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MediCorp seeks specialists MEDICINE >> Hospitals must compete to attract physicians

March 9, 2007 12:35 am

BY JIM HALL

When recruiters called last year--and dozens did--Dr. Reshma Parab told them that she wanted three things from her first job:

She wanted to practice endocrinology, her speciality, and not primary care.

She also wanted to live in a medium-size city. New York City, where she did her fellowship training, was too crowded and too expensive, she said.

And she wanted to be employed by a hospital or an established group. She didn't want to set up her own office.

"You have to be pretty savvy to be able to run a successful practice right off from a fellowship," Parab said. "I don't think most of us have those skills."

MediCorp Health System and Mary Washington Hospital met Parab's conditions, and she began working there in August. With two colleagues, she helped set up the hospital's first endocrinology practice for the treatment of diabetes and thyroid problems.

"I was really surprised how quickly we got busy," she said.

Parab's arrival here is symbolic of a change taking place across the nation. Officials at Mary Washington and other hospitals realize now that if they want to recruit specialists, they'll probably have to put them on the payroll.

One of the oddities of modern medicine is that doctors usually work at hospitals but not for them.

Of the 337 doctors with clinical privileges at Mary Washington, only 22 are employed full or part time by the hospital, according to MediCorp figures.

The hospital's parent company has long preferred that doctors join existing groups or set up their own practices. And many still do.

Last year MediCorp paid recruiting costs or offered start-up loans to 25 specialists who moved to the region to work in private practice.

But a shift in the company's strategy became apparent in 2005, when the hospital took over a cardiac-surgery practice and set up a neurosurgery practice and pediatric hospitalist program.

"It happened quickly," said Robert K. Lively, MediCorp's executive director of physician relations.

Since the beginning of last year, the company has employed 14 specialists, including Parab. These specialists work in diabetes management, general surgery, weight-loss surgery, cancer surgery and infectious-disease control. Another group are pediatric hospitalists.

These hirings occurred after MediCorp identified gaps in the region's medical offerings and concluded that existing practices would not be recruiting in those areas.

Company officials estimate that they spend about $1.1 million a year in recruiting programs and start-up loans. Another $8 million a year goes for physician salaries.

Also fueling the trend are the specialists themselves. Many prefer being salaried employees to being self-employed.

Merritt, Hawkins & Associates, a national physician-recruitment company, reported last year that "hospital employment of physicians appears to be on the rise."

A hospital has a "recruiting advantage" if it's willing to employ a specialist, the company said.

Many physicians, especially specialists, want to avoid the administrative duties of private practice, the company reported.

In addition, the market favors doctors because of the limited supply, said Mark A. Schwartz, director of medical staff development and physician recruitment for MediCorp.

It's not unusual for specialists to have dozens of job offers, Schwartz said.

"They don't necessarily want to take a risk. They don't have to," Schwartz said.

Last year when Merritt, Hawkins surveyed 285 residents in their final year of medical training, 52 percent said they would "strongly consider" working for a hospital. Eight percent felt similarly about solo practice.

"You come out and start interviewing and you realize you don't know a thing about setting up a practice," said Dr. Leslie C. Taguba, an endocrinologist recruited by Mary Washington last year.

Taguba finished her fellowship at the Cleveland Clinic in 2001, then went to work as an internist at a hospital in rural Wisconsin.

She left Wisconsin last year, telling recruiters that she wanted to practice endocrinology, for which she had been trained.

She realized when she started interviewing that while she knew much about diabetes, she knew little about business.

"I couldn't understand half of what they were saying," she said.

Taguba told recruiters that she wanted to work at a practice where she could learn things like hiring a staff, setting up a call schedule and dickering with insurance companies.

MediCorp, offering a new practice in Fredericksburg and plenty of support, fit the bill. She joined Parab and Dr. Francisco Cruz in the hospital-owned Endocrinology and Diabetes Associates.

"It's a training ground for us, " she said.

It was one thing for Parab and Taguba, who are beginning their careers, to choose hospital employment. But Dr. Victor R. Stelmack did as well. He has been a surgeon for 26 years.

Stelmack arrived in Fredericksburg last year from Columbus, Ohio. He was recruited by MediCorp to set up a bariatric-surgery program.

Stelmack chose a salaried position to avoid the hassles of solo practice.

"I was willing to give up the freedom of having my own office, so that I could take care of the things that I wanted to do, which is take care of the patients," he said.

MediCorp officials hope that other specialists will decide similarly this year.

So far, one has already opened a new practice here as a hospital employee, and more are being recruited.

Dr. J. Timothy Sherwood, a thoracic and general surgeon, opened an office this week.

MediCorp also plans to recruit and employ two rheumatologists and three or four neurohospitalists, Lively said.

In addition, the hospital wants to expand its pediatric program. It has contacted several children's hospitals, seeking a partner to bring pediatric specialists, such as a pediatric endocrinologist or pediatric gastroenterologist, to the area for weekly visits.

"One of our goals is to continue to develop Mary Washington Hospital as a regional medical center," Lively said.

Staff librarian Craig Schulin contributed to this story.

JIM HALL: 540/374-5433
Email: jhall@freelancestar.com