Field-tested strategies for physician recruitment and contracting.

The aging of the U.S. population presents a challenge to American hospitals and health systems. Not only are patients aging, but their care needs are becoming more complex as well. Compounding the problem is that many physicians are reaching retirement age, and their younger contemporaries (those born on or after 1965) tend to have a different approach to medical practice, valuing a work–life balance. In 2005, approximately 900,000 physicians were practicing, and of this number 36 percent were at least 55 years old and nearly 170,000 were at least 65 years old (Runy 2008). The Office of Inspector General has cited physician scarcities in various specialties, including obstetrics, family practice, general surgery, neurosurgery, orthopedics, urology, otolaryngology, cardiology, gastroenterology, neurology, and oncology. Cooper (2008, 13) predicted a 20 percent physician shortage within the next two decades, the effect of which may be especially detrimental to rural hospitals. According to a 2007 Merritt Hawkins survey, the average net inpatient and outpatient revenue generated by physicians varied from $1.43 million (family practice) to $2.66 million (invasive cardiology). A healthcare organization’s ability to recruit and retain physicians affects its ability to deliver mission-critical care to its community. Limited physician supply and growing demand for their services, coupled with multifaceted process requirements, can make physician recruiting seem like a house of cards, which is painstaking to construct and can be destroyed by a single careless remark or an improperly executed process. In this column, we discuss field-tested strategies for improving physician recruitment and contracting.