Tri-County Doctors: The business of recruitment

DAYTONA NILES / NNY BUSINESS
Dr. David Wallace just started his job at the River Hospital in Alexandria Bay.

By: Norah Machia

Several Northern New York hospital officials say there are a variety of successful approaches to physician recruitment, but the process of attracting primary care doctors and specialists to the region still remains a challenge.

     In recent interviews, administrators shared their “secrets of success” behind their physician recruiting efforts in a field that remains highly competitive on a nationwide level.’

                Anne M. Walldroff, Samaritan Medical Center’s director of physician recruitment, said the Watertown hospital has hired 17 new physicians since January, with a “few more in the pipeline” expected to start later this year.

                Education loan repayment is one popular incentive that may be offered to interested candidates, Mrs. Walldroff said.

                Some medical school graduates have as much as $250,000 to $400,000 in student-loan debt when they complete their residency programs, and “that debt can be a huge cloud over their heads,” she said.

                An education loan repayment incentive can put them on the road” to stabilizing their financial situation for themselves and their families, she added. 

                Another key to successful recruitment is being able to offer a candidate the opportunity to join an existing practice, Mrs. Walldroff said.

                “Most people don’t want to be the only doctor in a practice,” she said. “They like to work in a collaborative environment, and be able to exchange information with their colleagues.”

                This also allows younger physicians an opportunity to draw on the experience of their older colleagues, along with sharing on-call duties, Mrs. Walldroff added.

                Samaritan operates a graduate medical education program, and serves as an accredited teaching site for upper level osteopathic medical students.

                 “Many of those students have decided to return and practice at Samaritan,” Mrs. Walldroff said.

                The Watertown hospital also recruits physicians through an arrangement with Upstate Medical University, Syracuse. The cost of training a resident at that facility is covered by Samaritan, and in turn, that person agrees to practice at the Watertown hospital for several years after completing his or her residency.

                A major expansion and modernization project launched by Samaritan many years ago has helped significantly in the recruitment of physicians, Mrs. Walldroff said.

                “It’s been a huge help when they see the spacious and modern facilities where they can practice,” she said. “The new building has definitely made a difference in the expansion of services we have been able to offer our patients as well.”

                It was more than a decade ago that Samaritan officials launched the $61 million expansion, citing increased competition for physicians as a major reason for the large scale effort.

                 “Physician recruitment and retention is one of our strategic goals and one of the drivers of our facility master plan,” said Thomas H. Carman, Samaritan’s Chief Executive Office, in 2007 interview with the Watertown Daily Times.

                Mr. Carman himself still plays an active role in the hospital’s physician recruitment efforts by attending all physician candidate interviews, said Mrs. Walldroff.

In recent years, Samaritan has been successful at expanding group practices in specialty areas such as general surgery, oncology (cancer treatment) and otolaryngology (ear, nose and throat). But recruitment for psychiatrists and dermatologists continues to be a challenge.

                “We have to be straightforward and paint an honest picture of the pros and cons of the region,” noting the tough winter weather may be offset by “the beauty of the four seasons,” she said.

                The quality of life in Northern New York is often a draw to potential candidates, including the region’s school districts and the housing market, she said. Some physicians have commented how they could find a new house in this region for a fraction of what they would pay in an urban area, she said.

                The proximity of places such as Syracuse, the Thousand Islands, the Adirondacks, and Canada, all within an hour or two drive from Watertown, may also work as an incentive, she added.

                In an effort to further meet the needs of some physician recruits, Mrs. Walldroff took steps to bring an au pair service to the area. An au pair is a person from a foreign country who obtains a specific VISA to come to the United States and live with a family full-time and help care for their children.

                Mrs. Walldroff is partnered with a U.S. Department of State authorized program headquartered in Cambridge, Mass., which offers an extensive worldwide network of au pair international recruitment, screening and orientation services.

                She started the service after an inquiry from one of Samaritan’s latest recruits, Dr. Daniel Krebs, a board-certified family practitioner.

