Jerry A. Weissman – Vice President, Medical Staff Development, Community Health Systems David Baker – Regional Director, CHS.

As part of our ongoing concern to present timely insights and opinions of  healthcare executives “in the corner office,” will regularly spotlight the views of individuals serving in leadership roles with prominent hospitals and health systems. 

The following remarks are highlights of a recent conversation with the following individuals:

Jerry A. Weissman (middle) – Vice President, Medical Staff Development, Community Health Systems (CHS)  David Baker (left) – Regional Director, CHS. Representing the Jackson & Coker Industry Report: Ed McEachern – Vice President Marketing, Jackson & Coker Thomas McKeever (right) – Director of National Accounts, Jackson & Coker.

JCIR:  What important issues do you see impacting the health care industry today? 

JW:  There are concerns among hospital administrators that they can’t be all things to all people.  Related to this is the matter of assessing the profitability of service lines.  Some that are not profitable have to be curtailed.

Another matter of concern is effective physician recruitment and retention.  It’s important to build relationships throughout the process.  The key is to help the doctor find a niche in the community where he will really be appreciated for the medical care he will be offering.

Also, it’s important to treat doctors as customers.  In so doing, look at the reality of supply-and-demand.  Doctors nowadays have more options than ever before.  It becomes necessary to give them a reason to select the facilities that want to hire them.  Toward this end, it’s beneficial to have a user-friendly recruitment approach.

Lastly, the further reality is that doctors want to be hospital employees. They look for a certain quality of life, which is always important.  CEO’s need to recognize another reality:  “Doctors want to have all the toys”; that is, the latest medical equipment—which drives up the cost of health care delivery.

DB:  Another factor is the high medical malpractice rates, especially in southeastern Pennsylvania.  Doctors tend to request extra medical tests and procedures because they are scared of major medical malpractice claims. 

JW:  More and more, doctors are forced to practice defensive medicine.  Their thinking is, “Maybe I should; therefore, I will.”  This also raises the costs of health care considerably. 

JCIR:  How do you feel about proposed universal health care?

JW:  This is a very complex issue.  As much as we might agree that it is beneficial to think about treating more people, how is it to be paid for?  This is an important question for everyone who touches healthcare.  We all have to be willing to give up something, obviously.  Doctors wonder, though, as their income decreases, how do they see more patients?  Hospitals can’t continue to treat so many underinsured and uninsured.

Okay, we’re here now…where do we go from here?  How will primary care be affected?  We’re not replenishing the pool of primary care doctors who are tasked with treating more patients. Often, primary care physicians are saddled with great debt--leading many of them to opt for going into higher-paying subspecialties.  Certainly the system should be more equitable for primary care doctors. 

DB:  Without doubt, this is a problem for primary care physicians.  They do more preventive medicine, which may actually have a greater impact on treating more patients than is the case with subspecialists.

JCIR:  What about the trend concerning more remote forms of practicing medicine?

DB:  In our hospital system, we’re seeing more emphasis on contract services for such medical services such as telemedicine.  In addition, there are more midlevels working in rural areas or remote clinics.

JW:  In some cases, we’ve seen elimination of service lines in more remote areas, based upon factors such as medical malpractice and profitability of specific service lines. 

JCIR:  Does your healthcare system feel competition from the “doc-in-a- box” clinics such as in retail stores like Walgreens?

DB:  Not really.  In some cases we are already providing the midlevels for clinics like the ones at Walgreens.  We don’t expect this trend to discontinue. 

JW:  Competition is always good.  Doc shops serve a purpose in the grand scheme of things.  However, they are not perceived as a direct threat to hospitals by and large.

JCIR:  If you could spend an hour to personally consult with President Obama, what would you want to say to him?

DB:  Go slower with health care reform.  Involve the ideas of everyone involved in health care to suggest appropriate direction for appropriate reform measures.  Why the rush?  Furthermore, as good as your proposal might sound, who pays for it?  As a free-market guy, I’m concerned that tax payers are left with such a heavy burden.

JW:  By all means, involve all the stakeholders—patients, clinicians, hospital executives, legal experts.  Everyone needs their “day in the sun.”  Everyone who touches health care needs to voice their views.  Furthermore, a single [government] payer is questionable.

DB:  One unfortunate consequence is that universal health care might drive private insurance out of business, as some fear.  Also, it might take other forms of private competition out of the mix.  There’s definitely a need to reconnect consumers with providers so that it’s a win-win situation.

JW:  Consumers certainly need to take more part in their own health and wellness program.  Otherwise patients feel:  “Fix me…take care of me, even though I don’t have the money.”  In any case, consumers need to be more proactive prior to catastrophic events occurring, which are very costly.   

JCIR:  What are your views on end-of-life medical care, which is a controversial aspect of the proposed universal health care? 

JW:  We really have to look at the quality of life of the patient. There comes a point of no return when quality of life is minimal.  Hard decisions have to be made at that point, and everyone involved in health care delivery should be heard on the subject. 

