Gate Keepers: Recruiting Physicians

With 6 462 employees New Hanover Regional Medical Center/Cape Fear Hospital is unquestionably the county’s largest employer. Just under the NHRMC Physician Group the hospital and its affiliates employ 250 doctors physician assistants nurse practitioners and teaching faculty.

The list includes primary care physicians surgeons and specialists of all kinds. All contribute to the general health and wellbeing of the region. And all could be working somewhere else.

There is rigorous competition to bring the best and brightest medical professionals to town. That’s where physician recruiters come in.

Kathy Gresham has worked in physician recruitment for more than 30 years 10 of those as director of physician relations at NHRMC serving as the liaison between the hospital and its area physician practices. She is responsible for assisting these practices and the hospital in finding new physicians physician assistants and nurse practitioners.

She has brought in 50 in the past two years alone. The recruitment is due to growth.

“With a few exceptions for succession planning it is all growth which is an exciting place for us to be ” she says. “I have over 20 openings right now.”

In addition to physical health medical professionals contribute greatly to the economic health of the community.

“Through patient admissions tests prescriptions procedures and other activities physicians receive or control 87 percent of all spending on personal health in the United States ” states a report published in 2014 by Merritt Hawkins the nation’s leading physician search and consulting firm.

In another report from 2014 Merritt Hawkins lists 20 247 physicians in North Carolina with a combined $29.4 billion in economic output or $1.5 million per physician.

Estimates state each physician in a primary care realm is responsible for supporting 10 jobs including nurses and the support staff lab techs and billing and coding.

“It’s amazing the impact physicians have on our community ” Gresham says. “Of course there is their medical expertise but there are others areas where doctors make great contributions. They have huge social and financial input in the Wilmington area. Often their spouses become involved in charities and other organizations that contribute to making this a great place to live. Their children attend area schools bringing more parental volunteerism into the classroom. In fact whole families tend to become very involved in the community enriching everyone.”

Why We Care

There are other recruiters and head hunters enticing doctors to town. Between them Gresham estimates 50 physicians physician assistants and nurse practitioners are recruited to Wilmington annually.

“Everyone who relocates to the area brings what they love. As a result Wilmington is a different kind of community richer and more cosmopolitan than many similar small cities in the state ” says Alysa Bostick director of physician relations and marketing at Wilmington Health the largest multi-specialty private practice independently owned and managed by its physicians.

Tracy Pope’s Professional Health Care Consultants has been doing clinical and business recruiting since 1991. She recruits physicians and mid-level providers in all areas hospitals and medical practices.

“How our community is growing in medicine and the money that we bring into the community — it has a ripple effect — from real estate to retail ” Pope says. “Because of where we live geographically we get some of the best educated physicians in the country; they want to live here and our medicine is so good because of it. Best trained best educated.”

Some of the new physicians bring cutting-edge practices and technology to the area.

“Physicians make a mark and move our medical community forward ” Bostick says. “New technologies and devices are brought to this region which improve care. Many times the doctors are coming in from larger cities where they have more equipment and cutting-edge procedures.”

Dr. Matt Janik an invasive cardiologist brought a procedure called cardiac calcium scoring to Wilmington. Using a CT scan to measure a person’s risk of a heart attack Janik determines the degree and severity of hard plaque within the coronary arteries.

“The doctors we recruit have helped us grow the quality of care in New Hanover County ” Bostick says.

Dr. Megan Kinney pediatric and adult dermatology is the area’s first pediatrics fellowship-trained dermatologist.

“She treats port-wine stains hemangiomas and other vascular lesions as well as scar revision and improvement in both children and adults ” Bostick says. “Prior to her arrival children would have had to leave the area to receive the care they needed.”

They and other specialists recruited to Wilmington make it possible to get virtually any level of care without leaving town.

“I am genuinely displeased if I have to go out of this community to go to another health care center for care for me or my family ” Bostick says. “Ten years ago we all would have considered it commonplace. To keep the health care here so that we as mothers don’t have to travel with our children and with our spouses is one huge piece of it.”

Whom They Recruit

Most of the doctors targeted by the recruiters are young having recently finished medical school and their residencies.

“The majority of the physicians that we are recruiting are relatively new grads ” Gresham says.

There are exceptions. The recruiters look for doctors who fit a specific need and bring a new skill.

“In those areas I am going to recruit an experienced physician not a new grad to help us develop the new service line ” Gresham says. “Cardiology is a service line neurology is a service line those are two of the different specialties.”

Gresham recruited the area’s first movement disorder neurologist specializing in treating patients with Parkinson’s disease. Dr. Panida Piboolnurak completed her fellowship training at Cornell and is newly relocated to Wrightsville Beach. She joined NHRMC Physician Group on December 1 2016.

“She is an experienced physician someone who has been doing it for a few years but it is a brand-new modality here in Wilmington ” Gresham says.

Previously her patients were driving to Raleigh to seek care.

Retention/Turnover

While some areas have difficulty recruiting and retaining doctors the Wilmington region has attracted and kept some of the best and brightest.

“Once they get here they don’t want to leave ” Gresham says. “That has a lot to do with our community the quality of life here.”

The national average for physician turnover is about 6 percent. New Hanover’s is just over 1 percent including retirements.

However it can be a challenge to replace retired physicians.

