Managing a rural hospital or clinic gives you firsthand experience with these statistics. A little over 10% of doctors are working in rural areas, while about 20% of the U.S. population is living in these rural communities. To make it worse, the gap is getting larger. There are over 7,000 Health Professional Shortage Areas, or HPSAs, that the HRSA designates to rural areas throughout the United States.
It is time to look at staffing through a different lens when it comes to rural areas. Healthcare staffing for rural facilities is not like traditional staffing because you have to recruit a person, and many times their entire family, to an entirely different lifestyle. Traditional job ads that you put out with a focus on blasting ads with the hopes of getting applicants to reply are not working for the staffing of your rural facilities.
There is a gap that you have to close when recruiting to your rural facilities with the top of the line clinicians. Healthcare staffing needs to look at rural recruitment with a fresh, outside-the-box perspective to secure the right candidates for their rural facilities. Leading rural hospitals are already doing this, and these are the strategies they use.
You cannot diagnose a problem without knowing the root cause. This also applies to recruitment. Rural hospitals and large city hospitals require completely different recruitment strategies because they have completely different barriers to entry. Large city hospital candidates are mostly looking for salary, prestige of the facility, and shift schedules. When you are recruiting doctors to a rural area, they are making a commitment to their future.
You are on the wrong side of the numbers here. It is difficult to get a nurse to practice in a rural location when he has been training in a city his entire life and knows all the social circles and professional opportunities are concentrated there. It takes a deliberate break in that pattern to get someone to come work in rural healthcare.
Rural recruitment isn't only recruiting for the individual position of a nurse or physician; it's recruiting the entire family. Many prospective candidates cite lack of spouse/partner opportunity as the #1 reason for declining a rural offer. A move can be dead in the water for many professionals in tech and corporate fields, particularly the spouse/partner. Top tier recruiters in this niche anticipate the spouse/partner's need and create strong connections with business owners and leaders in the local chamber to provide opportunities, even the option of remote employment.
When considering working in a rural location, a lot of candidates will imagine isolation, and think that there is nothing to do there, that they will be behind on their career development and will not have all the things that they are used to having in a more metropolitan area. Part of what the candidates have to deal with when practicing medicine in a rural location is explaining that things aren't really like what they think. Because of that, when you recruit for these rural jobs, you have to find ways to educate them. Some of the benefits that practicing medicine in a rural area provides is the opportunity to do more kinds of clinical work, the need to spend less time on administration, a smaller amount of money for the patient and yourself to have access to care and other basic necessities.
Rural health care facilities can compete with large urban systems on salary. The tools available to them are different and unique, but when used together, can attract talented healthcare providers.
Educational debt is stressful for all clinicians, but even more so for those early in their careers. New clinicians will appreciate and be motivated by information in your recruitment materials that emphasizes loan repayment. A great resource is the National Health Service Corps (NHSC) because it helps you place clinicians in underserved areas by providing loan repayment in return for service for two or three years. There are now over 15,000 clinicians in the program as a result of their efforts beginning in 1972 [1].
The good news is that most states also offer their own localized loan repayment programs, too. Imagine how easy recruitment will be when candidates know they can get as much as $100,000 of their debt wiped out within just three years. This makes accepting an offer in a rural area financially better than accepting an offer in the city.
IMGs provide an exceptional source of labor for rural hospitals. In fact, many J-1 visa medical graduates must return to their home country for 2 years following residency. However, if a medical professional accepts a position at a Health Professional Shortage Area (HPSA) or Medically Underserved Area (MUA) for at least three years, they can skip this requirement under the Conrad 30 Waiver. The first rural facility to successfully apply for a J-1 visa waiver will receive an influx of committed physicians to serve their community for many years.
There are more components to attracting doctors to rural regions than just the offer. Candidates have more things to consider like cost of living, which you should explain for them in the offer. There is a much greater value to the dollar in the rural Midwest. With a salary of $220,000, you can have a luxury home on several acres of land. Whereas, that same salary in San Francisco or New York wouldn’t provide nearly as much. Do the calculations for your candidates in the offer and demonstrate to them what the actual cost of their housing and other living expenses would be.
If a candidate visits your hospital, looks at the clinic, and goes back to their hotel, you have already lost them. Rural recruiting is community recruiting.