DB:  It’s advisable for consumers to be educated and plan what they want to happen at the end of their life.  They need to take proper responsibility to help with the costs, which can be burdensome for those left behind.  From personal experience with an immediate family member, I know how hard these end-of-life decisions are, but they have to be made in a responsible manner. 

JCIR:  Are you happy with your choice of health care as a profession?

JW:  Yes.  I started teaching and it lead to recruiting.  Recruiting has always given me a sense of being a true professional, in as much as health care is definitely an honorable profession to represent.
 
DB:  I began working in physical education and coaching, then serving in administration of rural clinics.  I had to staff clinics and recruit for HCA in Nashville.  Also, I worked in consulting as part of my professional background.

When I was in coaching, I took pride in winning. Thus, I like to contribute to the success of situating a doctor in a community where he serves well and is happy.

JCIR: Would you encourage relatives to go into the health care field?

DB:  I would certainly encourage relatives to go into health care, and I have relatives who had made that decision.  It’s a “true profession” that most find very fulfilling.  To some extent, it is recession-proof as there is definitely a long-term need for health care in our society. 

JW:  Practicing medicine is an honorable profession.  It can be rewarding if you remove some of the barriers that doctors face, such as exorbitant medical malpractice, excessive rules and regulations, and the fact that some insurance companies don’t allow doctors to be doctors and practice medicine the way they were trained.

From the standpoint of health care executives:  It is rewarding to move doctors into communities where they are sorely needed.  It gives a sense of accomplishment to position them where there aren’t barriers keeping them from doing what they are trained to do.

JCIR:  How has technology changed recruiting?

JW:  Basically, we’ve gone from smoke signals to the Internet.  Nowadays recruiters have to be Internet savvy and use appropriate media to reach viable candidates.  We need to reach today’s generation, such as younger doctors who are greatly concerned with quality of life. 

Recruiting more International Medical Graduates is also part of today’s reality. Generally speaking, they are tech savvy.  Additionally, we need to be sensitive to cultural differences and help new hires blend into the communities where they will be practicing. 

DB:  Technology has moved so fast in the past 25 years, especially from the time when companies were just getting used to fax machines.  I well remember the time when we would mail resumes and hope they got there on time!  Social media is also having a big impact on the recruiting landscape, and recruiters must incorporate that into their recruitment strategies.

JCIR:  What advice would you give agency physician recruiters?

JW:  Agencies need to police themselves and not try to give hospital executives unsolicited advice.  Surely there are some good, quality recruiters—as well as some who are not a credit to their profession.  What is needed is for physician recruiters to be forthright and show honesty and integrity. 

Also, display a true interest in both parties.  In other words, be in it for the long haul.  Those who are simply after the quick buck tarnish others with a different outlook.  There are times when a placement just doesn’t work out.  But why try to win the battle if you lose the war?

DB:  By all means, don’t forget who the client is.  Always treat clients and doctors as professionals.  Furthermore, don’t try to control the process and dictate how things should be done.

JW:  Some recruiters misrepresent the opportunity or the doctor’s interest.  They make it really sound like he wants to relocate to Alabama, for instance, when that isn’t the case.  The client is annoyed to interview someone who really doesn’t want to relocate to their area. In short, know what the industry is all about.

JCIR:  How prevalent is the use of locum tenens providers in your hospital system?

JW:  About 99.9% of the time our focus is on permanent hires.  However, we are educating our CEO’s concerning the benefits of locum tenens, especially in maintaining coverage and revenue streams.  We also point out cost versus return on investment.

Locum tenens is good for doctors who are on vacation and to fill in during permanent searches.  We educate administrators concerning the advantages of locum-to-perm options to maintain service lines.

In the absence of a productive physician, it’s like having a plane full of passengers and no pilot.  Our shared concern is:  “Don’t just get a pilot; get the best pilot—like the one that landed in the Hudson River.”  To do that, it’s necessary to know what the health care industry is all about.

DB:  Some hospital recruiters are well versed in the use of locum tenens.  We need to educate others on the benefits of including it in an effective staffing model. 

Community Health Systems (www.chs.net) is one of the country’s prominent operators of general acute care hospitals.  Organizations affiliated with CHS either own, operate or lease over 120 hospitals in 29 states that collectively represent over 18,000 beds.  Additionally, CHS provides hospital management, consultative and advisory services to over 150 independent community hospitals and health systems located throughout the United States.

Jerry Weissman joined Community Health Systems in December 1993 and currently manages a staff of over 20 people.  His professional background includes over 20 years of physician recruitment and management experience, including association with Charter Medical Corporation and several years with a major physician search firm.  In addition, Mr. Weissman is an active member of the Association of Staff Physician Recruiters.

David Baker joined Community Health Systems in January 2001 and is the Regional Director for facilities located in Pennsylvania, New Jersey and West Virginia.  He also serves as liaison between Medical Staff Development and the Legal department.  His experience in health care includes clinic administrator, consultant, and owner/vice president of a national physician recruitment firm.