(originally published on
www.hospitalimpact.org)
Lack of access to primary care is an issue throughout the country and especially so in rural areas. In 2008-2009, the
Daniel Hanley Center for Health Leadership brought together leaders from across the state of Maine to understand the key motivators and incentives that will improve primary care physician recruitment and retention in rural areas.
This collaborative group of leaders reviewed the strengths and limitations of historical data obtained through focus groups, survey tools, and interviews. They then sought an innovative way to hear a fresh perspective and selected the Voice of the Customer (VOC) as the tool to explore this challenge in depth.
The Voice of the Customer provided a structured approach for interviewing a compiled matrix of individuals and positioning them to respond thoughtfully to a set of pre-determined and open-ended questions. The interview responses were then subjected to structured analysis resulting in a compilation of recurring themes and detailed customer (in this case primary care physician) requirements.
The outcomes from this effort were enlightening. Through the historical review this group learned that the typical approach to recruitment of primary care physicians was focused predominantly on compensation and technology.
But through the VOC process, they learned that primary care physicians are less concerned with compensation and technology and more concerned with finding an organization that truly cares about its physicians and takes the time to understand and develop a relationship with the physician candidate and family.
Other criteria that were important to physicians, they learned, included:
* Finding an organization that is willing to create an optimal practice model that positions the physician to focus on healing (and not RVU (revenue) generation)
* Finding a practice that will develop support systems sensitive to the initial understanding of the physician's goals and needs
* Finding an organization with a commitment to collaboration.
The physicians were also very clear, "pay me fairly but don't follow the strategy of overpaying to recruit me (especially if the items above are not in place). Yes the recruitment effort might be successful (as defined by bringing me on board), but retention will remain an issue because the root-cause of my dissatisfaction will not have been addressed."
They were also clear regarding their thoughts on technology. Technology should be a tool to be leveraged to best support the healing encounter--not simply as a tool to increase productivity.
Lastly, the VOC yielded the following:
If I am a primary care physician and you are recruiting me and it becomes apparent that the fit is not right, focus on collaboration with other practices and help guide me to another opportunity that is a better fit. Share information and candidates with other practices. The goal is to best position physicians for the optimal fit to improve access, to improve the health of individuals and the health of communities.
Collaboration between practices will only lead to improved recruitment and retention and thus improved access. So much like the healing encounter itself where relationship, understanding, trust and collaboration are four keys to success, so it is with primary care recruitment.