The Association for Advancing Physician and Provider Recruitment (AAPPR) is redefining recruitment to retention and is the only professional organization where physician and provider recruitment leaders and others who influence recruitment, onboarding and retention can connect, learn and advance their careers.
As the COVID-19 pandemic spread over the world, taking over our collective global consciousness, I couldn’t help but be reminded of the earliest days of my career as an infectious diseases physician. My fellowship began during another viral pandemic: H1N1 influenza. Every night brought calls to the bedsides of shockingly young patients who were profoundly sick in the ICU. The similarities between 2009 and the current COVID-19 pandemic, however, end there.
Despite being a new strain of influenza that was particularly deadly for young people, H1N1 quickly revealed its secrets to us. We learned early how it spread, how to treat it, and, eventually, how to develop a vaccine for it. The current novel coronavirus however, has offered no such early victories. Much of the spring passed in a blur as healthcare workers across the country struggled to cope with the sick flooding into our hospitals.
The pandemic made it impossible to deny the inequities in our society, with historically marginalized and underserved populations disproportionately represented among those sick and dying. It laid bare how unprepared we were across the world for a disease of this magnitude. As we were racing to get treatment studies up and running, infection control preventionists were working through appropriate ways to cohort patients and protect hospital workers, and our environmental services workers were perfecting safe ways to terminally clean rooms. We learned how the disease spread, as we tried to work out what medications and interventions worked. This collective challenge for our community of healthcare workers was unlike any most of us had experienced. Caring for the patients we were unable to save and speaking with their frantic family members over the phone contrasted dizzyingly with the euphoria of seeing critically sick patients eventually be discharged after weeks on the ventilator. My hospital rang a bell each afternoon as a reminder of those discharges, something that often afforded me a rare moment of uplift in the middle of a punishing day.
Six months on, we have learned more about this complicated virus. We have more information on which treatments don’t work and which may. We know better how to manage patients in the hospital and the complications that can arise with this infection. Having incorporated the lessons learned from the first wave, our community is developing logistical solutions to help us navigate the second one. For instance, my division responsively devised back-up teams to step up as the numbers surge again. Similar preparations are being made in hospitals around the world.
We should have been in a better place. We had a reprieve in summer when numbers went down, but they never went as low as they should have due to factors that are obvious to us all. The politicization of every aspect of this pandemic has exacerbated its harms, and hampered our response. And now we live through déjà vu as we turn to face the headwinds of the second wave.
While we have drugs that help patients with COVID-19, we do not have a cure. Our only true defense is prevention of spread. After forty six million worldwide cases and having lost well over a million humans to this virus, we know what that looks like. Hand washing, masks and social distancing. Hand washing works. Masks work. Social distancing works. We all have to practice all three. While vaccines are studied and a cure is perfected, preventive measures buy us time; they hold death at bay. They allow as many of us as possible to live until our species achieves herd immunity, which, despite media and political disinformation, is only truly obtained via vaccination. Without prevention, uncontrolled spread will burn through us like wildfire. So-called natural infection will cost us untold lives, and many millions more will experience illness and disability. Not only do we have no idea what threshold number of infections gets us to population immunity, we do not even know if such a thing is achievable or long lasting: thus far, we have no reliable understanding of how long immunity will last. What we do know are the myriad complications of this disease. We know that people with even “mild” disease suffer. We know that not only are people sick when acutely unwell, but a significant number are still symptomatic weeks and months after recovery. Uncontrolled spread, allowed in the hope that it will result in herd immunity via natural infection, carries too high a cost for us all, and offers no guarantee that it will bring this pandemic to an end. We must persevere and focus on prevention until a safe and effective vaccine is available to us all.
Multiple large vaccine trials are underway in an unprecedented, coordinated effort to achieve this. These trials must prioritize enrolling people to be truly representative of the population for them to have any impact on the covid-19 pandemic. Researchers and physicians must address historical and ingrained biases and enroll elderly volunteers and people of color, or the vaccines they produce will be inadequate. Once we have effective vaccines whose immunogenicity and effectiveness we fully understand, we come upon yet another hurdle. The vaccines must be made universally available without exception, quickly, and free of charge to all. We cannot allow venality and commerce to be a factor in this time of acute global challenge.
The H1N1 Influenza pandemic of 2009 is estimated to have caused just under 600,000 deaths worldwide. With 1.2 million deaths, of which at least 7,000 have been healthcare workers, this pandemic has far surpassed that. We have moved past a point where it is appropriate to ask if masks are irritating. We must acknowledge the grim reality of our situation and what is to come, and ask instead: what can we do? Wear a mask and socially distance. Our friends, our families, the entire global community depend on each of us taking responsibility for our own part in the fight to end this pandemic
March, 2020. Social Distancing was starting to become a familiar term, and all eyes were on the rising numbers of COVID among the U.S. It was just a typical day in the office on Friday the 13th – typical in the sense that we were still able to sit in our office and collaborate with our colleagues IN PERSON. Corporate travel had already been halted, COVID numbers were the talk in every corner, and we were moving to an official Pandemic in the world.
