The top recruiting challenges facing rural hospitals [and ideas for overcoming them]
Survey research finds the lower cost of living, greater autonomy and a higher sense of fulfillment are attractive characteristics rural healthcare facilities should pitch to prospective provider candidates
Rural healthcare facilities are under financial pressure. At the end of 2022, the American Hospital Association (AHA) reported 136 rural hospitals closed between 2010 and 2021.
The trend hasn’t slowed down either. As we turned the corner on the New Year, another 88 hospitals, many of which are rural, shuttered or cut back on the healthcare services offered.
There are many reasons why this is happening. One significant factor is that rural facilities struggle to attract talent, such as physicians, physician assistants (PAs) and nurse practitioners (NPs).
A periodic survey – Rural Physician Recruitment and Staffing Survey Results – by Jackson Physician Search does well to quantify some of the challenges and propose some ideas for overcoming them. Below are a few that stood out to us.
1. Rural hospitals have a smaller pool of potential candidates
One in 10 providers (10%) polled said they wouldn’t consider a rural position. This means rural facilities have a smaller pool of candidates for recruiting. “The biggest challenge we have is getting recruits to visit a rural setting,” said one hospital administrator in the report.
Solution: Many are offering temporary positions (i.e. Locum Tenens) as a means to give providers a chance to experience the role in a rural setting.
2. Compensation tends to be lower
What incentives would compel a provider to consider a rural position? Most providers (64%) said compensation. Yet many rural hospitals simply can’t match the financial resources of urban or suburban competition.
Solution: The low cost of living in rural areas could make up for the difference of a big salary in a high-cost location. To that end, even a modest bump in compensation could lead to greater take-home pay and win over a candidate. Jackson suggests that a slight increase would lead to faster fill times and thereby bring down the high cost of healthcare recruiting.
3. Geographic location and family needs
The survey asked respondents why they might decline a rural position. Many of the answers are traced to the location of the position and the needs of their family. These include factors such as whether their spouse could find gainful employment, accessibility of community amenities, available housing and the schools available for children.
Solution: Many of these are misguided perceptions. Lots of rural areas have great schools and affordable housing. What’s more, rural physicians surveyed “express a stronger belief than their counterparts that they live and work in a family-friendly environment.”
4. Potentially higher workloads
Fewer providers in rural areas may mean more patients per provider. In addition, rural communities tend to have more chronic conditions and more severe chronic conditions – so there are more patients overall and more work per patient too. The result is often higher workloads.
Solution: Rural facilities may have higher workloads, but they also tend to offer more autonomy for managing those workloads. Providers find this highly attractive, but administrators “underestimate the importance” of autonomy the survey found. The report says administrators would do well to reconsider how emphasizing autonomy can boost recruiting.
5. Provider retirement may hit rural hospitals harder
Nearly half (49%) “of Baby Boomer physicians will retire” over the next five years – and another 35% will do so over the next 10. Even more are “seeking to slow down” their pace of work. This will hit rural healthcare facilities harder because Boomers are more likely than subsequent generations to work in rural areas.
Solution: The survey data shows providers working in rural locations have a higher sense of personal fulfillment. This is a crucial point because younger generations, especially millennials, are strongly motivated by a sense of purpose. Communicating this point “feels like a sentiment that is promising for the future of rural healthcare.”
6. Fewer rural students attend medical school
Although medical school enrollment has grown, the number of students raised in rural areas has declined. “This is significant because we know that these are the ones most likely to practice in rural areas,” the report says.
Solution: The report says hospitals should extend their networking efforts “to nearby communities with medical schools so that you are consistently top-of-mind with placement counselors.” In other words, start building a pipeline of talent sooner.
7. Rising competition from alternative providers
Rural hospitals aren’t just competing with suburban and urban facilities anymore. They also have to compete with a variety of alternative providers. These include telehealth providers, retail chains like pharmacies that have opened clinics and an explosion of urgent care clinics. Even insurance carriers are a source of talent competition.
Solution. The advice Jackson Physician Search offers in the report is to make recruiting a continuous process. Most providers are “passive candidates” which means they are employed but open to considering new opportunities. Rural healthcare needs to be creative about opening lines of communication to these prospective candidates and maintaining a level of engagement. This way when you have an opening, the facility doesn’t start a search from scratch.
Get your recruiting house in order – and keep it that way
In our work with rural hospitals, we’ve noticed that many are unprepared to begin filling a vacancy. When a provider leaves, the facility and administrators are stuck scrambling to piece together the information they need to commission a recruiter and start an active search. This prolongs an already tedious process and has a real financial impact.
That’s why we launched Workforce Management – a new software product that streamlines the processes of recruiting, hiring, and onboarding new employees. The software is secure, intuitive, and easy to integrate with existing human resources (HR), recruiting or payroll systems a hospital may already have in place. Contact us today for a no-obligation online demo.
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