“When a doctor retires it takes 1.5 to take his or her place because young doctors are very much interested in achieving a reasonable balance between work and life ” Gresham says.

The Art of Recruiting

As the ones tasked with bringing top-notch talent to the area physician recruiters must be adept in assessing and understanding the needs and knowing how to find the best candidates. They also have to be persuasive salespeople who can provide the doctors what they need to know to choose Wilmington.

“Historically if you come into an organization that is large enough that it needs to recruit new physicians you have got probably four or five different people doing little bits and pieces of that job ” Gresham says. “So you have an HR person a travel person you’ve got an administrator you have the physician. There is no one person coordinating all of the activities that it takes to source attract and hire a physician so the physician recruiter is that person. These are the ones that understand what the needs are and the sophistication of the needs in our practices and we also understand what a good fit looks like for our practices. We are the gate keepers basically.”

Gresham plans every detail of the visit for prospective physicians: hotels rental cars and an area tour with a real estate agent. She organizes a day to visit with other physicians and to tour the hospital and facilities. If they are bringing their family she plans activities for the spouse and for the children.

“These folks are leaving families; they are leaving churches friends schools and having to come to our community to re-establish those relationships. It is a huge responsibility to make sure that we’re going to have what the physician and their family need in our town ” Gresham says.

Gresham recruited Dr. Chad Talton family medicine/hospitalist from Montana in 2009. Talton trained and worked in Montana but he came to the coast with plans to take up surfing after trying the sport once or twice.

“Kathy was an excellent recruiter and she made it real comfortable for us when we came down ” Talton says. “That’s what kind of drew us our interaction with her and then we enjoyed the community of Wrightsville Beach.”

His future wife came with him and now the family of six is very involved in the community.

“He loves to surf and she has found her place in the local equestrian community. I gave them their first SUP lesson in Banks Channel ” Gresham says.

A hospitalist with New Hanover Dr. Holly Ray is an eastern North Carolina native who attended N.C. State and then East Carolina University for medical school before being recruited by Gresham.

“I chose to come down to Wilmington because of work/life balance and coastal living and really the hospital compared to some of the other coastal hospitals in North and South Carolina ” she says.

She and her husband Cliff have started a company manufacturing ocean rescue paddleboards for lifeguards.

In the competition to find and attract top physicians the recruiters are up against the larger universities the medical schools the Charlotte and Charleston communities and the Research Triangle Park area.

Dr. Lindsay Prochaska a hematology/oncology fellow at the University of Kansas Medical Center in Kansas City will join the hospital in July. She too brings a new expertise to the community as she is completing an additional year of oncology with a focus on breast cancer. Prochaska had other options.

“I had other offers on the table ” she says.

One was in Kansas and two were in Georgia. She also talked with East Carolina.

Prochaska is a native of Virginia and her husband is from Raleigh. They both vacationed in the Wilmington/Wrightsville Beach area every year since childhood and always dreamed of settling in the area.

“Many of my husband’s family members live in Wilmington including his grandmother that I lived with during my fourth year of medical school while rotating at New Hanover Regional ” she says.

Gresham reaches out to the different university programs to find the best candidates. She visits program coordinators and attends resident receptions to meet and greet new young physicians. She spends a lot of time on the phone and a lot of time on the computer following up with the candidates.

“I get a lot of questions about hurricanes and crime but the most important aspect the doctors seem to be concerned about is education ” Gresham says. “Most of the doctors coming in have families and they want to make certain their children will receive a good education. With teacher salaries stagnant and our ratings slipping there have been concerns.”

When she assuages their concerns Gresham says most of the physicians put their children in public schools. The whole community then benefits as the doctors and their spouses get involved.

“They and their spouse can get involved in giving back to the community and make a difference in the lives of other people — not just in the work that they do but also personally how their families can make a difference. Their wives get highly involved in the community lead a lot of volunteerism efforts and help generate funds and resources for people in our community that need them ” Bostick says.

Dr. Kevin Adgent’s is one such family. A hospitalist originally from Maryland Adgent came to Wilmington with wife Drea and their son Ethan.

“Ethan is 8 and I’m very involved in the schools — anything from art projects to extra reading ” says Drea Adgent who also is involved with the Pink Ribbon Project raising funds and awareness for breast cancer. “We feel it’s our duty to give back. After all we live in a community where people come for vacations — how lucky is that! The beaches are minutes away and we’re not too far from the mountains. Wilmington is just the right size — not too big but big enough. We have access to everything we might want or need.”

Anne Barnhill contributed to this story.

Hospital Privileges and Residences

New Hanover County Regional Medical Center has 550 physicians and 320 nurse practitioners and physician assistants with hospital privileges. These doctors can admit patients round on those patients and write orders for the care of those patients. Some doctors do not have hospital privileges. Their patients rely on New Hanover’s hospitalist program for that higher level of care. Hospitalists are typically internal medicine physicians who only take care of patients inside the hospital and do not have outside practices. The hospital also offers residencies — essentially graduate-level training — for medical school graduates. “We have four residency training programs at New Hanover; we actually have our own medical students for the first time ever that are from Chapel Hill ” Kathy Gresham says. New Hanover’s four residency programs are internal medicine family practice OB/GYN and surgery. “All those programs are so excellent that we try to recruit physicians from those residency programs ” she says.