I headed home for the weekend … and then never went back. It happened so fast. As most of us in the nation, the majority of Mayo Clinic staff was pulled out of our offices and told to work from home until further notice – only direct patient care were to be on the campus. We had daily calls to update us on the ever changing situation of the nation and at Mayo. Elective or non-emergent cases were getting cancelled. Direct patient care staff was starting to get pulled home. It was getting scary.
At first, our team was told that hiring APPs and Physicians was a priority – so to continue to recruit full speed ahead, but interviews would be coordinated virtually. The pendulum was starting to slide in the opposite direction by the end of our 2nd week in. Mayo Leadership had asked all positions to be pulled from our website until further notice. Do not recruit. Instead, compile status reports of each position –do that tonight and then wait for more direction.
Our director pulled us into projects until we knew more. She tried to keep us calm, and keep us occupied. She was transparent that she couldn’t promise the future wouldn’t be scary. But that she had faith in Mayo. And then, in early April our highest leadership made some very historic decisions (historic for Mayo Clinic). It was announced all salaried staff were taking pay cuts. The higher up in ranking, the higher the pay cut. Our physicians were taking cuts too. Then, the words and information surrounding pending furloughs was announced.
Mayo Clinic? Furlough? What does that even mean? How does this happen in a matter of weeks? Thankfully, our leadership anticipated the questions and had the answers. Given the situation, they did as well as they could. We were provided multiple resources. All staff was asked to consider volunteering for furloughs. After it was all said in done, our Physician Recruitment team was cut by 80%. Just enough to keep the lights on, the rest of us were off for 4 months. Some were to be longer, none were to be less.
So, I embraced the summer with a bittersweet feeling. I have kids – so to be a full time mom off of work for a long period of time was fun to consider; especially with the kids not in school. But of course, in the back of your head there is worry. Would I really get my job back? Those left behind were busy holding down the fort. BUSY. I felt bad for them! But, it did help the anxiety and worry of a job to return to. They promised they couldn’t wait to have us all back together again.
Mid summer, WAY earlier than planned, Mayo leadership announced that furloughs would all end no later than 8/31/2020 – even if you were to be out longer. And, everyone’s full pay was being reinstated. VERY GOOD NEWS! In the spring, Mayo had made quick – drastic – changes to our payroll to be sure we could survive the revenue that had stopped from cancelling and delaying certain patient needs. Because of that and the fast-acting decisions to safely get patients back, things were up and running on a quicker timeline than planned.
This was all very exciting. And it has been great to have our entire team back. Across the nation, employees everywhere are working from home. The one difference for Mayo, unlike many others – is that it is permanent. We will NOT be going back to campus. Our offices have been condensed and repurposed. Leases have been let go. We are now completely virtual Mayo Clinic employees.
I walked in to our office to grab all of my things – and my calendar was still stuck on March. That hit me hard. I gathered 9 years of materials, paperwork, pictures, etc. and walked out of the office. I walked around our campus and smiled with my eyes at all the patients I saw (because…mask over my mouth). And I cried. We are recruiters! We like to interact with people. I personally love connecting with the patients and being reminded why we do our jobs. And just like that – my motivators had to change. I had to figure out different ways to remind myself why I do the job I do.
It’s tough. I’m not going to lie. It’s an interesting concept to wrap our heads around. But our Recruitment team is adjusting to the “new normal”. We are intentional with our team interactions. Making sure we find avenues to collaborate in a professional and social way safely via Zoom. It’s been a lifesaver for our sanity. We’ve identified different ways to give team shout outs. We celebrate the successes in very different ways. But we still do it.
We also clearly defined roles & responsibility among our departments, our assistants, the recruiters, and more to be sure that nothing gets missed. The candidate experience is different – but it is still meaningful. The job is getting done.
For me, the hardest part being home is blending my professional world with my home life. I value being a subject matter expert. Being a professional and known as Marissa the recruiter. Not Marissa the recruiter who has a kid walk behind her in the camera…or Marissa with the random table in the background (shout out to the inventor of virtual backgrounds!). I’m learning how to set my boundaries of work and home. I took my email off of my phone because my workstation is always a few steps away. I try to schedule intentional social breaks with people in my “COVID circle” such as a coffee or lunch.
I’m still learning. We all are. And, as we approach the colder Midwestern months – my anxiety of being stuck inside and home all the time is definitely getting to me. But, like all of us – I will keep adjusting my needs and finding my balance. I will keep supporting my colleagues and my family through this interesting year. I will keep working with the AIR leadership team to figure out ways to connect our community. I will keep on keeping on. And I bet you will too.
