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The Recession and the Three R’s of Healthcare: Reform, Recruitment and Retention


Medical Groups Are Adjusting to Meet Economic Challenges Reports Cejka Search and AMGA Survey

ST LOUIS, (March 30, 2010) – Continuing economic challenges and enactment of healthcare reform pose new pressures on how compensation is structured as medical groups seek to recruit and retain physicians. In fact, America’s leading medical groups ranked compensation-related strategies as most important for recruiting and retaining physicians at all career stages, according to the 2009 Physician Retention Survey. This is an annual survey from the American Medical Group Association (AMGA) and Cejka Search, a nationally recognized physician, allied health and executive search organization.

In the recently released AMGA/Cejka Search survey, the top three recruitment strategies medical groups most frequently cite as important were financially focused: Market-based Compensation (65%), Income Guarantee (61%) and Signing Bonus (42%). For the retention of physicians, respondents indicated the three most important strategies were Market-based Compensation (70%), Productivity Bonus (60%), and Flexible Schedule (34%).

“When it comes to physician recruitment and retention, compensation is a critical factor physicians consider before accepting a new position or leaving their current practice,” said Lori Schutte, president of Cejka Search. “Based on the changing marketplace, healthcare reform could add to the financial pressure from new physicians looking for guaranteed base salaries and difficulty retaining mid-career physicians who are motivated by the productivity-based model. Competition will be even greater between hospitals and medical groups for the target pool of physicians, and could make it necessary to revise or create new incentive programs.”

“Medical groups are leading the way in preparing for healthcare reform,” said Donald W. Fisher, Ph.D., AMGA’s president and chief executive officer. “The survey findings demonstrate that medical groups across America are actively implementing recruitment and retention strategies that successfully address the needs of physicians at every career stage while meeting the challenges imposed by a difficult economy and healthcare reform.”

Seventy-eight percent (78%) of respondents cited taking action to prepare for healthcare reform through active engagement in political lobbying through their association representation and/or examining operational strategies and planning in anticipation of future changes.

It’s a difficult economy and medical groups are taking action
• Survey respondents reported a 5.9% turnover rate in 2009, compared to 6.1% from the 2008 Physician Retention Survey and 6.7% from the 2006 Physician Retention Survey
• The stable-to-lower turnover rate of 5.9% suggests the effects of a difficult economy and real estate market on retirement or relocation, directionally reflecting the 2008 survey findings (response period was October through December 2008) which showed that the economy was already having an impact on recruitment and retention:
o Nearly two-thirds (62%) of the 2008 survey respondents reported that physicians were delaying retirement due to the economy
o More than half (53%) cited that the ability of candidates to sell a home to relocate to a new community had a negative effect on their recruitment activities
• The 2009 survey reported that due to economic conditions, a majority (85%) of respondents indicated that they were changing the way they recruit and more than three quarters (76%) cited adjusting their retention activities
o In response to the economy, medical groups are implementing flexible scheduling, examining operations to reduce expenditures and increase efficiencies, continuing to emphasize hiring for fit, on-boarding/orientation, mentoring, and conducting cost/benefit analysis of resource allocation

Recruitment and retention strategies evolve with physicians in their careers
• As careers progress, results showed a shift in the importance of recruiting and retention strategies:
o Guaranteed compensation was important for early career physicians
o Productivity-based compensation was important for mid-career physicians
o Flexible time and greater quality of life was important for late career physicians
• Several strategies were cited that were uniquely important to each career stage:
o Advanced Technology was ranked as important for early career physicians
o Shareholder or Partnership Opportunities and Leadership Opportunities were important to mid-career physicians
o Flexible Hours was important for late career physicians
o Notably, Hospitalist Support was ranked as being important in all three career stages

Part-time practice continues to grow
• Survey respondents reported that 21% of physicians work part-time, up from 19% in 2007
• Of those physicians working part-time, the gender mix also changed with the percentage of part-time physicians who are male increasing from 40% in 2007 to 43% in 2009
• Survey responses showed that among all part-time physicians, 22% are males aged 55+ and 34% are female aged 44 or younger
• Survey respondents who reported a primary reason for part-time work cited Administrative/ Leadership Duties (64%) and Preparing for Retirement (17%) as the most frequently mentioned reasons for male physicians and Family Responsibilities (54%) and Administrative/ Leadership Duties (32%) for female physicians

The 2009 survey is available to AMGA members for $150 for the electronic version and $175 for the printed edition. The non-member cost is $300 and $350, respectively. For more information and to purchase a copy of the survey, visit:

The Cejka Search and AMGA 2009 Physician Retention Survey was distributed electronically via email to 641 medical organizations and data was collected from November 2009 through January 2010. A total of 73 survey responses were compiled, representing an 11.6% survey response rate. These responding groups collectively represent a population of 12,452 physicians.

About American Medical Group Association (AMGA)
The AMGA represents medical groups and organized systems of care, including some of the nation’s largest, most prestigious integrated healthcare delivery systems. More than 102,000 physicians practice in AMGA member organizations, providing healthcare services for approximately 105 million patients (nearly one in three Americans). Headquartered in Alexandria, Virginia, AMGA is the strategic partner for these organizations, providing a comprehensive package of benefits, including political advocacy, educational and networking programs, publications, benchmarking data services, and financial and operations assistance. For more information, visit

About Cejka Search
Cejka Search,, is a nationally recognized physician, allied health and executive search organization providing services exclusively to the healthcare industry for more than 25 years. Partnering with organizations in pursuit of the nation’s best healthcare talent, Cejka Search completes assignments across all levels of the healthcare continuum. Cejka Search is a Cross Country Healthcare, Inc. (Nasdaq: CCRN) company, a diversified leader in healthcare staffing services.

For more information visit, contact
Michelle Kuehler (Black Twig Communications), 314-255-2340, or Nancy Burns (Cejka Search), 314-236-4461


 healthcare reform
 hiring physicians
 physician retention
 physician recruitment
 Cejka Search

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