To Improve Recruiting Hospitals should think “Baby.” Not “Emergency.”

Over the last decade hospitals have incorporated technology and new approaches into much of their recruiting in a  “reactive way,” akin to emergency care where, outside of accidents, ERs accept patients with acute issues and stabilize them but do not cure the health problem that caused the emergency.  In today’s digital era we do many things cheaper and more expensively online.  But hospital recruiting losses are into the billions (in costs and lost financial opportunity).  There are fundamental reasons for it which I touch on below.

But to promote improved time, quality and money-saving recruiting outcomes,  hospitals must start to look at recruiting proactively – less like “reacting” and more like how OB/Gyns and their Women’s Centers take deliberate steps for a healthy birth with mothers BEFORE their babies are born.

Hospitals should look at recruiting and making improvements proactively, much like their Women’s Centers take proactive steps for a healthy birth with mothers BEFORE their babies are born.

In a decade of work using and then test marketing Online Job Tour dealing directly with physician practice and hospital clients in recruitment, viewing 5,000 hospital websites and the layout of their content – plus watching it evolve and change, and speaking to thousands of hospital employees as well as jobseekers from pharmacists to double fellow-trained physicians, hospitals have a distinct pattern of taking steps to address recruiting ailments after recruiting shortcomings and poor outcomes are revealed, while they often still ignore the causes.

  • Isn’t that like a hospital – to wait until a sick person comes in seeking acute care?  Let’s keep in mind a set mentality such as this can absolutely drive a similar approach elsewhere – and that’s my basic point.
  • Hospital recruiting statistics over a decade are not improved, from cost, closing percentages of visiting candidates, time-to-fill jobs, quality of hires, and retention.

While hospitals have incorporated ATS (applicant tracking system) technologies to categorize and track candidates, the next step is addressing what to do BEFORE the jobseeker becomes a candidate and improving the actual recruiting process. How can hospitals source candidates better? Make recruiting more efficient and filling jobs faster?  Improve recruitment outcomes and quality hires?

  • These questions relate directly to doing something “proactive” – that is, to positively influence the process in their favor and expressly not just administrative tasks such as a computer driving filing process such as an ATS.

The Aversion to “Sales:” I have met hiring managers, HR Directors, and Chief Medical Officers who have repeatedly said to me “I don’t believe in ‘selling’” when it comes to their recruitment.

  • In numerous classified ads seeking hospital staff recruiters no documented success in any prior sales job is required!  The pay for these positions is relatively low and has few if any incentives.  Apparently, many hospitals do not believe in having proven “sales professionals” to represent their careers to go out into a market, with dramatic shortages in some areas that are projected to get worse, to compete for the best practitioners for their patients, while financially incentivizing efficiency and quality outcomes (which would ultimately help their overall budgets and drive more revenue to the hospital).  Therefore, not only is there no proactive orientation to hire in-house recruiters who want commission-based,  performance-oriented careers, but this has led to recruiting that is not incentivized to continually improve.

On the other hand, I have experience in stock brokerage, commercial real estate, and corporate staffing prior to entering healthcare recruiting; particularly retail stock brokers at the leading major firms are trained to “kill or be killed.”  My previous blog entry discussed how many hospitals have all but given up trying to source candidates for their physician openings on their own.  Hospitals are moving backward – they are making the recruiting process administrative.  There is a tangible reluctance to get out there and “battle” for their budgets and their patients with well-trained professionals and with technology tools to improve.  Imagine if drug, pharmaceutical, computer, companies, etc., cancelled their sales departments and merely hoped their advertising would draw customers.  Their sales numbers would obviously drop.  New product launches would fail.

The aversion to “selling” is a core reason why hospitals have not taken a proactive approach to recruitment to improve their efforts.
  • Is shying away from “selling,” or put another way, not having key recruiting policymakers with backgrounds in professional sales who can differentiate between sales being “high pressure” or “stress filled” business and instead having important tenets that can improve recruiting, a core reason why hospitals have not taken a more proactive strategic approach to recruitment?   Not having a proactive, competitive orientation driving talent acquisition strategy, especially in today’s internet age may be the single biggest reason why hospital recruiting seems more expensive and harder when it should be cheaper and easier.

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Before we discuss solutions, we need to acknowledge problems and challenges.  Here are some irrefutable examples of how hospitals have taken missteps in recruiting strategy as the Internet has encroached into career search:

SEO:  As the internet started to have more and more influence and jobseekers started to move online in the very early 2000s, like a sales professional whose career relies on sourcing new clients on their own, the third party recruiting industry – the biggest firms as the biggest culprits, started to study how they could capture jobseekers while hospitals didn’t proactively seek to understand the changing dynamic and set strategies to source their future candidates.  “SEO” (Search Engine Optimization) is a term hospitals learned too late; today third party healthcare recruiters show up on internet searches when physician and advanced practice jobseekers like nurse practitioners type “Pediatrician physician jobs in Ohio” effectively intercepting the candidates their own clients want, and then go to the hospital: “Look who we ‘recruited’ for you.”  SEO is pretty simple and especially large hospitals still don’t understand it and seem perfectly willing to pay a $25,000 recruiter fee for every placement to perpetuate this almost silly advantage they could correct and then attract jobseekers without the “middle man.”

