What better image for the “speed” of Government business than the Sloth!

The sloth is an interesting creature; the slowest animal on earth with a maximum speed of .0003 miles per hour. Even slugs are faster. However, the Sloth’s seemingly “slothful” behavior has an explanation. They have an incredibly slow digestive system. It can take them up to a full month to digest a single leaf! As a result, they have only two choices, eat more or move less. Since they have been on the earth for sixty-four million years, their choice to expend as little energy as possible seems a winning strategy.

Government business is slow. It is the nature of bureaucracy to have a plodding pace and comedians have gotten a lot of mileage out of this criticism including Disney. But it seems that GOVT Contractors adjust their pace of business to the bureaucracy layering an additional delay upon an already infinite timeline. In our experience, very few contractors have a sense of urgency about what they do…

Recently I ran across a new Contractor whose company name is almost an oxymoron in this environment, Fast Enterprises (they refer to their staff as “fasties’). If so, they are an anomaly in my experience.

GOVT staffing contractors have synchronized their speed with the speed of GOVT business almost like the Sloth to its digestive system. They pursue business deals, candidate closures, and business development with the earnestness of a glacier. Positions are open for months, sometimes years with seemingly little concern to fill them. And while we have built our company specifically for speed, we have found that no one really cares if you are fast or not.

One of my colleagues suggested that the benefit of being slow is that you don’t make mistakes. A word to the wise. Even the Sloth makes mistakes. On occasion, due to the fact that they move in slow motion, a sloth mistakes his own arm for a tree branch and falls to his peril to the jungle floor!

If you have open positions to fill, when you get around to it, give us a call – 888-406-9485

The First 72 Hours in Hiring Are Critical

Whether it’s solving a crime, responding to a disaster, treating an injury, or search and rescue, the first seventy-two hours are critical. As it turns out, the same is true in recruiting. Failure to understand the crucial first seventy-two hour cycle in passive candidate recruiting is a common reason for candidate fall off and yet another reason that the hiring process must be streamlined and swift.

The “burned-over” district…

Fifteen percent of employed adults are actively seeking employment at any given time. The competition for this low-hanging fruit is intense. So intense, that the candidates in high-demand career fields find the attention overwhelming. An active candidate may receive up to fifty calls a day, particularly after posting a resume. Many of these active candidates are chronic job seekers with checkered work histories and besmirched backgrounds. All are heavily recruited.

The fresh, green fields…

Meanwhile a full eighty-five percent of employed adults are happily and productively working with no interest in new opportunities. These are the choice candidates and the most difficult to find and recruit. But these are also the employees who are most likely to be happy in their next job and to stay for a long time. This is the province of the top notch professional recruiter who is not only able to locate and contact them, but sell them on considering new possibilities. This is the big leagues.

The window for harvesting….

Like picking Black Walnuts the window for harvesting passive candidates is short. Many hiring authorities fail to get this for the following reasons…

1. Hiring authorities are still in the mindset that they have the goods; that the job is the commodity rather than the employee. But these passive candidates do not NEED a job, they are happily working and well paid in their current position. We are in the position of having to sell them on us. Recently we recruited a physician for an Alaska assignment and the client asked us, “so why is he interested in Alaska?” The accurate response is: “He was not interested in Alaska. In fact, he was not looking for a job. If he relocated he wanted to move to Arizona! We sold him on Alaska and a substandard salary. That is what good recruiters do.” However, once we get them excited about your position that enthusiasm has a short shelf-life….
2. Employers tend not to understand the chemistry of passive candidate recruiting. Passive candidates are frequently almost offended when asked if they are open to new opportunities, after all they are not on the market! But once a savvy recruiter convinces (activates) them that they should consider an alternative, it doesn’t stop there. They almost immediately begin to look around, which means they start online window shopping. The result? An activated passive candidate very quickly becomes an active candidate. They view jobs, upload a resume, set a job alert and search online for your job, one among many.
3. Most hiring timelines are excessively long – An activated passive candidate’s enthusiasm for your new opportunity lasts for about seventy-two hours. If they don’t get an interview, interview and receive no feedback, or are forced to jump through too many preliminary hoops, their interest in the new opportunity begins to wane. Meanwhile, other companies and recruiters are showing interest in them and their current employer may notice the change and make a counter offer. Disillusionment begins to set in.
4. The GOVT hiring timeline is almost eternal – If the department has the right of review they may take 10-20 days providing an approval. Many GOVT Contracting Companies take days or longer to put together an offer. Then credentialing may be necessary adding another 30+ days. This protracted process puts the candidate at risk of receiving a better offer or simply second-guessing the decision, deciding to stay put, and not move forward with the new opportunity.

