Providers who choose to work in rural communities are drawn there for very different reasons; the key to effective recruitment rests in appealing to those motivations
by Intelliworx
Rural healthcare facilities are facing challenging financial times. Many have high operational costs combined with a low volume of patients. Patients in such geographies also tend to be older, more susceptible to chronic illnesses and underinsured. That combination drives up the cost of care while imposing a natural limit on cost recovery and revenue.
Download the 1-Page Plan HereIf we sprinkle in a dose of difficulty with insurance, particularly with reimbursement, and we catch a glimpse of the vexing problem it is to deliver healthcare to rural America.
The financial stress is having a compounding effect too. For example, an economic analysis by the USDA found 146 rural hospitals in the U.S. either closed or stopped providing inpatient services between 2005 and 2023.
Further, the forecast is even more dire. For example, a report from the Center for Healthcare Quality and Payment Reform warns hundreds of rural hospitals are at risk of closing:
“More than 700 rural hospitals – one-third of all rural hospitals in the country – are at risk of closing because of the serious financial problems they are experiencing. Over 300 of these rural hospitals are at immediate risk of closing because of the severity of their financial problems.”
Without a doubt, shuttered facilities simply make proper healthcare less accessible to rural populations.
Attracting and retaining providers in rural areas
These financial challenges add incline to an already steep climb that is rural healthcare recruiting. There are good reasons for this too including, but not limited to the following:
- Stay where they train. Many providers get their medical training in urban areas and prefer to remain there throughout their careers;
- Social setting. Provider peer groups tend to stay where they train as well, which an individual provider would lose if they left for a position in a rural area; this is “loss aversion,” where losing feels twice as worse as winning feels good and is a considerable psychological barrier to leaving; and
- Center of innovation. Much of the leading medical research and innovation takes place in urban healthcare facilities.
The source of competition for provider talent has grown as well, which adds to the conundrum. For example, pharmacy chains have opened up clinics, urgent care facilities have exploded, and even payers – the insurance companies – are recruiting providers. Optum, which is owned by UnitedHealth employs a reported 60,000 physicians.
To put this another way, healthcare providers may well have more employment options now than at any point in history. Add the pervasive shortage of healthcare talent to the equation and the limited supply and increased demand drive up the cost of human resources.
While rural facilities do try to match the compensation offered at urban facilities, the economics suggest this approach is, at best, a slow financial bleed. Keep in mind, that compensation is more than just salary, it also includes:
- Signing bonuses;
- Student repayment programs;
- Relocation reimbursement;
- Performance bonuses; and
- Housing stipends among other financial incentives.
It’s a complicated issue for employers because while employing providers is expensive, all revenue stems from an individual who is trained, qualified and credentialed to make a diagnosis. This is why we believe a better approach is to seek out more sustainable ways to attract and retain providers to rural locations.
Audience research is always the first step
The first step in any marketing or communications program is to spend time understanding the audience. The goal is to explore their hopes, fears, and aspirations so that you can understand what motivates healthcare providers – and what doesn’t. This step is a continuous process because what providers want evolves over their careers.
We’ve spent countless hours studying providers. We’ve reviewed a significant number of healthcare industry studies, fielded surveys of our own, attended conferences, hired experienced healthcare recruiters and even designed, built and launched a healthcare recruiting software solution designed for this purpose.
One-page marketing plan to attract rural providers
All this is a long way of saying we think we have a good grasp of the market. To that end, we offer this one-page marketing plan for rural healthcare employers.
1. Get the positioning right
Traditionally positioning is how customers perceive your organization. In this case, it’s positioning how providers perceive you as an employer. Urban healthcare facilities, especially teaching hospitals, might position themselves as “cutting edge” or “innovative.”
Rural hospitals can’t compete with that position (and shouldn’t try). A better approach is to play to your strengths. Rural facilities are best positioned noting their tight ties to the local community, a slower and more flexible lifestyle, and the potential for a well-rounded career.
Here are some ideas for rural healthcare positioning:
- Making a big difference in a small town;
- Delivering tangible outcomes in underserved communities; and
- Offering the autonomy to see the provider’s effect on local health.
Similarly, healthcare facilities associated with religious causes could position themselves as:
- Faith-based and holistic healthcare;
- Physical and spiritual treatment; and
- Mission-driven and compassionate care.
