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Another Physician Shortage – Really?

From the early 1930's prognosticators reported physician shortages. Several times governments, hospitals and the populous prepared for shortages that never materialized. One shortage prediction actually resulted in a physician surplus. No wonder today's predictions of physician shortages are met with less than a dramatic response.

The Third Party Physician Recruiting industry is often the source for much of the data associated with physician demographic and employment information. Each year the surveys and studies quoted are by those tasked with finding employment for physicians. In an industry where there is so little trust between third party recruiters and those they work for it is no wonder that there is some skepticism.

However, organizations outside the recruiting industry are confirming what the industry is reporting. The Association of American Medical Colleges predicts that by 2025, the US health system will have 46,000 fewer primary care physicians than it needs. The Bureau of Labor Statistics predicts there will be 212,000 physician openings by 2014 due to growth and net replacement of retiring physicians. That number represents more than 25 percent of the current physician work force. Adding to the shortage is the aging population. The National Ambulatory Healthcare Administration says people ages 66 and older average six physician office visits per year; individuals ages 46 to 65 average 5.4 visits annually; and people 25 to 35 years old average 2.2 visits a year. Increasing numbers of older patients mean heightened healthcare demand (PhysiciansPractice.com).

My father lives in a community of about 111,000. He reports wait times of up to six (6) weeks to see his primary care physician and then he frequently sees the PA or NP. In 2008, he experienced extreme fatigue. His primary care office suggested some blood work to see what was going on and "waiting to see how he was feeling in a few days." Fortunately my mom was not "waiting to see." She insisted they drive 30 miles to see a Cardiologist. In less than a week, he was on the table for bypass surgery. Good thing he did not wait on his primary care doctor.

Hype or not, the physician market is dramatically realigning as:

• The list of hospitals and practices looking to recruit grows daily.

• The shortage of Internists or Family Practitioners in rural areas or densely populated cities is expanding to areas previously unaffected.

• Increasingly more graduating physicians are opting to specialize

• The future of health care reform will move delivery of primary care from the emergency rooms to the practice office as the uninsured receive medical coverage.

• The recent health care reform and emphasis on government spending is causing doctors to move to employed positions in hospitals and facilities to avoid the risks of private practice.

• The shortage notwithstanding, many facilities are still not interested in foreign medical graduates or older more experienced physicians.

So, empirical evidence and the experts seem to support the shortage. If you are a doctor looking to move or one about to graduate, how does this affect you? What are your thoughts?

What's in a Name?

What's in a Name?

Apparently a lot! You told us that you love the functionality and service of epasonline.com, but the name was confusing. We do not want confusion. Therefore, while we were upgrading the site and enhancing the tools and technology, we thought it would be a good time for a name change:

Introducing: eDoctorJobs.com: same great tools and doctors, less confusing name.

At www.eDoctorJobs.com posting new jobs is even easier. The updated technology provides a state of the art job board. Doctors, clients and the search engines will readily connect the name with the service and you can continue on finding candidates and filling jobs.

Just give us a shout if you would like assistance setting up your opportunities. We are happy to help and to acquaint you with the new features. We are sure you are going to love www.eDoctorJobs.com.

Five Questions to ask Yourself About Your External Recruiter

Can you imagine needing a CPA or attorney and getting a phone call from a marketer? Can you imagine paying a retainer to a law or accounting firm and not meeting the lawyer or CPA doing your work? Can you imagine not knowing if they passed the CPA exam or the Bar? Wouldn't you want to know if they kept up on their continuing education? Can you imagine the marketer for that company calling to tell you that it was going to cost twice what they originally told you?

Of course you can't. When you need the services from a professional firm, you interview the professional, not the marketer. You talk to the CPA and discuss your situation, your position, your desires. You talk about how he or she will approach your relationship. You determine that they have passed the appropriate exams and training for their profession. You choose each other.

This is the way that professionals do business. When you last signed up with a third party physician recruiter did you meet the recruiter before you signed the agreement? Did you choose your recruiter from a list of biographies? Did you even have any input on the choice or the level of experience? Did you ask if they passed the ethics exam for their profession? Did you ask about their training?

In most cases third-party physician recruiters contact you via marketers, get you to sign sometimes a hefty contract and don't introduce you to your recruiter until the ink has long ago dried. Does it make sense? You tell me.

Why use a Physician Recruiter?

I began my career in healthcare recruiting in the role of a third party recruiter. Helping physicians find jobs is my passion. This industry is full of seasoned professionals, each promoting their version of the recruitment process. One company proudly touts their 44 step recruiting process. Impressive? I moved to the client sales side of the business and I currently work with hospitals and facilities who are trying to identify the best tools and methods of finding doctors. The truth of the matter is that doctors are looking for jobs. The methods they use to accomplish this are the real question. Some may do their searching using their own resources, trying to get in touch with the hiring authorities directly. They might use recruiting resources like ePAS or one or more of the many job boards. Some decide to use a recruiter and leave all of the contract/travel negotiations and arrangements up to that third party.

Doubtless third party recruiters have their place, but are they necessary? In fact consider this, if a hospital or practice recruiter has seven potential candidates to review and four will have large fees payable to a third part recruiters, which candidates will be the first selected? Correct: the three without large placement fees attached.

