Hospitalist Nhi Lan Pham, MD, accepted a signing/starting bonus to relocate to Texas after finishing her residency in internal medicine in the Detroit area in 2007. The accompanying relocation expenses helped Dr. Pham begin her career near her family in Austin, and the flexible work schedule she negotiated allowed her to spend time with her family.
Another hospitalist willing to relocate for the right job used the relocation budget to his advantage. Moving to take the right job cost $2,000. The employer had budgeted $5,000 for relocation expenses, and the physician was able to arrange to have the $3,000 difference added to his signing bonus.
Yet another physician, already established as a hospitalist in an underserved area of his state, was attracted to a new position. However, his original acceptance of a loan repayment from the state as an inducement to work in the underserved region precluded his applying for the new position. His arrangement with the state did not prevent his approaching the new hospital to see what might be possible. It was a wise move; the new hospital agreed to increase the hospitalist’s signing bonus by enough to reimburse the state for the loan repayment.
One foreign-born physician secured a commitment from his recruiter that his employer would sponsor him and his family for green cards. Another candidate agreed to a reduced starting salary in return for help in securing a visa.
With a projected need for 30,000 hospitalists by 2010, hospitalists find themselves in the driver’s seat when it comes to weighing offers. Incentives are increasingly enticing as hospitalist recruiters nationwide struggle to lure top talent.
Incentives, Perks
What does this mean in practical terms? It means not only rising salaries but also incentives and extra perks to attract candidates to this fast-growing specialty.
Financial benefits are widespread, including signing and performance bonuses. Many hospitalists can plan on a guaranteed income. Employers may agree to pay off student loans or reimburse tuition. Malpractice insurance and tail coverage are commonly covered. Some employers also allow part-time or temporary employment to give a new hospitalist an opportunity to decide about the future or to accommodate a personal schedule.
“There is often a laundry list of incentives from which to choose, as well as more of a cafeteria plan that a doctor and employer can customize to meet specific needs,” according to Mark Dotson, MD, senior director of recruitment at Brentwood, Tenn.-based Cogent Healthcare. Cogent is a recruiting firm dedicated to building and managing hospitalist programs.
By far, the most appealing incentives are flexibility of scheduling and workload that allow physicians to coordinate their work schedule with their lifestyle. In fact, Dan Polk, MD, chief of the division of hospital-based medicine at Children’s Memorial Hospital in Chicago, considers flexible scheduling the basis of his plan to retain staff and build job satisfaction.
“We support lifestyle choices and respect life situations,” Dr. Polk says. “We foster the idea of joining a great team, and we make the environment attractive enough to encourage people to stay. We try to work within the team to cover those who need help, such as maternity or family leave, and we compensate for extra time at a different rate. We embrace people who want to work part time or share a job. Our goals are to support people and to make them want to get up in the morning to come to work.”
Part of the attractiveness of schedule flexibility is fewer weekend and night hours. In addition, employers may allow hospitalists to limit their caseload. Some hospitalists, for example, request a cap of 15 to 18 patients a day.