Rural Physician Recruiting Challenges and Solutions

Practical Candidate Parameters The ideal physician candidate often fits a certain mold. Ivy Leagued-trained with movie star looks is what many healthcare facilities, both rural and non-rural, have in mind when formulating candidate parameters. The reality, however, is that the right candidate is the one who wants to be in your community, communicates well, has a strong work ethic and the requisite clinical skills. It is more effective to focus on these qualities than on an idealized image of what a candidate should be. Candidate parameters should be set in writing before the search and should be inclusive of all physicians who possess the needed attributes, whether they are older than 50, female, a minority member or internationally trained. The first candidate who possesses the majority of the necessary commitment, skills, and personality should be made an offer. It is a mistake to “comparison shop” in today’s market, because candidates who do not receive a timely offer usually move on. Obtain a HPSA Designation There are many reasons why a rural hospital, medical group or other healthcare organization would want to ensure that its service area be federally designated as a HPSA (Health Professional Shortage Area) or a MUA (Medically Underserved Area). HPSA or MUA designation may qualify a healthcare facility or a community for 29 federal programs or benefits, including status as a Federally Qualified Health Center (FQHC), the ability to use National Health Services Corps physicians, funding for electronic health records, scholarships for students interested in becoming doctors, and a 10% increase in Medicare reimbursement. Healthcare facilities also need HPSA or MUA designation to sponsor internationally-born physicians on J-1 visas for a waiver of the two-year home residency requirement. This is the rule that compels physicians on J-1 visas to return to their home countries for two-years before practicing in patient care roles in the United States. A waiver of this rule can be obtained if the physician can find employment with a sponsoring healthcare facility in a federally designated HPSA Wor MUA. Approximately 6,000 to 7,000 of all final-year medical residents and fellows entering the workforce each year in the United States are international medical graduates (IMGs) – or one quarter of the total. Of these, the great majority are born overseas and train in the United States on J-1 or H-1 visas. Since those on J-1 visas almost always seek out employment in underserved areas in order to obtain J-waivers, they can be an important resource for rural healthcare facilities in such areas requiring physicians. In addition, most international doctors wishing to obtain green cards using National Interest Waivers (an expedited form of green card processing) must practice in a designated shortage area for five years before being granted permanent residence. Suggestions for obtaining HPSA designation are included in AMN Healthcare’s white paper, Recommendations for Obtaining a HPSA Designation for the Purpose of Sponsoring International Physicians for J-Waivers.

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