**I = Interviewer
**R = Robert Hickey
Welcome to the D&Y Innovators exchange, a podcast series focusing on medical staff development leaders, whose dedication, work ethic, and unique industry approaches have enhanced and inspired their medical staffs to provide the highest levels of clinical service and quality patient outcomes to the community they serve.
With us today is Robert Hickey a tenured position recruitment leader with a Kaiser Permanente Mid-Atlantic division
I: Bob, when did you first realize and we’ve talked over the years about your career – but when did you first realize that you wanted to pursue a career in healthcare?
R: I knew way back when I was going to college that I like healthcare and wanted to get into it. Healthcare was going through some major changes at the time, we were coming out of the recession in 1982, there was not a good time in healthcare at that time. With the introduction of DRG’s and utilization management, that kind of stuff
The only thing I didn’t want to do in business was banking – so then I did 30 years in banking
I: makes perfect sense if you don’t think about it, right?
So the head of HR at one of the banks I worked at became the head of HR here – and, she called and they had a new initiative where they had to hire a whole bunch of physicians.
And I was starting a company at the time and I said I don’t really have time, she said you can give me 4 hours a day, I said absolutely not. So then I gave her 4 hours a day.
Then I came down and I said you need 2 recruiters full time and she goes “can you give me full time?” I said absolutely not – 2 weeks later i was giving her full time
So, I was running in the mortgage industry running my own company, and the mortgage industry was not doing well. I was having a good time doing the recruiting thing – and they needed to hire 2 and they only hired 1, and I decided to throw my name in the hat for the other one and i’ve never looked back. It’s been fun, it’s been a lot of fun.
I: What have you seen and, we’ve talked a little bit off the record about the recent graduate “millennial physician” but what have you seen to be most effective in recruiting a recent graduate?
R: Trying to meet them where they are, number 1. Finding out what their expectations are what they want to do, demographics have changed as far as attitudes and where people want to be in their lives.
We talked about the millennials — number one they don’t like to be called millennials, but the younger physicians want work life balance and I constantly ask them can you please define work life balance, because not everyone defines it the same.
What I have found is most of them are very honest, they are willing to commit to .8fte which is 32 hours of working a week, they will give you very very hard 32 hours they don’t want to do more than that because they want that family life and personal life and things like that. That’s worked out very well
The other thing is the change in trends as far as for the specialties that people are going into. Radiology in 2008 was very very tight, very few people were going into radiology and it was very difficult.
5 years later it became significantly easier, okay – so there was many of those
The other thing is the changing economic climate – in 2009 medicare change the reimbursement in a lot of different things – they cut the reimbursement as much as 50-60 percent some of the procedures cardiologists were doing
Cardiologists weren’t retiring cause they weren’t in a position to retire – so most of them added 5 years to their career so you run into that
Way early on even in 2008-09 when I first started, I saw a trend where there was going to be a significant shortage of primary care. Primary care numer 1 didn’t pay as well so a lot of people were encouraged more to go into specialty care
Most of us were raised with a primary care physician that was internal medicine trained predominantly male, working 60-80 hours a week, taking housing calls and that kind of stuff.
That trend has changed, and now PC is predominantly female, family medicine trained, wants to work part time;.
So the populations are aging, 10,000 people are turning 70 every day which shows the tremendous needs for Geriatric medicine, geriatricians are not paid typically more than internal medicine/family medicine trainted, so you do that additional fellowship but get no monetary incentive for that.
And who’s retired?
Whos retiring is the internal medicine males. Family medicine is extremely well trained in women’s health, little better trained in dermatology, trained in pediatrics, but not as much in geriatricas as much as internal medicine
So I tell a lot of the younger people that are starting family medicine residency i think you made the right decision to go into this – you can see from newborn all the way through, as soon as you finish take every CME you can in geriatrics – because you need to brush up on that cause that’s gonna be the area with the biggest need.
So that’s some of the trends I’ve seen as far as the change.
I: So switching gears in terms of trends that you are seeing and that are impacting the recent graduates, what have you seen to be most effective in recruiting a physician who’s been in practice 5, 8, 10 years?
R: One of the things is that their practice has changed, and for example primary care in the community their income has not changed in many many years because their cost has gone up, malpractice has gone up, paying staff has gone up things like that has not changed.
Running a business is not fun, it probably was 20-25 years ago, but we’ve all raised if you work hard and you’re honest and you’re smart you’ll do well unless you get struck but then, it changes your income substantially.
So what we’ve effectively done is we’ve sent out blast advertisements and emails if your practice has changed so maybe it’s time to change practices.
Unfortunately, I don’t think anybody‘s gone into medicine for the money okay they really don’t, and they’re not trained to go after the money. Unfortunately, medicine is a business and our views are becoming a big deal, and we don’t look at our views we don’t think our views has anything to do with quality medicine, we do what’s medically appropriate, not justified
Which is more in line with what they want they being all physicians want about 10% of the candidates we see are purely academic about 10% are purely fee for services and what I mean by that is they have that business mind and want to run a business they want to hire and fire people, negotiate contracts, that type of thing
About 60% fit our model perfectly, very very few could do academic, our model, and fee for service
So most can either do some academic, there are some fee for service, we find more people understand our practice the more they gravitate to it.
You’ve been listening to the D&Y innovators exchange featuring physician recruitment leader Robert Hickey with the kaiser Permanente Mid-Atlantic division
Join us next time when we discuss successful physician retention with Mr. Hickey.
D&Y's exclusive interview series with today's medical staff development leaders