                Dr. Krebs and his wife have four young children and had used the services of an au pair in Washington State,

                His family was attracted to Northern New York region because of its smaller school districts (they chose Sackets Harbor Central School), and the many outdoor recreational opportunities available, including downhill skiing. Carthage Area Hospital:

                The physician recruitment efforts made by a hospital are in large part driven by the needs of the community it serves, and “those needs can vary widely from area to area,” said Gary Rosenberg, administrator of support services for Carthage Area Hospital.

                 “I can recall more than fifty years ago when I was growing up in rural Minnesota, the same doctor who delivered me had also delivered my mother,” Mr. Rosenberg said. “And he was my grandmother’s primary care doctor as well.”

                It used to be that most primary care doctors “did everything from birth to death, including minor surgeries and deliveries,” but that’s been changing as medicine has become more specialized, he said. 

                 “Once you find a suitable and interested candidate, the process then becomes one of negotiation,” Mr. Rosenberg said. “Some things are valued more than others, but we are all looking for some sort of quality of life and work balance.”

                Typical incentives include salary offers, bonuses, vacation days, moving allowances, flexible work schedules, assistance with student-loan debt repayment and the opportunity for growth and advancement within the facility, Mr. Rosenberg said.

                The physicians who are recruited by Carthage Area Hospital have real potential to make an impact on the services and care provided by hospital because of its smaller size, an advantage to practicing in a larger, urban facility, he said.

                Each physician candidate may be looking for something different, depending on what point they are in their medical career, Mr. Rosenberg said.

                 “For the right people, we have the right niche,” he said. “It’s just sometimes challenging to find them.”

                It’s not uncommon for younger physicians who have just completed their residencies to be very “idealistic, skillful and bright, but with hopes of practicing in a large urban hospital with well-known specialists,” he said.

                Providing assistance with student loan repayment is a major incentive for this particular group, because the amount of their debt can be an “incredible burden for them,” after graduation, he said.

                Another group of potential recruits are well-established physicians looking to “slow down” because they have already spent years doing “that high speed workout,” Mr. Rosenberg said.

                 “That group is easier to reach with the ‘softer’ incentives,’” such as the quality of life in the community, the outdoor recreational opportunities, and other amenities of a rural lifestyle, he said.

                There is a third group of physicians who fall “in between” those who are fresh out of residency programs, and those who are working toward retirement, Mr. Rosenberg said. 

                 “This group is looking to raise a family and become settled in a community,” he said. “They are looking at the quality of the schools, the safety of the communities, the sports programs, etc.”

                The hospital has some recent success stories, including the recruitment of two physicians who had previously practiced at Fort Drum, Mr. Rosenberg said.

                Dr. W. Allen Fink started as Carthage Area Hospital’s Emergency Department Medical Director in January, after working at a larger hospital in the Seattle, Wash., area.

                Dr. Fink, a Fellow of the American College of Emergency Physicians, had previously worked at Fort Drum, and was drawn back to practice at Carthage for several reasons, including the ability to have a greater impact in a smaller hospital, Mr. Rosenberg said.

                “We pride ourselves as being a place for personal care, how we interact with the patients and each other,” Mr. Rosenberg said.

Another former military physician recruit is Dr. Diane Keating Jones, a board-certified pediatrician who had served as Chief of Pediatrics at Fort Drum, and at the West Point Military Academy.

     Last year, she joined the Carthage Pediatric Clinic at 117 N. Mechanic St.

                 “She is a mid-career physician, and very highly regarded,” Mr. Rosenberg said. “Both she and her husband loved the Northern New York area, and wanted to return.”

River Hospital, Alexandria Bay:

                River Hospital has also been successful in recruiting former Fort Drum health care practitioners. One recent hire is Dr. David M. Wallace, who is board-certified in family medicine and joined the River Family Health Center in March.

                The health center is located adjacent to the hospital, and provides comprehensive primary family health services.

                Dr. Wallace had served in the United States Army on active duty for 24 years, transferring to the reserves in 2015. He had arrived at Fort Drum in 2007, and worked as the Division Surgeon for the 10th Mountain Division Surgeon’s Office.

                It was there he worked with a colleague, Bradley Frey, one of the division’s senior physician assistants.

                The two colleagues stayed in contact, and are now both practicing at River Hospital. Mr. Frey is the River Community Wellness Program Director. 

