Q & A with Mike Shimmens, Executive Director for 3RNet
The Health Resources and Services Administration estimates that there are approximately 5,900 designated Primary Care HPSAs (Health Professional Shortage Areas) as of January, 2013, many of which are in rural areas. In this issue of Health Workforce News, Mike Shimmens, Executive Director for 3RNet (the National Rural Recruitment and Retention Network), shares an employer and community-based perspective on how to successfully attract and retain health professionals in rural places. Shimmens has worked in the area of health professional recruitment and retention for over 15 years. Shimmens has been with 3RNet since August 2012, serving previously as Director of Workforce Development at the Missouri Primary Care Association, and former Director of Medical Staff Development at St. Mary’s Health Center in Jefferson, MO.
What is the 3RNet’s role in addressing health workforce issues in rural and underserved areas?
The 3RNet is a membership organization of non-profit and governmental agencies within each state, who provide access to healthcare professionals to some of our most vulnerable safety net facilities. Since its inception in 1995, the 3RNet has operated a web site that allows members to pool resources and advertise open positions for physicians, dentists, nurse practitioners and many other healthcare professionals in their states. These listings most commonly come from rural health clinics, rural and critical access hospitals, community health centers and other safety net organizations. In addition to posting jobs on the website, 3RNet members are active in their respective states regarding all healthcare workforce issues and are often seen as the primary contact for questions regarding loan repayment at the state and federal level. Many also provide training to facilities on the recruitment and retention process and its importance to their sustainability. It is in this ongoing training that the 3RNet has really seen its role expand, as the national shortage of physicians and other healthcare professionals has increased the pressure on these facilities to become more systematic regarding their approach to recruitment and retention.
What unique features of rural life can draw potential healthcare professionals?
We know that lifestyle issues are very important to both the recruitment and retention of healthcare professionals and I feel that rural life can offer an abundance of opportunities. For one the pace of life outside of the practice is slower because of less traffic and people. Living in a city or large suburban area may offer some amenities but it mostly comes with a high cost in time. Secondly, the opportunities for recreation are more readily available and can be enjoyed more easily. I also believe that rural communities often have a close bond within their population and if they can provide welcome access to that bond for new healthcare professionals, they have a much higher chance of retaining them long term.
Tell us how to create a good match between an employer and a healthcare professional in the recruitment process and what affect that has on retention.
All organizations should first realize that recruitment and retention are one process and not two. Any work they do to ensure a good match on the front end will pay dividends through retention on the back end. The most basic element of the matching process is for the organization to perform a thorough assessment of the characteristics needed to be successful in their community. This includes a scan of both the facility they will be working at and the community it’s located in. With this in hand they should develop a realistic picture of what a successful candidate should look like and plan on screening closely according to the criteria they’ve set. Many employers are derailed in this process when they don’t define what they are looking for and end up settling for a less than acceptable candidate who is doomed to failure. Employers should plan on carrying out the work they do to find these successful healthcare professionals through an organized retention plan that continues to build the relationship.
In your experience, what are the top reasons physicians leave a rural practice?
I’ve seen physicians leave a rural practice for many reasons but I believe the most consistent has had to do with the management of the practice and how engaged they’ve been in its management. When a physician does not feel like they are a valued member of the decision making process they react like many of us would and seek a place where their talents are appreciated and rewarded. Fortunately, much of this can be mitigated if a facility builds a trusting relationship through recruitment that is then carried through with frequent communication and acknowledgement in a retention plan.
Discuss the role of the community in recruiting and retaining healthcare professionals and how do you engage them in the process.
When the decision to recruit has been made by a facility the first thing I recommend they do is create a team to perform all the necessary steps in the recruitment and retention process and assign tasks. When you talk about a practice in a rural area this team will be most successful if it has a member or two who represent the community and are considered champions because of their position in the community and their connections. They should be assigned tasks such as community tours, introductions to other community leaders and historical background on the area and its amenities. Hearing first hand from community members who’ve made this their home can pay huge benefits in the area of trust building with the candidate if properly managed in the overall plan.
Recently, health workforce leaders in 11 states joined to form the Multi-State/NHSC Retention Collaborative. What findings from the first year study did you find most significant in increasing our knowledge of retention?
From this study I’m most excited that through systematic surveying of such a large group, there has been a new baseline of retention data created. Prior to the funding of this project and many other state projects by the National Health Service Corps, our knowledge of clinician retention was not very well-developed. In the last two years that has changed because of this and many other state studies that have explored the multiple facets of clinician retention. It is also very exciting that the Multi-State Collaborative has developed a web-based system that will allow states who choose to participate to continue to survey their obligated clinicians and seek answers to common retention problems by sharing with one another their collective findings. This is a very promising development and one in which the 3RNet intends to fully support.
One finding from the Multi-State NHSC Collaborative is that non-parent and minority clinicians are less likely to stay in a rural community. How can stakeholders better engage those groups to promote higher rates of retention?
Employers and communities can use this information to help customize their retention plans to meet the unique needs of these providers. All retention efforts are based on building upon the trust that was created in the recruitment process and each and every clinician has different needs. Meeting these needs requires regular communication and sometimes creative approaches to solving issues that arise. Communities that provide resources to assist their clinicians will have a greater opportunity for success in the long run.
How have changes in technology altered the way employers recruit?
We are all very aware of the changes that social media and technology have brought to our recruitment efforts. There seems to be a new tool or communication mechanism that springs up daily. Employers recruiting today have to spend a great deal more time evaluating these methods and perhaps even doing some trial and error to see what works for them. In the end however, the facilities that maintain a systematic approach to recruitment and retention and work hard daily on the basics of timely communication and empathy with the candidates will be the most successful.
How is recruitment and retention different for healthcare professionals not from this country?
I believe that cultural awareness is the biggest issue when an employer seeks to hire someone from a different country. The steps you take to build their interest is mostly the same, but the listening skills required to identify cues regarding their needs has to have a filter for their culture and that can prove to be a big learning curve. In the end though, they are still looking for a trusting environment to practice, that values their skills and provides a welcoming community for their family. Employers of all types would be wise to consider putting the time in to develop these skills, because it has a good chance to land them some very talented healthcare professionals.
Are there recruitment and retention planning tools that you can suggest for Health Workforce News subscribers?
Fortunately for all us working to recruit healthcare professionals, there has been much work to systemize the process in the last 20+ years. I like to call it the “science” of recruitment and retention. It includes everything from the 3RNet manual entitled “Recruiting for Retention”; to the recently released “Midwest Retention Toolkit” that was a collaborative effort of the Primary Care Offices of Minnesota, Wisconsin and Indiana as well as the National Rural Health Resource Center and 3RNet. These documents borrowed from many resources created over the years and are great tools to have around for anyone involved in healthcare recruitment and retention. Contact your state 3RNet member to inquire about these two documents or to discuss what other resources they may have to assist you in your work. I also usually encourage people to look into the Association of Staff Physician Recruiters (ASPR) because of the wealth of knowledge and resources they have developed and make available to members.
Mike Shimmens can be reached at 573.635.1525 or firstname.lastname@example.org.
Please note that the views expressed in this article are the opinions of the interviewee and do not reflect the official policies, positions, or opinions of the Health Workforce Information Center or its funder.