Best practices would indicate that we should capitalize on the first seventy-two hours and be prepared to make hiring decisions and issue offers and contracts within the first three days realizing that this process is not about us – it’s about them. The first seventy-two hours are not only critical in rescue and recovery, but also to the hiring process. We need to be prepared to:

• Remove as many preliminary barriers to review and approval as possible
• Put the review, interview, and decision-making process on a short timeline (24 hours)
• Have offers and contracts prepared and ready at hand to facilitate the candidate’s commitment

Make the most of the first 72 hours.

The challenge of managing the protracted credentialing and security timeline is covered in a related article here….

Can’t hire fast? – you lose!

More on the primary care shortage and its impact on Government Contracting

This morning we spoke with a Family Practice Physician who confirmed what we all must know – there is a severe primary care shortage in the U.S.

The physician candidate in question just relocated to Colorado and received a job offer immediately over the phone, sight unseen. During the credentialing process for the new employer (NOTE – they have not yet met her) they called to ask her if she would accept the Medical Director Role. Not having been “on the market” recently, she was literally blown away! In her words, “it was even difficult looking for a new position because I get so many calls every day it is hard to figure out what is real.”

In this competitive market the race goes to the swift. If you cannot hire quickly you will lose candidate after candidate to employers who are more nimble. The company in the above story is not a small multi-specialty group, as you might think, but a billion dollar provider in 36 states. However, they understand the concept of FAST.

In the Government space there are some things outside our control, however, we discover that many contractors do not understand the concept of FAST and have not streamlined their processes on the front end to lock physicians down quickly.

KurzSolutions provides many services to accelerate revenue including helping you develop a quick hiring solution that includes expedited credentialing. Why not give us a call to find the competitive edge you need to win in the war for talent?  800-506-0884

Sleek. Agile. Fast.

It’s not an advertising slogan for a motorcycle or the name of a video game. It’s how you need to hire.

Five Essential Keys to Recruiting Physicians for the DoD Market

Physician recruiting in the DoD space is a unique phenomenon. We are chronically selling physicians on working in remote locations for substandard salaries during the most severe physician shortage in U.S. history!  Often our primary sales features sound similar to “mom, apple pie, and the American Flag.” Although there are other “features” to sell (see my blog on the subject), competition for available physicians is stiff and the recruiting challenges abound. If we want our men and women in blue and green and their families to have the best care possible, we need to ensure that we have the best recruiting strategies in our arsenal.

Obtain a copy of KurzSolutions, Whitepaper #203 –  “Five Essential Keys to Recruiting Physicians for the DoD Market”  – click here

There is a critical shortage of access to care for geriatric psych patients in the U.S. that is only surpassed by the shrinking size of the pool of geriatric specialists. The American Association for Geriatric Psychiatry has seen a decrease in the number of members over the past five years due, primarily, to a higher level of retiring providers vs. geriatric specialists entering the workforce. Geriatric fellowships number about 46 nationwide, each turning out one specialist per year, and only two new fellowships are being launched in the near term. Current rates will result in a continuously-shrinking workforce between now and 2022, just when the geriatric population of boomers begins to swell the patient ranks.