American Hospital Association Chair Tina Freese Decker may have said it best when she wrote: “I’ve often said that rural health care is about family. We care for each other and our communities as best as possible.”
2. Determine the right messaging
Messaging is a fancy word for “what you want to say.” It’s important to speak with one voice, but keep in mind people can use different words to convey the same message. In fact, it’s important to allow people to use their own words. This is because that brings authenticity and allows for the notion that different words resonate with different people.
So, what messages might resonate with receptive providers? Our research finds providers are quite explicit about what they find attractive about rural healthcare:
- lower cost of living (translates to higher take-home pay)
- more time with patients;
- better work-life balance;
- slower pace of rural life;
- job security;
- a greater sense of purpose;
- better cross-training and professional development (well-rounded);
- better organizational culture;
- more autonomy to manage how they work; and
- leadership opportunities.
These are good messages to emphasize, although we do recommend experimenting and testing what works best for your locality.
One final point on messaging: the messages you choose must be truthful. Avoid exaggeration and embellishment. If your marketing messages aren’t credible, retention will take a hit, and word will spread to prospective candidates quickly.
3. Determine the timing
The most important aspect of timing begins with position management. That means having a solid grasp of vacancies and turnover – alongside key attributes, such as location, responsibilities and compensation requirements.
Timing requires a proactive and hands-on approach because recruiting providers isn’t just about finding the right candidate. You must also adequately onboard new providers and ensure they are credentialed. That takes 1-3 months on average – and more is not uncommon.
Here are some useful benchmarks for timing:
- the average employee turnover rate in hospitals is 28%;
- the average time to fill a healthcare position is 49 days; and
- the average cost of a physician vacancy is $7,000-$9,000 per day.
Putting these statistics together with arithmetic places this in context: on average, a healthcare facility will see about one-third of their staff turnover, it will take them six weeks and cost nearly $400,000 in lost revenue – which doesn’t include recruiting costs.
The key to overcoming all this, as our CEO Rob Hankey wrote for Chief Healthcare Executive, is to get organized. If your positioning, messaging and human capital requirements are ready to go, then all you have left is implementation.
4. Tactical implementation
The last step is to choose the tactics by which you’ll convey your positioning and messaging. The most significant decision is deciding whether to hire a recruiting firm or to manage the process in-house. The cost of a recruitment firm can vary widely. We’ve observed fees that can range from 15% of a physician’s salary to as much as 35%.
It’s quite possible to save money by maintaining recruiting help in-house. However, you’ll need to arm them with the right tools to engage candidates and track progress. It’ll also require experience and perseverance – providers are busy people with genuinely important jobs.
Some of the campaign tactics to consider for open positions include the following:
- Maintain a well-conceived career page on your website;
- Post open positions to LinkedIn and job boards;
- Promote vacancies on social media;
- Participate in college and university recruitment programs;
- Exhibit at job fairs, industry conferences and trade shows;
- Advertise open roles in targeted trade publications and podcasts;
- Offer employee referral bonuses for provider candidates; and
- Conduct personalized recruiter outreach to potential candidates.
Some enduring programs to consider supporting recruiting efforts – on an ongoing basis whether you have an opening or not – include the following:
- Develop early career recruitment programs, like mentoring and shadowing;
- Commission your current providers as “ambassadors” to speak on campuses;
- Create and advocate for rural residency programs;
- Build rural fellowship or research programs;
- Network with community partners to support spousal employment;
- Initiate career development and leadership programs;
- Apply to speak on workforce trends at industry conferences and tradeshows;
- Contribute big ideas about provider workplace trends to news, trades, and podcasts; and
- Create provider testimonials and success stories – and promote them on digital and video channels on an ongoing basis.
Healthcare work is a calling, especially in rural communities
If there’s a common theme woven throughout this blog post, it’s the idea that healthcare work, more often than not, tends to be a calling. The place to build wealth and achieve status is probably better left to urban healthcare, while rural locations are a way to make a change you can see.
Providers who choose to work in rural communities are drawn to their work for very different motivations. The key to an effective marketing plan to attract providers for rural healthcare positions rests in appealing to those motivations.
* * *
The Healthcare Workforce Management solution by Intelliworx is specifically designed to support rural hospitals and healthcare. Check out this short video or contact us for a no-obligation demo.
If you enjoyed this post, you might also like:
Report proposes well-researched ideas for solving the primary care physician shortage
Image credit: Unsplash