Finding that new opportunity as a Physician, Nurse Practitioner, or Physician Assistant does not have to be hard. Many candidates successfully manage their own job search. Some things to consider are:

1. Job Boards – Posting information on these sites will allow recruiters to mine your information. Think judiciously about the number and type of sites you choose. Remember that data on the internet can live long after the search is filled. Job boards can be excellent places to see what is available in your market.

2. Homework - Decide where you want to live and do some market research. Get realistic data on cost of living, housing, and amenities. This data is all over the internet. Then review the open opportunities and get a feel for salaries and benefits. Again, this data is available from sources like the AMA and the MGMA at no cost to you. Hospital websites and internal recruiters can provide vast amounts of reliable information.

3. Email – Managing email can be a daunting task. Sift through those from third party recruiters, and only reply to those that come from actual hiring authorities. Sending a polite reply to a recruiter is important. (The person on the other side could be the CEO from the hospital.) A hiring entity that displays an interest in you is meaningful even if it is not the exact job you want. This is a small industry and people frequently move between facilities.

4. Voicemails -You will be getting phone calls, a lot of them. Don't let this scare you; these people want to talk to you about a job. One option is to use your voice mail to ask them to send you an email and schedule a time for a phone call.

Your job search doesn't have to be complicated by a recruiter who may be interested in channeling you to an opportunity that is not really what you want. Remember, third party recruiters are paid at the time you are placed at the job they have posted. Not necessarily the job that is right for you.

Take a hint from Nike and "Just Do It " As more and more physicians turn to services such as ePAS hospitals are more likely to consider those candidates first rather than those that come with a big placement fee. Ensure that your qualifications aren't lost behind those big fees. Comments are always welcome.

jknighton@epasonline.com @joe_knighton

The Evolution of Physician Search

As we approach the 10th anniversary of September 11, 2001, most of us recall vividly where we were on that fateful day. The internet allows virtually limitless access to video clips, stories, and memories of the tragedies that played out. I find it as painful to watch now as it was then and our thoughts and prayers go out to those who lost loved ones on that day.

Reflecting back ten years reminds me that we entered the physician-recruiting world that year also. As a small firm, we watched the events unfold from our first company offices. September 11, 2001 changed the way many of us viewed the world. This last decade has also dramatically changed the way we work. Our first company office was "networked" but we wondered who really needed internet access? In 2001, the "Blue Book" provided us client data in hard copy form. The US Postal service connected us to doctors via thousands of pieces of printed and stamped mail (aka personalized invitations).

In 1998, Google's creative founders wanted, "to organize the world's information and make it universally accessible and useful". Google, the company, went public in 2005. "Google" the verb became official in the 2006 editions of the Oxford and Merriam-Webster's dictionaries. In 2001, Wikipedia, the on-line encyclopedia, revolutionized research. LinkedIn, the professional on-line connection site, arrived in 2002; today it reports 120 million active users. Facebook began connecting people in 2004, today boasting 750 million active users. YouTube gave us videos and television shows on line starting in 2005 and Twitter first tweeted in 2006.

We can call the children tagged as "Generation Z" "digital natives". Digital communication has existed for their entire lives. Those of us from "Generation Old" remember when we questioned the endurance of the internet. Some of us are still surprised it lasted.

The internet revolutionized access to physician job information and candidate data. While initially, our industry was skeptical, recruiters and doctors evolved. Email became the preferred mode of communication and database companies exploded, allowing users to search candidates and jobs with ease. However, sometimes you can have too much of a good thing. "Google" physician jobs today and you get 1.9 million entries. Data posted on-line never dies and searching candidate databanks today is as time consuming as making cold calls was in 2001, not to mention pricey! Hundreds of affiliations and companies host databases and charge for the privilege of accessing their candidates. Many entities spend $15-30 thousand dollars a month for such access.

Add to that, Facebook, LinkedIn and Twitter accounts. We can 'Facebook, 'Tweet', and follow just about anyone 24/7. Many companies have dedicated employees tasked with the management of social media. If your IT guy is older than about 35, it may be time to get some new blood.

What does all this mean for physician search and doctor jobs? Organizations must evolve and find new ways to make their product "Value added". It will be interesting to watch the evolution. Comments?

An Insider’s Look at Physician Recruiting

Physician recruiting as an industry can trace its roots to the 1980s. Today, estimates place the number of physician recruiting firms at between 4500 and 5000. The vast majority of these are very small, local firms or individual recruiters working from home. The National Association of Physician Recruiters, founded in 1985 has attempted to standardize the industry and provide a much needed code of ethics.

Firms generally fall into one of three categories. Retained firms receive upfront fees and a placement fee when a physician is found. Contingent firms are paid only at the time of placement. The third category has resulted from the growth of the internet and social networking. These companies provide databases for posting positions and CVs, they offer a variety of candidate screening service levels.

As naïve CPAs we entered this industry ten years ago, believing that the placement of physicians would be similar to the executive placement industry. We were quickly disabused of that notion. In our combined 50 years of business experience we have never seen a business relationship as contentious as that between the internal physician recruiter and third party recruiting firms.

On the Fox Business Network, Bill O'Reilly claims that his show is "The No Spin Zone." It is my plan for this blog to be just that for physician jobs. Our industry is full of organizations who claim to be "The Experts" in physician recruiting. Here you will get an inside look at what I have learned and experienced in my 10 years in the industry. Sometimes it may be irreverent and perhaps I will irritate some along the way. Our industry is changing and so we should be willing to take an honest look at ourselves. Hopefully we will have some fun along the way. I welcome your comments.

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