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Primary Care Docs Are Getting Bigger Offers From Rural Practices

For the first time in The Medicus Firm’s history, search and placement activity in urban and metropolitan areas outpaced that of rural (pop. 25,000 or fewer) and mid-sized communities. Now that urban and metro practices are putting additional resources into the battle for primary care physicians, the competition has never been so intense.
By Andrea Clement Santiago |

Most healthcare professionals are already well aware that primary care physicians are in great demand, and recruiting these physicians is becoming increasingly challenging. The American Association of Medical Colleges (AAMC) projects a shortage of 31,000 primary care physicians by 2025.

How is this demand impacting the recruitment and retention of primary care physicians? Primary care search and placement activities comprise an increasingly large proportion of all search and placement activity among facilities and search firms alike, including Dallas’ The Medicus Firm. Nationwide, 36 percent of all placements made in partnership with The Medicus Firm in 2015 were primary care physicians.

To further illustrate the growing demand, family medicine and internal medicine physicians were the top two most frequently placed providers for the year, followed by hospitalists and physician assistants. Only 8 percent of The Medicus Firm’s placements were in private practice settings. A whopping 92 percent of the firm’s placed candidates were hired as employees by hospitals, health systems, or medical groups.

Furthermore, Texas clients placed the most doctors, followed by Ohio, Tennessee, California, and Georgia.

Competition for Primary Care Physicians and Advanced Practitioners

Most likely, your medical facility is actively recruiting primary care physicians, or will be very soon. Facilities must be ready to execute aggressive search strategies with a multi-pronged approach and a variety of resources, including search firms. Even the traditionally popular and desirable destinations such as metropolitan or coastal venues are now forced to retain firms to fill primary care openings. Gone are the days when the in-house recruiter could simply post a physician job online, sit back, and wait for doctors to apply.

For the first time in The Medicus Firm’s history, search and placement activity in urban and metropolitan areas outpaced that of rural (pop. 25,000 or fewer) and mid-sized communities. Now that urban and metro practices are putting additional resources into the battle for primary care physicians, the competition has never been so intense. Recruiters and administrators in rural areas must step up their game even further, to attract and sign the doctors they need.

Of course, there is only so much that one can control in a recruitment scenario. Population, amenities, weather, schools, geography, crime, etc. are not going to change, obviously. Therefore, recruiters and administrators must focus on what they can control, which includes primarily three factors: recruiting resources, search process, and the compensation package.

Facilities must utilize as many resources as possible from a financial and logistics standpoint. Resources include internal and external recruiters, marketing campaigns, job boards, and more. The process includes conducting thorough marketing, screening and presentation strategies, and hosting engaging, comprehensive interviews. It is also paramount to act promptly on candidates of interest, and extend a viable contract quickly, as soon as possible after concluding the candidate’s interview.

Compensation includes base salary, bonus structure, signing bonus, relocation bonus, benefits, and perks such as flexible schedules, student loan repayment, and more. In 2015, clients of The Medicus Firm relied heavily on signing bonuses and relocation packages, particularly in rural areas, which offered the highest base salaries and bonuses on average.

The average signing bonus for family medicine and internal medicine candidates was $22,846 in rural locations, and $17,143 in urban areas (with a population of a half million or more).

Additionally, the average offer to primary care physicians (internal medicine or family medicine, including base and signing bonus) is $245,875, while the urban average is $213,840. From a regional perspective, regardless of community size, the south/southwest region offered primary care physicians the highest base salaries on average, while the southeast/Carolinas offered the lowest, along with academic institutions, which offered around $192,000.

“Be careful when looking at regional averages,” advises Steve Look, executive vice president of The Medicus Firm, “Even if you are offering the average in your region, average may not be good enough to get the physician you need, if you are in a lower-paying region. When recruiting high-demand specialties such as primary care, facilities are competing on a national scale. If your physician search has gone unfilled for more than several months, you may want to look at offering above the average for your region, to successfully compete with a greater proportion of higher-paying opportunities.”

In some locations, advanced practice providers are helping to meet primary care needs, and an increase in PA placements seems to confirm that. Physician assistants were the fourth most placed provider among The Medicus Firm’s clients in 2015.

“The surge in placements of physician assistants appears to validate the expected reliance on advanced practice clinicians to meet the increased demand for primary care services,” Look explains. Additionally, the average salaries offered to physician assistants and the utilization of signing bonuses for PAs has increased dramatically over the past few years. The average salary offered to PAs who became hires of clients of The Medicus Firm in 2015 was $112,680.

What does this all mean for those who are in dire need of primary care providers? In sum, when in doubt, money talks.

“Compensation in several market categories now exceeds the MGMA national median. This is proof positive that ‘median’ is no longer the benchmark for primary care compensation nationally. An offer in the median range actually puts clients in many areas below current market standards,” says Look.

“When recruiting physicians, you must look beyond what your neighboring hospitals are offering, and consider how you compare on a larger scale, with practice opportunities across the country, because many of your candidates are doing just that,” Look concludes.

Andrea Clement Santiago is the Director of Communications and Media Relations for The Medicus Firm, a national retained healthcare recruiting company based in Dallas, TX, with an additional office in Atlanta, GA

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