Each of us has taken a different path in finding our way into the rewarding and unpredictable world of Physician recruitment. When someone asks what do you do, it’s always followed by – how did you ever find that kind of a job? Certainly, there is no straight answer and each of us brings the uniqueness of our past experiences into the roles we have today. However, we all carry the same skillset to succeed we are – very “-abled” individuals -hospitable, personable, reliable, accountable, etc. and in many cases sustainable because we are successful in our roles without the luxuries many other industries have.
In our roles, we are all salespeople – selling the opportunity, location, benefit package, etc. It’s easy to sell the features of the position because we all passionate about closing the deal. There is no greater feeling in your day than when you sign the doctor that will change healthcare in your community. However, your leadership may not quite understand how hard it was to secure the physician’s commitment which can be frustrating. Here’s some good advice -always take some time to celebrate your success with a fellow colleague or the ASPR network. We understand each other understand and will be there to celebrate with you!!
No matter where the position is located, organization structure, pay, or percent of academic time allocated, every job opening has its uniqueness. Being in Academic recruitment, in my opinion carries additional hurdles. Many of us have budget constraints and need to find ways to recruit on less than a dime. The free sourcing avenues can be taxing but, have produced qualified candidates – ACGME email blasts, LinkedIn, engaging your physicians/faculty, our residents and fellows. When I first started in this arena, medicine was different and we weren’t working to recruit our trainees but, that has come full circle in the last several years. The Liaison Committee on Medical Education (LCME) accreditation process or review can be challenging experience as well. A point of focus is ensuring diversified candidate pools and meeting other requirements related to the functions of a medical school. Unfortunately, many candidates don’t disclose information in the early stages of the application process as it’s not a requirement and unfortunately does not allow us to capture the metrics. We all push to have diversified pools but, having a confidential tracking tool can be a challenge. This topic has been an active conversation among academic recruiters for some time and many are all still in search of a great model. If you have one, please share it!
Through the years, I have experienced different office structures with each molding me into the role I have today. Under the direction of the late Joe Vitale at the Cleveland Clinic, I got my feet wet and will be forever grateful for the chance he took on me. Yet, it was my two colleagues and fellow AIR members, Michelle Seifert and Lauren Forst that really showed me the way. We were fortunate senior leadership saw the importance of inhouse physician recruitment professionals much earlier than my arrival. Upon arriving, the team was small compared to their vast enterprise today and each of us came into the role via very different paths. During my time at the Cleveland Clinic, as an example, we weren’t heavily involved in sourcing and to date, that has changed. Great focus was placed on the candidate experience and our roles did not formally make the job offer or negotiate the contract. Since those early years, the team has changed with the times as well and evolved into a much larger, broader and more robust Department expanding their geographic reach and services.
Due to my husband being relocated to the Dallas, TX area, my time at the Cleveland Clinic concluded. Fortunately, my experience in Cleveland interested leadership at UT Southwestern Medical Center. They liked my recruitment skill set and were interested in creating a similar model. I was eager to get started and mirror what Cleveland Clinic had done so successfully. Although I was supported in my efforts and work, not having physician leadership promote and the office, it never gained the traction I had envisioned. My services were more in line with being a concierge for recruitment working with departments that “got it” and understood the advantages of using my office. I was able to initiate an Onboarding process that does remain and has grown. During a change of leadership, I re-presented my plan and felt the office was going to morph into the vision I originally had but, once again not being promoted to the departments with the message coming from the Dean, the office never fully evolved like it could have. I did get to grow my team and take on APP recruitment, which was done full-cycle and proved to be a great learning experience. Ironically, it was as I was leaving and meeting with a physician leader the light went off as to what good could have become come with leadership support of the plan laid out a couple of times over the nine years.
Things changed and, in the summer of 2017, I was presented with the opportunity to become the Director of Faculty Recruitment in the School of Medicine for the newest medical school in the University of Texas system, the University of Texas Rio Grande Valley. The school, located in a medically underserved area, at the boarder of Texas and Mexico presented an exciting challenge. Without the support of my AAPPR friends, AIR colleagues and tools, I would have never taken the leap. This time I knew it would be different! The Dean was arriving from Temple University and knew the importance of inhouse physician recruitment professionals. Coincidently, through the years, I had shared with previous leaders an electronic marketing brochure Mike Lester, the leader for the Temple physician recruitment team had developed. How ironic!
During my interview, I shared my vision that never gained traction at UT Southwestern. This Dean gets it! My current position certainly encompasses all the “-ables” (I eluded to earlier) to be successful and more. Our team does full-cycle recruitment for the Clinical, Research and Medical Education Faculty in the School of Medicine. A supportive leadership structure that “gets it” means everything to a faculty recruitment professional and the success of the organization.
In closing, I can’t put a price tag on the value of AAPPR and AIR and what it has done for me professionally and personally. For those that may be new to their present role or have questions on whether to take a leap- network with this community. There are members that have “been there” and can help you. You will never find a more collegial and supportive environment. We are each other’s best resources and biggest cheerleaders.