In 2010, President Obama signed in to law the “Patient Protection and Affordable Care Act,” intended to address the grim future for geriatric patients by authorizing two studies of the issue by the Department of Health and Human Services and the Government Accountability Office.

Meanwhile, all champions face significant challenges to providing adequate geriatric care:

• Scarcity of Expertise – 1,700 geriatric specialists nationwide
• Clinical Complexity requiring intensive management, involving considerable risk of adverse outcomes, and medical complications
• Financial Disincentives – inadequate Medicare compensation is putting many geriatric practices out of business.

The most surprising fact related to the case is the high satisfaction level of physicians working in the geriatric space! A study by the UC Davis School of Medicine discovered “that geriatric physicians were more likely to have very high career satisfaction than 32 other specialties” (Archives of Internal Medicine).

The Silver Bullet

We represent the established leader in geriatric care in the northeast and a new paradigm (care model) that addresses many of the aforementioned challenges. Improving quality of care requires a vocational commitment to geriatrics from top to bottom in the organization and a commitment to specialization. Our emerging geriatric brain trust involves multi-disciplinary teams of psychiatrists, psychiatric mental health nurse practitioners, psychologists, and family nurse practitioners led by an administrative and executive team that has mastered the space, including billing and reimbursement. We focus on back office, our providers focus on what they do best – patient care.

We are experiencing 400% growth in evidence that we have created a facilitating environment for change and are at the transformative learning stage in the paradigm shift. Why not join a winning team?

FOR DETAILS CALL – ROB KURZ 800-506-0884 X5647

Physician dissatisfaction is at an all-time and the timing could not be worse. “The lack of an adequate primary-care infrastructure in the U.S. is a high obstacle to creating a high-performing healthcare system,” says David Bluementhal, President of the Commonwealth Fund, a healthcare research foundation. The Association of American Medical Colleges estimates the United States will be short 45,000 primary-care doctors in 2020, compared to 9,000 today. All this just when thirty million additional patients are entering the healthcare space through Obamacare.

A good friend of mine, a Pulmonary Care Physician, predicted this problem recently at a dinner party. In his words, “Whether you like nationalized healthcare or not, the current infrastructure is not adequate to provide for the additional patients that will be entering the marketplace.” Fact is, the American healthcare system is already over-stressed resulting in a high level of dissatisfaction among physicians with serious implications for the system.

In 2012 an Urban Institute study of 500 primary-care physicians found that 30% of those aged 35-49 planned to leave their practice within 5 years. The rate jumped to 52% for those over 50. A more recent survey by The Physicians Foundation revealed the following:

• More than 60 percent of physicians would retire today if they had the means.
• Physicians see 16.6 percent fewer patients per day than they did in 2008, a decline that could lead to millions of fewer patients seen per year.
• More than 52 percent limit Medicare patients’ access to their practices or plan to do so.
• More than 26 percent have closed their practices to Medicaid patients.
• Physicians spend more than 22 percent of their time on nonclinical paperwork, resulting in a loss of some 165,000 full-time equivalent (FTE) physicians.

A recent survey by Medscape/Web M.D., also shows dissatisfaction among doctors on the rise. In an online questionnaire of 24,000 docs representing 25 specialties, only 54% said they would choose medicine again as a career.

A Jackson Healthcare survey of 3,456 physicians echoes the same results, 42% of physicians are dissatisfied with their job.

Does It Matter If Physicians are Satisfied?

The implications of physician dissatisfaction are myriad. Physician turnover is greater in organizations with high levels of physician dissatisfaction impacting consistent patient care and delivery costs. High levels of dissatisfaction decrease physician commitment to the practice setting and lead to mental strain and burnout. Published high levels of dissatisfaction within the career can lead to fewer medical school applicants – further exacerbating what is already a serious shortage of physicians

In the words of Erik Swenson, Chief Medical Officer for Capella Healthcare:

“There have been many studies on how dissatisfaction on the job leads to poor work habits and a poor work environment. Healthcare is no different and recent healthcare studies have shown this. Dissatisfied physicians have worse relationships with their patients, staff, and colleagues. Behavioral issues are more common as physicians feel (and act) more stressed. Patient care quality is diminished, generally ends up costing more, and patients are less loyal. All of this leads to more complaints and more malpractice suits filed against these physicians, thereby further increasing dissatisfaction.”

