How to land the best associates for your medical practice

Your practice is growing, your new patient visits are backed up for weeks (or months), and you can't recall when you took your last vacation. To make matters worse, one of your partners just announced plans to retire. How to get your workload down to manageable proportions?

Add an associate.

That's easier said than done, it turns out, for many primary care practices and some specialty groups. Internists are in such demand that one prominent physician-recruiting website had 884 positions posted-and only 132 candidate resumes. Dermatologists, too, are in short supply: A recent survey found that one in three dermatology practices is seeking an associate or a buyer. In orthopedics, there's one resident entering the field for every two orthopedists who are retiring.

There's no single, sure-fire measure. But 25 years' experience as a consultant and practice broker helping doctors find associates and buyers has taught me that there are a number of ways to showcase your practice-and make it more likely that potential associates will see it as a place where they want to be.

Put a positive spin on your geography

You can't change your locale, of course, but you can highlight its strong points and mitigate or downplay its less attractive features. You can also reinterpret the meaning of geographic desirability, based on a lesson it's taken me years to learn: The main factor in successful recruiting is to find an associate who wants to live (and whose family wants to live) in or close to your community, often because of having family nearby. Many physicians eventually move to be near aging parents or in-laws who can help with child-rearing. But such geographic desirability only applies if the family members live less than an hour-or no more than 20 miles-away. The same rule of thumb applies to proximity to a beach, ski resort, or cosmopolitan city.

In today's economic downturn, however, cost of living is a key consideration. Thus, practices in high-end areas that might otherwise be among the most attractive places for physicians to settle are finding it difficult to recruit associates. If they've been hit hard by dominant health plans with low reimbursement rates, the cost of housing becomes prohibitive in relation to earnings potential.

The converse is also true. So if your practice is in an area where home prices and property taxes are reasonable, you can use that fact as a recruiting tool. It's a good idea, too, to promote local benefits like excellent schools, a low crime rate, or outdoor recreation. I once had a candidate who chose a practice in a small town that other associates had rejected, primarily because it was an excellent place for mountain biking-his favorite hobby.

Improve your practice's performance

Location and family may rank highest in the competition for associates, but these factors are rarely enough to overcome weak financial performance. The Internet has eased physician access to financial benchmarks for medical practices, and younger doctors tend to be more savvy than older physicians about expected income and overhead. As a result, if you can't afford to offer a compensation package that's at least in the 50th percentile of market salaries and incentives, recruiting will be especially difficult for you.

In such cases, I've found, it may be better to wait a year or two before attempting to bring in one or more new associates. That's not as long as it may sound, considering that I generally advise practices to allot up to three years to find an associate.