Also unfortunate is how hospitals seem willing to accept the many negative issues that relate to acquiring candidates that aren’t originally sourced, which add to their cost and jeopardize the hiring timeline all the way to retention.

Few Deliberate Recruiting Programs/sales training/tools/accountability/incentive pay:  A true recruiting platform should be the same as selling a drug, pharmaceutical or any product or b2b service:  a) trained sales professionals who are experts on the product who know how to locate leads and pre-qualify them, b) a sales presentation or tool as an extension of their expertise and which can be left with the prospect, and c) an accountability system which tracks their contacts and sales success – keeping statistics which clearly show the individual’s record – and d) payment should be provided accordingly.  While hospitals differ to a degree it is obvious that this kind of training, tools, and accountability, and pay, are absent.

There is no other industry where salespeople are not held to quotas and performance matrixes.   We all agree that working to ultimately hire a better practitioner works better and smarter, making the hospital more money.  It has been proven by numerous organizations that filing jobs sooner saves hundreds of thousands of lost earnings vs. the job being unfilled and yet I have met few professionals on the employer side clamoring about not filling jobs faster.  And there are poor placements being made with uninformed new employees which is clearly evident in poor retention numbers; clearly, many doctors are closed on the deal and the bonus and not holistically or convinced the career with the employer is an ideal, lifetime fit – all when lives are on the line for patients and their families.

All great sales professionals have selling tools that are an extension of expertise they must have on core subjects that address prospect issues while helping them sell and compete – it should be no different with hospital staff recruiters.  A world class recruiting tool will not only promote better outcomes but make money for the hospital.

Why are marketing people in charge of the hospital’s recruiting content?  Marketing isn’t sales.  Hospital marketing people were not hired to recruit anyone nor have most marketing people ever been in a sales job. Merely because marketing people oversee the hospital’s website is not a criterion for them to be placed in charge of how their hospital is going to develop online content to address the complex needs of physicians.

  • In a professional selling environment you don’t send trained salespeople out into their tough markets with no tools.  This seems obvious, yet most in-house recruiters have no sales/recruiting tool whatsoever.  The production of detailed, compelling recruiting material should be as important as hiring a sharp professional to recruit, and before calling any more outside recruiters, should be first thing outsourced by hospitals as an investment to improve their hiring process.  Those making recruiting policy and their recruiters don’t have real world “selling” expertise and their marketing people weren’t hired for, and generally don’t have, any recruiting experience – that combination won’t produce a world class recruiting product and this is THE reason you see little compelling recruiting material out there.
  • Just because it is online doesn’t mean it should be in marketing’s domain.  If you visit a hospital website and see a “Baby Photo” service, or a “Health Library,” often these are third party tools the hospital pays for – why can’t tools the hospital’s physician recruiter uses be viewed the same way?

A Group Mentality:  When everyone does it the same, and there are few motivations or incentives to improve, the result is mediocrity.  And it’s not fertile ground for innovation.

  • If you look across all hospitals and their websites for recruiting material, what you see are similar “passive” designs which employment sections which provide website links to other websites about the hospital’s community, along with a few paragraphs describing their service areas.  Merely offering links to someone else’s website is not doing jobseekers any favors – especially extremely intelligent web savvy physicians can easily find them.  This is not a “strategy” but a burden to ask an intelligent person to “do your own research” in hopes they will pick through these websites and “sell yourselves.” It shows no awareness by the hospital that the physician is considering 10 different jobs and is therefore insulting to them.
  • Sometimes you will see a 4-5 minute hospital recruiting video, a la the 1990s DVDs which the hospitals placed online.  This “old approach” at least has images but falls short for numerous reasons – how old is the video, there are generally clichés and not important details, recruiting videos often promote more questions, the video may not play well on the latest computer devices, etc.
  • There are very few in-house recruiters who are “expert” at (SRM – Social Relationship Marketing) : social networking activists on Twitter, Facebook, Pinterest, who use networking tools like Nimble and others to manage relationships they seek out with other hospital recruiters, medical school program directors, practitioners/prospective candidates and their family members, and others.
An expertly recruited physician or advanced practitioner, or nurse for that matter, already has the information they need and considered it through the recruiting process. Onboarding should be little more than a welcoming activity that signals the start of employment and the hospital working to ensure the start date.

