Miracle Cure: How one nonprofit is tackling Cincinnati physician shortages

Like you, Ann DeClue gets junk emails. A lot of them. But beyond the faux pharmaceutical ads and unmentionable enhancers, she’s facing another scourge—a slew of emails from recruiters, some of whom she contacted the last time she was job hunting.

Currently settled into an internal medicine position with Premier Health in Lebanon, DeClue says she signed a contract and is “very happy” with her job. Yet the calls and emails keep coming in weekly, and sometimes daily.

Scanning her email while we spoke, DeClue found three recruitment offers from the past five days: “Any little nugget of possibility, and they’re going to try to contact you.”

Yet DeClue doesn’t seem annoyed. She laughs at the emails that list her name incorrectly, sighing at the repeats.

With the country in an uproar over the Affordable Care Act (ACA), and President Obama going as far as taking an interview with Zach Galifianakis to get young people to sign up, DeClue is one of many physicians who understand just how valuable a commodity she’s become.

But physician scarcity was a problem in Cincinnati long before the ACA. Low salaries, a decaying downtown and quibbling battles between insurance companies and health systems were driving doctors to Dayton, Indianapolis and Louisville a decade ago.

And so business and community leaders banded together, launching Cincinnati MD Jobs (CMJ) in 2004 to address physician flight. As part of the Cincinnati Health Collaborative, the tiny nonprofit is still cranking out services today—but now it’s focused on providing employer-independent recruitment services. A 2013 study found that greater Cincinnati lacks nearly 200 primary care physicians today, and will only need more as newly insured residents—the report cites an estimated 124,000 in nine counties by 2020—seek free preventive services and primary care.

Quality of life key to recruitment efforts

Cincinnati MD Jobs is a non-commission-based physician recruitment agency that serves a range of health systems, which pay a single, annual, sliding-scale fee for the service. “It’s equivalent to a bit less than what they’d pay for one hire if they went through a physician recruitment firm,” says Heleena McKinney, a recruitment coordinator for CMJ. She says recruiters charge about $30,000 per hire. (Cincinnati health system recruiters interviewed for this article declined to provide specific figures, citing variable costs and services.)

In addition, “using outside firms gets an organization ‘warm bodies’ but doesn't always take into account whether the candidate is a good match for the organization's culture,” says Shawn Kessler, who helps employers across the U.S. learn to attract and retain physician employees as a senior strategist at ab+c Creative Intelligence.

Cincinnati still faces a shortage of primary care providers, but we’re now seeing less physician flight, McKinney says. She travels to career fairs, teaching newly minted MDs about Cincinnati employers and addressing common concerns: Is this a good place to settle down? Will my kids be happy? Are there things to do?

Kessler says that while younger physicians have an eye to financial compensation, their older counterparts care more about an institution’s reputation. But physicians of all ages, per Kessler, value one thing: work/life balance.

For Ann DeClue, that balance meant finding a job north of the city which would allow both her and her husband a comfortable commute. To help her coordinate a move from Maryland, CMJ personalized their services, helping her rework a résumé, which led to a fruitful connection with Premier Health recruiter Carol Bidwell. “You get the right info without people trying to place you in northeast Ohio if you specifically say southwest Ohio, so it’s much more personalized and relevant,” DeClue says.

Based in Dayton, Bidwell counts CMJ as one among several tools she uses to attract physicians to the four hospitals that comprise Premiere. She uses outside recruiters only for difficult searches, and prefers contingency firms, paid only when a physician is hired. After 13 years, she’s learned to identify which candidates would be willing to move (or return) to southwest Ohio.

“They look for things that are important to them and their families: neighborhoods, high-quality and reasonable cost of living, and the most important thing is family ties,” Bidwell says. A range of housing options (e.g., farmland, new housing or established neighborhoods), a variety of school systems, and strong area universities and medical schools might tip the scales, but geography and lack of family ties are harder to overcome.

Bidwell’s observations were echoed by Robin Eckhardt, director of physician services for Mercy Health’s southwest Ohio region. She named another tipping point: “If we can just get a candidate to visit, we can win them over. That was my personal experience when I visited from Chicago during my interview process, and I often share [that] with candidates, and it resonates with them.”

Spotlighting a new-and-improved Cincinnati appeals to natives

Not to be forgotten are native Cincinnatians who have left the city for medical training. According to Kessler, “Physicians are creatures who enjoy familiar surroundings. If you can find a candidate who trained or grew up in the region and moved away, s/he is a prime target.”

But that presents a challenge for Cincinnati. “We have Cincinnatians who left eight to 12 years ago and haven’t had the opportunity to find out how much the city has changed. … We reach out to them to invite them to a career fair, or just share that information.” McKinney explains. “The people who are coming to the city now haven’t been privy to the updates downtown, etc., so we let them know how different it is from when they were in high school.”

Beyond bonus negotiations (easier if your employer’s not paying a recruitment fee), malpractice rates, bidding wars and contingency fees, CMJ has a plug for any audience. For locals, it attracts talented doctors who can stave off the feared shortage of PCPs. For physicians, it offers an impartial look at local employers and a chance to address personal concerns face-to-face. For employers, it strengthens the pipeline by sweeping local residents toward local jobs, greeting new physicians in the community (armed with resources for everything from real estate agents to restaurant advice) and pounding the pavement to meet physicians who might otherwise wave the city aside. And for internists like Ann DeClue, it’s one more way to avoid those pesky emails.

Robin Donovan is a freelance writer specializing in health and medicine.
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