Causes of Dissatisfaction

Although the ranking may be different from one study to another, the top five causes of physician dissatisfaction are as follows:

• Low reimbursement – While this has obvious significance for a private practice, it is also the driver behind the emphasis on RVUs and mammoth case load requirements in employed settings. Providers who only survived by the proper mix of Medicare patients and privately-insured patients are now finding that commercial insurance rates are now equivalent to Medicare.
• Loss of autonomy – While many physicians have retreated to employed positions to escape the business pressures of private practice, the trade-off is loss of clinical autonomy.  Insurers, government regulations, and hospital “formularies” are just a few of the things that dictate how a physician can treat a patient,” according to Richard Jackson, CEO of Jackson Healthcare, “If we continue to devalue the experience and skills of our physicians, they will become the most expensive data entry clerks in the nation. “
• Administrative hassels – Administrative work now consumes more than 16% of physician time weekly. Electronic Medical Records have not provided any relief, particularly for primary care physicians who are more likely to spend time taking full medical histories.
• Patient overload – Focus on patient-centered care. A patient-centered care focus also scored an average of 8.5 out of 10 for physician importance. Even though the majority of hospitals and health systems believe they are a patient-centered organization, physician satisfaction with their organization’s focus on this aspect was just 7 out of 10. The formula for failure is simple – more patients, less patient time, and lots more patients.
• Loss of respect – Howard Forman, a professor at the Yale School of Management who researches diagnostic radiology, health policy and healthcare leadership says, “The transformation of the field from independence and professionalism to being commoditized and feeling like you’re just another worker is disheartening.” Many physicians fear that clinical decisions will be determined primarily by policy and untrained clerks making their training and expertise superfluous.

The Solution to Physician Dissatisfaction

Suffice it to say that one size does not fit all, neither can one solution be the panacea to a serious “industry-wide” dilemma. However, many physicians are finding satisfaction in a unique practice setting, the Military Treatment Facility (MTF).

Here are some reasons providers enjoy working in a military environment:

• Strict schedules – the military has a propensity of starting and ending on time. Most positions are M-F, 0730-1630.
• Professional working environment – strong emphasis on quality patient care working alongside motivated professionals at the top of their field with access to the most advanced resources
• No insurance or back office issues – everyone is covered by Tricare, making paperwork a matter of the software learning curve (no coding, billing, collections)
• No malpractice worries – medical malpractice is covered by an Act of Congress, Title 10
• Manageable Caseload – Primary Care Physicians, for example, typically see one patient every 20 minutes.
• Respect – Where else in this country will you be called “Yessir” or “Yesmam”? In addition, no pre-authorization for consults is required.

KurzSolutions specializes in placing physicians in all specialties in military civilian roles. We expect to place over 400 physicians in 2015, in patient-centered military treatment facilities where the training, skill, and expertise of physicians is valued and respected. Why not give us a call to discuss your options?

Endnotes:

1. http://kaiserhealthnews.org/news/doctor-burnout/  http://www.washingtonpost.com/national/health-science/a-growing-number-of-primary-care-doctors-are-burning-out-how-does-this-affect-patients/2014/03/31/2e8bce24-a951-11e3-b61e-8051b8b52d06_story.html
2. http://www.forbes.com/sites/susanadams/2012/04/27/why-do-so-many-doctors-regret-their-job-choice/
3. http://www.locumtenens.com/physician-recruitment/physician-dissatisfaction-growing.aspx
4. http://www.beckershospitalreview.com/hospital-physician-relationships/survey-42-of-physicians-are-dissatisfied.html
5. http://www.capellahealth.com/wp-content/uploads/2012/01/ClinicalConnections_MayJune2012_HR.pdf

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