You should go beyond just showing them the emergency room during their site visit. You should try to give them the best local dining, take them through the most popular local real estate, set them up with the local school district's superintendent, or take them to a local football game or some kind of local community event. It is essential for your recruits to picture themselves with their families, thriving, and happy in your area.
A number of young millennials and even Gen Z healthcare professionals have begun to depart major cities in search of less traffic, reduced costs, and reduced burnout. Younger workers value space, nature, and community in their environments. Market your rural facility as an oasis for your prospects. If your location is near the mountains, the lakes, hiking trails, or even hunting grounds, make that central to your recruitment material. Don’t try to sell your job to prospective candidates. Rather, try selling the low stress and high rewards of your lifestyle.
Recruiters who develop and sustain local relationships with people in positions of power like mayors and bank presidents are some of the most effective recruiters. When a potential candidate visits, the entire town should make them feel welcome and appreciated. If candidates think a town truly wants them, it can have an immensely strong draw and can be a powerful psychological incentive.
As opposed to filling positions with employees, staffing for rural health centers has changed to use available resources in positions that will remain unfilled. As the need to offer a patient convenience, telehealth is a strategic staffing technique.
Perhaps it is not feasible to bring a full-time onsite specialist to a small town with a population of 10,000, like a rheumatologist or a neurologist. However, partnering with telemedicine care groups will bring this kind of specialty service to your patients. By integrating virtual care to your care model, you lessen the workload on your PCPs, and you prevent them from feeling overburdened and isolated due to an excess of complex cases beyond their area of practice.
Rural hospitals that employ hybrid staffing models for their provider teams are finding a solution to the growing issue of staff burnout. Locum tenens, temporary staffing, helps hospitals cover staffing gaps while full-time, permanent staff take much-needed, scheduled time away. Permanent staff report improved satisfaction and greater overall morale when they feel that they have dependable, dedicated coverage.
For example, a rural hospital may allow a provider to work onsite in a rural community for two weeks while also working two weeks remotely to deliver telehealth services to other communities. Flexible employment models that let potential employees dictate their location and schedule provide a competitive advantage to healthcare organizations that would otherwise struggle to fill rural staffing needs.
Finding an exceptional clinician is great, but it is worse to lose them when they are eligible to end their loan repayment in two years. Retention is equal to recruitment in rural healthcare. In fact, rural facilities suffer from the loss of personnel, as it interrupts the community's healthcare.
You cannot put new hires into the rural healthcare workforce and expect them to survive. This is especially true given the circumstances that rural medicine creates. First of all, the clinical scope for a lot of rural roles requires new hires to operate at the peak of their licensure. For many rural jobs, it means that a new hire will have to manage emergencies that a doctor in an urban environment could just hand off to a specialist. To support new hires in rural jobs, there needs to be an effective mentorship program. Pair the new recruits with more experienced rural healthcare providers for their first few years, and make sure that this mentoring happens both clinically and emotionally.
Being in a rural clinic doesn't mean their career goals have gone by the wayside. You can offer opportunities that let them continue on the path of advancement. Offer to pay their way to conferences that let them grow their skills and offer the chance to meet other health professionals. Support them by providing stipends to get additional certifications. Things such as being point of care ultrasound and advanced trauma life support are great examples. Their growth will ensure they remain where you need them.
The most important stage in retention is day one. How a new physician fits in with their new location influences how long they remain in that role. Provide resources for physician loans to assist them in purchasing a home. Create networking opportunities with local boards and organizations. Happy children in schools combined with an established social circle makes physicians reconsider leaving their roles.
Working harder isn't the solution to rural healthcare staffing. It takes new and innovative ideas. There are three key elements to rural healthcare staffing: selling a lifestyle, being able to negotiate and sell the right combination of financial packages, and integration into the community. Standard advertising methods, including traditional job postings and automated systems, don’t have a prayer of attracting candidates looking to enter the world of rural medicine.
To succeed in this field, it takes the ability to go beyond the usual recruitment sources. That’s what modern recruitment tools provide.
Relode has the right mix of industry relationships and an artificial intelligence recruitment platform with an extensive peer-to-peer network to give you access to a unique candidate pool. Plus, they utilize the recruitment process differently and get the results you want for rural healthcare staffing.
When it comes to building stable teams for rural hospitals, Relode combines human touch, precision and speed, and leverages the right network. Rural recruitment just got simpler [1, 2, 7, 10].