Onboarding Programs:  Recently I have been reading how some hospitals are initiating onboarding programs as a way to strengthen physician and advanced practitioner retention – another “reactive” measure that is clearly not addressing recruiting shortcomings.  In some hospital organizations and companies, physician retention has dropped to 50% after 36 months.

I agree with onboarding for credentialing purposes as well as to maintain it, and a professional program that provides a schedule to officially welcome new employees into the staff, leadership, volunteer and physician groups.  But they should be an official “welcome” to both signal the end of the recruiting process and ensure the start date for the practitioner.  Onboarding should not include giving doctors and their families all the information on schools, real estate, and have them meet key community people.  A true sales pro would have already provided the same information during the recruitment of the practitioners and also insisted on making sure that information was considered and compared vs. other career options prior to hosting candidates for an interview, much less prior to making an offer!

  • The hospital recruiting process must be more than the administrative process of reacting to a hospital’s need for a new physician, cattle-calling outside recruiters, sifting through resumes, hosting candidates, and then hoping they choose your hospital and then celebrating in relief after the position is finally filled – while keeping no deliberate statistics for accountability purposes (this is obviously a generalized overview of how hospitals recruit physicians and to make my point that many lack a shrewd, efficient, tech-savvy, competitive orientation).

Any policy, or policy change, in any kind of company or industry which is set in reaction to anything is not only likely too late, but is never genius or visionary – certainly this is the case in recruiting.

Following problems and reacting do not promote improvement like anticipating needs and being proactive, which has revealed itself in hospital recruiting outcomes that are frankly, disappointing.

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As I have written, I believe a major reason for continual, perpetuated shortcomings in healthcare recruiting is the people in healthcare are “care givers” – they shy away from the “pressure” of sales or believing they are pressuring others (a misconception of how true sales professionals work).  Personalities also draw people to healthcare are very different than personalities that promote people to go into commission sales.

  • After meeting physicians, nurses and other clinicians, I am particularly fond of them – some RNs wind up as in-house recruiters.  My mother in-law is a nurse and my wife is a Pre-Med student.  Many employees of hospitals believe they are a part of a greater calling, and many are consciously aware their work impacts the lives of their patients and families.  That should be greater motivation to want to do better and insist on nothing but world class recruiting.
  • As a former sales trainer, I understand hesitancy and misunderstandings about “selling,” but tenets from selling, namely being active to make a difference in outcomes, makes a big recruiting difference vs. merely waiting on others or letting candidates drive the process, so I encourage looking at recruiting in terms of doing candidates a favor, and support their efforts with tools that guide them while putting the hospital and its area’s best foot forward – and doing it efficiently.  There’s little pressure in that, and no reason physician candidates would be put off – they want to FIND and CHOOSE a career thoroughly, confidently, efficiently.  Help them get there!
The “care giving” nature of hospital professionals is their best quality and can be harnessed for recruiting by thinking in terms of being similarly proactive as when dealing with certain patients, like pregnant mothers, to promote better outcomes.

Think “Baby:” With the shortage of physicians and the emerging data which shows how hospitals lose billions in finances and lost opportunities when a great deal can be saved with better, more efficient practices, if hospitals look into their own operations which have in place proactive approaches to their patients, this can be a revealing to promote shifting their recruiting to being more proactive to improve their outcomes and mitigate financial losses.

  • Look no further than how an OB/Gyn, in concert with a Women’s Birthing Center, seeks to first establish a due date and then proactively works with mothers to promote a full-term birth.  Stats are kept.  Ultrasounds are scheduled. The mother is placed on a healthy diet and there are “check points” set up to keep checking in on the health of the mother and the baby.

Hospitals can take innovative steps today to understand SEO and make attempts to start sourcing their own candidates online.  They should demand results from job board services they advertise on.  There should be deliberate checkpoints set up and records kept on the effectiveness of in-house recruiting from start to finish, including surveying candidates on the details of the process, and building from it, as well as keeping stats on costs, and closing to retention numbers.

Like an OB/Gyn for a mother, hospitals need to find an expert/specialist to make their recruiting material and support their efforts – and not totally rely on the third party industry which ultimately needs them to keep failing and in whom more recruiter fees paid only perpetuates their advantages.

Onboarding programs should be limited to “welcoming” the new employee and ensuring their start date – they should already be fired up and fully informed and committed because they were expertly recruited.

And finally, hospitals need to change in-house recruiters from being mere interview schedulers to incentivized professionals who are empowered by a great sales tool, trained to promote efficiency and solid outcomes, and they need to be accountable for their results – as much as to see where they can improve as to ensure they are having a meaningful impact on the process via their own efforts.

Thinking in terms of proactively helping a mom and her pregnancy is a great way to change the direction and the dialogue of how to improve hospital recruiting.

Follow Carl Brickman on Twitter: @OnlineJobTour
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