                 “It was nice to finally be back working with him,” Dr. Wallace said. “In the transition from military to civilian medicine, it has been wonderful to have a seasoned ex-military provider and leader to lean on for expertise during my transition period.”

                Dr. Wallace said he “chose to be a family physician for a reason.”

                 “I love the ability of caring for the whole family, from birth until death, and nurturing the community involvement in the approach to the individual patient,” he said. 

                River Hospital “provides that supportive atmosphere,” which results in “better and lasting care for all patients,” he said. 

                 “It builds a wonderful experience when you are speaking with other staff members about a patient, and they automatically know the patient’s first name, their family history, and the social dynamics of their care,” Dr. Wallace said.

                The St. Lawrence River communities “seem to be entirely dedicated to the success and welfare of their families,” which has been shown by the hospital’s growth in recent years, he said.

                 “I have never seen a community so committed to the local health care facility through their generosity and giving,” he added.

                Dr. Wallace is originally from Rochester, where his parents and brother and sister-in-law still reside. His wife’s family is from Vermont, so staying in the Northern New York region made sense because it provided a “middle area” in proximity to both families, he said.

                River Hospital officials have made it a priority to recruit primary care physicians and other health care providers to “ensure the members of the St. Lawrence River communities have their health needs served close to home,” said Andrea Pfeiffer, director of marketing and community relations.

                There are a variety of incentives for recruitment, including the “promotion of our small, friendly work environment, and close knit community,” she said.

                 “It hasn’t gotten easier, as recruiting in a rural community is sometimes tough,” Ms. Pfeiffer said. “But we have found some wonderful providers that are excited about serving a small community and practicing in a rural hospital.”

                The River Family Health Center is fully staffed with mid-level providers and physicians, she added.

Canton-Potsdam Hospital, Potsdam:

                 “Physician recruitment is not easy,” said Marlinda LaValley, vice president for administrative services, Canton-Potsdam Hospital. “We have to compete not only regionally, but also nationally.”

                The location of the hospital in Potsdam has been a draw for those who “want a rural lifestyle, but also access to urban areas” including places such as Montreal, a major metropolitan city, she said. Others seek out the beauty and tranquility of the Adirondacks in places such as Lake Placid.

                 “We explain what this area has to offer,” Ms. LaValley said. “It must match the personal, professional and family needs of the candidate.”

                The hospital also works to provide a support system for its physicians by “putting related practices together” in the same building, if possible, she said.

                For example, Canton-Potsdam Hospital has a team of orthopedic and sports medicine specialists, including a specialist in hand surgery and pediatric orthopedic surgery. These physicians work as a team, and can consult with a specialist in pain medicine, and staff in the physical rehabilitation services, all located on the St Lawrence Health System Medical Campus, Canton. 

                 “We cluster practitioners when it makes sense,” Ms. LaValley said.

                Canton-Potsdam Hospital officials review upcoming retirements when establishing their physician recruitment plans, and seek input from the medical staff itself to determine the community’s health care needs, she said.

                 “Our hospital has a strong relationship between physicians and administration,” she said. “That relationship is a huge factor in recruiting.”

                Potential candidates “feel comfortable asking questions of the medical staff, such as what it is like to work here, and to live here,” which enhances the information they already receive from the hospital administrators during the recruiting process, she said

                The hospital’s medical director, Dr. Robert T. Rogers, is board-certified in internal medicine. Dr. Rogers and Carlos Alberto, vice president of physician practice management, often work side-by-side on physician recruitment efforts, Ms. LaValley said. Both will meet with potential recruits.

                Many physicians place a strong value on the communication between staff and administration, Ms. LaValley said. They believe this type of relationship could allow them to have a stronger voice at the hospital in the future.

                Some recent successes in recruiting physicians to Canton-Potsdam Hospital have been made in the areas of endocrinology, rheumatology, and infectious diseases. Areas that still remain a challenge are primary care and neurology, she said. 

                 “It’s very important to ensure the candidate is the right fit,” Ms. LaValley said. “You don’t want to spend a lot of time recruiting a physician, have that person set up a practice, and then discover he or she is not happy here.”

                If a physician establishes a practice and leaves a short time later, “you’ve created this new demand for a service, and are left with no way to fulfill it,” she said.