Several years ago we filled two challenging searches, Neonatology and Orthopedics. We filled both of these opportunities in less than 60 days following the direct mail advertising. What made these particular opportunities challenging was their location and the fact that they had unsuccessfully searched for over 6 months prior to hiring us. We recently received a phone call from the same orthopedic group's office manager. He informed us that there had been a change in the administration over at the hospital that had previously supported the search to find their last partner. The office manager was very frustrated by the hospital's new administration and their approach to physician recruiting.

The Orthopedic group had been looking for the past twelve months, but the new administration's policy at the hospital was to only work with contingent firms. He shared with us that in the past year they had received forty-six CV's, conducted eleven interviews and the position was still unfilled. I asked the office manager why he did not call us to help them like they had done so previously. His response was "The administration would not support the search this time because they felt it would be less expensive to use a contingent firm versus a retained firm like yours."

We explained to the office manager that the total cost between retained and contingent is about the same. The main difference is we dedicate our resources daily to get the opportunity filled. Contingent firms represent the physician and we represent the client. Contingent firms sell a physician to the highest bidder, but a retained firm such as ours will work on the client's behalf, working to find the physician they are seeking. It is a simple representation of different interests. The irony is, clients that sign with contingent firms think that the firm is out there beating the bushes to find them a physician when, in reality, if they happen to talk to a candidate who has an interest in the region, the client will get a fax. There is no surprise the group could see 46 CV's, conduct 11 interviews and still have a job opening.

A contingent firm is not going to be detail oriented because they cannot afford to be. They cannot spend too much time on one search when there is no guarantee that they are ever going to get paid. We asked the office manager, "If you knew that you could work the next 40 to 80 hours and may or may not be compensated for your efforts, how enthusiastic would you be? The answer to that question is obvious. That is the situation that a lot of contingent firms find themselves in with harder to fill searches like Orthopedic Surgery. Their method of talking to one physician and sending that CV to fifty different hospitals and waiting to see who calls back, sometimes work with primary care opportunities, but very seldom works in a timely fashion with sub-specialty searches.

Sometimes we hear "if you're so good then why don't you take the risk with us and work contingent"? This question often comes from a potential client that has had a position open for longer than a year and is still trying to cut corners. Could you imagine a world where physicians only got paid if and when their patients fully recovered from their surgery or illness? Could you imagine the CEO or CFO only getting paid if their hospital turns a profit? This is obviously not realistic because a lot of factors are out of their control and they should be compensated for their work and held accountable for the results. That is the same philosophy we that Med Staff America believes in. We value our service and expect to be compensated fairly and be held accountable for the results.

The hospital administration's effort to save money upfront and implement a policy of not using retained firms has not only cost them the frustration that the office manager and the two partners of the orthopedic group have felt, but this search may have already cost them $1.8 million. This is the amount that the average Orthopedic Surgeon brings to a hospital in inpatient revenue. Some administrators say, "Well, we really didn't lose that amount of money". However, upon further investigation, the patients that reside within the hospitals medical draw area went somewhere for their orthopedic care and that hospital ended up with that $1.8 million. Remember, 100% of hospital revenue is derived from the medical staff either directly or indirectly.

Most often when administrations try to cut corners, the results are less than desirable. If someone were to come to you and say I have an investment opportunity where you can invest $30,000 and in return you will get $1.8 million annually, would you do it? Again, the answer is an obvious "Yes". Why is it then that some hospital administrators see these numbers and still choose cut the corners which lead to lost revenue and a lot of frustration?