interview tool.
As part of self-assessment, the National Health Service Corps Retention Calculator [4] can determine retention rates within an organization.
The National Association of Community Health Centers’s Recruitment and Retention Toolkit [5] is another guide for health centers to use in finding and keeping strong clinical staff.
Develop an organizational Recruitment and Retention Plan to define the need, goals and actions that will be undertaken. Sample plans can be found in MCN’s Tool Box [6] under the heading of “Human Resources.”
Bump Up Your Benefits Package with This Free Tool - Candidates for your open physician, dentist and other provider positions aren't just looking at the salary you're offering. They're also looking at the benefits package. The STAR² Center, a program of the Association of Clinicians for the Underserved, is offering a template benefits package [7] and free webinar [8] to help you design deal-closing benefits offerings. Keith Gillies, CFP, and Jennifer Gerarve, CFP, of Wealth Solutions LLC have worked with the STAR² Center to develop these tools. (Note: The tool does include some marketing information for Wealth Solutions, but those pages are easy to ignore or delete if you choose.) Several members of the PACHC and Career Center staff participated in the webinar and found it very helpful. For more information, contact Judd Mellinger-Blouch [9].
Assess Your Recruitment and Retention Practices to Increase Success
The STAR² Center offers a self-assessment tool to help you identify strategies that may improve your success with provider recruitment and retention. Using your responses, the self-assessment tool will provide brief recommendations on those topics you might want to pursue. Many topics covered in the tool have corresponding resources in the STAR² Center resource center. The report generated from this tool can be used with the individual health center recruitment and retention profile to paint a comprehensive picture of workforce challenges at an organization and next steps to address those challenges.
Assess Your Recruitment and Retention Practices to Increase Success - The STAR² Center offers a self-assessment tool [10] to help you identify strategies that may improve your success with provider recruitment and retention. Using your responses, the self-assessment tool will provide brief recommendations on those topics you might want to pursue. Many topics covered in the tool have corresponding resources in the STAR² Center resource center [11]. The report generated from this tool can be used with the individual health center recruitment and retention profile to paint a comprehensive picture of workforce challenges at an organization and next steps to address those challenges.

Recruitment Resources [12]

MCN has gathered links to a wide variety of recruitment resources in our Tool Box [6] under the heading of “Professional Practice and Development.” These include profession-specific (nurse practitioners, pediatricians, family physicians, etc.) job banks and others that relate to specific work settings (rural, regional, etc.).
The National Health Service Corps (NHSC), one of the primary recruitment resources for community health centers, now allows recruiting sites to register online, and conducts Virtual Job Fairs [13].
Similar to NHSC, the NURSE Corps Loan Repayment and Scholarship Programs [14] provide assistance to registered nurses and advanced practice nurses who work at Critical Shortage Facilities.
Developing partnerships with clinician training programs can provide a ready pool of potential recruits. Serving as a clinical rotation site for students and partnering with residency programs through HRSA’s Teaching Health Center Graduate Medical Education Program [15] are examples of “pipeline” approaches to recruitment.
State or regional Primary Care Associations can be consulted for information about other recruitment avenues such as state loan repayment programs or international medical graduates (J-1 Visa Waiver Program).

Retention Resources [12]

Focus on keeping your current clinical staff by monitoring their satisfaction. MCN’s Clinician Retention Interview [16] tool can be used for that purpose. A similar tool is the Stay Interview, from the book The Power of Stay Interviews for Engagement and Retention, which asks employees questions like, “What do you like most about working here?” and “On a scale of one to 10, how would you rate your intention to leave?”
Based on the needs and career goals of clinical staff, provide them with opportunities to teach, conduct a support group for patients, take unpaid leave to work internationally, job share, exercise midday, or work part-time. Remember that not everyone will be motivated by the same incentives or rewards.
Cultivate an organizational culture and practice environment that reflect the organization’s mission and quality health care. Clinicians who have strong leadership and a voice in decision making are more likely to feel ownership in the organization and pride in their association with it.

While this article has focused on the challenges and difficulties associated with recruitment and retention of clinicians, there is much that community health centers have to offer to dedicated clinicians who are interested in meaningful work. By seeking out those who are interested in working with multicultural underserved patients and providing them with the resources that they need to provide quality care, the organization, clinicians and patients will all benefit.

References [12]

NACHC, RGC, and GWU. Access Transformed: Building A Primary Care Workforce for the 21st Century. 2008. http://www.nachc.com/client/documents/ACCESS%20Transformed%20full%20report.PDF [17]
NACHC. The Struggle to Build a Strong Workforce at Health Centers. Fact Sheet, November 2009. http://www.nachc.com/client//WorkforceFS.pdf [18]
Accreditation Council for Graduate Medical Education. “Number of Accredited Programs by Academic Year.” https://www.acgme.org/ads/public [19]
Andrilla C.H., Curtin T., Hart L.G., Rosenblatt R.A. Shortages of Medical Personnel at Community Health Centers: Implications for Planned Expansion. Journal of the American Medical Association, 1042-9. 2006.
Finnegan, Richard P. The Power of Stay Interviews for Engagement and Retention. 2012. http://www.c-suiteanalytics.com/ [20]